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Biomedical subjects

Viroj Wiwanitkit

Publications and source records attributed to Viroj Wiwanitkit.

At least 109 records · Page 6Linked to original sources
PubMed2004

Review of clinical presentations in Thai patients with primary amoebic meningoencephalitis.

CONTEXT: Primary amoebic meningoencephalitis (PAM) is a very rare but deadly infection of the central nervous system. Since the disease was first identified in 1965, fewer than 200 cases have been observed worldwide. OBJECTIVE: The author performed a literature review of the reports of PAM in Thailand in order to study the clinical summary of PAM among Thai patients. DESIGN: This study was designed as a descriptive retrospective study. A literature review of the papers concerning PAM in Thailand was performed. RESULTS: According to this study, there have been at least 12 reports of PAM in Thailand, of which 2 cases were nonlethal. The mean age was 15.2 +/- 16.1 years with a male:female ratio of about 2:1. History of risk behaviors such as suffocation of surface water during swimming was demonstrated in 6 cases. Also, 2 interesting cases involved possible water contact according to the Thai tradition and culture. Concerning the patients' clinical features, fever, headache, impaired consciousness, and stiff neck were seen in all cases. However, some unusual presentations such as intermittent abdominal pain and convulsion were also seen in this series. Similar to worldwide findings, most cases occurred during the summer months. Most of the cases involved young males from rural provinces in various regions of Thailand. Concerning the laboratory investigation, the cerebrospinal fluid (CSF) profile presented the polymorphonuclear (PMN) pleomorphic with hypoglycorhachia pattern. Trophozoite could be identified in all but 2 cases in this series. CONCLUSION: PAM is sporadically reported in Thailand but remains a public health issue. The clinical diagnosis of PAM is usually difficult as many clinicians are unfamiliar with the disease. The prognosis outcome is usually grave although broad medications are prescribed.

Adolescent↗
PubMed2004

Comparison of cost effectiveness between measuring the serum erythropoietin level and reticulocyte count for monitoring thalassemic patients: a note in Thai beta thalassemia/Hb E subjects.

Iron deficiency anaemia and the thalassemia syndromes, a group of disorders resulting from inherited abnormality of globin chain production, are common causes of anaemia in Thailand, and in the Far East in general. Monitoring erythropoiesis in these patient is very important in evaluating the disease and the response to treatment. Recently, our group has just reported the feasibility in using serum erythropoietin (EPO) for monitoring purposes in thalassemia and demonstrated that the determination of serum EPO can be an alternative choice in the follow up of these conditions. This study reports a cost effectiveness analysis comparing the recently reported radioimmunoassay (RIA) for serum EPO determination and the previously used tool, the reticulocyte count. The study reports a higher detection rate for ineffective erythropoiesis when using serum EPO determination, however, the increased sensitivity is at balanced by a higher unit cost. In this analysis, the cost effectiveness for serum EPO and reticulocyte are 208.33 and 50 baht/detection, respectively. () Therefore, the reticulocyte count is more cost effective and is recommended for routine usage in our current medico-economic setting.

Anemia, Iron-Deficiency↗
PubMed2004

Urine phenol and myeloperoxidase index: an observation in benzene exposed subjects.

Benzene is a colorless poisonous liquid with a sweet odor. At present, it is documented as a known inducer of leukemia. Potential metabolic mechanisms underlying the hemopoietic toxicity of benzene include bioactivation of phenolic metabolites of benzene by myeloperoxidases in bone marrow, which results in hydroquinolone, a major leukemogen. There is no previous correlative study between the level of phenol, urine benzene metabolite, and the myeloperoxidase index (MPXI). Here, the correlation between the urine phenol and MPXI were studied in 24 Thai subjects occupationally exposed to benzene. Of interest, the regression analysis show no significant correlation between urine phenol level and MPXI (r = -0.05, P = 0.81).

Benzene↗
PubMed2004

ISO 15189, some comments on its application in the coagulation laboratory.

In laboratory medicine, the two main general aims are good service and good quality. Presently, external reviews and the accreditation of medical laboratories involve more than the mere assessment of conformance with standards for organizational processes. ISO series have been widely applied for clinical laboratory for recent years. ISO 15189 is the new quality system in the laboratory. It can be applied to coagulation study. Based on this system, the harmonization and standardization of coagulation laboratories are expected.

Blood Coagulation Tests↗
PubMed2004

Prevalence of dermatological disorders in Thai HIV-infected patients correlated with different CD4 lymphocyte count statuses: a note on 120 cases.

BACKGROUND: Skin disease is one health problem among human immunodeficiency virus (HIV)-seropositive patients. Several dermatological findings in HIV-infected patients have been investigated. In this study, the skin lesions of 120 HIV-infected patients with different CD4 count statuses in Bangkok, Thailand, are studied. METHODS: This study was performed as a cross-sectional descriptive study. All subjects had a complete physical examination to detect their dermatological disorders and carried out the necessary diagnostic procedures by consultation with the dermatologist. RESULTS: Eighty percent of all patients were observed to have one or more skin disorders. Xerosis (73.33%) and oral candidiasis (54.17%) were the most common skin disorders, followed by seborrheic dermatitis (46.67%), pruritic papular eruption (36.67%), oral hairy leucoplakia (12.50%), folliculitis (11.67%), herpes zoster (9.17%), and alopecia (6.67%). CONCLUSION: Although the pattern of cutaneous lesions was comparable with previous reports, the strikingly lower prevalence of skin tumor and drug eruption was reviewed. Patients with advanced HIV infection were found to have significantly more skin disorders than those with early stage HIV.

AIDS-Related Opportunistic Infections↗
PubMed2004

Can hematocrit and platelet determination on admission predict shock in hospitalized children with dengue hemorrhagic fever? A clinical observation from a small outbreak.

Dengue infection is a major public health problem, affecting children in the Southeast Asia region. In Thailand, the dengue hemorrhagic fever is still a major infectious disease among the children with up to two to three epidemics per year. Hemoconcentration accompanied by platelet depletion are the predominant laboratory signs of dengue hemorrhagic fever. Findings from 23 hospitalized patients with dengue hemorrhafic fever in a small outbreak in a provincial hospital in Thailand are reported. The question if hematocrit and platelet determination on admission can predict shock in hospitalized children with dengue hemorrhagic fever was studied. The data from the discharge summary of these patients were studied, focusing on the admission hematology laboratory data. Regression analysis was used to test the correlation between the admission hematology laboratory data (hematocrit, white blood cell count, and platelet) and the focused outcome (shock or no shock). Of these 23 patients, shock did not develop in 19, and shock developed in four. There was no significant difference in admission hematology laboratory data between both groups (p < 0.05). The regression analysis revealed no significant correlation between the studied hematology laboratory data and the focused outcome (p > 0.05). It means that the three studied investigations on admission cannot predict shock in our hospitalized dengue hemorrhagic cases. From this study, it can imply that closed monitoring of dengue hemorrhagic patients is necessary. The general practitioner cannot rely on the admission hematology laboratory data to predict shock in these patients. Additionally, it might confirm that, although dengue infection can be fatal, with proper supportive treatment, especially hospitalization and hydration for severe cases, the outcome is very good.

Adolescent↗
PubMed2004

Activated partial thromboplastin time abnormality in patients with cholangiocarcinoma.

Cholangiocarcinoma can be detected worldwide, but is most common in tropical areas where crowded living conditions and poor sanitation exist. This infection can demonstrate a wide spectrum of clinical presentations from no complaints to arrest. Similar to the other liver diseases, the activated partial thromboplastin time abnormality can be seen in the patients with cholangiocarcinoma. The activated partial thromboplastin times among 33 Thai hospitalized patients with cholangiocarcinoma are studied. The correlation between the activated partial thromboplastin time and the other characteristics of the patients is studied. Most characteristics of the patients show no significant correlation with activated partial thromboplastin time (p > 0.05). The only two parameters that showed significant correlation are alanine aminotransferase (ALT) and aspartate aminotransferase (AST) (p < 0.05). Because the activated partial thromboplastin times shows significant relation to AST and ALT but not to serum bilirubin and alkaline phosphatase, this might mention that the prolonged activated partial thromboplastin time seems to relate with the process of hepatic parenchyma damage than the biliary tract obstruction. Hence, as a hypothesis, the prolonged activated partial thromboplastin time might be a useful indication for excessive parenchymal involvement in cholangiocarcinoma. However, because the total number of cases in this study is rather small, a larger study to answer this question is necessary. In addition, the more systematic evaluations are required to answer the raised hypothesis.

Adult↗
PubMed2004

The urine trans, trans muconic acid biomarker and platelet count in a sample of subjects with benzene exposure.

Benzene exposure is of particular concern because of ongoing exposure to thousands of workers. Prolonged exposure can cause chronic toxicity, especially hematologic disorders. The effects of benzene on red blood cells and white blood cells have been clearly proposed; however, the effect of benzene on platelets has not been studied. The correlation between the level of trans, trans muconic acid (ttMA), a urine metabolite of benzene, and the platelet count of subjects occupationally exposed to benzene was studied. Thirty volunteers who were occupationally exposed to benzene were investigated for both urine ttMA levels and platelet parameters. According to the regression analysis, no significant correlation existed between urine ttMA level and any platelet parameters (p > 0.05). However, although there is no statistical significance, the platelet count and PCT decreased while the urine ttMA increased. In addition, using the upper normal limit ttMA level as the cutoff level, the statistically significant lower platelet count and PCT was observed in the subjects with urine ttMA higher than upper normal limit. This report is the first world report on this topic and the results from this study can provide good basic data for further understanding the effect of benzene exposure on the platelet.

Benzene↗
PubMed2004

Plateletcrit, mean platelet volume, platelet distribution width: its expected values and correlation with parallel red blood cell parameters.

The quantitation of platelets in peripheral blood is a well-recognized tool. Recently, new indices related to erythrocytes and platelet counts have been provided by hematologic analyzers. Concerning the platelet parameter, the three important parameters are plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW). The purpose of the study is to investigate these three parameters to define their expected values and the correlation with the parallel red blood cell parameters, hematocrit (HCT), mean corpuscular volumer (MCV), and red blood cell distribution width (RDW). Blood samples form 215 volunteers were analyzed for platelet parameters using Technicon H*3. The average (mean +/- SD) values obtained with expected ranges were PCT 0.24 +/- 0.05% (range, 0.23-0.24%), MPV 12.79 +/- 5.91 fL (range, 12.39-13.19 fL), and PDW 46.79 +/- 2.70% (range, 46.61-46.97%). Concerning the correlation between PCT, MPV, and RDW and their parallel red blood cell parameters, there was no significant correlation between PCT and HCT, and between MPV and MCV. However, there was a significant correlation between PDW and RDW. It seems that the anisocytosis of red blood cells and platelets might co-occur. However, these data are basic observations; further in-depth evaluation of the platelet parameters is recommended.

Adult↗
PubMed2004

Angiotensin-converting enzyme gene polymorphism: I and D alleles from some different countries.

Angiotensin-converting enzyme (ACE) displays potent vasoconstrictive effects, attenuation of fibrinolysis, and platelet activation and aggregation, thus possibly promoting thromboembolism (VTE). ACE gene plays important role in regulation of ACE. Because the renin/angiotensin system affects hemostasis through different mechanisms, data on the possible role of angiotensin-converting enzyme I/D polymorphism in the pathogenesis of thrombosis are interesting. Here, the reported pattern of I/D polymorphism of ACE gene from 9 Western and Asian countries was analyzed. The frequencies were analyzed using the method similar to the phylogenetic study. According to this study, the population from the same region of the world presents more similar ACE gene polymorphism pattern than that from the other regions. In addition, the significant correlation between the population ethnicity and the gene frequencies was detected in this study (chi square test, p < 0.05). The difference in pattern of I/D polymorphism of ACE gene may be important in relation to the risk of cardiovascular morbidity and mortality in Western and Asian subjects and may be relevant in explaining differences in thromboembolism diseases in different populations.

Alleles↗
PubMed2004

Blood carboxyhemoglobin level and platelets: a correlation study.

The high level of air pollution is an important problem. One of these major pollutants is carbon monoxide (CO), which can block normal physiology. Hematologic alteration is another important side effect of exposure to CO. Adverse effects on red blood cells, formation of nonfunctional hemoglobin called carboxyhemoglobin (COHb), have been well documented. The effect of CO on platelets is not well documented. Therefore, the correlation between the level of blood COHb and the platelet count was evaluated in 28 subjects exposed to CO. There is no statistical significance; however, decreased platelet count, platelet distribution width, and plateletcrit, and an increase in blood COHb were observed.

Adult↗
PubMed2004

Platelet count and platelet parameters in hemoglobin E carriers.

Hemoglobinopathies are an important inherited disorder with a high prevalence in Thailand. Of several hemoglobinopathies, hemoglobin E (Hb) disorder (beta 26, GAG-AAG, Glu-Lys) is the most common. Coagulation disorders in these patients have also been proposed. Even though thrombotic risks in the patients with hemoglobin disorders from standpoints of platelet dysfunction and coagulation factors are controversial, they are in favor of thrombosis due to thrombocytosis. A study was performed in 57 healthy subjects to evaluate platelet count and platelet parameters in hemoglobin E carriers compared to values in healthy subjects. Classified by standard hemoglobin electrophoresis, there were 46 healthy subjects and 11 hemoglobin E carriers. There are no significant differences in platelet count and platelet parameters between the two groups (p > 0.05). Although there are reports that indicate the change in the quality of platelet in hemoglobin E disorders, no quantitative disorder was detected. There was no trend toward increased platelet count in the HbE carriers.

Adult↗
PubMed2004

Effect of smoking on platelet count and platelet parameters: an observation.

Arterial thrombosis occurs with increased frequency in cigarette smokers. It is believed that disturbance of platelet function, especially aggregation, is the essential mechanism responsible for this pathology. However, the effect of smoking on the quantity of platelets might be another contributing factor. The effect of smoking on platelet count is still controversial. We performed a cross section-al study to compare the platelet count and platelet parameters in Thai police who are smokers and non-smokers. A total of 30 Thai police in Bangkok were included in this study. Of the 30 police, there are 5 non-smokers and 25 smokers. The platelet counts and platelet parameters of the subjects were not significantly different between smokers and non-smokers.

Adult↗