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Pinit Kullavanijaya

Publications and source records attributed to Pinit Kullavanijaya.

43 records · Page 3Linked to original sources
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↗
PubMedDate not supplied

Trimming a metallic biliary stent using an argon plasma coagulator.

BACKGROUND: Distal migration is one of the common complications after insertion of a covered metallic stent. Stent repositioning or removal is not always possible in every patient. Therefore, trimming using an argon plasma coagulator (APC) may be a good alternative method to solve this problem. METHODS: Metallic stent trimming by APC was performed in 2 patients with biliary Wallstent migration and in another patient with esophageal Ultraflex stent migration. The power setting was 60-100 watts with an argon flow of 0.8 l/min. OBSERVATIONS: The procedure was successfully performed and all distal parts of the stents were removed. No significant collateral damage to the nearby mucosa was observed. CONCLUSIONS: In a patient with a distally migrated metallic stent, trimming of the stent is possible by means of an APC. This new method may be applicable to other sites of metallic stent migration.

Aged↗
PubMedDate not supplied

Diagnostic role of serum interleukin 6 and CA 19-9 in patients with cholangiocarcinoma.

BACKGROUND/AIMS: Cholangiocarcinoma is particularly common in Northeastern Thailand where the liver fluke, O. viverrini, is endemic. Currently there is no sensitive and specific tumor marker for the diagnosis of this cancer. The aim of this study was to investigate the accuracy of carbohydrate antigen 19-9 and interleukin-6 in the diagnosis of cholangiocarcinoma. The first marker represents the commonly used serum marker in cholangiocarcinoma and the second marker is a multi-functional cytokine associated with cancer development. METHODOLOGY: The serum concentrations of carbohydrate antigen 19-9 and interleukin-6 were simultaneously determined in 45 patients with cholangiocarcinoma, 15 with hepatocellular carcinoma, 15 with metastatic liver cancers, 10 with benign biliary disease and 10 healthy controls. RESULTS: The sensitivity of carbohydrate antigen 19-9 value (> or = 37 U/mL) in diagnosing cholangiocarcinoma was 64.4%, while its specificity was 100% and 56.7% when compared with benign biliary disease and other liver cancers, respectively. The sensitivity and specificity of detectable interleukin-6 (> or = 0.18 ng/mL) for differentiating between cholangiocarcinoma and benign biliary disease was 71.1% and 90%, respectively, whereas the specificity for differentiating cholangiocarcinoma from other liver cancers was 26.7%. When higher concentrations of either carbohydrate antigen 19-9 (> or = 100 U/mL) or interleukin-6 (> or = 50 pg/mL) were used as the cut-off points, they provided additional diagnostic sensitivity and accuracy in differentiating between cholangiocarcinoma and other liver cancers to 80% and 76%, respectively. CONCLUSIONS: The combined assays of both serum carbohydrate antigen 19-9 and interleukin-6 could be useful in diagnosing cholangiocarcinoma, particularly in populations where this cancer is prevalent.

Adult↗