Papers by Sayomporn Sirinavin
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 1993
A 3-year-old boy with Wilms' tumor, post operative left nephrectomy stage, had HTS on day 99 ... more A 3-year-old boy with Wilms' tumor, post operative left nephrectomy stage, had HTS on day 99 of the combined chemotherapy which lasted for more than 20 days. He had severe respiratory distress due to a moderate amount of ascites and marked pleural effusion. Because of high fever, thrombocytopenia and marked hemphagocytosis in the bone marrow, he received IVIG for 2 days. Normal platelet count and markedly decreased pleural fluid were attained within 3 days. He subsequently tolerated full doses of combined chemotherapeutic agents with an additional one (doxorubicin). In cases of HTS, IAHS should be suspected. The bone marrow should be done and treatment accordingly so that there is no need to decrease, the dosage of chemotherapeutic agents afterwards.
PubMed, Sep 1, 1990
Dengue hemorrhagic fever (DHF) is an epidemic viral disease. The exact mechanism attributable to ... more Dengue hemorrhagic fever (DHF) is an epidemic viral disease. The exact mechanism attributable to platelet and vascular dysfunctions is still obscure. Plasma 6-keto-PGF1a (6KPGF1), the stable metabolite of PGI2 was determined in 60 DHF patients and in 11 non-DHF (NDHF) patients with fever of over 38.5 degrees C to compare with that of 33 normal children (NC) in the same age group (2-15 years). Among 60 DHF patients, 32 had blood obtained during impending shock, whereas blood samples of the remainder were taken during normotension. Their plasma 6 KPGF1 values (mean +/- SE) were 201.06 +/- 12.42 and 132.87 +/- 13.08 pg/ml respectively. All patients had serology positive for acute dengue viral infection. The plasma 6 KPGF1 (mean +/- SE) of 33 NC and 11 - NDHF subjects were 149.82 +/- 4.93 and 108.69 +/- 14.53 respectively. The plasma 6KPGF1 levels of 32 DHF patients with impending shock were significantly higher than those of 28 normotensive DHF patients (p less than 0.005), 33 NC (p less than 0.005) and 11 - NDHF patients (p less than 0.005). However the levels in 28 normotensive DHF patients are not statistically different from the values of 33 NC and 11 - NDHF patients. It is concluded that there is a tendency of excessive PGI2 production in DHF patients during hypotensive crisis.
PubMed, Apr 1, 1997
Infectious croup is a common and an important cause of upper airway obstruction in young children... more Infectious croup is a common and an important cause of upper airway obstruction in young children. Despite its frequency and potentially serious nature, there is still no definite conclusion regarding the beneficial effect of corticosteroid. A randomized controlled study on the effects of dexamethasone in infectious croup was conducted at the Department of Pediatrics, Ramathibodi Hospital between January 1985 and September 1986. Thirty-two patients, 2-37 months old, were included in this study. Fourteen patients received dexamethasone (0.5 mg/kg/dose daily for 3 days) and eighteen patients were the control group. The dexamethasone group had significantly lower croup scores at 48 hour (p < 0.05), shorter hospital course (p < 0.005) and lower incidence of endotracheal intubation (p < 0.05) than the control group. Five patients in the control group required endotracheal intubation. Complications included four episodes of pneumonia, one episode of sepsis, and one bacterial tracheitis. Pneumonia and sepsis occurred only in the control group. We concluded that dexamethasone therapy decrease the severity of infectious croup and the risk of complications.
Open Forum Infectious Diseases, 2015
Background. Invasive bacterial infections cause substantial morbidity and mortality in Thailand, ... more Background. Invasive bacterial infections cause substantial morbidity and mortality in Thailand, but population-based data are lacking to estimate disease burden. As part of the Thailand Invasive Bacterial Infection Surveillance network, we describe incidence and in-hospital mortality of invasive bacterial pathogens in 2 Thai provinces. Methods. Surveillance was conducted in Sa Kaeo (SK) in eastern and Nakhon Phanom (NP) in northeastern Thailand during 2010-2013. Cases were confirmed in residents of SK or NP by the isolation of Haemophilus influenzae, Streptococcus suis, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus agalactiae, or Salmonella species from a
There is a need for safe and cost-effective treatments for COVID-19.Andrographis paniculata(AP) i... more There is a need for safe and cost-effective treatments for COVID-19.Andrographis paniculata(AP) is an herbal plant that has been used for centuries to treat upper respiratory tract infections. Andrographolide is the major active component of AP that inhibits intracellular SARS-CoV-2 replication and has anti-inflammatory action. We performed a retrospective cohort study to evaluate the therapeutic and adverse effects of oral AP-products on COVID-19 by using the risk of pneumonia diagnosed by chest radiography as an indicator. This study included patients 15 to 60 years of age with laboratory-confirmed early-stage (asymptomatic or mild) COVID-19 without comorbidities at seven hospitals in three adjacent provinces in Thailand, between December 2020 and March 2021. Patients were treated for five days with either AP-extract (60 mg andrographolide, 3 times daily) or crude-AP (48 mg andrographolide, 3 times daily), when available. Patient information was prospectively recorded in the struc...
Acta Paediatrica, 1992
This randomized controlled trial was designed to answer the question: does administration of dexa... more This randomized controlled trial was designed to answer the question: does administration of dexamethasone to neonates with bronchopulmonary dysplasia decrease the need for assisted ventilation? Twenty‐five infants with a birth weight < 1501 g, requiring mechanical ventilation and FiO2 of ± 0.30 at 21‐35 days of age, were randomized to treatment with iv dexamethasone or to sham injections for 12 days. The primary outcome criterion was extubation within seven days after study entry. Treatment (n= 12) and control (n= 13) groups were well matched at entry. Dexamethasone facilitated weaning from assisted ventilation (p= 0.0154). There was no increased incidence of infection. Dexamethasone treatment resulted in a significant increase in glucosuria (p= 0.0002) and in systolic blood pressure (p= 0.0034). There was a significant decrease in heart rate (p= 0.0001) and a significant weight loss (p= 0.0002) following dexamethasone treatment. Dexamethasone treatment facilitated weaning from assisted ventilation but several systemic effects were noted that deserve further evaluation before dexamethasone becomes routine treatment.
Blood, 2007
Background: Viral infections are a common cause of complication following hemopoietic stem cell t... more Background: Viral infections are a common cause of complication following hemopoietic stem cell transplantation (HSCT). Cytomegalovirus (CMV) is known to be a concerning pathogen and most transplant centers have implemented CMV monitoring as a standard of care. With improvement of virological diagnostic methods, the role of other viruses including adenovirus (ADV) and polyomaviruses (PMV) as pathogens causing major infection are also increasingly appreciated, however, evidence to support routine monitoring of these viruses following HSCT is lacking. In addition, there is a paucity of data on the incidence of ADV and/or PMV co-infection in children who develop CMV infection following HSCT. The aim of this study was to uncover the incidence of CMV and ADV or PMV co-infection in pediatric recipients of allogeneic- HSCT and to correlate the finding with degree of CMV viremia. Methods: We retrospectively performed Q-RT- PCR of ADV, BKV and JCV in 219 blood samples from 77 pediatric patie...
The American Journal of Tropical Medicine and Hygiene, 1991
Antibodies against dengue viral proteins were demonstrated in sera from dengue-infected patients ... more Antibodies against dengue viral proteins were demonstrated in sera from dengue-infected patients by polyacrylamide gel electrophoresis, Western blotting, and enzyme immunoassay. Primary dengue cases showed low titers of IgG class antibodies to envelope (E) proteins and two non-structural proteins, NS3 and NS5, in sera collected during the convalescent phase. Secondary dengue- infected patients always demonstrated IgG antibodies to E proteins in sera collected during the acute phase, and high titers of IgG antibodies to many other proteins, including NS1, NS3, NS5, and C proteins in sera collected during the convalescent phase. Appearance of antibodies to E, NS3, and NS5 could be detected within five days after the onset of fever. These three dengue viral proteins and their corresponding antibodies may be involved in the immunopathologic mechanism underlying this disease. For diagnostic purposes, identifying the non-structural proteins such as NS3 and NS5 may be the best means for early confirmation of the disease.
The Pediatric Infectious Disease Journal, 2000
This study evaluated the roles of semiquantitative anti-HIV antibody tests for early diagnosis of... more This study evaluated the roles of semiquantitative anti-HIV antibody tests for early diagnosis of vertical HIV-1 infection in infants. The study included 0- to 18-month-old children of HIV-1-infected mothers. They were regularly followed up, and blood was obtained for semiquantitative anti-HIV tests using a particle agglutination (PA) test and a microparticle enzyme immunoassay (MEIA). One hundred forty-six children of HIV-1-infected mothers, including 104 infected and 42 uninfected infants, were studied. Using anti-HIV titer of &lt; or = 1:100 by PA and optical values of &lt; or = -3 by MEIA for diagnosis of not being infected, approximately 69 and 53% of the uninfected cases at age 7 to 8 months, 76 and 67% at age 9 months and 100% at age 12 months could be diagnosed. By comparison with the diagnosis by qualitative tests the figures were 16%, 8 and 11%, 70 and 74% at the same ages. All asymptomatic HIV-infected cases had persistently high PA titers and MEIA values of at least 1:5000 and 6, respectively, but 7 cases with AIDS-related manifestation at the time of tests had low anti-HIV titers. One severely ill, HIV-infected infant had a transient negative anti-HIV test at the age of 7 months. Two asymptomatic infected children, who had been breast-fed, had transient decrease in anti-HIV titers after the age of 6 months, and transient seroreversion occurred in one. CONCLUSION. Semiquantitative anti-HIV tests between the age of 6 to 12 months were very useful in diagnosis of HIV-1 infection in infants born of HIV-1-infected mothers. Interpretation must be accompanied by information about AIDS-related manifestation and history of breast-feeding.
Cochrane Database of Systematic Reviews, 1999
Antibiotic treatment of salmonella infections aims to shorten illness and prevent serious complic... more Antibiotic treatment of salmonella infections aims to shorten illness and prevent serious complications. There are also concerns about increasing antibiotic drug resistance. The objective of this review was to assess the effects of antibiotics in adults and children with diarrhoea who have salmonella. We searched the Cochrane Infectious Diseases Group trials register, the Cochrane Controlled Trials Register, Medline, Science Citation Index, African Index Medicus, Lilacs, Extra Med and reference lists of relevant articles. We also contacted experts in the field. Randomised and quasi-randomised trials comparing antibiotic therapy with placebo or no antibiotic therapy for salmonella infections in symptomatic or asymptomatic adults or children. Typhoid and paratyphoid salmonella infections were excluded. Trial quality assessment and data were extracted independently by two reviewers. Twelve trials involving 778 participants (with at least 258 infants and children) were included. There were no significant differences in length of illness, diarrhoea or fever between any antibiotic regimen and placebo. The weighted mean difference for length of illness was -0.07 days, 95% confidence interval -0.55 to 0.40; diarrhoea -0.03 days, 95% confidence interval -0.53 to 0.48; fever -0.45 days, 95% confidence interval -0. 98 to 0.08. Antibiotic regimens resulted in more negative cultures during the first week of treatment. Relapses were more frequent in those receiving antibiotics, and there were more cases with positive cultures in the antibiotic groups after three weeks. Adverse drug reactions were more common in the antibiotic groups (odds ratio 1.67, 95% confidence interval 1.05 to 2.67). There appears to be no evidence of a clinical benefit of antibiotic therapy in otherwise healthy children and adults with non-severe salmonella diarrhoea. Antibiotics appear to increase adverse effects and they also tend to prolong salmonella detection in stools.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2010
To describe the clinical course, serotype distribution and antimicrobial resistance patterns of i... more To describe the clinical course, serotype distribution and antimicrobial resistance patterns of invasive pneumococcal disease (IPD) cases in a public hospital. Retrospective review of IPD cases occurring from January 2004 through December 2008 was performed. Antibiotic susceptibility testing and serotyping were performed for available isolates. Fifty one IPD cases occurred during the study period, of which 47 had medical records available for review. The majority of cases occurred among children under 5 years of age (23.4%) and adults over 60 years of age (36.1%). Underlying diseases were identified in 72.3% of patients. Fifty-three percent of cases were associated with pneumonia, while 17% had meningitis, and 15% had isolated bacteremia. Serotype could be determined for 15 (31.9%) isolates, and 6B was most common. Based on current antibiotic susceptibility breakpoints for meningitis, 4 of the 7 available isolates from meningitis cases were penicillin resistant and one had reduced s...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 1999
A retrospective study of 100 patients with disseminated intravascular coagulation from 1993 to 19... more A retrospective study of 100 patients with disseminated intravascular coagulation from 1993 to 1997 is reported. Forty-five patients were neonates with a mean age of 12.6 days and 55 patients were infants, children and adolescents with a mean age of 6 years and 3 months. Most of them (91.5%) had complicated underlying conditions which included congenital anomalies, prematurity, malignancy, hematological and various diseases. Additionally, every patient had triggering conditions commonly identified as gram-negative septicemia. Bleeding and thromboembolic manifestations were found in 59.4 per cent and 19.8 per cent, respectively. The laboratory findings revealed red blood cell fragmentation, 89.6 per cent and thrombocytopenia, 85.8 per cent. Natural anticoagulants were studied in a few cases and revealed low levels of antithrombin III and protein C. The prompt effective management included treatment of underlying diseases, identification and relief of triggering conditions, correction...
The Southeast Asian journal of tropical medicine and public health, 1998
New injectable antimicrobial agents are generally costly and broad-spectrum. Overusage results in... more New injectable antimicrobial agents are generally costly and broad-spectrum. Overusage results in unnecessary economic loss and multi-drug resistant organisms. Effective strategies for decreasing costs without compromising patient care are required. This study aimed to evaluate the economic impact of a system using an antimicrobial order form to assist rational usage of expensive antimicrobial agents. The study was performed during 1988-1996 at a 900-bed, tertiary-care, medical school hospital in Bangkok. The target drugs were 3 costly, broad-spectrum antibacterial drugs, namely imipenem, vancomycin, and injectable ciprofloxacin. The restriction of these 3 drugs was started in 1992 and was extended to netilmicin and ceftazidime in 1995. A filled antimicrobial order form (AOF) was required by pharmacists before dispensing the drugs. The AOF guided the physicians to give explicit information about anatomic diagnosis, etiologic diagnosis, and suspected antimicrobial resistance patterns...
The Southeast Asian journal of tropical medicine and public health, 1997
A case of primary amebic meningoencephalitis (PAM) with severe spinal cord involvement was docume... more A case of primary amebic meningoencephalitis (PAM) with severe spinal cord involvement was documented in a 12 year-old boy from Samut Prakan Province, Thailand. This is the first reported case of Naegleria meningomyeloencephalitis in Thailand. He had a history of swimming in the canal nearby his house prior to the fever, headache and convulsion which rapidly progressed into a comatose state. PAM was only detected at post-mortem. The findings included suppurative exudates and necrosis of the olfactory bulbs and the basal parts of the frontal, temporal lobes, pons, cerebellum, medulla and the spinal cord. Numerous Naegleria trophozoites were present in the brain and spinal cord. Foci of neuronal degeneration and demyelination were noted.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 1993
Rarity of HIV-associated disseminated lymphomas in children initiated this report. The patient wa... more Rarity of HIV-associated disseminated lymphomas in children initiated this report. The patient was an 18-month-old girl who had a history of chronic cervical lymphadenopathy since 6 months of age. She was first seen because of rapid enlargement of an inguinal lymphnode. The bone marrow aspirate was compatible with Burkitt's lymphoma, L3 cell-type. She was treated with chemotherapy without satisfactory success. She developed neurological involvement of lymphoma. Accidental sharp injury which contaminated her blood, in a medical personnel leaded to having her blood tested for anti-HIV and it was found positive. Her mother had positive anti-HIV presumably acquired from blood transfusion after an abortion in early 1988. It occurred before the donated blood was compulsively tested for anti-HIV. She died at the age of 24 months.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 1989
Infant colonization with non-typhoidal Salmonella (NTS) is common and eradication is problematic.... more Infant colonization with non-typhoidal Salmonella (NTS) is common and eradication is problematic. Oral norfloxacin has promising properties for solving this problem, though it has potential toxicity to infants. The drug has been available in Thailand since 1987. Since then, some infants who had diarrhea or NTS colonization were treated with oral norfloxacin 15-20 mg/kg/day for 3-5 days on individual physician's judgement. This observational study was performed in infants and children who had NTS in stool, seen at Ramathibodi hospital from September 1987 to February 1988, in order to give preliminary information. Sixteen of 48 infants received oral norfloxacin treatment. Nine infants had established failure of NTS eradication from follow-up rectal swab cultures. Five infants did not have follow-up rectal swab culture, and two had negative culture once on day 7 after treatment. Considering that 7 infants who did not have evidence of bacteriologic failure were free from colonizatio...
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 1989
Primary amoebic meningoencephalitis (PAM) which is caused by free-living amoeba, Naegleria fowler... more Primary amoebic meningoencephalitis (PAM) which is caused by free-living amoeba, Naegleria fowleri, is a rare disease. We report the fifth case in Thailand in order to add more information. The patient was a previously healthy 4 1/2-year-old girl from Nakhon Pathom province. For several weeks before this illness she had swum in a water supply canal. She developed high fever with change in consciousness. Her cerebrospinal fluid contained numerous Naegleria fowleri which grew in culture media and mice inoculation. She did not respond to treatment with intravenous and intraventricular amphotericin B, and oral rifampicin. She died on the fifth day of illness. Water sample from the canal also grew N. fowleri. All five reported cases in Thailand were reviewed. It was found that none of them had been exposed to a common source. Four of the five cases were male, and four cases occurred during the summer months, March to May. These findings agree with worldwide information.
Vox Sanguinis, 1996
A four-year-old boy who was diagnosed with Glanzmann&#39;s thrombasthenia received supportive... more A four-year-old boy who was diagnosed with Glanzmann&#39;s thrombasthenia received supportive treatment and desmopressin for his bleeding episodes. He seldom received blood components, except for platelet concentrates, due to severe bleeding. He was exposed to 18 routine donors and 2 plateletpheresis donors who were negative for human immunodeficiency virus (HIV) antigen and anti-HIV upon screening. At the age of 3 years and 9 months (4.5 months after the transfusion of platelet concentrate), he developed full-blown AIDS and died from circulatory failure 3 months later. The source of HIV transmission was identified as I donor who developed anti-HIV 3 months after the last donation. The rather short incubation time of AIDS in this case was attributed to a large inoculum of HIV virus in the &#39;window period&#39; of infectivity of the newly infected donor. This case illustrates transfusion-transmitted HIV leading to AIDS, even though HIV antigen and anti-HIV screening tests were negative.
The Pediatric Infectious Disease Journal, 1988
The Pediatric Infectious Disease Journal, 2001
The relative paucity of information about systemic nontyphoidal Salmonella (NTS) infection in inf... more The relative paucity of information about systemic nontyphoidal Salmonella (NTS) infection in infants without an underlying disease prompted this study. Infants without an underlying disease, who had positive cultures for NTS from their normally sterile sites during 1978 through 1998, were included. Their medical records were reviewed. The study included 75 eligible infants; 68 (91%) had positive blood cultures. The spectrum of disease included transient bacteremia (5), bacteremia without localized infection (37), bone and joint infection (5) and meningitis (28); 53 and 88% of infants were &lt; or =3 and &lt; or =6 months old, respectively. All infants with localized infection were &lt; or =7 months old, and infants with meningitis were 3.35+/-1.87 (mean +/- SD) months old. In bacteremic infants risks for localized infection and meningitis were 30 and 24%, respectively. Abnormal neurologic findings were the only predictor for meningitis. Relapse of meningitis occurred in two infants despite treatment with cefotaxime for 4 and 6 weeks. Severe neurologic deficit occurred in 21% of infants with meningitis. Of 11 infants with meningitis who received early treatment at this tertiary care center, 1 died but none had severe neurologic deficits; whereas of 17 referred cases, 2 died and 6 had severe neurologic abnormalities. No death occurred in infants without meningitis. Systemic NTS infection in normal infants has a variable disease spectrum. Infants 0 to 6 months of age are at high risk for localized infection, especially meningitis.
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Papers by Sayomporn Sirinavin