1
|
Charatcharoenwitthaya N, Jaisamrarn U, Songpatanasilp T, Kuptniratsaikul V, Unnanuntana A, Sritara C, Nimitphong H, Wattanachanya L, Chotiyarnwong P, Amphansap T, Phruetthiphat OA, Valleenukul T, Chaiamnuay S, Petchlorlian A, Srinonprasert V, Tejavanija S, Kitisomprayoonkul W, Dajpratham P, Chaikittisilpa S, Somboonporn W. Summary of the Thai Osteoporosis Foundation (TOPF) Clinical Practice Guideline on the diagnosis and management of osteoporosis 2021. Osteoporos Sarcopenia 2023; 9:45-52. [PMID: 37496989 PMCID: PMC10366425 DOI: 10.1016/j.afos.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 07/28/2023] Open
Abstract
Objectives The Thai Osteoporosis Foundation (TOPF) is an academic organization that consists of a multidisciplinary group of healthcare professionals managing osteoporosis. The first clinical practice guideline for diagnosing and managing osteoporosis in Thailand was published by the TOPF in 2010, then updated in 2016 and 2021. This paper presents important updates of the guideline for the diagnosis and management of osteoporosis in Thailand. Methods A panel of experts in the field of osteoporosis was recruited by the TOPF to review and update the TOPF position statement from 2016. Evidence was searched using the MEDLINE database through PubMed. Primary writers submitted their first drafts, which were reviewed, discussed, and integrated into the final document. Recommendations are based on reviews of the clinical evidence and experts' opinions. The recommendations are classified using the Grading of Recommendations, Assessment, Development, and Evaluation classification system. Results The updated guideline comprises 90 recommendations divided into 12 main topics. This paper summarizes the recommendations focused on 4 main topics: the diagnosis and evaluation of osteoporosis, fracture risk assessment and indications for bone mineral density measurement, fracture risk categorization, management according to fracture risk, and pharmacological management of osteoporosis. Conclusions This updated clinical practice guideline is a practical tool to assist healthcare professionals in diagnosing, evaluating, and managing osteoporosis in Thailand.
Collapse
Affiliation(s)
- Natthinee Charatcharoenwitthaya
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Thammasat University, 99/209 Pahonyothin Road., Pathumthani, 12120, Thailand
| | - Unnop Jaisamrarn
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Thawee Songpatanasilp
- Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Vilai Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok-Noi, Bangkok, 10700, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok-Noi, Bangkok, 10700, Thailand
| | - Chanika Sritara
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Hataikarn Nimitphong
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Lalita Wattanachanya
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok-Noi, Bangkok, 10700, Thailand
| | - Tanawat Amphansap
- Osteoporosis and Geriatric Excellence Center, Department of Orthopaedics, Police General Hospital, 492/1 Police General Hospital, Rama1 road, Prathumwan, Bangkok, 10330, Thailand
| | - Ong-Art Phruetthiphat
- Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Thanut Valleenukul
- Department of Orthopaedic Surgery, Bhumibol Adulyadej Hospital, 171 Phahonyothin Road, Bangkok, 10220, Thailand
| | - Sumapa Chaiamnuay
- Rheumatic Disease Unit, Department of Medicine, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Aisawan Petchlorlian
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
- Geriatric Excellence Center, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Varalak Srinonprasert
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok-Noi, Bangkok, 10700, Thailand
- Siriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok-Noi, Bangkok, 10700, Thailand
| | - Sirakarn Tejavanija
- Clinical Nutrition Unit, Department of Medicine, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, Bangkok, 10400, Thailand
| | - Wasuwat Kitisomprayoonkul
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Piyapat Dajpratham
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok-Noi, Bangkok, 10700, Thailand
| | - Sukanya Chaikittisilpa
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, 1873 Rama 4 Road, Bangkok, 10330, Thailand
| | - Woraluk Somboonporn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Khon Kaen, 40002, Thailand
| |
Collapse
|
2
|
Sakulpaisal M, Sothornwit J, Somboonporn W. The effects of exogenous estrogen in women with SAR-CoV-2 infection: a systematic review and meta-analysis. Hum Reprod 2023:7128247. [PMID: 37071891 DOI: 10.1093/humrep/dead074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 03/22/2023] [Indexed: 04/20/2023] Open
Abstract
STUDY QUESTION Does exogenous estrogen use affect COVID-19-related mortality in women? SUMMARY ANSWER Menopausal hormone therapy (MHT) was associated with a lower likelihood of all-cause fatality related to COVID-19 in postmenopausal women (odds ratio (OR) 0.28, 95% CI 0.18, 0.44; 4 studies, 21 517 women) but the combined oral contraceptive pill in premenopausal women did not have a significant effect (OR 1.00, 95% CI 0.42-2.41; 2 studies, 5099 women). WHAT IS KNOWN ALREADY Men are much more likely to die from COVID-19 than women. STUDY DESIGN, SIZE, DURATION In this systematic meta-analysis, a literature search was conducted using the following search terms related toCOVID-19 and estrogen, sex hormones, hormonal replacement, menopause, or contraception. The PubMed, Scopus, Cochrane Library, and EMBASE databases were searched to identify relevant studies published between December 2019 and December 2021. We also searched MedRxiv as a preprint database and reviewed the reference lists of all included studies and clinical trial registries for ongoing clinical studies until December 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS All comparative studies that compared the rates mortality and morbidity (hospitalization, intensive care unit (ICU) admission, and ventilation support) due to COVID-19 in women using exogenous estrogen to a control group of women (nonusers) were included. A review of the studies for inclusion, extraction of data, and assessment of the risk of bias was performed independently by two reviewers. The ROBINS-I tool and the RoB 2 tool were used for bias assessment of the included studies. Pooled odds ratios (ORs) with 95% CIs were calculated using Review Manager V5.4.1. The I2 statistic was used to quantify heterogeneity. The quality of the evidence was assessed using GRADE criteria. MAIN RESULTS AND THE ROLE OF CHANCE After searching the databases, we identified a total of 5310 studies. After removing duplicate records, ineligible studies, and ongoing studies, a total of four cohort studies and one randomized controlled trial comprising 177 809 participants were included in this review. There was a moderate certainty of evidence that MHT was associated with a lower likelihood of all-cause fatality related to COVID-19 (OR 0.28, 95% CI 0.18, 0.44; I2 = 0%; 4 studies, 21 517 women). The review indicated a low certainty of evidence for other outcomes. The mortality rate of premenopausal women in the combined oral contraceptive pill group did not differ significantly from the control group (OR 1.00, 95% CI 0.42-2.41; 2 studies, 5099 women). MHT marginally increased the rate of hospitalization and ICU admission (OR 1.37, 95% CI 1.18-1.61; 3 studies, 151 485 women), but there was no significant difference in the need for respiratory support between MHT users and nonusers (OR 0.91, 95% CI 0.52-1.59; 3 studies, 151 485 women). Overall, the tendency and magnitude of the effects of MHT in postmenopausal women with COVID-19 were consistent across the included studies. LIMITATIONS, REASONS FOR CAUTION The certainty of the evidence for other outcomes of this review may be limited, as all included studies were cohort studies. In addition, the dosages and durations of exogenous estrogen used by postmenopausal women varied from study to study, and combined progestogen administration may have had some effect on the outcomes. WIDER IMPLICATIONS OF THE FINDINGS The findings of this study can aid in counseling postmenopausal women taking MHT when they are diagnosed with COVID, as they have a lower chance of death than those not taking MHT. STUDY FUNDING/COMPETING INTEREST(S) Khon Kaen University provided financial support for this review and had no involvement at any stage of the study. The authors have no conflicts of interest to declare. REGISTRATION NUMBER PROSPERO, CRD42021271882.
Collapse
Affiliation(s)
- Maytha Sakulpaisal
- Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jen Sothornwit
- Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Woraluk Somboonporn
- Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
3
|
Jongjakapun A, Somboonporn W, Temtanakitpaisan T. Effectiveness of vaginal estriol with lactobacilli on urinary symptoms in postmenopausal women: a randomized-controlled trial. Menopause 2023; 30:441-446. [PMID: 36728591 DOI: 10.1097/gme.0000000000002147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to compare the effects of a vaginal tablet containing estriol (0.03 mg) plus lactobacilli (E3/L) with placebo on lower urinary tract symptoms (LUTS) in postmenopausal women (PMW). METHODS This randomized, double-blinded, placebo-controlled trial was conducted at Srinagarind Hospital in Khon Kaen, Thailand. PMW with at least one LUTS, such as frequency, nocturia, dysuria, urgency, or stress or urgency urinary incontinence, were recruited. Participants were randomly assigned to receive either an E3/L tablet or placebo, administered vaginally daily at bedtime for 2 weeks, then twice a week for another 2 weeks. Symptom severity score was assessed using a visual analog scale (VAS), and quality of life (QOL) was measured using the validated Thai version of the Incontinence Impact Questionnaire-Short Form. The primary outcome was proportion of the PMW with LUTS improvement. Secondary outcomes were symptom severity score, participant satisfaction, QOL, and adverse events. Relative risk and 95% confidence intervals (CIs) were calculated using the chi-square or Fisher's exact test. An independent-sample and paired t test were used to compare means. RESULTS Thirty-eight participants in each group completed the study. The proportion of PMW whose symptoms improved (both in terms of most bothersome symptom and overall) did not differ significantly between the two groups. Relative risk was 1.00 (95% CI, 0.74-1.36) and 0.90 (95% CI, 0.71-1.15), respectively. There were no differences in symptom severity score, participant satisfaction, or QOL. CONCLUSIONS A 1-month course of vaginal E3/L does not appear to improve LUTS in PMW.
Collapse
Affiliation(s)
- Apiwat Jongjakapun
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | |
Collapse
|
4
|
Somboonporn W, Kantawee K. Recurrent ovarian endometrioma after conservative surgery: A retrospective study. Asian Pac J Reprod 2022. [DOI: 10.4103/2305-0500.335858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
5
|
Sothornwit J, Wattanakamolchai P, Werawatakul Y, Eamudomkarn N, Somboonporn W. Patterns of contraceptive use among Thai women aged ≥40 and at risk of pregnancy. EUR J CONTRACEP REPR 2020; 25:345-349. [PMID: 32567985 DOI: 10.1080/13625187.2020.1783653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aims of the study were to identify the patterns of contraceptive use among Thai women aged ≥40 years and the reasons for not using contraception. METHODS This cross-sectional study included sexually active women aged 40-49 years in Khon Kaen, Thailand. Information on contraceptive practice and reasons for not using contraception was collected through a self-reported questionnaire. The unmet need for a modern method of contraception and the unmet need for any method of contraception were calculated based on the percentage of participants who were not using contraception but who wanted to postpone or prevent pregnancy. RESULTS Of 400 women, 75.5% were currently using some form of contraception, with female sterilisation being the most used (35%). The main reasons for not using contraception included perceived low risk of pregnancy, health concerns, infrequent sexual intercourse and wish to become pregnant. The unmet need for a modern method of contraception was 23.3% (95% confidence interval [CI] 0.20%, 0.29%). Having children was a significant protective factor (adjusted odds ratio [OR] 0.18; 95% CI 0.08, 0.37; p = 0.000). The unmet need for any method of contraception was 12% (95% CI 0.09%, 0.16%). Previous abortion was a significant risk factor for not using any contraception (adjusted OR 2.23; 95% CI 1.12, 4.44; p = 0.022). CONCLUSION Although the use of contraception was common, some participants displayed a lack of knowledge and/or did not practise family planning. Our findings address the importance of improving knowledge about the risks of pregnancy and the need for effective contraception in this population.
Collapse
Affiliation(s)
- Jen Sothornwit
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panicha Wattanakamolchai
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Yuthapong Werawatakul
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nuntasiri Eamudomkarn
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Woraluk Somboonporn
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
6
|
Sitthisombat P, Soontrapa S, Kaewrudee S, Sothornwit J, Eamudomkarn N, Promsorn J, Takong W, Somboonporn W. Carotid plaque and lumbar bone mineral density status in post-menopausal women: An age-matched, analytical cross-sectional study. Post Reprod Health 2020; 26:9-18. [PMID: 31795810 DOI: 10.1177/2053369119890746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
ObjectiveTo explore the association between carotid plaque and lumbar spine osteoporosis in post-menopausal women.Study designAge-matched, cross-sectional study.Main outcome measuresCarotid plaque and carotid intima media thickness were measured with B-mode ultrasound. Lumbar spine bone mineral density was measured with dual-energy X-ray absorptiometry. Prevalence odds ratios and the respective 95% confidence intervals (95%CI) were calculated to determine the association.ResultsSeventy-two post-menopausal women with lumbar spine osteoporosis and 72 post-menopausal women with normal lumbar spine bone mineral density were enrolled. The adjusted prevalence odds ratio of carotid plaque presence in post-menopausal women with lumbar spine osteoporosis was 1.73 (95%CI; 0.60 to 4.94) when compared to post-menopausal women with normal lumbar spine bone mineral density. The presence of vulnerable plaque was greater in post-menopausal women with lumbar spine osteoporosis; however, the difference was not statistically significant after adjusting for other risk factors of cardiovascular disease (odds ratio 1.31; 95%CI; 0.39 to 4.43). There was no significant difference in carotid intima media thickness between the two groups. Multiple logistic regression analysis with backward elimination in assessment of potential risk factors for the presence of carotid plaque showed that the year since menopause, family history of cardiovascular disease and systolic blood pressure were nominally significant associated factors with a respective adjusted odds ratio of 1.06 (95%CI; 1.01 to 1.12), 6.23 (95%CI; 1.65 to 23.46) and 1.03 (95%CI; 1.01 to 1.06).ConclusionsThe current study indicates that lumbar spine osteoporosis is not associated with the presence of carotid plaque, whereas year since menopause, family history of cardiovascular disease and systolic blood pressure are associated factors.
Collapse
Affiliation(s)
- Patraporn Sitthisombat
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sukree Soontrapa
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Srinaree Kaewrudee
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jen Sothornwit
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nuntasiri Eamudomkarn
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Julaluck Promsorn
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wittawat Takong
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Woraluk Somboonporn
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
7
|
Chooprasertsuk W, Somboonporn W, Soontrapa S, Salang L, Amnatbuddee S. Combined vaginal administration of nystatin, diiodohydroxyquin, and benzalkonium chloride versus oral metronidazole for the treatment of bacterial vaginosis. Int J Gynaecol Obstet 2019; 145:261-267. [DOI: 10.1002/ijgo.12805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/06/2018] [Accepted: 03/19/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Wichinee Chooprasertsuk
- Department of Obstetrics and GynecologyFaculty of MedicineKhon Kaen University Khon Kaen Thailand
| | - Woraluk Somboonporn
- Department of Obstetrics and GynecologyFaculty of MedicineKhon Kaen University Khon Kaen Thailand
| | - Sukree Soontrapa
- Department of Obstetrics and GynecologyFaculty of MedicineKhon Kaen University Khon Kaen Thailand
| | - LingLing Salang
- Department of Obstetrics and GynecologyFaculty of MedicineKhon Kaen University Khon Kaen Thailand
| | - Siriruthai Amnatbuddee
- Department of Obstetrics and GynecologyFaculty of MedicineKhon Kaen University Khon Kaen Thailand
| |
Collapse
|
8
|
Sothornwit J, Somboonporn W, Soontrapa S, Kaewrudee S, Wongwiwatchai J, Soontrapa S. Carotid intima-media thickness and osteoporosis in postmenopausal women: a cross-sectional study. Climacteric 2018. [DOI: 10.1080/13697137.2018.1439916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- J. Sothornwit
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - W. Somboonporn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - S. Soontrapa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - S. Kaewrudee
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - J. Wongwiwatchai
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - S. Soontrapa
- Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
9
|
Buddhabunyakan N, Kaewrudee S, Chongsomchai C, Soontrapa S, Somboonporn W, Sothornwit J. Premenstrual syndrome (PMS) among high school students. Int J Womens Health 2017; 9:501-505. [PMID: 28860863 PMCID: PMC5560417 DOI: 10.2147/ijwh.s140679] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Premenstrual syndrome (PMS) is a common health problem among adolescents. Objective To assess the prevalence of PMS in Thai high school students. Materials and methods This was a prospective study conducted among menstruating high school students in Khon Kaen, Thailand, from September to December, 2015. Participants were asked to prospectively complete an anonymous questionnaire, which included information about demographic data, menstrual patterns, and symptoms to be recorded on a daily calendar of premenstrual experiences according to the diagnostic criteria proposed by the American College of Obstetricians and Gynecologists. All of the data were prospectively recorded for 90 consecutive days. Results Of the 399 participants, 289 (72.4%) completed the self-report questionnaire. Eighty-six participants (29.8%; 95% CI, 24.5%–35.4%) reported having PMS. The most common somatic and affective symptoms among participants with PMS were breast tenderness (74.4%) and angry outbursts (97.7%). There were significant differences between the PMS and non-PMS groups, and PMS was associated with various problems related to educational activities, including lack of concentration and motivation, poor individual work performance, poor collaborative work performance, and low scores. However, there were no significant differences regarding interpersonal relationships between the PMS and non-PMS groups. Conclusions PMS is a common menstrual disorder among Thai high school students. The most common symptoms reported in this study were angry outbursts and breast tenderness.
Collapse
Affiliation(s)
- Nattapong Buddhabunyakan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Srinaree Kaewrudee
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chompilas Chongsomchai
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sukree Soontrapa
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Woraluk Somboonporn
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jen Sothornwit
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
10
|
Abstract
BACKGROUND Since the time of publication of the Women's Health Initiative (WHI) study, menopausal symptom management has become more complex because of increased awareness of the risks associated with hormone replacement therapy (HRT). Currently, a wide range of management options is available. Some women take prescription drugs, and others use self care strategies, including lifestyle modifications, over-the-counter preparations and complementary and alternative therapies, such as herbal preparations, exercise programmes and relaxation techniques. Relaxation techniques consist of a group of behavioural interventions. They are considered relatively harmless, but their effectiveness in treating vasomotor symptoms and sleep disturbances remains debatable. OBJECTIVES To determine the effectiveness of relaxation techniques as treatment for vasomotor symptoms and associated sleep disturbances in perimenopausal and postmenopausal women. SEARCH METHODS Searches of the following electronic bibliographic databases were performed in February 2014 to identify randomised controlled trials (RCTs): the Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, PsycINFO, Social Science Citation Index and CINAHL. Handsearches of trial registers, relevant journals and published conference abstracts were also performed. SELECTION CRITERIA RCTs were included if they compared any type of relaxation intervention with no treatment or other treatments (except hormones) for vasomotor symptoms in symptomatic perimenopausal/postmenopausal women. DATA COLLECTION AND ANALYSIS Two review authors selected studies, assessed quality and extracted data. Included studies were combined, if appropriate, by using a random-effects model to calculate pooled mean differences and 95% confidence intervals. MAIN RESULTS Four studies were eligible for inclusion (281 participants): Two studies compared relaxation with electroacupuncture or superficial needling, one study compared relaxation with paced respiration or placebo control (α-wave electroencephalographic biofeedback) and one study compared relaxation with no treatment.No evidence was found of a difference between relaxation and acupuncture or superficial needle insertion in the number of hot flushes per 24 hours (mean difference (MD) 0.05, 95% confidence interval (CI) -1.33 to 1.43, two studies, 72 participants, I(2) = 0%; very low-quality evidence). Nor did any evidence suggest a difference between the two interventions in hot flush severity, measured using the Kupperman Index (MD -1.32, 95% CI -5.06 to 2.43, two studies, 72 participants, I(2) = 0%; very low-quality evidence).The other two studies found no clear evidence of a difference in hot flush frequency between relaxation and paced respiration, placebo or no treatment. The data for these comparisons were unsuitable for analysis.None of these studies reported night sweats, sleep disturbances associated with night sweats or adverse effects as an outcome.The main limitations of identified evidence were lack of data, imprecision and failure to report study methods in adequate detail. AUTHORS' CONCLUSIONS Evidence is insufficient to show the effectiveness of relaxation techniques as treatment for menopausal vasomotor symptoms, or to determine whether this treatment is more effective than no treatment, placebo, acupuncture, superficial needle insertion or paced respiration.
Collapse
Affiliation(s)
- Suprawita Saensak
- Faculty of Medicine, Chiang Mai University, Muang, 110 Intavaroros Road, Sriphum, Chiang Mai, Thailand, 50200
| | | | | | | |
Collapse
|
11
|
Saensak S, Vutyavanich T, Somboonporn W, Srisurapanont M. Effectiveness of a modified version of the applied relaxation technique in treatment of perimenopausal and postmenopausal symptoms. Int J Womens Health 2013; 5:765-71. [PMID: 24235848 PMCID: PMC3821752 DOI: 10.2147/ijwh.s53652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Awareness of the risks associated with hormone therapy for menopausal symptoms has sparked a global decline in this treatment. Alternative treatments to relieve menopausal symptoms are therefore required. The applied relaxation (AR) technique has proven to be successful for symptom amelioration, but requires participation in 12 weekly classes. The purpose of this study was to determine the effectiveness of a modified relaxation version (MR) of AR for treatment of hot flashes, night sweats, and sleep disturbances. METHODS We conducted a12-week, randomized, parallel, open-label, controlled trial in perimenopausal and postmenopausal women visiting the menopausal clinic. Participants were randomly assigned to an MR or AR group. The MR group (n=36) received a single session of (MR) training and the AR group (n=35) received conventional 12-week training. Participants were instructed to practice the techniques daily at home for 12 weeks. The main outcome was the measure on the severity scale and frequency of hot flashes, night sweats, and sleep disturbances. RESULTS All participants completed the study. Total severity scores in both groups decreased after 12 weeks, but there was no difference between the groups (P=0.93). The severity score for hot flashes in the MR group decreased more than in the AR group (P=0.02). The severity scores for night sweats and sleep disturbances decreased in both groups. The frequency of hot flashes, night sweats, and sleep disturbances were also decreased in both groups. CONCLUSION A shorter, modified version of the AR was equally effective or slightly better than the conventional AR for the relief of hot flashes, night sweats, and sleep disturbances in perimenopausal and postmenopausal women. Recommendations for future research include confirmatory studies and trials with larger samples.
Collapse
Affiliation(s)
- Suprawita Saensak
- Academic Department, Faculty of Medicine, Mahasarakham University, Maha Sarakham, Thailand ; Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | |
Collapse
|
12
|
Saensak S, Vutyavanich T, Somboonporn W, Srisurapanont M. Modified relaxation technique for treating hypertension in Thai postmenopausal women. J Multidiscip Healthc 2013; 6:373-8. [PMID: 24124377 PMCID: PMC3794966 DOI: 10.2147/jmdh.s51580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim To examine the effectiveness of a modified relaxation (MR) technique in reducing blood pressure levels in Thai postmenopausal women with mild hypertension, compared with a control group who received health education. Methods This is a 16-week, randomized, parallel, open-label, controlled trial in a menopausal clinic in a tertiary health care center in Northeastern Thailand. The intervention group received a 60-minute session of MR training and were encouraged to practice 15–20 minutes a day, at least 5 days a week. The control group received lifestyle education, including diet and exercise. The primary and secondary outcomes were systolic and diastolic blood pressure (SBP and DBP). Results Of 432 participants, 215 and 217 were randomly allocated to the MR and control groups, respectively. Of those, 167 participants in the MR group and 175 participants in the control group completed the study. The SBP was significantly more reduced in the MR group, with a mean of 2.1 mmHg (P < 0.001). There was no significant difference between groups on the changed DBP. Conclusion The MR technique may be effective in lowering SBP in Thai postmenopausal women visiting a menopause clinic. Its efficacy may be observed as soon as 4 weeks after start of treatment. Long-term and combined relaxation therapy and antihypertensive agents are warranted in a large cohort of this population. This trial is registered in clinicaltrials.gov (number NCT01429662).
Collapse
Affiliation(s)
- Suprawita Saensak
- Academic Department, Faculty of Medicine, Mahasarakham University, Maha Sarakham, Thailand ; Department of community Medicine, Faculty of Medicine, Chiang Mai University,Thailand
| | | | | | | |
Collapse
|
13
|
Saensak S, Vutyavanich T, Somboonporn W, Srisurapanont M. Relaxation for perimenopausal and postmenopausal symptoms. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2010. [DOI: 10.1002/14651858.cd008582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
14
|
Buppasiri P, Temtanakitpaisan T, Somboonporn W. Tuberculosis at vulva and vagina. J Med Assoc Thai 2010; 93:613-615. [PMID: 20524449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A 60- year-old woman, gravid 4, para 4-0-0-4 was admitted to the Department of Obstetrics and Gynecology, Khon Kaen University due to chronic extensive painful genital ulcer. She was treated by antiviral and antifungal regimens but the ulcer persisted. After acid fast bacilli was found on tissue biopsy, a standard 6- month course of antituberculosis was started. One month after treatment, the ulcer was completely cured.
Collapse
Affiliation(s)
- Pranom Buppasiri
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | | | | |
Collapse
|
15
|
Kaewrudee S, Ungpinitpong W, Thinkhamrop J, Sakondhavat C, Soontrapa S, Somboonporn W. P847 Prevalence of bacterial vaginosis and vaginal uropathogens in postmenopausal women with and without oral hormone therapy. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62337-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
16
|
Kleebkaow P, Maneetab S, Somboonporn W, Seejorn K, Thinkhamrop J, Komwilaisak R. P1045 Preoperative and postoperative agreement of histopathological findings in cases of endometrial hyperplasia. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Kleebkaow P, Maneetab S, Somboonporn W, Seejornj K, Thinkhamrop J, Kamwilaisak R. Preoperative and postoperative agreement of histopathological findings in cases of endometrial hyperplasia. Asian Pac J Cancer Prev 2008; 9:89-91. [PMID: 18439083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE To determine agreement of preoperative and postoperative histopathology of endometrial hyperplasia (EH). MATERIALS AND METHODS Histopathology of specimens obtained by curettage and hysterectomy within 1 year was retrospectively compared by a skilled gynecological pathologist. Patients who received hormone therapy were excluded. RESULTS Of 79 women with a preoperative diagnosis of EH, only 32 were diagnosed as EH from hysterectomy specimens. There was no endometrial cancer. The agreement between preoperative and postoperative histology did not achieve statistical significance (Kappa 0.011). Postoperative histopathology was more severe than preoperative diagnosis in 5 (6.3%) patients, including 3 preoperative diagnoses of simple hyperplasia without atypia, 1 simple hyperplasia with atypia, and 1 complex hyperplasia without atypia. CONCLUSIONS For EH diagnosed by curettage, we can be sure of the diagnosis. However, 6.3% had more severe histology from hysterectomy specimens. Thus, repeated curettage or other investigations should be reconsidered in women with recurrent bleeding.
Collapse
Affiliation(s)
- Pilaiwan Kleebkaow
- Department of Obstetrics and Gynecology, Faculty of Medicine Khon Kaen University, Thailand.
| | | | | | | | | | | |
Collapse
|
18
|
Somboonporn W. Emerging role of testosterone in menopause. Womens Health (Lond) 2007; 3:663-665. [PMID: 19803973 DOI: 10.2217/17455057.3.6.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Woraluk Somboonporn
- Khon Kaen University, Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen, 40002, Thailand.
| |
Collapse
|
19
|
Abstract
PURPOSE OF REVIEW Androgen therapy is being increasingly used in the management of postmenopausal women. The most common indication is to improve sexual function. The aim of this review is to evaluate current knowledge pertaining to testosterone and sexual function in postmenopausal women. RECENT FINDINGS The change of testosterone levels during the menopause transition remains controversial. A correlation of endogenous testosterone levels and sexual function is still inconclusive. A Cochrane Review and recent randomized control trials have, however, consistently demonstrated that short-term testosterone therapy in combination with traditional hormone therapy regimens improves sexual function in postmenopausal women, particularly surgically menopausal women with hypoactive sexual desire disorder. An adverse effect on the lipid profile has been identified which appears to be mostly associated with oral methyltestosterone. Data for other effects of testosterone and long-terms risks are lacking. Testosterone may act in a variety of ways in different tissues. This is, however, an area that requires further investigation. SUMMARY Testosterone therapy is a promising option for treating women with hypoactive sexual desire disorder after surgical menopause. Two remaining questions need to be answer: who is most likely to benefit from testosterone therapy and what are the long-term health risks?
Collapse
Affiliation(s)
- Woraluk Somboonporn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| |
Collapse
|
20
|
Abstract
The treatment of postmenopausal women with a variety of androgen formulations is increasing, despite the lack of clear guidelines regarding the diagnosis of androgen insufficiency. This review summarizes evidence on the efficacy and safety of adding testosterone to hormone therapy in postmenopausal women. Fair to good evidence exists that the use of testosterone in combination with hormone therapy has both benefits and risks. The benefits are an improvement in sexual function with various regimens of testosterone use (good evidence), an improved sense of well-being with transdermal testosterone (fair evidence), and a reduction in triglyceride levels with methyl testosterone (fair evidence). The most consistent risk is a reduction in high-density lipoprotein (HDL) cholesterol, particularly with methyl testosterone (good evidence). There has been insufficient reporting of other side effects; hence, testosterone therapy should be used with caution. The use of testosterone may be justified in specific clinical circumstances and should be limited to short-term use; long-term studies are not available. Close surveillance for HDL cholesterol and other side effects is necessary.
Collapse
Affiliation(s)
- Woraluk Somboonporn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| |
Collapse
|
21
|
Abstract
BACKGROUND : The value of adding testosterone to hormone therapy (HT) for the management of peri- and postmenopausal women is controversial and has not been systematically reviewed. OBJECTIVES : To determine the benefits and risks of testosterone therapy for peri- and postmenopausal women taking hormone therapy. SEARCH STRATEGY : We searched the Cochrane Menstrual Disorders and Subfertility Group Trials Register (1st November 2003), The Cochrane Library (Issue 2, 2003), MEDLINE (1966 to 1st November 2003), EMBASE (1980 to 1st November 2003), Biological Abstracts (1969 to 2002), PsycINFO (1972 to 1st November 2003), CINAHL (1982 to 1st November 2003), and reference lists of articles. We also contacted pharmaceutical companies and researchers in the field. SELECTION CRITERIA : Studies that were randomized comparisons of testosterone plus hormone therapy versus hormone therapy alone in peri- or postmenopausal women. DATA COLLECTION AND ANALYSIS : Two review authors assessed the quality of the trials and extracted data independently. Where it was necessary, the corresponding authors of eligible trials were contacted for additional information. For dichotomous outcomes Peto odds ratios and 95% confidence intervals were calculated. For continuous outcomes non-skewed data from valid scales were synthesized using a weighted mean difference or standardized mean difference. If statistical heterogeneity was found, a random-effects model was used and reasons for the heterogeneity were explored and discussed. MAIN RESULTS : Twenty-three trials with 1957 participants were included in the review. The median study duration was 6 months (range 1.5 to 24 months). Most of the trials were of adequate quality with regard to randomization and concealment of allocation sequence. The major methodological limitations were attrition bias and lack of a washout period in the cross-over studies. The pooled estimate from the studies suggested that the addition of testosterone to HT regimens improved sexual function scores for postmenopausal women. A significant adverse effect was a decrease in high-density lipoprotein (HDL) cholesterol levels. The discontinuation rate was not significantly greater with testosterone therapy (Peto odds ratio 1.01, 95% confidence interval 0.76 to 1.33) than with HT alone. There was insufficient evidence of a treatment effect for perimenopausal women or for other outcomes. AUTHORS' CONCLUSIONS : Only a limited number of studies could be pooled in the meta-analyses. This limited the power of the meta-analysis to provide conclusions about efficacy and safety. However, there is evidence that adding testosterone to HT has a beneficial effect on sexual function in postmenopausal women. There was a reduction in HDL cholesterol associated with the addition of testosterone to the HT regimens. The meta-analysis combined studies using different testosterone regimens. It is, therefore, difficult to estimate the effect of testosterone on sexual function in association with any individual hormone treatment regimen.
Collapse
|
22
|
Abstract
BACKGROUND Testosterone therapy is being increasingly used in the management of postmenopausal women. However, as clinical trials have demonstrated a significantly increased risk of breast cancer with oral combined estrogen-progestin therapy, there is a need to ascertain the risk of including testosterone in such regimens. OBJECTIVE Evaluation of experimental and epidemiological studies pertaining to the role of testosterone in breast cancer. DESIGN Literature review. SETTING The Jean Hailes Foundation, Research Unit. MAIN OUTCOME MEASURES Mammary epithelial proliferation, apoptosis and breast cancer. RESULTS In experimental studies, testosterone action is anti-proliferative and pro-apoptotic, and mediated via the AR, despite the potential for testosterone to be aromatized to estrogen. Animal studies suggest that testosterone may serve as a natural, endogenous protector of the breast and limit mitogenic and cancer promoting effects of estrogen on mammary epithelium. In premenopausal women, elevated testosterone is not associated with greater breast cancer risk. The risk of breast cancer is also not increased in women with polycystic ovary syndrome who have chronic estrogen exposure and androgen excess. However, in postmenopausal women, who are oestrogen deplete and have increased adipose aromatase activity, higher testosterone has been associated with greater breast cancer risk. CONCLUSION Available data indicate the inclusion of testosterone in estrogen-progestin regimens has the potential to ameliorate the stimulating effects of hormones on the breast. However, testosterone therapy alone cannot be recommended for estrogen deplete women because of the potential risk of enhanced aromatisation to estrogen in this setting.
Collapse
Affiliation(s)
- Woraluk Somboonporn
- Department of Obstetrics and Gynaecology, Khon Kaen University, Khon Kaen, Thailand
| | | |
Collapse
|
23
|
Abstract
Androgens have important physiological effects in women. Postmenopausal androgen replacement, most commonly as testosterone therapy, is becoming increasingly widespread. This is despite the lack of clear guidelines regarding the diagnosis of androgen insufficiency, optimal therapeutic doses, and long-term safety data. With respect to the breast specifically, there is the potential for exogenous testosterone to exert either androgenic or indirect estrogenic actions, with the latter potentially increasing breast cancer risk. In experimental studies, androgens exhibit growth-inhibitory and apoptotic effects in some, but not all, breast cancer cell lines. Differing effects between cell lines appear to be due primarily to variations in concentrations of specific coregulatory proteins at the receptor level. In rodent breast cancer models, androgen action is antiproliferative and proapoptotic, and is mediated via the androgen receptor, despite the potential for testosterone and dehydroepiandrosterone to be aromatized to estrogen. The results from studies in rhesus monkeys suggest that testosterone may serve as a natural endogenous protector of the breast and limit mitogenic and cancer-promoting effects of estrogen on mammary epithelium. Epidemiological studies have significant methodological limitations and provide inconclusive results. The strongest data for exogenous testosterone therapy comes from primate studies. Based on such simulations, inclusion of testosterone in postmenopausal estrogen-progestin regimens has the potential to ameliorate the stimulating effects of combined estrogen-progestin on the breast. Research addressing this is warranted; however, the number of women that would be required for an adequately powered randomized controlled trial renders such a study unlikely.
Collapse
Affiliation(s)
- Woraluk Somboonporn
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria 3168, Australia.
| | | |
Collapse
|
24
|
Soontrapa S, Somboonporn W, Komwilaisak R, Sookpanya S. Effectiveness of intravenous meperidine for pain relief in the first stage of labour. J Med Assoc Thai 2002; 85:1169-75. [PMID: 12546313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE To determine the effectiveness and side effects of intravenous meperidine in labour pain relief. MATERIAL AND METHOD A double blind, randomized controlled trial was conducted in 84 parturients, using normal saline as control. Visual analogue scale, postpartum parturients' opinion of effectiveness, sedative scores, nausea/vomiting, dizziness, delivery method, Apgar scores, and naloxone prescription were assessed. RESULT There were no statistically significant differences between the mean and median of visual analogue scale of meperidine and control group. In addition, the sedative scores, nausea/vomiting and dizziness in the meperidine group occurred more than those in the control group significantly. Even mean of the pain increment in the meperidine group was less than those in the control group (p < 0.05). The parturients' opinion on the effectiveness of pain relief during labor within 24 hours of the first postpartum day was only 23.80 per cent in the meperidine group, however, it was statistically significantly different when compared to 7.10 per cent in the control group. CONCLUSION Intravenous meperidine exhibited the effectiveness of pain relief of only 23.80 per cent of the subjects, in addition, it may cause many side effects.
Collapse
Affiliation(s)
- Sukree Soontrapa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | | | | | | |
Collapse
|
25
|
Ratanasiri T, Jirapornkul S, Somboonporn W, Seejorn K, Patumnakul P. Comparison of the accuracy of ultrasonic fetal weight estimation by using the various equations. J Med Assoc Thai 2002; 85:962-7. [PMID: 12450073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
OBJECTIVE To compare the accuracy of ultrasonic fetal weight estimation using the Hadlock's, Shepard's, Tongsong's and Hansmann's equations. MATERIAL AND METHOD The analytical-cross sectional study was conducted on 102 pregnant women who were admitted for delivery in the Labor Room at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University between January 1, 1999 and June 30, 1999. The fetal parameters, including biparietal diameter, abdominal circumference, transverse trunk diameter and femur length, were measured by ultrasound. The estimated fetal weight was calculated by those four equations. The mean absolute error was calculated from the absolute of the difference between the estimated fetal weight and the actual birth weight. RESULTS The mean absolute error and standard deviation of the estimated fetal weight by the Hadlock's, Shepard's, Tongsong's and Hansmann's equations were 8.09 +/- 4.18, 7.94 +/- 4.63, 7.77 +/- 3.70 and 7.83 +/- 4.35 per cent respectively and there were no statistically significant differences at 95 per cent confidence interval (p>0.05). CONCLUSION Apart from having comparable accuracy in the estimation of fetal weight to those of Hadlock, Shepard and Tongsong, Hansmann's equation employed at Srinagarind Hospital was more convenient to use than the others.
Collapse
Affiliation(s)
- Thawalwong Ratanasiri
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | | | | | | | | |
Collapse
|
26
|
Somboonporn W, Seejorn K, Kleebkaow P, Junthathamrongwat N, Ratanasiri T. Knowledge-attitude-practice of sexual intercourse of post-menopausal women using hormone replacement therapy. J Med Assoc Thai 2002; 85:167-71. [PMID: 12081115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To study knowledge, attitude, practice and concern related to sexual intercourse of post-menopausal women using hormone replacement therapy. MATERIAL AND METHOD One hundred and thirty subjects were included in the study from the 1st of May 2000 to the 31st of August 2000 at the Menopause Clinic, Srinagarind Hospital, Khon Kaen. All subjects were interviewed by a researcher with structured questionnaires. RESULTS Sixty seven per cent of the subjects had an acceptable level of knowledge, whereas, 87.7 per cent thought that they could have sexual intercourse similar to what they had in their pre-menopausal period. It was found that 85.4 per cent and 88.5 per cent of the subjects had either less or absent sexual desire and less sexual activity, respectively. In terms of their concern, 73.9 per cent of the subjects were not worried about sexual intercourse. CONCLUSION The majority of the post-menopausal women using hormone replacement therapy had a good level of knowledge and attitude concerning sexual intercourse. Although most of them had decreased sexual desire and activity, this sexual activity did not cause them concern.
Collapse
Affiliation(s)
- Woraluk Somboonporn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Thailand
| | | | | | | | | |
Collapse
|
27
|
Somboonporn W, Somboonporn C, Soontrapa S, Lumbiganon P. Bone mineral density of lumbar spines and proximal femur in the normal northeastern Thai women. J Med Assoc Thai 2001; 84 Suppl 2:S593-8. [PMID: 11853287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To determine reference data for age-matched bone mineral density (BMD) of normal northeastern Thai women. MATERIAL AND METHOD 350 northeastern Thai women aged 20-70 years were prospectively studied. After interview, the subjects were examined for BMD of lumbar spines and proximal femur. Mean BMD of each group was determined for each skeletal site. Standard deviation (SD) of BMD in the peak group was calculated to determine BMD cutoff level for diagnosing osteoporosis. RESULT Peak average BMD of lumbar spines was at 40-45 years, whereas peak BMD of proximal femur was at 35-40 years. Mean value of peak BMD of lumbar spines and proximal femur was 1.226 and 1.035 g/cm2, respectively. According to T-score less than -2.5 SD criteria, osteoporosis of lumbar spines and proximal femur was considered when measured BMD was below 0.889 and 0.785 g/cm2, respectively. CONCLUSION Our study provided the BMD reference data for northeastern Thai women.
Collapse
Affiliation(s)
- W Somboonporn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Thailand
| | | | | | | |
Collapse
|
28
|
Soontrapa S, Soontrapa S, Pongchaiyakul C, Somboonporn C, Somboonporn W, Chailurkit LO. Prevalence of hypovitaminosis D in elderly women living in urban area of Khon Kaen province, Thailand. J Med Assoc Thai 2001; 84 Suppl 2:S534-41. [PMID: 11853277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
This study included 106 volunteer elderly women who were living in an urban area of Khon Kaen province. The mean (+/-SD) of age and of serum 25(OH)D concentration of these elderly women was 69.42 (+/-6.77) years and 33.32 (+/-7.14) ng/ml respectively. There was a significant inverse relationship between serum 25(OH)D and PTH concentration. Serum PTH concentration started to increase steeply when serum 25(OH)D concentration declined < or = 35 ng/ml and increased significantly when serum 25(OH)D concentration declined < or = 30 ng/ml. Furthermore mean (+/-SD) of serum 25(OH)D concentration in the group of osteopenia and osteoporosis of femoral neck was 35.25 (+/-6.77) and 30.92 (+/-6.49) ng/ml respectively. As a result, the prevalence of hypovitaminosis D in these selected elderly women would be at least 34.9 per cent, or as high as 65.1 per cent.
Collapse
Affiliation(s)
- S Soontrapa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Thailand
| | | | | | | | | | | |
Collapse
|