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C Tuchinda

Publications and source records attributed to C Tuchinda.

16 recordsLinked to original sources

The epidemiology of insulin-dependent diabetes mellitus (IDDM): report from Thailand.

The epidemiology of diabetes mellitus in Thai children aged 0-15 years was studied in 1985 and compared with a previous study done in 1984. Four hundred and seventy-six questionnaires were sent each year to hospitals in Thailand. In 1984, thirty-six cases of newly diagnosed diabetes mellitus were found of which 35 were IDDM and one was NIDDM. In 1985, twenty-seven cases of new IDDM were found, no case of NIDDM was reported. Two cases of MRD were reported from the Northeastern and Southern part of Thailand. The incidence of IDDM in the whole kingdom of Thailand was 0.19/100,000/year in 1984 and 0.14/100,000/year in 1985. The male to female ratio was 1:1.5 in 1984 and 1:2 in 1985. The peak age at diagnosis showed the main peak at 14 years old in boys. The peak age of girls preceded boys by 1-2 years in 1984 and 1985. Similar findings in 1984 and 1985 were the onset of symptoms showing a seasonal variation with highest frequency in winter with a slight change of increased incidence in the rainy season of 1985. There was an increased incidence of IDDM in families with lower educational and socioeconomic levels. The newly diagnosed IDDM with DKA was 16.2, and 19.5 per cent in 1984 and 1985. The incidence of IDDM in Thai children, aged 0-15 years seems to be the lowest compared to other countries previously described which might be due to some genetic and environmental including diet, micronutrient, eating habits and life-style which might play a role in the difference.

Adolescent

Diagnostic significance of pH, lactic acid dehydrogenase, lactate and glucose in pleural fluid.

The pH, lactic acid dehydrogenase, lactate and glucose of pleural fluid simultaneous with serum lactic acid dehydrogenase, blood lactate and glucose were determined in 105 pediatric patients. The patients were classified into groups according to the diagnosis. The pleural fluid of empyema cases was found to have the lowest pH with a mean value of 6.83 (p less than 0.0075). The malignant pleural fluid has a relatively low pH with a mean value of 7.32. The lactic acid dehydrogenase in pleural fluid of empyema cases has the highest mean of 1,470.68 (p less than 0.05). The lactic acid dehydrogenase was found increased in malignancy, tuberculosis and parapneumonic effusion cases. Lactate level was found extremely high in empyema cases with a mean value of 13.68. It was also found extremely high in malignancy, tuberculosis and parapneumonic effusion cases. The glucose level was markedly decreased in empyema cases. There exists correlation of pleural fluid lactate to pH, lactic acid dehydrogenase and glucose, as well as that of pH to lactic acid dehydrogenase.

Child

Diabetic education, special consideration of Oriental patients.

The important of patient education program in the management of diabetes has been widely recognized. We studied to find out in general what the patients and their parents know about diabetes and their self-care by using a questionnaire. Then, the diabetic education was given by one-to-one basis to every patient. Thirty four insulin-dependent diabetes mellitus attended the diabetic the clinic at Siriraj Hospital, Bangkok age ranged from 4 to 22 years with peak age at 11 to 15 years. Male to female ratio was l:i. Majority came from low socioeconomic families. 23.5 percent were from separated families, one patient lived with neither her mother nor father. Only one patient had home glucose monitoring. Fourteen cases (41.2%) had been hospitalized with diabetic ketoacidosis (DKA) over the past year, however, there was no statistically significant difference between admission with DKA and low socioeconomic status. In addition to insulin, there were 8 patients taking herbs to cure diabetes. Only 6 patients were able to follow their meal plan and only one case ever used the food exchange list. Most patients accepted being diabetic and attended the clinic regularly mainly to get financial supports. The situation in our country is different from that in the western countries as the patients are low in literacy and socioeconomic status. A well-planned educational programme is essential to cater to the need to the oriental patients.

Adolescent