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Papers by Wilaiwan Chongruksut

Research paper thumbnail of Predicting Factors of Poor Outcome of Hemorrhagic Stroke Patients

Journal of the Medical Association of Thailand, Mar 1, 2019

Research paper thumbnail of Patcharin Khamnuan1,2

Background: Necrotizing fasciitis, a relatively uncommon infection involving the skin, subcutaneo... more Background: Necrotizing fasciitis, a relatively uncommon infection involving the skin, subcutaneous tissue, and fascia, is a rapidly progressive soft tissue infection and a medical and surgical urgency. Delayed debridement, with subsequent huge soft tissue loss is associated with loss of limb and infection and is the most common cause of mortality. The purpose of this work is to describe the epidemiology of necrotizing fasciitis and to identify the clinical characteristics that may be used to predict amputation in routine clinical practice. Methods: Retrospective cohort study data were collected from three general hospitals located in the Chiang Rai, Kamphaeng Phet, and Phayao provinces in northern Thailand. Epidemiologic data for all patients with a surgically confirmed diagnosis of necrotizing fasciitis between 2009 and 2012 were collected. Medical records and reviews were retrieved from inpatient records, laboratory reports, and registers. Clinical predictors for amputation were analyzed by multivariable risk regression. Results: A total of 1,507 patients with a diagnosis of necrotizing fasciitis were classified as being with amputation (n=127, 8.4%) and without amputation (n=1,380, 91.6%). The most common causative Gram-positive and Gram-negative pathogens were Streptococcus pyogenes (33.3% in the amputation group and 40.8% in the non-amputation group) and Escherichia coli (25% in the amputation group and 17.1% in the non-amputation group). Predictive factors for amputation included gangrene (risk ratio [RR] 4.77, 95% confidence interval [CI] 2.70-8.44), diabetes mellitus (RR 3.08, 95% CI 1.98-4.78), skin necrosis (RR 2.83, 95% CI 2.52-3.18), soft tissue swelling (RR 1.76, 95% CI 1.24-2.49), and serum creatinine values 1.6mg/dLonadmission(RR1.71,951.6 mg/dL on admission (RR 1.71, 95% CI 1.38-2.12). All data were analyzed using the multivariable risk regression generalized linear model. Conclusion: The most causative pathogens were S. pyogenes and E. coli. Clinical predictors for amputation in patients with necrotizing fasciitis included having diabetes mellitus, soft tissue swelling, skin necrosis, gangrene, and serum creatinine values 1.6mg/dLonadmission(RR1.71,951.6 mg/dL on admission. Thus, patients with any of these predictors should be monitored closely for progression and receive early aggressive treatment to avoid limb loss.

Research paper thumbnail of The association between proton pump inhibitor use and the risk of adverse kidney outcomes: a systematic review and meta-analysis

Nephrology, Dialysis and Transplantation, Feb 23, 2017

Background: Existing epidemiological studies illustrate that proton pump inhibitors (PPIs) may be... more Background: Existing epidemiological studies illustrate that proton pump inhibitors (PPIs) may be related to adverse kidney outcomes. To date, no comprehensive meta-analysis has been conducted to evaluate and quantify this association. Methods: We performed a systematic review and meta-analysis of studies to assess the association between PPI use and the risk of adverse kidney outcomes. We searched MEDLINE, Embase, SCOPUS, Web of Science, CINAHL, Cochrane Library and grey literature with no language restrictions (through 31 October 2016). Adverse kidney outcomes were acute interstitial nephritis (AIN), acute kidney injury (AKI), chronic kidney disease (CKD) and end-stage renal disease (ESRD). The risk ratios (RRs) and confidence intervals (CIs) were pooled using a random effects model. The strength of evidence (SOE) for each outcome was assessed using the Grading of Recommended Assessment, Development and Evaluation system. Results: Of 2037 identified studies, four cohort and five casecontrol studies with $2.6 million patients were included. Of these, 534 003 (20.2%) were PPI users. Compared with non-PPI users, PPI users experienced a significantly higher risk of AKI [

Research paper thumbnail of Use of serotonin reuptake inhibitor antidepressants and the risk of bleeding complications in patients on anticoagulant or antiplatelet agents: a systematic review and meta-analysis

Research paper thumbnail of Kidney stones recurrence and regrowth after extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

OBJECTIVE To estimate and compare the incidence rate of kidney stone recurrence and regrowth afte... more OBJECTIVE To estimate and compare the incidence rate of kidney stone recurrence and regrowth after ESWL with PCNL at one, two, and three years. MATERIAL AND METHOD A retrospective cohort study was performed The study recruited patients aged more than 18 years, diagnosed with kidney stones and treated by ESWL or PCNL between January 2006 and August 2010 at the urological unit of a university hospital located in the northern part of Thailand. Data were retrieved from medical records and analyzed using exact probability test or student's t-test. Poisson regression was used to compare the recurrence rate and the regrowth rate between ESWL and PCNL. RESULTS During three years of follow-up, the overall stones recurrence and regrowth were 15.5% and 25.1% in ESWL group and 12.6% and 16% in PCNL group, repectively. At one, two and three years after treatment, stones recurrence rate in the ESWL group were 13.1, 7.5 and 7.3 per 1,000 patient-months while in the PCNL group were 11.3, 6.1 an...

Research paper thumbnail of Prognostic factors for success in treating kidney stones by extracorporeal shock wave lithotripsy

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

BACKGROUND Extracorporeal shock wave lithotripsy (ESWL) is widely used worldwide to treat kidney ... more BACKGROUND Extracorporeal shock wave lithotripsy (ESWL) is widely used worldwide to treat kidney stone because it is without invasive and can be done on an outpatient basis. However, not all patients are treated successfully. The success of kidney stone treatment by ESWL depends on several factors. OBJECTIVE To investigate prognostic factors for the successful treatment of kidney stones by ESWL. MATERIAL AND METHOD A prospective cohort study was made of 394 patients with kidney stone who underwent ESWL using Storz SLX-20 Lithotripter at Chiang Mai University Hospital between June 2008 and October 2009. All patients were followed up for three months after treatment to evaluate treatment success. Success was defined as the presence of clinically insignificant residual fragments less than or equal to 4 mm or complete clearance of the stones. Data were analyzed using exponential risk regression to determine the prognostic factors of ESWL treatment success. RESULTS The ESWL treatment suc...

Research paper thumbnail of Predictors for kidney stones recurrence following extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL)

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2012

BACKGROUND Stone recurrence after extracorporeal shock wave lithotripsy (ESWL) or percutaneous ne... more BACKGROUND Stone recurrence after extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL) are common. Predictors for kidney stones vary among populations and areas. OBJECTIVE To determine predictors for kidney stones recurrence after ESWL or PCNL. MATERIAL AND METHOD A retrospective cohort study was conducted at a university hospital. The study cohort was patients aged more than 18 years, diagnosed with kidney stones, who were treated with ESWL or PCNL between 2006 and 2009. Medical files were reviewed for clinical profiles, stone characteristics, composition, type of treatment, presence of stone after treatment, stone reappearance, and related laboratory data. Predictors were determined by a multivariable poisson regression and presented as incidence rate ratios (IRRs) with 95% confidence interval. RESULTS From a cohort of 252 patients, 240 who had at least one follow-up and with complete plain kidney ureters and bladder (KUB) film or intravenous pyelogr...

Research paper thumbnail of Experience of Maharaj Nakorn Chiang Mai Hospital in extravesical ureteral reimplantation for vesicoureteral reflux in pediatric patients

Insight Urology

Objective: The most commonly used technique for vesicoureteral reflux (VUR) treatment in pediatri... more Objective: The most commonly used technique for vesicoureteral reflux (VUR) treatment in pediatric patients in Maharaj Nakorn Chiang Mai Hospital is extravesical ureteral reimplantation (EUR). This report describes our experience of clinical outcomes of this technique. Materials and Methods: A total of 30 children underwent EUR for unilateral and bilateral VUR between July 2007 and June 2015. We retrospectively reviewed their medical records. Patient characteristics, operative time, duration of catheter drainage, length of postoperative hospital stay, and perioperative complications were evaluated. Results: Twenty-two boys and 8 girls with a mean age of 4.4 years (range, 0.5-14.6) were included in the study. Reflux was graded 1 to 5. Fourteen unilateral and 16 bilateral procedures were performed. A Pfannenstiel incision was implemented in the first 20 cases and inguinal incision in the last 10 cases. Mean operative time was 115.5 minutes. Mean duration of catheter insertion was 5.7 ...

Research paper thumbnail of Kidney stone treatments : prognostic factors of success, incidence and risk factors of stone regrowth or recurrence = การรักษานิ่วในไต : ปัจจัยทำนายความสำเร็จ, อุบัติการและปัจจัยเสี่ยงของการเพิ่มขนาดของนิ่วหรือการกลับเป็นซ้ำ / Wilaiwan Chongruksut

Research paper thumbnail of Predicting Risk Factors of Working Aged Hemorrhagic Stroke Patients in a Tertiary Teaching Hospital in Chiang Mai

Stroke is the third leading cause of morbidity and mortality in Thailand accounting for a signifi... more Stroke is the third leading cause of morbidity and mortality in Thailand accounting for a significant and increasing share of hospital costs. The purpose of this project is to study the epidemiology of the prevalence and its predicting factors of working aged hemorrhagic stroke (HS) patients admitted at a tertiary teaching hospital in Chiang Mai, Thailand. We conducted a five-year retrospective descriptive study. The subjects in this study were patients diagnosed with HS, between 15-59 years of age, and admitted to a tertiary teaching hospital in Chiang Mai, Thailand from January 2009 to December 2013. A total of 404 working aged adults who had HS were admitted to the hospital during this review period; 60.9% males and 39.1% females. Nearly 70% of patients were between 46-59 years of age (M = 47.5, SD = 9.8). Of the patients admitted to the hospital, 76.7% were transferred there from other hospitals. Intracerebral hemorrhage was present in 59.7% of patients. Severe HS occurred in 35...

Research paper thumbnail of Adult-to-Adult Living Donor Liver Transplantation: Postoperative Outcomes and Quality of Life in Liver Donors: First Report in Thailand

Transplantation proceedings, 2019

BACKGROUND Deceased donor liver transplantation is a rare procedure in Northern Thailand because ... more BACKGROUND Deceased donor liver transplantation is a rare procedure in Northern Thailand because of cultural issues. Living donor liver transplantation (LDLT) can decrease waiting list mortality for the patients who have end-stage liver disease. In Thailand, our center is the only active adult-to-adult LDLT program. This study is the first report of outcomes and health-related quality of life in liver donors. OBJECTIVES The aim of this study was to evaluate the postoperative outcomes and health related quality of life in living liver transplant donors at the Transplant Center in Thailand. MATERIALS AND METHODS All patients undergoing liver resection for adult-to-adult LDLT at our center between March 2010 and July 2018 were evaluated in a cross-sectional study. The effect of donor demographics, operative details, postoperative complications (Clavien-Dindo classification), hospitalization, and health related quality of life was evaluated through health-related quality of life questio...

Research paper thumbnail of Outside-in circumcision for children: Surgical technique and treatment outcomes

Objective: Circumcision is a procedure performed by various specialists using a number of techniq... more Objective: Circumcision is a procedure performed by various specialists using a number of techniques. We aimed to describe a new technique called outside-in (OSI) circumcision and the clinical outcomes in children. Material and methods: The research design was prospective, descriptive study. Fifty-seven patients underwent OSI circumcision between July 2013 and June 2015. The patients were followed up at 1 and 4 weeks for clinical evaluation. Results: The average age was 5.2 years old (range: 0.1-14.1). The average operative time was 31 minutes (range: 15-45). There was no major complication. There were no statically significant differences in operative time in terms of types of phimosis and surgeons. Most parents were very satisfied with the operative outcomes and they wanted to recommend this technique to others. None of the parents requested the circumcision revised. Conclusion: OSI circumcision is simple, safe, effective, and has high satisfaction among patients and parents. การผ...

Research paper thumbnail of COVID-19 Public Stigma Scale (COVID-PSS): development, validation, psychometric analysis and interpretation

BMJ Open

ObjectiveAmid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major ... more ObjectiveAmid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major component of public discourse and social phenomena. As such, we aimed to develop and validate the COVID-19 Public Stigma Scale (COVID-PSS).Design and settingNational-based survey cross-sectional study during the lockdown in Thailand.ParticipantsWe invited the 4004 adult public to complete a set of measurement tools, including the COVID-PSS, global fear of COVID-19, perceived risk of COVID-19 infection, Bogardus Social Distance Scale, Pain Intensity Scale and Insomnia Severity Index.MethodsFactor structure dimensionality was constructed and reaffirmed with model fit by exploratory and confirmatory factor analyses and non-parametric item response theory (IRT) analysis. Psychometric properties for validity and reliability were tested. An anchor-based approach was performed for classifying the proper cut-off scores.ResultsAfter factor analysis, IRT analysis and test for model fit, we created...

Research paper thumbnail of Effects of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on all-cause mortality, cardiovascular death, and cardiovascular events among peritoneal dialysis patients

Research paper thumbnail of Comparative Effectiveness of Local Application of Chlorhexidine Gluconate, Mupirocin Ointment, and Normal Saline for the Prevention of Peritoneal Dialysis-related Infections (COSMO-PD Trial): a multicenter randomized, double-blind, controlled protocol

Trials

Background Current international guidelines recommend the use of a daily topical exit-site antimi... more Background Current international guidelines recommend the use of a daily topical exit-site antimicrobial to prevent peritoneal dialysis (PD)-related infections. Although nonantibiotic-based therapies are appealing because they may limit antimicrobial resistance, no controlled trials have been conducted to compare topical antimicrobial agents with usual exit-site care for the prevention of PD-related infections among the Thai PD population. We propose a controlled three-arm trial to examine the efficacy and safety of a daily chlorhexidine gluconate-impregnated patch versus mupirocin ointment versus usual exit-site care with normal saline for the prevention of PD-related infections. Methods/Designs This study is a randomized, double-blind, multicenter, active-controlled, clinical trial. Adult patients aged 18 years or older who have end-stage kidney disease and are undergoing PD will be enrolled at three PD Centers in Thailand. A total of 354 PD patients will be randomly assigned to e...

Research paper thumbnail of Age as a prognostic factor of 30-day mortality in hemorrhagic stroke patients: A Thai large tertiary care referral center

Research paper thumbnail of Interleukin-8 associated with chemosensitivity and poor chemotherapeutic response to gastric cancer

Journal of Gastrointestinal Oncology

Background: Gastric cancer (GC) patients have been found to have developed chemotherapy resistanc... more Background: Gastric cancer (GC) patients have been found to have developed chemotherapy resistance that has resulted in a lowering of their overall survival rates. Interleukin-6 (IL-6) and interleukin-8 (IL-8) could be responsible as the predictive biomarkers in monitoring drug resistance. We have developed a protocol to monitor drug treatment by testing ex vivo chemosensitivity and cytokine levels of primary gastric cultures obtained from endoscopic biopsies. Methods: We studied 49 patients with distal GC who underwent primary surgical resection between June 2014 and December 2016 in the northern endemic region of Thailand. The clinical and pathological data of patients were recorded, and the cancer sub-type was classified. The correlation of cytokine IL-6 and IL-8 protein expression levels and chemotherapy sensitivity in primary gastric cultures was investigated. Endoscopic biopsies were collected before and/or after chemotherapy treatment followed by FOLFOXIV regimen (oxaliplatin + 5-FU/leucovorin). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to examine ex vivo chemosensitivity to cisplatin, oxaliplatin, 5-fluorouracil (5-FU) and irinotecan. Enzyme-linked immunosorbent assay (ELISA) was performed to investigate cytokine levels. Results: Ex vivo drug treatment of 49 primary gastric cultures from naive patients revealed a significant correlation between basal levels of IL-8 and chemosensitivity to cisplatin (P=0.001) and oxaliplatin (P=0.001). IL-8 protein expression levels were significantly decreased in the early phase after cisplatin and oxaliplatin treatments leading to an increase in cell sensitivity to drug treatments. Among 49 patients, 11 patients were classified as partial or poor responders after drug interventions, in which case, second endoscopic biopsies were performed for determination of chemosensitivity and cytokine levels. The results demonstrated significant decreases in sensitivity to cisplatin (P=0.049) and oxaliplatin (P=0.014), meanwhile IL-8 protein expression levels were significantly increased by P=0.0423 in both drug treatments. There was no correlation of IL-6 and drug resistance when treatments of the primary gastric cultures involved each of the four chemotherapeutic drugs (P=0.0663). Conclusions: Upregulation of IL-8 after drug intervention might be useful as predictive biomarker in monitoring drug resistance in GC patients; however, this needs to be confirmed among a larger number of patients and with control groups that are properly age-paired. The established primary gastric culture could serve as a valuable tool for chemotherapy screening, while the repeated usage of platinum drugs may result in drug resistance via upregulation of IL-8 levels.

Research paper thumbnail of Phyllodes tumor of the breast: diagnosis, management and outcome during a 10-year experience

Cancer Management and Research

Background: Phyllodes tumor is a very rare tumor of the breast, incidence being 0.3-0.9% of all b... more Background: Phyllodes tumor is a very rare tumor of the breast, incidence being 0.3-0.9% of all breast tumors. Phyllodes tumors are classified into three grades: benign, borderline or malignant. The aim of this study was to investigate patient characteristics, imaging characteristic findings, surgical treatment and outcome of phyllodes tumor. Materials and methods: This is a retrospective review of phyllodes tumor patients who had undergone surgical management between

Research paper thumbnail of Prospective performance of the Prostate Health Index in prostate cancer detection in the first prostate biopsy of men with a total prostatic specific antigen of 4–10 ng/mL and negative digital rectal examination

Research paper thumbnail of A Clinical Risk Prediction Tool for Peritonitis-Associated Treatment Failure in Peritoneal Dialysis Patients

Scientific reports, Jan 4, 2018

A tool to predict peritonitis-associated treatment failure among peritoneal dialysis (PD) patient... more A tool to predict peritonitis-associated treatment failure among peritoneal dialysis (PD) patients has not yet been established. We conducted a multicentre, retrospective cohort study among 1,025 PD patients between 2006 and 2016 in Thailand to develop and internally validate such a tool. Treatment failure was defined as either a requirement for catheter removal, a switch to haemodialysis, or peritonitis-associated mortality. Prediction model performances were analysed using discrimination (C-statistics) and calibration (Hosmer-Lemeshow test) tests. Predictors were weighted to calculate a risk score. In total, 435 patients with 855 episodes of peritonitis were identified; 215 (25.2%) episodes resulted in treatment failure. A total risk score of 11.5 was developed including, diabetes, systolic blood pressure <90 mmHg, and dialysate leukocyte count >1,000/mm and >100/mm on days 3-4 and day 5, respectively. The discrimination (C-statistic = 0.92; 95%CI, 0.89-0.94) and calibrat...

Research paper thumbnail of Predicting Factors of Poor Outcome of Hemorrhagic Stroke Patients

Journal of the Medical Association of Thailand, Mar 1, 2019

Research paper thumbnail of Patcharin Khamnuan1,2

Background: Necrotizing fasciitis, a relatively uncommon infection involving the skin, subcutaneo... more Background: Necrotizing fasciitis, a relatively uncommon infection involving the skin, subcutaneous tissue, and fascia, is a rapidly progressive soft tissue infection and a medical and surgical urgency. Delayed debridement, with subsequent huge soft tissue loss is associated with loss of limb and infection and is the most common cause of mortality. The purpose of this work is to describe the epidemiology of necrotizing fasciitis and to identify the clinical characteristics that may be used to predict amputation in routine clinical practice. Methods: Retrospective cohort study data were collected from three general hospitals located in the Chiang Rai, Kamphaeng Phet, and Phayao provinces in northern Thailand. Epidemiologic data for all patients with a surgically confirmed diagnosis of necrotizing fasciitis between 2009 and 2012 were collected. Medical records and reviews were retrieved from inpatient records, laboratory reports, and registers. Clinical predictors for amputation were analyzed by multivariable risk regression. Results: A total of 1,507 patients with a diagnosis of necrotizing fasciitis were classified as being with amputation (n=127, 8.4%) and without amputation (n=1,380, 91.6%). The most common causative Gram-positive and Gram-negative pathogens were Streptococcus pyogenes (33.3% in the amputation group and 40.8% in the non-amputation group) and Escherichia coli (25% in the amputation group and 17.1% in the non-amputation group). Predictive factors for amputation included gangrene (risk ratio [RR] 4.77, 95% confidence interval [CI] 2.70-8.44), diabetes mellitus (RR 3.08, 95% CI 1.98-4.78), skin necrosis (RR 2.83, 95% CI 2.52-3.18), soft tissue swelling (RR 1.76, 95% CI 1.24-2.49), and serum creatinine values 1.6mg/dLonadmission(RR1.71,951.6 mg/dL on admission (RR 1.71, 95% CI 1.38-2.12). All data were analyzed using the multivariable risk regression generalized linear model. Conclusion: The most causative pathogens were S. pyogenes and E. coli. Clinical predictors for amputation in patients with necrotizing fasciitis included having diabetes mellitus, soft tissue swelling, skin necrosis, gangrene, and serum creatinine values 1.6mg/dLonadmission(RR1.71,951.6 mg/dL on admission. Thus, patients with any of these predictors should be monitored closely for progression and receive early aggressive treatment to avoid limb loss.

Research paper thumbnail of The association between proton pump inhibitor use and the risk of adverse kidney outcomes: a systematic review and meta-analysis

Nephrology, Dialysis and Transplantation, Feb 23, 2017

Background: Existing epidemiological studies illustrate that proton pump inhibitors (PPIs) may be... more Background: Existing epidemiological studies illustrate that proton pump inhibitors (PPIs) may be related to adverse kidney outcomes. To date, no comprehensive meta-analysis has been conducted to evaluate and quantify this association. Methods: We performed a systematic review and meta-analysis of studies to assess the association between PPI use and the risk of adverse kidney outcomes. We searched MEDLINE, Embase, SCOPUS, Web of Science, CINAHL, Cochrane Library and grey literature with no language restrictions (through 31 October 2016). Adverse kidney outcomes were acute interstitial nephritis (AIN), acute kidney injury (AKI), chronic kidney disease (CKD) and end-stage renal disease (ESRD). The risk ratios (RRs) and confidence intervals (CIs) were pooled using a random effects model. The strength of evidence (SOE) for each outcome was assessed using the Grading of Recommended Assessment, Development and Evaluation system. Results: Of 2037 identified studies, four cohort and five casecontrol studies with $2.6 million patients were included. Of these, 534 003 (20.2%) were PPI users. Compared with non-PPI users, PPI users experienced a significantly higher risk of AKI [

Research paper thumbnail of Use of serotonin reuptake inhibitor antidepressants and the risk of bleeding complications in patients on anticoagulant or antiplatelet agents: a systematic review and meta-analysis

Research paper thumbnail of Kidney stones recurrence and regrowth after extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

OBJECTIVE To estimate and compare the incidence rate of kidney stone recurrence and regrowth afte... more OBJECTIVE To estimate and compare the incidence rate of kidney stone recurrence and regrowth after ESWL with PCNL at one, two, and three years. MATERIAL AND METHOD A retrospective cohort study was performed The study recruited patients aged more than 18 years, diagnosed with kidney stones and treated by ESWL or PCNL between January 2006 and August 2010 at the urological unit of a university hospital located in the northern part of Thailand. Data were retrieved from medical records and analyzed using exact probability test or student's t-test. Poisson regression was used to compare the recurrence rate and the regrowth rate between ESWL and PCNL. RESULTS During three years of follow-up, the overall stones recurrence and regrowth were 15.5% and 25.1% in ESWL group and 12.6% and 16% in PCNL group, repectively. At one, two and three years after treatment, stones recurrence rate in the ESWL group were 13.1, 7.5 and 7.3 per 1,000 patient-months while in the PCNL group were 11.3, 6.1 an...

Research paper thumbnail of Prognostic factors for success in treating kidney stones by extracorporeal shock wave lithotripsy

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

BACKGROUND Extracorporeal shock wave lithotripsy (ESWL) is widely used worldwide to treat kidney ... more BACKGROUND Extracorporeal shock wave lithotripsy (ESWL) is widely used worldwide to treat kidney stone because it is without invasive and can be done on an outpatient basis. However, not all patients are treated successfully. The success of kidney stone treatment by ESWL depends on several factors. OBJECTIVE To investigate prognostic factors for the successful treatment of kidney stones by ESWL. MATERIAL AND METHOD A prospective cohort study was made of 394 patients with kidney stone who underwent ESWL using Storz SLX-20 Lithotripter at Chiang Mai University Hospital between June 2008 and October 2009. All patients were followed up for three months after treatment to evaluate treatment success. Success was defined as the presence of clinically insignificant residual fragments less than or equal to 4 mm or complete clearance of the stones. Data were analyzed using exponential risk regression to determine the prognostic factors of ESWL treatment success. RESULTS The ESWL treatment suc...

Research paper thumbnail of Predictors for kidney stones recurrence following extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL)

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2012

BACKGROUND Stone recurrence after extracorporeal shock wave lithotripsy (ESWL) or percutaneous ne... more BACKGROUND Stone recurrence after extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL) are common. Predictors for kidney stones vary among populations and areas. OBJECTIVE To determine predictors for kidney stones recurrence after ESWL or PCNL. MATERIAL AND METHOD A retrospective cohort study was conducted at a university hospital. The study cohort was patients aged more than 18 years, diagnosed with kidney stones, who were treated with ESWL or PCNL between 2006 and 2009. Medical files were reviewed for clinical profiles, stone characteristics, composition, type of treatment, presence of stone after treatment, stone reappearance, and related laboratory data. Predictors were determined by a multivariable poisson regression and presented as incidence rate ratios (IRRs) with 95% confidence interval. RESULTS From a cohort of 252 patients, 240 who had at least one follow-up and with complete plain kidney ureters and bladder (KUB) film or intravenous pyelogr...

Research paper thumbnail of Experience of Maharaj Nakorn Chiang Mai Hospital in extravesical ureteral reimplantation for vesicoureteral reflux in pediatric patients

Insight Urology

Objective: The most commonly used technique for vesicoureteral reflux (VUR) treatment in pediatri... more Objective: The most commonly used technique for vesicoureteral reflux (VUR) treatment in pediatric patients in Maharaj Nakorn Chiang Mai Hospital is extravesical ureteral reimplantation (EUR). This report describes our experience of clinical outcomes of this technique. Materials and Methods: A total of 30 children underwent EUR for unilateral and bilateral VUR between July 2007 and June 2015. We retrospectively reviewed their medical records. Patient characteristics, operative time, duration of catheter drainage, length of postoperative hospital stay, and perioperative complications were evaluated. Results: Twenty-two boys and 8 girls with a mean age of 4.4 years (range, 0.5-14.6) were included in the study. Reflux was graded 1 to 5. Fourteen unilateral and 16 bilateral procedures were performed. A Pfannenstiel incision was implemented in the first 20 cases and inguinal incision in the last 10 cases. Mean operative time was 115.5 minutes. Mean duration of catheter insertion was 5.7 ...

Research paper thumbnail of Kidney stone treatments : prognostic factors of success, incidence and risk factors of stone regrowth or recurrence = การรักษานิ่วในไต : ปัจจัยทำนายความสำเร็จ, อุบัติการและปัจจัยเสี่ยงของการเพิ่มขนาดของนิ่วหรือการกลับเป็นซ้ำ / Wilaiwan Chongruksut

Research paper thumbnail of Predicting Risk Factors of Working Aged Hemorrhagic Stroke Patients in a Tertiary Teaching Hospital in Chiang Mai

Stroke is the third leading cause of morbidity and mortality in Thailand accounting for a signifi... more Stroke is the third leading cause of morbidity and mortality in Thailand accounting for a significant and increasing share of hospital costs. The purpose of this project is to study the epidemiology of the prevalence and its predicting factors of working aged hemorrhagic stroke (HS) patients admitted at a tertiary teaching hospital in Chiang Mai, Thailand. We conducted a five-year retrospective descriptive study. The subjects in this study were patients diagnosed with HS, between 15-59 years of age, and admitted to a tertiary teaching hospital in Chiang Mai, Thailand from January 2009 to December 2013. A total of 404 working aged adults who had HS were admitted to the hospital during this review period; 60.9% males and 39.1% females. Nearly 70% of patients were between 46-59 years of age (M = 47.5, SD = 9.8). Of the patients admitted to the hospital, 76.7% were transferred there from other hospitals. Intracerebral hemorrhage was present in 59.7% of patients. Severe HS occurred in 35...

Research paper thumbnail of Adult-to-Adult Living Donor Liver Transplantation: Postoperative Outcomes and Quality of Life in Liver Donors: First Report in Thailand

Transplantation proceedings, 2019

BACKGROUND Deceased donor liver transplantation is a rare procedure in Northern Thailand because ... more BACKGROUND Deceased donor liver transplantation is a rare procedure in Northern Thailand because of cultural issues. Living donor liver transplantation (LDLT) can decrease waiting list mortality for the patients who have end-stage liver disease. In Thailand, our center is the only active adult-to-adult LDLT program. This study is the first report of outcomes and health-related quality of life in liver donors. OBJECTIVES The aim of this study was to evaluate the postoperative outcomes and health related quality of life in living liver transplant donors at the Transplant Center in Thailand. MATERIALS AND METHODS All patients undergoing liver resection for adult-to-adult LDLT at our center between March 2010 and July 2018 were evaluated in a cross-sectional study. The effect of donor demographics, operative details, postoperative complications (Clavien-Dindo classification), hospitalization, and health related quality of life was evaluated through health-related quality of life questio...

Research paper thumbnail of Outside-in circumcision for children: Surgical technique and treatment outcomes

Objective: Circumcision is a procedure performed by various specialists using a number of techniq... more Objective: Circumcision is a procedure performed by various specialists using a number of techniques. We aimed to describe a new technique called outside-in (OSI) circumcision and the clinical outcomes in children. Material and methods: The research design was prospective, descriptive study. Fifty-seven patients underwent OSI circumcision between July 2013 and June 2015. The patients were followed up at 1 and 4 weeks for clinical evaluation. Results: The average age was 5.2 years old (range: 0.1-14.1). The average operative time was 31 minutes (range: 15-45). There was no major complication. There were no statically significant differences in operative time in terms of types of phimosis and surgeons. Most parents were very satisfied with the operative outcomes and they wanted to recommend this technique to others. None of the parents requested the circumcision revised. Conclusion: OSI circumcision is simple, safe, effective, and has high satisfaction among patients and parents. การผ...

Research paper thumbnail of COVID-19 Public Stigma Scale (COVID-PSS): development, validation, psychometric analysis and interpretation

BMJ Open

ObjectiveAmid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major ... more ObjectiveAmid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major component of public discourse and social phenomena. As such, we aimed to develop and validate the COVID-19 Public Stigma Scale (COVID-PSS).Design and settingNational-based survey cross-sectional study during the lockdown in Thailand.ParticipantsWe invited the 4004 adult public to complete a set of measurement tools, including the COVID-PSS, global fear of COVID-19, perceived risk of COVID-19 infection, Bogardus Social Distance Scale, Pain Intensity Scale and Insomnia Severity Index.MethodsFactor structure dimensionality was constructed and reaffirmed with model fit by exploratory and confirmatory factor analyses and non-parametric item response theory (IRT) analysis. Psychometric properties for validity and reliability were tested. An anchor-based approach was performed for classifying the proper cut-off scores.ResultsAfter factor analysis, IRT analysis and test for model fit, we created...

Research paper thumbnail of Effects of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on all-cause mortality, cardiovascular death, and cardiovascular events among peritoneal dialysis patients

Research paper thumbnail of Comparative Effectiveness of Local Application of Chlorhexidine Gluconate, Mupirocin Ointment, and Normal Saline for the Prevention of Peritoneal Dialysis-related Infections (COSMO-PD Trial): a multicenter randomized, double-blind, controlled protocol

Trials

Background Current international guidelines recommend the use of a daily topical exit-site antimi... more Background Current international guidelines recommend the use of a daily topical exit-site antimicrobial to prevent peritoneal dialysis (PD)-related infections. Although nonantibiotic-based therapies are appealing because they may limit antimicrobial resistance, no controlled trials have been conducted to compare topical antimicrobial agents with usual exit-site care for the prevention of PD-related infections among the Thai PD population. We propose a controlled three-arm trial to examine the efficacy and safety of a daily chlorhexidine gluconate-impregnated patch versus mupirocin ointment versus usual exit-site care with normal saline for the prevention of PD-related infections. Methods/Designs This study is a randomized, double-blind, multicenter, active-controlled, clinical trial. Adult patients aged 18 years or older who have end-stage kidney disease and are undergoing PD will be enrolled at three PD Centers in Thailand. A total of 354 PD patients will be randomly assigned to e...

Research paper thumbnail of Age as a prognostic factor of 30-day mortality in hemorrhagic stroke patients: A Thai large tertiary care referral center

Research paper thumbnail of Interleukin-8 associated with chemosensitivity and poor chemotherapeutic response to gastric cancer

Journal of Gastrointestinal Oncology

Background: Gastric cancer (GC) patients have been found to have developed chemotherapy resistanc... more Background: Gastric cancer (GC) patients have been found to have developed chemotherapy resistance that has resulted in a lowering of their overall survival rates. Interleukin-6 (IL-6) and interleukin-8 (IL-8) could be responsible as the predictive biomarkers in monitoring drug resistance. We have developed a protocol to monitor drug treatment by testing ex vivo chemosensitivity and cytokine levels of primary gastric cultures obtained from endoscopic biopsies. Methods: We studied 49 patients with distal GC who underwent primary surgical resection between June 2014 and December 2016 in the northern endemic region of Thailand. The clinical and pathological data of patients were recorded, and the cancer sub-type was classified. The correlation of cytokine IL-6 and IL-8 protein expression levels and chemotherapy sensitivity in primary gastric cultures was investigated. Endoscopic biopsies were collected before and/or after chemotherapy treatment followed by FOLFOXIV regimen (oxaliplatin + 5-FU/leucovorin). The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to examine ex vivo chemosensitivity to cisplatin, oxaliplatin, 5-fluorouracil (5-FU) and irinotecan. Enzyme-linked immunosorbent assay (ELISA) was performed to investigate cytokine levels. Results: Ex vivo drug treatment of 49 primary gastric cultures from naive patients revealed a significant correlation between basal levels of IL-8 and chemosensitivity to cisplatin (P=0.001) and oxaliplatin (P=0.001). IL-8 protein expression levels were significantly decreased in the early phase after cisplatin and oxaliplatin treatments leading to an increase in cell sensitivity to drug treatments. Among 49 patients, 11 patients were classified as partial or poor responders after drug interventions, in which case, second endoscopic biopsies were performed for determination of chemosensitivity and cytokine levels. The results demonstrated significant decreases in sensitivity to cisplatin (P=0.049) and oxaliplatin (P=0.014), meanwhile IL-8 protein expression levels were significantly increased by P=0.0423 in both drug treatments. There was no correlation of IL-6 and drug resistance when treatments of the primary gastric cultures involved each of the four chemotherapeutic drugs (P=0.0663). Conclusions: Upregulation of IL-8 after drug intervention might be useful as predictive biomarker in monitoring drug resistance in GC patients; however, this needs to be confirmed among a larger number of patients and with control groups that are properly age-paired. The established primary gastric culture could serve as a valuable tool for chemotherapy screening, while the repeated usage of platinum drugs may result in drug resistance via upregulation of IL-8 levels.

Research paper thumbnail of Phyllodes tumor of the breast: diagnosis, management and outcome during a 10-year experience

Cancer Management and Research

Background: Phyllodes tumor is a very rare tumor of the breast, incidence being 0.3-0.9% of all b... more Background: Phyllodes tumor is a very rare tumor of the breast, incidence being 0.3-0.9% of all breast tumors. Phyllodes tumors are classified into three grades: benign, borderline or malignant. The aim of this study was to investigate patient characteristics, imaging characteristic findings, surgical treatment and outcome of phyllodes tumor. Materials and methods: This is a retrospective review of phyllodes tumor patients who had undergone surgical management between

Research paper thumbnail of Prospective performance of the Prostate Health Index in prostate cancer detection in the first prostate biopsy of men with a total prostatic specific antigen of 4–10 ng/mL and negative digital rectal examination

Research paper thumbnail of A Clinical Risk Prediction Tool for Peritonitis-Associated Treatment Failure in Peritoneal Dialysis Patients

Scientific reports, Jan 4, 2018

A tool to predict peritonitis-associated treatment failure among peritoneal dialysis (PD) patient... more A tool to predict peritonitis-associated treatment failure among peritoneal dialysis (PD) patients has not yet been established. We conducted a multicentre, retrospective cohort study among 1,025 PD patients between 2006 and 2016 in Thailand to develop and internally validate such a tool. Treatment failure was defined as either a requirement for catheter removal, a switch to haemodialysis, or peritonitis-associated mortality. Prediction model performances were analysed using discrimination (C-statistics) and calibration (Hosmer-Lemeshow test) tests. Predictors were weighted to calculate a risk score. In total, 435 patients with 855 episodes of peritonitis were identified; 215 (25.2%) episodes resulted in treatment failure. A total risk score of 11.5 was developed including, diabetes, systolic blood pressure <90 mmHg, and dialysate leukocyte count >1,000/mm and >100/mm on days 3-4 and day 5, respectively. The discrimination (C-statistic = 0.92; 95%CI, 0.89-0.94) and calibrat...