Srinagarind Medical Journal

Prevalence of High-Risk HPV Infection in Thai Women in Surin Province and Evaluation of Sensitivity and Specificity of Liquid-Based Cytology (LBC) in Cervical Screening

Phanchanut Mahantassanapong — 2024-10-31

Background and Objective: To evaluate the prevalence of high-risk human papillomavirus (HPV) strains among Thai women in Surin province and to determine the sensitivity of liquid-based cytology (LBC) in this population.

Methods: This retrospective descriptive study analyzed data obtained from Thai women living in Surin province who participated the cervical cancer screening project as per the service plan of cancer screening, Ministry of Public Health between January 1, 2022, and December 31, 2023. HPV detection was performed using real-time PCR, while LBC was employed for cytological analysis.

Results: Out of 26,371 women who participated in the screening, HPV 16 was the most prevalent strain (0.98%), followed by HPV 52 (0.45%) and HPV 18 (0.35%). The highest prevalence of infection was observed among women aged 41-50 years, with a rate of 2.01%. LBC demonstrated high sensitivity for detecting LSIL or CIN I histology with a sensitivity of 75%. For detecting HSIL, the sensitivity of LBC was 27.8% for CIN II and 70.0% for CIN III histology.

Conclusion: HPV 16 was the most prevalent infection in this study. LBC screening showed high sensitivity for detecting CIN I and CIN III lesions.

Effects of an Information Program, Motivation Enhancement and Decision-Making Skills Training on Preventive Behaviors for Recurrent Preterm Labor and Decision to Readmit in Pregnant Women with a History of Preterm Labor at Srinagarind Hospital

Laddaporn Chintong — 2024-10-31

Background and objective: Preterm labor remains a major public health problem worldwide. It is a leading cause of preterm birth, which is the major cause of perinatal mortality and morbidity. This research aimed to evaluate effects of an information program, motivation enhancement and decision-making skills training on preventive behaviors for recurrent preterm labor and decision –making skills training to readmit among pregnant women with a history of preterm labor at Srinagarind Hospital.

Methods: This quasi-experimental research employed a two groups pretest-posttest design. A total of 68 pregnant women (experiment and control group each group consisted of 34 women) were recruited. They were purposively selected based on inclusion criteria. The experimental group received the program with usual care, while the control group received only usual care. Data were collected using the demographic characteristics and obstetric history interview forms, the preventive behaviors of recurrent preterm labor questionnaires, and decision-making for hospital admission through interviews. Data were analyzed by using the Mann-Whitney U Test, independent t-test, Paired-sample t-test, Chi-square test, and Fisher's exact test.

Results: The experimental group had significantly higher posttest score of preventive behaviors of preterm labor than pretest (p<.001) and significantly higher than the control group (p<.001). Also, the experimental group showed a significantly lower decision-making time during readmission compared to the control group (p<.001).

Conclusion: An Information program, motivation enhancement and decision-making skills training improved pregnant women preventive behaviors for recurrent preterm labor and proper decision making in hospital admission. Thus, this program should be integrated into routine care provision.

Effects of Educational Program for Postpartum Perineal Wound Care on Knowledge, Attitude, and Perineal Wound Healing of Postpartum Mothers at Kranuan Crown Prince Hospital Khon Kaen Province

Pimonpan Nasangium — 2024-10-31

Background and Objectives: Perineal wound infection and dehiscence affect maternal health and women’s quality of life. This study aimed to examine the effects of educational program for perineal wound care on knowledge, attitude, and perineal wound healing in postpartum mothers.

Methods: This study was a quasi-experimental research using two-group pretest and posttest design. Forty parturient women who met the inclusion criteria were included and divided into a control group and an experimental group equally as 20 women each group. The research instruments were an educational program for perineal wound care. Data were collected by using the general information and pregnancy and delivery questionnaires, the knowledge and attitude of perineal wound care assessment forms, and the REEDA scale for wound healing assessment. Data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U Test, and one-way repeated-measures ANOVA.

Results: The experimental group had significantly higher knowledge score for perineal wound care after the program implementing than the control group (p < 0.001). The attitude towards perineal wound care after the program was no statistical significant difference between the experimental and control groups (p>0.05). Moreover, the experimental group had a significantly better mean score for perineal wound healing at 48 hours postpartum than the control group (p<0.05).

Conclusion: The educational program before delivery effectively increased knowledge and promoted better healing of perineal wounds within 48 hours postpartum. Thus, this program should be integrated into routine care provision.

Content Validity and Reliability of the Brief International Classification of Functioning, Disability and Health Core Sets for Children and Youth with Cerebral Palsy

Areerat Tatongjai — 2024-10-31

Background and Objective: The brief ICF core sets for children and youth (CY) with cerebral palsy (CP) is a tool that needs to be validated for assessment in people with cerebral palsy to ensure its appropriate application in the cultural, social and economic context of Thailand. Therefore, the purpose of this study was to test the content validity and reliability of the brief ICF core sets for CY with CP.

Methods: The brief ICF core sets for CY with CP in the version of English language was changed into a Thai version, 42 codes total, based on the Thai language-translated ICF. The brief ICF core sets for CY with CP in the Thai language version were considered the item content validity by five pediatric physical therapists. Ten pediatric physiotherapists were invited to test the intra- and inter-rater reliability of this tool with video clips watching the ICF assessment in 24 children and youth with CP and scoring using a Google form. Data were analyzed using intraclass correlation coefficients (ICCs).

Results: The content validity index can be acceptable the 38 codes (90%) out of 42 codes. The ICCs of intra-rater and inter-rater reliability were a value between 0.69 to 1.00 (p< 0.05) and 0.62 to 1.00 (p< 0.05), respectively.

Conclusion: This study showed that brief ICF core sets for CY with CP (Thai language) had acceptable content validity and between moderate to very good reliability. However, a feasibility study should test such face validity before application in practice.

Validity of Physical Therapy Pre-operative Multimedia Program for Open Heart Surgery

Nichamon Ekphaphan — 2024-10-31

Background and Objectives: Nowadays, there are a large number of patients and respiratory-transmitted diseases. Cardiac pre-operative program, which takes a long time, could increase the infection risk among healthcare workers and other patients. Thus, the researchers aimed to develop a valid of physical therapy pre-operative multimedia program for open heart surgery to reduce the risk of infection transmission.

Methods: This was a cross-sectional descriptive study that examined the validity of the physical therapy pre-operative multimedia program for open heart surgery. It evaluated the accuracy of the content and video content, as assessed by 5 experts, as well as the appropriateness of the language and video content, as assessed by 31 medical personnel. The data was analyzed using the Index of item-objective congruence (IOC). An IOC value of ≥ 0.8 was considered to indicate valid content.

Results: The physical therapy pre-operative multimedia program for open heart surgery was found to be valid, both in terms of the accuracy and appropriateness of the content, language, and video content. All items evaluated had an IOC value of ≥ 0.8 from the initial assessment. The suggestions from the experts and medical personnel were corrected as appropriate.

Conclusions: The physical therapy pre-operative multimedia program for open heart surgery was found to be valid.

Survey on Health Literacy and Health Behaviors in Patients with Stable Schizophrenia

Raksuda KIjaroonchai — 2024-10-31

Background and Objective: Schizophrenia is a condition requiring long-term treatment. Patients often exhibit lifestyles that increase health risks and have a high prevalence of comorbid medical conditions, especially metabolic syndrome. Health literacy has a positive correlation with health behaviors. This study aimed to determine the level and relationship between health literacy, health behaviors, and relapse prevention behaviors with the presence of comorbid medical conditions and inpatient treatment.

Methods: A cross-sectional survey was conducted on stable out patients schizophrenia at Srithanya Hospital, Nakhon Ratchasima Rajanagarindra Psychiatric Hospital, Songkhla Rajanagarindra Psychiatric Hospital, Pathum Thani hospital, Phra Nakhon Si Ayutthaya Hospital, and Sena Hospital in Phra Nakhon Si Ayutthaya province. Data were collected using assessments of health literacy, health behaviors, and relapse prevention behaviors. The data were analyzed using descriptive statistics, one-way ANOVA, binary logistic regression.

Results: A total of 972 participants were included, with 581 males (59.8%). The average age was 41.6±10.2 years. The percentage of participants with comorbid medical conditions was 25.9%. The median number of inpatient admissions was 1 (range 0-30). The average health literacy score was 52.3±15.9 (range 16-80) the average health behavior score was 47.8±6.4 (range 18-62) and the average relapse prevention behavior score was 59.7±9.8 (range 17-75). The duration of illness more than 10 years and a preventive behavior score of 58 or below are significantly associated with an increased likelihood of inpatient treatment (AOR = 1.90, 95%CI = 1.44-2.50, p = .00, AOR = 1.66, 95%CI = 1.27-2.19, p = .00, respectively).

Conclusion: Stable schizophrenia patients have fair levels of health literacy and health behaviors, which are lower than those of the general population. There is a significant association between the duration of illness and relapse prevention behaviors with inpatient treatment.

The Effectiveness of Individual Counseling Focusing on the Aberrant Motor Behavior Problem of People Living with Dementia

Kanokarn Kongpitee — 2024-10-31

Background and objectives: Aberrant motor behavior (AMB), such as roaming, taking things out , and touching or scratching repetitively is a group of common behavior problems in people with dementia. These symptoms may be annoying, endangered, and burdensome to caregivers. This study aimed to investigate the effectiveness of focused individual counseling for AMB in dementia on burden of caregivers.

Methods: A quasi-experimental, 2-arm, pre-post, interventional study recruited primary caregivers of dementia patients. The active group received a weekly individual counseling for 7 weeks with telephone follow-up for 15 – 40 minutes, and the control group received routine standard care. Data collection included demographic data, the neuropsychiatric inventory (NPI) and the Zarit burden interview (ZBI). Data analyses used descriptive statistics, Wilcoxon signed rank test and Mann-Whitney U test.

Results: From a total of 30 caregivers (n = 15 each group), the AMB severity score, the impact score on emotion from NPI, and the burden score from ZBI at baseline were not significantly different between groups (p > .05). After 7 weeks, the AMB severity score in the intervention group significantly decreased (p < 0.05) compared to the baseline, while both burden score and emotional impact score of the caregivers were not significantly changed (p > 0.05).

Conclusion: Individualized counseling program focused on AMB in dementia demonstrated effectiveness in alleviating of AMB, without significant changes in emotional distress and burden of the caregivers. Further trials with larger sample size and statistical rigorous methods should be conducted to confirm the results.

Outcomes of Palliative Care Program on Caregiver’s Burden and Satisfaction in End-of Life Care among the Late Stage - Dementia Patients

Rattanaporn Siriket — 2024-10-31

Background and Objectives: Late-stage dementia patients receiving palliative care are often complex cases requiring total care from caregivers. Consequently, caregivers experience fatigue due to the increasing care burden. This study aimed to assess the outcomes of a palliative care program for dementia patients, focusing on caregiver burden and satisfaction with end-of-life care

Methods: A retrospective study of medical records and care records profiles of 47 patients recruited from January 1 to December 31, 2022. The sample was selected using a purposive sampling. Descriptive statistics including mean, standard deviation and percentage, were used. A paired t-test was applied to compare the mean caregiver burden scores before and after the palliative care program.

Results: The 47 patients with dementia who participated in the palliative care program showed a significantly lower average caregiver burden score after the intervention compared to before (p < .05). Additionally, satisfaction with end-of-life care was evaluated, with results indicating high satisfaction (x̄ 3.773, Min 3.4 Max 4.0, SD 2.63).

Conclusion: Dementia patients who participated in the palliative care program received comfort care and died peacefully as needed with a very good level of nursing care.

Effect of Physical Activity Modulate Program to Autonomic Balance and Mental Health Status of Elderly in Kham Kwang Sub-district, Warin Chamrap District, Ubon Ratchathani Province

Nantaya Krasuaythong — 2024-10-31

Background and Objective: Physical activity affects the health status of the elderly. This study aimed to investigate the effect of the physical activity program on the autonomic balance and to examine the relationship between the effects of the physical activity program on mental health status and autonomic balance among elderly in Kham Kwang Sub-district, Warin Chamrap District, Ubon Ratchathani Province.

Methods: The study is quasi-experimental research with a two-group pre-post design involving a sample of 50 elderly individuals aged 60 years and older by purposive sampling (mean age 71.92 ± 8.81 years), n=25 per group. In the control group, they received regular care in the elderly while in the experiment group, they received the physical activity program that consisted of the exercise and physical activity program manual based on the five dimensions of wellness concept for the elderly for 12 weeks. The data analysis was performed using descriptive statistics, an independent sample t-test to compare differences between groups, and Pearson’s correlation to test relationships. The data are significant at p-value < 0.05.

Results: The physical activity program of this study did not show an effect on heart rate variability. The pre and post values after 12 weeks of heart rate, R-R interval, SDNN, pNN50, and LF/HF ratio in the experimental group showed no statistically significant differences, and no differences were found between the control group after 12 weeks. However, it is interesting to note that at the 12-week mark, only in the experimental group, a statistically significant correlation was found between GHQ-28 scores for physical symptoms and high-level baroreflex sensitivity (r = 0.56, p = 0.02).

Conclusions: This physical activity program may affect the balance of the autonomic nervous system and mental health in older adults.

Effects of Polycephalomyces Nipponicus Aqueous Extract on Mood and Motor Coordination in Acute Ethanol-Treated Mice

Sirinapa Rungruang — 2024-10-31

Background and Objective: Acute ethanol drinking leads to impaired motor coordination and judgment, which is one of the common causes of many accidents and deaths. Presently, many scientists have attracted medicinal plants containing polyphenols that have shown potential in alleviating the toxic and hangover effects of acute ethanol consumption. Polycephalomyces nipponicus, (P. nipponicus) an insect pathogenic fungus has demonstrated notable potential as a source of natural antioxidants and antimicrobial compounds and contains high total phenolic and flavonoid content. Therefore, the present study aimed to evaluate the effects of P. nipponicus extract on acute protective effects of ethanol-induced mood disorders and motor impairments in mice.

Methods: Male ICR mice were divided into 6 groups of 8 animals per group.: normal control, ethanol (2 g/kg), P. nipponicus extract (200, 600 mg/kg), and pretreated P. nipponicus, extract groups (200, 600 mg/kg). Before receiving ethanol, Mice were orally administered either water or P. nipponicus extract 200 or 600 mg/kg. One hour after, the mice were given either water or ethanol (2 g/kg). Thirty minutes following the second treatment, mice were subjected to exploratory test, tail suspension test (TST), rotarod test and footprint analysis.

Results: Ethanol treatment significantly decreased number of crossings, rearing and nose-poking in exploratory test indicating anxiety-like behavior, and increased immobility time in tail suspension test (TST) indicating depressive-like behavior. And then the rotarod test showed a decrease of time on the rod and an increase in gait abnormalities as observed in gait analysis, revealing the impairment of motor functions. P. nipponicus treatment, especially at 600 mg/kg, significantly alleviated the effects of ethanol in inducing mood disorders and motor impairments.

Conclusion: The results suggested that P. nipponicus extract could mitigate the acute effects of ethanol in inducing anxiety- and depressive-like behaviors and motor impairments.

Efficacy of Pneumococcal Vaccine 13-Valent (PCV13) for Pneumonia Prevention

Natcha Uaesuwanna — 2024-10-31

The purpose of this article was to study the Pneumococcal vaccine 13-valent (PCV13) for the prevention of pneumonia, providing a source of knowledge for those interested in PCV13. From 2023 to 2024, the authors rigorously reviewed research papers from both Thailand and international sources, including reputable organizations such as the World Health Organization, the Centers for Disease Control of the United States, the National Center for Biotechnology Information of the United States, and a vaccine textbook from the Bureau of General Communicable Diseases, Department of Disease Control, Thailand. A total of 34 articles were scrutinized to ensure the reliability of the information. The findings indicate that PCV13 is safe for preventing pneumonia, reduces the severity of the disease, and can lower the mortality rate without causing any serious side effects that could lead to death.

Trastuzumab Deruxtecan: Targeted Therapy for Breast Cancer

Narissara Tarabut — 2024-10-31

Breast cancer is one of the most common cancers and the leading cause of death in women worldwide. Breast cancer is caused by atypical mitoses in breast. Epithelial tissue that develop from duct cells and lobule cells is also the most common site for the development of cancers. According to etiology, breast cancers have been classified into four subtypes including of HR-positive, HER2- positive, both HR and HER2 Positive and Triple-negative.

Trastuzumab Deruxtecan is a monoclonal antibody-drug conjugate that is topoisomerase I inhibitor. It was more effective than chemotherapy in terms of survival and progression-free survival. However, there is a greater chance of adverse reactions than with chemotherapy. It is also toxic to the embryo and fetus. It is a contraindication for pregnancy.