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Biomedical subjects

S Koetsawang

Publications and source records attributed to S Koetsawang.

At least 55 records · Page 3Linked to original sources
PubMed1981

Pharmacokinetics of ethynyloestradiol in women for different populations.

The pharmacokinetics of a dose of 50 microgram ethynyloestradiol administered orally was studied in fourteen centres. Absorption was rapid and the highest serum concentrations of total ethynyloestradiol were found in most subjects at 1 h and by 24 h concentrations were less than 250 pg/ml. Calculation of the half-lives for absorption, distribution and elimination showed wide variations between subjects, the half-life of elimination varying from 2.5 h to more than 30 h. Bioavailability as measured by the area under the serum ethynyloestradiol concentration-time curve also showed more than a ten-fold variation. Intra-centre differences in the various parameters measured were as large as the inter-centre differences.

Biological Availability↗
PubMed1981

Postpartum sterilization by operating-room nurses in Thailand.

A training project to assess the performance of experienced operating room nurses as operators in postpartum sterilization was conducted in 1977-1978. The results for over 1000 nurse-operated clients and a comparison group of approximately 300 physician-sterilized clients show that nurses achieved comparable success with physicians in postpartum sterilization, as judged by clinical and attitudinal follow-up. No serious complications were recorded in either group. Minor infections in both groups were treated routinely. A stitch abscess for one nurse-operated client resulted in hospitalization; the client was released after 3 days. The clients in both groups returned to routine chores at home rapidly, and client satisfaction with the procedure was virtually unanimous in each group. This study lends support to the use of nurses in performing contraceptive surgery. The need for increased service coverage in this area is of high priority, and nurses provide a readily available and easily trained cadre of support staff.

Clinical Competence↗
PubMed1980

Pharmacokinetic study of different doses of Depo Provera.

Doses of DepoProvera of 25, 50, 100 and 150mg were administered to four groups of women. The mean time for the return of follicular and luteal activity increased with increasing dose of DepoProvera. Luteal activity was suppressed for a longer period than follicular activity. None of the women receiving the two higher doses of DepoProvera showed a return of luteal function within 100 days of injection. The period for which medroxyprogesterone acetate (MPA) was detectable in serum increased with increasing dose but the values for the 100 and 150mg doses were not significantly different. There was a significant correlation between the concentration of MPA in blood and the return of follicular and luteal function. It is suggested that in the population studied, 100mg DepoProvera would be as effective as the usual 150mg dose and that injection of 50mg DepoProvera would provide a contraceptive effect for two months. The dose of MPA in the monthly injectable CycloProvera could be substantially reduced without loss of effectiveness.

Adult↗
PubMed1980

Return of ovarian function and endometrial morphology in women treated with norethisterone oenanthate: a pilot study.

A comparative pilot study was undertaken in three centers to determine the time of return of ovulation after the injection of the steroidal contraceptive norethisterone oenanthate (NET-OEN). The effect of the compound on the endometrium and some properties of cervical mucus were also assessed. Increases in plasma progesterone levels suggested that ovulation resumed in all six women in Bahia within 60 days of injection of NET-OEN, whereas in Bangkok and New Delhi only two women in each center ovulated within this time. The difference in the time of return of ovulation between women in Bahia (mean time 42 days) and those in Bangkok and New Delhi (92.5 days) was statistically significant. Follicular function returned earlier than luteal function: all six women in Bahia and Bangkok and five of the six in New Delhi showed evidence of follicular activity within 60 days. All endometrial biopsies, obtained at a time of increased progesterone production, were secretory and suggested that administration of the gestagen did not exert a prolonged suppression of endometrial activity. In general, changes in cervical mucus were consistent with variations in plasma steroid levels.

Brazil↗
PubMed1979

Blood levels of medroxyprogesterone acetate after multiple injections of depoprovera or cycloprovera.

Mean levels of MPA in blood taken 90 days after injection were not significantly different between women who had received a single injection of DepoPrevera and those who had received eight injections at 90-day intervals. There was a wide variation in plasma MPA concentration in the two groups of women. In women who had received 31 to 45 injections of CycloProvera, plasma levels of MPA 28 days after injection were significantly higher than those of women who had received a single injection. The levels were also higher than those found in women 90 days after injection of DepoProvera. The results suggest that the dose of MPA in CycloProvera could be reduced.

Female↗
PubMed1979

Rate of metabolism of norethisterone in women from different populations.

The rate of metabolism of orally administered norethisterone was compared in fourteen centres by measuring plasma levels of the steroid by radioimmunoassay at varying times after oral administration of a 1 mg dose. The inter-centre differences were of the same order as the intra-centre differences. Variations in metabolism appeared not to be due to variations in body size.

Adult↗
PubMed1978

Study of "spontaneous" abortion in Thailand.

This analysis includes data on 3 530 patients with septic or incomplete, inevitable or threatened abortions who were treated at the Siriraj Hospital in Bangkok between January 1972 and December 1973. Data on the patients' socio-demographic characteristics; their reproductive, abortion, and medical histories; their pre- and postabortion contraceptive acceptance; and a clinical profile of their abortion treatment, including procedure time, length of hospitalization, and immediate and delayed postoperative complications are analyzed.

Abortion, Incomplete↗
PubMed1978

Laparoscopic electrocoagulation and tubal ring techniques for sterilization: a comparative study.

From August 1975 through May 1976, a comparative study was made of the effects of sterilization by standard electrocoagulation and tubal ring application techniques. The two techniques were randomly assigned to 300 patients. Results show that standard electrocoagulation and tubal ring procedures can easily and safely be performed on an outpatient basis, using local anesthetics and analgesics. Rates of surgical complications for both techniques were clinically acceptable, although tubal risk patients had a higher rate. Pain during the procedure and during the immediate recovery period was more severe for tubal ring patients. Despite the higher incidence of surgical complications and pain associated with the ring, many physicians prefer this method of sterilization because it eliminates the possibility, inherent in electrocoagulation, of inadvertent serious electrical burns.

Adult↗
PubMed1977

Outcome of pregnancy in the presence of intrauterine device.

The outcome of 196 pregnancies with Lippes Loop in situ was studied. In 102 cases with inaccessible thread, the IUD was left in place. Ninety-four women had the IUD removed when the thread was still visible. The incidence of spontaneous abortion and premature delivery was 56.8% in the group of 102, and was significantly higher than in those women whose loop was removed. No serious complications occurred in any of the cases. The results suggested that the IUD should be removed early in pregnancy when the string is still accessible.

Abortion, Spontaneous↗
PubMed1977

Female sterilization by laparoscopy: a comparative study of tubal occlusion with electrocoagulation and spring-loaded clip with one-year follow-up.

Findings are reported of a study conducted to evaluate and compare the safety and effectiveness of the spring-loaded clip and the electrocoagulation techniques of tubal occlusion via laparoscopy. The study was conducted from June, 1974 to June, 1975 on 300 cases in a Bangkok, Thailand hospital. Only patients who requested sterilization to limit family size were included in the study, and study patients were required to return for 6- and 12-month follow-up visits. To minimize possible patient and physician biases, all sterilization procedures were performed by one author (S. K.). and data were analyzed by the other author (S. P.). The specific operative technique was randomly assigned to the patient immediately prior to surgery, and the patient was unaware of the particular technique used. The findings showed no potentially serious complications for either technique. Neither complication rates nor incidence of pain were significantly different for the two procedures. The presence of adhesions was the most frequent cause of surgical difficulty in both techniques. No mechanical difficulties were reported. No pregnancies were reported within one year of sterilization.

Adolescent↗
PubMed1976

Spring clip sterilization: one-year follow-up of 1,079 cases.

This is a report of 1,079 patients who underwent laparoscopic clip sterlization as of March, 1974. A one-year follow-up was obtained on 977 patients, or 90.5 per cent. Complications due to the clip technique appear limited to postoperative cramps for 24 to 48 hours in 26 per cent of patients. No ectopic pregnancies were detected. Pregnancies, when corrected for unsuspected existing pregnancies and surgical and manufacturing errors, occurred in 2 to 6 cases, for a method failure rate of 2 to 6/1,000. This report documents that experienced laparoscopists can perform this practice with local anesthesia, in combination with first-trimester abortion, and in hospital facilities other than an operating room.

Anxiety↗
PubMed1976

Comparison of culdoscopic and laparoscopic tubal sterilization.

The growing number of women requesting interval sterilization (apart from term delivery or abortion procedures) necessitates the re-evaluation of traditional surgical procedures. A total of 800 women--the first 400 women undergoing culdoscopic and laparoscopic tubal sterilization procedures at Siriraj Hospital in Bangkok, Thailand--evaluate the appropriateness of the two sterilization procedures for use in interval sterilization programs. No serious operative complications occurred in either group. However, the rate of postoperative complications was considerably higher for the culdoscopic group than for the laparoscopic group. Hospitalization was required for only a small percentage of the patients and most had resumed their normal activities within two days of the operation. This study indicates that both procedures are effective and may be safely performed on an outpatient basis without general anesthetics and with minimal discomfort for the patients.

Culdoscopy↗