Sonographic findings of uterus and ovaries in normal pre- and post-menopausal women.

To investigate the significant findings of ultrasonography before hormonal replacement therapy (HRT) was given in normal pre- and post-menopausal women. Sixty eight Thai pre- and post-menopausal women with no previous HRT were recruited into the study, They were divided into 22 pre-menopausal women (group I), 28 post-menopausal women of < or = 5 years (group II) and 18 post-menopausal women of > 5 years (group III). Their mean age was 48.2, 50.2 and 57.3 years, respectively. Myoma uteri was found in 10 (45.5%), 2 (7.1%) and 1 (5.6%) in group I, II and III. There were 2 (9.1%), 3 (10.7%), 3 (16.7%) cases of ovarian tumor in these three groups respectively. The detection rate of ovaries from ultrasound was 90.7 per cent in group I, 89.1 per cent in group II and III. The corpus to cervix ratio in the three groups was 2.3, 2.4 and 2.3, respectively. Uterine volume in nulliparous and multiparous pre-menopausal women was 56.6 ml and 74.2 ml, but in group II and III were 60.1 ml and 37.1 ml respectively. Endometrial thickness was significantly different in group I, II and III (7.2, 4 and 2.9 mm.) Left and right ovarian volume of group I was significantly larger than that of group II and group III. In conclusion, the ultrasonography is highly recommended to detect uterine and ovarian abnormalities before HRT is given in pre- and post-menopausal women.

Emerging fluoroquinolone and macrolide resistance of Campylobacter jejuni and Campylobacter coli isolates and their serotypes in Thai children from 1991 to 2000.

This study investigated fluoroquinolone, macrolide resistances and serotype distributions among Campylobacter jejuni and Campylobacter coli isolated from children in Bangkok and rural settings during 1991-2000. Phenotypic identification, serotyping, and susceptibility testing were performed by standard microbiological procedures. The predominant serotypes of C. jejuni were Lior 36, 2 and 4 and of C. coli were Lior 8, 29 and 55. Resistance to nalidixic acid increased significantly during 1991-2000 and the frequency of isolates resistant to both nalidixic acid and ciprofloxacin in Bangkok was significantly greater than in rural settings. In 1996-2000, a significant trend was observed in C. jejuni isolates resistant to ciprofloxacin from Bangkok but not for macrolide resistance from both settings. In summary, fluoroquinolone resistance among C. jejuni and C. coli isolates became widespread in both Bangkok and rural settings in Thailand in the 1990s while widespread resistance to macrolides was undetected.

Survival analysis of patients with haemophilia at the International Haemophilia Training Centre, Bangkok, Thailand.

Haemophiliac treatment in less developed countries is limited to locally prepared fresh frozen plasma, cryoprecipitate, cryo-removed plasma and lyophilized products as replacement therapy. Factor concentrate is seldom used because of the high price. The present study reports the survival analysis of 164 patients comprising 138 haemophilia A and 26 haemophilia B cases from 134 families registered at the International Haemophilia Training Centre-Bangkok, Faculty of Medicine, Ramathibodi Hospital, Mahidol University from 1971 to 2000. The duration of follow-up ranged from 1 to 27 years and 8 months with a median of 9 years and 1 month. They received treatment on demand of bleedings, and 85 patients received additional home treatment for early bleedings. The proportion of death was 15.2%. The Kaplan-Meier survival curves revealed the median (95% CI) survival time of patients with severe and moderate degrees of 35 years and 6 months (21.4-49.7), and 38 years and 1 month (28.8-47.3), respectively. To compare the progressive achievement of haemophilia care services, the treatment period was divided into three decades: 1971-1980, 1981-1990 and 1991-2000. The patients with unaided proper walking increased from 62.8% in the first decade to 84.5% in the third decade. However, one-third of the patients developed one to four chronic haemarthrosis determined by clinical evaluation, especially patients with severe degree. Moreover, the estimated probability of a survival time beyond 13 years of age among patients with severe degree increased from 0.85 in the first decade to 0.94 and 1 in the second and third decades, respectively. Thus, established haemophilia care, even with limited resources, has significantly decreased the risk of death and increased the survival time among patients with haemophilia.