Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Down syndrome (DS) is the most common chromosomal abnormality in children. Atrio-ventricular septal defect (AVSD) is the most common congenital heart disease (CHD) reported in DS. The mortality rate of DS with congenital heart disease (CHD) is 5-7 times higher than normal population. The survival rate in DS has improved with time and has reported up to 91% and 85% at one and ten years of age, respectively. ⋯ According to this study, the prevalence rate of CHD in DS was high. VSD was the most common lesion and has better prognosis than AVSD. The main cause of death was a cardiac problem. Follow-up patients by using modified AAP guideline and standard treatment can improve their overall survival.
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Mucopolysaccharidosis (MPS) can be classified into 7 types according to the enzyme defects. Several countries use enzyme replacement therapy (ERT) as treatment for types 1, 2 and 6. ERT is very expensive:--therefore, to determine if this treatment could be made available in Thailand, it is important to know the numbers of the patients with MPS. ⋯ MPS2 is the most common type of MPS in this study, followed by type 6 and 1. The difference in growth parameters seen in MPS2 suggest that it may be a factor in the development of MPS2.
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Retroperitoneal soft tissue sarcomas (RSTS) are rare malignant tumors with a distinguishing feature of slow growth in the silent retroperitoneal space. The patients usually present late with a large retroperitoneal mass surrounded by the major vascular structures and visceral organs rendering curative resection an extremely difficult and risky operation. The purpose of the present study was to demonstrate surgical experience and results of treatment of RSTS at King Chulalongkorn Memorial Hospital. Operative techniques of these complex surgical procedures were also described. ⋯ Acceptable outcomes after complete surgical resection of the RSTS were achieved from this small but important case-series. The authors have demonstrated that CGR with concomitant resection of the contiguous organs can be safely performed in patients with large RSTS. Preoperative CT scan was invaluable for diagnosis and treatment plan. Preoperative core needle biopsy was not necessary when preoperative CT scan was diagnostic. Intention for curative resection should be attempted whenever possible to minimize chance of local recurrence and improve survival. Experience of the surgical team is an important factor for successful results when conducting these technically demanding operations.
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To determine the incidence and risk factors of postoperative apnea in premature infants who received general anesthesia for cryotherapy or laser photocoagulation for treatment of retinopathy of prematurity (ROP) at Queen Sirikit National Institute of Child Health. ⋯ The incidence of apnea after general anesthesia in infants with ROP treated with cryotherapy or laser photocoagulation was 24%. The risk factors of postoperative apnea were post-conceptual age less than 35 weeks and prior history of apnea. Patients with risk factors should be closely monitored.
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To test the diagnostic properties of the original and a modified STOP-Bang, as well as testing the additional use of a waist-to-height ratio (WHtR) of > or = 0.55 in screening for obstructive sleep apnea (OSA) in Thai patients. ⋯ Both STOP-Bang and its modified version were highly sensitive measures for OSA screening in medical or dental clinics. However, the modified version might be more suitable for Thais and Asians, and the additional use of WHtR > or = 0.55 might be useful for reducing the unnecessary sleep investigation or management in those who were classified as high-risk patients.