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Publication Open Access Diagnostic yield of endoscopic ultrasonography in patients with intermediate or high likelihood of choledocholithiasis: a retrospective study from one university-based endoscopy center(2014) Varayu Prachayakul; Pitulak Aswakul; Patommatat Bhunthumkomol; Morakod Deesomsak; Mahidol University. Faculty of Medicine Siriraj Hospital. Department of Internal Medicinemanagement algorithm proposed by the American Society for Gastrointestinal Endoscopy (ASGE) may not be appropriate for patients who fulfill the clinical criteria for a high likelihood of choledocholithiasis. Endoscopic ultrasonography (EUS) may replace... endoscopic retrograde cholangiopancreatography (ERCP) for the detection of CBD stones in all patients. The aims of this study were to determine the diagnostic yield and optimal timing of EUS in patients with an intermediate or high likelihoodItem Open Access คู่มือปฏิบัติงาน เรื่อง การระงับความรู้สึกในผู้ป่วยที่มาตรวจทางเดินอาหารด้วยการส่องกล้องอัลตราซาวนด์ (Sedation in patient undergoing Endoscopic Ultrasonography)(2564) วิไลพร สุพรรณ; มหาวิทยาลัยมหิดล. คณะแพทยศาสตร์ศิริราชพยาบาล. ภาควิชาวิสัญญีวิทยาPublication Open Access High Incidence of Hepatitis B Infection-Associated Cirrhosis and Hepatocellular Carcinoma in the Southeast Asian Patients with Portal Vein Thrombosis(2011) Korn Lertpipopmetha; Chirayu U Auewarakul; Mahidol University. Faculty of Medicine Siriraj Hospital. Department of MedicineBackground: Portal vein thrombosis (PVT) is a rare condition associated with serious morbidity and mortality. The objective of this study was to determine the frequency, clinical presentations, and risk factors of PVT from the set of data firstly collected among the Southeast Asian population. Methods: A retrospective study was undertaken to identify patients diagnosed with thrombosis of the portal system and other abdominal veins. The hospital medical records were retrieved based on the selected ICD-10 codes. Clinical presentations were collected and risk factors determined. Results: From 2000-2009, 467 hospital charts with designated ICD-10 codes of I81, I82.2, I82.3, I82.8, I82.9, or K55.0 were identified. PVT (I81) was the most common thrombosis (194 cases, 41.54%). The majority of PVT patients were males (65%), older than 40 years (75%), and presented with abdominal distension/ascites (69%), splenomegaly (54.6%), and abdominal pain (50.5%). Overall, the predominant risk factor was hepatocellular carcinoma (HCC) (52.5%), followed by liver cirrhosis without cancer (9.3%), abdominal infection/inflammation (9.3%), cholangiocarcinoma (8.2%), and abdominal intervention (7.7%). In young patients, abdominal interventions including umbilical catheterization (23.1%) and hepatectomy (7.7%) were the most frequent risks whereas in older cases, primary hepatobiliary cancer and cirrhosis (78%) were the major risks. Liver metastases from other organs were infrequently found. Chronic hepatitis B virus (HBV) infection was the main etiology associated with cirrhosis/ HCC leading to PVT in this cohort. A third of the older PVT patients (age >40) had HBV and very few carried hepatitis C virus (HCV) whereas none of the young PVT patients (age <20) had HBV or HCV. A variety of abdominal infections/inflammations were also found including liver abscess, splenic abscess, cholangitis, cholecystitis, pancreatitis, omphalitis, and abdominal tuberculosis. Single cases of systemic lymphangiomatosis and Klippel- Trénaunay vascular malformation syndrome were also identified. Other thrombophilic conditions such as myeloproliferative neoplasms, paroxysmal nocturnal hemoglobinuria, protein S deficiency, and anti-phospholipid syndrome were rarely encountered. Conclusion: HBV is the major risk of PVT in the Southeast Asian population. Several risk factors identified in this population have rarely been described and some are remarkably different from those reported in the West. Host and environmental factors may play a causal role in the initiation and development of PVT in various ethnicities and geographic locations.Publication Open Access Hysteroscopy in Endometrial Cancer(2018) Navamol Lekskul; นวมลล์ เล็กสกุล; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of Obstetrics and GynecologyEndometrial cancer is one of the most common gynecological malignancies. The majority of the patients present with abnormal vaginal bleeding; hence, the disease is diagnosed in the early stages. Usually transvaginal ultrasound and endometrial biopsy are the beneficial investigations, notably with occasional failure to obtain adequate endometrial tissue. Hysteroscopy increases the sensitivity and accuracy to identify endometrial cancer; however, the pressure of fluid distension media should be optimized because of the concern of impaired prognosis from malignant cell spillage. In sentinel lymph node mapping, hysteroscopic injection is considered as a method to potentially increase the detection rate in the para-aortic area. Fertility-sparing treatment of endometrial cancer in early stages is feasible with the combination of hysteroscopic resection and progestin therapy.Publication Open Access Betamethasone and methylprednisolone usage in lower third molar surgery : Review literature.(2015-09) Sirichai Kiattavornchareon; ศิริชัย เกียรติถาวรเจริญ; Gozali, Peiter; Wu, Michiko; Natthamet Wongsirichat; ณัฐเมศร์ วงศ์สิริฉัตร; Suphachai Suphangul; ศุภชัย สุพรรณกุล; Natthamet Wongsirichat; ณัฐเมศร์ วงศ์สิริฉัตร; Mahidol University. Faculty of Dentistry. Department of Oral and Maxillofacial Surgery; Mahidol University. Faculty of Dentistry. Advance General dentistry DepartmentThe surgical extraction of lower third molar is the most frequent intervention in oral surgery. This procedure is often associated with significant postoperative sequalae that may have both a biological and social impact. Beside severe complications such as dysaesthesia, severe infection, fracture and dry socket, patients frequently complain of pain, swelling and limitation in mouth opening due to inflammatory response following the surgical injury. Many previous studies of lower third molar surgery have focused on reducing pain, facial swelling and trismus. Although inflammatory response is good for healing but an exacerbated response can cause all of the complications. Nowaday, clinicians mostly prescribe betamethasone and methylprednisolone to overcome these complications. This review is to conclude ideas of betamethasone and methylprednisolone use in lower third molar surgery.