Medicine and Health Sciences Commons^™

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 …

Extent Of Some Heavy Metals In Cough Syrups Abused In Sokoto, Nigeria, Ai Umar, Yusuf Sarkingobir, Aminu Faruk, Malami Dikko, Hajara W. Adamu

Chulalongkorn Medical Journal

Background: Cough syrup abuse is an emerging public health trend in our society that need to be tackle due to the manifestation of harmful biological effects on users. Determination of the possible embedded constituents in drugs such as heavy metals will guide stakeholders and the public for taking right measures in curtailing the trend.

Objective: This study was carried out with the purpose of assessing the levels of heavy metals in commonly used cough syrup in Sokoto, Nigeria.

Methods: A survey using atomic absorption spectroscopy was employed for the study and the descriptive statistics were done.

Results: Levels of essential …

Pulmonary Rehabilitation For Critically Ill Elderly Patients With Covid-19 In Thailand: A Report Of Two Cases, Thitapa Issaragraisin, Jirapa Champaiboon

Chulalongkorn Medical Journal

The vast majority of patients exposed to coronavirus (COVID-19) were likely to face complications during their recovery from coronavirus. The first case was an old Thai woman presented with severe COVID-19 pneumonia. The other was an old Thai man presented with COVID-19 with complications such as acute respiratory distress syndrome, hyperglycemia, thrombocytopenia, right tension pneumothorax with recurrent pneumothorax and monoparesis. These two cases presented the role of physical therapy for critically ill elderly patients with chest complications from COVID-19.

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 …

Diagnosis And Treatment Of Helicobacter Pylori, Erin Raspet

Pacific Journal of Health

Helicobacter pylori is a widespread infectious disease most commonly associated with gastritis, peptic ulcer disease, and gastric cancer. The ability of this organism to influence immune function has been associated with a proinflammatory state that has been associated with several other conditions that can lead to significant mortality and morbidity. Treatment is possible with antibiotic regimens, however, increasing resistance requires treatment be informed by susceptibility information followed by a test of cure to ensure eradication of the infection. Given the global burden of this infection, it is important for providers to appropriately identify, diagnosis, and treat this condition to reduce …

U.S. Military Veteran Identity And Civilian Adjustment, Darren A. Sosa

Pacific Journal of Health

U.S. military veterans transitioning back into the civilian sector often experience a variety of challenges and need to readjust into non-military environments. In order to examine the psychological challenges involved in the transition and readjustment processes among U. S. active military veterans, a qualitative study was conducted. For 6 months, data was collected from veterans in California, Nevada, Texas, Florida, and New York. Following an IRB approval, semi-structured open-ended self-developed interviews were developed and conducted with sixteen military veterans who have served in 4 branches of the U.S. Armed Forces: Army, Navy, Air Force, and Marine Corps. Data and information …

Measurement And Imaging Of Intra Matrix Igg Diffusion, Riya Debbarma, Antonio C. F. Dos Santos, Diana Milena Ramiez Gutierrez, Fernanda M. Da Cunha, Michael Ladisch

Graduate Industrial Research Symposium

Bovine IgG diffusion measurement by tracking the movement of the protein over time in an in-vitro matrix is motivated by the large number of protein/peptide therapeutics currently under various stages of development in the pharmaceutical industry. Many of these therapeutics are monoclonal antibodies (IgG type proteins) that are candidates for subcutaneous, intra-vitreous and intra-articular administration depending on the target of the therapeutic. Hyaluronic acid (HA) is a major constituent and determines the key attributes of the subcutaneous environment, vitreous humor of the eye and synovial fluid of the knee joint. HA exhibits varying molecular weight at these anatomic locations thereby …

Characterization Of Biological Particles Using An Integrated Hyperspectral Imaging And Machine Learning, Kaeul Lim, Arezoo Ardekani

Graduate Industrial Research Symposium

Hyperspectral imaging (HSI) is a promising modality in medicine with many potential applications. This study focuses on developing a label-free lipid nanoparticle characterization method using a convolutional neural network (CNN) analysis of HSI images. The HSI data, hypercube, consists of a series of images acquired at different wavelengths for the same field of view, providing continuous spectra information for each pixel. Three distinct liposome samples were collected for analysis. Advanced image preprocessing and classification methods for HSI data were developed to differentiate liposomes based on their material compositions. Our machine learning-based classification method was able to distinguish different liposome types …

Sepsis Treatment: Reinforced Sequential Decision-Making For Saving Lives, Dipesh Tamboli, Jiayu Chen, Kiran Pranesh Jotheeswaran, Denny Yu, Vaneet Aggarwal

Graduate Industrial Research Symposium

Sepsis, a life-threatening condition triggered by the body's exaggerated response to infection, demands urgent intervention to prevent severe complications. Existing machine learning methods for managing sepsis struggle in offline scenarios, exhibiting suboptimal performance with survival rates below 50%. Our project introduces the "PosNegDM: Reinforcement Learning with Positive and Negative Demonstrations for Sequential Decision-Making" framework utilizing an innovative transformer-based model and a feedback reinforcer to replicate expert actions while considering individual patient characteristics. A mortality classifier with 96.7% accuracy guides treatment decisions towards positive outcomes. The PosNegDM framework significantly improves patient survival, saving 97.39% of patients and outperforming established machine learning …

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 …

Comparative Efficacy Of Topical Dimethicone And Permethrin For The Treatment Of Head Lice Infestation In Students, Behroz Davari, Somayeh Barik-Abi, Hassan Nasirian, Amir Hossein Zahirnia, Younes Mohammadi, Aref Salehzadeh

Chulalongkorn Medical Journal

Background: Despite improved living conditions, individual health and health indicators in human societies, head lice infestation continues to be a major health problem. Therefore, studying the efficacy of drugs and identifying treatment - resistant cases in the prevention and elimination of this disease is of particular importance.

Objective: The study aimed to determine the effectiveness of dimethicone and permethrin in infected pupils in elementary schools for girls.

Methods: This study was conducted on primary schoolgirls infected with head lice in Doroud County, Lorestan - Iran. The eighty infected girls were detected and randomized into two groups receiving any of the …

Detection Of Pathogenic Leptospira Spp. By Rpa-Nalfia Targeting Lipl32 Gene, Nattachai Srisawat

Chulalongkorn Medical Journal

Background: Lack of available sensitive point-of-care tests is one of the key challenges limiting the early point-of-care diagnosis of leptospirosis.Previously, a Recombinase Polymerase Amplification (RPA) and clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated protein 12a (CRISPR/Cas12a) lipL32 detection platform with high sensitivity and specificity was developed. However, its turnaround time is between one and two hours, and two reactions are required.

Objective: To develop the RPA in combination with a nucleic acid lateral flow immunoassay (NALFIA) detection platform to reduce the turnaround time and make it a one-step reaction.

Methods: RPA combined with nucleic acid lateral flow immunoassay (NALFIA) detection …

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 …

A Study Of Hiv Risky Behaviors And Self-Esteem Among Men Who Have Sex With Men (Msm) At Rsat Medical Technology Clinic Ramkhamhaeng, Buranee Kanchanatawan

Chulalongkorn Medical Journal

Background: Nowadays, studies show that the rate at which men who have sex with men (MSM) contract human immunodeficiency virus (HIV) remains the highest among ordinary people. Therefore, a reduction in contracting HIV with the support of caring individuals and self-protection is a must.

Objective: To study the association of HIV risk behaviors, self-esteem, and related factors among MSM at Rainbow Sky Association of Thailand (RSAT) Medical Technology Clinic Ramkhamhaeng.

Methods: Data were collected from 358 MSM clients at RSAT MT Clinic by using questionnaires including: 1) demographic questionnaire; 2) an HIV/AIDS knowledge test; 3) The Coppersmith Self-Esteem Inventory Adult …

Mandibular Plane To Hyoid In Lateral Cephalometry As A Predictive Parameter For Severity Of Obstructive Sleep Apnea, Likhit Khattiyawittayakun

Chulalongkorn Medical Journal

Background: Obstructive sleep apnea (OSA) is a common disorder affect­ing at least 2.0% to 4.0% of the adult population. Early diagnosis and treatment can reduce patient burden. A lateral cephalometric radiograph (LCR) is one method to evaluate upper airway obstruction in patients with OSA.

Objective: This cross­sectional study was aimed to investigate the predictive performance of mandibular plane to hyoid (MP­H) in LCR for determining the OSA severity.

Methods: One hundred and three adult subjects were analyzed. LCR was performed under standardized processes and measured twice on separate occasions. Receiver operating characteristic (ROC) curve analysis was performed to obtain the …

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 …