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Pinit Kullavanijaya

Publications and source records attributed to Pinit Kullavanijaya.

27 records · Page 2Linked to original sources
PubMed2002

Gastric juice urease test and brushing urease test for Helicobacter pylori detection.

The aim of the study was to demonstrate the sensitivity, specificity and accuracy of gastric juice urease test and brushing-urease test compared to the biopsy-urease test for Helicobacter pylori (H. pylori) detection. For each patient, two milliliters of gastric juice was collected and one milliliter in the supernatant was tested for rapid urease reactions. One gastric mucus brushing and two biopsies were taken from the body and the antrum. The brushing specimens were tested for rapid urease reaction by shaking the brush into the urea broth. The gold standards for diagnosing of H. pylori are positive H. pylori upon specimen culture or positive identification of H. pylori from polymerase chain reaction (PCR) assay using primer for vac A gene. Forty patients were enrolled in the study including ten patients with gastric ulcer, six patients with duodenal ulcer and twenty four patients with non-ulcer dyspepsia. Brushing-urease test and biopsy-urease test were not different sensitivity (87.50% vs 93.20%), specificity (100% vs 100%) and accuracy (90.25% vs 95.50%). The gastric juice urease test had a sensitivity of 65.25 per cent, specificity of 100 per cent and accuracy of 75 per cent for detecting of H. pylori infection. In conclusion, gastric juice urease test had low sensitivity in the diagnosis of H. pylori infection. Brushing-urease test is as accurate as biopsy-urease test in detecting H. pylori infection. However, the brushing method had lower gastric tissue injury than the biopsy and so should be used for detecting H. pylori infection in patients with coagulopathy.

Adult↗
PubMed2002

Inhibitory effect of Lactobacillus acidophilus on Helicobacter pylori in peptic ulcer patients: in vitro study.

Lactobacillus acidophilus (L. acidophilus) have been introduced into many fermented dairy products. The presence of L. acidophilus appears to decrease Helicobacter pylori (H. pylori) density in the human stomach and could enhance antibiotic therapy for H. pylori eradication. This study was designed to determine the optimal density of L. acidophilus that has a maximum inhibitory effect on H. pylori in peptic ulcer patients. To determine whether L. acidophilus has an inhibitory effect on H. pylori isolated from peptic ulcer patients and to determine whether the optimal density of L. acidophilus has a maximum inhibitory effect on H. pylori isolated from peptic ulcer patients. H. pylori was isolated from gastric biopsy specimens of peptic ulcer patients. The suspension of pure H. pylori colonies were inoculated into the broth and adjusted to match the density of No.3 MacFarland standard (approximately 9x10(8) cells/ml). Forty microliters of the suspension were equally spread onto each quadrant of the plate and left to dry. L. acidophilus was prepared from LC-1 (Nestle Research Center, Switzerland). They were grown on blood agar and incubated overnight at 37 degrees C. The suspension of L. acidophilus was inoculated into the broth and adjusted to match the density of No.1, No.2, No.3 and No.4 MacFarland standard (approximately 3x10(8), 6x10(8), 9x10(8) and 12x10(8) cells/ml respectively). Ten microliters of each density of L. acidophilus was dropped onto each quadrant of a previously inoculated H. pylori plate and then the plate was kept under microaerophilic conditions for 72 hours. Inhibition clear halo zone of H. pylori around the colonies of L. acidophilus was interpreted as the inhibitory effect. H. pylori were isolated from gastric biopsy specimens of fifteen peptic ulcer patients (eleven patients with gastric ulcer and four patients with duodenal ulcer). A total of sixty tests of inhibitory effect of L. acidophilus on H. pylori were evaluated in the present study. L. acidophilus had inhibitory effect on H. pylori in 13/15 patients (86.67%) and L. acidophilus in the density of No.3 MacFarland standard had a significantly higher inhibitory effect on H. pylori in the density of No.3 MacFarland than that of No.1 (60% vs 20%; p<0.05), No.2 (60% vs 20%; p<0.05) and No.4 (60% vs 20%; p<0.05) MacFarland standard. In conclusion, L. acidophilus has an inhibitory effect on H. pylori isolated from peptic ulcer patients. Approximately an equal density of L. acidophilus on H. pylori has the most favorable effect. This optimal density of L. acidophilus should have maximum effect on H. pylori clearance and could enhance antibiotic therapy for H. pylori eradication in humans.

Adult↗
PubMed2002

A retrospective study of colorectal cancer patients in King Chulalongkorn Memorial Hospital.

To determine the basic clinical information of colorectal cancer in Thailand, the authors retrospectively reviewed the medical records and pathological reports of 293 patients with histologically proven colonic cancer but only 137 patients met the inclusion criteria in King Chulalongkorn Memorial Hospital during the three-year period from July 1997 to June 2000. There were 72 males (53%) and 65 females (47%) with an age ranging from 24 to 90 years (mean age 61.2 years). Among these, 115 patients (83.9%) were older than 50 years. Bowel-habit change, weight loss and mucous bloody diarrhea were the most common presentations respectively. Distal colorectal cancer is the most common site of colonic cancer (71.3%) and 28.7 per cent were at the proximal colon. Dukes' D (35%) was the most common colorectal cancer staging in the hospital. Considering the sites of metastases, liver was the most common site of metastases (61%). The most common cell type was moderately-differentiated adenocarcinoma. Low anterior resection was the most common surgical procedure (24.9%) since the tumor was usually located distally. In conclusion, 1) bowel habit change was the most common presentation for colorectal cancer at the hospital and the majority of patients were elderly. 2) Colorectal cancer was usually found at the late stage which was associated with poor prognosis.

Adult↗
PubMed2002

Duodenal Helicobacter pylori associated duodenal ulcer depend on gastric Helicobacter pylori status.

Gastric Helicobacter pylori (H. pylon) plays an important role in the pathogenesis of duodenal ulcer (DU), although not all H. pylori infected persons will develop disease. Duodenal H. pylori was supposed to be one of the factors related with DU. The aim of this study was to investigate whether H. pylori in the duodenum of patients with DU plays a critical role in the pathogenesis of DU regarding the gastric H. pylori status. Furthermore, it was to determine the prevalence of duodenal H. pylori infection in Thailand. Ninety three patients were included in the study. They underwent gastroscopic evaluation for dyspeptic symptoms and none of them had previous H. pylori eradication therapy. An upper gastrointestinal endoscopy was performed and two specimens were collected each form the antrum, midcorpus and duodenal bulb in order to diagnose H. pylori infection. The gold standard for H. pylori detection is a positive specimen culture or polymerase chain reaction (PCR) assay for the vac A gene or positive urease test plus H. pylori seen in the pathology. Ninety three dyspeptic patients (43 males and 50 females; mean age 48.2 years; range 22 to 79 years) were included in the study. Duodenal H. pylori was detected in 31/93 (33.33%) patients which included 15 (48.38%) patients with duodenal ulcer, 2 (6.45%) patients with gastric ulcer and 14 (45.16%) patients with NUD. Five of thirty one (16.21%) patients with duodenal H. pylori infection had negative gastric H. pylori. These five patients included 1 with DU, 1 with DU and 3 with NUD. Duodenal H. pylori was associated with DU dependent of the presence of gastric H. pylori (p<0.05) and there was no association between duodenal H. pylori with negative gastric H. pylori and duodenal ulcer (p>0.05). Duodenal H. pylori is associated with duodenal ulcer dependent on the presence of gastric H. pylori. These results suggest that transmission of gastric H. pylori to the duodenum was prerequisited for the formation of DU.

Adult↗
PubMed2002

Informed consent.

Information to make patients fully aware of all the details of treatments is an important part of the medical practice before obtaining patient's signature in the consent form. Explanation may be detailed enough to make patients understand the process of treatment. However, sometime it may not be inclusive enough to cover all major statements that give pros and cons of the treatment. Perhaps detailed explanation may reveal too much information that may discourage patients to receive treatments and cause fear, anxiety, and hopelessness. If health care personnels do not mention all the risks involved in medical treatments, they may be subjected to an accusation of concealing the truth that should be made known to patients. This is one of many ways of looking at the problems. There is no easy answer to the problem of what 'appropriate' explanation should be. Most of our patients are from all walks of life which are not medical profession, and they do not have knowledge to understand technical terms. How should we approach patients in order to be safe from an accusation of that we are not over supporting, not giving the patients false hope? Therefore, we would like to present a guideline for informing and explaining to the patients under the following headings (15): 1. Diseases or major symptoms which are diagnosed. 2. The necessity to receive treatments for the benefits of patients or fetus. 3. If possible, determine the duration of treatments. 4. Methods of treatment, evaluation, and schedule for next appointment. 5. Inform about necessary investigations. 6. Inform about complications of risks, and cost of investigations 7. Usefulness and results of investigations. 8. If options of treatments are available, they should be explained in details, the pros and cons, the risks, and the costs, etc. 9. Maintaining medical confidentiality and the use of patient chart by medical personnel and other related health care providers, for instance, hospital staffs from all levels, medical students, technical medical students, and social workers, etc.

Humans↗
PubMed2002

Good conduct.

Explore the source record for details and available documents.

Ethics, Professional↗
PubMed2002

Effectiveness of ranitidine bismuth citrate based triple therapy for treating Helicobacter pylori.

OBJECTIVE: To determine the efficacy, safety and tolerance of a one week regimen of RBC, clarithromycin, and amoxicillin for H. pylori eradication in Thai patients. MATERIAL AND METHOD: Patients who were undergoing endoscopy for dyspeptic symptoms. On the day of endoscopy, three biopsies were taken for H. pylori diagnosis. The patients who had the presence of H. pylori infection by positive from rapid urease test or histologic examination were invited to take part in an open, prospective study. Patients received a combination of RBC 400 mg, clarithromycin 500 mg, and amoxicillin 1 g twice daily for 7 days. Repeated endoscopy was performed to evaluate H. pylori eradication at least 1 month after the end of treatment. Clinical symptoms, side effects and compliance were assessed by interview during the study and at follow-up. RESULTS: Thirty nine patients with H. pylori infection were included. Male and female rates was 27:12 with a mean age of 42.8 +/- 11.4 years (range 21-68). There was a 89.74 per cent eradication rate by intent-to-treat and 94.59 per cent by per-protocol analysis. There were no serious adverse events during the study. Two patients (5.13%) stopped the medication because of side effects. Two patients had failure to eradication after complete treatment. Subjective improvement of the clinical symptoms was found in 92.3 per cent. CONCLUSION: One week's regimen of RBC, clarithromycin, and amoxicillin triple therapy resulted in a relatively high efficacy, safety and tolerance for H. pylori eradication in Thai patients.

Adult↗