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Biomedical subjects

A Chuansumrit

Publications and source records attributed to A Chuansumrit.

88 records · Page 5Linked to original sources
PubMed1993

Platelet counts in thalassemic children before and after splenectomy.

Even though thrombotic risks in thalassemia patients from standpoints of platelet dysfunction and coagulation factors are controversial, they are in favor of thrombosis due to thrombocytosis. From the study of 74 cases of thalassemia in children, marked thrombocytosis occurred during day 8 to 4 months during which one should be aware of the thrombosis. However, none of thalassemia children had acute thrombosis even at platelet counts of 1.6 million/microliters.

Blood Platelets↗
PubMed1993

Disseminated intravascular coagulation in children: diagnosis, management and outcome.

A retrospective study of 46 patients with disseminated intravascular coagulation (DIC) is reported. Twenty three patients were neonates with a mean age of 6.7 days (SD = 10) and twenty three patients had a mean age of 2.4 years (SD = 3.3). The ratio of males to females was 1:1. Thirty-two out of 46 patients (69.6%) had underlying diseases such as congenital abnormalities in cardiovascular and gastrointestinal systems. The diagnosis of DIC was suspected in the critically ill patients who had certain conditions that could trigger DIC. The laboratory findings revealed red blood cell fragmentation 93.4%, thrombocytopenia 95.5%, prolonged coagulogram 71.9% and increased FDP 74%. The management included treatment of underlying diseases, identification and relief of triggering conditions, correction of coagulopathy and supportive care. In terms of infection, appropriate antimicrobial agents were administered. Exchange transfusion was performed in 21 patients and heparin was given to patients with major vessel thrombosis such as renal vein thrombosis. Inspite of the above mentioned managements, the overall case-fatality rate was 52%. Factors related to high case-fatality rate were accompanying fatal diseases, shock, hemorrhage or thrombosis. There were no correlations between fatality rate and age, sex, triggered conditions or exchange transfusion. There is a need to establish an effective treatment that can stop the rapid ongoing process of DIC in order to achieve a better outcome in patients with DIC.

Blood Coagulation Tests↗
PubMed1993

Hemogram in normal newborn babies with special reference to platelet count.

A prospective study was performed to verify the hemogram of 318 healthy fullterm newborn babies aged one hour to thirty days. The mean hemoglobin, hematocrit and reticulocyte count were between 17.6-17.9 g/dl, 52.2-53.4% and 5.7-6.7% in the first 72 hours of life. After that, they were decreased gradually approaching adult level at the later half of one month old. The white blood count at 12 to 24 hours was 18,482 +/- 6,600/microliters, gradually decreased to 9,817 +/- 2,496/microliters during 14 to 30 days. The ratio of immature to total neutrophils between 1-12 hours was 0.07 and 12 hour to 30 day was 0.04-0.05. The mean platelet counts in the first 72 hours was between (280 +/- 69) x 10(3)-(285 +/- 93) x 10(3)/microliters, it increased thereafter until 30 days old with a peak of 402 x 10(3)/microliters during 7-14 days. The platelet counts below 150 x 10(3)/microliters in the newborn period should be considered as thrombocytopenia.

Age Factors↗
PubMed1993

Surgical orthopedic correction of hemophilic hemarthrosis at Ramathibodi Hospital.

During 1982-1992, 15 major surgical orthopedic correction (SOC) were performed in 12 hemophiliacs. There were 11 synovectomy, 2 osteotomy, 1 currettage and suture wound, 1 release of multiple joint contracture and 1 removal of pseudotumour. During 1982-1989, frozen cryoprecipitate was entirely used for replacement therapy in 5 cases who had 7 SOC. During 1990-1992, 7 cases received SOC by using factor VIII concentrate (Emoclot or Profilate) alone or combined with cryoprecipitate in 8 SOC. Multiple surgical procedures could be performed by using factor VIII concentrates. The orthopedist could operate 3 joints in one setting ie right knee, left knee and right middle finger. There are many advantages of factor VIII concentrates over those of cryoprecipitate, especially in the aspect of HIV transmission by HIV seronegative blood products. The disadvantage is the extremely high cost of factor concentrates.

Adolescent↗
PubMed1993

Developing and maintaining the hemophilia program in Thailand.

Developing of the hemophilia program in Thailand during 1978-1990 has been achieved step by step as follow: 1. In 1978, organizing a series of scientific conferences to motivate and recruit expert teams and to have support from the health authority. 2. In 1978, a national survey of hemophilia which showed an incidence of 1:13,000 of population. 3. Training medical and paramedical personnel during 1973-1992. 4. In 1980, establishment of the National Hemophilia Society. 5. Improvement of blood bank and blood product supported by National Blood Center, Red Cross Society during 1960-1992. 6. In 1981, submitting hemophilia program to the 5th National Health Developmental Plan for 1982-1986. 7. Establishment of a nationwide hemophilia care program by integration with the national health care system. 8. In 1979, starting a home care program and initiation of comprehensive hemophilia care. 9. In 1982, promotion of comprehensive hemophilia care surgical orthopedic correction. 10. Promotion of local manufacture of equipment, reagents, therapeutic material and modification of technology. 11. In 1987, carrier detection. 12. In 1990, laboratory set up for prenatal diagnosis. The future plan is described for the years 1992-2000.

Blood Banks↗
PubMed1990

Acquired aplastic anemia in children: a review of 100 patients.

A retrospective study of acquired aplastic anemia in 100 Thai children treated with testosterone and prednisolone during 1969 to 1987 is reported. The age ranged from 3-14.5 years (mean 10.3 years). The male to female ratio was 2.3:1. The duration of follow up ranged from 1-17 year (mean 5 years). Prior exposure to possible etiologic agents was found in 36% : antipyretics, Ya-chood, insecticides, benzene, chloramphenicol and paint. The presenting symptoms were bleeding and anemia 72%, fever with either bleeding or anemia 28%. The common sites of bleeding were purpura, epistaxis, gum and teeth, and the gastrointestinal tract. All patients received appropriate supportive treatment and testosterone combined with prednisolone. The results of treatment were evaluated in 80 cases who were followed up until death or at least one year after the diagnosis. Two-thirds of the patients presented with laboratory findings similar to severe aplastic anemia; the fatality rate was 50% (40/80). Most of them succumbed to infection or bleeding in the first 6 months after diagnosis. The recovery rate was 50% with complete, partial and initial responses in 28%, 17% and 5% respectively. The late malignancy rate was 2%. For severe aplastic anemia or for patients who have poor prognostic factors, early approaches of bone marrow transplantation or antilymphocyte globulin administration should be considered.

Adolescent↗
PubMed1989

Heparin cofactor II in adults and infants with thrombosis and DIC.

Heparin cofactor II (HC II) was measured by a chromogenic activity assay in normal preterm infants (gestational age, 28-36 weeks; n = 17; 29% +/- 11.5 [mean +/- 1 SD], range 11-51), normal full-term infants (n = 18; 49% +/- 6.6 [mean +/- 1 SD], range 36-58), and normal adults (n = 38; 101% +/- 14 [mean +/- 1 SD], range 73-130). Normal children attained adult levels at approximately 5 to 7 months of age. The lower values in preterm and term infants most likely reflect immature liver function. Neither adults and children with a history of thrombosis with prior negative evaluation (n = 74), patients with documented protein C and protein S deficiency (n = 4), nor sick infants without evidence of consumptive coagulopathy (n = 15) had significantly lower levels of HC II activity. Infants with disseminated intravascular coagulation (n = 2) had strikingly lower levels of HC II activity.

Disseminated Intravascular Coagulation↗
PubMed1989

Exchange transfusion and pulse steroid therapy in a hemophiliac with inhibitor.

In Thailand, the management of bleeding in hemophiliacs with inhibitor is still a challenging aspect. The source of Factor VIII is locally prepared fresh frozen plasma and cryoprecipitate. The Factor VIII concentrate and other commercial blood products are not available because of the remarkably high price. Successful management of bleeding in a 3-year-old hemophiliac boy with moderate inhibitor level (11.82 BU) was reported. He had active bleeding from a 1 cm size cut wound at upper gingivo-buccal fold and did not respond to local measures and supportive treatment. He received exchange transfusion, intravenous cyclophosphamide and high dosage of cryoprecipitate. The bleeding stopped and the inhibitor declined to 2.6 BU. A week later, the bleeding recurred with an anamnestic response of inhibitor to 5 BU. The second exchange transfusion and methylprednisolone as pulse steroid therapy were given daily for 3 days. No cryoprecipitate was infused. The bleeding gradually stopped within 48 hours and the inhibitor level declined to 3.2 BU which was still at low level for at least 2 months. Exchange transfusion and methylprednisolone as pulse steroid therapy may be an alternative treatment for controlling bleeding in a hemophiliac with moderate inhibitor level in countries where a high concentrate of Factor VIII or other blood products are not available. It is practical, simple, effective and of low cost.

Blood Transfusion↗
PubMed1989

Results of the splenectomy in children with thalassemia.

Sixty-nine children with beta-thalassemia/E disease, hemoglobin H disease and beta-thalassemia major who were followed for at least 2 years before and after splenectomy were studied retrospectively for the results of the splenectomy. It was found that. 1. The hematocrit increased significantly in beta-thalassemia/E from 18 to 22 per cent, in hemoglobin H disease from 21 to 34 per cent and in beta-thalassemia major from 14-15 to 18-19 per cent. 2. The requirement of blood transfusions per year decreased significantly from 6 to 2 times in beta-thalassemia/E, 10 to 4-5 times in beta-thalassemia major and no transfusion was needed in hemoglobin H disease. 3. Postoperatively, there was a significant increase (p less than 0.05) in the liver size by the third year in beta-thalassemia/Hb E disease, and in the first year in beta-thalassemia major but the liver-size was decreased significantly by the fourth year in hemoglobin H disease. 4. Within 2 years postoperatively, the growth velocity in height kept up with their presplenectomy period in hemoglobin H and beta-thalassemia major (except two cases). The growth in weight kept up with their presplenectomy period in 40/49 cases (81.63%) in beta-thalassemia/Hb E but there was no change in the weight velocity in hemoglobin H and beta-thalassemia major. 5. There were 5 cases with immediate postoperative complications. Three cases had pneumonia, one case had septicaemia and one case had bleeding at the operative wound. Episodes of URI decreased in the post-operative period. Five cases of bacteremia developed within 6 years post-splenectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Rubber band technique for slow subcutaneous infusion of desferrioxamine (Desferal).

The DF given weekly by the RBIT in 14 thalassemia/hemoglobinopathy patients decreased the frequency of URIs and febrile illnesses in 5/10 patients. Five of the six patients had absence of frequent enteritis. There were no instances of pneumonia and otitis media in two patients with frequent infections before DF. Skin color was improved within 3 months. Most of the patients became more active at the same hematocrit level. The height and weight in eight patients was normal. The total number of blood transfusions in all patients was significantly decreased. It is advisable to use weekly DF infusion by RBIT in the patient who cannot afford to use the infusion pump and the full program of iron chelation.

Adolescent↗
PubMed1987

Home therapy for hemophilia in Thailand.

The home therapy for hemophilia in Thailand was initiated in 1979. The therapeutic material first used was frozen cryoprecipitate or fresh frozen plasma and later fresh dry plasma (FDP). During 1979-1982, ten patients attended regular home therapy. All of them lived in the rural area which were far from the provincial hospitals. The age ranged from 7 to 15 years with a mean age of 10 years. The duration of follow up ranged from 7 months to 7 years with a mean duration of 3 years. The utilized blood products as FDP varied from 3 to 30 bottles per year with a mean of 16 bottles per year or 0.5-2.9 bottles per kilogram body weight per year which increased gradually as the patients grow up. A total of 252 episodes of bleeding was recorded; mostly hemarthrosis 70% and muscular bleeding 19%. There was no any further disability detected in 6 cases (60%). The significant advantages were the reduction in admission rate from 6-8 admission per year to 0-1 admission per year; economic savings; psychological independence of well being and having a normal life. The disadvantage were inadequate dosage of infused material, delayed consultation and transfer which were preventable. Home therapy for hemophilia by using FDP is recommended for any developing country. It is safe, practical, efficient enough to preserve normal joint status and prevent disability.

Adolescent↗