Publisher: Mahidol University (Total: 2 journals)   [Sort alphabetically]

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Integrated Social Science J. : Faculty of Social Sciences and Humanities, Mahidol University     Open Access  
Siriraj Medical J.     Open Access  
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Siriraj Medical Journal
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2629-995X - ISSN (Online) 2228-8082
Published by Mahidol University Homepage  [2 journals]
  • Hidden Neuropathic Pain in Chronic Low Back Pain: Prevalence, Pattern, and
           Impact on Quality of Life

    • Authors: Panya Luksanapruksa, Nantthasorn Zinboonyahgoon, Monchai Ruangchainikom, Ekkapoj Korwutthikulrangsri, Borriwat Santipas, Nhathita Panatreswas, Sirichai Wilartratsami
      Pages: 480 - 486
      Abstract: Objective: A patient with Neuropathic Pain (NP) may suffer from pure NP or may have mixed nociceptive and neuropathic pain. No previous study has investigated NP among Thai patients with Chronic Low Back Pain (CLBP). This study aimed to investigate the prevalence and clinical presentation of NP, and the impact of NP on Quality of Life (QoL) in Thai Chronic Low Back Pain (CLBP) patients.Materials and Methods: Adult patients with CLBP longer than 3 months were included. NP was detected by painDETECT questionnaire, and NP was defined as a score 19. Demographic data, pain characteristics, treatment, Oswestry Disability Index (ODI), and quality of life score (Short Form 36, SF-36) were recorded.Results: 371 CLBP patients were enrolled. The overall prevalence of neuropathic pain was 50.1% (95% CI: 44.9-55.3%). The prevalence of NP in patients with axial low back pain, back pain with pain radiating above the knee, and back pain with pain radiating below the knee was 28.3%, 58.21%, and 59.5%, respectively. Only 48.9% of patients with NP received neuropathic pain medication. Multivariate analysis showed only older age to be associated with NP (OR: 1.017, 95% CI: 1.002-1.033). NP patients had a significantly higher ODI score. There is no difference in most dimension of SF-36 scores, except marginally higher general health and vitality dimension scores. Conclusion: Prevalence of NP in Thai CLBP patients is high. Additionally, it is undertreated and associated with higher disability especially among patients with radiating pain above the knee. Older age is an independent predictor of NP.
      PubDate: 2022-08-01
      Issue No: Vol. 74, No. 8 (2022)
       
  • Multimodality-guided Transbronchial Lung Biopsy in Peripheral Pulmonary
           Nodules: A Comparison Between using an Electromagnetic Navigation
           Bronchoscopy and a Thin Bronchoscope

    • Authors: Supparerk Disayabutr, Anuttra Ratnarathon, Jamsak Tscheikuna
      Pages: 487 - 494
      Abstract: Objective: To compare the diagnostic yield of using a thin bronchoscope (TB) and ENB in the diagnosis of small PPNs combined with routine R-EBUS and fluoroscopy.Materials and Methods: Patients with a PPN less than or equal to 30 mm were randomly assigned into 2 groups: 4 mm thin bronchoscope (TB group) and 5.9 mm conventional bronchoscope with an ENB (the superDimensionÒ) system (ENB group).Results: In total, 49 patients were enrolled and randomized into two groups: TB group (n = 24) and ENB group (n = 25). The mean size of the PPNs was 22 mm. There was no difference in nodule size, location of the nodules, the presence of computed tomography (CT) bronchus sign, and EBUS location between the groups. The diagnostic yields were 73.9% and 66.7% in the TB group and ENB group, respectively. There was no statistically significant difference in the diagnostic yield between the two groups. Multivariate analysis showed that the diagnostic yield was significantly higher when there was also a CT bronchus sign (odds ratio 48.82, p = 0.031) and when the bronchoscope could reach a greater airway depth (odds ratio 6.21, p = 0.023). The overall complication was 2%, which was pneumothorax in one patient in the TB group.Conclusion: Multimodality-guided techniques can improve the diagnostic yield in the diagnosis of PPNs. The PPNs larger than 2 cm with the presence of CT bronchus sign, the ENB provides a similar diagnostic yield compared to the thin bronchoscope. Further analysis and adequately powered prospective studies are required to confirm the advantages of ENB.
      PubDate: 2022-08-01
      Issue No: Vol. 74, No. 8 (2022)
       
  • Outcomes of an Early Laparoscopic Cholecystectomy in Acute Cholecystitis,
           Grades I and II

    • Authors: Napakadol Noppakunsomboon, Jirawat Swangsri, Yongyut Sirivatanauksorn, Napaporn Kongkaewpaisan
      Pages: 495 - 501
      Abstract: Objective: According to the accumulated benefits of laparoscopic cholecystectomy (LC) in acute cholecystitis (AC), early LC is becoming a standard management for selected patients. While patients with mild AC usually gain the advantages of this approach, removing a more inflamed gallbladder in patients with moderate AC has various results, depending on the institute where the procedure is performed. The aim of the study was to compare the outcomes between early LC in patients with grade I and II AC.Materials and Methods: From June, 2015 to December, 2019, electronic medical records in the division of Acute Care Surgery at Siriraj Hospital in Bangkok were reviewed retrospectively. An early LC was performed consecutively in 105 cases of AC grades I and II. The overall results and the outcomes comparing grades I and II AC were evaluated.Results: Forty-two patients were grade I (40%). Patients with grade I AC tended to be younger (56 +/- 17 years vs. 63 +/-15 years, p = 0.03). Among grade II patients, the late onset of more than 72 hours was the most common measure (62%). The estimated blood loss was significantly lower in grade I [30 (5-450) ml. vs. 100 (5-3,000) ml., p =0.018]. The overall conversion rate was 21%, which was significantly higher in grade II AC (28.6% vs. 9.5%, p = 0.026). There were no differences in operating time (125 +/- 47 minutes vs. 117 +/- 44 minutes. p = 0.365), total lengths of stay [4 (2-7) days vs. 5 (3-28) days, p = 0.163], and post-operative complications (19% vs 25%, p = 0.448). The minor bile duct injuries occurred in four patients (3.8%), 2 cases in each group. From the multivariate analysis, grade II AC did not statistically impact the conversion (adjusted OR 2.99, 95% CI 0.5-17.6, p = 0.225).Conclusion: Our study shows that the overall and evolving outcomes of early LC for grade I and II AC were safe and feasible. While a higher conversion rate and estimated blood loss attributed to grade II AC, a pre-operative severity grading can guide surgeons to accommodate their ability so as to maximize the benefits of early LC.
      PubDate: 2022-08-01
      Issue No: Vol. 74, No. 8 (2022)
       
  • Longus Colli and Vertebral Artery Guide Safety of Cervical Spine Surgery

    • Authors: Adisak Kasemassawachanont, Sanan Cheewadhanarak, Woratee Dacharux, Eve Mon Oo, Chairat Turbpaiboon, Somyot Wunnasinthop, Supin Chompoopong
      Pages: 502 - 508
      Abstract: Objective: To improve the safety of the anterior cervical vertebral surgical approach, MRI and CT have been used and the distances between the medial borders of the longus colli (LC) to expose the uncinated process (UP) have been reported. The anatomic parameters of the LC and vertebral artery (VA) were considered here in relation to the UP to minimize complications.Materials and Methods: Data were obtained from 60 Thai adult skeletons and 20 embalmed cadavers. Direct measurements of the dry cervical vertebrae were performed using digital Vernier calipers, while computer imaging analysis was used for the cadaveric measurements after capturing the images.Results: No significant difference was noted in the inter-UP distance between the dry and cadaveric cervical measurements. The average UP width was 6.7 ± 0.2 mm. The average distance from the tip of the UP to the VA was 2.6 ± 0.1 mm. The calculated distance from the LC to the UP which derived from the inter-UP distance and the distance between the LC increased from C2 to C7 with an average distance of 11.9 ± 0.3 mm.Conclusion: Within a distance of 11.9 ± 0.3 mm from the medial border of the LC, UP can be identified. Dissecting at a distance less than 10 mm posterior, 5–6 mm lateral and superior to the base of the UP can avoid VA injury and optimize the safety of the anterior cervical vertebral surgical approach. 
      PubDate: 2022-08-01
      Issue No: Vol. 74, No. 8 (2022)
       
  • Behavioral Problems in Grade One Students with Reading Difficulties in
           Thailand: A Cross-Sectional Study

    • Authors: Issarapa Chunsuwan, Patcharapun Sarisuta, Tippawan Hansakunachai, Paskorn Sritipsukho
      Pages: 509 - 517
      Abstract: Objective: Children with reading difficulties face a number of challenges when entering school. Numerous studies have revealed greater behavioral and emotional problems in children with reading disorders. There is limited data on the challenges faced by young struggling readers in Thailand. This study aimed to investigate behavioral and emotional problems in grade one students, comparing between children with and those without reading problems.
      Materials and Methods: A cross-sectional study was conducted of 901 grade onechildren in Thailand. The parental version of the Strengths and Difficulties Questionnaire (SDQ) was completed by parents along with a questionnaire of demographic data. Homeroom teachers completed the SDQ, teacher version. Reading assessments were performed to determine which students had reading difficulty.
      Results:Based on reading test scores, 131 students were considered to have reading difficulty. Students with reading difficulty were found to have significantly more behavioral and emotional problems in almost all aspects of the SDQ than children who were typical readers since they had just attended the formal education system. Overall, teachers reported five times as many problems in struggling readers, while parents reported twice as many.
      Conclusion: Thai grade one students with reading difficulty appear to have significantly more emotional and behavioral problems than typical readers.
      PubDate: 2022-08-01
      Issue No: Vol. 74, No. 8 (2022)
       
  • Effectiveness of the Four-Frequency Protocol of Repetitive Peripheral
           Magnetic Stimulation (rPMS) for Chronic Pain

    • Authors: Virachat Sanansilp, Pramote Euasobhon, Quyen V. Than, Pranee Rushatamukayanunt, Sukunya Jirachaipitak, Sarasate Eiamtanasate
      Pages: 518 - 529
      Abstract: Objective: Repetitive peripheral magnetic stimulation (rPMS) is a noninvasive method of delivering a magnetic field to the periphery other than the brain. The treatment has shown positive outcomes for chronic pain and provides many advantages. This study investigated the effectiveness of the four-frequency protocol of rPMS in patients with chronic pain.
      Materials and Methods: A retrospective review was conducted of patients with chronic pain treated with the four-frequency protocol. Data on patient demographics, pain characteristics, quality of life, and satisfaction were collected and analyzed.
      Results: Forty-eight patients (174 sessions) were eligible for analysis. Most patients (81%) were diagnosed with chronic neuropathic pain. Upon completing the 4-week course of treatment, the mean ± SD of percentage of pain reduction was 49.7% ± 34.8%. The pain score also significantly decreased from baseline (mean difference, 3.3; 95% CI, 2.5–4.1; P < 0.001). Responses to treatment were observed for most patients (79.2%) and most treatment sessions (87.4%). For immediate effectiveness, the mean ± SD of percentage of pain reduction at the end of each treatment session was 46.2% ± 27.6%. Improvements in mood, function, and sleep were reported by 75.8%, 77.3%, and 79.5% of patients, respectively. Furthermore, most patients (72.5%) expressed satisfaction with the treatment.
      Conclusion: The four-frequency protocol of rPMS for patients with chronic pain significantly reduced their pain scores for immediate effect and after the 4-week treatment course. A positive treatment response, an improved quality of life, and satisfaction with the therapy were found for nearly 80% of the patients.
      PubDate: 2022-08-01
      Issue No: Vol. 74, No. 8 (2022)
       
  • Chronic Myeloid Leukemia (CML) at National Referral Hospital in Indonesia

    • Authors: Wulyo Rajabto, Ary Harryanto Reksodiputro, Ikhwan Rinaldi, Hilman Tadjoedin, Dimas Priantono, Yohana Kusuma Angkasa
      Pages: 530 - 536
      Abstract: Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome and BCR-ABL fusion oncogene. CML is one of the illnesses that may be treated using Tyrosine Kinase Inhibitors (TKIs), a type of targeted therapy. Since TKIs are the standard of therapy, long-term survival of CML has improved compared to chemotherapy and interferon-alpha. For the first-line treatment for CML, there are four commercially available TKIs that serve as an integral part of the disease management. However, there are many challenges in diagnosing, treating, and monitoring patients with chronic phase CML in Indonesia. This study highlights the epidemiology data of chronic phase CML patients, particularly at Dr. Cipto Mangunkusumo General Hospital, an Indonesian national referral hospital, and how to diagnose, select first-line TKIs, and monitor the response of treatment after TKIs administration.
      PubDate: 2022-08-01
      Issue No: Vol. 74, No. 8 (2022)
       
 
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