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> en-US csompo@kku.ac.th (Pote Sriboonlue) kankha@kku.ac.th (Kannika Khanthawud) Fri, 16 Oct 2020 15:58:55 +0700 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Single Incision Laparoscopic Cholecystectomy Using Hand-made Glove Port https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247314 <p><strong><u>Background and objective:</u></strong> Due to many problems of using commercial port, this&nbsp; research aimed to study results of single incision laparoscopic cholecystectomy using hand-made glove port in aspect of efficacy safety and applicable for replacing commercial port.</p> <p><strong><u>Method</u></strong><u>:</u> This was a retrospective study, data of gallstone disease patients operated by single incision laparoscopic cholecystectomy using hand-made glove port at Mahasarakham hospital were collected between 1 January - 30 June 2020.</p> <p><strong><u>Results:</u></strong> A total of 22 patients mostly were females, mean age was 48.09 years old, mostly age between 50-60 years old. Mean body mass index was 24.81 kilogram/meter<sup>2</sup>, mean operative time was 55.68 minutes, blood loss from operation was 7.82 milliliters, length of hospital stay was 2.05 day, pain score at 24 hour post operation assessed by visual analogue scale was 1.82 and treatment cost was 25,839.39 Bahts. No perioperative and 4<sup>th</sup> week post operative complication. Hand-made glove port was more flexible than commercial port, no leakage during operation and reduced instruments conflict. Opacity of glove port caused difficulty during insertion of &nbsp;instruments to peritoneal cavity.</p> <p><strong><u>Conclusion:</u></strong> Hand-made glove port was efficacy, no problem during operation, safety and usefulness, could be replaced &nbsp;commercial port .</p> <p><strong>Keyword:</strong> Handmade glove port</p> Panuwat Khantasa-ard Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247314 Fri, 16 Oct 2020 00:00:00 +0700 Outcome of Modified Radical Mastectomy of Breast Cancer in Srinagarind Hospital https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247315 <p><strong><u>Background</u> and Objective: </strong>Modified Radical Mastectomy (MRM) is one option for the surgical treatment of breast cancer which is widely used in Srinagarind Hospital. <strong><u>This study aimed to </u></strong>evaluate the outcome of Modified Radical Mastectomy by studying the 5-year survival rate and 3-year disease-free survival rate, complication and risk factor of survival of breast cancer patients at Srinagarind Hospital.</p> <p><strong><u>Material and Method:</u></strong> We reviewed the case records of 215 consecutive breast cancer patients who underwent MRM at Srinagarind Hospital, Faculty of medicine, Khonkaen University between January 2004 and December 2007</p> <p><strong><u>Result:</u></strong> Of all the 215 patients over the study period, the mean age was 51.1 years old. The most common site of tumor was located by the upper outer quadrant (46.5%). Most patients had Stage II breast cancer: 117 patients (54.4%). The most common operative surgical complication was seroma collection <span style="text-decoration: line-through;">in</span> that was found in seven percent of patients. The 5-year survival rate was 83.6% and the 3-year disease-free survival rate was 78.9%.</p> <p><strong><u>Conclusion:</u></strong> The 5-year survival rate of breast cancer patient who underwent MRM was 83.6% and the 3-year disease-free survival rate was 78.9 %.</p> Anongporn Wongbuddha, Punnawat Chandrachamnong , Dumnern Vachirodom, Ongart Somintara Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247315 Fri, 16 Oct 2020 00:00:00 +0700 Position of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Thai People https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247316 <p><strong><u>Background and Objective</u></strong><strong>:</strong> Major cause of trauma death worldwide is from non-compressible torso hemorrhage. Currently, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) plays role in control of intraabdominal bleeding. Therefore, it is necessary to use several methods to confirm the position of the balloon precisely, such as fluoroscopy. But most hospitals in Thailand do not support fluoroscopic machine in ER. This study aimed to determine the intravascular length for placement REBOA and compare to the appropriate locations of external landmarks of the body.</p> <p><strong><u>Method</u></strong><strong>:</strong> Human cadaveric study, external anatomical (sternal notch, xyphoid process and umbilicus) and intravascular (left subclavian artery (LSA), celiac trunk (CT), lowest renal artery (LRA) and aortic bifurcation (AB)) landmarks from puncture sites. The landing zones were calculated with intravascular landmarks.</p> <p><strong><u>Results</u></strong><strong>:</strong> Twenty-two cadavers were analyzed. Mean external landmarks from right groin to umbilicus, xyphoid, sternal notchere 19.20, 32.26, 53.42 cm. and from left groin were 19.25, 32.62, 53.65 cm. The mean intravascular distance from right puncture site to AB, LRA, CT, LSA were 21.37, 30.47, 33.95, 55.97 cm. and from left puncture site were 20.69, 29.72, 32.87, 56.20 cm. There are statistically significant of clinical correlations between external and intravascular length of right groin - umbilicus with right puncture site - AB (p=0.0385) and right groin - sternal notch with right puncture site - LSA root (p=0.303).</p> <p><strong><u>Conclusion</u>:</strong> The use of external anatomical landmarks to estimate length of REBOA in Zone-1 and Zone-3 with evaluate the clinical response is safe to perform the procedure.</p> Panu Teeratakulpisarn, Phati Angkasith, Parichat Tanmit, Supatcha Prasertcharoensuk, Chaiyut Thanapaisal, Narongchai Wongkonkitsin Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247316 Fri, 16 Oct 2020 00:00:00 +0700 Continuous Quality Improvement of Clinical Practice Guideline for Management of Patients Undergoing Percutaneous Nephrolithotomy Under General Anesthesia in Srinagarind Hospital https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247317 <p><strong><u>Background and Objective</u></strong><u>:</u> Percutaneous nephrolithotomy (PCNL) is a minimal invasive surgery for treatment of renal calculi. It may cause pleural cavity injury, i.e., pneumothorax, hydrothorax, or hemothorax (P/H/H), which mostly occurs in supracostal access of trocar puncture. The previous practice guideline requires that, for safety, endotracheal tube must be retained at the end of surgery in all patients undergoing PCNL with supracostal access leading to patient discomfort and agitation. They were extubated after pleural cavity injury was assessed using portable CXR at PACU. To reduce patient discomfort, we improved the guideline using PaO<sub>2</sub>/FiO<sub>2</sub> (P/F) ratio ≤ 300 mmHg as criteria to retain endotracheal tube in these patients. The objective of this study was to evaluate the efficacy of the new guideline.</p> <p><strong><u>Methods</u></strong><u>:</u> This was a prospective, descriptive study. We included all adults undergoing elective PCNL at Srinagarind hospital, Khon Kaen university between July 2017 and November 2018. We identified the incidence of endotracheal tube retaining and pleural cavity injury.</p> <p><strong><u>Results</u></strong><u>:</u> Forty-seven patients were included. There were 20 cases (42.6%) with supracostal access. Among supracostal patients, there were 9 cases (45%) with P/F ratio ≤ 300 mmHg who required endotracheal tube retaining with 2 cases (4.3%) complicated with hydrothorax and 3 cases (6.4%) with sepsis.</p> <p><strong><u>Conclusions</u></strong><u>:</u> The improved guideline using P/F ratio ≤ 300 mmHg as criteria to retain endotracheal tube in patients undergoing PCNL with supracostal access can reduce incidence of endotracheal tube retaining from 100% to 45% without complication. The incidences of pleural cavity injury and sepsis were 4.3% and 6.4%.</p> Wilawan Somdee, Sirirat Tribuddharat, Thepakorn Sathitkarnmanee, Wichien Sirithanaphol, Narin Plailaharn, Pakorn Kiatsopit, Ukrit Rompsaithong, Suthannee Simajareuk, Viriya Thincheelong, Khochakorn Palachewa Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247317 Fri, 16 Oct 2020 00:00:00 +0700 The Effect of Overnight Fasting on Stroke Volume Index Measured by Whole Body Impedance Cardiography https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247318 <p><strong><u>Background and Objecitve</u></strong><u>: </u>Preoperative fasting is recommended to prevent pulmonary aspiration. Fasting induces hypovolemia. Intravenous fluid infusion is commonly given during anesthesia to minimize the risk of hypotension. However, intravenous fluid overload has been shown to deteriorate patient outcome. From previous literatures, the effect of preoperative fasting on intravascular volume is still inconclusive. There is no previous study that assesses intravascular volume status before and after fasting using the whole body impedance cardiography which is a non-invasive, practical and operator-independent. The reliability of whole body impedance cardiography is comparable to pulmonary artery thermodilution which is gold standard. In this study, we assessed stroke volume index (SVI) before and after fasting for 8 to 10 hours using whole body impedance cardiography.</p> <p><strong><u>Methods</u></strong><strong><u>:</u></strong> This is prospective observational study. We included volunteers with American society of anesthesiologists (ASA) physical status classification I–II with age between 18-65 years old. SVI and other hemodynamic parameters were measured before and after fasting using whole body impedance cardiography. The absolute change of hemodynamic parameters before and after fasting more than 10% indicated clinical significance. P value &lt; 0.05 indicates statistical significance.</p> <p><strong><u>Results</u></strong><strong><u>:</u></strong> Sixty-two volunteers were enrolled and completed the study. SVI before and after overnight fasting were 40.0±8.7 mL/m<sup>2</sup> and 37.7±8.2 mL/m<sup>2</sup>, respectively. SVI after fasting was decreased 5.5%. The percentage absolute change of SVI in individual volunteer was in a range between 3.1% to -17.0%. Twelve subjects (19.4%) have decreased in SVI. Stroke volume (SV), cardiac output (CO) and cardiac index (CI) were decreased 5.6%, 6.6% and 6.4%, respectively. All hemodynamic parameters except heart rate were statistically decreased after fasting (p-value &lt; 0.05) but the absolute change less than 10%.</p> <p><strong><u>Conclusion</u></strong><strong><u>:</u></strong> Overnight fasting does not clinically affect SVI measured by whole body impedance cardiography in healthy population. Some volunteers have significantly decreased in SVI after fasting and appropriate intravenous fluid therapy probably improves CO.</p> Sivaporn Termpornlert, Onrada Chuasuwan, Pornpatra Areeruk, Tanit Virankabutra Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247318 Fri, 16 Oct 2020 00:00:00 +0700 Accuracy of Multi-parametric Magnetic Resonance Imaging for Diagnosis of Prostate Cancer https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247319 <p><strong><u>Objective</u></strong><u>:</u> To assess the diagnostic accuracy of magnetic resonance imaging (MRI) for prostate cancer with multiple parameters.</p> <p><strong><u>Methods</u></strong><u>:</u> Patients who underwent both MRI and transrectal ultrasound-guided biopsy from July 2012 to August 2014, were reviewed retrospectively.&nbsp; Multiple parameters were assessed to determine the accuracy of MRI for prostate cancer; the apparent diffusion coefficient (ADC), dynamic contrast enhanced MRI (DCE-MRI), and the Cho/cit and (Cho+creat)/cit ratios.&nbsp; The areas under the receiver operating characteristic curves (AUC) were used to evaluate the diagnostic accuracy of metabolic ratios.</p> <p><strong><u>Results</u></strong><u>:</u> Thirty-six lesions from 28 patients were analyzed.&nbsp; Malignant lesions at the peripheral zone showed significantly lower ADCs than benign lesions (p &lt; 0.01).&nbsp; If lesion size was 1 cm or larger, the (Cho+creat)/cit ratio was significantly higher (p &lt; 0.01).&nbsp; The ADCs had a high specificity of 87.5%, an accuracy of 77.8%, and AUC of 0.68.&nbsp; DCE-MRI had high specificity of 91.7%, accuracy of 83.3%, and an AUC 0.78. The Cho/cit ratios showed a high sensitivity of 91.7%, but low specificity of 54.2%.&nbsp; The greatest AUC was 0.85 when the DCE-MRI was combined with the Cho/cit ratio, giving an accuracy of 83.3%.&nbsp; No significant improvement was established, however, when all 3 parameters were combined together.</p> <p><strong><u>Conclusion</u></strong><u>:</u> DCE-MRI and ADC had greater diagnostic accuracy than MR spectroscopy (MRS).&nbsp; Combined parameters improved specificity for prostate cancer lesions.</p> Chalida Aphinives, Chayanon Chinporncharoenpong, Kulyada Somsap, Vallop Laopaiboon Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247319 Fri, 16 Oct 2020 00:00:00 +0700 Factors Affecting Distance of 6-Minute Walk Test in Post Cardiovascular Surgery Patients after Discharge at Queen Sirikit Heart Center of the Northeast https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247320 <p><strong><u>Background and objective:</u></strong> The 6-minute walk test (6MWT) is a popular, practical and straightforward test that widely used to guide a cardiac rehabilitation program and assess exercise tolerance, therapeutic effect and prognosis. 6-minute walk distance (6MWD) varies with different factors. This research aimed to study the factors that affect 6MWD in post-cardiovascular surgery patients after discharge at Queen Sirikit Heart Center of the Northeast.</p> <p><strong><u>Methods:</u></strong> Data and attractive factors collected from the medical records of the post-cardiovascular surgery patients during their first follow-up after discharge from Queen Sirikit Heart Center of the Northeast from May 1<sup>st</sup>, 2017 to April 30<sup>th</sup>, 2018. The statistical analysis applied to mean, standard deviation, correlation coefficient and stepwise multiple regression analysis.</p> <p><strong><u>Results:</u></strong> 6MWD mean of 153 subjects was 276.05 ± 74.43 meters. The factors that relate to 6MWD are sex, height, maximum heart rate in the 6MWT, and the rate of perceived exertion before 6MWT. The shared factors in the prediction of 6MWD (r<sup>2</sup> = 0.288, p &lt; 0.001) are age, sex, and the rate of perceived exertion before 6MWT.&nbsp;&nbsp;&nbsp;</p> <p><strong><u>Conclusions:</u></strong> The affected factors that could predict 6MWD in post cardiovascular surgery patients discharged from Queen Sirikit Heart Center of the Northeast are age, sex, and the rate of perceived exertion before 6MWT.</p> Montri Yasud, Benja Songsaengrit, Pajeemas Kittipanya-ngam Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247320 Fri, 16 Oct 2020 00:00:00 +0700 Development of Reusable Hot and Cold Pack Made from Clay https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247321 <p><strong><u>Background and objectives:</u></strong> Reusable heat and cold treatment devices have a difficult disinfecting prองศาเซลเซียสedure. This study investigated the effectiveness of reusable hot and cold packs made from clay on temperatures storage and transfer property. The benefit of this study may be used as an alternative option to heat and cold treatment devices.</p> <p><strong><u>Method:</u></strong> Developing heat and cold pack from clay packed into vacuum bags and testing the heat and cold preservation properties and test the skin temperature during the heat and cold compress for 20 minutes.</p> <p><strong><u>Results:</u></strong> From a pilot study, it was found that the hot and cold packs, size 25 x 20 cm, made from clay, weight 500 grams, it has temperatures storage property for more than 20 minutes. The average skin temperature increased to a maximum of 44.0 ± 1.3<sup>o</sup>C and reduced to 41.6 ± 0.2 <sup>o</sup>C after 20 minutes. Cold compresses, the average skin temperature dropped to the lowest at 22.7 ± 0.1 <sup>o</sup>C, it was increased to 23.4 ± 0.1 <sup>o</sup>C after 20 minutes of cold compresses.</p> <p><strong><u>Conclusion:</u></strong> This study demonstrated the effectiveness of heat and cold packs made from clay. Based on physiological effects, it can be used as a treatment to promote hot and cold effects. This may be used as an alternative option for effectively heat and cold treatment.</p> Jirawat Wattanapanyawech, Chakirt Sattayarom, Thaniya Klinsophon, Sudarat Borisut Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247321 Fri, 16 Oct 2020 00:00:00 +0700 Update Interdisciplinary Clinical Practice Guideline for Patients with Cleft Lip and Palate at Prenatal Until 5 Years https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247322 <p><strong><u>Background </u></strong><strong><u>and Objective</u></strong><u>:</u> Patients with cleft lip and palate require long-term care from interdisciplinary team. The important phase of treatment is pre-natal until 5 years. Update clinical practice guideline therefore important.</p> <p><strong><u>Method</u></strong><strong><u>s:</u></strong> This participation action research were performed by 30 members&nbsp; of interdisciplinary team in Tawanchai Center which comprises of 10 disciplines. Participated in analyzing the problem and updating the guideline by 24 members, 2 times, sending the guideline to 3 disciplines which are pediatricians, obstetricians and psychiatrists not attending the meeting to give suggestions. And content validity was checked by 5 experts with updated guidelines applied and clinical outcome evaluation. Study was conducted for 4 months (January - April 2019), summarizing data and content analysis.</p> <p><strong><u>Results:</u></strong> It was found that during the 6 weeks before pregnancy, update by giving folic acid, between the ages of 3-6 months, adding the support for the shape of the nose after Cheiloplasty by nasal creator device. Consultation for pediatric dentists and send for the assessment, promoting language and speech development no. 1, cancel follow-up treatment according to the online registration system. Between the ages of 10-18 months, adding evaluating the development of alveolar and maxilla with oral health before palatoplasty, between the ages of 1 and a half-3 years and 4-5 years. Adding evaluation of the middle ear, repeated every 3 months. If not otitis media, repeat every 6 months until the age of 7 years until Eustachian work well. And cancel follow-up treatment according to the online registration system.</p> <p><strong><u>Conclusions:</u></strong> The updated guideline covers all interdisciplinary team care, from pre-natal until 5 years and evaluating results over the 5 years. There most beneficial to patients, and could be applied to other centers that has a similar context.</p> Suteera Pradubwong, Darawan Augsornwan, Suntaree Namjaitaharn, Orathai Saenbon, Jamras Wongkham, Tippawan Muknumporn, Chanatiporn Chonprai, Niramol Patjanasoontorn, Patimaporn Pungchanchaikul, Aggasit Manosudprasit, Poonsak Pisek, Benjamas Prathanee, Kengkart Winaikosol, Bowornsilp Chowchuen Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247322 Fri, 16 Oct 2020 00:00:00 +0700 Estimated Charge Cost For Cleft Lip And Cleft Palate Treatment : A Study Of In-Patients in Dental Hospital, Faculty Of Dentistry, Khon Kean University https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247323 <p><strong><u>Background and Objective</u></strong><strong>: </strong>The study was to determine treatment fee of cleft lip and cleft palate (CLP) patient admitted in the in-patient of Dental Hospital. The results will be the fundamental information for establishing the department’s policies and to be used as the basis for allocating budgets and improving patient care services.&nbsp;</p> <p><strong><u>Methods</u></strong><strong>:</strong> The retrospective descriptive study was performed during the 3 years period (2016 – 2018). Data was collected &nbsp;from medical records of CLP patients. Deformities of patient were identified by their ICD -10 code, the operations were identified by their ICD-9, the payment information was obtained from the financial unit, using Microsoft excel to collect and analyze data which included percentage, average and standard deviation.</p> <p><strong><u>Results</u></strong><strong>: </strong>According to 131 CLP patients, 73 were females (55.73%) and 55 (41.98%) were aged 11 - 15 years old. Most of them 121 persons (92.37%) have the national health insurance were. Surgery on alveolar bone grafting (ABG), Iliac crest bone graft (ICBG) were 125 persons (95.42%). The code of ICD-9 was 77.79; Excision of bone for graft were 125 persons (95.42%).&nbsp; The average medical fee of ONFC and ABG, ICBG surgery are 24,122.5 and 25,532.120 baht, However , the average reimbursement of the outer district patient paid by the National Health&nbsp; Security Insurance was 10,515.84 and 19,386.24 baht, correspondingly.</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> According to 131 CLP patients, mostly were 73 females , aged between 11 - 15 years who have the Nation Health Security Insurance coverage , the surgical treatment of ONFC and ABG, ICBG, the code &nbsp;of ICD-9 was 77.79. it was &nbsp;found that most of the medical charged from outer district was lower than actual .This study reported the imbalance of medical expenses that the hospital has actually treated and the reimbursed treatment fees from the National Health Security office.</p> Chuleeporn Supunya, Neunghathai Aphiphatkan, Pattaramon Rattanapan Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247323 Fri, 16 Oct 2020 00:00:00 +0700 The Effect of Options Counselling and Factors Associate with Decision Making on Pregnancy Options Among Unintended Pregnant Adolescents and Youths https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247324 <p><strong><u>Background and Objectives</u></strong><u>:</u>&nbsp; An options counselling for unintended pregnant women is provided by Srinagarind hospital to support them to make their own choices. This study aimed to study the effects of options counselling and factors associate with decision making on pregnancy options among unintended pregnant adolescents and youths.</p> <p><strong><u>Methods:</u></strong> A retrospective study over three years (2016-2019) was conducted. The data were retrieved from the medical records of unintended pregnant adolescents and youths who participated in the options counselling program at Srinagarind hospital. This study included pregnant adolescents and youths aged 24 years old and under. The sociodemographic data and decision making on pregnancy options were gathered and analyzed by the Fisher’s exact test.</p> <p><strong><u>Results:</u></strong> Thirty-one of samples with average age was 17.9 years old (SD ±3.0).&nbsp; Eighty-four percent were students from high school and college. Almost 94 percent were primigravida.&nbsp; The average gestational age at first visit was 12 weeks and 6 days (SD ±7 weeks and 6 days). The pregnant adolescents and youths who decided either to continue a pregnancy to term or terminate a pregnancy were accounted for 38.7 and 61.3 percent, respectively. In addition, 58.4 percent of them decided to use the effective contraceptive methods. Gestational age at the first visit was associated with decision making on pregnancy options (Fisher’s exact test 9.54, df=1, p=0.007).&nbsp; Age, occupation, number of pregnancies, contraceptive methods and healthcare access (by herself or being referred) were not significantly associated with decision making on pregnancy options.</p> <p><strong>Conclusion:&nbsp; Most of unintended pregnant women decided to terminate their pregnancies. The first visit was late for some women that could lead to delay receiving options counselling and minimize their choices. The release information of options counselling should be provided for all unintended pregnant women to promote healthcare accessibility within early trimester for reducing the crisis of unintended pregnancy.</strong></p> Kesorn Lao-unka, Orathai Seanbon, Jen Sothornwit, Somjit Muangpin Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247324 Fri, 16 Oct 2020 00:00:00 +0700 Multiplex PCR for Identifying BCR-ABL Fusion Transcript Types in Northeastern Thailand Chronic Myeloid Leukemia Patients https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247336 <p><strong><u>Background and Objective</u></strong><strong><u>:</u></strong>&nbsp; Philadelphia chromosome is the chromosome originating from the reciprocal translocation between long arms of chromosome 9 and chromosome 22 t (9;22) (q34; q11), it presents in 90 - 95% of patients with chronic myeloid leukemia. The aberration results from a reciprocal translocation are creating a BCR-ABL fusion gene. There are two major forms of the BCR-ABL fusion gene, involving ABL exon 2, but including different exons of BCR gene. The transcript b3a2 and b2a2 codes for a p210 protein. Other fusion gene leads to the expression of an e1a2 transcript, which codes for a p190 protein. Its frequency varies in different populations but there are no data from northeastern Thailand. In this study we aimed to report BCR-ABL fusion transcript types in northeastern Thailand CML patients by Multiple Reverse Transcriptase-Polymerase Chain Reaction (Multiplex PCR).</p> <p><strong><u>Materials and Methods</u></strong> Retrospective descriptive and analytical study of all adult CML patients in Srinagarind and Khon Kaen hospitals, which is the main tertiary medical center in the northeastern region Thailand. Data has been collected from medical records for 3 years (January 2017 to January 2020).&nbsp; &nbsp;Peripheral blood or bone marrow samples were analyzed by multiplex PCR from 177 adult northeastern Thailand CML patients. Aim to identify BCR-ABL fusion transcript types in northeastern Thailand CML patients by Multiplex PCR.</p> <p><strong><u>Results</u></strong><strong><u>:</u></strong> All patients examined were positive for some type of BCR/ABL rearrangement. The majority of the patients (93.79%) expressed one of the p210 BCR-ABL transcripts, b3a2 and b2a2 transcript types were detected in 58.19% and 35.59% respectively. Co-expression of b3a2 (p210)/e1a2 (p230) was detected in 0.56%. The expression of an e1a2 transcript type, which codes for a p190 protein showed 4.52%. And 1.14% was detected in e19a2 transcript type. Co-expression of p210/p190 was not detected.</p> <p><strong><u>Conclusions</u></strong><strong><u>:</u></strong> Multiplex RT-PCR is useful and saves time in the detection of BCR-ABL fusion transcript types; the occurrence of these transcripts associated with CML can assist in prognosis and treatment of disease.</p> Kanokon Chootawiriyasakul, Kanchana Chansung Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247336 Fri, 16 Oct 2020 00:00:00 +0700 Effect of Captopril on Erectile Dysfunction and Sperm Quality in Hypertensive Rats https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247337 <p><strong><u>Background and Objectives</u></strong>: Hypertension has been reported to be associated with erectile and testicular dysfunction.&nbsp; This study aimed to evaluate the role of the anti-hypertensive drug, captopril, on erectile and testicular function in L-NAME-induced hypertensive rats.</p> <p><strong><u>Methods</u></strong><strong>:</strong> Male Sprague-Dawley rats were divided into 3 groups including control group received tap water, L-NAME group received L-NAME at dose 40 mg/kg/day for five weeks and captopril group received L-NAME and captopril at dose 5 mg/kg/day for the last two weeks. At the end of the study, systolic blood pressure, erectile response to nerve stimulation, sperm concentration, sperm motility, and oxidative stress markers were determined.&nbsp; &nbsp;</p> <p><strong><u>Results</u></strong><strong>:</strong> L-NAME administration caused high blood pressure and decreased erectile response to nerve stimulation, reduced sperm concentrations, and sperm motility in rats. Moreover, the high level of vascular superoxide production, plasma, and tissue malondialdehyde, and low level of plasma nitric oxide metabolites were also observed in hypertensive rats compared to control rats (p&lt;0.05). Treatment with captopril alleviated these reproductive alterations caused by L-NAME.</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> Captorpil improved erectile dysfunction and sperm quality in L-NAME-induced hypertensive rats. The possible mechanism may associate with its antihypertensive and antioxidant properties.</p> Petcharat Chiangsaen, Anuson Poasakate, Poungrat Pakdeechote , Putcharawipa Maneesai Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247337 Fri, 16 Oct 2020 00:00:00 +0700 Optimization of Colorimetric Assay of Loop Mediated Isothermal Amplification for Detections of Mycobacterium tuberculosis https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247338 <p><strong><u>Background and objectives</u></strong><strong>:</strong> Tuberculosis is an airborne disease caused by <em>Mycobacterium tuberculosis</em> (MTB). It is a major public health problem of Thailand and worldwide, ranking as the second leading cause of death from worldwide infectious diseases. Diagnosis development is one of key factors to control it. The objective of this study was to optimize the colorimetric method of Loop-mediated isothermal amplification (LAMP), which is a new promising method because DNA is synthesized at a single temperature in relatively short period. &nbsp;</p> <p><strong><u>Methodology</u></strong>: The LAMP was set-up to detect the genomic DNA of MTB. The amplified product was detected by using Hydroxy naphthol blue (HNB), Sybergreen (SYBR) and gel electrophoresis. The amount of HNB was optimized for detection compare to the results of using SYBR and gel electrophoreses.</p> <p><strong><u>Results</u></strong>: Pre-addition of 5 mM HNB to the LAMP reaction solution showed observe-able blue-sky color of positive but did not interfere amplification efficiency. The minimum detection limit between using HNB, SYBR and gel electrophoresis were 10, 100 and 10 pg of MTB genomic DNA, respectively. &nbsp;</p> <p><strong><u>Conclusion</u></strong>: The colorimetric LAMP method using HNB was successfully optimized for detection of MTB. The optimal of concentration of HNB was 5mM and the minimum detection limit was 10 pg of MTB genomic DNA which is similar to those of gel electrophoresis.</p> Jittanun Srisutush, Arunnee Sangka, Wises Namwat Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247338 Fri, 16 Oct 2020 00:00:00 +0700 Parental Factors Associated with Children's Screen Time in Child Development Center, Khon Kaen Municipality https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247342 <p><strong><u>Background and objective</u></strong><strong>: </strong>Screen media usage increased substantially in children’s daily life. Parents play an important role in their children's screen time. The objective of this study was to determine the association of parental factors including parental perception, parents' behaviors regarding screen time control of their children, and parents’ screen time with child’s screen time.</p> <p><strong><u>Methods</u></strong><strong>:</strong> A total of 300 pairs of parents and &nbsp;children aged 2-5 years old from the Child Development Center, Khon Kaen Municipality participated in this cross-sectional analytical study. A self-response questionnaire was use to collect information including parental perception about child’s screen time, parents' behaviors regarding screen time control of their children, parents' behaviors regarding screen time control of their children, screen time usage of children and parents. The association between parental factors and child’s screen time was analyzed using multiple logistic regression.</p> <p><strong><u>Results:</u></strong> Majority of children (85.7%) and their parents (83.3%) used the screen more than 1 hour/day. The parental perception was classified as high and moderate levels accounting for 58.7 and 40.6 % respectively. Parents' behaviors regarding screen time control of children was at moderate and good levels, 58.0% and 39.3% respectively. The variables which statistically associated with child's screen time &gt; 1 hour/day were parental perception on obstacle to control screen time of children at moderate-high levels (OR<sub>adj</sub> 2.93, 95% CI: 1.22-7.05), parents' behaviors regarding screen time control of children at low-moderate level (OR<sub>adj</sub> 2.89, 95% CI: 1.29-6.53), and parental screen time &gt; 1 hour/day (OR<sub>adj</sub> 5.51, 95% CI: 2.57-11.83).</p> <p><strong><u>Conclusions:</u></strong> Most of the children used screen time more than the recommended level (&gt; 1 hour/ day). The parents should be aware of the effect of screen time usage of children and should avoid screen time usage midst their children. Children should be encouraged to have more physical activities to reduce screen time use.</p> Aroonluk Kongyoung, Benja Muktabhant Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247342 Fri, 16 Oct 2020 00:00:00 +0700 Relationships between Heart Rate Variability, Motor Impairments and Level of Disability in Chronic Ischemic Stroke Patients https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247347 <p><strong><u>Background and objective:</u></strong> Cardiac autonomic dysfunction that is measured by heart rate variability (HRV) is associated with motor impairments of acute chronic stroke patients. The purposes of this study were to investigate the association between HRV, motor impairments and disability level in chronic ischemic stroke patients.</p> <p><strong><u>Methods:</u></strong> Thirteen individuals with chronic stroke (6-72 months) were included. They were required to have the ability to stand independently for at least 5 minutes and could follow 2 step commands. Participants were evaluated their HRV for 20 minutes in supine position. Upper and lower extremities motor impairments and level of disability were assessed by Fugl-Meyer assessment (FMA) and modified Rankin Scale (mRS), respectively. Spearman’s correlation coefficients were used to investigate the association between outcome measures. Differences were considered statistically significant at p&lt;0.05.</p> <p><strong><u>Result:</u></strong> The results showed moderate positive correlations between upper extremity motor impairments (FMA-UEs) and low-frequency power in normal units (LF (nu)) (r=0.622; p=0.02), and low-frequency to high- frequency power (LF/HF) ratio (r=0.561; p=0.04). Furthermore, there were strong negative correlations between level of disability and LF nu (r =-0.855; p&lt;0.001), and LF/HF ratio (r=-0.711; p=0.006).</p> <p><strong><u>Conclusion:</u></strong> HRV of chronic ischemic stroke is associated with upper extremity motor impairments and level of disability.</p> Natchaya Chondaen, Phannarai Plusiri, Sukunya Srisawad, Sujitra Meesribau, Olan Isariyapan, Phatiwat Chotimol, Duangnapa Roongpiboonsopit, Benjarat Sangthong, Waroonnapa Srisoparb Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247347 Fri, 16 Oct 2020 00:00:00 +0700 Survival Rate of Oral Cancer Patients after Diagnosis in Buriram Hospital, Buriram Province https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247352 <p><strong><u>Background and Objective:</u></strong><strong> &nbsp;</strong>Oral cancer (OC) is one of the head and neck cancers. Nowadays, the OC trended to be increased, and there was no study about the survival rate of OC patients in Buriram province. Therefore, the objective of this study was to determine the survival rate of OC after diagnosis in Buriram hospital, Buriram province.</p> <p><strong><u>Methods:</u></strong> Data of patients with OC were retrieved from the Buriram hospital-based cancer registry. OC is an International Classification of Diseases for Oncology, 3<sup>rd</sup> edition; C00 – C06. Patients with OC who were histologically proved and admitted to the Buriram Hospital (2014-2018) and followed up until 2019 of 339 cases. Survival rate were estimated by the Kaplan-Meier method. We reported by median survival time and 95% confidence interval. Comparison group of survival rate were estimated by Log-rank test.</p> <p><strong><u>Result:</u></strong> Of 339 OC patients which follow-up time was 444 person-year, and died during the study were 261 cases, corresponding to mortality (Case-fatality) rate of 59.0 per 100 person-year. (95% CI; 52.1 - 66.6). The median survival of OC was 0.83 years (95% CI; 0.70 - 0.96). The overall survival experience of 1, 3 and 5 years were 43.9% (95% CI; 38.5 - 49.1), 25.0 % (95% CI; 20.2 - 30.0), and 14.8 % (95% CI; 10.0 - 20.4), respectively.</p> <p><strong><u>Conclusion:</u></strong> The 5-years survival rate of OC after diagnosis at Buriram hospital was low. Therefore, primary and secondary prevention are needed. Screening program for early detection are required for improving the survival rate. Including the factors affecting to OC need to be focus.</p> Sarawoot Nontasila, Supot Kamsa-ard, Raksak Amphaiphan, Natalie Rose Noisuwan, Thida Ratanawilaisak Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247352 Fri, 16 Oct 2020 00:00:00 +0700 Expression of Recombinant Peptide LcI from Bacillus amyloliquefaciens KKU14 and Test for Its Inhibition on Burkholderia pseudomallei https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247356 <p><strong><u>Background and objective:</u></strong> <em>Burkholderia pseudomallei</em> is a pathogenic bacterium, causing melioidosis, a serious infectious disease. Currently, the best treatment is using antibiotic drugs. However, many clinical strains are now intrinsically resistant to almost all available antibiotic drugs. Previous study indicated that <em>Bacillus amyloliquefaciens</em> KKU14 strongly inhibits <em>B. pseudomallei</em>. In this study, antimicrobial peptide LcI of <em>B. amyloliquefaciens</em> KKU14 was cloned and expressed to test activity against <em>B. pseudomallei</em>.</p> <p><strong><u>Materials and Methods:</u></strong><strong> &nbsp;</strong>Antimicrobial peptide LcI was searched from GenPept database (NCBI) and amplified from genome of <em>B. amyloliquefaciens</em> KKU14 by PCR and cloned into different cloning vectors. &nbsp;The recombinant clones were induced and their activity against <em>B. pseudomallei</em> strain P37 were tested by agar well diffusion and in-gel overlay.</p> <p><strong><u>Results:</u></strong> The recombinant peptide was successfully cloned. However, the expression could be observed only in pQE31 vector. The expressed peptide has the size of approximately 10 kDa. Nevertheless, the recombinant clones exposed no antimicrobial activities against <em>B. pseudomallei</em> strain P37.</p> <p><strong><u>Conclusion:</u></strong> The recombinant peptide LcI cloned from <em>B. amyloliquefaciens</em> KKU14 does not inhibit <em>B. pseudomallei</em> strain P37 in this study. This might due to improper folding of the recombinant peptide, or the peptide that was responsible for inhibition of <em>B. pseudomallei</em> might be other peptides, or the inhibition effect might need synergistically work from several peptides together, which has to be further investigated.</p> Wajeeorn Ouancharee, Chotima Potisap, Rasana W Sermswan, Atcha Boonmee Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247356 Fri, 16 Oct 2020 00:00:00 +0700 Update on Mechanism of Insulin Resistance and New Trend of Drug Development https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247361 <p>&nbsp;Insulin plays a crucial role in regulating the proper metabolic and energy balance. Once insulin signal transmissions are decreased, this can lead to a condition known as “insulin resistance”.</p> <p>Difference mediators, such as pro-inflammatory cytokines, free fatty acids, blood glucose and&nbsp; ROS level can increase the activity of kinases, i.e. several Protein kinase C (PKC) isoforms, c-Jun N-terminal kinases (JNK), Protein kinase A (PKA), Mammalian Target of Rapamycin (mTOR) and Mitogen-Activated Protein Kinase (MAPK), which affecting the signal of insulin receptors, IRS, and downstream-located effector molecules. Therefore, better understanding on the molecular mechanisms of these pathways is important for developing a more effective treatment of insulin resistance and associated diseases.</p> <p>This review summarizes the current knowledge on the mechanism of insulin resistance, the diseases associated with insulin resistance and biological effects of recent agents, which are developed for increasing insulin signaling, and are currently undergoing clinical trials.</p> Patcharin Singdam, Patchareewan Pannangpetch, Kampeebhorn Boonloh Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247361 Fri, 16 Oct 2020 00:00:00 +0700 Acute angle Closure Glaucoma https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247363 <p>Acute angle-closure glaucoma is an ocular emergency that potentially leads to irreversible blindness if the treatment is delayed. The main etiology is the iridotrabecular contact, resulting in anterior chamber angle closure and inadequate drainage of aqueous humor hence the intraocular pressure (IOP) suddenly increases. Risk of angle closure is high among the elderly, women, Asian population and those with hyperopia. Diagnosis relies on history of symptoms resulting from the acute IOP rising and ocular examination demonstrating angle closure with anatomical risk factors. Patients usually present with acute severe painful blurred vision, ciliary injection, seeing rainbow halo around lights, nausea, vomiting and headache. Ocular examination showed high IOP, shallow anterior chamber, anterior lens position, closed anterior chamber angle, and occasionally, optic disc edema. Treatment consists of immediate IOP reduction, control of inflammation and reopen the angle by laser or lens extraction with goniosynechialysis. Serial gonioscopy is considered for the long-term angle monitoring. Trabeculectomy is performed in cases of uncontrolled IOP after reopening of the angle.</p> Sukhumal Thanapaisal, Pawasoot Supasai Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/247363 Fri, 16 Oct 2020 00:00:00 +0700