Browsing by Author "Suwanna Ruangkanchanasetr"
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Publication Metadata only Blood lead level in Bangkok children(1999-12-01) Suwanna Ruangkanchanasetr; Joseph Suepiantham; Chomchun Tapsart; Chariya Sangsajja; Mahidol University; Thailand Ministry of Public HealthLead poisoning is one of the most harmful pollulant in children since it permanently effects the growth and intelligence. Objective : To evaluate the lead problem in Bangkok children and identify risk factors and impact associated with high lead levels (> 10 μg/dL) Materials and Methods : The longitudinal study (N = 84) followed blood lead levels at birth, 6,12,18 and 24 months of age. Also multiple cross-sectional studies comprising of children under 15 years of age attending the outpatient clinic, Ramathibodi Hospital (N = 511), kindergartens (N = 60) and secondary school students (N = 377) in Bangkok were conducted. The control for under 2 year-old children (N = 188) were those attending Metapracharak Hospital, Nakornprathom Province. Physical examinations were performed by pediatricians. Blood lead levels were assessed by Atomic Absorption Spectrometry. Questionnaires to identify risk factors were completed by parents of under 2-year-old children. Standford Binet tests were performed by psychologists for assessing the IQ in the longitudinal group at 2 years of age. Results : The mean blood lead levels were increasing with age from 5.57±2.31 μg/dL at birth, to 4.75±3.25 μg/dL at 2 years of age, 6.742.02 ±g/dL in kindergartens, and 9.03±3.65 μg/dL in secondary school students. They were in the acceptable range. However, the proportion of blood lead higher than 10 μg/dL were increasing from 1 to 6, 10 per cent at birth to 6 per cent at 2 years of age, 10 per cent in kindergartens and 35 per cent in secondary school students. The mean lead level in Bangkok children under 2 years of age was higher than those of the control group in Nakornprathom province, but not statistically singificant. In addition, there was no identified singificant risk factor except that the high lead group had a higher mean age and larger family size than those in the low lead group. In the kindergartens and secondary school, males had higher lead levels than females in the same age group. Conclusion : The blood lead levels in Bangkok children were not as high as expected. On the contrary, they tended to decrease following the reduction of ambient lead levels due to unleaded gasoline usage.Publication Metadata only Cardiac dimensions and function in children with obesity(2006-11-01) Anant Khositseth; Umaporn Suthutvoravut; Nalinee Chongviriyaphan; Suwanna Ruangkanchanasetr; Mahidol University; Faculty of Medicine, Ramathibodi Hospital, Mahidol UniversityBACKGROUND: Obesity can cause alterations in cardiac dimensions and function, and cardiac dysfunction during childhood may affect the quality of life in adulthood. This study was done to evaluate left ventricular dimensions, systolic function, and the left ventricular myocardial performance index in children with obesity. MEHTODS AND RESULTS: Thirty-three obese children whose mean age was 9.8 ± 2.4 years, weight was 61.3 ± 20.8 kg, body mass index was 29.5 ± 5.8 kg/m2, and percentage of actual weight to ideal body weight for height (% IBW) was 170 ± 25%, underwent echocardiography for the assessment of left ventricular dimensions, and systolic and global functions. There were 2, 14, and 17 children with mild (< 140% IBW), moderate (141-160% IBW), and severe obesity (> 160% IBW), respectively. The mean ratio of left ventricular end-diastolic dimension to predicted left ventricular end-diastolic dimension expressed in percentage was 98.3 ± 7.8%, the left ventricular shortening fraction was 37.5 ± 4.9%, and the left ventricular ejection fraction was 67.5 ± 5.9%. All were within the normal range, with the exception of two children (6%) who had mild left ventricular dilatation. The mean left ventricular myocardial performance index was 0.35 ± 0.08. However, 11 children (33%) had an abnormal index (< 0.4). The severity of obesity did not correlate with the global left ventricular dysfunction. CONCLUSION: The left ventricular dimensions and systolic function in children with obesity were essentially normal. The left ventricular myocardial performance index, which is an indicator for left ventricular global function, was found to be abnormal in 33% of the children, and may be used for the early detection of left ventricular global dysfunction.Publication Metadata only Cardiac dimensions and function in children with obesity(2007-12-01) Anant Khositseth; Umaporn Suthutvoravut; Nalinee Chongviriyaphan; Suwanna Ruangkanchanasetr; Mahidol University; Faculty of Medicine, Ramathibodi Hospital, Mahidol UniversityBACKGROUND: Obesity can cause alterations in cardiac dimensions and function. Cardiac dysfunction during childhood may affect the quality of life in adulthood. This study evaluated left ventricular (LV) dimensions, systolic function and left ventricular myocardial performance index (LMPI) in children with obesity. METHODS AND RESULTS: Thirty-three obese children with mean age of 9.8 ± 2.4 years, weight 61.3 ± 20.8 kg, BMI 29.5 ± 5.8 kg/m2 and percentage of actual weight to ideal body weight for height (%IBW) 170 ± 25%, underwent echocardiography to assess LV dimensions, systolic and global functions. There were 2, 14 and 17 children with mild (≤140%IBW), moderate (141-160% IBW) and severe obesity (>160%IBW), respectively. The mean ratio of left ventricular end-diastolic dimension (LVEDD) to predicted LVEDD expressed in percentage (%LVEDD) was 98.3 ± 7.8%, the left ventricular shortening fraction (LVFS) was 37.5 ± 4.9% and the left ventricular ejection fraction (LVEF) was 67.5 ± 5.9%. All were within normal range except that 2 children (6%) had mild LV dilatation. The mean LMPI was 0.35 ± 0.08. However, 11 children (33%) had abnormal LMPI (>0.4). The severity of obese children did not correlate with the global LV dysfunction. CONCLUSION: The left ventricular dimensions and systolic function in children with obesity were essentially normal. LMPI which indicates LV global function was found to be abnormal in 33% of children with obesity and may be used to do early detection of LV global dysfunction.Publication Metadata only Cyanide poisoning, 2 cases report and treatment review(1999-01-01) Suwanna Ruangkanchanasetr; Vinai Wananukul; Subharee Suwanjutha; Mahidol UniversityTwo patients, a 4-year-old girl and her brother 1 1/2 year-old, with cyanide poisoning are reported. They vomited and became comatose 9 hours after ingestion of boiled cassava. At a community hospital, they were intubated and given ventilatory support. The girl was transferred to Ramathibodi Intensive Care Unit. At 19 hours after ingestion, sodium nitrite and sodium thiosulfate were given as well as other supportive treatment. She recovered with normal breathing on the next day. The boy was referred to Ramathibodi 4 hours later. On arrival, he appeared normal except for the bitter almond breathe. Only supportive treatment was given. Their blood cyanide levels on arrival were 0.56 and 0.32 μg/ml (normal value < 0.3 μg/ml) respectively confirming the diagnosis of cyanide poisoning. Other abnormal laboratory findings included metabolic acidosis and lactic acidemia. The pathogenesis and management of cyanide poisoning are reviewed.Publication Metadata only Migraine in Thai children: Prevalence in junior high school students(2007-09-01) Anannit Visudtibhan; Vorasith Siripornpanich; Chaiyos Khongkhatithum; Surang Chiemchanya; Suthatip Sirijunpen; Suwanna Ruangkanchanasetr; Pongsakdi Visudhiphan; Mahidol UniversityA cross-sectional study to determine the prevalence of migraine in seventh grade Thai students in 4 junior high schools in Bangkok, Thailand, according to the diagnostic criteria of the second edition of the Classification of Headache of the International Headache Society was conducted in July 2004. The study included a screening self-administered questionnaire and face-to-face interview with physical examination. The diagnosis of migraine was made and confirmed by 2 pediatric neurologists. All of 1789 students in participating schools completed the questionnaire. After 2 interviews, 248 students (13.8%) were diagnosed with migraine. The prevalence in girls was higher than that in boys (16.2% vs 11.7%). Migraine as having aura was diagnosed in 34 students (13.7%). One student had sporadic hemiplegic migraine. Among 248 children, 176 (71%) reported the duration of headache between 1 and 2 hours. The leading precipitating factor of migraine was the stress related to daily school activities (17.7%). There were 32 students (12.9%) with frequent and intense headache who were referred to their primary physicians for further management. This study had disclosed a high prevalence of migraine in seventh grade Thai students in Bangkok City and reflected the existing burden of this illness in Thai students. © Sage Publications, Inc. 2007.Publication Metadata only Ocular toxicity of chloroquine among Thai patients(1999-12-01) Siripen Puavilai; Skowrat Kunavisarut; Mongkol Vatanasuk; Penwadee Timpatanapong; Suwitcha T. Sriwong; Suchela Janwitayanujit; Kanokrat Nantiruj; Kitti Totemchokchyakarn; Suwanna Ruangkanchanasetr; Mahidol University; Faculty of Medicine, Ramathibodi Hospital, Mahidol UniversityBackground: Chloroquine has been prescribed for the treatment of various diseases. The most serious side-effect of chloroquine is retinopathy. The frequency of occurrence of retinopathy varies from 0.001 to 40% depending on the criteria used. The purpose of this study was to evaluate the incidence of ocular toxicity from chloroquine treatment among Thai patients. Methods: A retrospective study was carried out in patients treated with chloroquine at Ramathibodi Hospital over the past 10 years (1987-1997). Patients eligible for review were followed by ophthalmic examination by an ophthalmologist for at least 6 months after starting treatment. Results: One hundred and fifty- five patients were studied. Nineteen were men and 136 were women. They ranged in age from 10 to 70 years. Most patients received 250 mg of chloroquine per day. The duration of treatment varied from 6 months to 14 years, and the cumulative dose of chloroquine ranged from 26 to 1771 g. Fourteen patients (9%) had only corneal deposition, while 22 (14.2%) developed retinopathy. There were no correlations between corneal deposits or retinopathy and age, sex, duration of treatment, or cumulative dose of chloroquine. Conclusions: The present study confirms the finding reported by Mackenzie (Am J Med 1983; 75 (Suppl 1A): 40-45) that retinopathy is not related to the duration of treatment and cumulative dose of chloroquine. Based on our finding that retinopathy can be detected as early as 9 months after starting chloroquine therapy, we recommend routine ophthalmic examination before treatment and every 6 months thereafter.Publication Metadata only Pediatric injuries in emergency room, Ramathibodi Hospital(1999-01-01) Adisak Plitponkarnpim; Suwanna Ruangkanchanasetr; Sudapan Thanjira; Mahidol UniversityThe purposes of this study were to analyze the epidemiological data of child injuries from the computerized data system of the emergency room at Ramathibodi Hospital from June 1995 to May 1996 and assess the accuracy of triage system for child injury cases. Among 14,427 pediatric patients, 1,023 patients (7%) were injured. Most were under 5 years of age (48%), and most were male. Twenty-five per cent of cases were triaged as true emergency cases. Twelve per cent were disposed on an admission or referral by physicians. The negative predictive value of triage system to classify as a non-urgent was 91 per cent. Common causes of injury included falls (38%), inanimate force (19%), transportation (14%), and animal bite (12%). Older age group had significantly more severe injuries than younger (p = 0.002). However, only the transportation injuries were significantly more severe than other types (p = 0.003). The present ER-based injury surveillance system is useful to describe the basic epidemiology of pediatric injuries and to evaluate the triage system. However, for injury prevention purposes, the injury surveillance system should include more data of injury circumstances, associated environment and products.Publication Metadata only Risk behaviors screening in Thai adolescents with acute and chronic illnesses(2018-01-01) Lalit Leelathipkul; Suwanna Ruangkanchanasetr; Jiraporn Arunakul; Faculty of Medicine, Ramathibodi Hospital, Mahidol University© 2018 Walter de Gruyter GmbH, Berlin/Boston. Adolescence is considered as a transition period from childhood to adulthood. This transition leads to various types of risk behaviors. Ten percent of adolescents suffer from a chronic illness that can limit their daily activities and which may exhibit higher rates of risk behaviors than those without chronic illnesses. To evaluate the prevalence of risk behaviors in chronically ill adolescents compared to adolescents without chronic illnesses and their associated risk factors. We enrolled 312 patients aged 10-20 years who visited Ramathibodi Hospital from January 2015 to December 2017. There were 161 adolescents with chronic illnesses and 151 without a chronic illness. We used a computer-based program for the Youth Risk Behaviors Survey as well as a confidentiality interview. Statistical analyses included the chi-squared (χ 2 ) and Student's t-tests as appropriate. The risk behaviors in chronically ill adolescents were the following: learning problems, 86.3%; excessive screen time, 62.3%; unintentional injuries, 60.2%; depression, 38.5%; low self-esteem, 18.1%; substance abuse, 13% and sexual behavior, 6.2%. Youths with a chronic illness were more likely to report significantly higher risk of excessive screen time (62.3% vs. 48%, p = 0.01), depression (38.5% vs. 15.9%, p < 0.01) and, also low self-esteem (18.1% vs. 8.6%, p = 0.01) compared to those without chronic illness. These results indicated that adolescents with chronic illnesses engage more in health risk behaviors and are prone to mental health and learning problems. These data emphasize the importance of health risk behavior screening and preventive counseling for young patients with chronic illnesses where these risks might worsen their disease.Publication Metadata only Risk factors of high lead level in Bangkok children(2002-11-01) Suwanna Ruangkanchanasetr; Joseph Suepiantham; Mahidol UniversityLead poisoning is the most important pollution in children which affects the developing brain and IQ. Previous studies of blood lead levels in Thai children were all higher than 10 μg/dl. Objective: To identify risk factors and impacts associated with high lead levels (>10 μg/dl) in Bangkok children. Material and Method: The longitudinal study (n = 84) followed blood lead levels of a birth cohort, 6, 12, 18, 24 and 72 months of age from 1993 to 1999. Multiple cross-sectional studies (1992-1996) comprising children under 15 years of age attending the outpatient clinic, Ramathibodi Hospital (n = 511), kindergartens (n = 60), 6 primary school students (n = 564) and secondary school students (n = 377) in Bangkok, were recruited. Blood lead levels were assessed by atomic absorption spectrometry. Questionnaires to identify risk factors were completed by parents of under 2-year-old children and primary school students. IQ was assessed in the longitudinal group at 2 years of age and in primary students. Results: The mean blood lead levels (μg/dl) were 5.57 ± 2.31 at birth, 5.03 ± 2.21 at 6 years of age in a cohort study, 6.74 ± 2.02 in kindergartens, 9.26 ± 3.68 in primary students and 9.03 ± 3.65 in secondary school students. The proportion of high blood lead increased with age from 1 per cent at birth to 35 per cent in secondary school students. In the kindergartens and secondary school, males had higher lead levels than females. In the primary school study, the significant risk factors (Odd Ratio-OR) of high lead level were; living in Bangkok (6.18), male (1.67), maternal labour workers (1.79), family income lower than 3,000 baht/month (2.24), a crowded family with more than 9 members (2.22), household members whose present occupation was related to printing (4.55) or lead smelting previously (4.85). Children in the high lead group had lower weight (p = 0.0000) and height (p = 0.0000) and were slow learners determined by their teachers (p = 0.0332). Conclusion: The blood lead levels in Bangkok children were not high and have tended to decrease following the reduction of air lead levels because of unleaded gasoline usage. A periodic surveillance survey is still necessary to monitor blood lead level in Bangkok children especially among those with risk factors.Publication Metadata only A study of nonbacterial agents of acute lower respiratory tract infection in thai Children(1990-01-01) Subharee Suwanjutha; Teerachai Chantarojanasiri; Siripath Watthana-Kasetr; Sayomporn Sirinavin; Suwanna Ruangkanchanasetr; Satit Hotrakitya; Chantapong Wasi; Pilaipan Puthavathana; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol UniversityFrom January 1986 to December 1987, 596 children < 5 years of age with lower respiratory tract infection (LRI) — manifested as laryngitis, croup, bronchitis, bronchiolitis, and pneumonia- were studied for evidence of infection with respiratory tract viruses, Mycoplasma pneumoniae, and Chlamydia trachomatis. Of the 596 children in the study, 315 were ambulatory and 281 were hospitalized. Virologic studies included isolation and rapid diagnosis of virus from specimens of nasopharyngeal aspirate (NPA) and serologic studies of blood samples. Cultures of NPA for C. trachomatis were performed for children < 6 months of age who had pneumonia. Of the LRI cases, 45070 were associated with viral infections of the respiratory tract and 12.1% were associated with C. trachomatis. Respiratory syncytial virus (RSV) accounted for 45.2% of infections with viral agents and was associated with acute bronchitis, acute bronchiolitis, and pneumonia. Parainfluenza type 3 virus was the most common virus found in conjunction with laryngitis and croup. The incidence of infections due to RSV peaked in July and August, while that of infections due to parainfluenza viruses peaked in February and March; influenza viruses and adenoviruses were isolated throughout the year. © 1990 by The University of Chicago.Item Metadata only The effects of personal and environmental factors on elementary students' health risk behaviors, Nakhonpathom province(Mahidol University. Mahidol University Library and Knowledge Center, 2009) Kithiya Suchprasert; Dalapat Yossatorn; Suwanna Ruangkanchanasetr; Sawitri ThayansinItem Metadata only The feasibility of measles vaccination in children with minor illness(Mahidol University. Mahidol University Library and Knowledge Center, 2024) Suvipa Nittayahgoon; Kanda Vathanophas; Anong Pariyanonda; Suwanna Ruangkanchanasetr; Pipat LuksamijarulkulPublication Metadata only Youth risk behavior survey: Bangkok, Thailand(2005-01-01) Suwanna Ruangkanchanasetr; Adisak Plitponkarnpim; Priyasuda Hetrakul; Ronnachai Kongsakon; Mahidol UniversityPurpose: To identify the prevalence of risk behaviors and related risk factors in adolescents in Bangkok, Thailand. Methods: Youth risk behavior survey questionnaires were collected from 2311 adolescents in 8 schools, 13 communities and 2 Juvenile Home Institutions from January to February 2001. Their mean age was 15.5 ± 1.8 years, and 59% were female. Risk factors of interest were gender, parental marital status, socioeconomic status, family relationship, parental drug addiction, peer group, loneliness, self-esteem, and school performance. Multiple logistic regression was used to identify significant risk factors associated with each risk behavior. Results: The risk behaviors leading to traffic accidents were rarely or never having worn a seat belt (30.6%) or helmet while bicycling (66.9%) and while motorcycling (50.1%), riding with drivers who had consumed alcohol (18.8%), and driving after consuming alcohol (12.1%). The studied group carried weapons (8.5%) and has been involved in a violent event (31.5%). Among 13.9% who were assaulted, 6.7% needed hospitalization; rape was reported by 2.4%. Depression was reported by 19.9%, with 12% having suicidal tendencies and 8% attempting suicide. The lifetime use vs. heavy use prevalence of substance abuse, respectively, was: 15.4% and 3.5% for smoking, 37.3% and 1.7% for alcohol, 37.8% and 4.6% for amphetamine use, and 37.9% and 0.1% for other drugs. Among the 10% who have had sexual intercourse, 1% were homosexual, 7.1% have never used a condom, and 2.1% resulted in pregnancy. Being male was a risk factor for every untoward behavior except depression. Other risk factors included poor self-esteem, poor school performance, and early school leaving. Factors relating to the family included a low socioeconomic status, poor relationships, broken families, and parental substance abuse. Socioenvironmental factors included being in a gang and loneliness. Some risk behaviors started at younger than 8 years old. Schools and media were given as the sources of information regarding sex, human immunodeficiency virus infection, and substance abuse. Conclusions: The prevalence of six major-risk behaviors in adolescents in Bangkok was significantly high. Several risk factors were identified, the knowledge from which may help to form preventive measures in this population. © 2005 Society for Adolescent Medicine. All rights reserved.