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The Journal of PrapokklaoHospital
Clinical Medical EducationCenter (J.P.M.C.)
Editor
Banthit Chaowagul
AssociateEditor
Prayuth Somprakit
Editorial Board
Prakit Kasemsarn
Prasert Rimchala
Suchart Chaimuangraj.
Pramot Chudurn
Somboon Kietinun
Sombat Navarfttara
Prapap Yoothavisuthi
Danai Danvivathana
Somboon Somlaw
Siriwatt Thiptharadol
Manager
Chaiyasit Bhinyovithayakul
AssistantManagers.
Pimon Chanakot
Jongkon Chucheun
Sirinarj Limmanonukul
Morakot Makkamal
Ctrintana Chingchit
Art
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Office address
TechnicalDepartmentof PrapokklaoHospital
Amphur Muang
Chantaburi22OOO
Tel. Chantaburi3l l6l l-3, 3ll270
hrblication
Quarterly
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Wilaipan Rimchala
CheocharnViriyaluppa
Nipawan Kosalwat
Surachart Harithaithaworn
Somsin Chaiwijit
Jitti Kositchaiwat
Bonlert Bhuriyagorn
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MEDICAL RECORD
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Observationson Radiologyin Tokyo
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Nipawan KosolwatM.D.
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How to Select New Drugs in General practice
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Abstract The Resultof Anti TB Campaign
Weekof Trad Province1985.
B.A. (Nuning), M.S.(Epidemiology)**
Siriwatana TiptharadolM.D., M.Ph.*,ChantanaChantawongse
Sanga TongsaiCertificateof Health Sanitary*+
*,**Trad PublicHealthOffice,Trad,Thailand.
J Propokklao Hosp Clin Med Educot Center 1987i4i913.
Trad Public HealthOffice had joined the nationwideweek of anti TB campaignduring 2 - 8 August,
Theobiectivesandactivitiescomposedof:l936byusingtheprimaryhealthcare(PHC)
conceptandstrategy,
1. UslngVillageHedth Communicators(vHC) and VillageHealthvolunteers(vHV) to:1.1 SearchfornewcasesofTBpatientsandcontactpersonsaccordingtothegivencriteriasymp1.2 Surveythe BCGscarin the under 15 year'children
personsto
1.3 Appoint the target group of Childrento recieveBCGvaccinationand the suspected
collectsputumfor laboratoryinvestigation
1.4 Givehealtheducationto thc patientsand communities
(chestx-ray sputrm examinations)ser2. Giving physicanexaminationsand laboratoryinvestigations
vicesat distict and provincialhospitals
3. Setting anti TB exhibitionsat the district and provincialhospitals
4. Campaigningthe anti TB activitiesto the public by usingall kinds of local massmedia(radio,local
cableTV, newspapers
etc)
Therewere897 volunteers(53.36%of registeredvolunteers)ioined the campaignactivlties.The volunteershad surveyed16,526 under - 1S-yearchildren (31.2%l 547 childrenhavingno BCGscar. Besides,
the volunteershad appointedthe 649 suspectedcasesto had their sputum examlnedfor TB by collectingthe sputum,flxed
slidesat villagohealth officcs and sendingto district or provincialhospital. There were 16 positiveslides(2.47%)
for TB, 1I slidesfrom new suspectedcasesand 5 from known cases
The carnpaignactiviti€shad shown that (1) The activeapproachthroughPHCvolunteerscan increase
treatment,preventionand follow up. (2) The effectivethc numbersof new TB casesand makemore early diagnosis,
nessand cfficacy of regularTB control program can be increasedby intetratinS,themto the PHC strategyand
activity.
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Abstract surveyof c,onsumption
of "Multiple-druget" inwattananakornHospitat.
Montrcc Kanharatanachei,
M.D.*
* Directorof WattananakornHospital,phrachinburi,
Thailand,
J PropohhlooHosp Clin l4ed Educot Center 1997i4:1*2O.
"lWultlpls'drug sef" meansthc drugs that havc bccn elrcady sct in group, for thc ccrtaln dlscaseor
symptom, by thc prlvat€ dispensary. Almost always it contains tablet of prcdnisolonc and par.cctamol
combincd
with other drugs (3-9 tablcts) supply in tiny bag. The clicnts can buy thcscklnds drugsin sct by telling the symp_
tom or condition to thc drug salerthat.
Thc survcy of 716 paticnts who had ever usedthis kind of drug, at the out-patient departmcnt
of wat', tananakorn Hospltal, revealcd that fcmalc patients comsumcd more than mate (6o%;4O%)Most of thcm were in
year
group.
25'29
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Thc paticnt's most occupation was agriculture. common discasothat madc the paticntg
bought those drugs was discas€of respiratory systcm, most of which were common con (gs.zi)
The lrugs wore
bought in the villagomore than in town. Duration of drug consumptionwas usueily less
than 7 days. Most
common sldc effcct, whlch was uncommonlyscen (11%),was dizzincss. Accordlngto this prelimlnary
study,our
hospital will furthcr protestthi3 kind of drug consumptionintensivelyby uring thc public rclation
to thc patientcat
thc out'paticnt dcpartmcnt. continulng studi€sand reports.re alsorcguircdas long es ..Multipledrug
s3t,'still rcmains in Wattananakorn.
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RALLISINDIALIMITED
TEDDINGTOM
CHEMICALFACTORY
BOMBAY€O 093
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uSu:nfiotjulriu orn"or
sl4/7s atudnrsciroaoooiuqqufn 71
(onoooiuws:luuo)
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.
(airns"urf
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Vol. 4 No. I Jan.- Mar.1987
ay
{
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; PrapokklaoHospClin Med EducatCenter
s
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2l
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To{Inoo9l :
tli o{ton:-{-[.usu9ldermoidItnnnv qt6|,1
I t'tu
ntJ,nuttril?u
il:vunt orilrvfron.u.-
Abstract Orronic RupturedDermoidCystwith FlairgroMhinto Vagina
Prayuth SomprakitM.D.*
*Departmentof Obstetrics& Gynecology,PrapokklaoHospital,Chantaburl,Thalland.
J Propo khloo Hosp Ctln Med Educot Center 1987; 4221'24'
A caseof chronic rupturcd dermoid cyst wlth oophoro vaginal flstula was prc:cntcd. Tho p.dcnt
was 25 ycer-old-fcmaleand pnascntcdwlth symptom of foul smcll lcukorrhea wlth hair from vrglna. Opcradvcflnd'
ing revealcddermold cyst of thc rlght ovary,4 cms. In diamcter, packedin the cuFdc*ac wlth smell flrUl. conncct'
cd to postcrior fornix of thc vaglna Thc paticnt was cured by right salplngo oophorcctomy. Rcvlcw of rul.tcd
articles was elso Presented.
unril
Benign cystic teratoma uiafifisl6anf,udr
oril.tsnail'lildrurdarfi
rdaronrf,efi
afi'r s tfio
6a ectoderm,mesodermuflgendoderm ueidrlu
rfludrulraqjriluectoderm 6rv1r1fifitr,risnfiil'jr
dermoidcystrurfioueirt:n fro1fitiuulVirchow
ua& A q
(o.a.r sas)16fi$a1nri'i1
teratomadrrurornlnfrnfi
'j1monstrousgrowth uni 6sn1dfiutflumr.:nrrufir
qo.ltfia.ronf.r\rjfi l, ut fi .rfrufi':rrei
n{ uorqt a.rrlrhuo fiorru fia dermoidcystfir'strirdou$rslil drufu
^z
orqdrn'ir zofl rrwlu{rJrufi 6t ffrrilqn1:rnolla{rfi anoRsfiofir6a'jrrfioornpartheloufinosv{ulu{rteufi
nogenesis 1lO.:secondarf oocyted'3
nrrfF,s
rdarontfio dermoidcyst $no;nuinurobiln
I:nuvrrnrfiu r s qil. ros6i?il1uqjo:tricioufiornr:
' iltugfr' uinvm u b wutn amvtlnn ffi o'u
n$
qoluu::or
dermoidcyst rflurflo.:ondnutd'rurnfi
rdolontf,erteratomafrlrauo 6o il:slrr*fosar
s
r raiad'u6'u
es-egr uonornfius'lnut6'riluduei!
22
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ran{ndrlnI: qnoruran:cilnrndr
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doufiarooryruki'uri
nr:fior{utad? R'n$oRrar
rl: r rurruz fl riaurrl: .:r'rnrur n{rJr af orno'irfl
rdo.:annrr6or{atrnsn1rRa1urflurusr5,:
dot"fr. rfruHruiluoonrurfluonurrirs
unronurfifin6urrafiu
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,duroodfiIuR'lfl usrRurRn'ir rfro.:anf r'lrirfio I last 4 yrs
d*1 firdrrr:rcfiulfionraurn'jrrdoranfr'ldrfio6u rJ:vr?rhviirrdou il:sdr16aururot.ru:norq
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:ru:rrufraunfi.r
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nO
ltnitU.:11l1jo{ Stern ttOgn0rs6.tl6i'
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onu'tdnvflndurrafiurdrenr4rumr
'uo.r
rfla.rantfi odrinrlrlrirfioI: nun:n"i'ou'loiru
rnn.ir udo
posteriorfornix nu'jrfi1rfin1 turorvirr{r1fi6o
yirhi'rfi
q
rontfio6u.1 n^t:rc
arooy
nr:o-n
rnulurio.: un:flrdururuoonrurorn:6'lndrr
slrril::ilrnra6il.
fia,radrquri:.:
utoorovirtfirfi
olfistularfirtJtuo1ur: rJrnruoqnfi6'nurwrln6ilqnnoirnfir luro:JnO
i
u|
6u1ld' rriu n:sr1'{rvilnnrrc
drkituqj rflu6'ua-, u d'rqiooTrruoqnodr loYfr'o
utur orvir runt : ur r fio uuu
rfrnfu:ra.rru{rJuoio't:Jfrrflu:rulu{r-hudfi a{lu cul-de-sac no'lilr6u [sirrornoflraornar
Itnuvr:ndoulo.:
dermoidcystdfinr:unnaanlou finururnfirusebumaonrurluriolouroulnitrri rrru
trifiarnrquu:,:uny6.:tiuruourfi
orflu: Goeio:r
uir.: flnuoqnomo\ilnufi{fi0iln6
frhirrn;da.onnao
unsfirfruruuon
nirl:Jturia.rnnoo
nr:ifioq-uulo{du Chronicrupturedderg
d.rnu16'riarurnunvdrnuto
moid cyst
nr:nrrrfrrnurrdlrdu PA chest: normal;
plain KUB : Calcifiednoduleat pelvic region,
ra€.:{orqzsir rr.N.'a
2622-z5A.N.
zs-rzsz+suggestive
of dermoidcyst; IVP : normal excreiufifl'lilub.Jy{uruln2 ernlnily{.fl.252etufirlr tory function of both kidneyswith calcified
rrulruot{Jru
nr:eirfio 9 nn1nil il.fl.2s2e ludirilrirs
1s Ero.rFnJ nodule in pelvic cavity suggestiveof dermoid
v{.fl.2s2efiornr:dr6'qernrrrfinfiuuafiuuir
rilul
q
firsqrlruru fl
il:yr?iloou-u rfiail:vurus fl riouul:,rfl ururnfiilrurnBndrtd'rioulurt'a.rrlaunuro
rrirHndl
rnfioulrartrjrur'[6' uorfi16ufra.:riou
riJun*rn:rr'[ri
rurnrlnusirfi
ail: silr ru+fl rurd{:Jru
a-{rno.irfiflnur
lrnn'jrrjn6unyflnfiurufiurur 16'rourur:-n
v',fiTro'ld'fuarrnfiu
nsrurnfl:silnrnfir
i'unr-,6
sfiaz flriau
do.:noaoirrulTugrfi
u usior
nr:fiilru'lrjdrn:rr fir-hfl
601il16'rular6n
cyst; Ultrasonography : dermoid cyst or bowel,
diameter about 5 cms. at superoposterior of
uterus.
jr
diteryron
urilvHrsi'o turia{rt'orn: r otrir'{u
frnr:d'nrsurnstrififi{fiqrfiodulurio.rr{an
iloqn
turorJn6 tl nruo
nnfrr.:drsiln6
flldtr.lrrln nrsrilu
dermoid cyst
rurorfueiraudnnr.:il:;l.lot 4 qrj.
Gortuuautucul-de-sac
rafrrornfileirntsaaRorR
ui r:rufiuufirnu'jrfl26oeiafi'lrjolnnoosuroil:srur
ru
u
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I PrapokklaoHospClin Med EducatCenter
V o l . 4 N o . 1 l a n . - M a r .1 9 8 7
nr:drst"et right salpingo-oophorectomy
nr:rhunrailairsYorafi.:ni
rfio{rJr sodI:.:r,{sr
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rf,aoornar:fi*Ernoanrurfiufr.:o{lu Novak ER, Woodruff JD. Novak's gynecologicand
obstetric pathology with clinical and endocrine relaui tr ru cul-de-sacuny fl o runruri6 d ri rtu"'rfio nr:
tions.
!u!
I.
8th ed. Philadelphia:
WB Saunders,
1 979:487-8.
:v nra16osrurn
6.rrfi
or[Jufistuladu:yra.ir
rria{ofloo
ruarfr'[ri'[oi uar ri rtriei:Jr uflor nr: qnu r fi nhuuafiu
2. Kistner RW. Mature (Benign)teratomas.In: Kistner
RW. Gynecology:Principlesand practice. 3rd ed. Chicago:Year Book MedicalPublisher,1979:394-9.
I
ruurroruru oulufrsoei'lufirijurfruHrufi
.:anr;nrli.l ? NovakER, lonesGS, JonesHW Jr. Dermoldcysts.ln;
Novak ER, JonesGS, JonesHW Jr, Novak'stextbook
'lilludo.:
noao'[6'6.:rlu'irrflurirjr sfi eiourir.royIsn6
of gynecology,9th ed. Balrimore: Willians& Witkins,
'[
1975:46Q-4.
fi ri'loi'fi
nr: o'nrflur olda nyi'o.:
rnsl fr.:du n rvfi'rfinr:
Stern JL, Buscemal, Rosenshein
NB, Woodruff JD.
o-nra ur o,lti o.:ri'o.rfioI vir td' fi nr: 6or{uua.:of ur I lu
Spontaneousrupture of benigncystic teratomas.Obstet
Gynecol198'l; 57:363-6.
riorfio lurn ourirrlfrntir"ir6'ovir\6'dr
r-lrn fiIonrnd
Figiel LS, Figiel SJ. Report of two casesof sigmoidal
oyufioduqnruoioaiur:6u"1
toirurn rrnyrr.rnSrfi'lri
fistula complicating tubo-ovarian dlsease.Dis Colon
Rectum1966;9:107-8.
or oovrfi:rfn urf.:'[ridnriruafir ror'[i16' ri rtd'firj r s'[il
SasakiH, NagasakoK, HaradaM, KobayashiS, Uetake
crunnfiusrTlfi6n rro:nnoaof}nlyieraQ.:enrum:mr6 K. Benigncystic teratomasof the ovary with rupture
q
vrr
.!
into the rectum. Dis Colon Rectum1979;22:248-51.
lillu: tafi
r:rnrillrnfia:sloo
onro,lnn::-stridr.:fi
fi
7 . Dandia SD. Rectovesical
fistula following an ovarian
dermoid with recurrentvesicalcalculus:acasereport. J
:auT:floon$ayt'il?Bd1ilr:nfi'oyfiusl:EiabJld'
usi
Urol '1967;97285-7
.
lu n: tflrriudn?r o:'[ 6i'il; nu rrart orTu{:-huriourirsr-o
Peterson
WF, PrevostEC, EdmundsFT, HundleyJM Jr,
MorrisFK. Benigncysticteratomaof the ovary:a clinitdila n mr;nr:r.irfio{'rJrufi
flI:otrn:ndourriudfru
co-statisticalstudy of 1,007 caseswith a reviewof the
fiTanrsrurnfioy6'a
ryirairdt'ooo
ofrotarur, uanornriu
literature.Am J ObstetGynecol1 955;70:368-82.
9
.
Kistner RW. Intraperitonealrupture of a benigncystic
q
tu nr: airo1'o
{ri r sdfinr: r o, uo,d. o.or fi ofiturio.:
teratoma: reviewof the literaturewith a report of two
vi'o.: oyda.:Enroodr'ldTouny16so.irlilflsrutofi
fl
cases.ObstetGynecolSurv1952;7:603-17,
nr:aoo1'uornh
dto nR1't
o'Rtd :Jt[:.J]J
granulomatous 1 0 . Mehra U, O'ConnorT, OstapowiczF, CavanaghD. Pregnancy with bilateral ruptured benign cystic teratofha.
uiar{rfiofirfiodu 6.rrGerfrunn
fiI: nun:ndaurfiod
Am J ObstetGynecol1976;'1242361-6.
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26
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1. LichtensteinL. Bone tumors. sth €d. Salnt Louis: CV
M o s b y1
, 977:186219.
2. HuvosAG. Bone tumors: diagnosis,treatmentand prog
nosis.Phifadelphia: WB Saunders,
1979 :2O6-32.
Actsat TWO sites
with antihistaminicaction
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lnhtblts hlstomlne releose
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to the histamine
assault.
Only one antihistamine
". . . azatadine. . . hasbeenfound to substanfiailydecreaseboth the
and releaseof mediatorsfollowlng nasatanergerichaied; oilrrerg-iisymptomatology
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Vol. 4 No. 1 Jan.- Mar.1987
33
I PrapokklaoHospClin Med EducatCenter
ilfturrs
rilurrmlfruT
n1:fror:ottrdonldur'lm
rt.u.*
isrd l.u0nt-u?"euli
Absttact
How to SelectNewDrugsin GeneralPractice
,itti KositchaiwatM.D.*
*Departmentof Medicine,PrapokklaoHospital,Chantaburi,Thailand.
J Propokkloo Hosp Clln Med Educdt Center 1987;4:33-36'
Drug prcscriptionplays an important role for physiciansin gcneralpractlcenowadeys.Not surprisangly a largcamount of drugshas bcon consumedannually In our country. Mcanwhllcncw prcparationshavealso contlnuously beon rrlcasod to thc market. Hence physicianshave inevatablyto u3€their apptoprlatc iudgoment for
thosc in upprtscrlbint thclG numcrouskinds of drugs. lt is thc author'sopinion thatyoung physiciansespechlly
country always prcfcrontlally solcct the new drugs as their drugs of choicc. Nevcrthclc$, as In onc's practicc, thc
physlcian must satisty hlmself thlt a drug's claims of supcriorlty to othen alrerdy evallableere iustlfied by the
cvldcncc .t hands. Drug information from industrial pharmaceutlcalsls usually not rcliable due to its tendcncy to
bc porsuaslverathor thom oducational. Data from clinical iournals, on the other hand, ar€ more rclleble but unfor'
tun.tcty dlfficult t9 criticizc. ln gencral,ifa ncw preparatlonclearly providcaa thcrapeuticeffcct that has not bscn
obtainablc wlth oldcr oncs, its uso is indicatod at an early datc, On the contrary, if the dru8 appcrB to do no morc
than older mcdlcations,it is good judgement to us?the older preparations,which are llkely to be both cheapcrand
safcr duc to thoir woll known sidc effects and toxicity. Onc leSitimate situatlon for using a ncw drug, howevcr, is
when otdcr prcparationshavefailed to produce the desired results in a Sivenpatacnt. In this article, knowlcdgc of
rescarchstudy dGsignand blostatistics,so called researchmethodology, has bcen applied. By this method, one can
approprlatcly make his ludicious usoof any new drug ln hls cvcryday practice'
grudrniunr:d'o
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ytf
rJ::nr u:nrdahitd'srfi
fiil:cfi nr rcianr:fnur6{u nr.:ms-rivrurfi rdafiot6'rduThephysician,s
Desk
$nsil: vnrrfi na.:fifi r*ni arunrirr r6flifa un.irsr 16n Reference, The PharmaoologicalBasis
of Thera_
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V o l . 4 N o . 1 J a n .- M a r .1 9 8 7
, PrapokklaoHospClin Med ErlucatCenter
35
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36
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l: uururar:cilnrnrir
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{rfiuuarlucrquR't:
the pharmaceutacal
industry and the rogulrtory authorlrornrsrd'.:oLrnr:dnurrr
unrfirdfiarfluuuuariu ties. In: Grahame-SmlthDG, Aronson JK. Oxford text
c{rraiuitrdrruyrvr6odrrhfioruurryrd6ousfinti book of clinical pharmacologyand drug therapy. Oxford: Oxford Unlversity, 1981:| 97-209.
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ufi?:su:ilfir drufurhsryretyrsf,
fl rornnrdurengru
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rrrr
dittt zszz: s6:l9o-?.
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7 . Departmentof Cllnlcal Epldemlologyand Blostatlstlcs,
ido,:fi
oqiufir"'[ri'jrnr:orunilIquardan
McMaster University Health SclencesCcntor. How to
nlnra.:fg
read clinical iournalsV: to dlstlngulshuscful from usoraionl rufufiosor.lrra
i ui riyr{refierfierru fir ulrmdroI
less or even harmful theragy, Can Mcd Assoc J t9El;
124:1156-62.
rvirfiufifiAyrd
16ldlunr:rdanlfiurln
rirr drfrriurirhu
8. HaynesRB, McKlbbon KA, FlugeraldD, ct al. How to
ra.iou oro'iri6nr:oln r{r,ovfldlu1fi'uvrvr6fi
or:nn
keep up with thc medltal literarure: I why try to kccp
rfionlfsrlnrjlurrrrJfrr161rfi'60'sfru
9.
10.
| 1.
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1 . BlaschkeTF, Nics AS, Mamelok RD. Principlesof
therapeutics.
In: Gilman AG, GoodmanL5, Rall TW,
Murad F, eds. The pharmacologlcal
basisof therapeutics.7th ed. New York: MacMillan,
1985:45-65.
ttth rrirrriq. nrr J:yundrntfirnunranflunrln6iin. orq:fl1?l A5 2528; r:216- 24.
I 2.
13.
up and how to tpt startsd. Ann Intcrn Med l9t6;
I 05:14#53.
Stinson ER, Mucller OA. Survcyof hcalth profcsslon.
al's informatlon hablts and needs. f AMA 1980; 243:
140.
rinuf n'xrlun{. oaClutul{o. cr:ilirrr 262E;3?:E2l-0.
Johns RJ, HazardWR. lssuein dtagnostlcand thcrapcutic managemenlln: Harvcy AM, f ohns Rf, McKuslck
VA, Owen AH, Ross RS, eds. Thc prlnclplcs and practice of mediclne.2lst ed. Norwalk: Appleton-Crntury.
Crofts, 1984:3O9.
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2529:38:379-83.
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unlrurn1allt 2528:4:409-12.
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Ott DI, Chen YM, Gelfand DW, WU WC, Munitz HA,
AJR 1986;146:993-6.
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Radiology 1986; 160:491-5.
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Vol. 4 No. I lan.- Mar.'1987
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V o l . 4 N o . 1 f a n . - M a r .1 9 8 7
I PrapokklaoHospClin Med EducatCenter
47
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fi !cruie'u'[n:rnr:ourfuuduac16n uocfiuio"uIR:mr:
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48
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V o f , 4 N o . 1 l a n . - M a r .1 9 8 7
J PrapokklaoHospCtln Med EducatCentcr
49
:o{ildnntcil:2{dM:uqx ttaJflolct6unrllrn:rclduu
T{.f,.2sg0utuuilildqiud-atnlRrna
iui ztlJ1r.lRU
ot rtouJ:;ql r 6ndrurunr:l:otouran:cilntndr
".r;,..,,".rruJflrlduuro.ruril60u1;rnul:uururaqud
2 ol riouJ:;q! z
tunrli *acrfluilitrulufrt'muldfn: nr:ou:rnuriliarJ:c{ru{uridr:rorr:vt?llitrluuollttlo
dndrurunri
50
?'r:''t:qludnlrinurunnufircn{ni0n
Irlnururnn:cilnrndr
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rlu{luafifinrril$ilfi{lltrou
I rdou
Ouarterly Statistical Report
Departnent
Medicine
Surgery
Orthopedic
Rehabilitative
medicine
Opthalmology
Otofaryngology
Pediatrics
Pediatricpatients
Wellbabyclinic
Newborn
Obsetrics& Gynecology
A.N.C.
Obstetric
Gynecology
Familyplanning
Psychiatry
Dcntistry
Otherservice
Total
Oct.
No. of Out-Patient
Mv.
Dec.
3,213
'1,567
s62
1,815
3s4
367
2,967
1,493
47s
1,602
376
288
54"1
1,279
350
288
857
79s
384
794
680
339
955
630
333
1,220
496
893
266
620
1,1O2.
l2
1,057
444
7s4
267
574
87s
ll
'1,@7
14523
r29t G
3,251
"1,545
MO
762
345
553
781
470
l3,uo
_
Gt.
No. of Infaticnt
Nov.
Dec.
491
330
107
524
309
111
555
316
100
35
33
34
36
38
28
163
229
270
384
339
333
393
"t66
,on
337
',63
26
35
154
-''
2,129
2,lx)
2,775
V o l . 4 N o . 1 f a n . - M a r .1 9 8 7
I PrapokklaoHospClln Med EducatCenter
No. of Operation
Typcsof Opcration
Minor
Maior
Generalsurgcry
Nourosurgery
Urologicalsurgery
Orthopedicsurgery
Thoracicsurgery
Plasticsurgery
Eye
E.N.T.
Obstetrics
Gynecology
Oct.
Nov.
Dec.
134
507
155
17
37
116
2
26
33
'19
98
467
165
6
28
103
)
35
25
26
36
38
67
389
159
13
2'I
95
60
42
No. of Anesthesia
Typcsof Anesthesia
Generalanesthesia
Regionalanestlesia
Brachialplexusnerveblock
Localanesthesia
Miscellaneous
10
24
27
2'.t
19
Oct.
Nov.
Dec.
255
140
't2
264
108
14
116
50
329
200
21
153
81
20'l
63
No. of X-Ray
Typesof X-Ray
Plainstudy
Specialstudy
UpperGl study
K.U.B.study
Biliarystudy
Arteriogram
Myelogram
Bronchogram
Miscellaneous
Ultrasound
Oct.
'1,5'12
83
34
40
3
2
3
'l
't32
Nov.
Dec.
1,485
77
29
35
2
4
4
1,295
75
34
29
3
4
2
3
107
3
93
5l
52
?r:dr: qudnr:inrrunnutrtnJnirjnI: uururnn:vrJnrndr
ilri l orlurir u.n.-i.R.zoso
No. of SpecialInvestigation
Typesof SpccialInvertigation
E.K.G.record
E.K.G.monitoring
Fetalmonitoring
Oct.
Nov.
Dec.
227
3
88
202
21
69
153
11
6
No. of Endoscopy
Typesof Endoscopy
Esophagoscopy
Bronchoscopy
Gastroscopy
Peritoneoscopy
Cystoscopy
Proctoscopy
Colposcopy
Sigmoidoscopy
BloodBankingServicc
Donor
Volunteer
Replacement
Professional
,
Transfusion
Wholeblood& Packedredcelt
Wholeblood
Packedredcell
Lyophilizedplasma
Frozenplasma
Freshfrozenplasma
Plateletrich plasma
Plateletconcentrate
Cryoprecipitate
Leukocytepoor blood
Compatibilitytest
Emergency
crossmatching
Mobileunit
Units
units
units
units
units
units
units
units
units
units
units
units
units
units
units
units
cases
units
times/month
Oct.
Nov.
1
9
34
t9
6
20
1
4
27
2
18
5
14
Oct.
Nov.
872
Dec.
2
4"t
1
't3
1
6
Dec.
s79
331
248
769
429
340
7M
592
367
225
828
698
373
893
711
32s
38
74
39
50
3
22
16
316
29
11
81
s33
339
'1,'184
66
4
1,396
58
3
39s
7
t,qzz
62
5
Vol.4 No. 1 Jan.- Mar.1987
J PrapokklaoHospClin Med EducatCenter
Units
PathologicalExamination
cases
Autopsy
pathology
Surgical
Prapokklaohospital
Otherhospitals
Cytopathology
hospital
Prapokklao
OtherhosPitals
Clinicalhematology
Clinicalchemistry
Clinicalmicrobiology
Clinicalmicroscopy
andSerology
I mmunology
caseS
cases
cases
cases
cas€s
cases
tests
tests
tests
tests
a'e5
Oct.
13
470
347
123
1,214
392
822
3,207
10,409
4,556
5,008
4,'127
{tununnttr
:hurlounr:}iur
:.lu
,.i
:lU / cU
oouffu!:riln'r
6, ylluno :'lu
oriln
riusrdoon:
: ri, oouflufr
:-lu
nr:r{rrilonuln::'ln:
.i
:]U /cu
n1:qoflu
..i
:1U/ cr
nr::hur:rnv{u
:1U
nr:inurl: nrJiriud
su/:'ru
n-uorn::
lil: vduf
:IU
riunn::ufroflu
65
3s7l4s2
Nov.
't4
4,568
4,877
2,96'l
TI.U.
fi.R.
53
43
2s6l3ss
2781391
18
40
44
4
)
23s1320
21s|474
sls
617
212
90
"t4114
44
49
717
212
)
5
1
8
'ts21226
fi.R.
9t.R.
irudtld:lrall,RrvI
Dec.
3
392
293
99
444
351
93
3,650
10,662
3,581
4,702
3,494
515
432
83
444
322
122
3,54O
'10,302
53
i
alrnn::fi
fi: {
1,220
n:1nfld{nao9l
n:{
103
95
123
9r:20ilsr:-l:3ust5il1t:n
fl: it
332
273
309
?'l{tt3^tun:oun:-')
fl: il
266
267
345
fi:.t
795
680
630
a.l
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9r:?0dln'lv{[nno
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]?ttltflnul9tou?a5u
nu/n5'r
nu/n;.r
n:{
1,057
1,097
1,99011,990 1,99411,994 3,49913,499
5,109/600
24
3,7741470
68
3,3351420
67
?1:d1:dudn1:inururnuarrrnlndrln
I:onururar:vilnrndr
ilri a sfuli r !.R.-i.fl. zsgo
rruilorn"ul:
n
|
^
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t.R.
us
lrud.ild:ltnl|quou Itn
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l#in.iu}Jdto
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322
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32
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nt: nnaoo'lul:lt^totutaq
4
ou1
dofnduurpryrcu-n
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?tfu{un::n
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0u1
ft: il
467
466
457
n: it
92
62
97
dorindul:nu-or
n:.t
27
24
24
.,',r,rnnrrufru
il
nrunrrtriru"sr
orf,rriru"sr
nruqrln:ni
nruoiln:$irdiu
nrooiln:cfirfiuru
orJn:cidrur6u
nu/ni.r
nu/ni.r
15712,893
u'l!,tit
9812,345
24198s
261848
1U
7
2
1J'l
2
2
4
24
35
24
TI.U.
t.R.
to
.rruHinurntrlil
urldnrulu
urrjr
12112,001
341882
turu/fror: 2611,417
turu/nin
3110,297
2311,292
turu/f,or: 3315,58t
,uuru/n:"u 't0/11,600
2715,407.10 2715,247
215,170.80
2911,275.5
2111,310.6
urldnruuon
01f'l
ifiqrarnir
t.uo',*r'hjdldr^risl
drl#drulunrrordn
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larirriocfl.rdo
rJ:cfitio'[e?
lUrU
72
413,2OO
56
16116,3OO
74
u'l1l
105,459.54
108,523.11
114,090.70
ulYl
319,443.75
320,516."t6
353,273.25
lJ1Yf 213,995.'t'l
2't1,993.05
239,192.55
V o l . 4 N o . 1 J a n .- M a r .1 9 8 7
J PrapokklaoHospClln Med EducatCenter
nuHdnurilrrflornrio
9t.R.
55
f .R.
1. l.V.fluid11 llilru
an:
6,032
6,245
2. DextroseSWo
ant
150
350
3. C.P.D.solution
nf,t
50
40
4. Ringerlactate
no:
s00
5. N.S.s.drqrHo
an:
1,400
1,400
1,500
dialysissolution
5. Peritoneal
an:
900
700
650
7. Tuberculin
test1:100
un.
ua.
ao:
N
30
100
100
60
150
500
150
'1,200
test1:1,000
8. Tuberculin
9. Waterfor infection
10. Hemodialysis
aflt
: ?rluril:'If,rrnrioiiardnld
ont
drlddrulunl:narl
duvrunr:ordnnir
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rJ:cilrinlri
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1,800
1,800
1 14 7 2
10,215,
10,930
u11l
"|-14,720
102,150
109,300
u11l
367,'lA4
326,990
349,760
u11l
252,384
224,130
24O,460
yt.u,
9t.ft,
nlt olltuluururrfl olnrao
6,250
rJ:vrnu"ortiiiruru
lrr'lutu
rJ:cuu"nlfi
(ll2et)
:il.qu$u
(urn)
(u111)
1. l.V. fluid ljlJlo
1,0006d.
600
2. l.V. fluid rjUlo
500 66.
100
3. l.V. fluid 1il1o
250'i,i.
4. l.V. fluid xulo
5. l.V. fluid l,u1o
2006'f;.
100.f;.i.
500
600
5. t.V. fluid xulo
50.i.f;.
500
1,000
5,000
f .R.
600
100
0lu tu
rJ:vnu"orl#
(r1el)
:Tt.sltTu
(urn)
100
25,500
100
13.150
950
'l,2oo
nuwnQ: rJiuurfiurnrnrddrnriruiorra
lurny
ftrnururo uifn
l.V. ftuid x1J10
5oo 6.f;.
10 u'111 28 u-rYl
.id.
l.V.fluidur.no 2OO
.f6.
l.V.fluidtil1o 1OO
l.V. fluid llu1o
250 .i.i.
10 urll
l.V.fluidllilro
l.V. fluid 1J1J'l9r1,0006.f;.
12 ulvl
33 ulvl
23 u'lYl
50d6.
Irlnururo
uiu"n
10 ulll
23 u111
10 ulyt
15 u-l1l
7 U'lYt
12 ulyl
56
?lrdlrqudnr:dnururnoarenf
ndr?nl:rroruranrcilnrndr
ihi n sfufi r !.R.-i.R. zsso
PerinatalMortality
ocToBER 1986
Totol Nunber of Deqth= 6 coses
Totol Numberof Delivery= 390coss
PerinatolMonolity Rote= | 5.3811,000
btrths
No. Age Parity ANC Gest.VDRL
1
2
22 0-G1-0 3 (35) 4A
32 2-GO2 3 (19) 30
-ve
-ve
3
4
32 1-G1-1 No
19 1-0-G11 (?)
37
?
-ve
.ve
s
6
26 1-l-C16 (9) 30
31 G0-0-0 No ?
-ve
-ve
Dcl.
Numberof Stlll Blrth = 3 cass
Stlll Bhth Rote= 7.6911,0Nblrths
wt.
Sex TypcofDeath
Br. Ass 3500
NL
1250
F
F
I
A
2150
2200
F
M
N
N
Br. Ass 13s0
NL
2150
F
M
N
I
C/S
C/S
Causeof Dcath
Anoxia,Achondroplasia
Unknown,Deadfetusin
utero
Anomaly,TrisomyE
Anoxi4 Downsyndrome,
Focepresentation
Anoxia,Polyhydramnios
Anoxia,Mid Pre+clamsia
NOVEMBER
19E6
Totol Nunber of Deoth= 4 coses
Totol Numberof Deliver= 3fi coss
PerlndtalMortaltty Rote= 11.76/1,000births
No. Age Parity ANC Crst. VDRL
-ve
Numberof Stlll Blrth = 4 ues
Still Blrth Rate= | 1.76./l,M0 blrths
Det.
wt.
NL
1300
1
30 GG2-0 no
31
2
21 GGl-0
40
NL
24AO
3
2s 2-G1-2s(13) 38
NL
2350
4
22 0-0-0-0 no
NL
1300
no
29
Sex Type of Death
Causeof Death
Unknown,Deadfetusin
utero
Unknown,Deadfetusof
2nd twins
Unknown,Deadfetuswith
pyrexia
A
Unknown,Deadfetusin
utero
Vol.4 No. 1 Jan.- Mar.1987
I PrapokklaoHospClln Med EducatCenter
57
DECEMBER1986
Totol Numberof Deoth= 6 coses
Totol Numberof Delivery= 331 coses
PerinatolMortollty Rote= | 8.13/1,000births
No. Age Parity ANC Gest.VDRL
't
2
32 3-0-G3 0
27 3-G0-3 4*
3
4
16 G0-G0 1* 32
20 GG0-0 2(28) 33
32
40
Del.
-ve
NI
-ve
c/s
-ve
NL
-ve
c/s
Numberof Stiil Birth = 4 cases
Still Birth Rote= | 2.08/l ,000 births
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nical Phpiolog.
Recommended mettrod for the
determination of gammaglutamyltransferase in
blood. ScandJ Clin Lab Invest 1e76;36:11e-2s.
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Textbook of virology: for students and practitioners of medicine and the other health sciencts.
sth ed. Baltimore:Williams & Wilhns, tsoa.
n. {twhfrflu na.t.ilnnd(Corporute Author)
dfrarir.:
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