Credibility of our profession. "Therefore trust the physician and drink his remedy in silence and tranquillity" Kahlil Gibran 1893-1931.
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
K Chaturachinda
Publications and source records attributed to K Chaturachinda.
The use and maintenance of instruments for large loop excision of transformation zone at Ramathibodi Hospital.
The average use of LLETZ in Ramathibodi Hospital from 1993 to 1998 was 73.3 cases per year (range 26-116 cases). The endocervical box (F2) loop electrode was the most frequently damaged at the rate of 4 pieces per 100 procedures. The damage rate of the 25 mm loop electrode was 3 pieces per 100 procedures and 20 mm loop electrode was 2 pieces per 100 procedures. The life of the instrument can be prolonged through proper care and continuous maintenance as well as by experienced operators and the assisting team.
Developing Countries↗
Use of Norplant implants in asymptomatic HIV-1 infected women.
The study of Norplant implants use in HIV-1 infected women was conducted at the Family Planning Clinic, Department of Obstetrics and Gynaecology. Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, from January 1993 to June 1996. The purpose of the study was to evaluate efficacy, clinical effects, side effects, and menstrual patterns of the Norplant system in HIV-1 infected acceptors. Forty one cases of asymptomatic HIV-1 positive women voluntarily participated in using Norplant implants after delivery or abortion. The mean age was 25.4 years. The most common menstrual pattern was irregular bleeding (63.4%). Mean blood pressure, body weight, and hemoglobin level were not different at insertion and at 12 months (p > 0.05). No pregnancy occurred during a 12-month period. It was concluded that the Norplant system was safe, efficacious, and well tolerated in HIV-1 positive women and is an appropriate contraception in these women.
Adolescent↗
Outpatient laparoscopic interval female sterilization.
A 23-year retrospective review of laparoscopic sterilization in Ramathibodi Hospital, Bangkok, Thailand, is reported. A total of 9041 cases of outpatient laparoscopic interval female sterilizations were done from January 1973 to December 1995. Intraoperative complications occurred in 35 cases (0.39%) and hospital admissions totalled 65 cases (0.72%). Adnexal injuries were the most frequent complication. There was one case of death from anesthetic complication. Management and prevention of complications are discussed.
Ambulatory Surgical Procedures↗
Modified minilaparotomy technique of interval female sterilization.
The study of a modified minilaparotomy technique of interval female sterilization is reported. The modified minilaparotomy technique of interval female sterilization is performed under local anesthesia using the Ramathibodi uterine manipulator, bivalve speculum, and a low midline incision. Sixty cases were treated with this technique. From the study, it was revealed that the mean age of patients +/- SD was 31.2 +/- 5.6 years, the mean body weight +/- SD was 43.3 +/- 5.1 kg, and the mean height +/- SD was 152.1 +/- 8.2 cm. The mean operating time was 24.3 +/- 5.5 min with a range from 15 to 35 min. All patients recovered and were allowed home within 2 h after operation. No immediate or late complications were observed. It was concluded that this technique is quick, safe, inexpensive, and easy to perform as an outpatient procedure.
Adult↗
Bone mineral density in long-term depot medroxyprogesterone acetate acceptors.
The study of bone density in long-term DMPA users is reported. The aims were to study and compare bone density in long-term DMPA users with intrauterine device (IUD) users. Fifty current users of DMPA with a minimum 36 months previous use were compared to 50 current IUD users as control. The bone mineral density was measured by dual energy x-ray absorptiometry (DEXA) at the non-dominant distal and ultradistal forearm. Serum estradiol was measured by microparticle enzyme immunoassay technique in both groups. Age, income, weight, height, BMI, and parity of both groups were matched. The mean bone mineral density of distal forearm in DMPA and IUD users was 0.48 +/- 0.05 g/cm2 in both groups. The mean bone mineral density of ultradistal forearm was 0.38 +/- 0.06 g/cm2 in DMPA users and 0.4 +/- 0.05 g/cm2 in IUD users. No differences in mean bone mineral density of distal and ultradistal forearm between DMPA and IUD users was demonstrated (95% CI -0.02, 0.02 and -0.04, 0.001, respectively). However, the serum estradiol levels were significantly different between DMPA and IUD users (95% CI -122, -68.1). From this study, it is suggested that long-term DMPA use should not have any adverse effect on bone density even if it reduces serum estradiol.
Absorptiometry, Photon↗
Bone mineral density during long-term treatment with Norplant implants and depot medroxyprogesterone acetate. A cross-sectional study of Thai women.
This cross-sectional study compares bone mineral density (BMD) in long-term Norplant implants and depot medroxyprogesterone acetate (DMPA) users. The objectives of this study were to evaluate and compare the bone mineral density between women using these contraceptives. Forty-one current users of Norplant implants and 50 DMPA users participated in the study. The BMD was measured by dual energy x-ray absorptiometry in the nondominant distal and ultradistal forearm. Serum estradiol was measured by microparticle enzyme immunoassay technique. The demographic characteristics were similar in both groups. The mean durations +/- SD of DMPA and Norplant implants were 59.14 +/- 30.73 and 31.1 +/- 11.2 months, respectively. The BMD of long-term Norplant implant and DMPA users was similar. The serum estradiol in the Norplant implant group was significantly higher than in DMPA users. However, the serum estradiol level in DMPA users ranged into normal for the follicular phase, which is higher than for postmenopausal women. This study suggests that two long-acting progestogen contraceptives do not differ with respect to their impact on BMD in long-term users.
Absorptiometry, Photon↗
Verres needle as an auxiliary instrument for mobilization of fallopian tubes and ovaries in diagnostic microlaparoscopy.
Explore the source record for details and available documents.
Fallopian Tubes↗
Interval female sterilization of HIV-1 positive women: laparoscopy versus minilaparotomy.
Explore the source record for details and available documents.
Adult↗
Association of contraceptives and HIV-1 infection in Thai female commercial sex workers.
We conducted a case-control study to evaluate the association between contraceptive methods and HIV infection among Thai female commercial sex workers in Khon Kaen and Lumpang provinces, Thailand; 118 cases of HIV-1 infected sex workers were eligible for inclusion and 258 HIV-1 negative women were recruited as controls during the period of October 1, 1993 to December 31, 1994. Cases and controls were matched by age, education, parity, age at first exposure to commercial sex, number of clients per night, duration of work and sexual practice during menstruation. The ratio of case per control was 1:2. Both cases and controls were interviewed and underwent blood testing by a team of investigators. The study revealed no significant association between oral pill, injection, other contraceptives and HIV-1 infection. However, condom usage showed a significant protective effect. It is suggested that these contraceptives in this high-risk group of women do not increase the risk of HIV infection. In contrast, the use of condoms could reduce the risk of HIV infection.
Adult↗
Effect of zidovudine treatment in late pregnancy on HIV-1 in utero transmission.
In Thailand, the prevalence of paediatric HIV-1 infection has increased rapidly through vertical transmission. According to the ACTG 076 trial regimen, zidovudine treatment in HIV-infected pregnancy can reduce vertical transmission. However, this treatment is complex and costly. It is not applicable for developing countries. We conducted a study to evaluate the effect of zidovudine treatment in late pregnancy on HIV-1 in utero transmission. Fifty cases of asymptomatic HIV-1 infected-women were voluntarily enrolled to the study. Zidovudine 250 mg orally twice a day was given to these patients from gestational age 36 weeks until labour. The newborns were evaluated at birth by a neonatologist and peripheral blood was tested for HIV genome by PCR technique within 48 hours of birth. The study revealed that no HIV genome was detected from the peripheral blood of newborns. It is suggested that zidovudine treatment in late pregnancy could reduce HIV-1 in utero transmission.
AIDS Serodiagnosis↗
Bone density in women receiving Norplant implants for contraception.
The aim of this study was to determine whether long-term Norplant uses is associated with changes in bone density. The study group consisted of forty one healthy women aged 19-42 years who had used Norplant for 31.1 +/- 11.2 months with a minimum period of 12 months. Fifty current IUD users constituted the control group. The bone density was measured by dual energy X-ray absorptiometry (DEXA) at the non dominant distal and ultradistal forearm. Serum estradiol was measured by microparticle enzyme immunoassay technique. Age, parity, income, weight, height and body mass index (BMI) of both groups were no differences. Our analysis did not find any differences in bone mineral density of distal forearm and ultradistal forearm between Norplant and IUD users (95% CI -0.01, -0.03 and -0.02, 0.02 respectively). Serum estradiol was not different in the two groups (95% CI -24.9, 110). This study revealed that the Norplant implants do not have any adverse effect on bone mineral density.
Adult↗
Modified needle elevation technique for misplaced Norplant implants removal.
This study reports on a simple, feasible and easily learned technique for Norplant implants removal. This technique is modified from the needle elevation technique. The objective of this study was to introduce an alternative Norplant implants removal technique, especially for misplaced capsules. Fifteen Norplant implants clients whose capsules were difficult to palpate had removal by this technique. The mean duration of Norplant implants use was 18.4 +/- 12.5 months. The mean length of removal time was 10.4 +/- 4.5 minutes. None of the capsules was damaged during the removal. No immediate or late complications were observed. The conclusion is that the modified needle elevation technique is a simple and easy method of removing misplaced Norplant capsules with less complications.
Adult↗
Cesarean and postpartum hysterectomy.
OBJECTIVE: To review the cases of cesarean and postpartum hysterectomy. METHOD: A retrospective study of all cases of cesarean and postpartum hysterectomy during 1985-1994. Maternal characteristics, method of delivery, indications for hysterectomy and complications were reviewed. RESULTS: The rate of cesarean and postpartum hysterectomy was 1:1667 deliveries. Half of these cases were delivered by cesarean section. The main indications for hysterectomy were massive bleeding due to uterine atony, abnormal placental adhesions or uterine rupture. Maternal morbidity was high and there was one maternal death. CONCLUSION: Cesarean and postpartum hysterectomy is a necessary life-saving operation. Although maternal mortality is rare, morbidity remains high. Prevention of complications that give rise to hysterectomy and optimally timed surgery should decrease maternal morbidity and mortality.
Adult↗
Serum vitamin A and beta-carotene levels in pregnant women infected with human immunodeficiency virus-1.
OBJECTIVE: To determine if low levels of serum vitamin A and beta-carotene are present in pregnant women with human immunodeficiency virus-1 (HIV-1) infection. METHODS: Serum concentrations of vitamin A and beta-carotene were measured in 74 pregnant women seropositive for HIV-1 infection (17 with CD4 count below 200 cells/microliter) and in 148 pregnant seronegative controls in the first trimester. Comparisons were made between groups stratified by CD4 count. RESULTS: Compared with controls, women with HIV-1 infection and CD4 count below 200 cells/microliter exhibited 37% lower mean serum vitamin A levels (0.820 versus 1.308 micromol/L, P < .001) and 37% lower mean serum beta-carotene levels (1.486 versus 2.362 micromol/L, P < .001). Mean maternal age, parity, gestational age, hemoglobin levels, and body mass index at entry into the study did not differ significantly between the control and HIV-1 infection groups. In addition, serum vitamin A levels correlated significantly with the percentage of CD4 lymphocytes (r = 0.589, P < .001), CD4 count (r = 0.772, P < .001), and CD4 to CD8 ratio (r = 0.593, P < .001). Serum beta-carotene levels correlated with the percentage of CD4 lymphocytes (r = 0.407, P < .001), CD4 count (r = 0.614, P < .001), and CD4 to CD8 ratio (r = 0.434, P < .001). CONCLUSION: Compared with levels in uninfected women, serum vitamin A and beta-carotene are decreased in HIV-1-infected pregnant women in the first trimester with CD4 counts lower than 200 cells/microliter. These micronutrient concentrations also correlate with CD4 count.
Adult↗
Laparoscopic sterilization in HIV-1-positive women.
Laparoscopic sterilizations in HIV-1-positive women were performed. Patients, who were HIV-1-positive, underwent voluntary laparoscopic sterilization. The mean age of patients was 27.5 +/- 3.8 years. Most were of low socioeconomic status. The mean duration of the operation was 14.4 +/- 5.4 min. No accidental injury to the surgical team was recorded, and no complications occurred among the patients. It was concluded that laparoscopic sterilization in HIV-positive patients was safe with low risk of HIV transmission to the surgical team.
Adult↗
Serum ferritin levels in normal and HIV-1 infected pregnant women.
Between May, 1994 and May, 1995 serum ferritin concentrations were measured in 74 pregnant women who were HIV-1 positive (17 with CD4 cell counts below 200 cells/uL) and in 148 HIV-1 negative pregnant controls in first trimester of gestation to determine if a high level of serum ferritin is present in pregnant women with HIV-1 infection. Comparisons were made between groups stratified by CD4 cell counts. Pregnant women with HIV-1 infection had 92% higher mean serum ferritin levels (112.8 versus 58.8 ug/L, p < 0.005) compared to controls, whereas the mean maternal age, parity, gestational age, haemoglobin levels and body mass index at entry into the study did not differ significantly between the control and HIV-1 infection groups. The serum ferritin levels inversely correlated with the percentage of CD4 lymphocytes, CD4 cell counts and the CD4/CD8 ratio. This study suggests that serum ferritin levels can also be used as an immunological marker in HIV-1 infected pregnant women.
Biomarkers↗
Female sterilization in Ramathibodi Hospital: 1987-1993.
A 7 year (1987-1993) restropective review of female sterilization in the Department of Obstetrics and Gynecology, Ramathibodi Hospital was reported. This paper is part of a continuing study of female sterilization in Ramathibodi Hospital. A total of 9,968 cases of female sterilization was done from January 1987 to December 1993. Post partum acceptors accounted for 63 per cent of total female sterilization, the overall postpartum female sterilization rate was 117.4 per 1,000 deliveries. 37 per cent was interval sterilization. The peak of interval sterilization was in March. 69.8 per cent of interval sterilization was performed by minilaparotomy technique, the remainder were by laparoscopy.
Adolescent↗