Browsing by Author "Ratikorn Saejong"

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    Comparison of the Efficacy and Safety between Generic Intravenous Omeprazole (zefxon®) and Original Omeprazole (losecspi®) in the Adjunct Treatment of Non-Variceal Upper Gastrointestinal Bleeding in Siriraj Hospital
    (2011-11-01) Darin Lohsiriwat; Ratikorn Saejong; Varut Lohsiriwat; Sasima Tongsai; Visanu Thamlikitkul; Mahidol University; Faculty of Medicine, Siriraj Hospital, Mahidol University
    Background: Clinical efficacy and safety of generic omeprazole have not been well studied in Thailand. Objective: Determine whether generic omeprazole (Zefxon®) is inferior to original omeprazole (Losec®) in the treatment of non-variceal upper gastrointestinal bleeding (UGIB) in Siriraj Hospital. Material and Method: Medical records of adult patients with the diagnosis of non-variceal UGIB receiving intravenous omeprazole (either Zefxon® or Losec®) in Siriraj Hospital between January 2006 and September 2010 were reviewed. Noninferiority study was used to investigate whether the generic omeprazole was no more than 10% less effective than the original omeprazole. The primary end points were recurrent bleeding and mortality within seven and 30 days. Surgery, endoscopic retreatment, blood transfusions, length of hospital stay and safety were also analyzed. Results: Of 200 randomly selected patients in each group, there was no difference in age, gender, co-morbidities, severity of UGIB, endoscopic findings and endoscopic intervention between patients receiving generic omeprazole and original omeprazole. Overall rate of recurrent bleeding, mortality, and surgical intervention within 30 days were 12.3%, 5.5% and 2.0%, respectively. The rates of recurrent bleeding, overall mortality, and non-variceal UGIB related mortality within seven and 30 days were not significantly different between the two groups. Neither were the rates of endoscopic retreatment and surgery. The incidence of adverse side effects was 3.5% in each group. Cox regression analysis showed no significant association between type of omeprazole and recurrent bleeding or mortality. Compared to the original omeprazole, the hazard ratio of recurrent bleeding, overall mortality, and non-variceal UGIB related mortality in patients receiving generic omeprazole was 1.44 (95% CI 0.82-2.53; p = 0.21), 2.12 (95% CI 0.90-5.43; p = 0.08) and 1.82 (95% CI 0.53-6.21; p = 0.34), respectively. Conclusion: Although the original omeprazole Losec® tended to have more favorable outcomes in the treatment of non-variceal UGIB in the present study, non-inferiority test showed that the efficacy and safety of the generic omeprazole Zefxon® was not inferior to those of the original omeprazole.
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    Hyperprolactinemia: a 12-year retrospective study at gynecologic endocrinology unit, Siriraj Hospital.
    (2013-10-01) Ratikorn Saejong; Chongdee Dangrat; Kitirat Techatrisak; Surasak Angsuwatthana; Manee Rattanachaiyanont; Prasong Tanmahasamut; Mahidol University
    Hyperprolactinemia is one of the most common endocrine disorders of the hypothalamic-pituitary axis. To date, no available data about hyperprolactinemia in Thai women has been published To determine clinical and laboratory findings of Thai female patients with different etiology of hyperprolactinemia, as well as the response of treatment, recurrence, and pregnancy after treatment. Medical records of 139 female patients with the diagnosis of hyperprolactinemia in Gynecologic Endocrinology Unit, Siriraj Hospital between January 1, 1999 and December 30, 2011 were retrospectively reviewed after the study protocol was approved by Siriraj Institutional Review Board. The data was analyzed to determine patient demographic data, presenting symptoms, duration of symptoms, initial serum prolactin levels, causes, imaging studies, treatment, treatment outcomes, and adverse events. Ninety-seven female patients with hyperprolactinemia were included in the study. Mean age at diagnosis was 31.8 +/- 7.7 years. Amenorrhea was the most common presenting symptom (49.5%) followed by galactorrhea (44.3%). Median initial serum prolactin level was 117 ng/mL (25.1-1,624 ng/mL). Pituitary adenoma is the most common cause (40.2%) followed by idiopathic hyperprolactinemia (37.1%). Microadenomas were found in 74.3% of pituitary adenoma. The median size of the tumor was 9 mm. Medical treatment was given to 79 (88.8%) patients. Bromocriptine was given to 66 patients. Mean of maximum dose of bromocriptine was 5.8 mg. Median duration of treatment was 35.8 months. Adverse events were reported in 24.2% of patients, dizziness was the most common adverse event. Median time to normalize serum prolactin level was 3.8 months. In 29 patients who desired pregnancy, eight patients got pregnant. Median time to pregnancy was 25.9 months. Patients with macroadenoma had significantly higher prolactin level than those with microadenoma (p = 0.024). Patients with galactorrhea had the shortest duration of symptom (p = 0. 010). There were no statistically significant difference in symptoms, duration of symptoms, and initial prolactin level between patients with and without pituitary adenoma. Patients with pituitary adenoma needed higher doses (p = 0.009) and longer duration of treatment (p = 0.007) than those without a tumor Normalization of prolactin level and recurrence rate was not different between the two groups (p = 0.056 and 0.374). Log rank test showed that the time to normalize and survival time of recurrence were not significantly different between patients with and without a tumor (p = 0.136 and 0.146, respectively). Amenorrhea was the most common presenting symptom in Thai hyperprolactinemic females, who attended Siriraj gynecologic endocrinology unit, followed by galactorrhea. Pituitary adenoma is the most common cause followed by idiopathic hyperprolactinemia. Patients with pituitary adenoma needed higher doses and longer duration of treatment than those without a tumor
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    Postoperative desogestrel for pelvic endometriosis-related pain: a randomized controlled trial
    (2017-07-03) Prasong Tanmahasamut; Ratikorn Saejong; Manee Rattanachaiyanont; Surasak Angsuwathana; Kitirat Techatraisak; Nutchaya Sanga-Areekul; Mahidol University
    © 2017 Informa UK Limited, trading as Taylor & Francis Group. Objective: To determine the effectiveness of desogestrel for relieving endometriosis-related pain. Methods: A double-blinded randomized placebo-controlled trial was conducted in 40 patients who had endometriosis with moderate-to-severe dysmenorrhea or chronic pelvic pain undergoing laparoscopic conservative surgery. After surgery, patients were randomized to desogestrel or placebo group. Outcomes included changes in visual analog scale (VAS) of dysmenorrhea, pelvic pain and dyspareunia, patient satisfaction, and adverse effects. Results: Forty patients were randomized to desogestrel group (n = 20) and placebo group (n = 20). At month 6, the desogestrel group had significantly lower median VAS of overall pelvic pain, dysmenorrhea and noncyclic pelvic pain. Comparing with the placebo group, the desogestrel group had greater reduction in VAS of overall pain, dysmenorrhea and pelvic pain, but comparable reduction in VAS of dyspareunia. No patient in the desogestrel group but 4 patients in the placebo group still had moderate-to-severe pelvic pain at 6 months postoperatively. The proportion of patients who rated the treatment as very satisfied was higher in the desogestrel group than in the placebo group. There was no serious adverse event during the study period. Conclusions: Desogestrel is effective and acceptable for postoperative therapy for patients with moderate-to-severe pain related to endometriosis.
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    Validity and reliability assessment of the Siriraj Asthma Control Questionnaire.
    (2011-02-01) Ratikorn Saejong; Wanchai Dejsomritrutai; Mahidol University
    The present study assessed the validity and reliability of the Siriraj Asthma Control Questionnaire in Asthma Clinic, Siriraj Hospital. The data of the questionnaire responses and spirometric results from 20 randomized asthmatic patients in the clinic including the record of 3 visits for each subject. The validation was performed by Kruskal-Wallis test comparing the scores with the level of asthma control determined by physicians according to GINA guideline. Internal consistency reliability was analyzed by Cronbach's alpha. Sixty questionnaires from 20 patients with age 29-73 years were analyzed. There were 40 controlled, 7 partly controlled and 13 uncontrolled visits. The scores from 5-items questionnaires and 6-items clinical score were significantly associated with the physician-diagnosed groups (i.e., controlled, partly controlled and uncontrolled groups). Median scores (min, max) were 0 (0, 5), 2 (0, 6), 4 (0, 12) respectively, (5-items, p < 0.001) and 2 (0, 7), 3 (1, 7), 6 (2,15) respectively, (6-items, p < 0.001). Internal consistency reliability of both 5-items questionnaire and 6-items clinical score were within the acceptable range (0.829 and 0.708 respectively). 5-items questionnaire is more associated with the physician diagnosed group and more consistent than 6-items clinical score. Further analysis revealed cutoff point at 2.5 to separate uncontrolled from controlled or partly controlled patient with sensitivity 76.9% and specificity 89.4% and cutoff point at 1.5 to separate uncontrolled or partly controlled from controlled patient with sensitivity 70.0% and specificity 85.0%. The validity and reliability of Siriraj Asthma Control Questionnaire is acceptable and might be used in the clinical practice and research in Thai asthmatic patients.