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Biomedical subjects

S Kurathong

Publications and source records attributed to S Kurathong.

At least 19 recordsLinked to original sources
PubMed1992

Predisposition to reinfection by intestinal helminths after chemotherapy in south Thailand.

Rates of reinfection by the intestinal helminths hookworm, Ascaris lumbricoides and Trichuris trichiura after chemotherapy were studied in two villages in Phang-Nga Province, southern Thailand. It was found that intensity of infection levels attained after reinfection correlated positively with pretreatment intensities of infection for all parasites. This implies that certain persons in the community are predisposed to receiving high numbers of worms, due either to environmental or personal risk factors. Therefore, it would be advantageous to identify such persons and treat them preferentially. Targeted chemotherapy, however, should be combined with efforts to identify the risk factors that vary within the community and direct educational efforts or environmental intervention towards the section of the community most affected by the parasites.

Anthelmintics↗
PubMed1992

Prevalence and outcomes of HBV and anti-HCV seropositive patients with chronic liver disease and hepatocellular carcinoma.

The prevalences of serological markers of hepatitis B virus (HBV) and antibody to hepatitis C virus (anti-HCV) were determined in 168 patients (135 males and 33 females), aged 19-79 years (mean = 50.8) in Thailand. Of these, 33 had chronic persistent hepatitis, 35 chronic active hepatitis, 50 cirrhosis and 50 hepatocellular carcinoma (HCC). Seromarkers for either HBV or anti-HCV or both were detected in 140 (83.3%), 3 (1.8%) and 18 (10.7%) patients, respectively, but 7 (4.2%) were sero-negative for both viruses. The overall prevalence of anti-HCV was 12.5% but was significantly lower in HCC (2%) compared to the other 3 groups of liver disease (12-21.5%, p less than or equal to 0.05) and in HBsAg positive (5%) compared to HBsAg negative (30%) patients (p less than 0.001). After 0.5-9 years follow-up of all anti-HCV positive patients, 2 died and another 6 had progressive liver disease. The prevalence of coexistent HBV seromarkers was similar in patients with a progressive (87.5%) and a stable clinical course (92.3%) (p = 0.62). A higher proportion of the anti-HCV-positive patients with a progressive course had a history of blood transfusion [75.0% vs 46.1% (p = 0.20)]. These findings suggest that HBV is the most important etiologic virus associated with chronic liver disease and HCC in Thailand, but HCV may play a role particularly in HBsAg-negative patients.

Adolescent↗
PubMed1992

Prevalence of anti-HCV antibody in family members of anti-HCV-positive patients with acute and chronic liver disease.

Presence of circulating anti-hepatitis C antibody (anti-HCV) was screened in 201 Thai patients with acute and chronic liver disease who presented to Ramathibodi and Phya Thai Hospitals during 1984-1990. Of these, 29 patients (14.4%) were positive for anti-HCV. Circulating anti-HCV was determined in 92 family members (20 spouses, 72 household contacts) of these index cases and was detected in 5 contacts (2 spouses, 2 daughters and 1 mother) of 3 index cases. The overall prevalence of anti-HCV among the contacts was 5.4% (5/92) and it was higher in sexual partners (2/20, 10.0%) compared to other household contacts (3/72, 4.2%) but this was not statistically significant (p = 0.297). The anti-HCV-positive contacts were significantly older (mean +/- SD = 61.4 +/- 14.4) than the other contacts either comparing within the same families (26 +/- 16.5; p = 0.012) or all studied families (25.1 +/- 13.3; p = 0.006). One anti-HCV-positive contact had hepatocellular carcinoma, one had unexplained elevation of serum aminotransferase and the remaining 3 had no clinical or laboratory evidence of liver disease. All of the 3 index cases with anti-HCV-positive contacts, had chronic liver disease (2 cirrhosis, 1 chronic persistent hepatitis) and the prevalence of anti-HCV in these families (8/13, 61.5%) was significantly higher than the remaining 26 families (26/108, 24.1%) (p = 0.008). The results of this study suggest that sexual and other intrafamilial personal contact may be important for HCV transmission. Duration of close contact and family relationships appear to determine this mode of HCV transmission.

Acute Disease↗
PubMed1989

Prevalence, incidence, intensity and associated morbidity of intestinal helminths in south Thailand.

Intensive surveys for Ascaris lumbricoides, Trichuris trichiura and hookworm were carried out in two villages in Phang Nga Province, southern Thailand, in order to measure prevalence, estimate incidence and determine the relation between intensity of infection and morbidity before and after chemotherapy. The study populations were a small upland village community (Nai Tone) and a grade school in a small coastal village (Boh Saen). About half of the Nai Tone villagers were given a broad spectrum antihelminthic (albendazole), and the Boh Saen students were all treated successively with three drugs: piperazine citrate to treat for Ascaris, pyrantel pamoate to treat for hookworm, and mebendazole to treat for Trichuris. Stool examinations were made using the quick Kato smear technique, questionnaires were administered concerning a variety of possible symptoms, and anthropometric and blood biochemical parameters were measured both before and after treatment. The prevalence of Ascaris was 31.0 and 22.6%, hookworm was 89.1 and 88.0% and Trichuris was 59.7 and 77.8% in the Nai Tone and Boh Saen study populations, respectively. Average intensity of Ascaris was highest in the 0-9 year age class (greater than 32,000 epg) in Nai Tone Village. Hookworm intensity of infection was higher in males than in females in all age classes, and in Nai Tone Village at least 25% of males and 20% of females had 8000 or more epg of faeces. Trichuris intensity of infection was highest between 5 and 10 years of age in both populations. The only signs or symptoms showing a significant (P less than 0.05) difference between high and low classes of intensity of infection and a significant improvement (P less than 0.01) after drug treatment, were headache and flatulance in the case of hookworm infection in Boh Saen School. The presence of multiple infections made testing of hypotheses concerning particular parasite species difficult.

Age Factors↗
PubMed1989

Omeprazole or cimetidine once daily for the treatment of duodenal ulcers?

Thai patients (n = 257) entered a double-blind randomized trial to compare omeprazole, 20 mg once daily, and cimetidine, 800 mg once daily for treatment of duodenal ulcer. The healing rates observed in the omeprazole and cimetidine groups were 65% versus 45% (P less than 0.01) at 2 weeks and 97% versus 85% (P less than 0.01) at 4 weeks. At the end of 4 weeks' treatment, omeprazole achieved equal healing rates (97%) for both large (greater than 10 mm) and small ulcers, whilst cimetidine healed large ulcers at a lower rate than that observed for small ulcers (71% versus 89%). There were significantly fewer reports of daytime epigastric pain after 2 weeks of omeprazole compared with cimetidine (P less than 0.01). No major clinical side-effects or changes in laboratory variables were detected during or after treatment with either drug. In conclusion, omeprazole (20 mg) was found to be superior to cimetidine (800 mg) administered once daily for the treatment of duodenal ulcer as measured by ulcer healing and pain relief.

Adult↗
PubMed1989

Cholangiocarcinoma masquerading as liver abscess.

A 60-year-old man from Eastern Thailand was admitted to hospital because of right upper quadrant abdominal pain and fever. Ultrasonographic examination revealed two cavitary lesions in the right lobe of the liver. Needle aspiration obtained 110 ml of anchovy sauce-like pus which showed no bacteria on gram stain and routine culture. Serological test for E. histolytica antibody was negative. Initially, the patient responded well to metronidazole. Two weeks later, the symptoms recurred and sonography revealed one large cavitary lesion with three adjacent locules in the right lobe of the liver. Repeated needle aspiration again showed anchovy sauce-like pus which grew Enterobacter agglomerans. O. viverrini ova were detected in the stool. Laparotomy revealed histologically proven cholangiocarcinoma. This report indicates that O. viverrini infection associated with CCC can masquerade as liver abscess.

Adenocarcinoma↗
PubMed1989

Pancreatitis: an analysis of 106 patients admitted to Ramathibodi Hospital during 1969-1984.

In analysing 106 patients with pancreatitis admitted to Ramathibodi hospital from 1969 to 1984, 71 were males and 35 females. Their ages ranged from 8-83 years. Of the 106 patients, 92 were diagnosed as acute, and 14 as chronic pancreatitis; 49(46.2%), 48(45.3%), and 9(8.5%) had mild, moderately severe, and fulminant disease, respectively. Etiologically, chronic alcoholism, biliary tract stones, and unknown cause were found associated in 33.0, 24.5 and 22.6 per cent, of the total cases respectively. Relapsing pancreatitis occurred in 35 patients (33.0%), 27(77.1%) of whom were chronic alcoholic. Five (62.5%) of the 8 patients with traumatic induced pancreatitis were children. Among the more common clinical symptoms and findings: abrupt epigastric pain occurred in 76 patients (71.7%), localized abdominal tenderness in 59(55.7%), generalized abdominal tenderness in 33(31.1%), nausea and vomiting in 34(32.0%), fever of over 38 degrees C in 20 (18.8%), palpable mass in 17(16.0%), and ascites in 8(7.5%). Laboratorically, elevated serum amylase was the most useful single diagnostic test, i.e. it was elevated in 100(94.3%) of the 106 patients. Pseudocyst, pancreatic abscess, and GI hemorrhage with liver failure occurred in 10 (9.4%), 2(1.8%), and 3(2.8%) patients, respectively. Sixty-six patients were treated medically and 40 patients were subjected to surgery. Regardless of whether they were treated medically or surgically, 7 of the 9 patients with fulminating pancreatitis died, and another 2 remaining patients were taken home in moribund state.

Adolescent↗
PubMed1988

Histological, biochemical and clinical findings in hepatitis B carriers undergoing elective abdominal surgery.

Prospective surveillance for serum Hepatitis B surface Antigen (HBsAg) was performed in 255 patients undergoing elective abdominal surgery at Ramathibodi Hospital during 1984-1987. HBsAg was detected in 13 patients (5.0%), 11 of whom gave consent for serial evaluation of liver histology and laboratory findings. There were eight males and three females aged 20-75 years (mean = 43.4 years). Nine of the eleven patients had wedge liver biopsies taken at operation and two patients had percutaneous biopsies performed. All patients were followed up at 3-6 month intervals and after 20-36 months, follow-up liver biopsies by the percutaneous route were performed in the nine cases who gave consent. The histological findings of initial and follow-up biopsies from these patients were all abnormal, ranging from reactive hepatitis to chronic active hepatitis. During the follow-up study, none of the patients lost their HBs antigenemia and orcein staining of liver biopsies for HBsAg was positive in all ten cases tested. In the nine cases who underwent follow-up liver biopsy, progression of liver pathology was found in seven, although none of these patients showed clinical deterioration or had significant rise in HBsAg titre or SGOT/SGPT levels. The mean age of the five cases who progressed to CAH (51.2 years) was higher than that of the remaining four cases (32.5 years) who had no or minor changes in liver histology, although the difference was not significant. Of the five cases with progression to CAH, four cases were more than 40 years old. None of the conventional clinical or laboratory parameters correlated with the progression of liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1987

Opisthorchis viverrini infection in rural and urban communities in northeast Thailand.

The prevalence and intensity of liver-fluke (Opisthorchis viverrini) infection were investigated among 559 patients who were born in, and had lived all their lives in, either the rural or urban northeastern Thailand. 344 (79.4%) of 433 rural dwellers were infected compared with only 69 (54.8%) of 126 urban dwellers (P less than 0.005). The intensity of infection, and the reported level of consumption of koi-pla, a favourite dish of local inhabitants prepared from uncooked freshwater fish which often contains viable metacercariae, were greater among rural dwellers than their urban counterparts (P less than 0.05 to P less than 0.005). Infection due to O. viverrini appears to be mainly a rural problem strongly associated with the habit and frequency of eating koi-pla.

Adolescent↗
PubMed1987

A new solid phase passive hemagglutination test for IgM antibody to hepatitis B core antigen.

There is a need for a simple, sensitive, specific, and inexpensive test for immunoglobulin M antibody to hepatitis B core antigen (anti-HBc IgM). A solid phase passive hemagglutination test (SP-PHA) was developed for this purpose and compared with the enzyme-linked immunosorbent assay (ELISA) test. Hepatitis B core antigen (HBcAg) used in PHA and SP-PHA was synthesized in Escherichia coli. Human IgM was captured to a microtiter plate coated with anti-human IgM, and the presence of anti-HBc IgM was demonstrated by the adherence of HBcAg-sensitized erythrocytes to the bottom of a U-shaped microtiter plate. ELISA and SP-PHA were made at 1:100 and 1:1,000 serum dilution, respectively. Both were positive in 100% of 36 cases of acute hepatitis B, 68.18% of 22 cases of chronic hepatitis B, and 20% of 75 healthy carriers of hepatitis B surface antigen (HBsAg) but none in 65 anti-HBc-positive blood donors that had negative results for HBsAg. Results of both tests were identical but were false positive because rheumatoid factor was found only in ELISA. End-point titration by SP-PHA and PHA was also found useful for the differentiation of acute hepatitis B from chronic hepatitis B and HBsAg carriers.

Enzyme-Linked Immunosorbent Assay↗
PubMed1986

Detection of antibodies in sera from patients with Opisthorchiasis.

The indirect immunofluorescent antibody technique (IFA) was used for detection of antibodies in sera of patients with Opisthorchiasis. Antibodies to fluke worm and egg antigens were detected in 166 of 205 (81%) patients. The test showed that only the IgG class of antibodies reacting exclusively with integumental wall of the worm (AW) were positive in 46.8% (96/205), reacting only with the wall of intact eggs in 11 out of 205 (5.4%) and antibodies to both fluke and their egg antigens were present in 28.8% (59/205). In addition, 5.4% (11/205) of patients' sera were positive for autoantibodies producing a speckled antinuclear antibodies (ANA) pattern. The sera positive for only AW contained detectable autoantibodies to other cell antigens including: anti-smooth muscle antibodies of 9.4% (9/96), antimitochondrial antibodies of 3.1% (3/96), anti-liver/kidney microsomes of 1% (1/96) and anti-parietal cell antibodies of 1% (1/96). Autoantibodies were undetectable in sera from normal subjects. Among the ANA positive sera, 55% (6/11) exhibited antibodies against an extractable nuclear antigen (ENA) by a tanned red cell hemagglutination assay. This finding may suggest that the autoantibody response was due to the cross reaction between worm antigen and self antigen or it may be the result of polyclonal activation of B lymphocytes in these patients.

Adolescent↗
PubMed1986

Clinical field trial of praziquantel in opisthorchiasis in Nong Rangya Village, Khon Kaen Province, Thailand.

A clinical field trial of praziquantel was carried out in Nong Ranya Village, Amphoe Ban Phai, Khon Kaen Province, with a population of 309 individuals, and 94% prevalence rate of opisthorchiasis. A mass treatment was carried out using a single dose of praziquantel at 40 mg per kg body weight. Acceptance for treatment was 91%. Follow-up stool examinations performed on days 14 and 60 gave prevalence rates of 20.5% and 22.2% respectively. Side effects including dizziness, headache, abdominal discomfort, nausea, vomiting, diarrhoea, lassitude, arthralgia, sleepiness, cramps and hot sensation were the complaints from 80% of adults and 40% of children. All of these were mild and transient except in one adult female who had severe diarrhoea and required intravenous fluid infusion.

Adolescent↗
PubMed1985

Opisthorchis viverrini infection and cholangiocarcinoma. A prospective, case-controlled study.

During a prospective, 24-mo case-controlled study, 551 patients from northeastern Thailand were independently evaluated for Opisthorchis viverrini infection, hepatobiliary tract disease, and hepatic carcinoma to determine whether there was any association between hepatic carcinoma and O. viverrini infection. Stool examination by the formalin-ether concentration method revealed O. viverrini ova in 389 (70.6%) patients. Of the 551 patients, 72 (13.1%) had both clinical and laboratory evidence of hepatobiliary tract disease, chronic liver disease, or hepatic carcinoma, alone or in combination. Of these 72 patients, 28 (38.9%) had a liver biopsy that revealed cholangiocarcinoma in 7 patients with O. viverrini ova in their stools, and in 4 patients without. In another patient with ova in the stool combined hepatocellular carcinoma and cholangiocarcinoma was found. In the 4 patients with cholangiocarcinoma who had no O. viverrini ova in their stools, ova were detected in the bile fluid aspirated from the intrahepatic biliary tree during exploratory laparotomy. An additional patient with clinically suspected cholangiocarcinoma and O. viverrini ova in stool had a left supraclavicular lymph node biopsy specimen taken that revealed metastatic adenocarcinoma; this adenocarcinoma was interpreted as compatible with cholangiocarcinoma. Cholangiocarcinoma, therefore, was found only in patients with O. viverrini ova in stool or in the intrahepatic biliary tree. Statistical analysis revealed that patients with known O. viverrini infection had a higher incidence of cholangiocarcinoma than did patients without such infection (X2 test, p less than 0.05).

Adenoma, Bile Duct↗