Search Results

You are looking at 1 - 7 of 7 items for

  • Author: Kaewjai Thepsuthammarat x
Clear All Modify Search
Open access

Kaewjai Thepsuthammarat, Bandit Thinkhamrop and Chanpen Choprapawon

Abstract

Background: Cognitive development is one of the most important aspects of child development. Stimulation is essential, especially for children between 1 and 2 years of age. Play materials is one realm where choice is relatively limited.

Objective: We investigated the relationships between play materials and cognitive ability.

Methods: This large, prospective, community-based cohort study, in the four regions and the capital of Thailand, studied the relationships between toys and cognitive ability in 4,116 children when they reached the first year of life. Details of play toys were collected at home and cognitive scores were measured using the Capute scale two weeks later. Multivariable analysis incorporated the following variables in the final multiple regression model, the 12 types of play materials, study center, parent factors (i.e., age, education, marital status, and income), and child factors (i.e., sex, weight, height, gestational age, birth weight, breastfed, hospital admission, mother-child attachment, number of members in family, number of sibling, iodine consumption, and life events).

Results: The first three common materials played with at home included push/pull toys (75.3%), home utensils (75.0%), and sound-making toys (73.9%). Adjusted for the potential factors, five out of the 12 types of play materials were significantly associated with the Capute scale, viz., sound-making toys (p = 0.029), push/pull toys (p = 0.003), creative toys (p = 0.003), natural materials (p = 0.002), and storybooks (p = 0.027). Children who played with natural materials had a higher Capute score than those who did not, with the mean difference of 1.9 (95%CI: 0.7 to 3.1). This was followed by creative materials (mean difference = 1.8, 95%CI: 0.6 to 2.9), and push/ pull toys (mean difference = 1.8, 95%CI: 0.6 to 3.0).

Conclusion: The results of the current study underscore the importance that natural materials, creative materials, and push/pull toys be available for children to play with during the first year of life.

Open access

Sombat Treeprasertsuk, Kaewjai Thepsuthammarat, Bubpha Kitsahawong and Kamthorn Phaosawasdi

Abstract

Background

The burden of acute diarrheal diseases is a major problem in Thailand. The mortality rate is 0.5% of admissions in the 2010 Nationwide Hospital Admission Data. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study in 2010 showed that the mortality rate of diarrheal disease was 2.65% of all deaths globally.

Objectives

To examine the burden of adult acute diarrhea in Thailand using nationwide data in 2010.

Methods

There were 820,735 admissions of patients aged ≥19 years with a diagnosis of digestive diseases (ICD10-K00-K93) and acute diarrhea (ICD10-A09). About one-third of admissions (214,722 admissions; 26%) were for acute diarrhea with a mean patient age 51.5 (SD 15.3) years.

Results

Approximately two-thirds of the 214,722 admissions were for acute diarrhea (59%) in patients 19–60 years old, and the remaining 41% were elderly patients >60 years old. Approximately 0.5% of admitted patients (1,048 patients) died. The complications during hospitalization were septicemia (2.2%), mechanical ventilation (0.6%), and renal failure requiring hemodialysis (0.14%). The predictors of mortality were patients >60 years old at admission, male sex, and the presence of complications. The total cost for management of acute diarrhea in Thailand in 2010 was 905,784,298 baht or 30,035,807 USD for 214,722 admissions.

Conclusions

Acute diarrheal diseases accounted for 26% of the digestive diseases in the 2010 Thai nationwide data with high expenditure.

Open access

Arnkisa Chaikitpinyo, Manat Panamonta, Yuttapong Wongswadiwat, Wiboon Weraarchakul, Ouyporn Panamonta, Aunejit Panthongviriyakul and Kaewjai Thepsuthammarat

Abstract

Background: Rheumatic fever (RF), rheumatic heart disease (RHD), and congenital heart disease (CHD) are still major problems among Thai school children.

Objective: To examine trends in the prevalence of RF/RHD and CHD along with the socioeconomic status of school children in urban Khon Kaen, northeastern Thailand.

Methods: We conducted cross-sectional survey of 8,555 school children aged 5-15 years from 4 schools in urban Khon Kaen from January to March 2006. Pediatric cardiologists examined the school children and all cardiac diagnoses were confirmed by echocardiography. Socioeconomic data were also collected. Schools were divided into high and low socioeconomic status (SES) schools, based on the prevailing levels of parental education and household income. All positive cases of heart disease were followed and reviewed at a university hospital up to December 2013.

Results: Of 8,555 children examined, 2 had RF/RHD, and 10 had CHD. The prevalence of RF/RHD was 0.23 per 1,000 (95% CI 0.03-0.84), and the prevalence of CHD was 1.2 per 1,000 (95% CI 0.56-2.15). Prevalence of RF/RHD among urban school children in the center of northeastern Thailand had declined from 1.13 to 0.23 per 1,000 since 1986. The indices of socioeconomic development revealed marked improvement during this 20 year interim. The prevalence of RF/RHD was higher among low SES schools (4.6 per 1,000) compared with high SES schools (0 per 1,000).

Conclusion: There is a low prevalence of RHD in school children in this region compared with the period before 1986.

Open access

Rapat Pittayanon, Sombat Treeprasertsuk, Kamthorn Phaosawasdi, Bubpha Kitsahawong, Kaewjai Thepsuthammarat and Pinit Kullavanijaya

Abstract

Background

Data on the incidence and burden of Clostridium difficile infection (CDI) in Asia is limited.

Objectives

To evaluate the incidence and burden of CDI in Thailand.

Methods

We used 2010 Nationwide Hospital Admission Data, which included the diagnosis of digestive disorders from various causes coded using the ICD-10. Patients with a diagnosis of Clostridium difficile (ICD10-A07) aged >18 years, were included. Their baseline characteristics, clinical outcomes, and risk factors for CDI were analyzed. Length of hospital stay (LOS), mortality rate, and hospital expenses were used as indicators to evaluate the burden of CDI in Thailand.

Results

Of 4,863,935 admissions in 2010, 554 patients in 570 admissions (0.01%) were diagnosed with CDI. Of these, 106 (19.1%) died during the index hospitalization, and 98.1% had at least one comorbidity. The mean LOS for patients with CDI was longer than with other colitis (P < 0.001) and was also significantly longer for those who died during the index admission, compared with those who survived during the index admission (P = 0.04). The hospital expense for those who died was significantly higher than for those who survived (P < 0.001). From a multivariate analysis, age ≥85 years old, comorbidity, and sepsis were risk factors for mortality during admission with adjusted odds ratios of 2.40, 7.4, and 5.14, respectively.

Conclusions

The calculated burden of CDI in Thais is high; although the incidence of CDI is lower in Thailand than in Western countries. The mortality relates to the elderly age-group and comorbidity, especially sepsis.

Open access

Sirirat Anutrakulchai, Cholatip Pongskul, Dhavee Sirivongs, Pantipa Tonsawan, Kaewjai Thepsuthammarat, Sutin Chanaboon, Supannee Promthet and Bandit Thinkhamrop

Abstract

Background

Chronic kidney disease (CKD) is a global public health problem with a high risk of hospitalization and death. Few nationwide data have been reported regarding the outcomes of patients hospitalized with CKD in developing countries.

Objectives

To study the risk factors associated with mortality and high treatment costs of adult patients hospitalized with CKD in Thailand.

Methods

The medical data forms for adult inpatients with CKD collected in fiscal year 2010 were analyzed to determine the number of CKD admissions, associated comorbidities and complications, mortality rates, and hospital charges. Factors influencing mortality rates were evaluated by multiple logistic regression.

Results

The total number of CKD patients was 128,338. After adjustment, the major factors associated with high hospital charges were (a) comorbidities (e.g. pneumonia OR 3.18, 95% CI 3.03–3.34; sepsis OR 2.87, 95% CI 2.74–3.00; acute kidney injury (AKI) on preexisting CKD OR 2.83, 95% CI 2.69–2.98) and (b) dialysis treatment (i.e., hemodialysis OR 5.16, 95% CI 4.94–5.39; peritoneal dialysis OR 3.40, 95% CI 3.14–3.69). The risk factors for high mortality were: being male, elderly, having comorbidity (viz., sepsis, respiratory failure, stroke, pneumonia, ischemic heart disease, AKI in addition to CKD, heart failure, and diabetes), and CKD complications (viz., metabolic acidosis, hyperkalemia, volume overload, and anemia requiring blood transfusion).

Conclusions

Prevention and early treatment of any comorbidity and complications of CKD might reduce mortality and treatment costs of patients hospitalized with CKD.

Open access

Manat Panamonta, Arnkisa Chaikitpinyo, Pagakrong Lumbiganon, Ouyporn Panamonta, Narong Auvichayapat, Yuttapong Wongswadiwat, Kaewjai Thepsuthammarat, Aunejit Panthongviriyakul and Choowong Pongchaiyakul

Abstract

Background: Although there have been many descriptive studies of diphtheria from resource limited countries, descriptions of the natural history of diphtheritic myocarditis in patients from these countries are scarce.

Objective: To present the natural history of diphtheritic myocarditis from a hospital in northeastern Thailand.

Methods: The clinical features of 38 patients with diphtheria admitted to the Khon Kaen University Hospital in northeastern Thailand between 1983 and 1996 were reviewed.

Results: Of the 38 cases of diphtheria, 10 progressed to diphtheritic myocarditis (26%). Electrocardiographic findings of the 10 patients with myocarditis were myocardial and conduction abnormalities. The presence of a clinically severe (toxic) type (P < 0.001) or a swollen neck (bull neck) (P = 0.001) was a predictor of the occurrence of myocarditis. Five (50%) of the 10 patients with myocarditis had conduction abnormalities (third-degree atrioventricular block 3, left bundle branch block 1, and right bundle branch block 1). Four patients with severe symptomatic bradyarrhythmia (third-degree atrioventricular block 3, and left bundle branch block 1) received ventricular pacing, and 3 patients died after this pacing. Echocardiographic abnormalities of left ventricular dilatation and myocardial hypertrophy were found in all 5 patients with conduction abnormalities. All 6 of 7 survivors of diphtheritic myocarditis had normal 12-lead electrocardiographic results at 1-month follow-up. A patient who was the survivor of third-degree AV block had an electrocardiographic finding of flat T waves, and with a complete echocardiographic normalization of left ventricular dilatation and myocardial hypertrophy.

Conclusion: The present study confirms that increasing diphtheria immunization coverage in the population remains the most important strategy for the control of diphtheria. In resource limited countries, clinical findings, electrocardiography, and sometimes where available, echocardiography are helpful in assessing the severity of diphtheritic myocarditis, decision making of acute management, and predicting fatal outcome.

Open access

Warawut Siwaprapakorn, Manat Panamonta, Arnkisa Chaikitpinyo, Pagakrong Lumbiganon, Ouyporn Panamonta, Orathai Pachirat, Sompop Prathanee, Yuttapong Wongswadiwat, Junya Jirapradittha and Kaewjai Thepsuthammarat

Abstract

Background: Infective endocarditis (IE) is an important cause of child morbidity and mortality, but the current burden of the disease in Thai children is unknown.

Objectives: To determine the current burden of IE in Thai children.

Patients and Methods: The records of all children aged <15 years admitted to Khon Kaen University Hospital from 1992 to 2011 were reviewed.

Results: Of 69,822 admissions, 56 patients fulfilled the modified Duke criteria for definite IE giving a rate of 0.8 cases per 1,000 admissions. Age at diagnosis was 7.9 ± 3.8 years (range, 8 days to 14.8 years). There was congenital heart disease in 38 (68%) patients, rheumatic heart disease (RHD) in 10 (18%), and no previous heart disease in 8 (14%). RHD was a less frequent underlying disease during the latter half (2002-2011) of the period studied (1/34 vs. 9/22, P < 0.001). Blood cultures were positive for pathogens in 34 (61%) patients with 11 cases of Streptococcus viridians and 8 cases of Staphylococcus aureus infections. Vegetations on echocardiography were present in 46 (82%) patients. For 8 embolic events, patients with large vegetations had a higher rate (4/6) than patients with small and no vegetations (4/50) (P < 0.003). In-hospital mortality was 11%. Eight patients with S. aureus infection had a higher mortality (5/8) than 26 patients (1/26) infected with other pathogens (P < 0.001).

Conclusion: The changing epidemiology of pediatric IE was toward fewer children with RHD. Mortality among children with IE was higher in those with S. aureus infection.