Srinagarind Medical Journal <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 Survival Outcome of Patients with Stage 4 Neuroblastoma after Tumor Resection in Srinagarind Hospital <p><strong><u>Background and Objectives:</u></strong> More than half of patients with neuroblastoma were in stage 4 with metastatic disease at diagnosis, leading to high morbidity and mortality rates. We aimed to study the survival outcome of the patients who had stage 4 neuroblastoma at Srinagarind Hospital. Prognostic factors for survival were also determined.</p> <p><strong><u>Methods:</u></strong> A retrospective cohort review medical records of stage 4 neuroblastoma patients, from 2006 to 2015 at Srinagarind Hospital, Khon Kaen University. Using survival analysis for survival outcome and Cox-regression analysis for prognostic factors.</p> <p><strong><u>Results:</u></strong> 61 patients, 32 male (52%), 29 female (47%) were analyzed. Median age of patients was 4 years. 21 patients were categorized in unresectable group, while 38 were resectable which consisted of complete and incomplete resection (25 and 13 cases, respectively). In overall mortality data, 43 patients (72%) died after diagnosis. The mortality rates of unresectable complete resection and incomplete resection groups were 2.7%, 2.36%, and 1.6%, respectively. The median survival times of unresectable, complete resection, incomplete resection group was 11.43, 23.10, and 35.87 months, respectively. There were no statistically significant differences of survival experience between resectable and unresectable groups (p = 0.239), between complete resection and unresectable groups (p = 0.524), and between incomplete resection and unresectable group (p = 0.149).&nbsp;</p> <p><strong><u>Conclusions:</u></strong> No significant differences of survival outcome between resectable and unresectable groups in stage 4 neuroblastoma. Prognostic factors are tumor location at spine, age group (&gt;18 month), positive urine VMA and presentation of liver metastasis.</p> Phicharmon Krittalack Ratiyaporn Phannua Kanokrat Thaiwatcharamas Sinobol Chusilp Patchareeporn Tanming Suchat Areemit Copyright (c) 2021-01-08 2021-01-08 36 1 1 7 Clinical Manifestations in Children Diagnosed Prenatally with Congenital Lung Malformation <p><strong><u>Background and objective</u></strong>: Congenital lung malformation is a group of rare disease characterized by intrathoracic lesion. Prenatal diagnosis was used worldwide but accuracy is limited. This study aimed to determine prenatal and postnatal clinical manifestations in children with congenital lung malformation.&nbsp;&nbsp;</p> <p><strong><u>Method:</u></strong> A retrospective chart review was performed on patients who were prenatally diagnosed with congenital lung malformation at Srinagarind hospital during 1<sup>st</sup> January 2003 to 31<sup>st</sup> October 2019.</p> <p><strong><u>Result:</u></strong> Nineteen children were prenatally diagnosed with congenital lung malformation at mean gestational age of 26.63<u>±</u>6.1 weeks. 11 children (57.9%) did not have any sign and symptoms after delivery. Symptoms and abnormal physical examination were occurred after delivery in 8 children (42.1%). Tachypnea and decrease breath sound were the most common symptoms and signs that presented. They were confirmed diagnosis by computer tomography of chest and found congenital lung malformation in 16 children (84.2%). The most common diagnosis was congenital pulmonary airway malformation (13 cases, 81.2%). 12 cases (75%) underwent surgery and complication were developed in 7 cases (58.3%) &nbsp;</p> <p><strong><u>Conclusion:</u></strong> Congenital lung malformation is the disease that can detect prenatally. The most common clinical presentation was tachypnea. Congenital pulmonary airway malformation is the most common cause.</p> Phanthila Sitthikarnkha Rattapon Uppala Copyright (c) 2021-01-08 2021-01-08 36 1 8 14 Comparison of Acute Radiation Dermatitis between Hypofractionated and Conventional Radiotherapy in Postmastectomy Breast Cancer <p><strong><u>Objective:</u></strong> To compare the acute radiation dermatitis between hypofractionated radiotherapy (HFRT) and conventional radiotherapy (CRT) in postmastectomy breast cancer.</p> <p><strong><u>Methods:</u></strong> This study was the experimental research design (randomized controlled trial). Seventy six patients underwent a mastectomy and divided into two groups with &nbsp;38 cases in group I used HFRT regimen 42.56 Gy in 16 fractions over three weeks and 38 cases in group 2 used CRT regimen 50 Gy in 25 fractions over five weeks. The study was performed at Division of Radiation Oncology, Roi Et Hospital, from January 1, 2019, to April 30, 2020. All cases were categorized in different grading of acute radiation dermatitis by Radiation Oncologist at Week 1,2,3 during radiation and 1 month, 3 months post-radiation. The statistical analyzed were used descriptive statistics and Z-test. The statistical significance was set at p&lt;0.05.</p> <p><strong><u>Results:</u></strong><strong>&nbsp; </strong>There was no significant difference of acute radiation dermatitis in CRT and HFRT. We found that acute radiation dermatitis grade 1 at week 1,2and 3 during radiotherapy of CRT vs HFRT was 5.26% vs.7.89% (p=0.644), 28.95% vs. 18.42% (p=0.280), 50% vs. 28.95% (p=0.085), respectively. Acute radiation dermatitis grade 1 of the first-month postmastectomy radiation was 15.79% vs. 10.53% (p=0.301) in patients treated with CRT vs. HFRT. Dermatitis grade 1 was the most common grade for acute radiation dermatitis. Few patients in this study developed grade 2 or more skin toxicities.</p> <p><strong><u>Conclusion:</u></strong> This study revealed that the treatment outcome of acute radiation dermatitis between HFRT (42.56 Gy in 16 fractions) and CRT (50Gy in 25 fractions) in postmastectomy breast cancer was not different. Hypofractionated radiotherapy is shortening treatment time, reduces cost-saving, and more convenient.</p> Sawanee Nirunsiriphol Copyright (c) 2021-01-18 2021-01-18 36 1 15 23 Radiation Doses at Eye Lens and Thyroid Gland of Patients and Medical Staffs Received from Video Fluoroscopy <p><strong><u>Background and Objective:</u></strong> This study aimed to measure radiation exposure to eye lens and thyroid of patients and medical staffs during x-ray fluoroscopy. The measurement of area radiation dose inside and outside of fluoroscopic room were also observed. The radiation dose to eye lens and thyroids from different fluoroscopic techniques were measured in head phantom.</p> <p><strong><u>Methods:</u></strong> Optically stimulated luminescence (OSL) dosimeters were placed on eyes and thyroid of patients and staffs, and head phantom for radiation dose measurement. The survey of area radiation dose was conducted using OSL dosimeters.</p> <p><strong><u>Results:</u></strong> Patients underwent fluoroscopy received the highest dose at right thyroid at 645.4 µSv/min. Staff’s thyroid and hands received radiation dose in the range of 1-2.4 µSv/min. The radiation doses inside and outside fluoroscopic room were in the safety level. The different fluoroscopic techniques affect the resolution and noise of images. The continuous fluoroscopic technique releases higher radiation dose than the pulse fluoroscopic technique.</p> <p><strong><u>Conclusions:</u></strong> Radiation protection considerations can be performed by adjusting the appropriate exposure techniques, using the radiation protective equipment, training and providing staff knowledge’s. Also, the monitoring of personal dose received from work will enhance an individual self’s awareness of radiation protection.</p> Somsak Wongsanon Petcharakorn Hanpanich Pattra Wattanapun Arunnit Boonrod Kantapong Jaiwong Panatsada Awikunprasert Vithit Pungkun Copyright (c) 2021-01-19 2021-01-19 36 1 24 30 Assessment of the Entrance Skin Radiation Dose from the Digital Radiography in Srinagarind Hospital <p><strong><u>Background and objectives:</u></strong> Digital radiography is a common diagnostic practice and it has been a significant increase in the number of x-ray examinations. Patients were frequently exposed to radiation may consider increasing the risk of exposure to radiation. The purpose of this study was set up to evaluate the entrance skin dose (ESD) in common digital radiography in Srinagarind hospital, faculty of medicine, Khon Kaen university and compared to ESD with national and international diagnostic reference level (DRL) including study of parameters which effect the ESD.</p> <p><strong><u>Material and method:</u></strong> The retrospective study was conducted from January to May 2019 by using picture achieving communication systems (PACS). The digital radiographic parameters from total 1,010 patients from 12 examinations including chest, cervical spine, thoracic spine and lumbar spine, skull in anteroposterior/posteroanterior (AP/PA) view and lateral view, abdomen and pelvis in AP view were recorded. The ESD was calculated using the specific formula. All data were analyzed using descriptive analysis and the correlation of digital radiographic parameters and ESD was also analyzed.</p> <p><strong><u>Result:</u></strong> The result showed that the highest kVp for DR was observed in chest LAT while the highest mAs was observed in lumbar spine LAT. The median ESD of all digital radiography examination was lower than the international IAEA DRL value while the median of ESD of chest PA, abdomen AP, pelvis AP, lumbar spine LAT and skull AP/PA was lower than Thai national DRL except for the median ESD of lumbar spine AP and skull LAT were higher than national DRL. Moreover, the median ESD was compared with the Japanese and United Kingdom (UK) DRL. The comparison between ESD and Japanese DRL was showed the result like the Thai national DRL. While the comparison between ESD and UK DRL, the median ESD of abdomen AP, pelvis AP and lumbar spine LAT were lower than UK DRL except for the median ESD of chest PA, lumbar spine AP, skull AP/PA and skull LAT were higher than UK DRL. In addition, mAs showed a high positive correlation with ESD while weight, age and kVp were showed a low correlation with ESD.</p> <p><strong><u>Conclusion:</u></strong> This study provided the median ESD in Srinagarind hospital and already compared with national DRL, international IAEA DRL, Japanese DRL and UK DRL. When the median ESD was higher than national and international DRL, technologist and team member could investigate and determine the cause of problem. The quality assurance program and efficiency of X-ray machine firstly check to ensure the good performance of the machine and radiation output and then the protocol and exposure technique were also revised. Further step, dose optimization is required to reduce the patient dose and limit the stochastic effect risk.</p> Thongjit Mahajanthavong Thawatchai Prabsattroo Woranan Kirisattayakul Somsak Wongsanon Waraporn Sudchai Copyright (c) 2021-01-19 2021-01-19 36 1 31 38 Hearing Screening of Newborn at Newborn Intensive Care Unit, Roi Et Hospital <p><strong><u>Objective</u></strong><strong><u>:</u></strong> To study the hearing screening of newborn at Newborn Intensive Care Unit.</p> <p><strong><u>Methods:</u></strong> This was a retrospective study, all data were retrieved from medical records of 729 cases at Newborn Intensive Care Unit, Roi Et Hospital during October 1, 2013 to July 31, 2019.&nbsp; The hearing loss screenings were used Distortion-product otoacoustic emissions (DPOAEs) by audiologist took time for 1-2 minutes per ear. The sound used for examination was loudness approximately level 60-70 decibels which was not harmful to ears and hearing of infant. The echo measurement was performed by audiologist by insert probe to outer ear canal of infant. Then released sound to stimulate and record the response of the inner ear. The machine will automatically process and reported the results that Pass or Refer. The statistics used for data analysis were descriptive statistics, Chi-square test and Fisher’s Exact test.&nbsp; The statistical significance was set at p &lt;0.05.</p> <p><strong><u>Results:</u></strong> Of 729 infants most of them were male 59.67%, preterm birth 42.25%, birth weight &lt; 1,500 gram 15.09%, hearing screening Pass both ear 90.53%, Refer both ear 4.66%. Right ear Refer 1.23%, Left ear Refer 0.27%. The factors associated with hearing loss of infants in Newborn Intensive Care Unit were Craniofacial anomalies (p=0.001), Ototoxic medication (p=0.019), Low apgar score (p=0.036), On mechanical ventilator (≥7 days) (p=0.011) and Stigmata associated syndrome to include Stigmata associated syndrome to include sensorineural hearing loss 1 conductive hearing loss (p=0.026). Rate of hearing screening was 97.07%, referral rate was 4.66% and follow up rate was 47.05%. Of 6 infants has diagnosed for hearing loss (0.83 %), received hearing aid 5 cases, and loss follow up 1 case.</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> This study revealed that the hearing loss screening of newborns in high risk group at the Neonatal Intensive Care Unit that very important. It was found out that the risk factors of hearing loss of newborn had several factors. The newborns at risks should be monitored and continuously to treated, if abnormalities were found the treatment and recovery should promptly performed.</p> Chairat Sererat Wipada Sererat Copyright (c) 2021-01-19 2021-01-19 36 1 39 47 Effectiveness of Multidisciplinary Care development in Geriatric Hip Fractures. <p><strong>Background and Objectives</strong>: Geriatic patients with hip fracture is one of the common causes of injury-related complication, morbidity and mortality if inappropriate care. The development of multidisciplinary care were effectiveness for geriatric hip fracture&nbsp; more securely.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<strong>Methods</strong>: The research and development study was conducted in participants who had geriatric hip fracture and admitted to the orthopaedic department of Saraburi Hospital from February 2017 to January&nbsp;&nbsp;&nbsp;&nbsp; 2019. A purposive sampling of 124 patient for retrospective and 124 patient for prospective group were recruited for the study. Both groups were evaluated for age, gender, type of fracture , and treatment. Descriptive statistics, Independent t-test and Chi-Square were used to analyze data.<strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Results</strong>: The results showed the prospective group had time from admission to surgery was 5.9±2 days (retrospective group 11.1±4), the length of stay in hospital was 14.5±4 days (retrospective group 21.2±5 ) then followed up of 1 year mortality rate was measured to be 9.6% (retrospective group 17.7% ) less than the retrospective group with statistic significantly. (p&lt;0.05)&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<strong>Conclusions</strong>: Multidisciplinary care development were effectiveness for decreased&nbsp; morbidity and mortality rate in geriatric hip fracture. <strong>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Keyword: </strong>Geriatric; Hip fracture; Multidisciplinary care</p> ธำรงค์ศักดิ์ คงมั่น Copyright (c) 2021 Srinagarind Medical Journal 2021-01-19 2021-01-19 36 1 55 60 Antihypertensive and Antioxidative Effects of Asiatic Acid in Rats with Long-Term Exposure to Cadmium <p><strong><u>Background and objective</u></strong><strong>:</strong> Cadmium (Cd) is a toxic heavy metal which causes oxidative damage to various tissues and associated with hypertension.&nbsp; Antioxidants have been used to protect against Cd intoxication. Asiatic acid&nbsp;(AA) is a pentacyclic triterpenoid extracted from Bua-Bok (<em>Centella asiatica</em>) and possesses strong antioxidant activities. This study aimed to investigate whether AA could attenuate hypertension and oxidative stress in rats chronically exposed to Cd.</p> <p><strong><u>Methods</u></strong><strong>: </strong>Male Sprague-Dawley rats were exposed to Cd daily via consumption of water containing 10 ppm cadmium chloride for 16 weeks. Rats in the control groups received deionized water as drinking water. AA (15 or 30 mg/kg b.w.) was orally administered once daily for the last 4 weeks of the experiment.</p> <p><strong><u>Results</u></strong><strong>:</strong> Cd induced hypertension in rats by increasing arterial blood pressure and peripheral vascular resistance. Cd significantly attenuated the vasodilating responses to acetylcholine (p &lt; 0.05) while the vasodilating responses to sodium nitroprusside were unchanged. AA in a dose dependent manner significantly improved hemodynamics and increased endothelial-dependent responses (p &lt; 0.05).&nbsp; AA alleviated oxidative stress, enhanced blood glutathione and increased plasma nitrate/nitrite level. Moreover, AA also reduced the accumulation of Cd in blood and vascular tissues.</p> <p><strong><u>Conclusions</u></strong><strong>:</strong> These results suggest that AA is a protective antioxidant against Cd-induced hypertension, endothelial dysfunction and oxidative stress.</p> Akarachai Tubsakul Weerapon Sangartit Poungrat Pakdeechote Veerapol Kukongviriyapan Upa Kukongviriyapan Copyright (c) 2021-01-19 2021-01-19 36 1 61 67 Effect of Learning Program on Nurse’ Knowledge and Skill Improvement in Caring for Patients with Cleft Lip-Cleft Palate, Khon Kaen, Thailand <p><strong><u>Objective</u></strong><strong><u>:</u></strong> To evaluate pre- and post-knowledge of nurses through the usage of learning program in caring for patients with Cleft Lip and/or Palate, including users’ satisfaction and clinical outcomes.</p> <p><strong><u>Methods</u></strong><strong><u>:</u></strong> Experimental study was conducted in a separated group of nurses who participated in an education program on nurses' knowledge in caring for patients with cleft lip-cleft palate. Both theoretical and skill training had been provided for 2 days. Data collection was done using pre- and post-test, satisfaction evaluation, and clinical outcomes assessment.</p> <p><strong><u>Results</u></strong><strong><u>:</u></strong> The survey on 36 female nurses with age range of 40-49 years old found a statistically significant increase in overall knowledge score (xˉ = 77.86, df = 16.64, CI = 13.50-19.78., p &lt;0.05) had the highest level of satisfaction with the overall learning program (4.59±0.63). Clinical outcomes revealed that among 18 patients in total with age range of 4-60 months, 11 patients were female and had cleft lip and cleft palate (61.11 percent). Significantly, the clinical outcomes were compatible with 5 target values.</p> <p><strong><u>Conclusion</u></strong><strong><u>:</u></strong> Learning Program on Nurses’ Knowledge and skill in Caring for Patients with Cleft Lip and/or Palate is usable. The nurses revealed higher score in issues and in overall with statistical significance. The nurses satisfied with the program and gained the opportunity to develop knowledge and skill which is useful in patient care. Clinical outcomes are at satisfied level, so this learning program should be distributed in broader scale.</p> Suteera Pradubwong Darawan Augsornwan Suntaree Numjaitaharn Kesorn Lao-unka Pattama Surit Bowornsilp Chowchuen Copyright (c) 2021-01-19 2021-01-19 36 1 68 76 The Impact of Smartphone Texting on Gait Speed in Adolescent <p><strong><u>Background and Objective</u></strong><u>:</u> The adolescents pay attention to social media using several applications on a smartphone and are online and on their phones, texting, sharing, talking, you name it, everywhere, i.e., bedroom, bathroom, public transport or while walking etc., Even though, social media on a smartphone is a useful technology, but it also effects on physical health. Smartphone use during walking may be change gait speed. The purpose of this study was to compared walking speed during walking with use and no use smartphone in internet addict adolescent.</p> <p><strong><u>Methods</u></strong><strong><u>:</u></strong> &nbsp;Twenty-five subjects aged 12-16 years old with moderate internet addict level using the internet addiction diagnostic questionnaire (IADQ) were invited in this study. All subjects were evaluated the walking speed using 10-metre walk test in two condition. Frist condition, subjects were instructed to walking without smartphone use. Second condition, subject will be texting using smartphone during their walking. The mean walking speed data was analyzed by Independent-sample T test and statistical significance was set at <em>p</em> &lt; 0.05.</p> <p><strong><u>Results</u></strong><strong><u>:</u></strong> Subjects who walking with texting using smartphone showed significant increasing in both normal comfortable walking speed (0.12 m/s increasing, p &lt; 0.000) and maximum walking speed (0.3 m/s&nbsp; increasing, respectively).</p> <p><strong><u>Conclusions</u></strong><strong><u>:</u></strong> Texting using smartphone during walking reduce gait speed in moderate internet addict adolescent. This may increase the greater risk of falls. However, future studied should be investigate in other level of internet addict adolescent.</p> Nichapa Parasin Kewalee Seeharach Copyright (c) 2021-01-26 2021-01-26 36 1 77 81 Epidemiology of Eye Diseases in Handi-capped Inmates, Ubon Ratchathani Province <p><strong><u>Background and objectives:</u></strong> Blindness and vision impairment (VI) are a global problem that the causes of the VI are usually preventable. Handi-capped inmate (HI) has their freedom restricted, however, a proper healthcare should not be restricted. Epidemiological study about eye diseases may be useful for planning the effective screening program and comprehensive eye care in HIs.</p> <p><strong><u>Methods:</u></strong> A descriptive analysis using a data from questionnaires, refractive values and comprehensive eye exam in HIs at the central prison, Ubon Ratchathani province was done between February - March 2020.</p> <p><strong><u>Results:</u></strong> Sixty HIs in this study, which 58 HIs had physical disability (96.67%). Sixteen HIs had distant VI (26.67%), which common causes were cataract and refractive error. HIs whom aged 35 years old and older had near VI about 18 cases (39.1%). Dry eye symptoms were commonly found which compatible with ocular surface abnormalities e.g. pinguecula, pterygium and abnormal conjunctival and corneal fluorescein staining were 98.33%, 35% and 75%, respectively.</p> <p><strong><u>Conclusion:</u></strong> VI and eye diseases were commonly found in HIs which should be received a comprehensive eye care from public health team, prison staff and ophthalmologist. Effective visual acuity testing, eye disease screening in prison and referring to ophthalmologist are necessary. Ocular surface diseases should be concerned in HIs with vision disturbance.</p> Siripong Siramon Latiporn Udomsuk Virarat Jinatongthai Copyright (c) 2021-01-19 2021-01-19 36 1 48 54 The Effectiveness of Health Literacy Development Program in the First-Degree Relatives of Breast Cancer Patients on Breast Cancer-Preventive Behaviors <p><em><strong><u>Background and Objectives:</u></strong></em> Breast cancer is the most common invasive cancer and it is the third leading cause of cancer deaths among women in Thailand. Lifestyle changes are shown to be important in the prevention of breast cancer. This study aimed to study the effectiveness of program for health literacy development of the first-degree relative of breast cancer patient.</p> <p><strong><u>Methods:</u></strong> This&nbsp;study&nbsp;is&nbsp;a&nbsp;double blind&nbsp;randomized&nbsp;controlled&nbsp;trial, with two groups’ pretest-posttest control group design. The study was conducted among the first-degree relatives of breast cancer patients attending the Ubon Ratchathani Cancer Hospital. The 48 samples aged between 20-65 years old were randomly assigned to 2 groups which consisted of 24 samples for each group. The experimental group participated in the effectiveness of program for health literacy development of the first-degree relatives of breast cancer patients on breast cancer preventive behaviors, controlled group received routine care. The study was conducted over a period of 5 weeks.</p> <p><strong><u>Result:</u></strong> The result of participating in the health literacy program had been found that the experimental group had mean score of health literacy, health literacy in breast cancer prevention, breast cancer prevention behavior and breast self-examination skill higher more than the control group significantly (p &lt; 0.05). The posttest of experimental group has managed stress better than the control group significantly (p &lt; 0.05).</p> <p><strong><u>Conclusion:</u></strong> This program able to development for health literacy and behavior in breast cancer prevention and improving breast self-examination skills.</p> Sairung Prakobchit Sumattana Glangkarn Copyright (c) 2021-01-20 2021-01-20 36 1 82 89 Outcome of Pain Management Program in Gynecological Cancer Patients Who Received Palliative Care in Srinagarind Hospital <p><strong><u>Background and objective</u></strong><strong>:</strong> Gynecological cancer patients who received palliative care had been suffered from pain. Therefore, providing care with pain management programs and determining the outcome could manage the pain more effectively. We performed this study to assess the percentage of patients who had decreased pain equal to 50% or more and their satisfaction with pain management.</p> <p><strong><u>Method</u></strong><strong>:</strong> A retrospective study of medical records, care records, and information systems were applied in this study. The sample were medical records of 45 gynecological cancer patients who were admitted and treated in gynecological 5B ward from January 1 - December 31, 2019.&nbsp; Descriptive statistic, mean, percentage, standard deviation, and their 95% CIs were used for data analysis.</p> <p><strong><u>Results</u></strong><strong>: </strong>There were 45 gynecological cancer patients received palliative care in 2019. Most of them had initial pain score 7-10 (severe pain) and 95.6% (95% CI 84.85 - 99.46) had more than 50% reduction of pain within the first 48 hours after receiving care with the pain management program in gynecological patients receiving palliative care. Moreover, the patients were satisfied with the overall pain management at a very good level (mean 3.33, 95% CI 3.19 - 3.47).</p> <p><strong><u>Conclusion</u></strong><strong>: </strong>The pain management program in gynecological cancer patients receiving palliative care in gynecological 5B ward of Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, could effectively decrease pain.</p> Pornapa Boontasaeng Bandit Chumworathayi Parichart Piasupun Copyright (c) 2021-01-20 2021-01-20 36 1 90 96 Association of Self-Care Behaviors and Beliefs about Diabetes with Glycemic Control of Type 2 Diabetic Patients in a Multiethnicity Area, Nakae District, Nakhonphanom Province <p><strong><u>Background and objectives</u></strong><strong>:</strong> Self-care behavior and health beliefs may affect blood sugar control of type 2 diabetes. This study aimed to examine the relationship of self-care behaviors and beliefs about diabetes with the level of HbA1c of type 2 diabetic patients.</p> <p><strong><u>Methods:</u></strong> This cross-sectional analytical study was conducted in 290 type 2 diabetic patients living in Nakae District, Nakhonphanom Province. Information was collected during January to February 2020 using a structured questionnaire including general characteristics, self-care behaviors, and beliefs about diabetes. Global physical activity questionnaire was used to collect data of physical activity. HbA1c data was retrieved from the medical record of Nakae Hospital. Multiple logistic regression was performed to analyze the association of self-care behavior and the belief about diabetes with blood sugar level.</p> <p><strong><u>Results</u></strong><strong>:</strong> Eighty percent of the participants were female with an average age of 58.9 ± 9.7 years. They belonged to three different ethnic groups, namely 50.7 to the Thai Kaleng, 19.3% to the ThaiYor and 17.6% to the Phutai. Only 20.7% of the patients were able to properly control their blood sugar (HbA1c &lt; 7%), but 59.3% had elevated HbA1c values (HbA1c ≥ 8%). For multiple logistic regression analysis which was adjusted by ethnic groups showed that age ≥ 60 years (OR<sub>adj</sub> = 0.37, 95% CI: 0.21 - 0.62), having diabetes for ≥ 10 years (OR<sub>adj</sub> = 2.13, 95% CI: 1.25 - 3.62) and frequent consuming sweet drinks (≥ 1 time/week) (OR<sub>adj</sub>= 1.71, 95% CI: 1.03 - 2.83) were statistical significantly associated with poorly controlled of blood sugar (HbA1c ≥ 8%). While the beliefs about diabetes was not found to be associated with HbA1c level.</p> <p><strong><u>Conclusions</u></strong><strong>: </strong>The majority of the patients with type 2 diabetes poorly controlled their blood sugar level. Implementing programs to promote the health of diabetic patients, should emphasis on reducing the consumption of sweetened beverages, especially for those with diabetes for a long time and in their middle age.</p> Sasiwan Khanthacha Benja Muktabhant Copyright (c) 2021-01-20 2021-01-20 36 1 97 104 Survival Rate of Lung Cancer Patients after Diagnosis in Srinagarind Hospital: An Update data on the Srinagarind Hospital -Based Cancer Registry between 2013 and 2017 <p><strong><u>Background and Objective:</u></strong> This is the lastest data for tertiary hospitals. &nbsp;The objective of this research was to determine the survival rate of lung cancer patients after diagnosis at Srinagarind hospital.</p> <p><strong><u>Methods:</u></strong> Data were collected from the Srinagarind hospital-based cancer registry (2013-2017), and followed up until 2019 of 2,149 cases. &nbsp;The survival rate was estimated using the Kaplan-Meier method. A comparison group was used to estimate the survival rate using the Log-rank test. We reported the median survival time and the 95% confidence interval.</p> <p><strong><u>Result</u></strong><strong><u>:</u></strong> Of 2,149 lung cancer patients, 1,867 died during the study which corresponding to a case-fatality rate of &nbsp;86.0 per 100 person-years (95%CI; 82.1 - 90.0). The median survival time was 0.46 years (95%CI; 0.42 - 0.50). The respective overall survival experience rate after diagnosis at 1, 3, and 5 years was 31.2% (95%CI; 29.2 - 33.2), 12.9% (95%CI; 11.5 - 14.5), and 10.2% (95%CI; 8.7 - 11.7). The survival rate between targeted therapy and nontargeted therapy were statistically significant. (Log-rank test = 59.9, &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;p = 0.001)</p> <p><strong><u>Conclusion</u></strong><u>:</u> The survival rate of lung cancer at 5 years after diagnosis was poor. Further research should focus on the factors affecting the effectiveness of targeted therapy for lung cancer.</p> Wachiraporn Musika Supot Kamsa-ard Chananya Jirapornkul Chalongpon Santong Anakapong Phunmanee Copyright (c) 2021-01-20 2021-01-20 36 1 105 110 Methadone maintenance treatment <p>Opioid substitution therapy (OST) is the cost effective method to prolong retention rate, decrease drug dependence, prevent HIV transmission, promote health and wellbeing and decrease crime. Methadone maintenance treatment (MMT) is the treatment program that involves the long-term prescribing of methadone as an alternative to the opioid. It is the most effective treatment among OST. The long-term objective is drug abstinence. Inclusion criteria for treatment in many countries are similar including age of 16-18 years, failure from previous methadone therapy, having motivation. However, the differences are method of drug use, history of treatment and duration of opioid dependence. The exclusion criteria focuses on methadone contraindication. The inclusion criteria of Thai treatment guideline is less strict resulting in more patient access. But the dose of methadone using in Thailand is lowest among countries so the withdrawal syndrome and negative treatment outcome may occur. Duration of treatment is about 1 year similarly in all countries. Treatment outcome was monitored regarding withdrawal syndrome, side effects, and toxicities. The most influencing factor for treatment outcome is patient adherence and the health care professionals have the great impact. Motivation for treatment is the important strategy and treating soon after diagnosis is recommended to enhance treatment success.</p> Duangjai - Duangrithi Copyright (c) 2021 Srinagarind Medical Journal 2021-01-20 2021-01-20 36 1 119 125 Back Pain Management for Patients Underwent Transfemoral Coronary Angiography: Nurse’s Role <p>Back pain is a common problem among patients underwent transfemoral coronary angiography (CAG). After the intervention, patient is required to stay in supine position with a straight leg for several hours to prevent vascular injury related bleeding, which consequently causes back pain. Prolong stay in supine position results in weight bearing pressure on back muscle causing back pain. Back pain management for patients underwent transfemoral CAG is a pivotal nursing role either independently or collaboratively with other professions. This paper describes mechanism of pack pain related to transfemoral CAG, pain assessment tool, pain management strategies, and nurse’s roles in pain management after CAG from a literature review, which can be utilized to provide patient care.</p> Wasana Ruaisungnoen Copyright (c) 2021 Srinagarind Medical Journal 2021-01-20 2021-01-20 36 1 111 118