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Biomedical subjects

P Visudhiphan

Publications and source records attributed to P Visudhiphan.

At least 37 records · Page 2Linked to original sources
PubMed1989

Tuberculous meningitis in children: treatment with isoniazid and rifampicin for twelve months.

Patients with tuberculous meningitis were treated with isoniazid and rifampicin for 12 months. To evaluate the result of treatment, we studied the outcome of patients treated from January 1979 to December 1985. Of the 51 patients, 27 were female, and 5, 25, and 21 patients were in the first, second, and third stages of the disease, respectively. Increased intracranial pressure of greater than 200 mm H2O was observed in 42 patients. Three patients required ventriculostomy, and one of them needed ventriculoperitoneal shunting. Three patients died within the first week of admission, and four patients were lost to follow-up. Forty-four patients were followed for 1 1/2 to 7 years; 31 of them recovered completely. Thirteen patients recovered with neurologic sequelae, which included mental retardation, motor weakness, seizures, and hydrocephalus. No serious side effect of the drugs were observed except for transient elevation of liver enzyme activities in four patients. The combination of isoniazid and rifampicin for 1 year, with appropriate management of increased intracranial pressure, seemed to be safe and effective enough to be used as a routine treatment of tuberculous meningitis in areas where resistance to these drugs is uncommon.

Adolescent↗
PubMed1989

Brain tumors in children at Ramathibodi Hospital.

Brain tumors remain the second most common neoplasm of childhood, however, there is no adequate study of this disease in Thai children. From the year 1971 to 1987, 468 children under 15 years of age were admitted to the Department of Pediatrics, Ramathibodi hospital with the diagnosis of brain tumor. Four hundred and forty-four patients had primary intracranial tumors, of these, 17 were excluded due to inadequate information and the remaining 427 patients were studied. Male to female ratio was 1.3:1, the age ranged from one day old to 14 years old. The duration of illness before admission ranged from a few days to 4 years, with over 70 per cent within 3 months. Headache, vomiting and papilledema were the three most common symptoms and signs. Supratentorial and infratentoral tumors were seen in 209 and 216 patients respectively, craniopharyngioma was the most common supratentorial tumor (51/209) and medulloblastoma was the most common infratentorial tumor (95/216), however, malignant astrocytoma is the overall most common tumor type. Early diagnosis and treatment were needed for good outcome.

Adolescent↗
PubMed1989

Moyamoya disease: a report of four cases of Thai children.

Moyamoya disease is a cerebrovascular disorder characterized by occlusion of the internal carotid arteries with cerebral angiographic finding of smoke-like collateral vessels. Typical moyamoya blush can also be seen in immediate enhanced CT scan of the brain. The disease is rare in non Japanese. The present communication reports four Thai children aged 3-12 years, presented at the Department of Pediatrics, Ramathibodi hospital with recurrent hemiparesis. In one patient, brain biopsy was almost carried out. The disease should be suspected in every child with recurrent cerebral ischemic episodes. Cerebral angiogram and immediate enhanced CT scan are the two most useful investigation procedures. Either of them should be selected first for diagnosis before other unnecessary invasive investigations are done.

Arterial Occlusive Diseases↗
PubMed1989

Maple syrup urine disease: case report of 2 Thai infants.

Maple syrup urine disease (MSUD) is a rare inborn error of metabolism characterized by typical urine odor. The deficiency of branched-chain ketoacid decarboxylase enzyme is responsible for the clinical abnormalities. The classical disease usually manifests in the neonatal period with lethargy, refused feeding, seizures and death. Since 1984, at the Department of Pediatrics, Ramathibodi hospital, 2 patients with classical MSUD have been seen. The parents of one patient were relatives and already had 2 affected but undiagnosed daughters. Both patients had strong urine odor which was described as the odor of boiled Chinese herbal medicine. The first child died at 4 months old and the second was severely retarded at one year old. The importance of early diagnosis and genetic counselling are emphasized.

Female↗
PubMed1982

Torticollis as the presenting sign in cervical spine infection and tumor.

This report presents five patients with cervical-area infection and four with spinal cord tumors who presented with torticollis early in the course of their illnesses. three children were found to have osteomyelitis of the cervical spine; two, retropharyngeal abscess; two, intramedullary astrocytoma; one, extradural neuroblastoma; and one, extradural sarcoma. Though torticollis is most frequently a benign condition, its persistence or its association with other objective findings should lead to search for an etiologic basis.

Abscess↗
PubMed1980

Causes of spontaneous subarachnoid hemorrhage in Thai infants and children. A study of 56 patients.

The authors report 56 cases of spontaneous subarachnoid hemorrhage in Thai infants and children. The causes were: hemorrhagic disorders in 22 cases, arteriovenous malformations and aneurysms in 18, gnathostomiasis in nine, bleeding tumors in four, hypernatremia in one, and undertermined causes in two cases. Coagulation studies and cerebrospinal fluid examination for eosinophils are recommended before further invasive studies in such cases.

Adolescent↗
PubMed1979

Hydrocephalus in tuberculous meningitis in children: treatment with acetazolamide and repeated lumbar puncture.

Increased intracranial pressure was found in 36 of 49 children with tuberculous meningitis. Four patients who presented with acute onset died early. Eight patients with obstructive hydrocephalus were treated surgically. In the 24 patients who had communicating hydrocephalus and were treated with acetazolamide and repeated lumbar punctures, treatment was successful in all but two, in whom shunt surgery was needed.

Acetazolamide↗
PubMed1977

A bleeding syndrome in infants due to acquired prothrombin complex deficiency: a survey of 93 affected infants.

A bleeding syndrome due to severe prothrombin complex deficiency is reported in 93 infants. Most were breast fed (98 per cent), aged 2 weeks to 1 year and there were no serious preceding or associated diseases. Hemorrhagic diathesis, pallor and mild hepatomegaly were the major manifestations. The incidence of intracr anial bleeding was strikingly high (63 per cent) particularly with subdural and subarachnoid hemorrhage. Acute onset, short course and rapid clinical and laboratory improvement after vitamin K therapy were observed. Mortality rate was 35 per cent but has been reduced to 17 per cent since 1969. The location of bleeding, prompt diagnosis and early treatment are the major factors affecting prognosis. Severe prothrombin complex deficiency due to vitamin K deficiency accounted for the pathogenesis of bleeding. Possible causes of vitamin K deficiency were discussed but definite conclusions could not be drawn.

Cerebral Hemorrhage↗
PubMed1975

Evaluation of rifampicin in the treatment of tuberculous meningitis in children.

Of the 20 patients given rifampicin and isoniazid, 19 survived and one died. Twelve patients recovered from the disease without any significant neurologic defect. Seven patients had moderate to severe handicaps which included hemiparesis in four, hydrocephalus in two,mental retardation in three, and blindness in one. There was no hearing deficit. The average hospital stay in this group was 3-1/2 weeks. Among the 13 patients given streptomycin, PAS, and isoniazid, four are dead. Only three patients recovered with a completely good condition. The remainder had either single or multiple neurologic defects. The moderate degree of nerve deafness was also observed in two patients.

Adolescent↗