Prevalence of exclusive breastfeeding at 3, 4 and 6 months in Bangkok Metropolitan Administration Medical College and Vajira Hospital.

OBJECTIVE: To determine the prevalence of exclusive breastfeeding at 3, 4, and 6 months postpartum in women who delivered at Bangkok Metropolitan Administration Medical College and Vajira Hospital, and to evaluate the potential factors for continuation of exclusive breastfeeding. MATERIAL AND METHOD: A prospective descriptive study was performed in 210 mothers who delivered in the authors' institution between December 1, 2006 and February 28, 2007. All eligible subjects were interviewed before discharge from the hospital. The successive postpartum interviews were then conducted via telephone at 3, 4, and 6 months after delivery. RESULTS: Average maternal age was 27 years and over half (54.3%) were primipara. Rates of exclusive breastfeeding at 3, 4, and 6 months were 48%, 26%, and 11% respectively. Significant factors for exclusive breastfeeding were duration allowed for work absence and intended time to breastfeed. CONCLUSION: Approximately half of the mothers in the present study provided exclusive breastfeeding to their babies in the first 3-month postpartum. The prevalence of exclusive breastfeeding at 6 months was lower than the 30% goal of the 9th National Economic and Social Development Plan. The need to return to work and intended time to breastfeed were the significant factors affecting duration of exclusive breastfeeding.

Results of laparoscopic pelvic and/or para-aortic lymphadenectomy in gynecologic oncology patients in Bangkok Metropolitan Administration Medical College and Vajira Hospital.

OBJECTIVE: To determine the results of laparoscopic lymphadenectomy in gynecologic oncology patients. MATERIAL AND METHOD: Medical records of 31 gynecologic oncology patients who underwent laparoscopic lymphadenectomy between November 1, 2004 and February 28, 2007 were retrospectively reviewed. RESULTS: The median age of the study population was 47 years (range 24-77 years). Sixteen patients (51.6%) had endometrial cancer while 15 (48.4%) had ovarian malignancy, with median numbers of resected pelvic and paraaortic nodes of 12 (range 3-30 nodes) and 1 (range 1-3 nodes). The groups of lymphadenectomy only, lymphadenectomy with total laparoscopic hysterectomy, and lymphadenectomy with laparoscopic assisted vaginal hysterectomy had median blood losses of 100 ml (range 30-220 ml), 350 ml (range 100-800 ml), and 200 ml (range 150-400 ml) respectively. Accidental injuries of common iliac artery and large bowel occurred in two patients, all of whom were converted to a laparotomy for correcting the damaged sites. Overall, the median duration for postoperative recovery was three days (range 2-8 days). CONCLUSION: The results suggest that surgical staging for gynecologic malignancies can be adequately performed through laparoscopic surgery, with benefit in terms of early postoperative recovery.

First 4-hour urinary protein - creatinine ratio for diagnosis of significant proteinuria in preeclampsia.

OBJECTIVE: To evaluate the diagnostic accuracy of the first 4-hour urinary protein - creatinine ratio for prediction of the significant proteinuria in preeclampsia. STUDY DESIGN: Diagnostic test SUBJECTS: One hundred and sixty-four pregnant women who were initially diagnosed with hypertensive disorder and hospitalized in the obstetric ward and labor room at Bangkok Metropolitan Administration Medical Collage and Vajira Hospital between July 2005 and April 2006. MATERIAL AND METHOD: Urine samples were collected within 24 hours in two consecutive periods: the first 4 hours and the next 20 hours. The urine volume, urine protein and creatinine concentration were separately measured and the first 4-hour urinary protein - creatinine ratio were calculated. With the use of a protein level > or = 300 mg in 24 hours urine collection as the gold standard, the sensitivity and specificity of the first 4-hour urinary protein-creatinine ratio for diagnosis of significant proteinuria were determined with cutoffs range. RESULTS: One hundred and sixty four patients were recruited for this study including 112 patients (68.3%) who had preeclampsia. The first 4-hour urinary protein-creatinine ratio was most accurate for diagnosis of preeclampsia is 0.30 with 81% sensitivity, 88% specificity, PPV of 93%, and NPV of 71%. CONCLUSION: The first 4-hour urinary protein-creatinine ratio at 0.3 is the most accurate value for diagnosis of significant proteinuria in preeclampsia