Knowledge and attitude of pregnant women at risk for having a fetus with severe thalassemia after genetic counseling at Srinagarind Hospital

Objectives: The primary objective was to assess the knowledge and attitude of pregnant women at risk for having a fetus with severe thalassemia after receiving genetic counseling from Maternal and Fetal Medicine Staffs at Srinagarind Hospital and the secondary objective was to analyze the factors associated with decision of prenatal diagnosis and termination of pregnancy.Materials and Methods: Descriptive study recruited 105 pregnant women who were at risk for having a fetus with severe thalassemia after genetic counseling during September 1, 2010 to January 31, 2011. The questionnaire consisted of four parts demographic characteristics, knowledge of thalassemia, attitude towards thalassemia and factors associated with decision of prenatal diagnosis and termination of pregnancy after genetic counseling. Data analysis was done by using descriptive statistics, chi-square test and odds ratio.Results: More than half of the participants (57.1%) had adequate knowledge of thalassemia. The three significant contributing factors of thalassemia knowledge were education level (bachelor degree) (OR 33.4, 95% CI 3.6-310.3), family income (more than 20,000 Baht/month) (OR 6.4, 95% CI 1.5-27.1) and desire to have children (unplanned pregnancy) (OR 0.3, 95% CI 0.13-0.82), (p<0.05). Most of participants (85.7%) had good attitudes towards thalassemia. Ninety five percents of participants decided to have prenatal diagnosis of thalassemia when indicated and 88.0% of those accepted to terminate pregnancy if the fetuses were affected. Conclusion: Knowledge and attitude of thalassemia in pregnant women at risk were adequate and good. Factors associated with decision of prenatal diagnosis and termination of pregnancy probably were education level, family outcome and desire to have children

Amniotic Fluid Index (AFI) for Normal Pregnant Women in Northeastern Thailand

Objective:To construct normal reference chart of amniotic fluid volume by using the amniotic fluid index (AFI) method from 20 to 40 weeks of gestation in northeastern Thailand.Study design: A cross-sectional prospective descriptive study.Setting: Antenatal care clinic, Srinagarind Hospital, Khon Kaen University, Khon Kaen.Material and methods: All recruited 381 pregnant women with an uncomplicated singleton pregnancy from 20 to 40 weeks of gestation in northeastern Thailand from March 1, 2013 to June 30, 2014 enrolled in this study. All of them had an abdominal ultrasonography for amniotic fluid measurement using AFI method. Stat software was used to analyse the data and mean of the AFI was used in each gestational age.Main outcome measures: Normal reference chart of AFI for normal pregnancy women from 20 to 40 weeks of gestation in northeastern Thailand.Result: Mean AFI in study is 13.85 (± 3.61) cm. AFI trends to increase from GA 20 weeks to GA 29 weeks. The highest mean AFI is 15.38 cm at GA 29 weeks. Then the AFI trends to decline until GA 40 weeks. The normal reference chart of AFI was then established in this study.Conclusion: The author established normal reference chart of AFI for northeastern Thai pregnant women that can be implemented in the population of this region. The result from this study can be used to develop reference standard criteria for oligohydramnios and polyhydramnios in Thailand

Pluralism Medical Treatment, Prevention, and Control of COVID-19 Infection and Its Long-Sufferings among the Older Adults in the Northeast of Thailand from 2019 to 2022

COVID-19 in 2019 has brought both changes and challenges to the world. This global pandemic has an impact on people of all age levels, especially older adults. In Thailand, older persons are at high risk of COVID-19 infection. They are included in the so-called 608 groups. The objective of this review article was to synthesize and present medical pluralism, the development of drugs from herbs, and projects conducted to treat, prevent, and control the infection and long sufferings of COVID-19. The review covers 10 studies, three projects produced at Mahasarakham University, Chaiyaphum Rajabhat University, and Khon Kaen University that were reviewed, synthesized, and analyzed. The results of the synthesis indicate that modern and Thai traditional medicine can help reduce the severity of the infection and long sufferings of COVID-19. The medical pluralism between modern and Thai traditional medicine is needed to remedy COVID-19 cases among the older adults in the Northeast of Thailand

Second Trimester Genetic Amniocentesis: Khon Kaen University 14-year experience

Objective: To evaluate the results of second trimester amniocentesis for prenatal diagnosis of chromosomal abnormalities at Khon Kaen University.Material and Method: A review of data from 2,825 genetic amniocenteses between January 1, 1993 and December 31, 2006 at Srinagarind Hospital,Faculty of Medicine,Khon Kaen University. Data reviewed included medical records, amniocentesis record forms and questionnaires sent by mail that inquired about complications and pregnancy outcomes. The mail out questionnaires response rate was 75.5%.Main outcome measure: Fetal loss rate after amniocentesis within 2 weeks.Results: The most common indication for genetic amniocentesis was advanced maternal age (90.7%). Chromosomal abnormalities were found 3.1%. The most common chromosomal abnormality was trisomy 21 (0.91%). The procedure failed in only one case (0.03%). Additional tapping was required in 1.29% of them. The culture failure rate was 2.01%. The fetal loss rate after amniocentesis was 0.6%.There were no significant differences in the factors affecting fetal loss that included maternal age, gestational age, placental puncture, operator, number of tappings, myoma uteri and color of amniotic fluid. Pregnancy outcome of the fetus with normal chromosomes included fetal death (0.3%) and preterm delivery (5.1%). Conclusion: Second trimester genetic amniocentesis at Khon Kaen University was a safe procedure in prenatal diagnosis of chromosomal abnormalities