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Pathum Thani, Thailand

Rangsit University is a private institution of higher education with the primary aim of creating graduates in the area of study meeting the requirements of national development by focusing mainly on science, technology, design and management including independent professions which are requisites in development of one’s own career.Rangsit University is fully accredited by the Thai Government’s Commission on Higher Education, Ministry of Education. Renowned for its academic excellence and international teaching standards, RSU is rated in the highest category in quality assurance audits conducted by the Ministry of Education and the Thai Office for National Education Standards and Quality Assessment .The main campus is located on a 296 rai site in the Lak-Hok sub-district of Pathumthani Province, and is only 30 minutes drive by freeway from downtown Bangkok. Surrounded by two golf courses, lakes, sporting facilities, restaurants and excellent shopping facilities, the main campus has much to offer and provides an ideal study environment. Rangsit University is the only private university which has been assessed on education standard quality by the Office for National Education Standards and Quality Assessment and rated "Very Good".The curricula are broadly categorized into groups, as follows; Faculties of Medial and Health science: College of Medicine, Faculty of Dentistry, Faculty of Pharmacy, Faculty of Medical Technology, Faculty of Nursing Science, Faculty of Physical Therapy, Faculty of Science, Faculty of Optology and Faculty of Oriental Medicine Faculties of Engineering and Technology: College of Engineering, Faculty of Information Technology, Faculty of Biotechnology and Institution of Aviation Faculties of Humanities and Social science: College of Social Innovation, College of International, Institute of Diplomacy and International Studies, Faculty of Liberal Arts, Faculty of Communication Arts, Faculty of Law, Faculty of Education and Graduate School Faculties of Art and Design: Conservatory of Music, Faculty of Architecture, Faculty of Arts and Design and Faculty of Digital Art Faculties of Economics and Business Administration: College of Public Administration, Faculty of Business Administration, Faculty of Accounting, Faculty of Tourism and Hospitality Industry and Faculty of EconomicsCurrently there are total of 133 programs; 88 undergraduate programs for, 36 Master Degree programs, 1 Graduate Diplomaand 8 Doctoral Degree programs. Wikipedia.

Singalavanija S.,Rangsit University
Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2011

Stevens-Johnson syndrome (SJS) is a rare and severe life-threatening hypersensitivity syndrome. The etiology is unclear but is associated with drug exposure or infections and frequently high morbidity and mortality. To determine etiologies, treatments and complications of Stevens-Johnson syndrome (SJS) in children. A retrospective descriptive study was performed at Queen Sirikit National Institute of Child Health during 1979 and 2007 (29-year study). The authors collected and separated data into three phases from 1979 to 1987, 1988 to 1997 and 1998 to 2007. Diagnosis was confirmed by pediatric dermatologists. There were 189 patients, 56 cases between 1979-1987, 72 cases between 1988-1997 and 61 cases between 1998-2007. The ratio of male to female was 1.6: 1. The range of age was from 2 months to 15 years old with a mean age of 5.5 years. One hundred and sixty-five cases (87%) had a history of drug taking before onset of the rash. The most common drugs exposure were antibiotics in 69 cases (42%), anticonvulsant drugs in 58 cases (35%), non-steroids anti-inflammatory drugs in 8 cases (5%), antimalarial drugs in 4 cases (2%) and unknown drugs in 26 cases (16%). Mycoplasma infections were found in 5 cases (3%). One hundred and nine cases (58%) were treated with systemic corticosteroids. The corticosteroid treatment was increasing from 18% in the first phase to 64% and 87% in the second and third phase respectively. The overall complications were found in 38 cases (20%) included bacterial skin infections in 16 cases (8%), eye complications in 12 cases (6%), hepatitis in 4 cases (2%) and other complications in 6 cases (2%). Ten patients (5%) died from sepsis and underlying diseases. The mortality rate declined from 9% in the first phase to 1.5% in the third phase. Etiology of SJS in children was associated with drug exposure with the most commonly implicated drug being antibiotics and anticonvulsants. Corticosteroid may have a role in the treatment of SJS.

Bunnag T.,Rangsit University
Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2011

Dengue virus infection is an important mosquito-borne disease with the reported 40,000-100,000 cases per year in Thailand. Shock is one of the common presentations at the emergency room (ER) and dengue shock syndrome (DSS) is among the common causes of shock. Proper and timely management of DSS determines the outcomes and prognosis of DSS patients. To find the prevalence of DSS at the ER and evaluate the medical management and risk factors associated with the outcome of DSS patients. A retrospective study on patients who presented with shock, including DSS patients at the ER of Queen Sirikit National Institute of Child Health (QSNICH), Bangkok, Thailand, from 1st January 2008 to 31st December 2009 was done. The prevalence of patients who presented with shock at the ER was retrieved from the Statistical and Information Technology Departments. Out-patient cards and In-patient charts of DSS patients were reviewed. Clinical and laboratory data were compared between recovered and death cases. Statistical analysis was done by using SPSS version 14.0. There were 109 shock patients seen at the ER during the present study period with 59 DSS (54.1%), 30 septic shock (27.5%), 13 hypovolemic shock (11.9%), 1 cardiogenic shock (0.9%) and 6 other non-specific shock (5.5%). DSS cases were found all year round with the peak prevalence from June to August which is the rainy season. Twenty-six of DSS (44.1%) were referred cases and 5 of them died, case fatality rate was 8.8%. All death cases had prolonged shock, massive bleeding and liver failure at presentation while these findings were found in 2 (4.4%), 16 (35.6%) and 10 (22.2%) cases of recovered cases. Encephalopathy, renal failure and respiratory failure were found in 80, 60 and 60% of the death cases while in recovered cases they were found in 11.1, 4.4 and 2.2%. Acidosis was found higher in the death group (60%) than in recovered group (8.9%). Other common presenting findings in death and recovered groups were bleeding (35.6 vs 100.0%), fluid over load (31.1 vs. 80%), hyponatremia (40% for both groups) and hypocalcemia (83.3 vs. 80%). Among the 45 recovered cases; 3 cases were misdiagnosed and another 8 cases (17.8%) received no i.v. fluid at the ER. Cross matching was done in 32 cases (64%) and blood was transfused in 16 cases (50% of the cross matching). DSS is the most common shock found at the ER especially during June to August. ER physicians should be alert for making the correct diagnosis of DSS with proper intravenous fluid resuscitation and correction of the common complications/laboratory abnormalities, i.e. acidosis, hyponatremia, hypocalcemia and cross matching for massive bleeding. A referred case with liver failure together with renal and respiratory failure was likely associated with mortality while fluid overload and significant bleeding do not if they are managed properly. Early signs of shock should be detected in walk in cases to prevent later shock after admission.

Saereeporncharenkul K.,Rangsit University
Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2011

To establish the correlation between pre-pregnancy body mass index (BMI) and pregnancy outcomes in Thai women. Cultural modernization has changed lifestyle of Thai population including eating habits, leading to higher incidence of overweight in pregnant woman. This study aims to analyze the relationship between BMI of Thai women before pregnant and pregnancy outcomes. The study population included 3,715 deliveries in Rajavithi Hospital, Bangkok, Thailand, between January 1, 2009 and December 31, 2009. The number of individuals in each adverse outcomes was compared with those in each BMI group. Odds ratios were calculated using normal BMI as reference. The overweight and obese BMIs resulted in significant risk of cesarean section, pre-eclampsia and diabetes mellitus with [OR (95% CI)] 1.37 (1.13-1.68), 2.3 (1.4-3.7), 4.02 (2.66-6.08) for overweight and 2.11 (1.53-2.90), 5.7 (3.3-9.8), 6.02 (3.52-10.32) for obesity, respectively. The underweight BMI resulted in significant risk of preterm, very preterm, low birthweight (LBW) infant with [OR (95% CI)] 1.79 (1.48-2.16), 1.69 (1.15-2.47), 1.61 (1.27-2.03). Only obesity attributed to significant risk of macrosomia with [OR (95% CI)] 5.36 (2.73-10.52). Both overweight and obesity led to significant risk of postpartum hemorrhage and severe postpartum hemorrhage with [OR (95% CI)] 1.71 (1.21-2.44), 2.13 (1.08-4.22). No correlation was found between pre-pregnancy to stillbirth and congenital anomaly. Overweight and obesity could increase risk in cesarean section, pre-eclampsia, DM, PPH and severe PPH, but were protective factors of LBW. Only obesity played high risk of macrosomia. Underweight was a protective factor for cesarean section, pre-eclampsia, DM and PPH, but could cause risk in preterm, very preterm and LBW.

Kalayanarooj S.,Rangsit University
Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2011

There has been confusion regarding the clinical classification of dengue. The current WHO classification used since the 70s classifies dengue into dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS). In 2009, a new classification of dengue proposed by WHO Tropical Disease Research (TDR) was published in the WHO TDR 2009 dengue guidelines. This new classification classifies dengue into dengue (D), dengue with warning signs (DW) and severe dengue (SD). To compare the effectiveness in clinical management between the current WHO classification and the newly suggested classification (TDR) and to assess the 4 criteria of the DHF case definition of the current WHO classification for possible modification. A prospective study of suspected dengue patients admitted to the Dengue Unit, Queen Sirikit National Institute of Child Health between June-August 2009 was done. All cases were managed according to the Thai National Dengue Guidelines 2008. The final diagnoses were based on the current WHO Classification together with dengue laboratory confirmation. TDR classification was applied later by the author, using the data from the present study case report forms of each patient. Statistical analysis comparing clinical and laboratory data between each group of patients was done by using SPSS version 14. Total 274 confirmed dengue patients and 24 non-dengue febrile illnesses (ND) were used for analysis. There were 180 DF (65.7%), 53 DHF grade I (19.3%), 19 DHF grade II (6.9%), 19 DHF grade II (6.9%) and 3 DHF grade IV (1.1%) as classified by the current WHO classification while the suggested TDR classified 85 (31%), 160 (58.4%) and 29 (1.1%) as D, DW and SD respectively. At least one of the warning signs were found in 50, 53.3, 83, 88.2, 100 and 100% of ND, DF, DHF grade I, DHF grade II, DHF grade III and DHF grade IV patients. Vomiting and abdominal pain were the 2 most common warning signs found in both ND and dengue patients. Intensive monitoring and careful medical and i.v. fluid management were needed for 94 DHF patients compared to 189 DW and SD patients by the new TDR classification. There were 8 DSS patients who had AST > 1,000U and one patient presented with encephalopathy. These 8 patients cannot be classified properly in the current WHO classification. One non-dengue patient who presented with gastrointestinal bleeding was classified as SD. Bleeding and/or positive tourniquet test was found in and 69.7% of DHF patients. Plasma leakage detected using hemoconcentration, chest x-ray (CXR) and ultrasonography. Hemoconcentration could detect plasma leakage in 44.7% and CXR added up evidence of plasma leakage to 86.3%. Ultrasonography was the most sensitive technique to add evidence of plasma leakage up to 100%. Platelet < or = 100,000 cells/mm3 was found in 93.5% of DHF patients. Current WHO classification is recommended for continuing use because the newly suggested TDR classification creates about 2 times the workload to health care personnel. In addition, the TDR classification needs dengue confirmatory tests. More than 90% of DHF defined by WHO case definition are dengue confirmed. However, current WHO classification needs to be modified for more simple and friendly use. The suggested modification is to address plasma leakage as the major criteria. Tourniquet test positive or bleeding symptoms can be considered as minor criteria. Unusual dengue is proposed to be added to the current WHO classification to cover those patients who do not fit with the current WHO classification.

Bunchorntavakul C.,Rangsit University | Bunchorntavakul C.,University of Pennsylvania | Reddy K.R.,University of Pennsylvania
Alimentary Pharmacology and Therapeutics | Year: 2013

Background Herbal and dietary supplements are commonly used throughout the World. There is a tendency for underreporting their ingestion by patients and the magnitude of their use is underrecognised by Physicians. Herbal hepatotoxicity is not uncommonly encountered, but the precise incidence and manifestations have not been well characterised. Aims To review the epidemiology, presentation and diagnosis of herbal hepatotoxicity. This review will mainly discuss single ingredients and complex mixtures of herbs marketed under a single label. Methods A Medline search was undertaken to identify relevant literature using search terms including 'herbal', 'herbs', 'dietary supplement', 'liver injury', 'hepatitis' and 'hepatotoxicity'. Furthermore, we scanned the reference lists of the primary and review articles to identify publications not retrieved by electronic searches. Results The incidence rates of herbal hepatotoxicity are largely unknown. The clinical presentation and severity can be highly variable, ranging from mild hepatitis to acute hepatic failure requiring transplantation. Scoring systems for the causality assessment of drug-induced liver injury may be helpful, but have not been validated for herbal hepatotoxicity. Hepatotoxicity features of commonly used herbal products, such as Ayurvedic and Chinese herbs, black cohosh, chaparral, germander, greater celandine, green tea, Herbalife, Hydroxycut, kava, pennyroyal, pyrrolizidine alkaloids, skullcap, and usnic acid, have been individually reviewed. Furthermore, clinically significant herb-drug interactions are also discussed. Conclusions A number of herbal medicinal products are associated with a spectrum of hepatotoxicity events. Advances in the understanding of the pathogenesis and the risks involved are needed to improve herbal medicine safety. © 2012 Blackwell Publishing Ltd.

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