Biomedical subjects

Dittakarn Boriboonhirunsarn

Publications and source records attributed to Dittakarn Boriboonhirunsarn.

14 recordsLinked to original sources

PubMed2026

Genetic determinants of gestational diabetes mellitus in thai pregnant women: role of GCKR, CDKAL1, TCF7L2, NEDD1, and CMIP variants.

BACKGROUND: Gestational diabetes mellitus (GDM) has a high global prevalence and arises from complex interactions between genetic predisposition and environmental factors. GDM is associated with metabolic disturbances and chronic low-grade inflammation, both of which contribute to its pathogenesis. This study aimed to investigate the association between GDM and 135 single-nucleotide polymorphisms (SNPs) across 20 genes related to metabolic traits. METHODS: In this case-control study, 152 pregnant women with GDM and 684 pregnant women with normal glucose tolerance (NGT) who underwent antenatal examination at Siriraj Hospital, Bangkok, were enrolled. Clinical data and blood samples were collected from all participants. Genomic DNA was isolated and subjected to whole-genome sequencing using the DNBSEQ-T7RS high-throughput sequencing platform. Genotype analyses were performed using R software, and haplotype analyses were conducted using the online SNPStats software. RESULTS: After adjusting for maternal age and pre-pregnancy body mass index, polymorphisms in TCF7L2 (rs34872471, rs7901695, rs4506565, rs7903146, rs12243326, and rs12255372), NEDD1 (rs10431408, rs11830756, rs249579, rs249585, and rs4762339), CMIP (rs2306115 and rs201681534), CDKAL1 (rs4710942), GCKR (rs2293572 and rs2293571), and GCK (rs5883890) were significantly associated with the risk of GDM. Haplotype analysis demonstrated that the TCF7L2 rs12243326-rs12255372 CA haplotype was associated with a decreased risk of GDM (OR = 0.44, 95% CI: 0.23-0.81), while the NEDD1 rs249579-rs249585-rs4762339 GGT haplotype was associated with an increased risk of GDM (OR = 1.40, 95% CI: 1.08-1.82). CONCLUSIONS: These findings suggest that genetic variations in TCF7L2, NEDD1, CMIP, CDKAL1, GCK, and GCKR contribute to GDM susceptibility in the Thai population.

Humans↗

PubMed2006

Non-compliance to clinical practice guideline for screening of gestational diabetes mellitus in Siriraj Hospital.

OBJECTIVE: To evaluate the rate of non-compliance to Clinical Practice Guideline (CPG) for screening of Gestational Diabetes Mellitus (GDM) and related factors in Siriraj Hospital. STUDY DESIGN: Descriptive cross-sectional study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. MATERIAL AND METHOD: One-hundred-and-fifty-nine pregnant women at risk for GDM and who delivered at Siriraj Hospital were enrolled Data were collected from history and medical records including base line characteristics, clinical risk factors of GDM, and compliance to guideline. Rate of non-compliance and related factors were evaluated RESULTS: The rate of non-compliance to GPG for screening of GDM at Siriraj Hospital was 22% (95%CI 16.3%-29.1%). The rate was highest among women who had AnteNatal Care (ANC) at a private clinic (82.1%), followed by the private cases in the hospital (40%). Those who received ANC at the hospital had the lowest non-compliance rate of 6.6%. The most common neglected risk factor was maternal age > or = 30 years. Significant higher compliance was found among women with 2 or more clinical risk factors compared to those with only 1 risk factor (p = 0.028). CONCLUSION: The rate of non-compliance to CPG for screening of GDM at Siriraj Hospital was 22%. Highest non-compliance rate was found among the private cases. The most common neglected risk factor was maternal age > or = 30 years.

Adult↗

PubMed2005

Menopausal symptoms and knowledge towards daily life and hormone replacement therapy among menopausal women in Bangkok.

OBJECTIVE: To evaluate prevalence and intensity of menopausal symptoms, knowledge towards daily life and hormone replacement therapy (HRT) among natural menopause women in Bangkok. DESIGN: Cross-sectional, descriptive study. MATERIAL AND METHOD: One hundred and sixty two natural menopause women who attended the health seminars or exhibitions except topics about menopause and HRT in Siriraj Hospital from March - June 2005. Targeting women were asked to fill out the structured questionnaires. Data concerning personal history, menopausal symptoms, knowledge of menopause, HRT and daily life in menopause were collected. RESULTS: A total of 148 questionnaires (91.4%) were completed for the analyses. Of 148 women, 141 (95.3%) had menopausal symptoms. The most common and most severe menopausal symptom was muscle and joint pains (84.5% and 23.0%, respectively). The majority of the women understood correctly regarding knowledge about menopause issue and daily life during menopause (80.6% and 89.2%, respectively). Although 51.1% of the women showed their knowledge about HRT correctly, only 8.1% were currently using HRT. The main reasons for this low percentage of HRT use were ability to tolerate the menopausal symptoms (49.0%) and lack of correct knowledge about HRT (48.9%). CONCLUSION: The most common and also the most severe menopausal symptom in natural menopause women was muscle and joint pains. Most of them demonstrated their correct understandings about menopause issue and daily life in menopause and half of them demonstrated their correct understandings about HRT.

Adult↗

PubMed2005

Prevalence and risk factors for residual cervical neoplasia in subsequent hysterectomy following LEEP or conization.

OBJECTIVES: The purposes of the present study were to determine the prevalence of residual disease in the hysterectomy specimens following cold knife conization (CKC) or loop electrosurgical excision procedure (LEEP) and to evaluate the predictive factors for residual disease. DESIGN: Descriptive study SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital. SUBJECTS: A total of 120 patients who underwent hysterectomy after either LEEP or CKC. MATERIAL AND METHOD: The medical records of 120 women were reviewed to estimate the prevalence of residual disease.. The patients' characteristic and pathologic parameters were analyzed for the risk factors of residual disease. Chi square test and Student t test were used for statistical analysis. RESULTS: Of the 120 patients, 46 cases had residual disease in their hysterectomy specimens so the prevalence was 38.3% (95% CI 29.5, 47.2). Invasive cervical cancer was found in the hysterectomy specimens in 4 cases (8.7%). Only ectocervical margin was the predictive factor of residual disease in the hysterectomy specimen (p = 0.002). Age, conization pathologic findings, glandular involvement, endocervical margin status, stromal invasion, and endocervical curettage results were not predictive factors for residual disease in the hystectomy specimens. CONCLUSION: Residual disease was found in 38.3% of hysterectomy specimens after conization. Also undiagnosed invasive cervical cancer was found. Careful examination for residual disease in hysterectomy specimens should be performed, especially among those with positive cone margin.

Adult↗

PubMed2004

Accuracy of frozen section in the diagnosis of malignant ovarian tumor.

AIM: To evaluate the diagnostic accuracy of frozen section for histopathologic diagnosis of ovarian tumors. METHODS: A total of 147 surgically removed ovarian tumors were studied. Each ovarian tumor sample was evaluated for histopathologic diagnosis using both frozen and paraffin sections. Interpretation was separate and blinded between each technique. Accuracy, diagnostic values and their 95% confidence intervals (CI) were estimated by comparing the results from both techniques, using paraffin section as a gold standard. RESULTS: Overall accuracy of frozen section was 89.8% (95% CI 83.4-94.0). Sensitivity was 90.4% (95% CI 78.2-96.4) for malignant, 33.3% (95% CI 6.0-75.9) for borderline, and 93.3% (95% CI 85.4-97.2) for benign tumors. The predictive value was 100% (95% CI 90.6-100) for malignant, 20% (95% CI 3.5-55.8) for borderline, and 92.2% (95% CI 84.1-96.5) for benign tumors. Most false negatives occurred in mucinous and borderline tumors. No benign tumor was misdiagnosed as malignant by frozen section. Accuracy and negative predictive value were significantly lower in epithelial rather than germ and other cell types. Excellent agreement with regard to histologic cell type was observed (Kappa 0.81). CONCLUSION: Frozen section appears to be an accurate technique for the histopathologic diagnosis of ovarian tumors. Some limitations were observed among borderline and mucinous tumors; this emphasizes the great value of frozen section in the diagnosis of ovarian tumors.

Adult↗

PubMed2004

Accuracy of transvaginal ultrasound for the evaluation of myometrial invasion in endometrial carcinoma.

OBJECTIVE: To evaluate the accuracy of transvaginal ultrasound for the evaluation of myometrial invasion in endometrial carcinoma in comparison with standard paraffin section. METHOD: A total of 111 patients with endometrial carcinoma diagnosed from fractional curettage underwent pre-operative transvaginal ultrasonography to assess myometrial invasion. Operation for surgical staging was subsequently performed and the hysterectomy specimen was evaluated for depth of myometrial invasion by standard paraffin section blinded from transvaginal ultrasound results. Final histopathologic diagnosis and depth of myometrial invasion were obtained from standard paraffin section. Ultrasonographic assessment was compared with the histopathological results. RESULTS: In evaluation of myometrial invasion, transvaginal ultrasound yielded the sensitivity of 69.4 per cent, specificity of 70.6 per cent, positive predictive value of 53.2 per cent, negative predictive value of 82.8 per cent, and accuracy of 70.3 per cent. The accuracy, sensitivity, specificity, negative predictive value, false positive and negative rates were comparable between grade 3 and grade 1 and 2 tumors. However, the positive predictive value was significantly higher among grade 3 than grade 1 and 2 tumors. The Kappa coefficients were 0.57 and 0.22 for grade 3 and grade 1 and 2 tumors respectively. CONCLUSION: Transvaginal ultrasound for assessment of depth of myometrial invasion in endometrial carcinoma provided acceptable accuracy compared with standard paraffin section. This technique might be of value for the decision making in the intra-operative management of endometrial carcinoma.

Carcinoma, Endometrioid↗

PubMed2004

Correlation of uterine cervical length measurement from transabdominal, transperineal and transvaginal ultrasonography.

OBJECTIVE: To investigate the feasibility of transperineal ultrasonography for uterine cervical assessment by determining the correlation of uterine cervical length measurement from transabdominal, transperineal and transvaginal ultrasonography and comparing discomfort arising from each technique. MATERIAL AND METHOD: Fifty pregnant women of 37 weeks' gestation or later who gave consent participated in this research. They had no exclusion criteria, which were listed as the following: preterm premature rupture of membranes, previous cervical surgery, undiagnosed vaginal bleeding, and true labor pain. They all underwent transabdominal (3.5-MHz curvilinear transducer), transperineal (3.5-MHz curvilinear transducer) and transvaginal ultrasonography (7.5-MHz curvilinear endovaginal transducer). The uterine cervical length was measured from the straight line between the external and internal os. If either of the external or internal os was not clearly demonstrated, the authors would justify the cervical length as non-measurable. Measurement in each technique was performed twice and the mean cervical length was used for data analysis. Discomfort arising from each technique was evaluated by visual analog scale. RESULTS: Uterine cervical length was measurable in 23 (46%), 49 (98%) and in all cases by transabdominal, transperineal and transvaginal ultrasonography respectively. In the transabdominal technique, no significant differences in woman's age, weight, body-mass index and parity were observed between measurable and non-measurable cases. Significant correlation was demonstrated between transperineal and transvaginal ultrasound (r = 0.73, p < 0.01). A significantly higher discomfort score was demonstrated in transvaginal ultrasonography, but no significant difference in discomfort score was found between transabdominal and transperineal ultrasonography. CONCLUSION: Transperineal ultrasonography is feasible for acceptable uterine cervical visualization with only slight discomfort to the patients.

Adolescent↗

PubMed2004

Incidence of gestational diabetes mellitus diagnosed before 20 weeks of gestation.

The objectives of this study were to determine the incidence of gestational diabetes mellitus (GDM) before 20 weeks of gestation and evaluate associated risk factors. A total of 1200 pregnant women who started their antenatal care at Siriraj Hospital before 20 weeks of gestation and were at risk of developing GDM were enrolled. A 50-gram glucose challenge test was used as a screening method and 100-gram oral glucose tolerance test was used to diagnose the condition. All women were screened during their first visit and again at 28-32 weeks of gestation. The results showed that the incidence of GDM diagnosed before 20 weeks of gestation was 5.3% (95% CI 4.1-6.7%), and another 4.9% were diagnosed during 28-32 weeks. This demonstrated the usefulness and effectiveness of the current guideline for GDM screening that approximately half of women with GDM could be diagnosed early in their pregnancies. The 2 independent risks for developing GDM before 20 weeks of gestation were age > or = 30 years and GDM in previous pregnancy (adjusted OR 2.5, 95% CI 1.3-5.0, and 7.1, 95% CI 1.8-27.6, respectively). This specific group of women should be counseled regarding the importance of early GDM screening during their pregnancy.

Adolescent↗

PubMed2004

Reference centile chart for fetal liver length of Thai fetuses.

OBJECTIVE: To create a reference centile chart for fetal liver length of Thai fetuses. DESIGN: Prospective, cross-sectional study. SETTING: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. MATERIAL AND METHOD: A total of 752 pregnant women, who attended the antenatal clinic at Siriraj Hospital, Mahidol University, Bangkok, were recruited between 13-40 weeks of gestation. Each fetus was measured only once for the purpose of this study. Using real-time ultrasound with a 3.5 MHz convex transducer; the authors measured fetal liver length. The mean and standard deviation (SD) were estimated at each week of gestation using linear regression modeling. RESULTS: A total of 750 fetuses were measured for fetal liver length. Linear regression models were fitted to estimate the mean and 95% confidence interval for liver length at each gestation age. The centile chart of liver length was also presented CONCLUSION: A reference centile chart for fetal liver length of Thai fetuses has been created.

Cross-Sectional Studies↗

PubMed2004

Accuracy of Nugent's score and each Amsel's criteria in the diagnosis of bacterial vaginosis.

OBJECTIVE: To determine the diagnostic accuracy of Nugent's score and each Amsel's criterion in the diagnosis of bacteria vaginosis (BV), considering Amsel's criteria as the gold standard. DESIGN: Cross-sectional, descriptive study (diagnostic test) Setting: Family planning clinic, Siriraj Hospital, Mahidol University. SUBJECTS: A total of 217 women who attended the Family Planning Clinic at Siriraj Hospital between August and December 2003. METHOD: Pelvic examination was performed on each participant. Samples of vaginal discharge was tested for BV infection using both Amsel's criteria and Nugent's score. Interpretation was made blinded without knowledge of each test result. Using Amsel's criteria as a gold standard, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Nugent's score and each of Amsel's criteria were estimated. RESULTS: Considering Amsel's criteria as the gold standard, Nugent's score showed a sensitivity of 65.6% (95%CI 46.8%, 80.8%), specificity of 97.3% (95%CI 93.5%, 99.0%), positive predictive value (PPV) of 80.8% (95%CI 60.0%, 92.7%), negative predictive value (NPV) of 94.2% (95%CI 89.7%, 96.9%) and accuracy of 92.6% (95%CI 88.1%, 95.6%). Both vaginal pH and whiff test demonstrated 100% sensitivity. However, vaginal pH showed lower specificity than the whiff test (58.9% and 97.3% respectively). CONCLUSION: Nugent's score might not be suitable to use as a screening test for diagnosis of BV due to its low sensitivity. The whiff test is the best clinical criteria of Amsel's criterion in the diagnosis of BV due to its high sensitivity and specitivity.

Adult↗

PubMed2004

Maternal grief after abortion and related factors.

OBJECTIVE: To investigate maternal grief after abortion and the factors that might relate to the intensity of maternal grief. DESIGN: Cross-sectional, descriptive study. SUBJECT: 132 women who attended the abortion clinic, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Thailand. METHOD: The subjects were asked to complete the questionnaires including demographic characteristics, history of previous pregnancy, and Perinatal Grief scales, two weeks after abortion. The data was then analyzed to determine maternal grief and related factors of grief intensity. RESULTS: There were 7 women with severe grief intensity (5.3%), 50 with moderately grief intensity (37.9%) and 75 with mild grief intensity (56.8%). The factors associated with PGS scores were low income, had had ultrasonography, gestational age of > 16 weeks and methods of treatment. CONCLUSION: Grief is worldwide among women who have recently aborted. The related factors with grief intensity can be used for screening psychological problems of the women who experience abortion. If found, the physicians can closely observe and help them to work through their coping mechanism and prepare them to get another successful pregnancy in the future.

Abortion, Induced↗

PubMed2003

A model for malignancy probability prediction of adnexal masses.

OBJECTIVE: To develop a model for pre-operative malignancy probability determination in a patient with an adnexal tumor or tumors by the application of multivariate logistic regression analysis to variables at the time of pelvic sonography. METHOD: Pre-operative ultrasound examination including Doppler analysis was performed on 117 consecutive women scheduled for surgery because of an adnexal mass or masses. Each tumor was classified as probably benign or malignant using a subjective evaluation system on the gray-scale morphological images. Then, Doppler sonography was carried out. The resistance index (RI) and pulsatility index (PI) of the vessel with the highest velocity were recorded. Multivariate logistic regression analysis was performed with the histological outcome as the dependent variable. Independent variables included patient's age, menopausal status, gray-scale morphological data, RI and PI. The probability of malignancy was formulated from statistical analysis. RESULTS: There were 117 women included in the study, 83 (71%) with histologically benign and 34 (29%) with histologically malignant ovarian tumors. Regression analysis on the five variables resulted in the retention of only patient's age, morphological data and RI as significant contributing factors for malignancy prediction. The probability of malignancy was 1/(1+e(-z)) where e was the base value for natural logarithms and z was the regression equation: -3.6355 + 1.8028 (age) + 2.1047 (morphological data) + 2.9816 (RI). CONCLUSION: A model for estimation of probability of malignancy for an adnexal tumor was derived using multivariate logistic regression analysis. The prediction should be more accurate than that from either gray-scale ultrasound imaging or Doppler velocimetry alone. The test of the model is now on-going.

Adult↗

PubMed2003

Uterine artery resistance index above 95 percentile: prevalence and adverse perinatal outcome prediction in pregnancies complicated by hypertensive disorders.

Uterine artery resistance index (UARI) was determined in a cohort of pregnant women complicated by a hypertensive disorder. The prevalence of the value above 95 percentile (UARI95) and its prediction of adverse perinatal outcomes were evaluated. Fifty-eight women were included in the study. The prevalence of UARI95 in this group of women was 27.6 per cent. The correlations between mean UARI95 and adverse perinatal outcomes were: 31.6 per cent sensitivity, 74.4 per cent specificity, with only 60.3 per cent accuracy. The mean UARI95 does not qualify as a reliable screening test for adverse perinatal outcomes in pregnancies complicated by hypertensive disorders.

Adult↗

PubMed2002

Color Doppler ultrasonography for prediction of malignant ovarian tumors.

The purpose of this cross-sectional study was to evaluate whether the pulsatility index determined by the color Doppler sonography could be used to distinguish between benign and malignant ovarian tumors. A total of 120 patients who had their ovarian tumors removed surgically at the Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University were included in the study. Each patient had color Doppler sonography performed prior to laparotomy. The Doppler results were compared to the histological diagnosis of the ovarian tumors. Of the 113 patients whose intratumoral blood flow could be evaluated, the pulsatility index was significantly lower in malignant lesions than in benign lesions (0.85 +/- 0.46 vs 1.63 +/- 0.64, p<0.001). The sensitivity, specificity, and accuracy of the pre-operative pulsatility index (< or = 1.0) in detecting malignant ovarian tumors were 82.9 per cent, 80.8 per cent, and 81.4 per cent, respectively; with 65.9 per cent positive predictive value, 91.3 per cent negative predictive value, 19.2 per cent false positive rate, and 17.1 per cent false negative rate. The present results suggest that color Doppler sonography may be a useful clinical tool in the pre-operative evaluation of ovarian masses. However, the pulsatility indexes showed considerable overlap between benign and malignant lesions, indicating that color Doppler sonography has limitations in the differentiation of benign from malignant ovarian masses. The cost of the equipment and experience requirement also limits its use in general gynecologic practice.

Adolescent↗