Suvit Bunyavejchevin

Prevalence of osteopenia and osteoporosis in Thai women.

ObjectiveTo determine the age-specific and age-adjusted prevalence of osteopenia and osteoporosis in pre-and postmenopausal Thai women. MethodsThis was a descriptive study of 1,935 Thai women ranging in age from 40 to 80 years, with randomly selected strata using multistage sampling and stratifying from six representative provinces of the country. After recruiting, all the women were interviewed by a well-trained interviewer using structured questionnaires. Bone mineral density (BMD) of lumbar spine 1-4 and nondominant hip was measured by a dual energy photon absorptiometer. The investigators were trained and standardized; inter-and intraobserver variations were measured periodically. Every BMD outcome was re-examined by the specialist. Age-specific prevalence of osteoporosis and osteopenia were determined using both Thai and Western standard BMD values. Age-adjusted prevalence of osteopenia and osteoporosis was calculated using the age-adjusted direct method. ResultsUsing the Thai BMD reference, the age-specific prevalence of osteoporosis among Thai women rose progressively with increasing age to more than 50% after the age of 70. The age-adjusted prevalence of osteoporosis also rose progressively. It was 19.8%, 13.6%, and 10% for lumbar spine, femoral neck, and intertrochanteric. The age-adjusted prevalence of osteoporosis indicates the overall magnitude of that condition in the population or country. In our study, using a Western BMD reference resulted in a misleadingly high prevalence of osteoporosis in the population of Asian countries. ConclusionIt is important to calculate the age-adjusted prevalence of osteopenia and osteoporosis to address the overall magnitude of the problem in Thai women. This will allow us to predict the socioeconomic impact of preventable chronic conditions such as osteoporosis. The results obtained from this study are important data for public health policy: maximizing bone mass throughout life as well as detection of important risk factors is essential.

Dengue Hemorrhagic Fever during Pregnancy : Antepartum, Intrapartum and Postpartum Management

Dengue hemorrhagic fever is a common tropical disease in Thailand that nowadays has an increasing incidence during adulthood.

Validation of the Prolapse Quality of Life (P-QOL) questionnaire in Thai version

Introduction and hypothesisThe aim of this study was to validate the Thai version of the Prolapse Quality of Life (P-QOL) questionnaire.MethodsThe P-QOL questionnaire was translated into Thai. Test–retest reliability and internal consistency were tested. All patients who visit the gynecologic outpatient clinic of King Chulalongkorn Memorial Hospital between March 2008 and September 2009 completed the P-QOL questionnaires.ResultsOne hundred fifteen patients with symptomatic pelvic organ prolapse and 60 asymptomatic patients were included. There was a significant correlation between P-QOL domain scores and vaginal examination findings (POP-Q stage). A higher POP-Q stage and a higher impact on quality of life were detected in symptomatic patients. The total scores from all domains were significantly higher in symptomatic patients.ConclusionThe Thai version of the P-QOL questionnaire is a valid, reliable, and simple instrument to assess the symptoms’ severity and the quality of life in Thai-speaking patients with pelvic organ prolapse.

Preemptive Analgesic Efficacy of Parecoxib vs Placebo in Infertile Women Undergoing Diagnostic Laparoscopy: Randomized Controlled Trial

STUDY OBJECTIVE To compare the preemptive analgesic efficacy between parecoxib and placebo in infertile women undergoing outpatient diagnostic laparoscopy. DESIGN Double-blind, randomized, placebo-controlled study (Canadian Task Force classification I). SETTING Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. PATIENTS Sixty infertile women undergoing diagnostic laparoscopy from November 2009 to January 2011. INTERVENTION Patients were randomized to receive either 40 mg parecoxib (treatment group) or normal saline solution as placebo (control group) intravenously at 15 minutes before surgery. Postoperative shoulder and wound pain was self-assessed using a visual analog scale at 2, 6, 12, and 24 hours after surgery. Administration of rescue analgesic agents, and adverse effects were recorded. MEASUREMENTS AND MAIN RESULTS There were 30 patients in each group. Shoulder pain scores at each time measured, as well as wound pain score, was significantly lower in the parecoxib group compared with the placebo group (p < .001). The percentage of patients who required postoperative rescue analgesic therapy was lower in the treatment group compared with the control group (26.7% and 40.0%, respectively; p = .04). The treatment group required less rescue analgesic therapy than did the control group (mean [SD], 314.8 [53.9] and 842.6 [122.7] mg acetaminophen; p = .04). There was no significant difference in adverse effects between the 2 groups. CONCLUSION Preoperative administration of 40 mg parecoxib, compared with placebo, provided significantly superior postoperative pain relief after diagnostic laparoscopy.

Successful treatment of a heterotopic tubal pregnancy by gasless laparoscopic surgery

Heterotopic pregnancy is a rare event and management is by either laparotomy or laparoscopic surgery to remove the extrauterine pregnancy. As there has been no report detailing the use of gasless laparoscopy for management of heterotopic pregnancy, the authors herein report a case of heterotopic pregnancy that was successfully managed by gasless laparoscopic surgery. The subsequent antenatal course was unremarkable. The intrauterine pregnancy carried to term with uneventful maternal and fetal outcomes. Thus, gasless laparoscopy can be used as an alternative method for the management of heterotopic pregnancy.

Attitudes toward pessary use among Thai women with pelvic organ prolapse

This study was conducted to investigate attitudes toward pessary use in Thai women with pelvic organ prolapse (POP).

Symptom score change and patient versus doctor satisfaction in overactive bladder before and after anti-muscarinic treatment

To evaluate voiding symptoms and questionnaire score change before and after anti‐muscarinic treatment and evaluate the correlation of agreement in patient and doctor satisfaction after treatment.

Overactive Bladder Symptom Scores responsiveness before and after anticholinergic treatment in women with overactive bladder: The pilot study

The aims of this study were: (i) to evaluate change of Overactive Bladder Symptom Scores (OABSS) from before to after solifenacin treatment; and (ii) to evaluate correlation between change of OABSS and 3‐day micturition diary, International Prostate Symptom Score (IPSS), and Patient Perception of Bladder Condition (PPBC).

Correlations of third-trimester hiatal biometry obtained using four-dimensional translabial ultrasonography with the delivery route in nulliparous pregnant women

Purpose: The goal of this study was to evaluate normal hiatal dimensions in the third trimester in nulliparous Thai pregnant women and to establish which biometric factors were associated with various pregnancy outcomes. Methods: Fifty-seven consecutive nulliparous pregnant Thai women in their third trimester were recruited on a voluntary basis from April to October 2014. All subjects underwent four-dimensional (4D) translabial ultrasonography. Hiatal biometric parameters were measured at rest, while performing a Valsalva maneuver, and during contraction. Information about the patients’ eventual deliveries was obtained from their medical records. Results: The mean values of the patients’ age, body mass index, and gestational age at the time of examination were 27.4±5.47 years, 26.7±3.48 kg/m2, and 36.6±1.49 weeks, respectively. No subjects had vaginal lumps or experienced prolapse greater than stage 1 of the Pelvic Organ Prolapse Quantification system. Ultrasonography showed that the mean values of the hiatal area at rest, while performing a Valsalva maneuver, and during contraction were 13.10±2.92 cm2, 17.50±4.81 cm2, and 9.69±2.09 cm2, respectively. The hiatal area at rest, the axial measurement at rest, and the axial measurement while performing a Valsalva maneuver were significantly associated with the route of delivery (P=0.02, P=0.04, and P=0.03, respectively). Conclusion: The route of delivery was associated with hiatal biometric values measured using 4D translabial ultrasonography, based on the results of nulliparous Thai women in the third trimester.

Should we use the shorter Thai‐version quality of life and symptoms questionnaires in women with overactive bladder?

The aim of this study was to test: (i) the validation and reliability of the Thai versions of overactive bladder (OAB) questionnaires (the 8‐item and 3‐item Overactive Bladder Symptoms Score questionnaires [OAB‐v8 and OAB‐v3, respectively] and the Overactive Bladder Questionnaire [OAB‐q]); and (ii) the correlation of the OAB‐v8, OAB‐v3, and the single‐question Quality of Life Questionnaire (1‐QoL) to the OAB‐q in Thai women with OAB.