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� !��� !� : Zinc deficiency in preterm manifested by dermatitis

�+,����� : Termsang Srisuwanporn, MD.

6�7����� : Department of pediatrics, Nopparatrajatani Hospital, Bangkok,

Thailand

Two cases report of preterm VLBW, were admitted NICU .The first case, 25 weeks preterm, AGA, Apgar score 6, 6, 6, birth weight 772 gm was diagnosed mild RDS and Sepsis, the second case, 32 weeks preterm SGA, birth weight 1190, Apgar score 8,9,9 was diagnosed respiratory distress due to hypothermia. Symptomatic Zinc deficiency was observed at the age of 8 and 4 weeks old, body weight 1,290 gm and 1,570 gm. respectively. Both cases skin manifestation were dry scale on erythematous plague at face, scalp, trunk with vesiculopustular erosion on neck fold, axillary fold and anorectal fold. Infants were fed with preterm formula and breast milk the first case had partial parenteral nutrition. Serum level of zinc concentration was normal in the first (112 µg/dL) and low in the second (70 µg/dL). The lesion healed rapidly after supplement oral zinc sulphate .At first, we missed diagnosis for candidiasis and cow9s milk allergy. Conclusion, rashes development in such infants in the month following preterm birth should raise the suspicious of zinc deficiency which can diagnose by low serum zinc level or therapeutic response by oral zinc supplement. Nutrition supplement of zinc in infant formula currently does not appear to meet the demand of rapid growing of extremely low birth weight and small for gestational age infant during the first month of life. Keywords : dermatitis, Zinc deficiency, preterm/small for gestational age (SGA)

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� !��� !� : Medication Used and Adverse Drug Events in Systemic Lupus Erythematosus

Patients

�+,����� : Artitaya Thaipanich1, Jarunee Longkham2, Jeerapat Wongchinsri2

6�7����� : 1Department of Pharmacy, Nopparat Rajathanee Hospital, Bangkok, Thailand 2Department of Internal medicine, Nopparat Rajathanee Hospital, Bangkok,

Thailand Background : Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease. Corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), anti-malarial drugs and immunosuppressant drugs are used for long term control of the disease. Most of these drugs can lead to adversedrug events. Objective : To survey medication use, frequency of changing medications and adverse drug events in SLE patients. Methods : A retrospective 236 SLE patient charts were reviewed. Completed 79 charts continuing treatment at least 12 months were analyzed. Types of medication for SLE treatment, the number of medicine used per patient, frequency of changing the dose or medications, adverse drug events in 12 months were recorded. Data was analyzed by descriptive statistic. Results : The study analyzed 79 SLE patient charts, including 77 females (97.5%) and 2 males. The mean age of SLE patients is 39.91±10.99 years old. The mean duration of disease was 8.86±7.28 years (rang from 1-32 years). Most common clinical manifestrations are skin, renal and muscoskeletal system respectively. Major medications used in SLE patients were corticosteroids (64 patients; 81.01%), NSAIDs (16 patients; 20.25%), anti-malarial drugs (19 patients; 24.05%) and immunosuppressant drugs (22 patients; 27.85%). Other frequently used medicines were calcium supplements and angiotensin converting enzyme inhibitors (ACEIs). The number of medication used by one patient was from 1-10 items. The mean of medication used is 4.58±1.90 items/patient. Frequency of changing dose or medications was 6.63±5.41 times/patient/year. The adverse drug events found in 20 patients were herpes infection (9 patients), maculopathy (6 patients), steroid induced myopathy (2 patients), steroid induced diabetes mellitus (2 patients) and cyclophosphamide induced luekopenia (1 patient).

�6�@ PR7/I

Conclusion : Corticosteroid is the most frequently used medication in SLE patients. The average number of medicines used was 4.58±1.90 items/patient. The adverse drug event most frequently observed was herpes infection.

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(Nursing System development Continuity of care for patients with stroke in

Nopparat

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