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Biomedical subjects

V Thamlikitkul

Publications and source records attributed to V Thamlikitkul.

At least 37 records · Page 2Linked to original sources
PubMed1991

Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults.

One hundred and fifty-two adult patients with pharyngotonsillitis were enrolled in the randomized double blind study to assess the efficacy of Andrographis paniculata. The patients were randomized to receive either paracetamol or 3 g/day of Andrographis paniculata or 6 g/day of Andrographis paniculata for 7 days. The baseline characteristics of the patients among the three groups were not different. The efficacy of paracetamol or high dose Andrographis paniculata was significantly more than that of low dose Andrographis paniculata at day 3 in terms of the relief of fever and sore throat. The clinical effects were not different at day 7. Minimal and self limiting side effects were found in about 20 per cent in each group.

Acetaminophen↗
PubMed1991

A correlation of clinical performance on written test and standardised patient.

The objective of the study was to determine the relationship between written responses and actual performance on a patient with a sore throat. The written test was in a format of modified essay question. The standardised patient was a medical student who had chronic recurrent pharyngotonsillitis. The study subjects were residents in the Department of Medicine who were not aware of the study objective. The 37 residents were asked to complete the written test and 18 of them were randomly selected for actual performance assessment. The standardised patient saw the selected residents during their usual service hours. The information obtained from the standardised patient, medical records and prescription slips were analysed. The results revealed: 1) Thirty per cent of the information actually performed were not recorded. 2) Thirty-four per cent of the actions described in the written test were not actually performed, most of these actions were unnecessary and superfluous. 3) There was a good correlation between written responses and actual performance on a standardised patient.

Adolescent↗
PubMed1991

Synergy study of vancomycin or teicoplanin plus gentamicin against enterococci, Staphylococcus aureus and coagulase-negative staphylococci by time-kill method.

We conducted a time-kill study comparing the combination of vancomycin plus gentamicin versus teicoplanin plus gentamicin against 20 clinical isolates each, of enterococci, S. aureus and coagulase-negative staphylococci. The concentrations of vancomycin and teicoplanin were selected so that cultures containing these drugs alone contained 10(3) to 10(6) cfu/ml after 24 hr, mostly 2 to 4 times the MIC for each isolate. In this way we could be certain that synergism or antagonism would not go undetected. One-fourth of the gentamicin MIC for each isolate was used throughout the study. In vitro bactericidal synergy was considered to be present when vancomycin plus gentamicin or teicoplanin plus gentamicin yielded at least a 2 log 10 decline in cfu/ml compared to vancomycin or teicoplanin alone. There was no significant difference between the two antibiotic combinations against these gram-positive cocci. The antibiotic combinations showed synergy against 75 per cent of enterococcal isolates, 70 per cent of S. aureus isolates and 50 per cent of coagulase-negative staphylococcal isolates when measured at 24 hr of incubation. Five (25%) enterococcal strains resistant to the synergistic effect of the antibiotic combinations had gentamicin MICs greater than 64 mg/L. For staphylococcal isolates, no association was found between synergy and gentamicin susceptibility, methicillin resistance, or tolerance to vancomycin or teicoplanin.

Anti-Bacterial Agents↗
PubMed1991

Treatment of community-acquired pneumonia with ofloxacin.

Our study of 28 carefully selected patients proved that ofloxacin is a safe and effective drug for mild to moderately severe community-acquired pneumonia. An effective oral antimicrobial drug such as ofloxacin can be used as an alternative to conventional therapy in community-acquired pneumonia.

Administration, Oral↗
PubMed1990

Pasteurella multocida infective endocarditis: a case report.

A 17-year-old man presented with acute febrile illness with jaundice, embolic skin lesion, heart murmur, renal insufficiency and abnormal CSF. Pasteurella multocida was isolated from blood cultures. In spite of adequate antibiotic treatment for endocarditis of the mitral valve, he developed a fatal ruptured cerebral mycotic aneurysm. Post mortem examination revealed an atrial septal defect, vegetation at the anterior mitral leaflet, intraventricular, subarachnoid and intracerebral hemorrhage.

Adolescent↗
PubMed1990

Randomized controlled trial of Cassia alata Linn. for constipation.

Cassia alata Linn. is a medical plant. Its leaves have been claimed to be effective as a laxative. The studies done so far have shown no toxicity as a result of consuming Cassia alata Linn. leaves. The plant has been found to contain anthraquinones, presumed to be the active ingredient causing the laxative effect. The objective of the study was to test efficacy of Cassia alata Linn. leaves for treatment of constipation compared with a placebo and mist. alba in a multicenter randomized controlled trial carried out in one provincial and 5 community hospitals. Eighty adult patients admitted to 5 community hospitals and one provincial hospital with at least 72 hours of constipation were included in the study. Twenty-eight patients were in the placebo group, 28 in the mist. alba group, and 24 in Cassia alata Linn. group. Each patient was given 120 ml of fluid with caramel color, mist. alba, or Cassia alata Linn. infusion at bed time. Evaluation was performed after 24 hours whether the patient defecated or not. The characteristics of the patients among the three groups were not different. Eighteen per cent of patients in the placebo group passed stools within 24 hours, whereas, 86 and 83 per cent of patients in mist. alba and Cassia alata Linn. groups respectively, passed stools. The differences observed between placebo and mist. alba, placebo and Cassia alata Linn. were statistically highly significant, P less than 0.001 and clinically important. Minimal self-limited side effects, i.e., nausea, dyspepsia, abdominal pain and diarrhea were noted in 16-25 per cent of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Liver abscess: a clinical study of 222 patients.

The medical records of 222 patients with liver abscess at Siriraj Hospital from 1978 to 1985 were analysed. Amoebic abscess was three times more prevalent than pyogenic abscess. In both groups middle aged males were affected more often than others. The main clinical manifestations were fever, right upper quadrant pain and hepatomegaly. History of colitis in the past, marked leukocytosis, elevation of alkaline phosphatase and a single abscess confined to the right lobe were suggestive of amoebic liver abscess. The presence of concurrent abdominal infection, marked anemia and jaundice were associated with pyogenic abscess. Patients with pyogenic abscess developed complications more often and the case fatality rate was greater than patients with amoebic abscess. Most of the patients were successfully treated with a combination of antimicrobials and drainage.

Adolescent↗
PubMed1990

Vibrio bacteremia in Siriraj Hospital.

From January 1983 to March 1988, 26 isolates of Vibrio spp. were recovered from the blood of patients admitted to Siriraj Hospital. Thirteen strains were identified as non 0-1 Vibrio cholerae, 3 were Vibrio vulnificus and 10 were Vibrio spp. The medical records of 20 patients were available for clinical analysis. Most of them were adult men with cirrhosis. Clinical features included fever, abdominal pain, diarrhea, peritonitis, shock and skin lesions. Some patients had a history of seafood consumption or seawater exposure. The isolates were sensitive to commonly used antibiotics. All patients except one received at least one antibiotic that was sensitive in vitro. However, the case fatality rate was still high, 50 per cent. Clinicians should be aware of the clinical syndrome caused by Vibrio spp. in order to manage those patients promptly and appropriately.

Adolescent↗
PubMed1989

Randomized double blind study of Curcuma domestica Val. for dyspepsia.

Curcuma domestica Val. is a medicinal plant. It has been claimed to be effective for dyspepsia. The studies done so far showed no toxicity due to consuming Curcuma domestica Val. The plant has been found to contain volatile oil and curcuminoids which are believed to be the active ingredients. The objective of the study was to test the efficacy of Curcuma domestica Val. rhizome for treatment of dyspepsia compared with a placebo and flatulence in a multicenter, randomized, double-blind trial carried out in one provincial and 5 community hospitals. One hundred and sixteen adult patients who had acid dyspepsia, flatulent dyspepsia, or atonic dyspepsia were included in the study. Forty-one (41) patients were in the placebo group, 36 and 39 were in the flatulence and Curcuma domestica Val. groups respectively. Each patient received 2 capsules of placebo or study drugs 4 times a day for 7 days. Each patient was then assessed for symptoms response, side effects and satisfaction. Ten patients did not participate in the follow-up. The baseline characteristics of the patients among the three groups were not significantly different. Fifty-three (53) per cent of the patients receiving placebo responded to the treatment whereas 83 per cent of the patients receiving flatulence and 87 per cent of patients receiving Curcuma domestica Val. responded to the treatment. The differences in efficacy between placebo and active drugs were statistically significant and clinically important. Mild and self-limited side effects were observed at similar frequency in the three groups. About 50 per cent of the patients in each group were satisfied with the treatment they received.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

A model for testing antiseptic efficacy: a preliminary study on Betadine and Germidine.

Efficacy of povidone iodine antiseptic, betadine and germidine, was tested against normal skin flora and four pathogenic bacteria namely S. aureus, S. epidermidis, E. coli and Pseudomonas aeruginosa by a new model. The study was performed on the volar surface of forearms of ten patients. First of all, the skin flora was cultured then 10(8) cu/ml of the tested organisms was applied by a cotton swab and left to dry for 1 minute before the culture was repeated. Betadine or germidine was applied over the area previously painted with the organism. The culture was taken 1 to 2 minutes thereafter. The results showed that this model was feasible and convenient. Betadine and germidine are efficacious against normal skin flora and pathogenic bacteria.

Gram-Negative Bacteria↗
PubMed1988

Antibiotic dispensing by drug store personnel in Bangkok, Thailand.

The current pattern of antibiotic use by drug store personnel in Bangkok was examined. Ten well-trained medical students (simulated patients) presented to 40 randomly selected drug stores with common complaints, namely urethral discharge, acute watery diarrhoea, fever with sore throat, coryza, skin infection and acute dysuria. Analysis of medications obtained revealed that 50-100% of drug stores dispensed antibiotics for each condition. Co-trimoxazole, ampicillin, chloramphenicol, penicillin V and tetracycline were commonly given. Most antibiotics were dispensed inappropriately with respect to choice of drug and duration of treatment. The cost per treatment varied from 20 cents to 6 $US. Strategies to promote rational use are proposed.

Adult↗
PubMed1987

Clinical evaluation of efficacy, pharmacokinetics, and safety of teicoplanin for serious gram-positive infections.

Nineteen patients hospitalized for serious gram-positive infections were treated with teicoplanin, a new glycopeptide antibiotic. A variety of infections were treated, including endocarditis, septic thrombophlebitis, osteomyelitis, pyogenic arthritis, and soft tissue infection. Of 13 infections that could be evaluated in 12 patients, there were 8 clinical cures, 2 improvements, 1 recurrence, and 2 failures. Of the eight patients with Staphylococcus aureus bacteremia, seven were clinically cured or improved with teicoplanin therapy. Of the nine patients in whom the bacteriological response to treatment could be fully evaluated, six were cured; there was recurrence of infection in one, and treatment failed in two patients. In vitro testing showed the 13 bacterial isolates (9 S. aureus, 3 S. epidermidis, and 1 group B streptococcus) to be uniformly susceptible to teicoplanin, with MICs ranging from 0.12 to 0.5 microgram/ml. Every isolate was more susceptible in vitro to teicoplanin than to vancomycin. Three of the staphylococcal isolates were resistant to methicillin. Pharmacokinetic studies demonstrated that after an initial drug-accumulation period, a single daily dose adequately maintained the teicoplanin concentrations in serum within therapeutic ranges. Teicoplanin also penetrated well into synovial fluid. The drug was well tolerated by either intravenous or intramuscular administration. The most significant adverse reaction was an urticarial rash which required discontinuation of therapy in one patient; a second patient experienced a modest decrease in high-frequency auditory threshold. Asymptomatic eosinophilia and mild elevation of serum transaminases were noted as well. The results of this study suggest that teicoplanin is a safe and effective new agent for treatment of serious infections caused by gram-positive organisms.

Adult↗
PubMed1987

Cryptosporidiosis in Siriraj Hospital, Bangkok, Thailand.

During January to July 1986, 1,500 fecal specimens from out and in-patients attending Siriraj Hospital, Bangkok were examined for Cryptosporidium oocysts by modified acid fast technique. Eight were found to be positive. The prevalence of cryptosporidiosis was 3.7% in children with acute diarrhoea. Medical records of the patients showed that the main clinical presentation was acute diarrhoea with fever for one to 7 days duration. Stool examinations and cultures revealed no white blood cells or parasites or other enteropathogenic bacteria. All recovered within two weeks. The study suggest that Cryptosporidium is a relatively common nonviral cause of acute diarrhoea in young children and routine laboratory study to detect Cryptosporidium may be justified.

Acute Disease↗
PubMedDate not supplied

Social, behavioral, and practical factors affecting antibiotic use worldwide: report of Task Force 4.

In addressing its charge from the General Chairperson of this study, Task Force 4 decided to direct special attention to antibiotic use in developing nations because of the critical importance of the disease burden of bacterial infections in these regions of the world. The task force recognized the impact of respiratory and diarrheal diseases on morbidity and mortality among young children in developing nations. Another major concern was the potential for global spread of resistant strains. Emergence and spread of antibiotic-resistant bacteria is augmented in settings in which treatment may be inadequate because of socioeconomic constraints and where there is crowding and poor sanitation. Much of the information concerning the factors that govern antibiotic use in these countries is anecdotal. No two countries are identical in their use of antimicrobial agents, and patterns of use may differ greatly in regions within the same country. Efforts to improve the usage of antibiotics in developing countries must take into consideration the perception of health and disease of the populations, the availability of antibiotics, and the characteristics of the established systems of medical care.

Acute Disease↗