Chenchit Chayachinda

Premenstrual Syndrome in Thai Nurses

Objective. To investigate prevalence of premenstrual syndrome (PMS) and its associated factors among Thai nurses. Methods. The study was conducted in 423 nurses in a university hospital during October 2005 to March 2006. Prevalence of PMS was determined using a validated Thai version of Premenstrual Symptoms Screening Tool (PSST). Factors associated with PMS were analyzed using Student t-test and Chi-square test. Results. The prevalence of PMS in Thai nurses was 25.1%. Nurses with younger age, nulligravida, lower income, more coffee consumption, dysmenorrhea, and negative attitude toward menstruation had higher prevalence of PMS. After multiple logistic regression analysis, the significant factors associated with PMS were coffee consumption >1 cups/day and negative attitude toward menstruation; odds ratios (95% confidence interval) were 2.322 (1.257 to 4.288) and 5.768 (2.096 to 15.872), respectively. Conclusion. According to the Thai PSST, 25.1% of Thai nurses are suffering from PMS. The significant associated factors were more coffee consumption and negative attitude toward menstruation.

Prevalence and cumulative incidence of abnormal cervical cytology among HIV-infected Thai women: a 5.5-year retrospective cohort study

BackgroundCervical cancer is one of the most common AIDS-related malignancies in Thailand. To prevent cervical cancer, The US Public Health Service and The Infectious Disease Society of America have recommended that all HIV-infected women should obtain 2 Pap smears 6 months apart after the initial HIV diagnosis and, if results of both are normal, should undergo annual cytological screening. However, there has been no evidence in supporting whether this guideline is appropriate in all settings - especially in areas where HIV-infected women are living in resource-constrained condition.MethodsTo determine the appropriate interval of Pap smear screenings for HIV-infected Thai women and risk factors for subsequent abnormal cervical cytology, we assessed the prevalence, cumulative incidence and associated factors of cervical cell abnormalities (atypical squamous cell of undetermined significance or higher grades, ASCUS+) among this group of patients.ResultsThe prevalence of ASCUS+ was 15.4% at the first visit, and the cumulative incidence of ASCUS+ gradually increased to 37% in the first 3.5 years of follow-up appointments (first 7 times), and tended to plateau in the last 2 years. For multivariate correlation analysis, women with a CD4 count <350 cells/μL had a significant correlation with ASCUS+ (P = 0.043). There were no associations of subsequent ASCUS+ with age, pregnancy, contraceptive method, highly active anti-retroviral treatment, assumed duration of infection, or the CD4 count nadir level.ConclusionThere are high prevalence and cumulative incidence of ASCUS+ in HIV-infected Thai women. With a high lost-to-follow-up rate, an appropriate interval of Pap smear screening cannot be concluded from the present study. Nevertheless, the HIV-infected Thai women may require more than two normal semi-annual Pap smears before shifting to routinely annual cytologic screening.

Dyspareunia and Sexual Dysfunction after Vaginal Delivery in Thai Primiparous Women with Episiotomy

INTRODUCTION Episiotomy remains commonly practiced in Thailand. There are limited data on its impacts on sexuality among Asian women during the first postdelivery year. AIMS The aim was to study dyspareunia and sexual function at 3-12 months after vaginal delivery in Thai primiparous women with episiotomy. METHODS A total of 190 participants were approached on Day 2 postpartum. Of these, 93 sexually active women were evaluated for dyspareunia and sexual function at 3 months by using 10-cm visual analog scale and the validated Thai version of Female Sexual Function Index (TFSFI). TFSFI < 26.5 was defined as having potential sexual dysfunction. At 6 and 12 months, sexual function was evaluated by telephone interview. MAIN OUTCOME MEASURES The prevalence of dyspareunia at 3 months and the changes of TFSFI scores during the first postdelivery year were the main outcome measures. RESULTS The average age of the participants, over 90% of whom were high school finishers, was 24. Their partners were around 3 years older, and the median partnership duration was 3 years. At 3 months, 30.1% of participants reported dyspareunia. There was no association between dyspareunia and the following characteristics: pre-pregnancy dyspareunia, newborns head circumference and birthweight and breast-feeding (P > 0.05 for all). Sexual dysfunction was demonstrated in 66.7% at 3 months, 31.0% at 6 months, and 14.9% at 12 months. From 3 to 12 months, the median TFSFI scores in all domains increased significantly. There was no difference of the scores in all domains at 3 and 12 months between women with and without dyspareunia at 3 months. However, at 6 months, those without dyspareunia had better scores in pain, orgasm, satisfaction, and total scores (P < 0.05 for all). CONCLUSION Dyspareunia at 3 months is common in Thai primiparous women with episiotomy. Those with dyspareunia have a slower resumption of normal sexual function.

Post-partum, post-sterilization tubo-ovarian abscess caused by Fusobacterium necrophorum: a case report

IntroductionPost-partum, post-sterilization tubo-ovarian abscess is a rare event. Fusobacterium necrophorum subspecies funduliforme, a normal flora found mainly in the oral cavity, appears to be the etiologic organism.Case presentationIn this case report, a 25-year-old Thai woman had a post-partum, post-sterilization tubo-ovarian abscess caused by the strictly anaerobic bacterium, Fusobacterium necrophorum subspecies funduliforme. Progressively severe symptoms started 3 weeks after her third vaginal delivery with a tubal sterilization on the following day. On admission, she presented with peritonitis and impending shock. An exploratory laparotomy showed a ruptured left tubo-ovarian abscess. A segment of her ileum had to be resected because of severe inflammation.ConclusionsFusobacterium necrophorum subspecies funduliforme can be an etiologic organism of a ruptured tubo-ovarian abscess following tubal sterilization in a healthy host.

Reported reasons for breakdown of marriage and cohabitation in Britain: Findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Objectives Breakdown of marriage and cohabitation is common in Western countries and is costly for individuals and society. Most research on reasons for breakdown has focused on marriages ending in divorce and/or have used data unrepresentative of the population. We present prevalence estimates of, and differences in, reported reasons for recent breakdown of marriages and cohabitations in Britain. Methods Descriptive analyses of data from Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability sample survey (15,162 people aged 16–74 years) undertaken 2010–2012, using computer-assisted personal interviewing. We examined participants’ reported reasons for live-in partnership breakdown in the past 5 years and how these varied by gender and partnership type (married vs. cohabitation). Results Overall, 10.9% (95% CI: 9.9–11.9%) of men and 14.1% (13.2–15.0%) of women reported live-in partnership breakdown in the past 5 years. Mean duration of men’s marriages was 14.2 years (95% CI: 12.8–15.7) vs. cohabitations; 3.5 years (3.0–4.0), and for women: 14.6 years (13.5–15.8) vs. 4.2 years (3.7–4.8). Among 706 men and 1254 women reporting experience of recent breakdown, the reasons ‘grew apart’ (men 39%, women 36%), ‘arguments’ (27%, 30%), ‘unfaithfulness/adultery’ (18%, 24%, p<0.05), and ‘lack of respect/appreciation’ (17%, 25%, p<0.05) were the most common, irrespective of partnership type. A total of 16% of women vs. 4% of men cited domestic violence. After adjusting for age at interview and duration of partnership, there were no significant differences in reasons given for breakup by partnership type, except that men more commonly cited ‘moving due to changing circumstances’ as a reason for a cohabitation ending than for a marriage (AOR = 3.78, 95% CI: 1.08–13.21); and among women, ‘not sharing housework’ (0.54, 0.35–0.83) and ‘sexual difficulties’ (0.45, 0.25–0.84) were less commonly cited as reasons for cohabitation ending than marriage. Conclusion These representative data on recently ended marriages and cohabitations among men and women in Britain show that there were more similarities than differences in the reasons reported for breakdown across partnership type. For both marriages and cohabitations, cited reasons relating to communication and relationship quality issues were most common, followed by unfaithfulness/adultery. Our findings support a focus on relationship quality, including communication and conflict resolution, in preventive and therapeutic interventions addressing breakdown of live-in partnerships.

Reproductive outcomes of patients being hospitalised with pelvic inflammatory disease

Abstract This study aimed to investigate the prevalence and the predictors of the adverse reproductive outcomes in patients who had been hospitalised with pelvic inflammatory disease (PID). The retrospective cohort study was conducted by contacting all the patients admitted with PID or tubo-ovarian abscess (TOA) during January 2004 and December 2011. Those who were sexually active and aged 14–40 years were included. The exclusion criteria were no intention to conceive or undergoing hysterectomy, bilateral salpingo-oophorectomy, bilateral complete or partial salpingectomy. At a follow-up duration of 69 [IQR 51–93] months, of 94 eligible participants, 24 (25.5%) met the criteria of infertility, 15 (16.0%) had recurrent PID and 13 (13.8%) reported chronic pelvic pain. Less than half had subsequent pregnancies including 30 live births, seven miscarriages and one ectopic pregnancy. There was no association between the adverse reproductive outcomes and length of hospital stay >6 days, surgical treatment and recurrent PID. After adjusting for age, parity, abortion, hospital stay, surgical treatment, TOA was the only negative predictive factor for live birth (aOR 0.23, 95%CI 0.07–0.79, p = .019). The high prevalence of adverse outcomes following PID or TOA should alert clinicians for proper long-term care.

No association between CYP17 ‐34T/C polymorphism and insulin resistance in Thai polycystic ovary syndrome

To investigate the association of CYP 17 ‐34T/C polymorphism with insulin resistance (IR) in Thai polycystic ovary syndrome (PCOS).

Number of External Anogenital Warts is Associated with the Occurrence of Abnormal Cervical Cytology

BACKGROUND Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. OBJECTIVES To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. MATERIALS AND METHODS Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. RESULTS A total of 191 women were eligible, with a mean age of 27.0±8.9 years; and a mean body mass index of 20.6±8.9 kg/m2. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ≥ 5 was the only factor associated with LSIL+ (aOR 2.65, 95%CI 1.11-6.29, p 0.027). CONCLUSIONS LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.