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Biomedical subjects

N Poungvarin

Publications and source records attributed to N Poungvarin.

53 records · Page 3Linked to original sources
PubMed1991

The correlation of the short latency somatosensory evoked potentials and the strokes disability.

Median and tibial short latency somatosensory evoked potentials (SSEPs) were studied in 54 stroke patients, 27 males and 27 females. Thirty-two patients had cerebral infarction and 22 had cerebral hemorrhage. Median SSEPs abnormalities correlated with the Barthel score (p = 0.005) as well as tibial SSEPs (p = 0.01). Both median and tibial SSEPs were very sensitive (sensitivity = 79.41% and 85.71%) and high positive predictive value (77.14% and 75%) in the assessment of neurological disability. However, normal median and tibial SSEPs did not exclude severe neurological deficits (positive predictive value = 63.16%, 64.29% and sensitivity = 60%, 47.37%).

Adult↗
PubMed1991

Brainstem germinoma presenting as intermittent apnoea: a rare entity: report of one patient and review of literature.

A 17-year-old man who had repeated pneumonia and presented with intermittent apnoea was described clinically and pathologically. Neurological examination and computed axial tomography revealed a calcified mass over the lower brainstem. Neurological intervention was done with removal of the tumour and the pathological section showed the classical picture of germinoma. The patient was given irradiation treatment afterwards and he was weaned off the respirator within a week. Unfortunately, he died because of recurrent chest infection after a long hospital admission of 92 days. Reviewing the literature showed the rarity of the germinoma at the brainstem location.

Adolescent↗
PubMed1991

The fifth nonlethal case of primary amoebic meningoencephalitis.

The fifth nonlethal case of primary amoebic meningoencephalitis was reported. He was a 61-year-old gardener from northeast Thailand who had an abrupt onset of high fever, headache and stupor. Lumbar puncture showed numerous naegleria in the cerebrospinal fluid. The combination of 0.5 mg/kg/day of intravenous amphotericin B for 14 days, oral rifampicin and oral ketoconazole for 1 month cured the patient with no recurrence after one year of follow-up. The authors emphasise the regimen of low dose amphotericin B for a prolonged period instead of a high dose over a short period.

Amebiasis↗
PubMed1990

Risk factors for cerebrovascular disease in urban community of Thailand.

Risk factors for cerebrovascular disease (CVD) were surveyed in an urban community of Thailand from October 1988 to May 1989. Two hundred and ninety males aged between 35-64 years were randomly selected from 2,605 households in Bangkok Noi area. Two hundred and seven subjects completed the study. The mean age was 47.7 (SD = 9.6) years and 157 subjects (75.8%) were manual workers. Smoking rate was 69.1 per cent. There were 27 subjects (13.0%) who had systolic blood pressure over 160 mmHg and 41 subjects (19.8%) who had diastolic blood pressure over 95 mmHg. Only 12 subjects (5.8%) had Body Mass Index (BMI) over 25. Blood chemistry determination of the study population revealed 9.8 per cent with blood sugar over 120 mg/dl, 29.5 per cent with hypercholesterolemia (cholesterol over 250 mg/dl), 23.8 per cent with hypertriglyceridemia (triglyceride over 175 mg/dl), and 20.2 per cent with low high density lipoprotein-cholesterol (HDL-C below 35 mg/dl). Pearson correlation coefficients showed correlation of BMI with blood pressure and total cholesterol but lack of correlation between blood cholesterol level and age in our study. Blood pressure levels, however, correlated significantly with age.

Adult↗
PubMed1990

L-deprenyl therapy in Thai patients with Parkinson's disease: before and after, clinical trial of 50 patients.

Fifty Thai patients with Parkinson's disease of all staging were allocated for 10 mg/day L-deprenyl therapy as the monotherapy (6 patients) and adjunctive therapy for at least two months. The assessment of this open study included the activities of daily living using Schwab/England Scale, Hoehn and Yahr staging and Unified Parkinson Disease Rating Scale (UPDRS) by comparison of the initial and after two month of treatment scores. There was improvement of both Schwab/England Scale and UPDRS in Hoehn and Yahr stage I, II and III patients. In stage IV and V patients there was no benefit of L-deprenyl therapy of both clinical and statistical analyses. Adverse effects of L-deprenyl were not serious. There were dry mouth (20%), anorexia (10%), nausea and vomiting (8%), insomnia (6%), lightheadedness (4%) constipation (4%), abdominal pain (2%), generalised ache (2%). We conclude that L-deprenyl therapy is effective, safe, but costly. It is more effective in early Parkinsonism. The effectiveness of L-deprenyl is less in more advanced states of Parkinson's disease. Thus, selection of the appropriate Parkinsonian patient for L-deprenyl therapy is vital.

Activities of Daily Living↗
PubMed1990

Opsoclonus in malaria: the first report in the literature.

The first report in the literature of opsoclonus in malaria was presented. A 24-year-old woman had a two week history of high fever and lassitude. Physical examination revealed no specific neurological sign on admission. Ring form and gametocytes of Plasmodium falciparum were found in blood smear. Combined treatment of quinine and tetracycline were prescribed. She developed classical abnormal eye movement of opsoclonus and hand tremor on the following day, which gradually subsided on the tenth hospital day. Computed brain tomography and cerebrospinal fluid study were normal. She was discharged home after 3 weeks of admission with some occasional minimal opsoclonus without hand tremor.

Adult↗
PubMed1990

Evaluation of enzyme-linked immunosorbent assay (ELISA) test in the diagnosis of tuberculous meningitis.

The detection of immunoglobulin G antibody in the CSF to purified protein derivative in patients with tuberculous meningitis and non-tuberculous meningitis patients by enzyme-linked immunosorbent assay (ELISA) were performed at the Department of Medicine, Siriraj Hospital Medical School from 1986 to 1988. Seventeen proven tuberculous meningitis patients showed 14 positive results. This yielded the sensitivity of the test as 82.4 per cent only nine of the thirty non-tuberculous meningitis patients showed a positive result. Thus demonstrating the specificity of the test as 70.0 per cent. The ELISA test for detecting the antibody of tuberculosis in the CSF is a rather sensitive test for diagnosis of tuberculous meningitis but it is not so specific for the condition.

Enzyme-Linked Immunosorbent Assay↗
PubMed1990

Transcranial Doppler ultrasonography: experience of 500 patients.

The experience of 500 transcranial Doppler (TCD) sonographies at Siriraj Hospital between April 1988- June 1989 were reported. The indications for TCD study were hemiplegia 156 (31.20%), vertigo 119 (23.80%), transient ischemic attack (TIA) 26 (5.20%), hemihypalgesia 14 (2.80%), dysarthria-dysphagia syndrome 13(2.60%), visual problem 13(2.60%), syncope 10(2.00%), memory loss 8(1.60%), aphasia 6(1.20%), carotid bruit 6(1.20%), miscellaneous (artereovenous malformation, aneurysm, arteritis, carotico-cavernous fistula, tinnitus, etc) 25(5.00%), and healthy subjects 92(18.4%). Abnormal TCD studies were found in various conditions of different percentages, i.e. 91.03 per cent in hemiplegia, 76.47 per cent in vertigo, 65.38 per cent in TIA, 71.43 per cent in hemihypalgesia, 61.54 per cent in dysarthria - dysphagia syndrome, 38.46 per cent in visual problem and 30.43 per cent in normal subject. TCD is noninvasive, safe and painless. It is a useful screening test for prophylaxis of cerebrovascular disease in the elderly.

Adult↗
PubMed1990

Spontaneous supratentorial intracerebral haemorrhage: a prognostic study.

A prospective study to determine the prognostic factors of spontaneous supratentorial intracerebral haemorrhage was carried out in 93 cases admitted to the Faculty of Medicine, Siriraj Hospital from 1984 to 1986. The overall mortality found in this study was 48.39 per cent, most of which occurred within the first ten days of admission. Death resulting from brain herniation secondary to cerebral oedema accounted for 86.05 per cent of those who died. Comparison to determine the possible factors related to the prognosis of the survival and dead groups was made of the following items: age, sex, onset-treatment duration, Glasgow Coma Scale at the onset, side, site and size (in ml) of the lesion, evidence of blood leakage into the ventricle and hyperglycaemia. Statistically significant prognostic parameters found in this study are level of consciousness, haematoma size, extension of blood into the ventricle and hyperglycaemia.

Adult↗
PubMed1989

CT diagnosis of cerebral cysticercosis.

CT findings of 132 patients with cerebral cysticercosis were analysed. The most common finding was multiple parenchymal punctate calcifications, accounting for 53 per cent; calcifications mostly scattered in both cerebral hemispheres. The second most common finding was enhancing ring(s) or nodule(s) of about 1 cm in diameter with perifocal edema, about 43 per cent. Other findings included thin-walled parenchymal cysts of various sizes from less than 1 cm to 7 cm in diameter, non-enhancing low-density area, intraventricular and cisternal cysts, and hydrocephalus due to obstruction of cerebrospinal fluid pathway by the cyst, arachnoiditis, or ependymitis. About 30 per cent of patients had a combination of these forms of cysticercosis. Seizure disorder was the most common presenting symptom. Praziquantel was used effectively in parenchymal cystic forms but without response in intraventricular and cisternal cysts. In conclusion, CT is considered to be the procedure of choice for the detection of cerebral cysticercosis and the follow-up of patients after medical or surgical treatment. When multiple forms of cysticercosis are present, the diagnosis can usually be made with accuracy. A single finding of non-specific pattern such as enhancing ring or nodule, low-density area, or parenchymal cyst(s) without typical mural nodules, has to be differentiated from other conditions such as tumors and inflammatory process. Clinical correlation and follow-up scan are required in these cases in which the definitive diagnosis cannot be ascertained, and in certain cases, surgical intervention may be necessary.

Adolescent↗
PubMed1989

Low dose aspirin and its antithrombotic effect in ischaemic stroke patient.

The investigators conducted a study of low dose aspirin and antithrombotic effectiveness in ischaemic strokes at Siriraj hospital Medical School, Mahidol University from July 1986 to June 1987. Thirty-six patients, 27 males and 9 females were enrolled in the study. The ages of the patients ranged from 33 to 80 years with a mean age of 55 +/- 12 years. Forty-seven per cent of patients had hyperfunction of platelet before treatment which fell to 3 and 0 per cent 24 hours and 7 days after low dose aspirin treatment (75 mg/d). The platelet count was significantly increased to compensate its hypofunction after seven days of treatment. There was no change in euglobulin lysis time, serotonin level in platelet after low dose aspirin treatment. Plasma prostacyclin in ischaemic stroke patients was statistically significantly reduced in comparison to normal subjects (223.8 pg/ml); but there was no further suppression of plasma prostacyclin after low dose aspirin therapy. Thus, we conclude that low dose aspirin (75 mg/d) is effective for antithrombotic effect in ischaemic stroke patients without any suppression of prostacyclin. We do recommend low dose aspirin for recurrent ischaemic stroke prophylaxis as it has fewer side effects, is cheap, easily administered and effective.

Adult↗
PubMed1987

Effects of dexamethasone in primary supratentorial intracerebral hemorrhage.

To evaluate the efficacy of dexamethasone for treatment of primary supratentorial intracerebral hemorrhage, we studied 93 patients 40 to 80 years old, using a double-blind randomized block design. After the subjects were stratified according to their level of consciousness (Glasgow Coma Scale), those with objectively documented primary supratentorial intracerebral hemorrhage were randomly assigned to either dexamethasone or placebo. For ethical reasons, three interim analyses were planned, to permit early termination of the trial if one study group did better than the other. During the third interim analysis, the death rate at the 21st day was identical in the two groups (dexamethasone vs. placebo, 21 of 46 vs. 21 of 47; chi-square = 0.01, P = 0.93). In contrast, the rate of complications (mostly infections and complications of diabetes) was much higher in the dexamethasone group (chi-square = 10.89, P less than 0.001), leading to early termination of the study. In the light of the absence of a demonstrable beneficial effect and the presence of a significant harmful effect, current practices of using dexamethasone for treatment of primary supratentorial hemorrhage should be reconsidered.

Adult↗