Siriraj Medical Journal

56-60

Authors: Kobkun Muangsomboon, M.D., Chayanit Thepchana, M.D., Phakphoom Thiravit, M.D., Sorranart Muangsomboon, M.D.

Objective: To describe CT ndings of abdominal tuberculosis (TB) because CT has the ability to demonstrate changes in the abdomen and is increasingly used for primary evaluation of abdominal conditions. Methods: The abdominal CT images of 33 patients with proven abdominal TB in Siriraj Hospital from January 2005 to December 2009 were retrospectively reviewed. The CT ndings of ascites, peritoneum, lymph node, gastrointestinal and visceral organ involvement were evaluated. Results: The peritoneal and lymph node involvement were the most common features (78.8% of each nding). Peritonitis with ascites (wet type) was more common than dry type. Most of the patients with lymph node involvement had multiple groups (96.2%) and the most common location was mesenteric region. The gastrointestinal tract involvement was likely to be the combination of large bowel and small bowel diseases and the most common feature was bowel wall thickening (88.2%). The solid organ involvement was found about 20.4% which was always the part of multiple organs involvement or dissemi- nated disease. The lymph node involvement in the immunocompromised group was statistically signi cantly different when compared with the non-immunocompromised group. (p 0.001) Conclusion: CT scan is a reliable imaging modality to demonstrate abnormality in the abdominal cavity. The common features in the patients with abdominal tuberculosis include the combination of peritoneal, lymph nodes and multiple organs involvement. Diagnosis of abdominal tuberculosis is sometimes dif cult to rely on CT features, so interpretation of images with the clinical and laboratory data could be a valuable tool in the diagnosis of abdominal tuberculosis, especially in patients with non-speci c abdominal symptoms. Early and accurate diagnosis leads to an effective therapy and good prognosis with decrease of mortality rates.

66-69

Authors: Puntaree Suppawach, M.NS, Ketsarin Utriyaprasit, Ph.D. (Nursing), Tipa Toskulkao, Ph.D. (Neuroscience), Pacharapol Udomkiat, M.D.

Background: The recovery period after total knee replacement (TKR) is perceived as one of crisis and associated with recovery symptoms, and adverse physical functioning. Objective: To study the relationships among age, BMI, recovery symptoms and functional status in Thai TKR patients. Methods: A cross-sectional correlational design with patients after TKR who were rst followed-up at the university hospital were conducted. The data was collected by questionnaires on demographic and clinical characteristics. The recovery symptoms after TKR were measured using the recovery symptoms and their functional status was measured using the Modi ed Thai WOMAC score. Descriptive statistics and Pearson product moment correlation coef cient were utilized for data analysis Results: This study included 88 eligible patients, (74 women, 14 men) with an average age of 67.63 years (S.D.=7.9), with an average BMI 27.46 kg/m2 (S.D.=3.91). The most common recovery symptoms were pain (mean=6.41, S.D.=0.95), limping (mean=5.02, S.D.=2.62), and numbness (mean=4.57, S.D.=2.64). The functional status found that most had heavy domestic duties (mean=9.82, S.D.=0.51). Recovery symptoms had a positive relationship with functional status (r=0.395, p<0.01). However, age and BMI were not statistically signi cant with functional status (r=0.037, 0.033, p>0.05 respectively). Conclusion: This nding provides a beginning explanation about the phenomena of age, BMI, recovery symptoms and functional status in a speci c culture, Thai TKR patients. Interventions to improve functional outcomes in Thailand should be tailored to recovery symptoms management.

75-78

Authors: Kanoknat Boonvisudhi, M.D., Prapat Wanitpongpan, M.D., Alita Changnoi, B.NS.

Objective: To establish the reference intervals with gestation for the area of the lungs to head circumference ratio (LHR) by tracing method in normal Thai fetuses at 20-40 weeks of gestation. Methods: This was a prospective longitudinal descriptive study of 60 normal singleton pregnancies at 20-40 weeks of gesta- tion. Right and left lung areas were obtained by manual tracing of the borders of the lungs technique at four-chamber view level. The examination was repeated every 4 weeks. Inter-observer and intra-observer reliabilities were assessed and the results showed very good correlation. Results: The mean left lung area increased with gestational age from 246 mm2 at 20 weeks to 646 mm2 at 35 weeks and then slightly decreased to 622 mm2 at 40 weeks. The mean right lung area increased from 354 mm2 at 20 weeks to 938 mm2 at 35 weeks and then slightly decreased to 795 mm2 at 40 weeks. Accordingly, the left LHR increased with gestational age from 1.38 at 20 weeks to 2.02 at 34 weeks and slightly decreased to 1.80 at 40 weeks. The right LHR increased from 1.98 at 20 weeks to 2.93 at 34 weeks and slightly decreased to 2.30 at 40 weeks. Conclusion: The reference intervals with gestation for the lungs’ area to head circumference ratio (LHR) by tracing method in normal Thai fetuses at 20-40 weeks of gestation was established. The left and right LHR increased with gestational age from 20-34 weeks and then slightly decreased after that.