Srinagarind Medical Journal https://li01.tci-thaijo.org/index.php/SRIMEDJ <p>Frequency : in every&nbsp;two months; on February, April, June, August, October&nbsp;and December. Policy is to encourage distribution of scientific information in medical and health sciences. It publishes seven types of article; medical innovation, original article, case report, review article, conference, symposium and letter to editor.</p> Faculty of Medical, Khon Kaen University en-US Srinagarind Medical Journal 0857-3123 Down Syndrome Screening Outcomes in Advanced Maternal Age Pregnant Women at Roi Et Hospital https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252550 <p><strong><u>Background and Objective</u></strong>Down syndrome screening in elderly women is very important to identify fetal abnormal chromosome, especially Down syndrome. The objective was to study the Down syndrome screening outcomes in advanced maternal age pregnant women at RoiEt Hospital.</p> <p><strong><u>Methods</u></strong>This study wasretrospective cohort study.All data were collected from medical records of advanced maternal age pregnancy with age <u>&gt;</u> 35 years, 14-18 weeks gestation agethat abnormal Quadruple tests were providing for amniocentesis at Roi Et Hospital during January 2019 to December 2020. The descriptive statistics were used for all data analyzed.&nbsp;&nbsp;</p> <p><u>Results</u> One hundred and seventy-one of pregnant women were enrolled, which&nbsp; mean age and mean gestational age were 37.61 ± 3.31 years, and 14.56 ± 0.48 weeks, respectively . The Quadruple test were found high risk for Down syndrome 90.64%, high risk for Edwards syndrome 4.09%, high risk for Patau syndrome 1.75%, and high risk for Neural tube defect 7.02 %. Amniocentesis was performed in 157cases for chromosomal study at Roi Et Hospital.The chromosome study were found normal karyotype 96.17%,Down syndrome 1.91% (47,XX+21 2 cases and 47, XY+21 1case), 47,XXX 1.27%,46,X,inv(Y)(p11.2q11.23) 0.65%, and Ultrasound examination revealed anencephaly in 1 case. The 3 cases of advanced maternal age pregnancy who were diagnosed with Down syndrome had agreed for terminate.</p> <p><strong><u>Conclusion:</u></strong> This study revealed that advanced maternal age pregnancy has screening by Quadruple test positive and confirmed diagnosed for Down syndrome 3 cases. All of them consented for termination process.</p> Sirikanya Somsri Copyright (c) 2021-10-04 2021-10-04 36 5 513 521 Ultrasound Uterine Cervical Angle Screening At Second Trimester to Predict Spontaneous Preterm Birth in Singleton Pregnancy https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252551 <p><strong><u>Background and Objective:</u></strong> The preterm delivery was dependents on various factors, includes with cervical changes. The study of 2016 and 2018 in Europe and Americas found the cervical length (CL), uterine cervical angle (UCA) and gestational age were predictive factors for preterm delivery. Risk for preterm delivery may varies for difference races. Primary objective was prediction of spontaneous preterm birth with UCA in Northeastern Thailand population.</p> <p><strong><u>Methods:</u></strong> A cross sectional study in single pregnancy, age &gt; 18 years with ultrasonographic examination at antenatal care unit, Srinagarind Hospital.</p> <p><strong><u>Results:</u></strong> The mean of gestational age, CL, UCA and gestational age at delivery were 20.20±1.30 yr., 3.74±0.67 cm, 93.93±18.75 degree and 38.37±1.84 weeks, respectively. The preterm delivery was associated with UCA&lt; 97 degree. Sensitivity, specificity, positive predictive value and negative predictive value were <u>57.9%</u><u>, 54.9%, 14.7% and 90.7%, respectively.</u></p> <p><strong><u>Conclusion:</u></strong> The preterm delivery was associated with UCA&lt;97 degree. Sensitivity, specificity, positive predictive value and negative predictive value were 57.9%, 54.9%, 14.7% and 90.7%, respectively.</p> Sukanya Chaiyarach Kiattisak Kongwattanakul Ratana Komwilaisak Copyright (c) 2021-10-04 2021-10-04 36 5 522 526 Compliance of Iron Supplementation During Pregnancy https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252552 <p><strong><u>Background and objectives:</u></strong> This study aimed to determine the compliance rate of iron supplementation and the hemoglobin concentration in second trimester and at term <u>of pregnant women</u> to take into consideration for the optimal practice.</p> <p><strong><u>Methods:</u></strong> The study conducted among term pregnant women admission to the hospital for delivery who had non-anemic status at the initial visit for antenatal care, received daily iron supplementation before 20 weeks of gestation. They were interviewed to obtain the personal data, daily taking the supplemented tablet and side-effects. The compliance rate categorized as &gt;80%, &gt;50-80%, 25-50%, and &lt; 25% according to the women’s response that they took daily tablet of 6-7, 3-5, 2, and 0-1 day(s) in one week, respectively. The laboratory results of hemoglobin level were retrieved from their medical records.</p> <p><strong><u>Results:</u></strong> Among 350 participants had the compliance rate of &gt;80%. The common side-effects were nausea and constipation.&nbsp; The side-effect rates were 10.5%, 12.1%, 66.7% in &gt;80%, &gt;50-80%, &lt;25% compliance groups, respectively. While hemoglobin concentrations above 13 gm/dl, which defined as high concentrated hemoglobin, revealed 12% during second trimester, and up to 30% at term in high compliance group.</p> <p><strong><u>Conclusions:</u></strong> The pregnant women had compliance rate greater than 80% of taking iron supplementation 6-7 tablet/week.</p> Romthira Srisai Jadsada Thinkhamrop Sukanya Chaiyarach Sukanya Kreetiyutanont Copyright (c) 2021-10-04 2021-10-04 36 5 527 533 Two Incisions Laparoscopic Cholecystectomy by Handmade Glove Port and Additional Trocar https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252553 <p><strong><u>Background and objective:</u></strong> Conventional instruments used in SILC revealed instruments conflict and difficulty in Calot’s triangle dissection, this&nbsp; research aimed to study results of TILC by handmade glove port and additional trocar to correct &nbsp;problem and limitation of SILC.</p> <p><strong><u>Method</u></strong><u>:</u> This was a retrospective study.Collected data of gallstone disease patients operated by TILC by handmade glove port and additional trocar at Mahasarakham hospital between 1 July - 31 December 2020.</p> <p><strong><u>Results:</u></strong> Total 30 patients included 11 males and 19 females, mean age was 52.4 years old, mostly age between 50-60 years old.Mean body mass index was 24.14 kilogram/meter<sup>2</sup>, operative time was 43.27 minutes, blood loss from operation was 7.17 milliliters, length of hospital stay was 2.07 day, pain score at 24 hour post operation assessed by visual analogue scale was 1.83 and treatment cost was 26,249.35 Bahts.No perioperative, 4<sup>th </sup>and 12<sup>th</sup> week post operative complication. No instruments conflict, usable conventional instruments, wider surgical angulation and more convenience in Calot’s triangle dissection than SILC.</p> <p><strong><u>Conclusion:</u></strong> TILC by handmade glove port and additional trocar was efficacy, able to correct problem and limitation of SILC&nbsp; with the same conventional instrument.</p> Panuwat Khantasa-ard Copyright (c) 2021-10-04 2021-10-04 36 5 534 540 Analysis of Hepatobiliary Phase of Gadoxetate Disodium Characteristics of Hepatocellular Carcinoma https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252554 <p><strong><u>Objective</u></strong><u>:</u> &nbsp;To characterize the patterns of hepatocellular carcinoma (HCC) nodules and to determine the factors correlated with the hepatobiliary phase characteristics of the HCC nodules using gadoxetate disodium-enhanced hepatobiliary phase MRI.</p> <p><strong><u>Methods</u></strong><u>:</u> A retrospective review of medical records and dynamic imaging using gadoxetate disodium-enhance MRI of patients with HCC at Srinagarind Hospital, Khon Kaen University, Thailand between April 2011 and October 2013 was performed.&nbsp; Demographic data were analyzed using descriptive statistics. Univariate logistic regressions were used to analyze the outcomes.</p> <p><strong><u>Results</u></strong><u>:</u> Forty-five HCC were eligible for this study; the majority of the HCC patients (39 cases; 87.2%) had hypointensity of HCC nodules in the hepatobiliary phase. Of the 6 patients with hyperintense HCC nodules, 1 showed homogenous hyperintensity with hypointense rims and 5 showed hyperintensity with hypointense rims and focal defects in the hepatobiliary phase. Only ALT ³100 U/L was significantly associated with homogeneous hyperintensity and hyperintense rims with focal defects (p=0.008). There was no association between AFP level, size of the HCC nodules, and the Child-Puge classification with the pattern in the hepatobiliary phase.&nbsp;</p> <p><strong><u>Conclusion</u></strong><u>:</u> In the gadoxetate disodium-enhanced hepatobiliary phase MRI images, the hypointense pattern was the most commonly seen in HCC nodules with typical vascular patterns. For HCC appearing as a hyperintense nodule in the hepatobiliary phase, a hypointense rim with a focal defect pattern could be observed. The patients with HCC and ALT ³100 U/L were associated with the hyperintense pattern of the hepatobiliary phase using gadoxetate disodium.</p> Julaluck Promsorn Mareenis Paholpaks Nittaya Chamadol Panita Limpawattana Copyright (c) 2021-10-04 2021-10-04 36 5 541 549 Comparison between Laparoscopic Splenectomy Using LigaSure and Open Splenectomy for Non-traumatic Diseases https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252555 <p><strong><u>Background and Objective:</u></strong> Laparoscopic splenectomy (LS) has become the standard approach for non-traumatic splenic disorders. Previous studies demonstrated the effectiveness and safety of LigaSure for the dissection and sealing of splenic pedicels in LS. This study compared the efficacy and safety of LS using LigaSure and open splenectomy (OS) in patients with non-traumatic disease.</p> <p><strong><u>Materials and Methods</u></strong><strong><u>:</u></strong> We retrospectively reviewed patients who underwent LS and OS. Operative data, perioperative course, and clinical outcome were assessed.</p> <p><strong><u>Results:</u></strong> In all, 25 patients were included in the analysis; 6 in the OS group, and 19 in the LS group. The OS group had a significantly shorter duration of surgery (median [interquartile range; IQR] = 45 [30-95] vs. 100 [60-120] minutes, p=0.030). The LS group had significantly lower post-operative pain scores (median [IQR] = 7 [6-9] vs. 3 [1-5], p&lt;0.001) and shorter time to step diet (median [IQR] = 18 [18 to 24] vs. 6 [6 to 18] h, p=0.003). No mortality occurred in either group. There was no significant difference in perioperative complications between the two groups (16.7% vs. 26.3%, p=0.629).</p> <p><strong><u>Conclusion:</u></strong> Laparoscopic splenectomy using LigaSure appeared safe, feasible, and efficacious for non-traumatic splenic disorders. LS using LigaSure was associated with a significantly longer duration of surgery, lesser postoperative pain, and faster resumption of oral diet compared to OS, without increased risks of intraoperative bleeding and perioperative complications.</p> Araya Khaimook Phadungkiat Tipmanee Sujaree Bhimonpun Arunchai Chang Copyright (c) 2021-10-04 2021-10-04 36 5 550 556 Validity of Pre-Operative and Post-Operative Cardiac Rehabilitation Questionnaires in Patients with Open Heart Surgery https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252556 <p><strong><u>Background and Objectives:</u></strong> Patients who plan for open heart surgery should gain knowledge about pre-operative and post-operative cardiac rehabilitation for their rapid recovery and safety. Presently, there is no valid tool for determining patients’ knowledge and comprehension in pre-operative and post-operative cardiac rehabilitation. Thus, we developed questionnaires for determining knowledge and comprehension in the pre-operative and post-operative cardiac rehabilitation for patients with open heart surgery.</p> <p><strong><u>Methods:</u></strong> This study design was a cross-sectional descriptive study. The questionnaires were consisted of 10 pre-operative and 8 post-operative cardiac rehabilitation items. The questionnaires’s validity was assessed by 36 medical personnels (physiotherapists, physicians, and nurses) who worked at Queen Sirikit Heart Center of the Northeast and physiotherapists who worked at nearby hospitals. The Index of item-objective congruence (IOC) &gt; 0.8 was considered as valid.</p> <p><strong><u>Results:</u></strong> The IOC score of all items in the pre-operative and post-operative cardiac rehabilitation questionnaires was <u>&gt;</u> 0.8, except post-operative rehabilitation item 4 which IOC was 0.5. The IOC of item 4 after adjusting &nbsp;was &nbsp;<u>&gt;</u> 0.8.</p> <p><strong><u>Conclusions:</u></strong> Questionnaires for determining knowledge and comprehension in pre-operative and post-operative cardiac rehabilitation for patients with open heart surgery were valid.</p> Supatra Chantawong Worrawut Usupharach Benja Songsaengrit Pajeemas Kittipanya-ngam Copyright (c) 2021-10-04 2021-10-04 36 5 557 561 Comparison of Efficacy between Short Hydration and Continuous Hydration for Prevention of Cisplatin Induced Nephrotoxicity https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252557 <p><strong><u>Background and Objective</u></strong><strong><u>:</u></strong> Cisplatin is antineoplastic drug that has been used in the treatment of several type of solid tumor and hematologic malignancies. Nephrotoxicity is one of the major and most serious toxicities caused by cisplatin. Hydration is used very commonly and while effective but several strategies able to prevent nephrotoxicity. This study was to comparison efficacy of short and continuous hydration for prevention of cisplatin induced nephrotoxicity (CIN).</p> <p><strong><u>Methods:</u></strong> The retrospective study collected data from medical records and electronic databases between 1 January 2011 and 31 December 2018. Inclusion criteria was solid tumors type of patients with age ≥ 20 years old received single cisplatin or combination regimen as inpatients setting, divided into 2 groups, short hydration group (1 L 0.9%NaCl intravenous rate ≥ 500 ml/hr) and continuous hydration group (1 L 0.9%NaCl intravenous rate &lt; 200 ml/hr) for prevention of CIN and performance status (ECOG) 0-2. No data for evaluation of efficacy and serum creatinine &gt; 1.5 mg/dl prior treatment were excluded. Primary outcome was the incidence of CIN ≥ grade 3 after received cisplatin at any cycles. Grading of nephrotoxicity classified by common terminology criteria for adverse events (CTCAE) 5.0.</p> <p><strong><u>Results:</u></strong> A total of 81 patients were enrolled. Forty eight patients in short hydration group; median cisplatin dose was 69.33±16.03 mg/m<sup>2</sup>. Thirtythree patients in the continuous hydration group; median cisplatin dose was 73.39±14.72 mg/m<sup>2</sup>. No incidence of CIN ≥ grade 3 at any cycles reported after received cisplatin. The different of incidence of CIN at any cycles any grade between short hydration group and continuous hydration group did not reach statistical significance &nbsp;[15 patients (31.2%) vs 16 patients (48.5); p=0.12]. The incidence of CIN at cycle 1 any grade different between 2 groups did not reach statistical significance [6 patients (12.5%) in short hydration group and 4 patients (12.1%) in continuous hydration group; p=0.95].</p> <p><strong><u>Conclusion:</u> </strong>This study showed benefit of short and continuous hydration group were similar for prevention of cisplatin induced nephrotoxicity.</p> Kwanjit Danwilai Pongpipat Samutpeth Saharat Pongsura Wittawat Jitpewngarm Apichai Manoi Copyright (c) 2021-10-04 2021-10-04 36 5 562 568 The Effect of Counseling for Inhaler Device Usage on Knowledge and Skills of Asthmatic Patients at Vachiraphuket Hospital https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252558 <p><strong><u>Background and Objectives</u></strong>: Asthma, a chronic non-communicable disease, is classified as a global public health problem. Appropriate inhaler use is an important factor for disease control. This study compares the knowledge and skills of inhaler use before and after counseling process according to the GINA 2017 guideline.</p> <p><strong><u>Methods:</u></strong> It is a quasi-experimental study. Measured results before and after consultation in asthmatic patients using metered dose inhaler or/and accuhaler for service at Vachiraphuket Hospital during June to September 2018.</p> <p><strong><u>Results:</u></strong> Sixty-five eligible patients were enrolled. The study participants had significantly higher average scores of meter dose inhaler (10.4±6.8 vs 17.1±1.2, p&lt;.05) and accuhaler (11.1±5.8 vs 17.1±0.8, p&lt;.05) after counseling on both devices. The meter dose inhaler group: patients responded to each question and performed more accurately in each question after counseling than before the consultation. All questions were statistically significant. As for the accuhaler, patients answered and performed more accurately in each question after counseling than before the consultation. In most of them, the questions were statistically significant. Unless having to spray more than one time that still does not work properly.</p> <p><strong><u>Conclusions:</u></strong> Counseling for a patient using an inhaler should explain and emphasize the importance of the steps in order for the patient to understand and perform correctly.</p> Apichat Jittsue Wannakon Chuemongkon Titima Phet-aporn Janthip Charoensabsakorn Copyright (c) 2021-10-04 2021-10-04 36 5 569 576 Outcomes of Pharmaceutical Care by SMART AsthCOPD Application Program to Care Asthma Patients https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252559 <p><strong><u>Background and objectives</u></strong><strong>:</strong> Drug Related Problems (DRPs) lead to an increased rate of hospitalization due to asthma exacerbations. In the past, pharmacist provided pharmaceutical care using paper documentation which might lost and was not connected to an electronic medical record. Then, the SMART AsthCOPD application program was developed to solve those problems. The objectives of this study were to assess the impact of computer application on DRPs, assess the impact on the accuracy of patient technique for MDI use and the rate of hospitalization from asthma exacerbation before and after using the SMART AsthCOPD application program to care patients with asthma.</p> <p><strong><u>Methods</u></strong><strong>:</strong> &nbsp;Patients aged 18 years or older with an asthma diagnosis, ICD-10 coded J45-J46 who were seen for three visits in an internal medicine adult asthma clinic and a pharmacy specialist clinic from October 1, 2016 to September 30, 2018 were included. Data of clinical outcomes were retrospectively collected from an electronic medical record from September 1, 2016 to October 31, 2018. McNemar’s test was used to compare the correctness of technique to use MDI, and hospitalization from asthma exacerbations.</p> <p><strong><u>Results</u></strong><strong>:</strong> Of 497 patients, who were provided pharmaceutical care for three visits. The average age was 58.08 ± 15.25 years. The most commonly identified DRP in these patients was non-adherence. Incorrect MDI technique was seen in 44.7%. Most of them had no caregiver and use MDI without spacer. After the third pharmaceutical care, patients had proper MDI technique from 63.0% to 89.1% (p&lt;0.001). The rate of emergency department visits and hospital admissions due to asthma exacerbation decreased from 15.3% to 5.6% and 6.2% to 3.4%, respectively (p&lt;0.001, p&lt;0.001).</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> Providing pharmaceutical care with using the computer application program significantly improves the proper technique to use MDI. Moreover, pharmacist can continuous follow-up patients with DRPs and the incidence of hospitalization due to disease exacerbation were decreased.</p> Ananya Songmuang Thanatcha Songmuang Copyright (c) 2021-10-04 2021-10-04 36 5 577 585 Electrocardiographic Survey in Elderly Hypertensive Patients https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252560 <p><strong><u>Background and objective</u></strong><strong>:</strong>&nbsp; The result of electrocardiographic survey in elderly hypertensive patients in Thailand has limited information.&nbsp; This study aimed to investigate the characteristics of electrocardiogram (ECG) in elderly hypertensive patients.&nbsp;</p> <p>&nbsp;<strong><u>Methods</u></strong>: &nbsp;This research was a survey study.&nbsp; The data was collected during September to October 2018. The population consisted of 165 elderly hypertensive patients treated at Tha Nang Ngam, the primary hospital. The number of sample size was 117 cases calculated from the Taro Yamane formula, the error of 0.05. The instruments in the study were the demographic data form, the basic physical examination form and electrocardiography machine.</p> <p><strong><u>Results</u></strong>: Most of elderly hypertensive patients were 75 females (64.1%), mean age 68.8±7.0 years, mean body mass index 25.2±4.5 kg/m<sup>2</sup>, the average of systolic blood pressure 135.7±14.9 mmHg, the average of diastolic blood pressure 75.8±11.0. The normal ECG was found in 65 elderly hypertensive patients (55.6%).&nbsp; The most abnormal ECG were Left ventricular hypertrophy 13 cases (11.1%) and Inverted T-wave 13 cases (11.1%), Sinus bradycardia 8 cases (6.8%).</p> <p><strong><u>Conclusion</u></strong>:&nbsp; The normal ECG was detected in the major group of elderly hypertensive patients.&nbsp; The abnormal ECG were Left ventricular hypertrophy and Inverted T-wave, Sinus bradycardia, respectively. &nbsp;</p> Prawpan Suwanakitch Nattanon Suyana Peeraphat Moolwong Panuwat Patra Charut Tuntiaumnuay Tomorn Thongsri Copyright (c) 2021-10-04 2021-10-04 36 5 586 590 The Neuroprotective Effect of Caffeic Acid against L-Methionine Induced Memory Deficits in Adult Rats https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252566 <p><strong><u>Background and objective:</u></strong> L-methionine is found in natural products such as meat, milk and cereal grain. It is a non-essential amino acid and can be changed to homocysteine by methylation. Excess accumulation of homocysteine is a course of hyperhomocysteinemia and leads to memory deficit. Caffeic acid is a phenolic compound found in coffee and tea. Previous studies reported the neuroprotective effect of caffeic acid on memory and cognitive functions. Therefore, this study aimed to determine the neuroprotective effect of caffeic acid against L-methionine induced memory deficit.&nbsp;</p> <p><strong><u>Methods: </u></strong>Sixty male Sprague-Dawley rats were divided into 6 groups: control, L-met, caffeic acid 20, caffeic acid 40, caffeic acid 20+L-met, caffeic acid 40+L-met groups. The control group received propylene glycol and carboxymethyl cellulose by oral gavage once a day for 28 hours. The caffeic acid 20, caffeic acid 40, caffeic acid 20+L-met, caffeic acid 40+L-met groups, caffeic acid (20 and 40 mg/kg) and L-methionine (1.7 g/kg) groups were administered by oral gavage once a day for 28 days. Changes of body weight and locomotor activity were examined. Moreover, spatial and recognition memory were determined using the novel object location (NOL) and novel object recognition (NOR) tests, respectively.</p> <p><strong><u>Results:</u></strong> The results demonstrated that caffeic acid (20 and 40 mg) and L-methionine did not have a negative effect on the body weight and locomotor activity.&nbsp; Impairments of spatial and recognition memories were found in the L-met group, but was not detected in the other groups</p> <p><strong><u>Conclusion:</u></strong> This study reveals that caffeic acid (20 and 40 mg) could potentially protect against L-methionine induced memory deficits.</p> Oabnithi Dornlakorn Aurasa Saenno Tanaporn Anosri Soraya Kaewngam Kornrawee Suwannakot Copyright (c) 2021-10-04 2021-10-04 36 5 591 596 Knowledge, Attitudes, and Preventive Behaviors of COVID-19 among Residents in Pru Yai Sub-district, Muang District, Nakhon Ratchasima Province https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252568 <p><strong><u>Background and Objectives:</u></strong> The COVID-19 pandemic causes deaths, health effects, and economic impacts across the world including Thailand. This study aimed to identify knowledge, attitudes, and preventive behaviors of COVID-19 and their factors among residents in Pru Yai Sub-district, Muang District, Nakhon Ratchasima province.</p> <p><strong><u>Methods:</u></strong> A cross-sectional descriptive study was conducted in 348 samples. Data were collected using a questionnaire. It consisted of personal informations, and a set of questions to assess COVID-19 knowledge, attitudes, and preventive behaviors. The data were analyzed using descriptive statistics, Spearman correlation, and Chi-square test. &nbsp;</p> <p><strong><u>Results:</u></strong> The average score of knowledge was moderate, whereas those of attitudes and preventive behaviors were good. Most subjects had a good level of knowledge (62.4%), attitudes (71.3%), and preventive behaviors of COVID-19 (72.4%). Knowledge was positive correlated with attitude (r<sub>s</sub>= 0.49) and with preventive behavior (r<sub>s</sub> = 0.47). Attitude had a positive correlation with preventive behavior (r<sub>s</sub> = 0.79). Factors related to the level of knowledge, attitude, and preventive behavior were age, education level, income, and source of COVID-19 information via the internet/social media platform.</p> <p><strong><u>Conclusions</u></strong><strong>:</strong> &nbsp;Knowledge and attitudes had relationships with preventive behaviors of COVID-19. The level of the knowledge, attitudes, and behaviors were related to personal characteristics. The data could be used as guidelines for efficient COVID-19 pandemic prevention and control in the communities.</p> Daranchanok Phansuma Pongsit Boonruksa Copyright (c) 2021-10-04 2021-10-04 36 5 597 604 The Study of the Satisfaction of Veterinary Students of Khon Kaen University on the Use of Horse Incisor Teeth Models with Augmented Reality (AR) Media in Anatomy Teaching https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252569 <p><strong><u>Background and Objective</u></strong>: The objectives of this study were to study of the satisfaction of veterinary students at Khon Kaen university on the use of Horse incisor teeth models with Augmented Reality (AR) media in anatomy teaching. The important content was studying incisor teeth anatomy of horses to estimation the age for using the horse properly, for trading, for insurance policy and also for disease prognosis. Moreover, the estimate of horse age will be also useful for other animals.</p> <p><strong><u>Methods</u></strong>: This study was developmental research. Samples were 24 students from Faculty of Veterinary Medicine, Khon Kaen university. The study instruments were horse incisor teeth models with AR and satisfaction questionnaires. Statistic measurements for data analysis were mean, percentage and standard deviation.</p> <p><strong><u>Results</u></strong>: The horse incisor teeth models are main instructional media with AR is supplementary instructional media showed good quality and helped the experimental group to learn and understand content of horse teeth. Result of satisfaction evaluation of horse incisor teeth models was in a highest level with mean of 4.69, percentage of 93.85 and standard deviation 0.46 and result of satisfaction evaluation for AR was also in a highest level with mean of 4.72, percentage of 94.11 and standard deviation 0.45.</p> <p><strong><u>Conclusion</u></strong>: The experimental group was able to learn and understand content of horse incisor teeth models with AR well. The horse incisor teeth models with AR can be used as an effective instructional media.</p> Witthaya Yohaken Piyanat Sudee Kan Komany Pakarat Tempiam Dodsadee Musikpodohe Songpol U-Pachitakul Suwit Uopasai Copyright (c) 2021-10-04 2021-10-04 36 5 605 610 Incidence Rate and Spatial Analysis of Liver Cancer in Nakhon Phanom Province https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252571 <p><strong><u>Background and Objective</u></strong><u>:</u>&nbsp; &nbsp;Incidence of Liver cancer (LC) in Nakhon Phanom province tends to increase. The spatial factor is an important factor. The purpose of this study was to analyze spatial factors and incidences rate of LC in Nakhon Phanom province.</p> <p><strong><u>Methods:</u></strong> A retrospective descriptive study was used for this study. Of 1,899 LC patients lived in Nakhon Phanom province and treated in Nakhon Phanom hospital between January 1, 2010 to December 31, 2019 were obtained from the Hospital-database. The studied factors were personnel profile, climatic and environmental factors. &nbsp;The Moran's I and Anselin Local Moran's <em>I</em>, LISA determined relationship. The Age-Standardized Rate, ASR were reported with their 95% confidence interval.&nbsp;</p> <p><strong><u>Result:</u></strong> The ASR of LC was 22.5 per 100,000 population year (95%CI: 21.5 to 23.5). Moran’s<em> I</em> analysis was spatially correlated with variables. The statistical significance of the clustered pattern were the distance from the water resources, population density, and altitude variables (p &lt; 0.05). The LISA, 99 sub-districts with LC incidence according to the following variables; 4 sub-districts as for attitude, 22 sub-districts as for distance from the water resources and in14 sub-districts as for population density.</p> <p><strong><u>Conclusion:</u></strong> LC is a high incidence rate in the sub-district area and adjacent area in Muang district. It is also found as the clustered of LC. Further research should focus on the relationship between exposure and LC in this area have affected the incidences in Thailand might shed some new light on the prevention and control of LC.</p> Oraya Sahat Supot Kamsa-ard Apiporn Thinkhamrop Suwannatrai Nut Thunyaharn Copyright (c) 2021-10-04 2021-10-04 36 5 611 616 Effects of the Self-Efficacy Enhancing Program on the Practice Behavior of Caregivers for the Older Patients with Mild Traumatic Brain Injury after Discharge and Post-concussion Syndrome https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252572 <p><strong><u>Background and Objective:</u></strong> The older patients with mild traumatic brain injury (mTBI) after being discharged, have a higher mortality rate. The caregiver plays an important role. The purposes of this study were to examine the effects of the self-efficacy enhancing program on the practice behavior of caregivers for the older patients with mTBI after discharge and post-concussion syndrome.</p> <p><strong><u>Methods:</u></strong> The study was a quasi-experimental research two groups posttest design. The fifty-six participants who were caregivers for the older patients with&nbsp;mTBI&nbsp;at Accident and Emergency Ward 2 which divided into a control group and intervention group equally. The experimental group received the self-efficacy enhancing program while the control group received a usual care program. The instruments used were 1) the practice behavior of caregivers and post-concussion syndrome in the older patients during 48 hours questionnaire and 2) the practice behavior of caregivers and post-concussion syndrome in the older patients during 2 weeks questionnaire. Data were analyzed using Independent t-test, and Mann-Whitney U test.</p> <p><strong><u>Results:</u></strong> The results for 48 hours and 2 weeks after brain injury showed that the experimental group gained scores on the practice behavior of caregivers higher than those of control group at level of significance (p &lt;.05). Also, it was indicated that the older patients with mTBI in the experimental group had post-concussion syndrome differences from those who were in the control group at level significant (p &lt;.05).</p> <p><strong><u>Conclusions:</u></strong> The program can be used to increase caregivers’behavior in caring of the older with mTBI in order and reduced the post-concussion syndrome after discharged.</p> <p>&nbsp;</p> Supapon Rooplor Mayuree Leethong-in Sirimart Piyawattanapong Copyright (c) 2021-10-04 2021-10-04 36 5 617 624 Three-dimensional Cell Culture Model for In-Vitro Drug-Testing Platforms in Cancer Research https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252574 <p>Chemotherapy and radiotherapy are widely used as a standard treatment regimen for many cancers. However, resistance to the standard treatment regimens usually occurs for several malignant tumors. Thus, searching for novel anticancer agents with high therapeutic effectiveness and less side effects is urgently needed. However, there are several evidences suggesting that two-dimensional (2D) cell culture models cannot recapitulate key characteristics of <em>in-vivo</em> tumor and do not provide <em>in-vivo</em> and clinically relevant data for anti-cancer drug discovery and development. Therefore, three-dimensional (3D) cell culture models have been developed. Cultured cells under 3D cell culture models provide several aspects of <em>in-vivo</em> solid tumor and offer better <em>in-vitro </em>models for anti-cancer drug screening and validation. This review article will clarify the limitations of 2D cell culture models and application of 3D cell culture models as a better <em>in-vitro</em> models for cancer research. Including, application 3D cell culture models in chemo- and radiotherapy drug testing, cancer metastasis, cancer stem cell and cancer metabolisms.</p> Prin Sungwan Wunchana Seubwai Copyright (c) 2021-10-04 2021-10-04 36 5 625 633 Diagnosis in Periprosthetic Joint Infection and Clinical Practice Guideline for Periprosthetic Joint Infection in Srinagarind Hospital https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252575 <p><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong>Total joint replacement (TJR) surgery is one of the most successful operations for end-stage arthritic disorders and fractures around the joint. However, periprosthetic joint infection (PJI) is a concerning complication after TJR and affects postoperative functional outcomes. Diagnosis for PJI is the first step leading to definite treatment. In clinical practice, the authors found incomplete laboratory studies and misinterpretation in some diagnostic tests, especially the recently proposed tools. Incomplete investigations delay the diagnosis and appropriate management, impact poor functional results, and increase morbidity. Therefore, we reviewed the current evidence of PJI-related risk factors, clinical clues of signs and symptoms, the common pathogen, and PJI diagnosis criteria. This clinical practice guideline is proposed for Srinagarind Hospital’s physicians, orthopaedic residents, and other health care providers for guidance on the PJI diagnosis.</p> Witchaporn Witayakom Rit Apinyankul กมลศักดิ์ สุคนธมาน Copyright (c) 2021-10-04 2021-10-04 36 5 634 638 Nursing Care for Prevention Complications of Patient with Spine and Spinal Cord Injuries in Rehabilitation Phase https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/252577 <p>Spine and spinal cord injuries are serious condition and could disabilities. In developed countries, the estimated incidence were 10.4–130.6 cases per million people per year. Two-year survival following discharge from hospital with spinal cord injury tends to increase by 87 percent. The goals of early treatment in this group of patients are reduce mortality, reducing additional injuries of the spinal cord and prevention of complications. The goal of treatment in the rehabilitation phase is to facilitate the recovery of the spinal cord, including muscle strength and sensation as well as preventing complications such as respiratory infection and urinary tract, constipation, pressure ulcers and Deep Venous Thrombosis.</p> Patcharee Butsankot Juthamas Kongklang Copyright (c) 2021-10-04 2021-10-04 36 5 639 648