Health Science, Science and Technology Reviews

Developing a decision tree model for screening SARS-CoV-2 infection

2024-09-25T16:28:30+07:00

The development of a decision tree model using Rapid Antigen Tests (RAT) combined with clinical data aims to determine the sensitivity and specificity of SARS-CoV-2 detection through the RAT method and compare with Realtime RT-PCR method. This study also seeks to assess the sensitivity and specificity of the decision tree model. The findings indicate that the RAT for detecting the antigens of the 2019 coronavirus has a sensitivity of 91.14% (CI 88.48 - 95.45), specificity of 99.21% (CI 98.10 - 99.64), positive predictive value of 97.75% (CI 95.77 - 98.81), negative predictive value of 96.74% (CI 95.64 - 97.79), and accuracy of 97.00% (CI 96.03 - 97.79).

The study evaluates the performance of three classification algorithms using decision tree techniques: J48, ID3, and CART. The results indicate that the most suitable primary model for application is the J48 classifier combined with the SMOTE technique, yielding a sensitivity of 96.1%, specificity of 99.2%, and accuracy of 98.5% after pruning to reduce model complexity. This model produced eight classification rules. When the final model was evaluated against blind data, it achieved sensitivity, specificity, and accuracy rates of 96.2%, 98.7%, and 97.4%, respectively. Therefore, RAT is an efficient method of detecting antigens of coronavirus due to its quick results and suitability for highly affected areas. Additionally, the integration of clinical data with RAT analysis can improve the screening process and increase the sensitivity and accuracy of the test results.

Anticancer potential of Moringa oleifera aqueous leaf extract on human cholangiocarcinoma cells

2024-09-30T11:17:50+07:00

Cholangiocarcinoma (CCA) is an aggressive malignancy with poor responses to conventional chemotherapeutic agents. At present, the development of new strategies for treatment of this deadly disease is highly desired. Medicinal herbs and dietary plants provide very attractive approaches in chemotherapy. The aim of this study was to determine the potential anticancer effect of Moringa oleifera aqueous leaf extract (MOE) against human CCA cells, KKU-100. According to the MTT assay, MOE decreased CCA cell viability with the IC₅₀ values of 3.8 ± 0.1 and 2.6 ± 0.3 mg/mL at 24 and 48 h, respectively. MOE also inhibited the colony forming capability of the cells as determined by clonogenic assay. Moreover, MOE at 5 mg/mL could induce the apoptotic cell death of CCA cells by which the percentage of early apoptotic cells and late apoptotic/necrosis cells were 10.5 ± 0.7% and 23.7 ± 2.3%, respectively. The anti-migration and anti-invasive effects of the extract were subsequently investigated by wound healing and invasion assay, respectively. The results showed that MOE could significantly suppress migratory and invasive abilities of CCA cells. Taken together, MOE exhibits potential anticancer activities against CCA by limiting ability of cell to thrive, inducing apoptotic cell death and suppressing metastatic ability of CCA cells.

The prevalence of respiratory sarcopenia in preoperative cardiac surgery patients in Thammasat University Hospital

2024-09-11T10:38:21+07:00

Respiratory sarcopenia is a condition characterized by the weakness of respiratory muscles associated with sarcopenia due to aging or systemic inflammation such as cardiovascular disease. Patients with cardiovascular disease commonly experience exertional dyspnea, which exercise intolerance, physical inactivity and a subsequent decline in quality of life. Thus, this study aimed to explore the prevalence of respiratory sarcopenia and compare between no sarcopenia, no sarcopenia and low respiratory muscle strength, no respiratory sarcopenia and no respiratory sarcopenia. A cross-sectional study was designed with total of 122 participants. All participants were diagnosed with respiratory sarcopenia according to the Asian Working Group for Sarcopenia 2019, consisting of skeletal muscle mass test (measured bioelectrical impedance analysis), muscle strength test (measured handgrip strength), physical performance test (gait speed test) and respiratory muscle strength test (measured respiratory pressure meter). All data analyzed by SPSS program Version 20.0. Descriptive statistical analysis was used. Chi–square test and ANOVA were conducted to compare these parameters. P-value is set as less than 0.05. The results found that the prevalence of respiratory sarcopenia during preoperative cardiac surgery patients was 56.56%. Participants with respiratory sarcopenia had a significantly lower maximum inspiratory pressure (32.68±15.58 cmH₂O, p<0.001), low muscle mass index (6.01±1.51 kg/m², p<0.001) and low muscle strength (22.75±9.68 kg, p<0.05) than those without. In this study, respiratory sarcopenia in preoperative cardiac surgery patients shown a reduction in respiratory muscle strength compared to no respiratory sarcopenia.

A comparative study of postoperative complications in patients undergoing hip fracture surgery within 48 hours and 72 hours at Chiangkham Hospital, Phayao Province

2024-10-28T16:09:30+07:00

This retrospective cohort study aimed to compare clinical outcomes and complications in patients aged 60 years and above who underwent hip fracture surgery within 48 hours and 48-72 hours after admission to Chiangkham Hospital, Phayao Province, between October 1, 2020, and June 30, 2024. A total of 148 patients

were included, divided into two groups: those who received surgery within 48 hours (n=104) and those who received surgery between 48-72 hours (n=44). Data were analyzed using descriptive statistics, Chi-square test, Fisher's exact test, t-test, Linear regression and Logistic regression. The results showed that the group receiving surgery within 48-72 hours had a significantly higher rate of urinary tract infections (47.72% vs 27.88%, p=0.020), with a 2.36 times higher risk (95% CI: 1.15-4.83, p=0.019). This group also had a significantly longer hospital stay (p=0.015) and higher treatment costs (p=0.011). No significant differences were found in other complications. Hip fracture surgery in patients within 48 hours after admission may help reduce the risk of urinary tract infections, decrease hospital stay duration, and lower treatment costs. These findings support the early surgery approach and reduce complications for this patient group.

Quality of life among elderly patients undergoing total knee arthroplasty, Maharaj Nakorn Chiang Mai Hospital

2024-09-10T10:09:14+07:00

This correlational study explores the quality of life and its associated factors among older adults undergoing total knee arthroplasty (TKA). The study included 84 patients, all aged 60 and over, who had undergone TKA surgery at Maharaj Nakorn Chiang Mai Hospital. Data were gathered through structured interviews using the Demographic Data Recording Form, the Thai version of the Modified WOMAC (Western Ontario and McMaster University) Questionnaire, and the WHOQOL–BREF–THAI Questionnaire. Test reliability of instruments was .80. Data analysis employed descriptive statistics, as well as Eta and Pearson’ s product-moment correlation coefficients. Results showed that the overall quality of life for patients was generally good (Mean=102.59, S.D.=13.88). Subsection analysis revealed that environment (Mean=33.01, S.D.=5.87) and mental health (Mean=24.25, S.D.=3.54) were rated as good, while physical health (Mean=25.96, S.D. =3.59) and social relations (Mean=11.50, S.D.=1.86) were rated as moderate. Knee movement was significantly negative related to overall quality of life (r=-.342, p≤.01), while variables such as sex, disease status and body mass index showed weak, non- significance relationships. Furthermore, age, the number of knees operated on, pain and stiffness did not significantly affect overall quality of life (p-value >.05). These findings provide valuable baseline information for nurses and healthcare providers aiming to enhance the quality of life in elderly TKA patients. The insights from this study could be applied to improve patient care in the future.

Treatment outcomes and factors associated with open arthrotomy in bacterial septic arthritis patients at NongKhai Hospital

2024-10-28T16:49:02+07:00

Bacterial septic arthritis is a medical emergency condition. Some studies have shown that the surgical and the non-surgical methods result in similar treatment outcomes. Meanwhile, some studies have found that patients treated by the surgical method have significantly longer lengths of stay but a lower mortality rate than patients treated by the non-surgical method. This study therefore aimed to determine treatment outcomes and factors associated with open arthrotomy in bacterial septic arthritis patients at NongKhai Hospital. The study methodology was descriptive. Factors analysis was conducted using Univariate analysis, and only factors with p<0.20 were further analyzed using Multiple logistic regression with statistical significance at p<0.05. 201 eligible patients were enrolled of which 40 patients were treated by non-surgical method, and 161 patients were treated by open arthrotomy. According to the current study, univariate analysis of the data revealed nine factors associated with open arthrotomy including diabetes mellitus, chronic kidney disease, steroid use, prior joint injury within a 1-month, prior treatment, white blood cell counts in blood ≥10,000 cells/mm³, white blood cell counts in synovial fluid ≥100,000 cells/mm³, positive synovial fluid culture, and cellulitis (p<0.20). Further multiple logistic regression analysis of these factors revealed only one statistically significant factor which is prior treatment (p=0.012, 95% CI 1.269-7.148, Adjusted OR=3.011). As for treatment outcomes, there is no significant difference between the open arthrotomy and non-surgical groups. However, it was found that the open arthrotomy group had a longer length of stay and higher cost of treatment than the non-surgical groups statistically significant.

The comparison of distance covered in each minute from 6-minute walk test between mobile application and standard 6-minute walk test in Hemodialysis patients

2024-11-21T16:42:48+07:00

Chronic kidney disease (CKD) leads to a decrease in functional activities and quality of life. In Thailand, a study has been conducted using a mobile application to assess the 6-minute walk test (6MWT), which facilitates testing and allows for distance tracking each minute to observe walking trends over time. However, there has been no study conducted on CKD patients undergoing hemodialysis. This study aimed to compare the distance walked each minute during the 6-minute walk test using a mobile application with standard testing in CKD patients undergoing hemodialysis. Twenty-five CKD patients undergoing hemodialysis for at least six months participated in the study. A wrist-worn 3D accelerometer was attached to their dominant side to measure the walking distance and monitor vital signs, which were entered into the application. The test involved walking back and forth over a 15-meter distance for six minutes. After the test, vital signs were recorded again in the application. The researchers noted the actual distance walked each minute and compared with the application data. The results found that the average age of the participants was 65 years. The total distance recorded by the application deviated from the real distance by 2.81%, which is within the acceptable limit of 5% as per medical device standards. The distance walked each minute as recorded by the application also showed a deviation of less than 5% from the standard test, except for the second minute, which had a deviation of 6.87%. This findings suggest that the application can be used as a substitute for standard testing in CKD patients undergoing hemodialysis. The decrease in walking distance during the middle of the test may be attributed to muscle fatigue, while the slight increase in distance towards the end could be due to verbal encouragement in the last 15 seconds.

Proactive pharmaceutical care and treatment outcome in psychiatric patients: A retrospective quasi-experimental study

2024-12-17T09:50:12+07:00

This retrospective quasi-experimental study aims to evaluate the effectiveness of proactive pharmaceutical care by pharmacists and examine the characteristics of drug-related problems among psychiatric patients. The study included psychiatric patients who were followed up at the psychiatric clinic of Chiang Kham Hospital. The experimental group received proactive pharmaceutical care from October 1, 2022, to May 31, 2023. The historical control group received standard pharmaceutical care from October 1, 2021, to September 30, 2022. Proactive pharmaceutical care involved pharmacists identifying and resolving drug-related problems and monitoring adverse drug reactions. Treatment effectiveness was assessed 3 months post-consultation using the adapted clinical global impression-improvement (CGI-I) scale with four levels: 1. No improvement or death, 2. Partial improvement, 3. Improvement, and 4. Stable condition. Associations between pharmaceutical care and treatment outcomes were analyzed using ordered logistic regression, adjusted for gender, age, and psychiatric diagnosis, with results presented as common odds ratio (COR) with 95% confidence intervals (CIs). A total of 192 patients were included: 35 in the proactive pharmaceutical care group and 157 in the historical control group. Of these, 54.2% were male, with a mean age of 48.98 ± 15.83 years. Diagnoses included schizophrenia (55.7% of all participants), depression and anxiety (28.6% of all participants), and other psychiatric disorders (15.6% of all participants). Of 230 identified drug-related problems, the most common problems were lack of monitoring for adverse drug reactions (46.5% of all drug-related problems), occurrence of adverse drug reactions (16.5% of all drug-related problems), and patients not receiving prescribed medications (16.1% of all drug-related problems). Interestingly, the proactive care group showed better treatment outcomes, with an adjusted COR of 3.12 (95% CI: 1.41, 6.91). This association was more pronounced in females (adjusted COR: 3.60; 95% CI: 1.15, 11.28) than in males (adjusted COR: 3.09; 95% CI: 0.94, 10.17). Sensitivity analyses confirmed these findings. In conclusion, this study highlights that adverse drug reactions are significant drug-related problems in psychiatric patients. Proactive pharmaceutical care by pharmacists is associated with improved treatment outcomes in psychiatric outpatients. Further research in other hospital settings is recommended to confirm these findings, which could lead to enhanced quality of care for psychiatric patients.

Application of luminol in forensic science and biomedical sciences

2024-07-23T13:59:55+07:00

Luminol has long been a mainstay in forensic science, serving as a crucial tool for detecting latent bloodstains that elude the naked eye at crime scenes. Its effectiveness stems from the principle of chemiluminescence, where luminol emits a characteristic blue light upon oxidation in the presence of blood. This distinctive luminescence has made luminol testing an indispensable technique in crime scene investigations. This comprehensive review article delves into the rich history of luminol's discovery and its extensive forensic applications. It meticulously examines the structural composition of luminol and unravels the intricate mechanism of its chemiluminescent reaction, particularly emphasizing the pivotal role of blood in accelerating the reaction. The review further explores the practical aspects of luminol utilization, encompassing its efficacy on diverse surfaces, its remarkable sensitivity in detecting even minute blood traces, and its versatility in various crime scene scenarios. However, the review also acknowledges the limitations of luminol, including its susceptibility to interference from extraneous substances and its potential impact on subsequent bloodstain and DNA analysis. It meticulously discusses strategies to mitigate these limitations and ensure the integrity of forensic investigations. In addition to its established role in latent blood detection, this review also highlights the emerging applications of luminol in biological science research such as biosensor technology, opening new frontiers in bioanalysis. It envisions the potential of luminol-based immunoassay for the detection of a wide range of biomolecules, paving the way for advancements in clinical diagnostics and biomedical research.