Digital Commons Network^™

High Carotenoid Values In People With Flexibility Training, Chanachai Lohasaptawee Mr., Ponlapat Rojnuckarin Professor Dr., Natthaya Lekhawatthanapong Miss

Chulalongkorn Medical Journal

Background: Free radicals play essential roles in the aging and various pathological processes. Antioxidants may be helpful to prevent these conditions. Therefore, the body should have high antioxidant values and carotenoids can be a representative of antioxidants.

Objectives: The purpose of the study was to use the BioPhotonic Scanner S3 and resonant Raman spectroscopy technology for comparing the skin carotenoid values between those who exercised frequently and those who did not exercised within a 6-month period.

Methods: Four equal groups of six hundred male and female volunteers, ages 20 to 60 years, who resided in Bangkok Metropolitan Region were formed, …

Determination Of Initial Hepatitis B Surface Antigen (Hbsag) Cutoff Index (Coi) Threshold For Reporting Hbsag Reactivity, Piya Wongchampa, Arkom Chaiwongkot, Rangsima Reantragoon

Chulalongkorn Medical Journal

Background: The Hepatitis B surface antigen (HBsAg) commercially-available screening test suggests a confirmatory testing in all cases that are reactive, but this will take a long time to reporting of results and increase the total test cost.

Objectives: To investigate the correlation between cutoff index (COI) values of initial HBsAg screening test and their corresponding confirmatory neutralization results in order to identify a COI value for distinguishing samples that truly need confirmatory neutralization testing.

Methods: A retrospective study of 72,496 HBsAg screening test results using the Elecsys HBsAg II kit of patients at King Chulalongkorn Memorial Hospital, the Thai Red …

Organizational Executions And Policies On Workplace Health Promotion: A Cross-Sectional Study In Thailand, Taechit Taechamanodom, Pornchai Sithisarankul, Jate Ratanachina

Chulalongkorn Medical Journal

Background: The workplace, as an environment, exerts a profound impact on the health and well-being of the workforce, thereby assuming a pivotal role in both economic prosperity and societal advancement. Within organizational contexts, the human resources (HR) department assumes a pivotal role in the holistic care and administration of the workforce, encompassing multifaceted dimensions of health and well-being.

Objectives: This study aimed to investigate the executions and potential of workplace health promotion policies in workplaces in Thailand.

Methods: A cross-sectional study was undertaken among the human resources (HR) executives and personnel across listed 814 enterprises located in Rayong province and …

Perceptions Of Emergency Physician Professionalism Among Healthcare Providers And Patients: A Multicenter Study In Thailand And The Us, Khuansiri Narajeenron Md, Mhpe, Tanawat Tarapan Md, Jasmina Dukovic, Krongkarn Sutham Md, Intanon Imsuwan Md, Ar-Aishah Dadeh Md, Tanyaporn Nakornchai Md, Deena Bengiamin Md, Bharath Chakravarthy Md, Mph, Craig Anderson Phd, Mph, Somchit Eiam-Ong Phd, Wirachin Hoonpongsimanont Md, Ms

Chulalongkorn Medical Journal

Background: Universal standards for emergency physician professionalism (EPP) amongst different groups of healthcare workers do not exist.

Objective: The aim of this study was to explore perceptions of EPP among attending physicians (APs), emergency medicine (EM) residents, first- and fourth-year medical students (MS1s and MS4s, respectively), EM nurses and emergency department (ED) patients.

Methods: A multicenter, cross-sectional study conducted at seven university-based EDs in Thailand and the US from July 2016 - January 2018. We created 39 cards (13 core elements) describing behaviors derived from a global literature review. Subjects ranked each card from the most to least important for …

Comparison Study Of Endoscopic-Guided Versus Electromyography-Guided Botulinum Toxin Injection Treatments In Adductor Spasmodic Dysphonia, Manintorn Praditthum, Premsuda Sombuntham

Chulalongkorn Medical Journal

Background: Electromyography (EMG)-guided botulinum injection is recommended in clinical practice guideline for spasmodic dysphonia. However, other alternative techniques have been practiced in absence of EMG machine. Comparison of techniques is limited in the literatures.

Objective: This pilot study aims to compare the effectiveness of treatment between the EMG-guided technique and the endoscopic-guided technique in adductor spasmodic dysphonia.

Method: Five patients who were diagnosed with Adductor spasmodic dysphonia (AdSD) were enrolled and then randomized into 2 groups. Patient data (before and after treatment) were collected. The outcome measurement included voice analysis, voice handicap index (VHI), duration aspiration, duration of breathiness, mean …

Does Asymptomatic Generalized Joint Hypermobility Influence Musculotendinous Extensibility And Knee Joint Proprioception?, Pawan Chaiparinya, Sujitra Boonyong, Chitanongk Gaogasigam

Chulalongkorn Medical Journal

Background: It is unclear whether generalized joint hypermobility (GJH) influences the musculotendinous unit (MTU) extensibility or proprioception of the knee joint in individuals with asymptomatic GJH.

Objectives: To compare the quadriceps and hamstring MTU length as well as knee joint force sense (FS) and joint position sense (JPS) between individuals with asymptomatic GJH and non-GJH controls.

Methods: Thirty-two female subjects were recruited, with 16 subjects in the GJH and non-GJH groups. The angles measured from modified prone knee bend (mPKB) and straight leg raising (SLR) tests were used to identify the quadriceps and hamstrings MTU extensibility using photographic-based angle measurements. …

Pediatric Appendicitis Or Not? A Retrospective Cohort Study From A Single Institution - Our Management And Factors Determining The Disease, Nimmita Srisan, Teerasak Phewplung, Katawaetee Decharun, Prapapan Rajatapiti, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Purpose: The aims were to assess our treatment guidelines and to determine factors in differentiating children with acute appendicitis from other diseases.

Methods: Pediatric surgery consultations for suspected appendicitis from October 2019 to October 2021 was retrospectively studied. The treatment guidelines of children with suspected appendicitis were elucidated. Moreover, factors identifying the diagnosis of appendicitis were analyzed using multi-variate logistic regression.

Results: Ninety-one children were consulted for suspected appendicitis. Forty-one children (45.1%) were promptly successfully treated without observation or ultrasonography, except one negative appendectomy (2.4%). The other 50 children (54.9%), showed equivocal clinical symptoms and signs, requiring further management either …

Exonic Variants Of Gpihbp1 Gene In Thai Subjects With Severe Hypertriglyceridemia, Wanee Plengpanich

Chulalongkorn Medical Journal

Background: Hypertriglyceridemia (HTG) is one of the risk factors for cardiovascular disease and acute pancreatitis. It is associated with genetic variations in various genes involved in triglyceride metabolism. Glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1 (GPIHBP1) encodes a membrane protein involved in an intravascular triglyceride hydrolysis. Objective: The purpose of this study was to examine the genetic variants in the exons of GPIHBP1 gene in Thai subjects with severe HTG. Methods: All 4 exons of the GPIHBP1 gene were sequenced in 101 Thai subjects with severe HTG. All subjects had triglyceride levels e” 10 mmol/L or 886 mg/dL. Subjects with normolipidemia (n …

Association Of Pnpla3, Tm6sf2 And Hsd17b13 Variants With Nafld Risk In Hiv And Non-Hiv Individuals, Varis Ruamviboonsuk

Chulalongkorn Medical Journal

Background: Non-alcoholic fatty liver disease (NAFLD) has multiple risk factors, including genetic risk factors. Patients with certain genetic variants are more susceptible to the disease. People living with human immunodeficiency virus (PLWH) have higher prevalence of NAFLD compared to those without human immunodeficiency virus (HIV) infection. However, the evidence on genetic factors in PLWH with NAFLD is limited. Objectives: This study aimed to investigate whether carriers of PNPLA3 rs738409, TM6SF2 rs58542926, and HSD17B13 rs6834314 had association with the risk of NAFLD, and whether PLWH with NAFLD also had similar genetic risk factors as those with NAFLD alone. Methods: These single …

Attitudes Toward End-Of-Life Care And Advance Directives: A Prospective Survey In A Family Medicine Clinic, Bangkok, Thailand, Basmon Manomaipiboon

Chulalongkorn Medical Journal

Background: Advance directives (ADs) have long been legalized and advocated, still few patients complete ADs in Thailand. In our setting, advance directive information will be provided to interested patients and palliative care patients. Objectives: This study examined the attitude toward end-of-life care and ADs, the prevalence of ADs completion and identified the factors associated with advance care planning among patients who attended a family medicine clinic, Faculty of Medicine, Vajira Hospital, Navamindhradhiraj university, Bangkok, Thailand. Methods: A total of 300 subjects completed a self-administered structured questionnaire, including sociodemographic factors, individuals’ health status, healthcare experiences, and other factors influencing advance care …

Factors Related To Positive Airway Pressure Adherence In Patients With Obstructive Sleep Apnea At King Chulalongkorn Memorial Hospital, Puntarik Srisawart

Chulalongkorn Medical Journal

Background: Positive airway pressure (PAPs) is a standard and efficacious treatment for obstructive sleep apnea (OSA). Poor adherence could lead to impaired daytime performance, increasing risk of traffic accidents, hypertension, cardiovascular events, and neuropsychological disturbances. Previous studies reported rates and factors influencing PAPs adherence, but the data in Thailand was still lacking.

Objectives: To investigate the rate of PAPs adherence, the prevalence of depressive and anxiety symptoms, and the factors associated with PAPs adherence among patients with OSA.

Methods: This is a cross-sectional descriptive study that was conducted during June 2021 to September 2022. The data was collected from patients …

The Association Between Medication Use And Peri-Operative Delirium In Older Hip Fracture Adult Patients At King Chulalongkorn Memorial Hospital, Krittin Wannarong, Yanin Thipakorn, Jirada Prasartpornsirichoke, Warong Sitthisarunkul, Chumpol Suraphanphairoj, Paul Thisayakorn

Chulalongkorn Medical Journal

Background: Delirium is a common adverse consequence in the hip fracture population. Many medications can affect the emergence of the perioperative delirium but the data in older hip fracture patients is lacking.

Objective: To investigate the association between the type and amount of the selected medication classes and the occurrence of perioperative delirium in older hip fracture patients.

Methods: This is a cross-sectional study which collected data from patients aged ≥ 65 years who underwent hip surgery at King Chulalongkorn Memorial Hospital. The Delirium Rating Scale–Revised-98-Thai version (DRS-R-98-T) was used to assess the delirium one day before the surgery, and …

The Stability Of Diazepam In Authentic Blood Samples From Thai Postmortem Cases, Peerayuht Phuangphung

Chulalongkorn Medical Journal

Background: Diazepam is a common drug detected in Thai postmortem cases. The stability of diazepam in blood was previously studied using spiked blood samples. However, there is no available data for stability in authentic postmortem blood samples.

Objectives: This study aims to determine the stability of diazepam in authentic postmortem blood samples.

Methods: Postmortem blood samples were obtained from the cadavers of Thai people who were sent for medico-legal autopsies at the Department of Forensic Medicine, Siriraj Hospital, Mahidol University. Blood samples were analyzed for diazepam and nordiazepam within one week after sample reception (initial concentrations: day_0). …

Resilience And Related Factors Among Volunteers Of Thai Red Cross Society At King Chulalongkorn Memorial Hospital, Kanyaphak Nakalekha

Chulalongkorn Medical Journal

Background: Volunteers of the Thai Red Cross Society have contributed valuable helps to the Thai Red Cross Society and King Chulalongkorn Memorial Hospital. However, there was still a lack of studies on mental health aspects in this group, especially positive psychological resources, i.e., resilience.

Objectives: To examine the levels of resilience quotient (RQ) and associated factors among volunteers of the Thai Red Cross Society at King Chulalongkorn Memorial Hospital.

Methods: We recruited 287 subjects who were currently working as volunteers of the Thai Red Cross Society during 2021 - 2022. The subjects were asked to complete five questionnaires including personal …

The Symptoms And Management Of Children With Attention-Deficit/Hyperactivity Disorder During Covid-19 Pandemic At The Child And Adolescent Psychiatry Clinic, King Chulalongkorn Memorial Hospital, Nuttorn Pityaratstian

Chulalongkorn Medical Journal

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused abrupt changes in almost everybody’s life, particularly children. Children and adolescents with attention-deficit hyperactivity disorder (ADHD) have difficulties in many aspects in lives and may have worsening of the symptoms during the pandemic.

Objectives: This cross-sectional descriptive study aimed to investigate the changes of the ADHD symptoms and managements of children with ADHD during the first lockdown and after-lockdown period.

Methods: Parent-reported questionnaires i.e. the Swanson, Nolan, and Pelham Rating Scale-IV (SNAP-IV) and a demographic questionnaire, were applied to collect data from 109 children with ADHD aged between 4 -18 years …

Role Commitment And Coping Strategies In Female Patients With Depressive Disorders At King Chulalongkorn Memorial Hospital, Peeraphon Lueboonthavatchai

Chulalongkorn Medical Journal

Background: Role commitment, coping strategies, and social support were factors associated with depression in female depressed patients. However, studies concerning these factors in Thai female depressed patients were still limited.

Objective: To determine the severity and associated factors of depression in female patients with depressive disorders. The associated factors included role commitment, coping strategies, and social support.

Methods: One hundred and fifty two patients aged 18 years and above diagnosed as major depressive disorder or persistent depressive disorder or double depression using DSM-5 criteria were recruited. All subjects completed five questionnaires, namely: 1) Demographic Questionnaire; 2) Beck Depression Inventory-II (BDIII) …

Accuracy Of Acr-Tirads In Assessment And Diagnosis Of Thyroid Nodules In Patients Underwent Thyroid Surgery In Taksin Hospital, Worawan Chainamnan

Chulalongkorn Medical Journal

Abstract:

Background:

Ultrasound is generally considered to evaluate thyroid nodule sonographic morphology. The ultrasound-based risk stratification systems have been used to assess the probability of cancer in thyroid nodules.

Objective:

To determine the efficacy of ultrasound-based American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in estimating the risk of malignancy in thyroid nodules.

Methods:

A descriptive retrospective cross-sectional study was conducted in Taksin Hospital. In total, 324 patients with thyroid nodules underwent sonography and surgery, which pathological diagnosis were available, from January 2008 to April 2022. The ACR-TIRADS and ultrasound features were used to determine the risk …

Congruence And Self-Esteem Of Patients Receiving Treatment For Methamphetamine Use At A Substance Dependency Treatment Center In Thailand, Rasmon Kalayasiri

Chulalongkorn Medical Journal

Background: Congruence, a state of being able to communicate within oneself and with others, is classified as one of the main structures of the Satir’s model for psychotherapy. High self-esteem and congruence are important indicators of fully functioning human beings, especially of patients who used drugs such as methamphetamine (meth).

Objectives: The study’s purposes were to explore the congruence, self-esteem, and related factors among individuals who used meth and received treatment at a substance dependency treatment center in Thailand.

Methods: Levels of congruence, self-esteem, and family relationship were collected from 340 patients with meth use problems at the largest substance …

Predicting Factors Of Dietary Behaviors Among Patients With Chronic Obstructive Pulmonary Disease, Ratchanee Prarach, Noraluk Ua-Kit

Chulalongkorn Medical Journal

Background: Inappropriate dietary habits in chronic obstructive pulmonary disease (COPD) patients accelerate the symptoms of the disease. Modifying dietary habits to be appropriate reduce the risk factors, and thereby decrease the chance of relapse. Objective: To study the factors that influence dietary behaviors among patients with COPD.

Methods: The sample comprised a total of 132 patients, both male and female with COPD, who were out-patients at the Respiratory Clinic and OPD Medicine, Rajavithi Hospital and King Chulalongkorn Memorial Hospital. Descriptive and stepwise multiple regression were used for the statistical analysis.

Results: The factors that can predict dietary behaviors with the …

Prevalence Of Small T Trauma In Depressed Adolescent And Early Adulthood Patient In King Chulalongkorn Memorial Hospital, Krittapast Thongrakyoo, Puchong Laurujisawat, Parichawan Chandarasiri

Chulalongkorn Medical Journal

Background: Trauma and depression are known to be related, especially in adolescents and early adulthood patients in which depression usually starts, then deteriorates, and causes decreased function and worse quality of life.

Objective: To study prevalence of small t trauma level in depressed adolescents and early adulthood patients and to study whether small t trauma level and severity of depression are related.

Methods: This cross-sectional descriptive study recruited depressive patients aged 15 – 25 years to complete a questionnaire consisted of 3 parts: demographic data and Big T trauma, BDI-IA scale Thai version, and the Small t trauma Level of …

Factors Affecting Long-Term Psychosocial Outcomes After Hypospadias Repair, Saralee Matanaromyakit

Chulalongkorn Medical Journal

Background: Congenital hypospadias is one of the most common genital malformations. Despite current progress in surgical techniques, long-term psychosocial outcomes received little attention.

Objective: To evaluate long-term psychosocial outcomes after hypospadias repair and analyze the root causes regarding satisfactory outcomes.

Patients and methods: Patients who underwent hypospadias repair during childhood period were recruited. Regarding psychosocial outcomes, the patients were invited for evaluation by the questionnaires in Thai version form. Data was analyzed by STATA program. Univariate analysis and multiple linear regression were used for statistical analysis.

Results: There were 38 hypospadias patients, median age =14 years (range 11-27) participating in …

Effects Of Fine Particulate Matter On Hospital Admission Due To Stroke In A Business City Of Thailand, Piyanee Kasiravat

Chulalongkorn Medical Journal

Background: About 99.0% of global population was living in the area where air pollutant levels exceed World Health Organization Standard. Particulate matter whose diameter is equal to or less than 2.5 microns (PM2.5), is an important risk factor for chronic diseases including chronic respiratory diseases, heart diseases and lung cancer. However, the association between PM2.5 and cerebrovascular event is still controversial, especially in Asian populations.

Objective: To assess the association between PM2.5 and hospital admissions due to stroke.

Methods: A retrospective study was conducted using air monitoring and health data during 2017 - 2019 in Hatyai, a business city in …

Depression, Smartphone Addiction And Association Factors Among Preclinical Medical Students, Aticha Wattanaudomchai

Chulalongkorn Medical Journal

Background: There were few studies of smartphone addiction behavior has been found in preclinical medical students.

Objective: To determine the prevalence and associated factors of depression of smartphone addiction behavior among preclinical medical students of Chulalongkorn University.

Methods: This is a cross-sectional descriptive study. The data were collected from preclinical medical students at Chulalongkorn University in 2020 academic year, prior to COVID-19 pandemic in Thailand. The instruments included the Smartphone Addiction Scale Thai version (SAS-SV-TH), Patient Health Questionnaire-9 Thai version (PHQ-9-T), Pittsburgh Sleep Quality Index Thai version (PSQI-T), and Thai Interpersonal questionnaire. The data were analyzed using SPSS version 25. …

Clinical Outcomes Of Spinal Schwannoma Microsurgery, Nattawut Niljianskul

Chulalongkorn Medical Journal

Background: Gross total resection of solitary spinal schwannomas (SS) and preservation of neurological functions are the gold standard of treatment for symptomatic patients; however, some patients present with postoperative neurological deficit.

Objective: This study is aimed to evaluate the neurological outcomes of SS microsurgery and identify the risk factors of postoperative neurological deficit among patients at the Vajira Hospital.

Methods: The following preoperative and postoperative neurological outcome measurements were reviewed at 1, 6, and 12 months according to the following procedure: Frankel Grading, McCormick Score, American Spinal Injury Association Grading, Karnofsky Performance Status Scale, and Japanese Orthopedic Association Score. The …

Social Functioning And Associated Social Skills In Patients With Depressive Disorder In Psychiatric Outpatients, King Chulalongkorn Memorial Hospital, Peeraphon Lueboonthavatchai

Chulalongkorn Medical Journal

Background: Previous study have shown that 68.0% of patients with depressive disorder had social functioning impairment. The impaired social skills of these patients also affected the patients’ daily lives. However, there were limited studies concerning on social functioning, social skills and associated factors of patients with depressive disorder.

Objectives: This study aimed to investigate social functioning, social skills, and associated factors of patients with depressive disorder.

Methods: We recruited 150 patients from June to December 2019, aged above 18 years old, assessed: 1) Demographic data form; 2) Beck Depression Inventory-II (BDI-II) - Thai Version; 3) Social Skills Inventory; 4) Interpersonal …

Predictive Factors Of Success In The First Radioactive Iodine Treatment For Graves’ Disease, Pinyaporn On-Ekkasit

Chulalongkorn Medical Journal

Background: Initial treatment options for Graves’ disease are radioactive iodine (RAI) treatment, antithyroid drugs (ATDs), and surgery. RAI is effective and the definitive treatment for Graves’ disease.

Objective: To evaluate factors associated with success in the first RAI treatment for Graves’ disease.

Methods: A total of 89 patients who received the first RAI treatment for Graves’ disease between September 2016 and January 2021 were retrospectively reviewed. Thyroid function outcome was evaluated within one year after RAI treatment. Logistic regression analysis was performed to identify factors associated with success after RAI treatment.

Results: The success rate of the first RAI treatment …

Work Ability Among Older Workers In An Agricultural Community In Nan Province, Thailand: A Cross-Sectional Study, Jate Ratanachina, Wilawan Mormoon

Chulalongkorn Medical Journal

Background: There is a global challenge regarding demographic change together with theaging population. Research on work ability among older workers in an agricultural area remains crucial, particularly in Thailand, an aged society country with thirty percent of its working population in the agricultural sector.

Objective: To estimate work ability among older workers in an agricultural community and to determine the relationship between work ability and its associations.

Methods: A cross-sectional study of adults aged 40 to 65 was conducted in an agricultural community in Nan province, Thailand, between May and August 2019. The study participants consisted of 345 villagers …

Accuracy Of Ultrasonography In Diagnosis Of Acute Appendicitis At King Chulalongkorn Memorial Hospital, Thitinan Chulroek

Chulalongkorn Medical Journal

Background: Acute appendicitis is one of the most common emergency abdominal surgical condition with a yearly incidence rate of approximately 140 per 100,000 persons in Thailand between 2014 to 2017. The diagnosis of appendicitis is mainly relied on clinical manifestations, but these diagnostic approaches are not always accurate. Imaging tests such as graded compression ultrasonography (US) and computed tomography (CT) have become more commonly used to improve the diagnostic performance.

Objective: To evaluate the sensitivity, specificity and predictive values of US in the diagnosis of acute appendicitis at King Chulalongkorn Memorial Hospital (KCMH).

Methods: We retrospectively gathered data from the …

Urinary Oxalate Excretion Is Increased In Calcium Oxalate Nephrolithiasis Patients And Associated With Increased Urinary Capacity Of Calcium Oxalate Crystallization, Chanchai Boonla

Chulalongkorn Medical Journal

Background: Calcium oxalate (CaOx) stone is the most common type of stones formed in the urinary tract. Formation of CaOx stone is driven by increased CaOx crystallization in urine.

Objective: To develop a new test, called indole-reacted calcium oxalate crystallization index (iCOCI), and to measure the capability of urine to produce CaOx crystals.

Methods: One hundred samples of 24-h human urine samples obtained from CaOx stone-forming subjects (SFS, n = 50) and non-stone subjects (NSS, n = 50). The levels of oxalate were determined by two methods, i.e., oxalate oxidase method and iCOCI test. Unpaired student t - test, Pearson’s …

Prevalence Of Preoperative Delirium And Associated Factors In Elderly Hip Fracture Patients At King Chulalongkorn Memorial Hospital, Paul Thisayakorn

Chulalongkorn Medical Journal

Background: Preoperative delirium in hip fracture is under-studied. Effective diagnosis, prevention, and management of preoperative delirium may be able to reduce the incidence of the postoperative complications.

Objective: To study the prevalence of preoperative delirium and its associated factors in elderly patients who underwent hip fracture surgery.

Methods: This is a cross-sectional study which collected the data from patients aged more than 65 years who underwent hip surgery at King Chulalongkorn Memorial Hospital. Preoperative cognitive status assessment was done by using the Thai Mental State Examination (TMSE) and The Confusion Assessment Method-Thai (CAM-T) on the day before surgery. The DSM-V …