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Biomedical subjects

S Punyagupta

Publications and source records attributed to S Punyagupta.

At least 19 recordsLinked to original sources
PubMed2001

The long term outcome of thirty eight post-transfusion hepatitis C.

Thirty-eight cases of post-transfustion HCV hepatitis have been followed for 5-24 years. Cirrhosis and hepatocellular carcinoma were found in 44.7 per cent and 13.1 per cent respectively. Cirrhosis was recognised by pathological evidence as early as one and a half years after transfusion and the clinical evidences of decompensated cirrhosis were noted in the fifth year post-transfusion onward. Hepatocellular carcinoma was first recognised in year ten and thereafter. Nine patients died of liver failure or hepatocellular carcinoma during years 8-16 of the follow-up. Therefore, it is of utmost importance to screen out the HCV infected blood donors and to treat the HCV patients as early and as effectively as possible.

Adult↗
PubMed1999

Clinical study of 457 cholecystectomy cases in a private hospital.

This is a retrospective study of 457 cases of cholecystectomized patients, who were admitted to Vichaiyut Hospital from 1970 to 1996. The ratio of male to female was 1:1.6 and the most common age range was 51-60 years, 45.3 per cent of patients were older than 60 years. Associated or underlying diseases were highly prevalent (81.6%). Diabetes mellitus, cardiovascular disease and liver disease were the three most common associated diseases. In acute cholecystitis the pathological findings were in accordance with clinical feature in only 46.2 per cent but in chronic or subsided cholecystitis pathology confirmed in 97.5 per cent. Carcinoma of the gallbladder was found in 0.9 per cent. Clinical diagnosis of cholecystitis was incorrect in 1.1 per cent. Multiple gallstones were found in 67.3 per cent, single stone in 23.5 per cent, sand stones in 2.1 per cent and acalculous cholecystitis in 7.1 per cent. Combined gallstones and CBD stones were found in 9.8 per cent. Enteric bacteria were isolated from the bile in 32.5 per cent and in acute cholecystitis similar organisms were isolated from both bile and blood cultures in 12.8 per cent. Morbidity rate of cholecystectomy was 7.6 per cent, the most common complication was perioperative infection in 3.5 per cent. It is interesting to find that atelectasis was recognized only in 2 out of 57 laparoscopic cholecystectomy. Mortality rate was low (0.66%).

Adult↗
PubMed1992

Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis.

A prospective randomized trial was conducted at Srinagarind and Khon Kaen hospitals. Ceftazidime (100 mg/kg of body weight per day) and co-trimoxazole (trimethoprim, 8 mg/kg/day; sulfamethoxazole, 40 mg/kg/day) therapy was compared with conventional therapy (chloramphenicol, 100 mg/kg/day; doxycycline, 4 mg/kg/day; trimethoprim, 8 mg/kg/day; sulfamethoxazole, 40 mg/kg/day) in the treatment of 64 patients with bacteriologically confirmed cases of severe melioidosis who were admitted during September 1986 to January 1989. Of 61 evaluable patients (3 were excluded because of severe drug allergies), 42 were septicemic, and 31 of these patients had the most severe form, disseminated septicemic melioidosis. Their cumulative mortalities on day 7 were compared. There were significantly lower overall mortalities from melioidosis, septicemic melioidosis, and disseminated septicemic melioidosis in the group receiving the new treatment compared with those in the group receiving the conventional treatment (47 versus 18.5% [P = 0.039], 57.7 versus 25% [P = 0.039], and 82.3 versus 30.7% [P = 0.006], respectively); but the differences could have been influenced by the greater severity of illness, e.g., shock at initial presentation, in the patients who received the conventional treatment. Among patients with disseminated septicemia and initial shock, there was no significant difference in mortality between the regimens. Both regimens effectively eradicated bacteria from the circulation within 24 h (97 versus 96%, respectively). We recommend ceftazidime and co-trimoxazole as the drugs of choice for treatment of severe melioidosis, especially in those patients with disseminated septicemia.

Adult↗
PubMed1990

Eosinophilic meningitis in Thailand. Clinical and epidemiological characteristics of 162 patients with myeloencephalitis probably caused by Gnathostoma spinigerum.

The clinical and epidemiological characteristics of 162 patients with eosinophilic myeloencephalitis, believed to be caused by invasion of the central nervous system by Gnathostoma spinigerum, are described. The case mortality rate was at least 12%, and probably higher. Single live young adult G. spinigerum were recovered from the brains of 2 patients at autopsy and from the eye lids of 2 other living patients. The disease caused by this parasite can be distinguished from that caused by Angiostrongylus cantonensis by characteristic acute nerve root pain, signs of spinal cord and cerebral involvement, and the presence of bloody or xanthochromic cerebrospinal fluid. As judged by its prevalence and mortality, central nervous system disease caused by G. spinigerum is the most important parasitic disease of the central nervous system in Thailand. Since invasion of the nervous system by this parasite is a significant cause of intracranial hemorrhage in Thailand, it should be kept in mind by internists, neurologists, neurosurgeons, and pathologists who care for patients residing in, or who have visited, areas where G. spinigerum occurs.

Adolescent↗
PubMed1981

Study on pathogenicity and central nervous system migration of the larval stage of Gnathostoma spinigerum in experimental animals.

Studies were conducted on the pathogenicity and the route of migration to the central nervous system by the immature larval stage of G.spinigerum in experimental animals. Five mice and one rat showed signs of nervous tissue damage and CNS involvement. The significant findings were massive haemorrhagic areas and blood clot around large lower nerve trunk and spinal cord invasion by the worm. The possible roles of the immature larval stages of G.spinigerum in human was discussed.

Animals↗
PubMed1975

Eosinophilic meningitis in Thailand. Clinical studies of 484 typical cases probably caused by Angiostrongylus cantonensis.

Six hundred and forty-six patients with an eosinophilic pleocytosis were studied in Thailand over a 3-year period ending in March 1968. It was possible to segregate the cases into two clinical entities, which were termed typical eosinophilic meningitis and eosinophilic myeloencephalitis respectively. The clinical and laboratory finding of 484 cases of typical eosinophilic meningitis are reported here. The latter entity was generally benign and self-limited with a case mortality ratio of less than 0.5%. Acute severe headache was the most significant symptom. Fever was uncommon and abnormal neurologic findings were absent in 58% of cases. Sixteen percent of patients had visual impairment and 12% had an abnormal fundus. Impairment of the sensorium of a slowly progressive type and weakness of the extremities without localization were noted in 5% and less than 1% of patients, respectively. These signs occurred only in severely ill patients. Involvement of the cranial nerves was found in 17% of patients. Paralysis of the external rectus muscle of the eye and facial paralysis were found in 3% and 4%, respectively. The cerebrospinal fluid was characteristically turbid with a leucocyte count of more than 500 cells per mm3 in 75% of cases. It appeared that specific treatment of the disease was not indicated and that steroids and antibiotics did not have a definite beneficial effect on the course of the illness.

Adolescent↗