Publisher: Prince of Songkla University (Total: 2 journals) [Sort by number of followers]
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Journal of Health Science and Medical Research
Number of Followers: 0 ![]() ISSN (Print) 2586-9981 - ISSN (Online) 2630-0559 Published by Prince of Songkla University ![]() |
- Risk Factors and Outcomes of Acute Kidney Injury after Type A Aortic
Dissection Surgery at A Tertiary Care Hospital
Authors: Thavat Chanchayanon, Jutarat Tanasansuttiporn, Garnphipak Heerungeeragon, Maliwan Oofuwong
Pages: 379 - 390
Abstract: Objective: This study aimed to determine the risk factors predisposing to postoperative acute kidney injury (AKI) after type A aortic dissection repair; regarding patient-related, surgery-related and anesthesia-related factors. Material and Methods: A retrospective cohort study was conducted in patients who underwent type A aortic dissection repair under cardiopulmonary bypass (CPB), during the periods from January 2008 and December 2019. Patient-related, surgery-related and anesthesia-related factors were evaluated for association with AKI. AKI was defined by the Kidney Disease: Improving Global Outcomes criteria. The outcomes and mortality of AKI were also investigated. Results: Included were 95 patients, and the incidence of AKI was 65.3%. The 30-day mortality resulted only in the AKI group (14.9%). From multivariate logistic regression analysis, receiving intraoperative cryoprecipitate (odd ratio; OR 14.18; 95% confidence interval (CI), 3.27-61.5) and PRC transfusion (OR 1.001; 95% CI, 1.0005-1.002) in ICU were the risk factors for AKI. The protective factors were: higher preoperative serum bicarbonate levels (OR 0.83; 95% CI, 0.70- 0.99), higher volume of urine output during CPB (OR 0.71; 95% CI, 0.55-0.91) and higher immediate postoperative mean arterial pressure (OR 0.95; 95% CI, 0.92-0.98). Thirty-day mortality was significantly higher in the AKI group (14.5% vs 0%; p-value=0.025), and 15.0% of patients required renal replacement therapy. Conclusion: The higher level of three factors including preoperative serum bicarbonate levels (>23 mmol/l), volume of urine output during CPB and immediate postoperative mean arterial pressure (>81 mmHg) are likely to be the protective factors of AKI.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021846
- Prevalence of Lewis Blood Group Polymorphisms in Southern Thai Blood
Donors
Authors: Natthaphon Nanakorn, Suwimon Boonthongkhao, Supattra Mitundee, Natda Tonwong
Pages: 391 - 400
Abstract: Objective: To determine the frequencies of five of the most common (59T>G, 202T>C, 314C>T, 508G>A and 1067T>G) single nucleotide polymorphisms (SNPs) of the FUT3 gene in Thai blood donors and examine their associations with the presence or absence of Lewis antigens on red blood cells. Material and Methods: A total of 364 donor specimens from Songklanagarind Hospital and Regional Blood Centre XII Songkhla, Thailand, were recruited for the study. Molecular analysis of each SNP was performed by polymerase chain reaction amplification with sequence-specific primers (PCR-SSP). The Lewis phenotype was investigated in 159 individuals using the standard hemagglutination test. Results: The frequencies of the SNPs were 32.0% (59T>G), 46.6% (202T>C), 21.7% (314C>T), 37.9% (508G>A), and 25.0% (1067T>A). The prevalences of the Lewis phenotype were 61.0% for Le(a-b+), 7.6% for Le(a+b-), 11.3% for Le(a+b+), and 20.1% for Le(a-b-). The Lewis-negative phenotype was significantly associated with homozygosity in 59T>G and 1067T>A (χ2=49.873, and χ2=44.520, respectively). Conclusion: Our findings suggest that le59,1067 is largely responsible for the Lewis-negative phenotype in our southern Thai population. Genetic variations in FUT3 polymorphisms may be used as molecular markers for ethnicity and to help understand the roles of the Lewis blood group in infections or clinical diseases.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021847
- Correlation of Uric Acid with Oxidative Stress and Endothelial Dysfunction
in Type 2 Diabetes Mellitus
Authors: Siva Prasad Palem, Ammasai Perumal
Pages: 401 - 409
Abstract: 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 them 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.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021850
- Characteristics of the Wells Score and Associated Factors of Pulmonary
Embolisms in Inpatients with Deep Venous Thrombosis
Authors: Sarayuth Boonchai, Osaree Akaraborworn
Pages: 411 - 418
Abstract: 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.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021851
- Comparison of CT Severity Index and Modified CT Severity Index in the
Clinical Severity Assessment of Acute Pancreatitis
Authors: Piyaporn Apisarnthanarak, Pattira Boonsri, Voraparee Suvannarerg, Walailak Chaiyasoot, Supot Pongprasobchai, Anucha Apisarnthanarak
Pages: 425 - 435
Abstract: 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.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021854
- The Correlation between the CT Liver Volume and the Actual Weight of the
Resected Cirrhotic Liver in Transplantation Patients
Authors: Kulyada Eurboonyanun, Chalerm Eurboonyanun, Julaluck Promsorn, Jiranthanin Phaorod, Tharatip Srisuk, Nittaya Chamadol, Mukesh Harisinghani
Pages: 437 - 447
Abstract: 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.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021855
- Effectiveness of Innovation Basic Life Support Training Devices to
Layperson: A Randomized Controlled Trial
Authors: Wiput Laosuksri, Boriboon Chenthanakij, Krongkarn Sutham, Wetchayan Rangsri, Radom Pongvuthitham, Chaiy Rungsiyakull, Thawan Sucharitakul, Navadon Khunlertgit, Borwon Wittayachamnankul
Pages: 449 - 458
Abstract: 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.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021856
- The Occurrence of Antibiotic Resistant Bacteria Contamination in
Sub-district Health-promoting Hospitals in Chiang Rai, Thailand
Authors: Korakot Chansareewittaya, Sirikarnnapa Krajangcharoensakul
Pages: 459 - 473
Abstract: 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.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021857
- Hemolytic Uremic Syndrome Caused by Mycoplasma Pneumoniae Infection in
Children: A Case Report and Literature Review
Authors: Sirinthip Kittivisuit, Prayong Vachvanichsanong, Thirachit Chotsampancharoen
Pages: 475 - 480
Abstract: We describe the case of a 6-year-old boy with a Mycoplasma pneumoniae (M. pneumoniae) respiratory tract infection associated with thrombotic microangiopathic hemolytic anemia and thrombocytopenia with renal failure which was diagnosed as atypical hemolytic uremic syndrome. Renal biopsy showed features of thrombotic microangiopathy. The patient was treated with azithromycin for the M. pneumoniae infection, and supportive care with red cell transfusion and renal dialysis in the acute period. The microangiopathic hemolytic anemia and thrombocytopenia resolved within 2 months after diagnosis but the renal function damage was irreversible. The patient developed end-stage renal disease and required long term renal replacement therapy.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021848
- A Safe Start Laparoscopic-assisted Pancreaticoduodenectomy in
Songklanagarind Hospital, Thailand: Case Report
Authors: Tortrakoon Thongkan, Nan-ak Wiboonkhwan, Thakerng Pitakteerabundit, Piyanun Wangkulangkul
Pages: 481 - 486
Abstract: Total laparoscopic pancreaticoduodenectomy (PD) is a highly complex procedure. Evidence suggests laparoscopic- assisted PD (LAPD) might be an important link in the process of transition from open PD to total laparoscopic PD. We present the first successful LAPD in a female patient with distal cholangiocarcinoma at Songklanagarind Hospital, Thailand in July 2018. The postoperative course was satisfactory without the clinical relevance of complications. No evidence of recurrence was found after 35 months of follow-up. The results ensured the feasibility and safety of LAPD in the initial phase; regarding both complications and oncological outcomes in a high-volume center for open PD.
PubDate: 2022-07-22
DOI: 10.31584/jhsmr.2021849
- Predictors of Health-Related Quality of Life among Thai People with
Coronary Heart Disease: A Preliminary Study
Authors: Kanthima Meesoonthorn, Kittikorn Nilmanat, Umaporn Boonyasopun, Cathy Campbell, Jeongok Logan
Pages: 367 - 378
Abstract: Objective: To examine the prediction of severity of illness, health promoting behaviors, cardiac self-efficacy, and acceptance of illness on health-related quality of life (HRQOL) among Thai people with coronary heart disease (CHD) in Thailand. Material and Methods: A cross-sectional design was used. A quota sampling was used to recruit 110 people with CHD, who met the inclusion criteria, from 20 selected hospitals across Thailand. Five self-reporting questionnaires were used: a demographic data questionnaire, Thai version of MacNew HRQOL, Thai version of Health-Promoting Lifestyle Profile- II, Thai version of Cardiac Self-Efficacy Scale Questionnaire, and the Thai version of Acceptance of Illness Scale. Data were analyzed using descriptive statistics, a point-biserial correlation or a bivariate Pearson’s correlation and multiple stepwise regression analyses. Results: One hundred and ten people were included. Most of the participants were men (64.5%) with an average age of 62.07 9.98 years. Most of them (76.4%) were best categorized as class I under the Canadian Cardiovascular Society (CCS) classification system. The findings showed that 46 percent of the variance (adjusted R2=0.46) for HRQOL was explained by being CCS class I (β=0.22, p-value<0.010), cardiac self-efficacy (β=0.41, p-value<0.010) and acceptance of illness (β=0.35, p-value<0.010). Health promoting behavior was a non-significant predictor of HRQOL (β=0.10, p-value=0.260). Conclusion: The results support the severity of illness, cardiac self-efficacy, and acceptance of illness in explaining HRQOL among people with CHD. Therefore, nursing interventions that are suitable for the severity of the disease, and aimed at boosting cardiac self-efficacy and acceptance of illness should be considered to enhance HRQOL.
PubDate: 2021-10-21
DOI: 10.31584/jhsmr.2021845
- PRRT2 Gene Analysis of Paroxysmal Kinesigenic Dyskinesia (PKD) in Thai
Children
Authors: Pantaree Laosuebsakulthai, Surachai Likasitwattanakul, Theerapong Pho-iam, Wanna Thongnoppakhun, Mongkol Chanvanichtrakool
Pages: 419 - 424
Abstract: 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.
PubDate: 2021-11-24
DOI: 10.31584/jhsmr.2021853