Siriraj Medical Journal

157-162

Authors: Sitthipong Srisajjakul, M.D., ViratchadaTanksurakit, M.D.

Objective: To retrospectively compare between non enhanced and enhanced abdominal CT scan and evaluate sensitivity in diagnosis of acute pancreatitis. Methods: A total of 150 patients diagnosed with acute pancreatitis between January 2008 and December 2011, were enrolled in this study. Abdominal CT images on both precontrast and postcontrast phase in 141 patients (91 male and 50 female, and age range 4-81 years) were retrospectively reviewed. Single non contrast studies were done in 9 of 150 patients. The time period from clinical onset to imaging was within 4 weeks except for 4 patients. Two observers evaluated the CT ndings (intraparenchymal, peripancreatic and locoregional ndings) of each phase of image separately. The agreement between non contrast and contrast enhanced CT scan of each nding, CT grade and severity were evaluated. Results: The percentagess of pancreatic CT ndings were pancreatic enlargement, abscess, necrosis and pseudocyst at 75.9/75.9%, 11.3/3.5%, 30.5/17.7%, and 6.4/5.7%, compared between Contrast enhanced computed tomography (CECT) and noncontrast enhanced computed tomography (NECT), respectively. The percentages of peripancreatic ndings were ir- regular pancreatic outline, obliterated peripancreatic fat, retroperitoneal edema, acute peripancreatic uid (APFC) and acute necrotic collection (ANC) at 82.3/89.4%, 77.3/85.1%, 18.4/0%, 36.9/44.7% and 32.6/14.9%, respectively. The percentages of locoregional ndings were Gerota’s fascia sign, pancreatic ascites, pleural effusion and adynamic ileus at 75.9/85.8%, 61.0/56.7%, 46.8/48.2% and 2.1/0% respectively. About CT grading, grade A (normal CT ndings) was found 7.8% and 8.5% on CECT and NECT, respectively. Grade C, D and E were found 36.9/61.7%, 14.9/10.6% and 40.4/19.1%, respectively. Also for severity, mild level was found 44.7/70.2% and severe level was found 55.3/29.8% on CECT and NECT. Conclusion: Both NECT and CECT scans of the whole abdomen in patients with acute pancreatitis have concordance in interpretation of the CT ndings as well as sensitivity in diagnosis. Moreover, NECT has equivalent ef cacy in screening of pancreatic abnormality, as compared with CECT. Therefore, we suggest that NECT can be the initial screening modality in patients with acute pancreatitis to con rm diagnosis, severity assessment or evaluation of the complication.

168-172

Authors: Chaivanee Kaosayapandhu, B.Sc.

Objective: The purpose of this study was to determine the types and categories of dispensing errors reported by ve inpatient pharmacies in a 2200-bed tertiary care teaching hospital from January 2010 to December 2012. Methods: Dispensing error reports from ve inpatient pharmacies in a 2200-bed tertiary care teaching hospital over a three- year period were analyzed. The reported incidents were categorized according to type of errors and categories of errors. The statistical analyzes were performed in frequency and percentage. Results: A total dispensing error rate was 1.68 reports per 10,000 processed prescriptions from ve different inpatient phar- macies for the period examined. Among the total of 535 prescriptions with dispensing errors, the three main types of errors included 315 (55.65%) being the wrong drugs, 110 (19.43%) being the wrong strengths, and 57 (10.07%) being the wrong dosage forms. The remaining types of errors were 31 (5.48%) wrong quantities, 30 (5.30%) missing items, 12 (2.12%) wrong instructions, and 11 (1.94%) wrong patients. The categories of errors, according to severity category A-I, were: 534 (94.3%) for categories A and B; 22 (3.9%) for category C; and 10 (1.8%) for category D. Conclusion: Accurately reported and analyzed information on dispensing errors within the organization is needed to change the drug dispensing practice. A redesigned pharmacy distribution system is essential for preventing and reducing dispensing errors.

178-180

Authors: Jiraporn Setakornnukul, M.D., Porntip Iampongpaiboon, M.Sc., Yoawalak Chansilpa, M.D.

A 47-year-old woman with unresectable recurrent carotid body tumor was treated by 3-dimension conformal ra- diotherapy with total dose of 48 Gy in 16 fractions. Slow onset of tumor response, but eventually complete remission was noted with long-term tumor control at 5 years.