Lamphun Hospital

Lamphun, Thailand

Lamphun Hospital

Lamphun, Thailand
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Panyasai S.,University of Phayao | Sukunthamala K.,Chiang Mai University | Jaiping K.,Lamphun Hospital | Wongwiwatthananukit S.,Lamphun Hospital | And 2 more authors.
American Journal of Clinical Pathology | Year: 2011

The β-chain hemoglobin (Hb) variants interfere with the diagnosis of β-thalassemia trait using high-performance liquid chromatography (HPLC) and capillary electrophoresis (CE). We analyzed the effect of Hb Hope, a β-chain Hb variant frequently found in the Thai population, on β-thalassemia trait diagnosis. HPLC and CE were used to quantify the level of HbA2 in 11 whole blood samples containing Hb Hope. The levels of Hb Hope detected by both methods were similar. An elevated HbA2 level was found in all samples analyzed by the CE method, while 1 was increased when analyzed by HPLC, which was a compound heterozygous of Hb Hope and β-thalassemia-1 SEA-type deletion. Of 11 samples, 6 had mean corpuscular volumes within the reference range. All samples showed negative results for molecular analysis of β0-thalassemia codon 17, 41/42, and 71/72 mutations and β-thalassemia 3.5-kb deletion. Therefore, Hb Hope interfered with the diagnosis of β-thalassemia trait analyzed by CE but not by HPLC. © American Society for Clinical Pathology.

Pornprasert S.,Chiang Mai University | Moriyama A.,Yamaguchi University | Kongthai K.,Health Promoting Hospital | Waneesorn J.,Regional Medical science Center 10 | And 3 more authors.
Clinical Laboratory | Year: 2013

Background: Differentiation of β-thalassemia/HbE disease from homozygous HbE in samples containing HbA2/E > 75% and HbF < 15% is difficult. The aim of this study is to observe the possibility of using Hb typing and hematological parameters to identify both disorders. Methods: Multiplex amplification refractory mutation system (MARMS)-PCR for β-thalassemia codons 17 (A > T), 41/42 (-TCTT), 71/72 (+A), and IVSI-nt1 (G > T) mutations and ARMS-PCR for HbE were performed in 67 samples that contained HbA2/E > 75% and HbF < 15%. Results: β-thalassemia/HbE disease was identified in 10 of 67 (14.93%) samples. Levels of hemoglobin, hematocrit, and mean corpuscular volume (MCV) of β-thalassemia/HbE disease were significantly lower than those of homozygous HbE whereas, levels of HbF were significantly higher. Conclusions: In places where the molecular analysis is not available, HbF > 5% in combination with MCV < 55 fL, hemoglobin < 100 g/L, and hematocrit < 0.30 L/L could be used for screening of β-thalassemia/HbE disease.

Khunpradit S.,Lamphun Hospital
Cochrane database of systematic reviews (Online) | Year: 2011

Evidence on the benefits of admission tests other than cardiotocography in preventing adverse perinatal outcomes has not been established. To assess the effectiveness of admission tests other than cardiotocography in preventing adverse perinatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2011). Randomised (individual and cluster) controlled trials, comparing labour admission tests other than CTG for the prevention of adverse perinatal outcomes. Two review authors independently assessed eligibility, quality and extracted data. We included one study involving 883 women.Comparison of sonographic assessment of amniotic fluid index (AFI) on admission versus no sonographic assessment of AFI on admission. The incidence of cesarean section for fetal distress in the intervention group (29 of 447) was significantly higher than those of controls (14 of 436) (risk ratio (RR) 2.02; 95% confidence interval (CI) 1.08 to 3.77).The incidence of Apgar score less than seven at five minutes in the intervention group (10 of 447) was not significantly different from controls (seven of 436) (RR 1.39, 95% CI 0.54 to 3.63).The incidence of artificial oxytocin for augmentation of labour in the intervention group (213 of 447) was significantly higher than controls (132 of 436) (RR 1.57; 95% CI 1.32 to 1.87).The incidence of neonatal NICU admission in the intervention group (35 of 447) was not significantly different from the controls (33 of 436) (RR 1.03; 95% CI 0.66 to 1.63) There is not enough evidence to support the use of admission tests other than cardiotocography for fetal assessment during labour. Appropriate randomised controlled trials with adequate sample size of admission tests other than cardiotocography for fetal assessment during labour are required.

Khunpradit S.,Lamphun Hospital
Cochrane database of systematic reviews (Online) | Year: 2011

Caesarean section rates are steadily increasing globally. The factors contributing to these observed increases are complex. Non-clinical interventions, those applied independent of patient care in a clinical encounter, may have a role in reducing unnecessary caesarean sections. To evaluate the effectiveness and safety of non-clinical interventions for reducing unnecessary caesarean sections. We searched the following electronic databases: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (29 March 2010), the Cochrane Pregnancy and Childbirth Group Specialised Register (29 March 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 2); MEDLINE (1950 to March 2010); EMBASE (1947 to March 2010) and CINAHL (1982 to March 2010). We included randomised controlled trials (RCTs), quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) with at least two intervention and control sites, and interrupted time series analyses (ITS) where the intervention time was clearly defined and there were at least three data points before and three after the intervention. Studies evaluated non-clinical interventions to reduce unnecessary caesarean section rates. Participants included pregnant women and their families, healthcare providers who work with expectant mothers, communities and advocacy groups. Three review authors independently assessed the quality and abstracted data of all eligible studies using a standardised data extraction form, modified from the Cochrane EPOC checklists. We contacted study authors for additional information. We included 16 studies in this review.Six studies specifically targeted pregnant women. Two RCTs were shown to be effective in reducing caesarean section rates: a nurse-led relaxation training programme for women with a fear or anxiety of childbirth and birth preparation sessions. However, both RCTs were small in size and targeted younger mothers with their first pregnancies. There is insufficient evidence that prenatal education and support programmes, computer patient decision-aids, decision-aid booklets and intensive group therapy are effective.Ten studies targeted health professionals. Three of these studies were effective in reducing caesarean section rates. A cluster-RCT of guideline implementation with mandatory second opinion resulted in a small, statistically significant reduction in total caesarean section rates (adjusted risk difference (RD) -1.9; 95% confidence interval (CI) -3.8 to -0.1); this reduction was predominately in intrapartum sections. An ITS study of mandatory second opinion and peer review feedback at department meetings found statistically significant results at 48 months for reducing repeat caesarean section rates (change in level was -6.4%; 95% CI -9.7% to -3.1% and change in slope -1.14%; 95% CI -1.9% to -0.3%) but not for total caesarean section rates. A cluster-RCT of guideline implementation with support from local opinion leaders increased the proportion of women with a previous caesarean section being offered a trial of labour (absolute difference 16.8%) and the number who had a vaginal birth (VBAC rates) (absolute difference 13.5%). The P values are, however, not reported due to unit of analysis errors. There was insufficient evidence that audit and feedback, training of public health nurses, insurance reform, external peer review and legislative changes are effective. Implementation of guidelines with mandatory second opinion can lead to a small reduction in caesarean section rates, predominately in intrapartum sections. Peer review, including pre-caesarean consultation, mandatory secondary opinion and postcaesarean surveillance can lead to a reduction in repeat caesarean section rates. Guidelines disseminated with endorsement and support from local opinion leaders may increase the proportion of women with previous caesarean sections being offered a trial of labour in certain settings. Nurse-led relaxation classes and birth preparation classes may reduce caesarean section rates in low-risk pregnancies.

Charnsil C.,Chiang Mai University | Sriapai P.,Lamphun Hospital
Journal of the Medical Association of Thailand | Year: 2011

Objective: (1) to examine the co-occurrence of attention deficit and hyperactivity symptoms in children with autistic disorder, and (2) to study the correlation between attention deficit hyperactivity symptoms and the severity of autistic disorder. Material and Method: This was a clinical based study. The authors used Childhood Autistic Rating scale (CARs) to evaluate the severity of autistic disorder. Swanson, Nolan, and Pelham Teacher and Parent Rating Scale, Version IV (SNAP-IV) was used to measure attention deficit and hyperactive symptoms in children with autism. Results: Thirty (n = 30) children enrolled in this study. All participants displayed attention deficit symptoms and 18 participants demonstrated hyperactivity as well. Nonparametric correlation showed a high positive correlation (Spa = 0.90, p = 0.00) between the severity of autistic disorder and hyperactivity and not the attention deficit symptoms (Spa = 0.29, p = 0.16). Conclusion: The authors finding shows a high comorbid rate of attention deficit and hyperactive symptoms among the participants.

Patumanond J.,Chiang Mai University | Tawichasri C.,Chiang Mai University | Khunpradit S.,Lamphun Hospital
Clinical and Experimental Obstetrics and Gynecology | Year: 2012

Objective: To develop a clinical risk score to help in recognizing macrosomia at the time of delivery. Methods: A case-control data analysis was conducted at a university-affiliated general hospital in Lamphun, Thailand. Macrosomic cases were 67 women who delivered babies weighing at least 4,000 g. Controls were 779 women with babies weighing between 2,500 g. and < 4,000 g. The best predictors were selected by multivariable logistic regression and transformed into clinical risk scores. Result: The best combination of predictors included parity, gestational age at delivery, weight at delivery and symphysis-fundal height. The scores predicted macrosomia correctly with an AuROC of 94.1% (95% CI; 92.3, 95.6). The likelihood ratio of positive for macrosomia was 0 in the low risk category and 10.68 (95% CI; 7.76, 14.68) in the high risk. Conclusion: A simple clinical risk score may help obstetricians suspect macrosomia at the time of delivery in areas where antenatal care services are inadequate.

Hanterdsith B.,Lamphun Hospital | Mahanupab P.,Chiang Mai University
American Journal of Forensic Medicine and Pathology | Year: 2010

A 20-year-old well nourished woman was found dead suddenly and unexpectedly in her bedroom. According to her medical history, Graves' disease was diagnosed in August 2000 and the symptoms of thyrotoxicosis were poorly controlled. Autopsy and histology revealed diffuse enlargement of the thyroid gland (125 g, diffuse hyperplastic goiter), pulmonary edema, cardiomegaly (440 g) without coronary artery occlusion or stenosis. The cardiac muscles showed interstitial fibrosis with hypertrophy of the myocardial fibers. The circumstances and scene of death as well as the detailed postmortem analysis indicated that thyroid crisis from Graves' disease was the cause of death. Copyright © 2010 by Lippincott Williams & Wilkins.

Pornprasert S.,Chiang Mai University | Tookjai M.,Chiang Mai University | Punyamung M.,Chiang Mai University | Pongpunyayuen P.,Chiang Mai University | Jaiping K.,Lamphun Hospital
Clinical Chemistry and Laboratory Medicine | Year: 2016

Background: To date, the hemoglobin (Hb) typing control materials for laboratory investigation of thalassemia with low (1.8%-3.2%) and high (4%-6%) levels of HbA2 are available but there are no Hb typing quality control materials for analysis of thalassemia and hemoglobinopathies which are highly prevalent in South-East Asian countries. The main aim of the present study was to develop the lyophilized Hb typing control materials for laboratory investigation of thalassemia and hemoglobinopathies that are commonly found in South-East Asia. Methods: Erythrocytes of blood samples containing Hb Bart's, HbH, HbE, HbF, Hb Constant Spring (CS), Hb Hope, and Hb Q-Thailand were washed and dialysed with 0.85% saline solution. The erythrocytes were then lysed in 5% sucrose solution. The lyophilized Hb typing control materials were prepared by using a freeze drying (lyophilization) method. The high performance liquid chromatography (HPLC) analysis of lyophilized Hb was performed after the storage at -20 °C for 1 year and also after reconstitution and storage at 4 or -20 °C for 30 days. In addition, the Hb analysis was compared between the three different methods of HPLC, low pressure liquid chromatography (LPLC) and capillary electrophoresis (CE). Results: Following a year of storage at -20 °C, the HPLC chromatograms of lyophilized Hb typing control materials showed similar patterns to the equivalent fresh whole blood. The stability of reconstituted Hb typing control materials was also observed through 30 days after reconstitution and storage at -20 °C. Moreover, the Hb typing control materials could be analyzed by three methods, HPLC, LPLC and CE. Even a degraded peak of HbCS was found on CE electropherogram. Conclusions: The lyophilized Hb typing control materials could be developed and used as control materials for investigation of thalassemia and hemoglobinopathies. © 2016 by De Gruyter 2016.

PubMed | Mahidol University and Lamphun Hospital
Type: Journal Article | Journal: Palliative & supportive care | Year: 2016

The purpose of this study was to investigate the psychometric properties of the modified Thai Spiritual Well-Being Scale in patients with advanced cancer.This cross-sectional study was employed to investigate psychometric properties. Some 196 participants from three tertiary hospitals in Bangkok and suburban Thailand were asked to complete a Personal Information Questionnaire (PIQ), The Memorial Symptom Assessment Scale (MSAS), and the Spiritual Well-Being Scale (SWBS). Validity was determined by known-group, concurrent, and constructs validity. Reliability was estimated using internal consistency by Cronbachs coefficients.Three factors were extracted: so-called existential well-being, religious well-being, and peacefulness accounted for 71.44% of total variance. The Cronbachs coefficients for total SWB, EWB, RWB, and peacefulness were 0.96, 0.94, and 0.93, respectively.These findings indicate that the Thai SWBS is a valid and reliable instrument, and it presented one more factor than the original version.

Pornprasert S.,Chiang Mai University | Jaiping K.,Lamphun Hospital
Hemoglobin | Year: 2014

A subject with Hb E (HBB: c.79G > A) trait is asymptomatic and can become a blood donor. However, a blood transfusion from a Hb E trait donor can affect β-thalassemia (β-thal) diagnosis. Blood samples from three Thai women were sent to the Associated Medical Sciences (AMS) Clinical Service Center, Chiang Mai, Thailand, for thalassemia diagnosis. Their Hb A2 levels, analyzed by high performance liquid chromatography (HPLC), were higher than 4.0%, thus they were diagnosed to have β-thal. However, elevated Hb A2 levels in these patients were not certain because the Hb A2 levels analyzed at the initial hospitalization and follow-up were controversial. In addition, there were some cases shown to have controversy between the increased Hb A2 level and red cell indices. The blood transfusion history was confirmed and hemoglobin (Hb) analysis was reanalyzed by capillary electrophoresis (CE). On the CE electrophoregram, Hb A2 levels were observed to be normal and Hb E peaks were present. Therefore, to rule out misdiagnosis and unnecessary genetic counseling, Hb analysis should be performed on the recipient prior to blood transfusions. Moreover, CE has a high efficiency to prevent the misinterpretation of Hb analysis in patients who receive blood transfusions from a donor carrying Hb E. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted.

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