Journal of Health Science and Medical Research
Latest Publications


TOTAL DOCUMENTS

214
(FIVE YEARS 172)

H-INDEX

1
(FIVE YEARS 1)

Published By Faculty Of Medicine Prince Of Songkla University

2630-0559, 2586-9981

Author(s):  
Pornpanit Dissaneewate ◽  
Methasit Suksintharanon ◽  
Chulin Chewakidakarn ◽  
Wich Orapiriyakul ◽  
Apipop Kritsaneephaiboon

Early internal fixation of rib fractures in the setting of flail chest has proven benefits over traditional conservative treatment. This can decrease pneumonia, time on mechanical ventilation, length of stay in intensive care units, need for tracheostomy and increase in the pulmonary function test. However, there are few reports regarding on how to restore the costochondral junction, or costal cartilage in cases of anterior or anterolateral flail chest involving cartilage matrix of the ribs or costochondral joint. This case report describes a surgical technique to restore the costochondral junction with plate osteosynthesis and the results. 


Author(s):  
Jiratti Jaruwatthanasunthon ◽  
Panita Worapratya ◽  
Thammapad Piyasuwankul

Objective: We aimed to apply the modified systemic inflammatory response syndrome (mSIRS), the quick sequential organ failure assessment score (qSOFA), and National Early Warning Score (NEWS) to triage suspected sepsis patients. Therefore, knowing the predictive performance of each scoring system, using given cut-points for triaging patients with suspected sepsis, could help predict the progression of sepsis.Material and Methods: This study is a single-center retrospective chart review. The study enrolled patients older than 18 years with suspected sepsis patient at the time they presented at the triage zone. The primary outcome was to determine which scoring system were the most accurate to triage sepsis patients. The secondary outcomes were predictions of mortality related to the scoring.Results: Considering the outcome to be represented by a SOFA score of ≥2, the area under the curve of the receiver operating characteristic curves for the entire range of mSIRS, qSOFA and NEWS were 0.494, 0.669 and 0.751, respectively. Using a cut point for qSOFA of ≥2 provided a low sensitivity of 36.2% and high specificity of 93.0%; whereas, using a cut point for NEWS of >4 provided a high sensitivity of 89.0% and low specificity of 33.0%.Conclusion: In summary, qSOFA is the most accurate scoring system for diagnosis sepsis which was consistent with previous study. However, qSOFA had the lowest sensitivity, so is not appropriate in a triage situation. Therefore, we decided to use NEWS as the triage tool because of its better sensitivity and acceptable specificity as we need to triage almost all possible cases.


Author(s):  
Korakot Chansareewittaya ◽  
Sirikarnnapa Krajangcharoensakul

Objective: To determine the antibiotic susceptibility patterns (antibiogram profiles) of the bacterial agents usually involved in hospital-acquired infections found in 12 sub-district health-promoting hospitals (HPHs) in Chiang Rai, Thailand.Material and Methods: Swabs from 10 different sampling points in each sub-district HPH were aseptically collected. Standard microbiological methods were performed to define the bacterial species. Antibiotic susceptibility was determined by the disk diffusion method following the standard guidelines of the Clinical and Laboratory Standards Institute (2016).Results: The antibiogram profiles of the 153 isolated bacteria showed that 55.6% of the isolates were resistant to antibiotics. Single drug resistant, double drug resistant, and multi-drug resistant bacteria accounted for 18.3%, 18.3%, and 19.0%, respectively. The Pseudomonas aeruginosa isolate was susceptible to all tested antibiotics. MDR phenotypes were most common in coagulase-negative staphylococci (13.1%), followed by members of the family of Enterobacteriaceae (3.9%) and Staphylococcus aureus (0.7%).Conclusion: The MDR rates reported in this study are “worrying”. These results suggest that sub-district HPHs may become sources of HAIs caused by antibiotic-resistant bacteria which can be inevitably transmitted into the wider community. Antibiotic stewardship, antibiotic susceptibility surveillance and hygiene practices may be used to prevent and limit the spread of such bacteria from sub-district HPHs to the community.


Author(s):  
Kulyada Eurboonyanun ◽  
Chalerm Eurboonyanun ◽  
Julaluck Promsorn ◽  
Jiranthanin Phaorod ◽  
Tharatip Srisuk ◽  
...  

Objective: Volumetric assessment with computed tomography (CT), known as CT volumetry, is the preferred method for estimating future liver remnant. However, the data regarding the usage of CT volumetry to estimate future liver remnant of the diseased liver is still lacking. This study was designed to evaluate the correlation between the liver volume, calculated by CT, and the actual weight of the resected liver in patients who underwent orthotopic liver transplantation.Material and Methods: A total of 32 patients having underwent liver transplantation; from March 2009 to June 2015, were included. A radiologist retrospectively reviewed the pre-operative CT and performed the volume measurement. Statistical analysis was performed to determine the relationship between the estimated liver volume and the actual liver weight.Results: The estimated liver volume was significantly different among the cirrhosis of different etiology (p-value=0.001 for the total liver volume and p-value=0.003 for the functional liver volume). Compared with the total liver volume, the functional liver volume had a stronger correlation with the actual weight of the resected liver (r=0.955 vs. r=0.786). The following formula can be used to accurately estimate the expected weight of the resected liver (expected liver weight: ELW), based on the estimated functional liver volume (FLV) derived by CT volumetry: ELW=489.531+(0.618*FLV). The R-squared for this regression model was 0.914.Conclusion: CT volumetry is reliable and accurate in predicting the actual amount of the resected liver parenchyma in cirrhotic patients.


Author(s):  
Wiput Laosuksri ◽  
Boriboon Chenthanakij ◽  
Krongkarn Sutham ◽  
Wetchayan Rangsri ◽  
Radom Pongvuthitham ◽  
...  

Objectives: The use of a cardiopulmonary resuscitation feedback device and automated external defibrillator trainer is beneficial in basic life support (BLS) training. Nevertheless, Thailand lacks these devices in BLS support training. This study aimed to compare the efficacy of the Chiang Mai BLS training devices with conventional training devices in BLS training for laypeople.Material and Methods: A randomized controlled trial was conducted to compare the efficacy of the Chiang Mai device group with the conventional device group, by assessing the theory and practical examination scores of the participants; who were adult, laypeople attending the BLS provider course endorsed by the Thai Resuscitation Council. Evaluating instructors were blinded from both groups of participants.Results: A total of 60 adult, laypeople participants were divided into two groups: 32 and 28 participants of the Chiang Mai device group and conventional device group, respectively. Overall examination scores of included participants were very high. The participants in the Chiang Mai device group had a higher median score of multiple-choice question assessment [9.0/9.0 (8.5-9.0) vs 8.5/9.0 (8.0-9.0) points, p-value=0.134] as well as a higher median score of practical examination [26.0/26.0 (24.3-26.0) vs 25.0/26.0 (24.0-26.0) points, p-value=0.278] when compared to those using conventional BLS training devices. However, there was no statistical significance between both groups.Conclusion: The effectiveness of the Chiang Mai BLS training device in basic life support training for adult laypeople is comparable to conventional BLS training devices.


Author(s):  
Piyaporn Apisarnthanarak ◽  
Pattira Boonsri ◽  
Voraparee Suvannarerg ◽  
Walailak Chaiyasoot ◽  
Supot Pongprasobchai ◽  
...  

Objective: To compare the computed tomography severity index (CTSI) and the modified computed tomography severity index (MCTSI) in the clinical severity assessment of acute pancreatitis.Material and Methods: This retrospective cohort study comprised acute pancreatitis patients who underwent contrastenhanced abdominal computed tomography (CT) scans within 4 weeks after clinical onset. Two experienced abdominal radiologists, blinded to the clinical outcome, independently reviewed the CT images and retrospectively scored them using CTSI and MCTSI. Any discrepancies were resolved by a consensus review. The clinical severity assessment of each participant was categorized by the determinant-based classification of acute pancreatitis severity. The correlations of CTSI and MCTSI with the clinical severity assessment were analyzed.Results: This cohort study consisted of 40 participants—28 of them were men (70.0%)—with a mean age of 59.3 years. They were clinically divided into mild, moderate, severe, and critical groups comprising 11 (27.5%), 16 (40.0%), 7 (17.5%), and 6 (15.0%) participants, respectively. Due to the small number of patients in the severe and critical groups, we combined these into a single severe category (13 patients, 32.5%). The CTSI and MCTSI scores showed moderate and fair agreement with the clinical severity assessment. A trend linking poor clinical outcome with high CTSI/MCTSI scores (moderate and severe groups) more commonly than low scores (mild group) was observed. There was a very strong agreement between CTSI and MCTSI (rs =0.97).Conclusion: CTSI and MCTSI showed a moderate and fair agreement, respectively, with the clinical severity assessment. Compared to low scores, a poor clinical outcome was more often associated with high CTSI/MCTSI scores.


Author(s):  
Pantaree Laosuebsakulthai ◽  
Surachai Likasitwattanakul ◽  
Theerapong Pho-iam ◽  
Wanna Thongnoppakhun ◽  
Mongkol Chanvanichtrakool

Objective: To examine the frequency of the proline-rich transmembrane protein-2 (PRRT2) gene mutation in Thai patients with paroxysmal kinesigenic dyskinesia (PKD). Material and Methods: A retrospective study of children aged 0-18 years with a diagnosis of PKD at Siriraj Hospital. The genetic analyses of the PRRT2 gene were done by bidirectional Sanger sequencing.Results: Twelve patients with PKD were included. The known PRRT2 mutation, c.649dupC (p.Arg217Profs*8), was identified in three of the patients (25.0%), one of the nine sporadic cases (11.1%) and two of the three familial cases (66.6%), all from different families. PKD had a complete response to carbamazepine treatment regardless of PRRT2 mutation status. Conclusion: Our study provided the new details of the clinical phenotypes and PRRT2 gene analysis findings for Thai PKD. PRRT2 mutations were identified in our Thai PKD patients with increased detection rates in the familial PKD cases. The c.649dupC (p.Arg217Profs*8) was also found to be a hot-spot mutation in our Thai PKD patients. Furthermore, this study demonstrates the importance of PRRT2 gene analysis in order to properly diagnose and treat these patients.


Author(s):  
Asamaporn Puetpaiboon ◽  
Thanyalak Amornpojnimman

Spinal myoclonus following neuraxial anesthesia isextremely rare. Herein, wereport onacase of spinal myoclonus after spinal anesthesia for elective colpocleisis with perineorrhaphy, in a 71-year-old woman. Sudden, brief, repetitive, and rhythmic hyperkinetic movement in both legs developed two hours after spinal injection with hyperbaric bupivacaine; which then spontaneously resolved after 45 minutes without leaving any neurologic deficit.


Author(s):  
Sarayuth Boonchai ◽  
Osaree Akaraborworn

Objective: To evaluate the characteristics of the Wells score and associated factors of acute pulmonary embolisms (PE) in surgical-based inpatients’ with acute deep venous thrombosis (DVT), at Songklanagarind Hospital.Material and Methods: Acute DVT inpatients in the departments of surgery, obstetrics-gynecology and orthopedics; from 2010 to 2016, were extracted from medical records, and retrospectively reviewed. The Wells score was calculated for risk stratification in terms of low, moderate, and high probability. Finally, the associated factors of acute PE were assessed.Results: There were 278 inpatients diagnosed with acute DVT in the surgery (n=142), obstetrics-gynecology (n=101, and orthopedics (n=35) wards. The numbers of low, moderate and high risk probability were 4 (1.0%), 141 (51.0%) and 133 (48.0%), respectively. We identified four factors that were significantly different between the three specialties comprising of: “paralysis, paresis, or recent plaster immobilization of the lower extremities”, “recently bedridden or underwent a major surgical procedure”, “leg edema” and “active cancer”. Regarding the surgery service, patients with acute PE experienced a higher rate of bilateral DVT than those who did not—28.0% and 8.0%, respectively.Conclusion: The low-risk probability determined by Wells score had low incidence of acute DVT in in-patient department settings. Acute bilateral DVT was more significantly associated with acute PE in the surgery service.


Author(s):  
Siva Prasad Palem

Objective: To evaluate the correlation of uric acid with oxidative stress and endothelial dysfunction in type 2 diabetic subjects.Material and Methods: The study included 120 subjects, among when 60 were type 2 diabetes subjects and the remaining 60 were age and gender matched healthy controls. The biochemical parameters, blood glucose, lipid profile, uric acid and homocysteine, were measured by standard kits in an autoanalyzer. Oxidative stress was evaluated by measuring malondialdehyde (MDA) and total antioxidant power by manual methods such as thio-barbituric acid reactive substances and ferric reducing ability of plasma (FRAP). Endothelial dysfunction was assessed by measuring nitric oxide (NO) by the kinetic cadmium method.Results: A significant elevation of triglycerides, low density lipoprotein (LDL), and MDA were observed in the type 2 diabetes mellitus patients while FRAP and NO were significantly reduced compared to the healthy controls. In addition, the uric acid levels had a highly significant correlation with FRAP (r=0.212, p-value=0.020), and moderately significant correlation with triglycerides (r=0.173, p-value=0.057) and homocysteine (r=0.178, p-value=0.051). Uric acid was negatively correlated with MDA and positively correlated with NO, but not statistically significant.Conclusion: Our findings suggest that uric acid may have antioxidant properties since it had a significant positive correlation with FRAP.


Sign in / Sign up

Export Citation Format

Share Document