Suksathien Y.,Maharat Nakhon Ratchasima Hospital
Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2012
The patient who suitable for short stem THA must has good neck quality for initial stable fixation. In Thailand, the majority of patients are end stage osteonecrosis and have relatively narrow neck diameter so it's may be increased risk of intraoperative femoral fractures and leading to stem failure. Evaluate the initial clinical and radiographic results of short stem THA over a maximum follow-up period of about 24 months, paying special attention to early problem. The case series of 50 patients receiving short stem THA during March 2010 to September 2011. There were 15 cases of Mayo stem and 35 cases of Metha stem. The appearance of bone trabeculae development and radiolucent line at 1 year postoperative was reviewed using Gruen's classification. The Harris hip score was recorded at 6 months, 12 months and 24 months postoperative for evaluated the clinical results. In Mayo stem group, the mean age of patient was 44.2 years (range, 19-58) with the mean BMI of 20.9 (range, 16.9-28.1). There were 2 cases of intraoperative fractures and were treated with cerclage wires, 1 case had 3 mm subsidence with radiolucent line in zone 1, 2. Bone trabeculae was developed at zone 2 (60%), 6 (86.7%), 7 (53.3%) and radiolucent line was observed at zone 1 (6.7%) and zone 2 (6.7%). In Metha stem group, the mean age of patient was 43.9 years (range, 24-59) with the mean BMI of 22.2 (range, 16.5-32.3). There was 1 case of intraoperative fracture and was treated with cerclage wire, no further subsidence was observed. Bone trabeculae was developed at zone 1 (15.4%), 3 (79.9%), 6 (100%), 7 (92.3%) and no radiolucent line was observed. The mean Harris hip score was significantly improved from 44.9 (range, 22.7-59.7) preoperatively to 95.9 (range, 87-100) at 6 months (p < 0.01) in both stem design. The clinical results of short stem THA are generally satisfactory. The short-term results are promising and the learning curve acceptable. Its design enable preservation of the bone stock and the bone trabeculae appears to confirm the assumption of proximal force transmission. It is a promising option for young and active patients.
Insiripong S.,Maharat Nakhon Ratchasima Hospital
The Southeast Asian journal of tropical medicine and public health | Year: 2013
The ratio of hematocrit (Hct) to hemoglobin (Hb) in the people with normal red blood cell (RBC) morphology is generally three to one. We studied Hct/Hb ratios among patients with alpha-thalassemias (Hb H, H-CS, AEBart, AEBart-CS, EFBart and EFBart-CS diseases) diagnosed by high performance liquid chromatography, and compared them with normal subjects and with patients having anemia due to chronic kidney disease (CKD). The Hct and Hb levels were derived by automated analyzer. The means +/- SD of the Hct/Hb ratios were 3.5 +/- 0.2 (range 3.3 - 4.1), 3.0 +/- 0.1 (range 2.9 - 3.2) and 3.0 +/- 0.1 (range 2.8 - 3.2) in the alpha-thalassemia, normal and CKD groups, respectively. The mean Hct/Hb ratio in subjects with alpha-thalassemia was higher than the mean in normal subjects and in those with CKD. The Hct/Hb ratios for each genotype of the alpha-thalassemia were not different from each other. The underlying mechanisms for the higher Hct/Hb ratio among those with alpha-thalassemia are theorized to be less density and/or more hydration of a-thalassemia RBCs, more entrapment of plasma in the spun RBC, the high percent of nucleated RBC and WBC interference. A ratio of 3.5 +/- 0.2 may be helpful in cases of moderate anemia when typing only shows Hb A and E, to consider investigation for alpha-thalassemia, or in cases of alpha-thalassemia with acute blood loss, if the Hct is less than 35%, in the decision to transfuse.
Insiripong S.,Maharat Nakhon Ratchasima Hospital
Journal of the Medical Association of Thailand | Year: 2010
A granulocytosis in dengue hemorrhagic fever has not been mentioned, it may probably be included under the term of leucopenia. Here is the case of a 14-year Thai boy presenting with fever and diarrhea for 3 days. He was diagnosed as dengue hemorrhagic fever, grade I because he had hemoconcentration, thrombocytopenia without bleeding and positive IgM dengue antibody. On the 5th day, he developed agranulocytosis and was treated with G-CSF and empirical antibiotics. His leucocyte count was successfully normalized within 1 day and persistently sustained until discharge.
Khananurak K.,Chulalongkorn University |
Vutithanachot V.,Chumphae Hospital |
Simakachorn N.,Maharat Nakhon Ratchasima Hospital |
Theamboonlers A.,Chulalongkorn University |
And 2 more authors.
Infection, Genetics and Evolution | Year: 2010
Rotaviruses are the most common cause of severe diarrhea among infants and young children worldwide, especially in developing countries. In Thailand, rotavirus has presented a major public health problem causing severe diarrhea in infants and young children. It was responsible for about one-third of diarrheal diseases in hospitalized patients. In this study, we have analyzed the distribution and performed molecular characterization of rotaviruses circulating in infants and young children with diarrhea admitted to the city and rural hospitals in Thailand between July 2007 and May 2009. Group A human rotavirus was detected in 158 (28.4%) of 557 fecal specimens by RT-PCR. The peak incidence of infection was found in the winter months between December and March. The G1P strain was identified as the most prevalent (49.4%) followed by G9P (22.2%), G2P (20.2%) and G3P (0.6%). The uncommon strains G12P, G12P and G3P were also detected. Phylogenetic analysis of selected G and P genotypes isolated in this study was performed to compare with the reference strains from different countries. Emergence of G12 in the northern part of Thailand was observed and phylogenetic analysis demonstrated close relation between Thai isolates and strains from India. The present study reveals the recurring changing genotypes of rotavirus circulating in Thailand. The genetic association between isolates from Thailand and other countries ought to be considered with regard to local and global dissemination of rotavirus as it is crucial for prevention especially, with respect to vaccine implementation. © 2010 Elsevier B.V.
Kitiyodom S.,Maharat Nakhon Ratchasima Hospital
Journal of the Medical Association of Thailand | Year: 2015
Objective: To compare the adequacy of endometrium and the post-procedural pain between the manual vacuum aspiration (MVA) and metal curettage method. Material and Method: The present research was a clinical experiment. A randomized controlled trial study was done with older than 35-year old females with abnormal intrauterine bleeding who attended the out-patient gynecology department of Maharat Nakhon Ratchasima Hospital between December 1, 2013 and April 30, 2014. Patients were allocated with simple randomization technique into two groups, the experimental group was using MVA and the control group was using conventional metal uterine curettage. Pain levels were assessed according to the visual analogue scale. All tissue samples were examined by pathologists. Statistics used were percentage and Chi-square. Results: Percentages of tissue adequacy for pathological examination of control and experiment groups were 87.88 and 90.91, respectively. There was no significant difference between the two methods (p-value = 0.572). The patients with severe pain in the experiment group were less than that of the control group. The relative risk is 0.47 (95% CI = 0.30-0.72). Conclusion: MVA caused less pain than the metal curette method, while both provided the same rate of adequacy of endometrial tissue sampling for pathological diagnosis. The MVA offered more humanized health care for gynecological patients who required such procedure. Further researches focusing on the cost-effectiveness or medical complications could benefit a practice guideline and the health care system for this patient group. © 2015, Medical Association of Thailand. All rights reserved.