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Nualanong Visitsunthorn

Publications and source records attributed to Nualanong Visitsunthorn.

10 recordsLinked to original sources
PubMed2006

Pediatric Asthma Quality of Life Questionnaire (PAQLQ): validation among asthmatic children in Thailand.

Quality of life (QoL) is an important consideration among asthma sufferers. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) is one of the most widely used instruments for measuring health-related QoL in children with asthma. The standardized version of PAQLQ contains 23 questions in three domains, i.e., activity limitation, symptoms and emotional function. The objective of this study was to validate the Thai-translated version of the PAQLQ. The study design consisted of a five-week single cohort study. Patients recorded symptoms, and peak expiratory flow rate (PEFR) each morning and evening during the first and fifth week of the study in asthma diary. At each clinic visit, a trained-interviewer administered the PAQLQ and performed spirometric measurements. Fifty-one children, ages between 7 and 17 yr participated in the study. Scores from the asthma diary were used to classify patients into stable vs. unstable groups. The construct validity of the questionnaire was confirmed in both cross-sectional and longitudinal studies by demonstrating correlations between various PAQLQ domains with clinical asthma parameters (asthma diary, beta-agonist use and PEFR). There was high internal consistency for scores of the three domains (Cronbach's alpha-coefficient = 0.83-0.95). For those with stable asthma, the reliability of PAQLQ was good for the rating scale (intra-class correlation coefficient--ICC = 0.84) and for total score (alpha = 0.97) indicating high reproducibility of the PAQLQ. The significant difference of changes QoL scores between stable and unstable groups was observed in all domains. We conclude that the Thai version of PAQLQ is valid and reliable for implementing in Thai children with asthma.

Adolescent↗
PubMed2005

Medical charge of asthma care in admitted Thai children.

BACKGROUND: Asthma is one of the most common chronic diseases in children. Due to high admission rate for acute asthmatic attack, children often miss their schools and parents have to stop working to take care of them. These affect both mental and physical health as well as socioeconomic status of the family and the country. OBJECTIVES: To evaluate medical charge of asthma care in children admitted to the Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University. MATERIAL AND METHOD: The study was a retrospective and descriptive study. Data were collected from children with asthmatic attack admitted to the Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand from January 1st, 2000 to June 30th, 2003. Cost of room, food, drugs, devices, laboratory study and service charge were recorded. Total medical charges per year, per patient per admission and per patient per day were calculated. Data were analyzed with Chi square test, ANOVA and Post Hoc test. A p value of < 0.05 was considered statistical significant. RESULTS: Numbers of children with asthmatic attack admitted to the Department of Pediatrics, Siriraj Hospital increased between 2000-2002 (113,147 and 176 in 2000, 2001, and 2002). Seventy two percent of the patients were < or = 5 years of age. Most were mild intermittent asthma. The average duration of hospitalization was 4 days (95% CI, 3.6-4.3). Average medical charge per patient per admission and per day was 3236.20 and 998.60 Bahts respectively. There was no significant difference in the medical charge per patient among the admitted years. Medical charge of admission was significantly associated with the asthma severity. (p < or = 0.05) CONCLUSION: The rate of admission from asthmatic attack in children at Siriraj Hospital and the total medical charge per year increased between 2000-2002. Nevertheless, medical charge of asthma admission per person was unchanged. Main expense in medical charge of asthma admission was the cost of medication and room. Severity of asthma was related directly to medical charge.

Adolescent↗
PubMed2005

Pediatric sinusitis:symptom profiles with associated atopic conditions.

INTRODUCTION: Sinusitis is a very common disease in childhood. Clinical manifestations in childhood sinusitis are different than in adult. Information in childhood sinusitis in Thailand is limited. We performed a prospective descriptive study to determine clinical characteristics of childhood sinusitis in Thailand MATERIAL AND METHOD: One hundred pediatric patients with clinical diagnosis of sinusitis attending pediatric allergy clinic, pediatric outpatient clinic, and pediatric ENT clinic were recruited. Clinical diagnosis was defined by presence of symptoms indicating upper respiratory infections with exudates at middle meatus by anterior rhinoscopy. Thorough history taking and physical examinations were conducted with findings recording into sinusitis questionnaire. Sinus radiographs were taken in 77 patients and were read blindly a single radiologist who was unaware of clinical conditions of patients. Allergy skin prick tests were performed with a panel of common aeroallergens in Thailand. RESULTS: Age range of the 100 patients were between 1.7 to 12.4 years with a mean (+/- SD) of 6 +/- 2.72 years. History of atopic disease among patients and their families was positive in 49% and 47% respectively. Four most common clinical manifestations were rhinorrhea (95%), nocturnal and productive cough (91%), nasal congestion (74%) and posterior nasal dripping (66%). The three most common signs were obstruction of middle meatus (100%), swelling of turbinates (92%) and granular pharynx (48%). All paranasal sinuses X-rays were abnormal with maxillary sinus being the most commonly involved sinus (99%) followed by ethmoid sinus (91%). The majority of patients had involvement of more than one sinus. Skin prick tests were positive in 53.6%. The two most common sensitizing allergens were dust mites (57.7) and cockroaches (18.6%). CONCLUSION: The presence of symptoms of rhinorrhea, cough, nasal congestion and posterior nasal drip should alert physicians for diagnosis of sinusitis in pediatric patients. Maxillary and ethmoid sinus were the most common sinuses involved. Atopic predisposition is present in up to 53.6% in this population.

Adolescent↗
PubMed2005

Chronic rhinosinusitis and recurrent nasal polyps in two children with IgG subclass deficiency and review of the literature.

UNLABELLED: Chronic rhinosinusitis (CRS) is a chronic inflammatory disorder of mucosa of the nose and the paranasal sinuses. Two major forms of CRS can be differentiated; CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). The pathophysiology and etiology of nasal polyps (NPs) are partly understood. IgG subclass deficiency was shown to be associated with an increased susceptibility to infections. However the association between NPs and IgG subclass deficiency has never been reported. OBJECTIVES: To report two cases of recalcitrant CRS and recurrent NPs with IgG subclass deficiency. CASE REPORT: Two children (6 and 8 year-old boys) were referred to the Pediatric Allergy/Immunology Clinic, Siriraj Hospital due to a prolonged history of CRS and recurrent NPs. Both of them were treated with aggressive medical (topical and systemic corticosteroids, antibiotics, leukotriene antagonist, nasal irrigation) as well as surgical therapy, without significant improvement. Immunologic investigation in both patients showed that IgG, IgA, and IgM level were normal. IgG subclasses level in patient No. 1 were IgG1 1,235 (280-1120) mg/dl (79%), IgG2 235 (30-630) mg/dl (23.5%), IgG3 27.3 (40-250) mg/dl (1.74%), and IgG4 92.4 (11-620) mg/dl (5.9%). IgG subclasses level in patient No. 2 were IgG1 1,139 (280-1120) mg/dl (82.5%), IgG2 170 (30-630) mg/dl (12.3%), IgG3 5.6 (40-250) mg/dl (0.4%), IgG4 65.7 (11-620) mg/dl (4.8%). The diagnosis of CRS and recurrent NPs with IgG3 subclass deficiency in the first patient and IgG2/IgG3 subclass deficiency in the second patient were made. Patient No. 1 was given monthly IVIG therapy for the total of 7 courses and medications were gradually tapered. Currently, the patient is doing well after the cessation of IVIG therapy for 3 months. Patient No. 2 denied the IVIG treatment and was lost to follow up. CONCLUSION: We reported two cases of recalcitrant CRS and recurrent NPs in children. Immunologic work up revealed IgG subclass deficiency. The treatment with monthly IVIG improved CRS and NPs in treated patient which brought up the possibility of association between NPs and IgG subclass deficiency. Further study on the direct role of IVIG in NPs will be needed in the future.

Child↗
PubMed2002

How do Thai children and adolescents describe asthma symptoms?

Prevalence of childhood asthma appears to be increasing worldwide. In Thailand, the prevalence of childhood asthma increased from 4.2% to 13% within the past decade. The last epidemiologic survey in Thailand utilized the International Study of Asthma and Allergies in Childhood (ISAAC) phase I questionnaire translated into Thai language. Language in the questionnaire can affect the reliability and validity of results of the survey. The purpose of this study is to determine common Thai wordings actually used by Thai children and adolescents to describe wheeze, chest tightness, shortness of breath and dyspnea. Sixty asthmatic Thai children, aged 9.2-18 years with asthmatic attacks less than 1 yr prior to the study, and 178 age-matched controls were recruited into the study. Asthmatic children spontaneously expressed their terms describing their asthma symptoms (in Thai) and then answered a preoutlined questionnaire regarding asthma terminology during an interview session after viewing the severe attack scene of the International ISAAC video questionnaire. Controls responded only to the preoutlined questionnaire after viewing the video scene. Of the 60 asthmatic children (38 males and 22 females, mean age 11.9 yr), 75% had their last asthmatic attacks within 2 months prior to the study. Wheeze was referred to as " and '/wi:d/' in 50% and 33% of patients, respectively, and " in 93.8% among controls. Using only the word '/wi:d/' in our previous ISAAC-I survey, as it sounded like the English word 'wheeze', it appears that up to 67% of the cases could have been missed. Dyspnea was referred to as rapid breathing and feeling tired in 78.2% of cases and as rapid and difficult breathing in 76.3% of controls. Chest tightness was referred to as chest discomfort in 65.7%. Shortness of breath was referred to as not being able to catch a breath, too short a breath, not enough breath and feeling suffocated in 88.8%. Local terms for asthma symptoms should be established and validated into each language to obtain reliable epidemiologic data.

Adolescent↗
PubMed2002

Evaluation of consistency between local and imported seafood allergen extracts.

BACKGROUND: Seafood is a common cause of food allergy in Thai adults and children. Skin prick test is a safe and convenient way to screen seafood allergy. To date, the Allergy Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University uses imported extracts for seafood skin prick test. The extracts are expensive and may not be the same species as seafood in Thailand. OBJECTIVES: To compare the consistency between local seafood allergen extracts prepared by the Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University and imported seafood allergen extracts. METHODS: The study was a prospective comparative trial performed in children who attended the Pediatric Allergy Clinic, Siriraj Hospital from March 1999 to October 2000. The skin prick test was performed with the local seafood allergen extracts prepared by a pharmacist from the Department of Pharmacology and the imported seafood allergen extracts included shrimp, fish and crab. Histamine and normal saline were used as positive and negative control respectively. The positive result was recorded when wheal reaction was > or = 3 mm larger than negative control. RESULTS: Eighty eight patients (57 boys and 31 girls) were included in this study. The average age was 7.7 years (1-15 years). Half of the patients had a history of seafood allergy. The study showed probable consistency between imported and local skin prick test of shrimp and crab extracts (kappa = 5-7) but no consistency between imported and local skin prick test of fish extracts (kappa < 5). The study also showed no consistency between history of seafood and skin prick test result. CONCLUSION: Local seafood allergen extracts from the Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University are safe but they cannot replace the imported seafood allergen extracts. Further investigations about sensitivity and specificity of both kinds of allergen extracts are necessary.

Adolescent↗
PubMed2002

Linear growth of prepubertal asthmatic Thai children receiving long-term inhaled corticosteroids.

BACKGROUND: Long-term inhaled corticosteroids are recommended in persistent asthma in children. The aim of this study was to determine the growth rate of asthmatic Thai children who received long-term inhaled corticosteroids. METHOD: This controlled clinical trial was carried out on 145 prepubertal asthmatic Thai children, 81 in the study group (the group who received long-term inhaled corticosteroids) and 64 in the control group. RESULTS: The mean age of the patients when the study began was 5.9 years in the study group and 4.7 years in the control group. The average dose of inhaled corticosteroids used was 300 microg/day. The average duration overtime of inhaled corticosteroid usage was 2 years (9 months-5 years). The study showed that inhaled corticosteroids (300 microg/day for 9-60 months) have no significant effects on growth rate. From linear regression analysis, the factors that influenced the growth rate of asthmatic patients were the severity of the asthma and the age of the patients when nasal corticosteroids were started. Insulin-like Growth Factor 1 (IGF 1) and Insulin-like Growth Factor Binding Protein 3 (IGFBP 3), were measured in 7 patients in the study group and 5 in the control group. All were normal, the height standard deviation score (Ht.SDS) was below average. CONCLUSIONS: The average dose of inhaled corticosteroids (300 microg/day for 9 months) has no significant effects on the growth rate of prepubertal asthmatic Thai children.

Administration, Inhalation↗
PubMed2002

IgA deficiency: a report of three cases from Thailand.

Selective IgA deficiency has been reported to be the most common primary immunodeficiency disease in Western countries. A markedly lower frequency of this condition has been reported in the Japanese population. While most of the IgA deficient cases are healthy, some patients develop significant recurrent sinopulmonary infections, allergic disorders and autoimmune diseases. Herein, we report three cases of IgA deficiency among Thai patients, all of whom suffered from chronic sinopulmonary infections. Two of the three patients had absolute IgA deficiency while the third had a partial IgA deficiency. The associated conditions found in these three patients were deficiencies of an IgG subclass, allergic rhinitis and lupus nephritis. The youngest child (5 years old boy with lupus nephritis) expired from Pneumocystis carrinii pneumonia complicated with adult respiratory distress syndrome.

Adolescent↗