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Biomedical subjects

Boonchai Uerpairojkit

Publications and source records attributed to Boonchai Uerpairojkit.

17 recordsLinked to original sources
PubMed2006

Interventricular septal thickness of Thai fetuses: at 32 to 35 weeks' gestation.

OBJECTIVE: To establish the normal value of fetal InterVentricular Septal Thickness (IVST) from 32 to 35 weeks' gestation in Thai fetuses. MATERIAL AND METHOD: Thai pregnant women with normal fetuses were recruited for prenatal 2-dimensional M-mode echocardiographic measurements of fetal IVST at 32 to 35 weeks' gestation. All had a confirmed gestational age, normal structural scanning and negative diabetic screening at 24 to 28 weeks 'gestation. The IVST was measured from the 4-chamber view during diastole and systole. The 5th, 50th and 95th percentile of the IVST during Diastole (IVSD) and the IVST during Systole (IVSS) were demonstrated The relationship between the IVSD and IVSS and gestational age were determined RESULTS: A total of 410 measurements were obtained. The normal values of the IVSD and IVSS according to gestational age were presented as 5th, 50th and 95th percentile ranks. The correlation coefficients (r) between the IVSD and IVSS and gestational age were 0.11 and 0.12, respectively. The IVSD and IVSS were not statistically different with advancing gestation. The 95th, percentile of the IVSD was 4.51 millimeters (mm) (range = 4.26 to 4.74 mm) and IVSS was 6.23 mm (range = 5.96 to 6.68 mm). The intraobserver variability was 7.6%. CONCLUSION: The normal values of fetal IVSD and IVSS in a Thai population from 32 to 35 weeks' gestation were established. This could be used as a baseline data in detecting the asymmetrical septal hypertrophy during fetal life.

Adult↗
PubMed2006

Nasal bone hypoplasia in trisomy 21 at 15 to 24 weeks' gestation in A high risk Thai population.

OBJECTIVE: To assess the utility of nasal bone hypoplasia in the detection of fetuses with trisomy 21 in the second trimester in a high risk Thai population. MATERIAL AND METHOD: A prospective study involving pregnant women undergoing amniocentesis due to increased risk of aneuploidy from January 2005 to December 2005. Fetal biometry and nasal bone measurements were obtained at the time of amniocentesis. Linear regression model and diagnostic tests were analyzed using the SPSS computer program. RESULTS: A total of 407 fetuses were evaluated. In euploid fetuses, the Nasal Bone Length (NBL) increased linearly with advancing gestational age. Fetuses with Down syndrome had a significantly higher proportion of NBL below the 5th centile when compared with normal fetuses (p < 0.05). The optimal nasal bone threshold associated with trisomy 21 is a BiParietal Diameter/Nasal Bone Length (BPD/NBL) ratio of 10 or greater, yielded a sensitivity of 80%, specificity of 86% for detection of trisomy 21. CONCLUSION: Nasal bone hypoplasia is associated with an increased risk of Down syndrome in the presented population.

Adult↗
PubMed2005

Intrauterine therapy for fetal supraventricular tachycardia in a twin pregnancy.

A case of a twin pregnancy in which one fetus developed hydrops secondary to supraventricular tachycardia was detected at 21 weeks' gestation. Transplacental digoxin therapy successfully converted the supraventricular tachycardia to a normal sinus rhythm without evidence of maternal or fetal side-effects. The pregnancy proceeded to term and elective cesarean section was carried out at 37 weeks' gestation.

Adult↗
PubMed2005

Searching for medical ethics in Dharma conversation.

Our medical ethics team has a great opportunity to consider the terminology of"Moral Rights", "Good guys", "Understanding the real world" and the issues about "live salvation". What has been mentioned about these terms in Buddhism? In Buddhism, it has been cited that moral duty is the cause that leads to the moral rights as result. When we act the right as well as decent things, we are entitled to get the fair deals in return. We used to forget to consider that, isn't our moral duty or not?, to just either pay respect to the other people's rights or simply protect the other people's rights. Regarding to the Buddhism religion, there are a certain criteria to be "Good guys" i.e. firstly, not to make any sin at all such as not to exploit the others physically, verbally and mentally. Secondly, to make merits, such as helping out; showing the mercy and kindness to the underprivileged; donating money, land and properties, or even sharing the justified idea is also included. We also forgot to ask about tempting the others with a certain of hindrance i.e. assets, land and properties. Have you already made the sin with these temptations or dominating the idea of people? How the people will understand the fine line between the sin and meritorious deed? Buddhism kindly advises us to understand and consider the real world in two steps as well as in parallel way. Looking around us as surrounding of illusion. These illusion or fantasies will not be sustainable, only temporarily indeed. For example, human being has to go through aging process, illness and eventually death. What we need to consider in parallel is the matter about "Within us". What is the secret issue about "Within us"? Brain, spirit, heart or extremities, wherever we point at, will be just only human biological tissues or various elements. Last, but not least, practicing salvation when you still alive is perplexing. Live salvation is already existed within us, nowadays. No need to wait for the next life. Salvation can exist when we still alive. Salvation is to purify our spirit which require proper training to keep it clean in sustainable way.

Buddhism↗
PubMed2005

Ethics and the comprehensive application of epistemology in medical practice.

Our simple definition of ethics is good thought, speak and action. Epistemology means the hypothesis of facts about thought, speech and action. Medical practice is all means of medicine. Medicine classifies people into normal and abnormal. The abnormal are the sick. They loose some organs or those normal looking organs are dysfunctional. They are social problems, some can be treated, and some do not get the appropriate care. The problems of society of normal people are overeating and obesity, abortion, drug abuse, promiscuity, torture, terrorism, disobeying rules and order, corruption, brain-washing and unethical advertisements, etc. On the other hand, the social problems of the abnormal are down, deafness, blindness, dumb, hypertension, hypercholesterolemia, diabetes mellitus and cancer, etc. An example of the social-doctor problem is the mal distribution of doctors in rural areas. It was reported by the ministry of public health that the ratio of doctor to population to be 1:800 in Bangkok and 1:5, 700 in some rural areas in the north eastern part of Thailand. The doctors, themselves, are at a high grade of worker and intelligent quotient. They know all the problem and, at the same time, create problems, both, faster than the general population can do. It affects good and bad in the society. In the past, present and the foreseeable future the medical students get their studies in the western style. Their medical schools are situated in big cities. These schools are old and famous. They learn their medical procedure in a big hospital of more than 400 beds in the inpatient department wards. Their instructors and professors are highly qualified, are middle class people and well accepted in the society. Their families are lovely and warm. Their children study in the first class schools in town. The medical students feel very happy and appreciate seeing their professors in television routinely at prime time. In conclusion, their professors are an example of role model for them to follow. Everyone looks for security in her/his profession. Facts need no proof and reference. People with justice in mind should believe and understand the above mentioned. This leads to the problem of mal distribution of doctors in rural areas, why do doctors live in big cities or wish to be in the private sector? In fact, not many a number of doctors serve in the rural area. About 4-5 of them, their name will be announced yearly as the best rural doctor award. After the big ceremony, lasted not longer than a month, it is hard to remember their name. They are proud to be praised, it pushes them into stress intentionally with all the best of their intelligence and the total of their body strength to work harder in rural. Unfortunately their earning, the security of their profession, the increased chance of being sued, to get caught in the medical litigation, the expenses of their family social status and the study of their children cannot be compared to of those doctors in big city and/or in the private sector. Mal distribution of doctors in remote rural areas has been a persisting unresolved problem in many parts of the world, why not apply the principles of ethics and epistemology? They have been left, untouched forever.

Career Choice↗
PubMed2004

Random urinary protein-to-creatinine ratio for prediction of significant proteinuria in women with preeclampsia.

OBJECTIVE: To evaluate the accuracy of random urinary protein-to-creatinine ratio for prediction of significant proteinuria in women with suspected preeclampsia. METHODS: A prospective study was conducted in hospitalized pregnant women with a suspicion of preeclampsia. Random mid-stream urine specimens were obtained for protein-to-creatinine ratio determination, and then participants were instructed to collect 24-h urine samples for protein measurement. With the criterion of 24-h proteinuria of at least 300 mg as a significant proteinuria, the sensitivity and specificity of a random urinary protein-to-creatinine ratio of > or = 0.19 for prediction of significant proteinuria were analyzed and a receiver operating characteristic curve was constructed to determine the optimal cutoff value. RESULTS: Forty-two patients completed the study. Sixty-nine percent of the study population had significant proteinuria. A cutoff of 0.19 demonstrated a sensitivity of 100% and a specificity of 53.8%. A ratio below 0.22 could rule out a significant proteinuria. The optimal cutoff value is 0.25 which yielded sensitivity, specificity and accuracy of 96.6%, 92.3% and 95.2% respectively. CONCLUSION: In hospitalized preeclamptic patients, the random urinary protein-to-creatinine ratio at a cutoff of > or = 0.25 revealed a highly accurate prediction of significant proteinuria and could be a more practical alternative for assessment of proteinuria.

Adolescent↗
PubMed2004

First trimester umbilical cord and vessel diameters of Thai fetuses.

OBJECTIVE: To establish the reference ranges for first trimester umbilical cord and vessel diameters of Thai fetuses. MATERIAL AND METHOD: A prospective study was performed on normal pregnant women between 10(+0) and 13(+6) weeks of gestation who underwent ultrasound examination. The diameter measurements were obtained by a 7.5 MHz vaginal--or a 3.75 MHz abdominal transducer. Statistics were analyzed using SPSS computer program. RESULTS: Records of 184 pregnancies were analyzed and the outcome demonstrated a strong correlation between umbilical cord diameter and gestational age (r = 0.90; p < 0.001). Umbilical vessel diameters were also correlated with gestational age. CONCLUSION: First trimester umbilical cord and vessel diameters of Thai fetuses are related to gestational age. The presented reference ranges might be useful for further studies, such as prediction of adverse pregnancy outcome or combination with biochemical or other ultrasound markers for fetal aneuploidy screening.

Adult↗
PubMed2004

The management of acardiac twins at King Chulalongkorn Memorial Hospital: case series.

Acardiac twin is a rare event with high perinatal mortality rate and the management strategies remain controversial. The authors report 4 cases of twin pregnancies associated with one acardiac twin diagnosed at King Chulalongkorn Memorial Hospital during the period 1993 to 2002. Two cases were expectantly managed and intrauterine interventions were performed in order to occlude umbilical artery of the acardiac twin in 2 cases, by using Guglielmi detachable coil (GDC) embolization and absolute alcohol injection. Overall, the perinatal mortality rate for the pump twin was 50% and the survival rate of expectant management in the present series was 100%. GDC embolization was judged to be technically successful since it completely occluded the circulation to the acardiac twin. However, the pump twin was dead which might have resulted from the compromised state due to cardiac failure. At present, it seems that conservative management with close antenatal surveillance is the treatment of choice when the twin-weight ratios are substantially less than 70%. Invasive techniques should be considered when there is ultrasound evidence of hydramnios or congestive heart failure of the pump twin at a previable gestational age.

Adult↗
PubMed2003

Correlation between random urinary protein-to-creatinine ratio and quantitation of 24-hour proteinuria in preeclampsia.

OBJECTIVE: To determine whether random urinary protein-to-creatinine ratio correlated with the quantitation of 24-hour proteinuria in cases of preeclampsia. DESIGN: Cross-sectional descriptive study. SUBJECTS: Pregnant patients hospitalized in the obstetric ward, King Chulalongkorn Memorial Hospital due to preeclampsia. METHOD: The random urine specimens were obtained from the eligible subjects for protein-to-creatinine ratio determination, the subjects were then instructed to collect 24-hour urine samples for protein measurement. RESULTS: Twenty-five pregnant patients completed the study. There was a strong correlation between the random urinary protein-to-creatinine ratio and the quantitation of 24-hour proteinuria (r = 0.929, p < 0.001). CONCLUSION: The presented data support a strong correlation between random urinary protein-to-creatinine ratio and quantitation of 24-hour proteinuria in hospitalized pregnant patients with preeclampsia.

Adolescent↗
PubMed2002

Value of humerus length shortening for prenatal detection of Down syndrome in a Thai population.

OBJECTIVE: To assess the value of humerus length shortening for prenatal detection of Down syndrome in a Thai population. METHODS: A prospective study was performed on 3053 women undergoing second-trimester amniocentesis, between 16 and 24 weeks gestation, for the indications of advanced maternal age and a past history of chromosomal abnormality. Biparietal diameter (BPD) and humerus length measurements were obtained before the procedures. Regression equations relating BPD to humerus length were used to calculate observed humerus length/expected humerus length ratio in chromosomally normal and Down syndrome fetuses. Sensitivity, specificity, false-positive rate and likelihood ratio of a positive test result at various observed humerus length/expected humerus length ratios for detection of Down syndrome were calculated. A receiver-operator characteristic curve was used to determine the threshold screening ratio. RESULTS: There were 3003 chromosomally normal pregnancies and 24 fetuses with Down syndrome. The relationship between humerus length and BPD was: expected humerus length = 0.7403BPD - 5.1057, R2= 0.77, P < 0.001. Humerus length in Down syndrome fetuses was significantly shorter than in normal fetuses (P < 0.001). A ratio of 0.91 for observed humerus length/expected humerus length yielded a sensitivity of 41.7%, specificity of 88.3%, a false-positive rate of 11.7% and likelihood ratio of a positive test result of 3.63 (95% confidence interval 2.24-5.88) for detection of Down syndrome. CONCLUSIONS: Humerus length shortening in the second trimester appears to be a useful adjunctive screening parameter for fetal Down syndrome in a Thai population.

Amniocentesis↗
PubMed2002

Reference ranges for Doppler indices of uterine arteries in pregnant women during 22-28 weeks' gestation: a study at King Chulalongkorn Memorial Hospital.

Color pulsed Doppler ultrasound was used to examine the uterine arteries of a total of 265 normal pregnant women during 22-28 weeks' gestation at the Division of Maternal-Fetal Medicine, King Chulalongkorn Memorial Hospital. Reference ranges for pulsatility index (PI) were determined and throughout this gestational range, the mean values were nearly constant and lower than 0.9 and the upper limit of 95 per cent confidence interval (CI) for the PI values were lower than 1.0. In conclusion, the authors have established the reference ranges for PI of uterine arteries in the late second to early third trimester of pregnancy in Thai pregnant women. This could be beneficial for the baseline data in the evaluation of pregnant women complicated with preeclampsia and fetal growth restriction.

Adolescent↗