Trihydroxyethylrutosides in the treatment of hemorrhoids of pregnancy: a double-blind placebo-controlled trial.

The safety and efficacy of Trihydroxyethylrutosides (HR) in the treatment of 53 patients with 1st-2nd degree hemorrhoids of pregnancy (16th-34th week) was investigated in a double-blind randomised, placebo controlled trial. The dosage of Trihydroxyethylrutosides was 1 tablet of 300 milligrams twice daily for the first 2 weeks. If the treatment was successful, the treatment was stopped. If the clinical signs or symptoms still persisted, the treatment was continued for another two weeks using the same dosage and re-evaluated at the end of the fourth week after initial treatment. The parameters for efficacy were symptoms (pain, bleeding, exudation and pruritus) and the objective signs on proctoscopy (bleeding, inflammation and dilatation of the hemorrhoidal venous plexus). The study revealed improvement of symptoms in the study group which was better than in the control group after 2 weeks of treatment but the clinical signs were not different. After a further 2 weeks of treatment, the result showed improvement of both clinical signs and symptoms in this study. Only one mild transient side effect was reported in the HR group and there were no drug-related problems in the pregnancies, delivery or the babies.

A comparison of clinical and ultrasound estimation of fetal weight.

The accuracy of clinical and ultrasound estimation of fetal weight was compared by an analytical cross sectional study. 266 pregnant women who were admitted to the labour room, Siriraj Hospital during the period from February 1, 1999 to March 1, 1999 were included in this study. Fetal weight was estimated in all pregnant women clinically by 2nd year resident physicians and 6th year medical students, followed by ultrasound estimation within 24 hours before delivery. Every estimation was blinded from each other. From the study, clinical estimation by 2nd year resident physicians was comparable with ultrasound estimation and both were significantly more accurate than estimation by 6th year medical students. The proportions of accuracy were 66.7 per cent, 63.3 per cent and 55.3 per cent respectively. Clinical estimation by 2nd year resident physicians tended to have equally over- and underestimation. On the contrary, ultrasound estimation tended to underestimate when the method was inaccurate. Among infants with a birth weight less than 2,500 grams, ultrasound estimation performed slightly better than clinical estimation. However, every method underestimated the fetal weight when an infant weighed more than 4,000 grams. In conclusion, accuracy of clinical estimation of fetal weight by 2nd year resident physicians was comparable to that of ultrasound estimation and may be used as an alternative to ultrasound estimation for pregnant women. However, when the clinical estimate of fetal weight is less than 2,500 grams, ultrasound estimation should be performed for more accurate results and also for assessment of other abnormalities. Careful attention should be paid to infants with a birth weight of more than 4,000 grams since no method can correctly estimate the fetal weight and physicians should be aware of birth trauma.

Charts of Thai fetal biometries: 4. Abdominal circumference.

A cross-sectional study was conducted in order to construct a new reference chart for Thai fetal abdominal circumference (AC). A total of 621 normal pregnant women between 12-41 weeks of gestation and their fetuses were recruited. Measurements were made once at a randomly assigned gestational age specifically for the purpose of this study only. Due to unfavorable fetal position in some cases, AC data were available in 615 measurements. Linear regression models were fitted separately to estimate the mean and standard deviation as functions of gestational age. Reference centiles were constructed from both equations, assuming the data were normally distributed. A new reference centiles for AC is presented and compared with previously published data. Our derived centiles were lower than those from Western studies which may partly be due to racial differences. This emphasizes the need to develop fetal biometries charts specifically for each region.

Charts of Thai fetal biometries: 3. Femur length.

A cross-sectional study was conducted in order to construct a new reference chart for Thai fetal femur length (FL). A total of 621 normal pregnant women between 12-41 weeks of gestation and their fetuses were enrolled. Measurements were made once at a randomly assigned gestational age specifically for the purpose of this study only. Femur length data were available in 608 measurements due to unfavorable fetal position in some cases. Linear regression technique was used to model separately the mean and standard deviation as functions of gestational age. Reference centiles were constructed from a combination of both models, assuming the data were normally distributed. A new reference centiles chart for FL is presented and compared with previously published data. While our derived centiles were clearly lower than those from Western studies, they were found comparable with those from a Thai study. This demonstrated the important effect of racial differences between populations on fetal biometries and elucidates the need to develop fetal biometries charts specifically for each region.

Charts of Thai fetal biometries: 2. Biparietal diameter.

A cross-sectional study was conducted in order to construct a new reference chart for Thai fetal biparietal diameter (BPD). A total of 621 normal pregnant women between 12-41 weeks of gestation and their fetuses were recruited. Measurements were made once at a randomly assigned gestational age specifically for the purpose of this study only. Due to unfavorable fetal position in some cases, BPD data were available in 613 measurements. Linear regression models were fitted separately to estimate the mean and standard deviation as functions of gestational age. Reference centiles were constructed from both equations, assuming the data were normally distributed. A new reference centiles chart for BPD is presented and compared with previously published data. Our derived centiles were clearly lower than those from Western studies showing the importance of racial differences between populations. This elucidates the need to develop fetal biometries charts specifically for each region.

Charts of Thai fetal biometries: 1. Methodology.

A cross-sectional study was conducted in order to construct new reference charts for Thai fetal biometries that are commonly used in obstetric ultrasound practice. We discussed and illustrated a sound appropriate study design and statistical analysis which lead to more valid results. A total of 621 normal pregnant women between 12-41 weeks of gestation and their fetuses were recruited. Each fetus was measured once at a randomly assigned gestational age specifically for the purpose of this study only. Stepwise linear regression technique was used to model the mean and its standard deviation as functions of gestational age. Goodness of fit and normality of the data were checked before the final models were chosen. Reference centiles were derived, taking into account the increasing variation as pregnancy proceeds. We demonstrated the stated technique with humerus data from the same study. Reference charts for other fetal biometries have been derived and are presented in subsequent papers.

A high incidence of liver cancer in Khon Kaen Province, Thailand.

Based on a population-based cancer registry in Khon Kaen Province, Thailand, data were collected actively and passively from all hospitals, health centers and the office of the Chief Medical Officer of Khon Kaen. The data were collected prospectively for the year 1988 and retrospectively for the years 1985-1987. Liver cancer, especially cholangiocarcinoma, was the leading cancer in both sexes. The age-standardized incidence rates for the year 1988 were 89.2/10(5) in males and 35.5/10(5) in females respectively, which are among the highest rates recorded in the world. The number of reported liver cancer cases increased each year. The observed geographical clusters of liver cancer appear to be associated with the prevalence and intensity of Opisthorchis viverrini infection, as reported in previous studies in this area.

Cass scores as a preoperative prediction for recurrences of cervical cancer after radical hysterectomy and pelvic lymphadenectomy at Srinagarind Hospital.

Risk factors for recurrence after radical hysterectomy and pelvic lymphadenectomy at Srinagarind Hospital was studied from 218 patients operated between 1976 to June 30, 1988. Four preoperative risk factors i.e., cell types, age, stages and size of the lesions were computed and cross-tabulated with the recurrence rate from the data of the whole patients. The correlation was found to be statistical significant. This scoring system should be called from the first letter of the factor as 'CASS' and used for selection of the patients for radical hysterectomy and pelvic lymphadenectomy.

Epidemiology of cancer in Khon Kaen.

The prospective and retrospective data collection of cancer cases in all the hospitals and death certificates in Khon Kaen province were reported as a population-based cancer registry of Khon Kaen province. Liver cancer especially cholangiocarcinoma and cervical cancer lead the group. The age-standardized incidence rate of cancer of Khon Kaen was about 72.4 to 173.3 per 100,000 population per year and it is higher in males than in females.