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) csompo@kku.ac.th (Sompong Chantakram) Wed, 23 Sep 2020 14:45:06 +0700 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Conservative Treatment vs Internal Fixation in Non-displaced Tibial Plateau Fracture; Retrospective Cohort Study https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239873 <p><strong><u>Background and objective</u></strong><strong>: </strong>Tibial plateau fracture is a complex periarticular knee joint fracture that is mainly treated by internal fixation or conservative treatment in some cases. Although many studies have detailed techniques and outcomes of surgical fixation in tibial plateau fractures, minimal literature exists on the functional and radiological outcome of nonsurgical management. Despite literatures reporting good clinical outcome in internal fixation, patients that have been treated by conservative treatment in&nbsp;Maharat&nbsp;Nakhon&nbsp;Ratchasima&nbsp;Hospital have also reported good results according to research comparing clinical outcomes between the two groups. Nowadays the guideline of&nbsp;treatment in&nbsp;tibial&nbsp;plateau fractures remains controversial especially in&nbsp;non-&nbsp;displaced or minimally displaced fractures.This study sought to compare functional results and radiological results in patients with non-displaced tibial plateau fracture that are treated surgically and nonsurgically.</p> <p><strong><u>Methods : </u></strong>Over the last 6 years, 603 consecutive tibial plateau fracture were treated in Maharat Nakhonratchasima Hospital. Overall, 65 patients (11%) were non-displaced fracture and were available for follow-up for 12 weeks. 43 patients were treated nonsurgically and 22 patients were treated surgically. The functional results and radiological results were recorded by modified version of the knee scoring system of Hohl and Luck . The functional results and radiological results were compared between the two groups.</p> <p><strong><u>Results :</u></strong> 65 patients were included in this study. Overall, 95% of surgery group attained good to excellent functional results vs 91% in conservative group. 77% of surgery group attained good radiological results vs 47% in conservative group..</p> <p><strong><u>Conclusions :</u></strong> Conservative treatment in patients with non-displaced tibia plateau fracture is still an alternative option although it has a higher chance to collapse more than operative&nbsp; group.</p> Naruepol Ruangsillapanan, Urawit Piyapromdee, Wasit Panoinont Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239873 Fri, 21 Feb 2020 00:00:00 +0700 Prevalence and Clinical Risk Factors of Coronary Artery Disease in Rheumatic and Non-Rheumatic Valvular Heart Disease Patients Undergoing Preoperative Coronary Angiography https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239883 <p><strong><u>Background and Objective:</u></strong> Preoperative coronary angiography (CAG) is an essential procedure before conducting a valvular operation. However, it is invasive and may cause serious complications. Identification of the prevalence of coronary artery disease (CAD) and its clinical risk factors in patients with rheumatic (RHD) compared to those with non-rheumatic heart disease (NRHD) should result in more appropriate patient selection and reduction of the over-utilization of CAG.</p> <p><strong><u>Methods:</u></strong> We conducted a retrospective cross-sectional study by reviewing the records of all consecutive patients with valvular heart disease who underwent preoperative CAG under our care at Queen Sirikit heart center from April 2015 - April 2018.</p> <p><strong><u>Results:</u></strong> A total of 238 patients were included in this study, 110 (46.2%) of whom suffered from RHD and 128 (53.8%) of whom had NRHD. The overall prevalence of significant CAD was 13.9% (20.3% in NRHD and 6.4% in RHD, p-value = 0.002). Overall, age over 50 years, diabetes mellitus, hypertension, and chronic kidney disease stage 3 or higher were risk factors for CAD and RHD was a protective factor according to univariate analysis. However, only hypertension and age remained significant after multivariate analysis. In contrary, female patients with rheumatic etiology and had no diabetes mellitus and hypertension were the lowest-risk subgroups.</p> <p><strong><u>Conclusion:</u></strong> The prevalence of CAD was lower in patients with RHD compared to those with NRHD. However, the clinical risk factors that predicted CAD in both groups were conventional CAD risks. Thus, alternative non-invasive preoperative coronary studies should be an option in RHD patients with low traditional CAD risk factors.</p> Danon Kaewkes, Keetapong Pongtipakorn Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239883 Fri, 21 Feb 2020 00:00:00 +0700 Incidence of Acute Kidney Injury by Neonatal RIFLE Criteria in NICU https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239889 <p><strong><u>Background and objective</u></strong>: Acute kidney injury (AKI) is an important contributing factor to the mortality of critically ill neonates. However, the standardized AKI for this population is still inconclusive until neonatal RIFLE score has been proposed in 2013. This study aimed to identify the incidence of AKI in critically ill neonates by using neonatal RIFLE.</p> <p><strong><u>Methods</u></strong><strong>:</strong> In this descriptive, retrospective study included all neonates admitted to the tertiary care NICU during January 2013-December 2014. The patient demographics, co-morbidities, and outcomes data were recorded. AKI was classified by neonatal RIFLE into urine output-based criteria and serum creatinine-based criteria. The objectives were 1. To determine the incidence of AKI as defined by neonatal RIFLE score in NICU. 2. To identify factors affecting AKI in critically ill neonates.</p> <p><strong><u>Results</u></strong><strong>:</strong> A total of 263 neonates were enrolled. The incidence of AKI by neonatal RIFLE was 24.3%, compared with 8% of those diagnosed by attending physicians (p&lt;0.001). Forty-eight of 64 patients (75%) with AKI were classified by urine output criteria only, eight patients (12.5%) were diagnosed by eGFR criteria only and eight patients (12.5%) matched both criteria. Congenital heart diseases and administration of vancomycin were found to be significant independent factors of AKI in the NICU (p&lt;0.05). Most neonates with AKI (81.3%) had complete renal recovery. The mortality rate of neonates with AKI by neonatal RIFLE was 26.5% compared to 4% of neonates without AKI.&nbsp;</p> <p><strong><u>Conclusion:</u></strong> The incidence of neonatal AKI by using urine output criteria from neonatal RIFLE was high (24%) and useful to detect and early management of neonatal AKI.</p> Napat Laoaroon, Pakaphan Kiatchoosakun, Suwannee Wisanuyotin, Apichat Jiravuttipong, Junya Jirapradittha, Sunee Panombualert Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239889 Fri, 21 Feb 2020 00:00:00 +0700 Prevalence of Clinical Lumbar Instability in Patients with Chronic Low Back Pain by Radiography (Pilot Study) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239891 <p><strong><u>Background and Objective</u></strong><strong>:</strong> Lumbar Instability (LI) could be classified into many subgroups which Clinical Lumbar Instability (CLI) was considered as affected on patients. CLI defined as the translation and rotation values of each lumbar segment greater than normal translation and rotation with clinical sign. CLI could result in patients in many aspects which had been reported. However, the evidence on reporting of lumbar instability have different methodology. The aimed of this study was to report CLI in patients with chronic low back pain by radiography.</p> <p><strong><u>Methods</u></strong><strong>:</strong> This was a cross-sectional descriptive study in 50 chronic low back pain (CLBP) participants aged 33.7±13.3 years. Data were collected by interview for demographic data and flexion-extension radiograph for diagnosis instability. Descriptive statistics were used for calculation.</p> <p><strong><u>Results</u></strong><strong>:</strong> This study found that the amount of CLI was 92%. Age of participants with CLI range from 20-59, which the participant aged 30 to 39 and 50 to 59 years showed 100% of CLI, aged 20 to 29 and 40 to 49 years showed 93.3% and 66.7%, respectively.</p> <p><strong><u>Conclusions</u></strong>: The finding of prevalence, age, and LBP period in this study demonstrated that CLI could be occurred in people who aged from 20 years onward. There were young patients with CLBP, the practitioner should aware of assessment about CLI in order to providing suitable management.</p> Arisa Leungbootnak, Rungthip Puntumetakul, Taweesak Janyacharoen, Wantana Siritaratiwat, Surachai Sae-jung Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239891 Fri, 21 Feb 2020 00:00:00 +0700 Survival Outcomes in Patients with Hepatoblastoma: Who has the Greatest Chance of Surviving? https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239893 <p><strong><u>Background and Objective</u></strong><strong>: </strong>Hepatoblastoma (HB) is the most common malignant liver tumor in children. This study aimed to review the survival outcomes of HB at Srinagarind hospital.</p> <p><strong><u>Method</u></strong><strong>: </strong>All children diagnosed with HB between 2003 and 2016 were included. The demographic data and outcomes were reviewed, and the survival outcome was analyzed.</p> <p><strong><u>Results</u></strong><strong>: </strong>There were 47 patients diagnosed with HB. After excluded 4 incompletes recorded, 43 cases were calculated. The median age at diagnosis was 1.08-year (19 days to 13.8 years). The number of patients with PRETEXT III and IV were 15 (34.8%) and 10 (23.3%), respectively. Eleven patients (25.6%) came with distant metastasis at the time of diagnosis. Only 6 patients (14%) underwent liver resection without pre-op chemotherapy. The other received pre-op chemotherapy. Still, 16.3% remains unresectable. The median follow-up was 3.18 years (1.83 months to 11.03 years). The overall 5-year survival rate in the hepatoblastoma patients in our study was 63.21%. The overall 5-year survival and disease-free survival rates in operable patients were 75.21% and 72.8%, respectively. Patients who lived longer than 3 years after surgery, survived. The 5-year survival rate for the patients who do not require chemotherapy before surgery was 100% whereas the other group had 56.24%. Moreover, we found that the non-recurrent group had a significantly higher survival rate compared to the recurrent group (p = 0.0017).<br><strong><u>Conclusions</u>: </strong>The overall survival rate in hepatoblastoma patients appeared to be higher including our country, and patients who lived longer than 3 years were likely to survive. The recurrence of hepatoblastoma significantly impacted the survival rate.</p> Kanokrat Thaiwatcharamas, Ratiyaporn Phannua, Sinobol Chusil, Patchareeporn Tanming, Suchat Areemit, Paisarn Vejchapipat, Wichien Sirithanaphol Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239893 Fri, 21 Feb 2020 00:00:00 +0700 Result of Desferrioxamine Administration by Retained Scalp-vein Into Subcutaneous in Thalassemic Patients https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239898 <p><strong><u>Purpose and Objective</u></strong><u>:</u> Thalassemia is a genetic disease. This disease is cured and cared by using supportive treatments such as blood transfusion, and iron chelator. The purpose of this research was to evaluate the results of desferrioxamine administration by retained scalp vein into subcutaneous in thalassemic patients.</p> <p><strong><u>Methods:</u></strong> This investigation aimed to determine 30 thalassemic patients, age up to 12 years old, who attended the pediatrics clinic at Srinagarind hospital during January - October 2013. The research tool was questionnaires. The data were analyzed by using frequency, percentage, means and standard deviation.</p> <p><strong><u>Results:</u></strong> The use of desferrioxamine administration by retained scalp vein into subcutaneous in thalassemic patients, have reduced&nbsp; iron levels in 50 percent of the&nbsp; patients. All of the patients accounted for 100 percent able to prepare medication and correctly inject themselves. There satisfactions were in a high level. Therefore, thalassemic patients should be encourage to inject by this method.</p> <p><strong><u>Conclusion:</u></strong> Desferrioxamine administration by retained scalp-vein into subcutaneous in thalassemic patients can reduce the number of injection. The use of desferrioxamine injection technique&nbsp; was safely carried out and was high satisfaction by patients and caregivers.</p> Ruenrudee Kaennak, Arunee Jetsrisuparp, Salughit Srimongkol Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239898 Fri, 21 Feb 2020 00:00:00 +0700 Level of Knowledge in Self-measured Blood Pressure Monitoring among Family Physicians in Thailand https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239901 <p><strong><u>Background and Objectives</u></strong><strong>:</strong> Self-measured blood pressure (SMBP) should be advised by health professionals for hypertensive patients. However, there is no study of level of knowledge of family physicians (FPs). This study aimed to explore the level of knowledge of SMBP among FPs and its associated factors.</p> <p><strong><u>Method</u></strong><strong><u>s</u></strong><strong>:</strong> A cross-sectional descriptive study was conducted in FPs whose names appear in the 2017 registry of the Royal College of Family Physicians of Thailand. A self-administered questionnaire was utilized. Descriptive statistics and chi-squared test were used for data analysis. The level of knowledge is classified into three levels: high (score 80% and above) moderate (score 60%-79.99%), and low (score less than 60%).</p> <p><strong><u>Results</u></strong><strong>:</strong> Of 172 FPs who participated, 59.3 % were female, and age between 30-39 years old was 56.98%. Only 38.95% of FPs advised on SMBP regularly. The majority of participants (79.07%) have a low level of knowledge on SMBP. There is no statistically significant relationship between the level of knowledge and these factors include gender, age, years after MD, work settings, training for treatment of hypertension, and frequency of advice SMBP.</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> Most FPs have a low level of knowledge on SMBP, and there is not any factor in this study was associated with physicians’ level of knowledge.</p> Ornisa Issaranon, Ruankwan Kanhasing, Sawanee Tengrungsan Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239901 Fri, 21 Feb 2020 00:00:00 +0700 Upper Limb Functions and Complications of Hemiplegic Side in Patients with Chronic Stroke in the Community https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239904 <p><strong><u>Background and objective:</u></strong> Upper limb dysfunctions and complications of hemiplegic side are most common problems after stroke. However, currently no studies have been undertaken to investigate these problems in community-dwellers with stroke in Thailand. This study aimed to evaluate upper limb functions and complications of hemiplegic side in individuals with chronic stroke in a community.</p> <p><strong><u>Methods:</u></strong> Participants were stroke survivors with at least 6 months post-stroke who were able to sit independently for at least 50 minutes and understand commands to perform various tests. Upper limb functions of hemiplegic side of the patients were evaluated by the Short form Fugl-Meyer Assessment Scale (S-FM) and the Streamlined Wolf Motor Function Test for chronic stroke (SWMFT-C), which each of 6 activities. Complications of the hemiplegic upper limb were identified by interviews, observations and basic physical therapy evaluations. Data were analyzed by using descriptive statistics.</p> <p><strong><u>Results:</u></strong> Ninety-seven patients who were on average of 62.9±12.2 years old and 37.2±56.3 months post-stroke were recruited. Evaluations of the hemiplegic upper limb functions of the patients revealed that average scores of each activity of the S-FM and SWMFT-C ranged from 1.14 to 1.31 points (full score = 2 points) and 1.99 to 2.40 points (full score = 5 points), respectively. Additionally, the average timescale of the SWMFT-C activities ranged from 44.74 to 55.98 seconds. The two most common hemiplegic upper limb complications were shoulder pain and shoulder subluxation, following by wrist pain, muscle atrophy and hand edema.</p> <p><strong><u>Conclusions:</u></strong> Community-dwellers with chronic stroke had a decrease in upper limb functions of hemiplegic side. Most of them had complications of the upper limb, particularly the shoulder joint problems. So, continuing rehabilitation after hospital discharge is necessary to enhance the recovery of upper limb in hemiplegic side.</p> Benjamaporn Seephim, Waroonnapa Srisoparb, Nomjit Nualnetr Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239904 Fri, 21 Feb 2020 00:00:00 +0700 Prototype of Internet GIS Supporting the Community-Dwelling Elderly Healthcare https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239906 <p><strong><u>Background and Objective:</u></strong>&nbsp; Health information management is important for the community-dwelling elderly healthcare services. This study aimed to develop and evaluate the prototype of Internet GIS in order to support task of the community-dwelling elderly healthcare.</p> <p><strong><u>Methods:</u></strong> The health data collected from 384 elders were surveyed and analyzed prior to be developed the Internet GIS by using open source software. The developed Internet GIS was finally evaluated for the users’ satisfactions and system efficiencies by 30 healthcare providers.</p> <p><strong><u>Results:</u></strong>&nbsp; The advantages of the elderly’s database in this study can be searched and displayed as a map which can depict destination routed to elder’s houses.&nbsp; After using the Internet GIS, users were very satisfied because this Internet GIS can increase efficiency and convenience for the task of the elderly homecare.</p> <p><strong><u>Conclusion:</u></strong> The Internet GIS prototype is useful for family medicine works because it is able to increase the efficiency of retrieving the elderly health information either individual elderly or overview of the elderly health in the study area.</p> Watcharaporn Taburee, Chingchai Hoomhong, Chada Narongrit Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239906 Fri, 21 Feb 2020 00:00:00 +0700 Outcomes of Surgical Patients Care in 3A ward: Colorectal Cancer https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239909 <p><strong><u>Background and Objectives</u></strong><strong>: </strong>The aim of this study was to evaluate the outcomes of colorectal patients undergoing surgery, quality of surgical patients care team, and development opportunity.</p> <p><strong><u>Methods</u></strong><strong>: </strong>This descriptive study was performed on 62 patients. The data were collected via: 1) General baseline data, 2) Indicators of quality of care for patients undergoing surgery in 2017. The statistics used were frequency, percentage, arithmetic mean and content analysis.</p> <p><strong><u>Results</u></strong><strong>: </strong>Colostomy surgery was the most performed method in 28 patients (45.16). Fifty-five patients received nutritional screening (88.70%) and high risk for malnutrition was found in 21 cases (38.18%). All patients received pre-post operation information. After surgery, 60 cases (96.77%) could early ambulation within 24-48 hours, average pain of 72 hours in the period of 0-3 score was 42 cases (67.74%), no lung infection, surgical site infection 3 cases (4.80%), bowel leakage 1 cases (1.61%) all patients received information before returning home. Patients who underwent colostomy surgery were evaluated for image and self-concept &nbsp;in 2 cases (7.14%) received colostomy training 60 cases (96.77%) had duration of hospital stay for 6-15 days.</p> <p><strong><u>Conclusion:</u></strong> Most patients received nutritional screening. After surgery, the patient can walk out of bed within 24-48 hours. The average pain within 72 hours is 0-3 points. There are complications, leak of intestines and infected wounds. Receive information on how to go back home. Demonstration and practice in bowel care should promote nutritional status Develop skills and competencies in assessing image and self-concept in patients with abdominal intestinal surgery.</p> Pimchanok Thongcumjan, Pusda Pukdeekumjorn, Tharinee Phetcharat, Ongart Somintara Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239909 Fri, 21 Feb 2020 00:00:00 +0700 The Appropriateness of Post-Exposure Management in Patients at Risk to Rabies in Emergency Room, Srinagarind Hospital https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239910 <p><strong><u>Background and Objective:</u></strong> Rabies is zoonosis with high mortality rates. The post-exposure management of patients at risk impact to spreading in human. So we aimed to study the percentage of appropriateness in post-exposure management of patients at risk to rabies by using 2013 Rabies practice guideline of Department of Disease Control, Ministry of Public Health, Thailand.</p> <p><strong><u>Material and Methods:</u></strong> A retrospective descriptive study enrolled patients who visited Srinagarind hospital between January to December 2014 by using International Classification of Diseases and Related Health Problem 10<sup>th</sup> revision (ICD-10) code T14.1, W50-W55, Z24.2.&nbsp;&nbsp;</p> <p><strong><u>Results:</u></strong> After searching by ICD-10 codes, 2009 patients were enrolled and only 960 cases met our criteria. Five hundred thirty six cases (55.8%) were women. The average age was 35.8 years old and average duration from exposure to medical contact was 13.4 hours. The most common carriers were dog (66.0%) and the characteristics of exposure were biting at leg or hand and 461 wounds (48.0%) were level III that classified by World Health Organization (WHO) category. But there were only 806 cases that contained enough data in medical record to decide appropriateness in post-exposure management. Finally, we found the overall appropriate management was 48.3%, appropriate rabies vaccine was 95.2%, and appropriate rabies immunoglobulin was 91.1%. &nbsp;&nbsp;</p> <p><strong><u>Conclusion:</u></strong> The post-exposure management of patients at risk to rabies by 2013 Rabies practice guideline was proper at 48.3%. Emergency physicians need to update the post-exposure management of patient at risk to rabies and complete the important data in medical record for patient safety.&nbsp; &nbsp;</p> Thapanawong Mitsungnern, Thawatchai Saetia, Dhanu Gaysornsiri Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239910 Fri, 21 Feb 2020 00:00:00 +0700 Test-retest Reliability of Body Center of Mass Sway Assessed by Kinect-Based Exergames Device in Healthy Elderly https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239911 <p><strong><u>Background and Objective:</u></strong> The main factor of fall risk prevention in elderly is fall risk assessment; FRA. Therefore, reliable assessment method is very important. The purpose of this study was to define the test-retest reliability of body center of mass (COM) sway assessment while perform sit to stand using Kinect-Based Exergames device in older adults.</p> <p><strong><u>Methods:</u></strong> Twenty older adults aged more than 60 years (mean age was 67.30 ± 5.58 years) were instructed to performed Five Time Sit to Stand Test (FTSST) while the body COM sway in 3 directions were evaluated by Kinect and software which was developed. The participants were assessed two trials with 1-week resting period. The Intraclass correlation coefficients (ICC<sub>3,1</sub>) was used to explore test-retest reliability and significant levels were set at p &lt; 0.05.</p> <p><strong><u>Results:</u></strong> The results showed that test-retest reliability of body COM sway during FTSST was good reliability (ICC<sub>3,1</sub> were between 0.83 – 0.90).</p> <p><strong><u>Conclusion:</u></strong> The kinematics assessment of body COM sway during FTSST which were evaluated by Kinect and software which was developed is test-retest reliable assessment.</p> Weerasak Tapanya, Sirintip Kumfu, Noppharath Sangkarit, Rungthip Puntumetakul Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239911 Fri, 21 Feb 2020 00:00:00 +0700 Results of Screening Colonoscopy in Kasetwisai Hospital https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239915 <p><strong><u>Background and </u></strong><strong><u>Objective:</u></strong> &nbsp;Colorectal carcinoma&nbsp; is the most common malignancy of the&nbsp; gastrointestinal tract. It is the third common cancer in men, the fourth common cancer in women, and the fifth common cancer for both sex in the world<sup>1</sup>. When &nbsp;patients come to the hospital with gastrointestinal symptoms ,frequently it is too late. Early detection along with improvements in medical and surgical care are thought to be responsible for the decreasing mortality of colorectal cancer observed in recent year. The best way to find early cancer of colon , potential people were selected for screening colonoscopy<sup>2</sup>.</p> <p><strong><u>Materials and methods:</u></strong> The potential people(50-70 years old and positive Fit-test)and no contraindication for colonoscopy 822 cases were selected &nbsp;and performed screening colonoscopy from December 2017 – January 2019 in Kasetwisai Hospital.</p> <p><strong><u>Results:</u></strong> There were well differentiated adenocarcinoma in 11 cases ( 2.09 %) and&nbsp; all were &nbsp;stage II by TNM Staging whom received medical and surgical care. Adenomatous polyp and tubulovillous adenoma were found in 169 cases ( 21.16 % ) were diagnosed and performed polypectomy.In this group there were intermediate and high risk polyps (large polyp/tubulovillous adenoma)&nbsp; 45 cases (4.43% ) &nbsp;. Others were diverticulums 61 cases (8.06%) ,colitis/proctitis 30 cases (4.42%) , parasitic infestation 12 cases (1.16%) and hemorrhoids 3 cases (0.7%) . The complication was colonic perforation in 2 cases (0.24%).</p> <p><strong><u>Conclusion:</u></strong> It is now well accepted that the majority of colorectal carcinoma was evolved from adenomatous polyp; the sequence of events is <em>adenoma – carcinoma sequence.</em>The incidence of invasive carcinomas increase with size (35-50% in polyp larger than 2 cm )<sup>3</sup>. This study could eliminated colorectal&nbsp; cancer strategies by targeting the neoplastic polyps for removal before malignancy develops in 169 cases (21.16 % of all the potential people 822 cases).</p> Boonruen Chaichanrom Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239915 Fri, 21 Feb 2020 00:00:00 +0700 Lifestyle and Personal Characteristic Factors Associated with Overnutritional Status among Supporting Staff of Khon Kaen University https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239917 <p><strong><u>Background and Objective:</u></strong> The prevalence of obesity is increasing among Thai population. This cross-sectional analytic study aimed to evaluate the associations between lifestyle and personal characteristic factors</p> <p>with overnutritional status among the supporting staff of Khon Kaen University.</p> <p><strong><u>Methods</u></strong><strong>:&nbsp; </strong>387 participants were evaluated the nutritional status by using body mass index (BMI) The BMI index of ≥ 23 kg/m<sup>2</sup> was defined for overnutritional status. General information, time spent for sedentary activity and food consumption were obtained from individuals using structural questionnaire. Physical activity was assessed by using the global physical activity questionnaire.&nbsp; Multiple logistic regression was applied to examine the association of overweight and lifestyle factors.</p> <p><strong><u>Results:</u></strong> The majority (77.8%) of the respondents was female with mean age of 42 years. Fifty-five percent of the participants were overnutrition. The participants who had physical activities at vigorous, moderate and low levels were 40.0, 23.8 and 36.2%, respectively. The average time spent for sedentary activities was 11.7 hours/day. According to food consumption, the subjects were at risk of being overweight in high and moderate risk levels at 19.7 and 73.1%, respectively. The following risk factors were significantly associated with overnutrition (p&lt;0.05), i.e., male (adjusted OR =2.5, 95% CI: 1.39 to 4.35), age 41-60 years (adjusted OR =3.36, 95% CI: 2.08 to 5.44), education below bachelor degree (adjusted OR =3.18, 95% CI: 1.41 to 7.15), having obese relatives (adjusted OR =2.45, 95% CI: 1.54 to 3.88) and eating at night time (adjusted OR =1.87, 95% CI: 1.01 to 3.45).</p> <p><strong><u>Conclusion:</u></strong> More than half of the supporting staff of the Khon Kaen University were overnourished. Weight control activities should be organized in this group, especially in males aged 40 years and over who have a low education degree and have obese relatives, and stopping / reducing eating at night time should be recommended.</p> Nattapong Anchalee, Benja Muktabhant Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239917 Fri, 21 Feb 2020 00:00:00 +0700 Applying Augmented Reality for Anatomy Teaching and Learning https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239922 <p><strong><u>Background and Objective </u></strong><u>: </u>&nbsp;At present, communication technology has continue developing complexly. McLuhan stated that “Medium is a Message”. This term remind us to aware that “channel” in communication process has more important, even message is the same but changing communication channel makes change to message. Receiving 3D image by AR have to use device with digital camera attached e.g. smart phone or tablet. Applying AR for teaching and studying Anatomy is a routine to research contains 3 research questions. Firstly, can 3D image gain very attention from audience? Secondly, How many method to create 3D image for AR? Thirdly, can 3D image, which use AR as a tool, replace Anatomy text book? In this research, researcher build Application which present 3D skull image. Seven bones, i.e. 1) Frontal Bone,&nbsp; 2) Temporal Bone, 3) Occipital Bone, 4) Zygomatic Bone, 5) Nasal Bone, 6) Maxilla Bone and 7) Mandible Bone, were choosen to present in this research. The application base on Android Operation System.</p> <p><strong><u>Method</u></strong> : Researcher used Trial-Error as a research method and used Focus&nbsp; Group interview to test effectiveness and gain opinion of samples which were 40 medical students, from second year students to interns medical students, also 5 Anatomy Lecturers were sampled by using simple random sampling from student and lecturer list. Questions were asked in Focus Group Interview were concerned interesting of AR Questions also about knowledge and understanding in Anatomy which appeared in Anatomy text book by using AR as the added on.</p> <p><strong><u>Result</u></strong> : The results showed that samples want the skull can be turned 360 degrees via touch screen of device. Moreover, sample want to zoom in and zoom out via touch screen. For turning skull via touch screen, researcher have collected this function as sample had recommended. On the other hand, zooming in and zooming out are too much consume technology resources of device. By the way, researcher aimed to develop this application and this function in future. Interviewing samples showed that AR skull can be added on in Anatomy text book which gain more attention and interesting from audience.</p> <p><strong><u>Conclusion</u></strong> : AR technology can’t replace Anatomy text book but, with AR, text book has more added value. Moreover, 3D image presented by AR technology, can provide wide perspective, high perspective and depth perspective, that ordinary 2D image in text book can’t present to readers.</p> Jiranda Gritcharoen Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239922 Fri, 21 Feb 2020 00:00:00 +0700 Effect of Trapezius Muscle Stretching with Mindfulness Meditation on the Alteration of Muscle Tension and Electromyography https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/246894 <p><strong><u>Background and Objective:</u></strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Previous studies have found that changes in tension and electrical waves from stretching muscles can reduce neck and shoulder pain. And currently, the mindfulness meditation, which is called the Anapanasati, has been widely applied to use with various pain treatments. But no study of stretching with Anapanasati combination is still questionable. Thus, this study aimed to compare the effect of neck stretching with Anapanasati toward the change of muscle tension and Electromyography.</p> <p><strong><u>Methods:</u></strong> Healthy female aged 20-25 years were 26 participants in this study and randomized allocation into two groups; 13 its each. The intervention group performed the stretching at upper Trapezius muscle with Anapanasati and the control group performed Anapanasati alone. They was measured using the muscle tension score and the root mean square (RMS) ratio of surface Electromyography (sEMG) to measure <u>pretest</u> and posttest; interview and observation during intervention were also recorded.</p> <p><strong><u>Results:</u></strong> The results showed that the muscle tension scores were decreased in both groups and relaxation consistently; nevertheless, the RMS ratio was tended to decrease in the intervention group, compared with the control group. The upper trapezius muscle stretching <u>was</u> rather influenced with mindfulness meditation could reduce muscle tension and promote relaxation.</p> <p><strong><u>Conclusions:</u></strong> Toward the concentration of movement and self-awareness in body sensation, associated with the development of neck stretching effectively.</p> Orawan Buranruk, Kulwarang Wongwilairat Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/246894 Tue, 07 Jan 2020 00:00:00 +0700 Association of Vitamin D Deficiency and Depression https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239924 <p>It is now generally accepted that vitamin D deficiency is a health problem that affects not only musculoskeletal health but also a wide range of &nbsp;physical and mental disorders that include &nbsp;cardiovascular disease, diabetes, various cancers and nervous system&nbsp; problem leading to mental health problem. Vitamin D deficiency or low level are associated with schizophrenia, depression, &nbsp;Alzheimer’s disease and among others. Risk factors for vitamin D deficiency include lacking of adequate sun exposure , living in northern latitude areas, habitual indoor activities, &nbsp;darker skin, obesity, old age , postpartum women, newborn. Unbelievably that 45.2 percent of Thai people have low level of vitamin D. Vitamin D plays an important role in the prevention of various mental health problems especially depression. Globally, more than 300 million people of all ages suffer from depression. More women are affected by depression than men. Depression is the most common cause of depression is&nbsp; generally considered to be complex. An increasing number of studies have shown that vitamin D deficiency is associated with the occurrence of depression. In this review has collected and criticized the importance of vitamin D, the prevalence of vitamin D deficiency especially in the Thai population. And the relationship between vitamin D deficiency and depression. The administration of vitamin D to supplement the treatment of depression is discussed. Hopefully, this article will be useful for health promotion. &nbsp;</p> Patcharin Chanapa Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239924 Fri, 21 Feb 2020 00:00:00 +0700 Abnormality of Aortic Arch Branching in a Thai Embalmed Cadavers and its Clinical Application: A Rare Case Report https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239923 <p><strong><u>Background and Objective</u></strong><strong>: </strong>In normal development, the aortic arch (AA) gives 3 major branches: 1) Brachiocephalic trunk, 2) Left common carotid artery, and 3) Left subclavian artery. The abnormality of those AA branching is important for thoracic surgery consideration.&nbsp; Although the abnormality of aortic arch branching has been reported in some races, this abnormality in Thai cadavers has never been investigated previously. &nbsp;&nbsp;</p> <p><strong><u>Method</u></strong><strong>: </strong>Dissections in this study were performed in Thai embalmed cadavers during teaching gross anatomy for Medical students of Ubon Ratchathani university.&nbsp; The cadavers were carefully dissected thoracic region to investigate the anatomical structures of AA branching. This study was carried out from 10 female and 12 male cadavers.&nbsp;&nbsp; &nbsp;</p> <p><strong><u>Resul</u></strong><strong>t: </strong>From total 22 cadaveric samples, it was noted that only one male cadaver (58 years old, 4.55% of total investigated samples) has abnormality of the left vertebral artery obviously projected from the AA by running out between the left common carotid artery and left subclavian artery<strong>.</strong></p> <p><strong><u>Conclusion</u></strong><strong>: </strong>The information of this rare variation in the origin of vertebral artery from the AA is of the most importance to surgeons performing surgery in thoracic region. For radiologist, it is noted to avoid the misinterpretation of radiographs during performing angiography.</p> Chanwit Maneenin, Naowarat Maneenin, Chanasorn Poodendaen, Wannisa Sukhorum, Sitthichai Iamsaard Copyright (c) https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/239923 Fri, 21 Feb 2020 00:00:00 +0700