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Papers by Chusak Okascharoen

Journal of Perinatology, 2005

Insufficient tools for bedside prediction of late-onset neonatal sepsis (LNS) initiated this stud... more Insufficient tools for bedside prediction of late-onset neonatal sepsis (LNS) initiated this study. The objective was to develop and validate a simple prediction-scoring model for LNS defined as culture-proven sepsis occurring 72 hours after birth. METHODS: The study was performed at a university hospital in Bangkok. The derivation phase included medical records of 1870 neonates, randomly selected from 9347 records of neonates who had been hospitalized for >72 hours during 1998 to 2000, of which 1824 records were available. In all, 100 neonates were clinically suspected of sepsis and 17 had proven LNS. The validation phase included 73 neonates suspected of having sepsis during July 2002to June 2003 and 25 who had LNS. Weighted coefficients from Cox's proportional hazards model and receiveroperating-characteristic (ROC) curve analysis were used. RESULTS: The incidence density of LNS was 17/11355 (1.5/1000) person-days. A scoring model was developed and consisted of the following: hypotension (score 4), abnormal body temperature (score 3), respiratory insufficiency (score 2), neutrophil band form fraction >1% (score 2), platelet count <150 Â 10 3 /ml (score 2), and umbilical venous catheterization (1 to 7 or >7 days; score 2 or 4). The area under the ROC curves for prediction of LNS in a neonate suspected of sepsis in each of the two phases was 0.85 and 0.80, respectively (p ¼ 0.436). The mean probabilities of LNS were approximately 0.10 (low risk) for scores from 0 to 3; 0.50 (intermediate risk) for scores from 4 to 6; and 0.70 (high risk) for scores Z7. CONCLUSION: A simple prediction-scoring model for LNS was developed. Validation of the scores suggested good diagnostic performance.

Copyright © 2013 Bunyarit Sukrat et al.This is an open access article distributed under the Creat... more Copyright © 2013 Bunyarit Sukrat et al.This is an open access article distributed under the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To conduct a systematic review and meta-analysis of hemoglobin effect on the pregnancy outcomes. Methods. We searched MEDLINE and SCOPUS from January 1, 1990 to April 10, 2011. Observational studies addressing association between hemoglobin and adverse pregnancy outcomes were selected. Two reviewers independently extracted data. A mixed logistic regression was applied to assess the effects of hemoglobin on preterm birth, low birth weight, and small for gestational age. Results. Seventeen studies were included in poolings. Hemoglobin below 11 g/dLwas, respectively, 1.10 (95%CI: 1.02–1.19), 1.17 (95%CI: 1.03– 1.32), and 1.14 (95 % CI: 1.05–1.24) times higher risk of preterm birth, low birth weight, and small for gestational a...

Journal of Perinatology, Jun 14, 2007

Objective: To prospectively validate performance of a prediction score for diagnosis of late-onse... more Objective: To prospectively validate performance of a prediction score for diagnosis of late-onset neonatal sepsis (LNS) in a new patient population. Study Design: Data were prospectively collected from March 2003 to May 2004. Newborns were enrolled if they were in the neonatal intensive care unit (NICU) between 2 and 90 days, and during the first episode of clinical sepsis suspected. LNS was defined as a positive blood or cerebrospinal fluid (CSF) culture, which became the criterion standard. Result: A total of 105 neonates were evaluated for sepsis. Demographic characteristics were as follows: (mean (s.d.)) were gestational age (GA) 29 (3) weeks; birth weight (BW) 1232 (620) g and postnatal age 17.5 day (12). Thirty-five (33%) neonates had LNS (35 positive blood cultures; 2 positive CSF). No significant differences in GA, BW, gender, age and central line utilization were found between LNS positive and LNS negative groups. Using a cutoff score of p3, the score predicted positive culture with sensitivity of 0.97 (95% confidence interval 0.85, 0.99) and a negative likelihood ratio of 0.07. The discrimination and calibration ability of LNS score was acceptable. Conclusion: A simple clinical decision rule previously developed to predict LNS performs equally in an independent population and NICU.

BMC Pregnancy and Childbirth

Background Adolescent pregnancy is an important health and social issue that affects both individ... more Background Adolescent pregnancy is an important health and social issue that affects both individual and social well-being. However, deriving a national estimate is challenging in a country with multiple incomplete national databases especially the abortion statistics. The objective of this study was to estimate the adolescent pregnancy rates in Thailand using capture-recapture method. Methods An application of capture-recapture method was conducted using two cross-sectional databases (i.e., the national birth registration and the Ministry of Public Health standard health databases) and one hospital-based data source from medical record reviews. A 3-sources capture-recapture with log-linear model was applied to estimate adolescent pregnancy rates. Results A total number of 741,084, 290,922 and 25,478 records were respectively identified from the birth registrations, standard health databases and hospital-based survey data during 2008 to 2013. The estimated adolescent pregnancy rates...

The Journal of Infection in Developing Countries

Introduction: Tuberculosis (TB) remains a serious public-health problem worldwide. The successful... more Introduction: Tuberculosis (TB) remains a serious public-health problem worldwide. The successful tuberculosis treatment was in low rate among the hill tribes in Thailand. This study aimed to determine factors associated with the unsuccessful tuberculosis treatment among the hill tribe TB patients in northern Thailand. Methodology: A retrospective cohort study was conducted using secondary data from the national TB reporting system. Data of newly registered hill tribe patients with TB receiving treatment were obtained from 18 government hospitals in Chiang Rai province, during 2014–2017. TB treatment outcomes and factors associated with unsuccessful were determined. Results: A total of 770 hill tribe patients with TB registered during the study period. The majority were males aged 25–64 years. About 80% of the patients lived in rural areas and 53.9% worked in agriculture. The overall TB treatment success rate was 80.4%. Two factors were associated with unsuccessful TB treatment: age...

Zeitschrift für Geburtshilfe und Neonatologie, 2007

D50. PEDIATRIC CRITICAL CARE, 2010

BioMed Research International, 2013

Objective. To conduct a systematic review and meta-analysis of hemoglobin effect on the pregnancy... more Objective. To conduct a systematic review and meta-analysis of hemoglobin effect on the pregnancy outcomes.Methods. We searched MEDLINE and SCOPUS from January 1, 1990 to April 10, 2011. Observational studies addressing association between hemoglobin and adverse pregnancy outcomes were selected. Two reviewers independently extracted data. A mixed logistic regression was applied to assess the effects of hemoglobin on preterm birth, low birth weight, and small for gestational age.Results. Seventeen studies were included in poolings. Hemoglobin below 11 g/dL was, respectively, 1.10 (95% CI: 1.02–1.19), 1.17 (95% CI: 1.03–1.32), and 1.14 (95% CI: 1.05–1.24) times higher risk of preterm birth, low birth weight, and small for gestational age than normal hemoglobin in the first trimester. In the third trimester, hemoglobin below 11 g/dL was 1.30 (95% CI: 1.08–1.58) times higher risk of low birth weight. Hemoglobin above 14 g/dL in third trimester decreased the risk of preterm term with ORs...

Journal of Perinatology, 2003

Orphanet Journal of Rare Diseases

Background: Prader-Willi syndrome (PWS) is a multisystem genetic disorder, which has a typical ea... more Background: Prader-Willi syndrome (PWS) is a multisystem genetic disorder, which has a typical eating behavior and growth pattern. In the infancy period, children with PWS have low body weight followed by hyperphagia in later childhood. Disease-specific growth charts have been recommended for monitoring PWS patients. Previous literature demonstrated growth differences among individuals with PWS of different ethnicity. Methods: A retrospective multicenter study was performed in PWS patients from different areas of Thailand included collaboration with the Thai PWS support group during 2000-2017. Baseline characteristics and anthropometric data were reviewed. Both growth hormone and non-growth hormone received patients were included, but the data after receiving GH were excluded before curve construction. Growth charts for Thai PWS compared to the 50th normative centile were constructed using Generalized Least Squares (GLS) methods. Curve smoothing was performed by Fractional Polynomials and Exponential Transformation. Result: One hundred and thirteen patients with genetically confirmed PWS (55 males and 58 females) were enrolled. Fifty percent of patients were diagnosed less than 6 months of age. We developed growth charts for non-growth hormone treated Thai children with PWS aged between 0 and 18 years. A growth pattern was similar to other ethnicities while there were some differences. Mean birth weight of PWS patients was less than that of typical newborns. Mean adult height at 18 years of age in Thai children with PWS was lower than that in American children, but taller than Japanese. Mean weight of Thai PWS males at 18 years of age was more than those from other countries. Conclusion: This study is the first to document PWS-specific growth charts in Southeast Asian population. These growth charts will be useful in improving the quality of patient care and in evaluating the impact of growth hormone treatment in the future.