To determine the prevalence of dysmenorrhea, impact on daily activity, quality of life, and knowledge of management among Siriraj nurses. Four hundred ninety three female nurses in the Faculty of Medicine Siriraj Hospital, Mahidol... more
To determine the prevalence of dysmenorrhea, impact on daily activity, quality of life, and knowledge of management among Siriraj nurses. Four hundred ninety three female nurses in the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand A cross-sectional descriptive study was done at Siriraj Hospital, Bangkok, Thailand Subjects were asked to complete a questionnaire (32 items) and a Short form-36. The questionnaire included demographic data, menstrual pattern, age at dysmenorrhea, severity of dysmenorrhea, pain score, impact of dysmenorrhea on daily activity, and method and knowledge of medications to treat dysmenorrhea. Evaluation of the quality of life using short form-36 questionnaire was also asked. The prevalence of dysmenorrhea was 70.2%. The prevalence of mild, moderate, and severe dysmenorrhea was 29.6%, 38.9%, and 1.6% respectively. Dysmenorrhea was significantly associated with age of participants, amount of menses, and the family history of dysmeno...
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To determine the prevalence of dysmenorrhea, effect on daily activity, academic activities, quality of life, and knowledge of management in Siriraj medical students. A cross-sectional descriptive study at the Faculty of Medicine Siriraj... more
To determine the prevalence of dysmenorrhea, effect on daily activity, academic activities, quality of life, and knowledge of management in Siriraj medical students. A cross-sectional descriptive study at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand that included 552 female medical students who were asked to complete two questionnaires. The first questionnaire (32 items) included demographic data, menstrual pattern, severity of dysmenorrhea, pain score, impact of dysmenorrhea on daily and academic activities, the method and knowledge of medications to treat dysmenorrhea. The second questionnaire was Short Form (SF)-36 questionnaires used to evaluate the health-related quality of life. The prevalence of dysmenorrhea was 77.7%. The prevalence of mild, moderate, and severe dysmenorrhea was 35.3%, 39.3%, and 3.1% respectively. Age of menarche, duration of menses, and the family history of dysmenorrhea were significantly different between two groups. St...
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To determine the prevalence and predictors of metabolic syndrome in perimenopausal and postmenopausal Thai women. The cross-sectional study was carried out in the Siriraj Menopause Clinic, Faculty of Medicine Siriraj Hospital, Mahidol... more
To determine the prevalence and predictors of metabolic syndrome in perimenopausal and postmenopausal Thai women. The cross-sectional study was carried out in the Siriraj Menopause Clinic, Faculty of Medicine Siriraj Hospital, Mahidol University, a tertiary-care university hospital, from May 2006 to August 2009. Metabolic syndrome was diagnosed using the International Diabetes Federation (IDF) criteria for an Asian population, the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria with Asian waist circumference, and the NCEP-ATP III with body mass index cut-off value. The outcome measures were the prevalence and predictors of metabolic syndrome in perimenopausal and postmenopausal Thai women. There were 971 women classified into perimenopausal (n = 331), naturally postmenopausal (n = 442) and surgically postmenopausal (n = 198) groups. The overall prevalences (95% confidence interval, CI) of metabolic syndrome were 16.0% (15.1-24.3%), 15.9% (13.6-18.2%), and 14.9% (14.0-19.8%) by IDF criteria, modified NCEP-ATP III criteria with Asian waist circumference, and with body mass index cut-off value, respectively. Focusing on the NCEP-ATP III criteria with Asian waist circumference, the prevalence was the highest in the surgically postmenopausal group (19.7%, 95% CI 15.1-24.3%) followed by the perimenopausal (12.4%, 95% CI 9.4-15.4%) and naturally postmenopausal (16.9%, 95% CI 14.0-19.8%) groups, but without statistical significance. The prevalence increased with age, body mass index and family history of cardiovascular disease. The overall prevalence of metabolic syndrome in perimenopausal and postmenopausal Thai women is 14.9-16.0%, depending on diagnostic criteria, and its significant predictors include age, body mass index, and family history of cardiovascular disease.
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Background: Pelvic ultrasonography is necessary for the diagnosis of polycystic ovary syndrome (PCOS). Compared with transabdominal ultrasonography, a transvaginal approach provides better endometrial imaging, but is more invasive. A... more
Background: Pelvic ultrasonography is necessary for the diagnosis of polycystic ovary syndrome (PCOS). Compared with transabdominal ultrasonography, a transvaginal approach provides better endometrial imaging, but is more invasive. A thick endometrium is associated with endometrial abnormalities indicating further surveillance. Objectives: We determined factors associating with endometrial thickness in PCOS Thai women. The information is useful to identify patients who need endometrial surveillance. Methods: One hundred sixty-nine Thai women with PCOS diagnosed using revised Rotterdam 2003 criteria were examined for weight, height, waist circumference, and signs of hyperandrogenism. Endometrial thickness was determined by ultrasonography. Venous blood samples were collected after 12-hour fasting period and at 2 hours after 75-gram oral glucose loading. Results: Endometrial thickness had moderate correlation with BMI (r = 0.207, p = 0.007), 2-hour glucose (r = 0.227, p = 0.003), and ...
To determine the prevalence of endometriosis among other benign gynecologic diseases and to identify the characteristics of patients at increased risk of concomitant diagnosis before surgery A descriptive cross-sectional study of331 women... more
To determine the prevalence of endometriosis among other benign gynecologic diseases and to identify the characteristics of patients at increased risk of concomitant diagnosis before surgery A descriptive cross-sectional study of331 women with benign gynecologic diseases who underwent surgery in the Department of Obstetrics and Gynecology, Faculty ofMedicine Siriraj Hospital, Mahidol University, Bangkok, Thailand were included The subjects were interviewed for demographic data, obstetrics, and medical history. Data from medical records were reviewed and collected Operative notes and pathological reports were reviewedfor the diagnosis of endometriosis. The outcome measurement is the prevalence of endometriosis that was diagnosed by the surgeon from operative finding or pathological report and the characteristics of the patients at increased risk of concomitant diagnosis before surgery. Of the 331 women with benign gynecologic diseases, 101 had coexistent endometriosis. Prevalence ofe...
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Gynecologic endoscopic surgery is a minimally invasive surgical technique for treatment of various gynecologic diseases. When compared to conventional laparotomy, this procedure has advantages in many aspects such as reduced postoperative... more
Gynecologic endoscopic surgery is a minimally invasive surgical technique for treatment of various gynecologic diseases. When compared to conventional laparotomy, this procedure has advantages in many aspects such as reduced postoperative pain, short hospital stay, and decreased morbidity associated with laparotomy. However 15 to 30% of the patients experienced moderate or severe postoperative shoulder pain. Methods to minimize postoperative shoulder pain after gynecologic endoscopy are essential to maximize the quality of life of the patients. To evaluate the benefit of intraperitoneal instillation of bupivacaine plus morphine for reducing postoperative shoulder pain incidence after gynecologic endoscopy. A randomized clinical trial was conducted in 158 patients undergoing laparoscopic procedures. The patients were randomly assigned to receive either 0.5% bupivacaine hydrochloride 20 mL mixed with morphine 3 mg (study group) or normal saline (control group) instillation to subdiaph...
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To determine the prevalence of vaginal atrophy and sexual dysfunction in current users of systemic postmenopausal hormone therapy (pHT). A cross-sectional study was conducted in 97 current users of pHT at Siriraj Menopause Clinic from... more
To determine the prevalence of vaginal atrophy and sexual dysfunction in current users of systemic postmenopausal hormone therapy (pHT). A cross-sectional study was conducted in 97 current users of pHT at Siriraj Menopause Clinic from 2005 to 2007. Subjective symptoms of vaginal atrophy and sexual dysfunction were assessed by interviewing. Objective signs of vaginal atrophy were assessed using pelvic examination, vaginal pH, and maturation value (MV). The prevalence of vaginal atrophy in current users of systemic pHT determining from patient's symptoms, pelvic examination, vaginal pH, and MV were 44.3%, 15.5%, 21.6% and 8.8%, respectively. The prevalence of sexual dysfunction varied from 48.7% to 71.6% depending on types of dysfunction. There was poor association between the subjective symptoms and signs, and the objective indicators of vaginal atrophy. Among various regimens of pHT, tibolone had the lowest prevalence of subjective atrophic symptoms; estrogen-only pHT had the lo...
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Conjugated linoleic acid (CLA), a mixture of positional and geometric isomers of linoleic acid found in dairy products and meat from ruminants, has been widely shown to possess anticarcinogenic activity against breast cancer both in vitro... more
Conjugated linoleic acid (CLA), a mixture of positional and geometric isomers of linoleic acid found in dairy products and meat from ruminants, has been widely shown to possess anticarcinogenic activity against breast cancer both in vitro and in animal models. However, little information is available concerning the mechanisms of the antitumor effects of these compounds. In this study, we investigated whether CLA has direct antiestrogenic activity in estrogen receptor positive (ER+) breast cancer cells. Treatment of the ER+ cell line, MCF-7, with 5 purified CLA isomers as well as "mixed" CLA showed a dose-dependent growth inhibition with the 9cis,11cis and 9cis,11trans being the most and least potent isomers, respectively. In assessing effects on a number of variables that play obligatory roles in the estrogen signaling pathway, we determined that CLA treatment downregulated ERalpha expression at both mRNA and protein levels and decreased binding activity of nuclear protein...
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Research Interests:
Objectives. To study the cut-off point of Homeostatic Measurement Assessment-Insulin Resistance (HOMA-IR) as a screening test for detection of glucose intolerance in Thai women with polycystic ovary syndrome (PCOS). Study Design.... more
Objectives. To study the cut-off point of Homeostatic Measurement Assessment-Insulin Resistance (HOMA-IR) as a screening test for detection of glucose intolerance in Thai women with polycystic ovary syndrome (PCOS). Study Design. Cross-sectional study. Setting. Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital. Subject. Two hundred and fifty Thai PCOS women who attended the Gynecologic Endocrinology Unit, during May 2007 to January 2009. Materials and Methods. The paitents were interviewed and examined for weight, height, waist circumference, and blood pressure. Venous blood samples were drawn twice, one at 12-hour fasting and the other at 2 hours after glucose loading. Results. The prevalence of glucose intolerance in Thai PCOS women was 20.0%. The mean of HOMA-IR was 3.53 ± 7.7. Area under an ROC curve for HOMA-IR for detecting glucose intolerance was 0.82. Using the cut-off value of HOMA-IR >2.0, there was sensitivity at 84.0%, specificity at 61.0%, positive predictive value at 35.0%, negative predictive value at 93.8%, and accuracy at 65.6%. Conclusion. HOMA-IR >2.0 was used for screening test for glucose intolerance in Thai PCOS women. If the result was positive, a specific test should be done to prove the diagnosis.
Research Interests:
Research Interests:
The energy of interaction of antiestrogenic ligands bound to DNA derived from molecular modeling was compared to the capacity of the ligands to directly inhibit the transcriptional activity of an estrogen responsive gene.... more
The energy of interaction of antiestrogenic ligands bound to DNA derived from molecular modeling was compared to the capacity of the ligands to directly inhibit the transcriptional activity of an estrogen responsive gene. 3-Phenylacetylamino-2,6-piperidinedione (A10) and related compounds were intercalated into a partially unwound DNA site in a canonical estrogen response element (ERE). The piperidinedione/ERE complexes were subjected to energy minimization and the strength of interaction of the ligands with the DNA was measured. The ability of the ligands to inhibit transactivation was assessed using a reporter gene constructed with the ERE of the vitellogenin gene promoter (ERE(v)-tk-Luc) transiently transfected into the human estrogen receptor-positive MCF-7 breast cancer cell line. The results demonstrate a direct correlation between the calculated energetic fit of the compounds in the ERE and inhibition of ERE(v) transactivation. The order of potency of the compounds to suppress estrogen-dependent reporter gene activity was identical to that previously shown for inhibiting the growth of MCF-7 cells. To our knowledge, these results provide the first direct experimental evidence that the predicted fit of a class of compounds into a defined DNA binding site correlates with the ability of the compounds to modulate specific gene functions regulated at that site.
Research Interests: Thermodynamics, Breast Cancer, Molecular modeling, DNA, Humans, and 12 moreComputer Simulation, Computer Model, Female, Gene Function, DNA binding, "Intercalating Agents", Nucleic Acid Conformation, Response Elements, Biochemistry and cell biology, Energy minimization, Breast Cancer Cells, and Piperidines
Gap junctions, made up of connexins (Cxs), play fundamental roles in coordinating a number of cellular processes through their ability to directly regulate cell-cell communication. Cx43 is the most widely expressed Cx in the endometrium... more
Gap junctions, made up of connexins (Cxs), play fundamental roles in coordinating a number of cellular processes through their ability to directly regulate cell-cell communication. Cx43 is the most widely expressed Cx in the endometrium and is known to be important in a variety of physiological and pathological processes in this tissue. In this study, we investigated the ability of the retinoid, all-trans-retinoic acid (RA), to regulate Cx43 expression in human endometrial stromal cells. Primary endometrial stromal cells obtained from patients undegoing surgery for infertility workup were treated in vitro with RA and control compounds for different time periods, up to 48 h. Cx43 mRNA and protein levels, protein phosphorylation, and gap junctional intercellular communication (GJIC) were analyzed. Treatment of the cells with RA showed a dose-dependent increase in Cx43 expression at both the mRNA and protein levels. In addition, RA induced a relative decrease in the phosphorylated species of Cx43 while causing a corresponding increase in the nonphosphorylated form. Concomitant with these changes, RA-treated cells demonstrated up to a 250% enhancement of GJIC as assessed by dye transfer experiments. Augmentation of GJIC and alterations of Cx43 expression were observed over the same range of RA concentrations. Treatment of cells with the protein kinase C activator 12-O-tetradecanoylphorbol-13-acetate increased the phosphorylated species of Cx43 and correspondingly inhibited GJIC. Phosphorylation of Cx43 is inversely related to GJIC in endometrial stromal cells. Retinoids increase GJIC in endomentrial stromal cells through upregulation of Cx43 expression while inducing a decrease in the phosphorylated species of the protein. The data suggest a novel mechanism by which retinoids can influence endometrial cell biology.
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To determine the prevalence of metabolic syndrome (MS) in reproductive-aged polycystic ovary syndrome (PCOS) Thai women. A Cross sectional study was done at the Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology,... more
To determine the prevalence of metabolic syndrome (MS) in reproductive-aged polycystic ovary syndrome (PCOS) Thai women. A Cross sectional study was done at the Gynecologic Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital of 250 PCOS Thai women who were diagnosed using Revised Rotterdam 2003 criteria, and who did not take medications affecting sex hormones or lipid metabolism, and attended the Gynecologic Endocrinology Unit between May 2007 and January 2009. Patents were interviewed and examined for weight, height, waist circumference, and blood pressure. Venous blood sample of each patient was drawn after 12-hour fasting. Prevalence of MS determined using the definitions of National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), International Diabetes Federation (IDF), and National Heart Lung and Blood Institutes/American Heart Association (NHLBI/AHA). Mean +/- SD of age, body mass index (BMI), and waist circ...