Journal of the Medical Association of Thailand最新文献

{"title":"Effectiveness of Auricular Acupressure Combined with Medication and Medical Advice for Smoking Cessation","authors":"","doi":"10.35755/jmedassocthai.2024.4.13965","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13965","url":null,"abstract":"Objective: Nicotine withdrawal symptoms (NWS) are the main impediments to the quitting attempt. The present study investigated the effectiveness of specific auricular acupressure combined with medication and medical advice to quit smoking.\u0000\u0000Materials and Methods: Two hundred eighty-two patients voluntarily participated in a smoking cessation program at the Smart Quit Clinic, Charoenkrung Pracharak Hospital. The patients were randomly divided into two groups, the treatment group (n=141) receiving specific auricular acupressure and the control group (n=141) receiving non-specific auricular acupressure. Five specific auricular acupressure points, including shenmen, lung, mouth, stomach, and sympathetic, were used to treat NWS. Each point was pressed with Wang Bu Liu Xing for one minute. The acupressure was applied three times a day for 12 weeks. The succession of cessation was assessed using carbon monoxide (CO) levels in exhaled breath and relief of NWS.\u0000\u0000Results: The success of smoking cessation in the treatment group was significantly higher than the control group after cessation at weeks 12 and 24. Specific auricular acupressure such as shenmen, lung, mouth, stomach, and sympathetic, could reduce anxiety, craving on smoking, insomnia, and nervous symptoms since the first week after cessation.\u0000\u0000Conclusion: Specific auricular acupressure using Wang Bu Liu Xing is an effective and safe treatment method for relieving NWS.\u0000\u0000Keywords: Auricular acupressure; Nicotine withdrawal symptoms (NWS); Smoking cessation; Wang Bu Liu Xing","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":"177 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity of Two Doses of BNT162b2 among Children Aged 6 Months to 4 Years Following Symptomatic COVID-19","authors":"","doi":"10.35755/jmedassocthai.2024.4.13960","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13960","url":null,"abstract":"Background: Children aged 6 months to 4 years have been recommended to receive three doses of BNT162b2, after COVID-19 infection, to immunize against SARS-CoV-2. Therefore, they might need fewer doses of vaccine compared with COVID-naïve children.\u0000\u0000Objective: To describe the immunogenicity of 2-dose BNT162b2 following COVID-19 in healthy young children previously infected with SARS-CoV-2.\u0000\u0000Materials and Methods: A prospective cohort study was conducted among children aged 6 months to 4 years who had SARS-CoV-2 infection during Delta-variant, which was July to November 2021, or Omicron-variant-predominant eras, which was February to August 2022. Participants received two doses of intramuscular BNT162b2 at an 8-week interval. Neutralizing antibodies against SARS-CoV-2 Omicron variant BA.4/5 were measured using pseudovirus neutralization tests (pVNT; ID₅₀) at baseline and 28 days after the second dose. Results were compared with a parallel cohort of COVID-naïve children who received 3-doses of BNT162b2 at 0, 4 and 12 weeks.\u0000\u0000Results: Between November and December 2022, 80 children with a median age of 2.9 years (IQR 2.1 to 3.8) were enrolled. The median time from COVID-19 infection to the first dose was 13.8 months (IQR 13.8 to 16.2) in the Post-Delta Group, and 8.0 months (IQR 3.7 to 8.2) in the Post-Omicron Group. After 2-doses of BNT162b2, the geometric means (GMs) of pVNT increased from 105 (95% CI 48 to 231) to 863 (95% CI 638 to 1,168) in the Post-Delta Group and from 264 (95% CI 192 to 361) to 2,268 (95% CI 1,831 to 2,811) in the Post-Omicron Group. In comparison, the GM of pVNT was 59 (95% CI 31 to 114) in the parallel cohort of COVID-naïve children who received 3-doses of BNT162b2.\u0000\u0000Conclusion: Two doses of BNT162b2 were able to boost the immune response with high neutralizing antibodies against the circulating Omicron variant in children who were previously infected with SARS-CoV-2.\u0000\u0000Keywords: SARS-CoV-2 vaccine; BNT162b2; Child; Infant; Neutralizing antibody titer; Anti-SARS-CoV-2 IgG","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140688361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Conservative Management of Intraperitoneal Urinary Bladder Injury Secondary to Port Placement in Laparoscopic Appendectomy: A Case Study","authors":"","doi":"10.35755/jmedassocthai.2024.4.13966","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13966","url":null,"abstract":"The present report elucidated a rare complication post-laparoscopic appendectomy, the suprapubic laparoscopic port-related urinary bladder rupture. By highlighting the present case, the author emphasized the importance of surgical awareness, the feasibility of conservative management in specific scenarios, and the vital role of patient involvement in decision-making.\u0000\u0000Keywords: Laparoscopic appendectomy; Intraperitoneal urinary bladder rupture; Laparoscopic port-related injury","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Gender Affirmation, Parental Attachment, and Suicide-Related Behaviors in Individuals with Gender Dysphoria","authors":"","doi":"10.35755/jmedassocthai.2024.4.13963","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13963","url":null,"abstract":"Objective: To study the prevalence of suicide-related behaviors in individuals with gender dysphoria and to study the associations among gender affirmation, parental attachment, and suicide-related behaviors.\u0000\u0000Materials and Methods: The present study was a cross-sectional survey study involved individuals with gender dysphoria attending the Gender-Variation (Gen-V) Clinic at Ramathibodi Hospital between August 2020 and February 2021. An online questionnaire was administered, including demographic data, history of gender affirmation, the Impulse, Self-harm, and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A), and the Inventory of Parent and Peer Attachment-Revised (IPPA-R; parental part only). Descriptive statistics, chi-square tests, and adjusted logistic regression analyses were performed using SPSS v.18.0.\u0000\u0000Results: The present study included 105 participants with a mean age of 29.2 years (range 18 to 53). Of these participants, 86.7% (n=91) identified as trans men, 36.2% (n=38) reported a history of lifetime non-suicidal self-injury (NSSI), 78.1% (n=82) reported engaging in other self-harm behaviors, and 52.4% (n=55) reported suicidal ideation, respectively. Higher scores on the parental attachment scale were associated with a decreased likelihood of suicidal ideation (adjusted odds ratio [aOR] 0.90, 95% CI 0.86 to 0.95, p<0.001). Additionally, participants who had undergone gender-affirming surgery were less likely to engage in NSSI (aOR 0.33, 95% CI 0.12 to 0.95, p=0.039).\u0000\u0000Conclusion: The present study demonstrates the overwhelming prevalence of NSSI, other self-harm behaviors, and suicidal ideation among individuals with gender dysphoria. Gender-affirming surgery and secure attachment with parents may contribute to lower rates of NSSI and suicidal ideation among them.\u0000\u0000Keywords: Gender dysphoria; Non-suicidal self-injury; Suicidal ideation; Gender affirmation; Attachment","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Transnasal Esophagoscopy: Experience in a Tertiary Hospital","authors":"","doi":"10.35755/jmedassocthai.2024.4.13970","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13970","url":null,"abstract":"Objective: To report and analyze outcomes of transnasal esophagoscopy (TNE).\u0000\u0000Materials and Methods: The present study retrospectively reviewed the medical records of patients who underwent TNE at Sawanpracharak Hospital, a provincial public hospital between September 2022 and August 2023. Data collected included demographics, indications for TNE, biopsy results, timing of the procedure, changes in diagnosis following TNE, and any complications encountered were collected and analyzed.\u0000\u0000Results: Forty-eight patients underwent the TNE with a mean age of 59.2±13.18 years. The most frequent indications for TNE were dysphagia at 37.5%, biopsy tumor at 20.8%, head and neck cancer surveillance at 20.8%, complete examination for neck node unknown primary at 8.3%, suspected foreign body in aerodigestive tract at 6.3%, and follow-up treatment at 6.3%. Biopsies were performed in 23 cases, with a rapid urease test conducted in nine cases. Of these tests, 44.4% were positive for Helicobacter pylori. Additionally, pathological examination was performed in 14 cases and revealed squamous cell carcinoma in 35.7% of those examined. Importantly, TNE led to a change in diagnosis in 41% of the studied patients. Notably, minor complications were observed in only 2.1% of the cases.\u0000\u0000Conclusion: TNE emerges as a valuable diagnostic tool for the comprehensive assessment of laryngeal, tracheal, and esophageal lesions. This minimally invasive procedure eliminates the need for sedation, expediting the examination process while minimizing complication risks. Moreover, TNE is well-suited for head and neck cancer patients, facilitating both diagnosis and treatment follow-up.\u0000\u0000Keywords: Transnasal esophagoscopy; Esophagoscopy; Head and neck cancer; Dysphagia; Helicobacter pylori","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Operative Lower Eyelid Massage Versus Standard Care for Prevention of the Lower Eyelid Scar Contracture after Subciliary Approach in Traumatic Facial Fracture Repair: A Randomized Controlled Trial","authors":"","doi":"10.35755/jmedassocthai.2024.4.13967","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13967","url":null,"abstract":"Background: Subciliary incision, a common technique for traumatic facial repair, associates with lower eyelid scar contracture and malpositioning. Despite proposed management techniques like eyelid massage, the efficacy of post-operative massage remains unexplored in preventing and treating these issues.\u0000\u0000Objective: To assess the effectiveness of lower eyelid massage in preventing lower eyelid scar contracture and malposition following the subciliary approach for traumatic facial repair, compared to standard care without massage.\u0000\u0000Materials and Methods: A randomized controlled trial enrolled patients with traumatic facial fractures slated for subciliary approach repair. Patients were randomly allocated to the lower eyelid massage as the experimental group or standard care as the control group. The massage group received post-operative instructions. Data on demographics, injury profiles, lower eyelid scar contracture as graded by the grading of lower eyelid scar contracture (GLESCO) criteria, eyelid malpositioning, comfort scores, and complications were gathered over a 6-month follow-up.\u0000\u0000Results: The present study included 59 patients, with 30 in the massage group and 29 in the control group. There were no significant differences in demographic characteristics, injury profiles, or complications between the two groups. Post-operative assessments revealed the massage group exhibited a trend towards lower GLESCO grades with an average decrease of 0.72 grade per week (95% CI –1.46 to 0.02, p=0.058) and lower eyelid malpositioning grades with an average decrease of 0.49 grade per week (95% CI –1.03 to 0.05, p=0.073) compared to the control group. However, there was no significant difference in comfort scores between the two groups with an average difference of 0.18 score per week (95% CI –1.08 to 1.45, p=0.775).\u0000\u0000Conclusion: Lower eyelid massage demonstrated potential benefits in preventing lower eyelid scar contracture following traumatic facial repair. However, its impact on eyelid malpositioning and comfort scores was not statistically significant in the present study. Further study with larger sample sizes is warranted to validate these findings.\u0000\u0000Trial registration: ClinicalTrials.gov, NCT06311318\u0000\u0000Keywords: Subciliary incision; Subciliary approach; Lower eyelid massage; Facial fracture; Scar contracture; Eyelid malposition; Ectropion","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Echocardiographic Predictors of the In-Hospital Mortality and the Association with the Microorganisms in Patients with Infective Endocarditis","authors":"","doi":"10.35755/jmedassocthai.2024.4.13971","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13971","url":null,"abstract":"Background: Infective endocarditis (IE) is an infrequent, but serious disease with high mortality.\u0000\u0000Objective: To evaluate the factors predicting the in-hospital mortality in patients with IE and to determine the association between factors and microorganisms.\u0000\u0000Materials and Methods: The medical records of adult patients diagnosed with IE by modified Duke’s criteria at Siriraj Hospital, the largest tertiary referral center and medical school in Thailand, between December 2014 and April 2020 were retrospectively reviewed.\u0000\u0000Results: One hundred thirty-nine patients with IE were included with an average age of 54.4±15.9 years and 62.6% were male. Native valve endocarditis (NVE) was diagnosed in 77.3%. The three most common pathogens were Streptococcus spp. at 50.4%, culture negative IE at 16.5%, and Staphylococcus aureus at 12.2%. Streptococcus spp. was the more common in NVE (p=0.017) and mitral valve IE (p=0.042). Heart failure and embolic stroke occurred in 43.9% and 12.2% of patients, respectively. Valve surgery was performed on 63 patients. Aortic, mitral, and multivalve involvements of IE were reported in 53.3%, 49.6%, and 10.1%, respectively. Valvular complications were detected in 40.3%, which were perforation, pseudoaneurysm, and perivalvular abscess in 30.2%, 8.6%, and 7.9%, respectively. The in-hospital mortality rate was 19.4% and significantly higher in older age (adjusted odd ratio [aOR] 1.05, 95% confidence interval [CI] 1.003 to 1.11), renal insufficiency (aOR 21.37, 95% CI 3.95 to 115.57) and higher pulmonary artery systolic pressure (aOR 1.008, 95% CI 1.03 to 1.13).\u0000\u0000Conclusion: IE remains a serious disease with high mortality. The predictors of in-hospital mortality in patients with IE were age, renal insufficiency, and high pulmonary artery systolic pressure.\u0000\u0000Keywords: Infective endocarditis; IE; In-hospital mortality; Predictor","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an Oral Vancomycin Capsule for the Treatment of Clostridioides difficile Infections in an Academic Medical Center in Thailand","authors":"","doi":"10.35755/jmedassocthai.2024.4.13969","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13969","url":null,"abstract":"Background: The oral capsule formulation of vancomycin (Vancin-S) recently became available in Thailand; therefore, information on its effectiveness and safety in treating Clostridioides difficile infection (CDI) has not been available.\u0000\u0000Objective: To evaluate CDI outcomes and to access safety at the HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC) following recommended oral vancomycin capsule treatment.\u0000\u0000Materials and Methods: Retrospective review of MSMC patients prescribed oral vancomycin capsule between December 1, 2022 and August 31, 2023. Inclusion and exclusion criteria were applied, analyzing CDI outcomes post- oral vancomycin capsule treatment and within 90 days thereafter. Safety of oral vancomycin capsule usage was also assessed.\u0000\u0000Results: Of the 41 patients prescribed oral vancomycin capsule, 13 met inclusion criteria and did not meet with exclusion criteria. There were eight definite and five probable CDI cases, with 12 initial treatments and one initial fulminant treatment. The incidence of CDI in the MSMC was 21.33 person-year. Clinical improvements were observed by the tenth day, with one patient experiencing residual symptoms, subsequently testing negative for CDI. All patients were cured. The oral vancomycin capsule treatments were well-tolerated without significant adverse effects. No CDI recurrence was detected among 12 cases followed up within 90 days post-treatment.\u0000\u0000Conclusion: The oral vancomycin capsule demonstrates safety and potential efficacy for CDI treatment in Thailand.\u0000\u0000Keywords: Oral vancomycin; Clostridioides difficile infection; Thailand","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140689662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-Tidal Carbon Dioxide Monitoring in Anesthesia: Unraveling the Mysteries of Respiratory and Circulatory Physiology","authors":"","doi":"10.35755/jmedassocthai.2024.4.13968","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13968","url":null,"abstract":"The present article underscored the indispensable significance of end-tidal carbon dioxide (ETCO2) monitoring in anesthesia and critical care, offering critical insights into both ventilation and metabolism dynamics. The meticulous management of tidal volume, respiratory rate, and inspired oxygen levels during anesthesia plays a pivotal role in maintaining optimal arterial oxygen and carbon dioxide concentrations. Effective ventilation is imperative for proper gas exchange within the alveoli and maintaining a stable acid-base balance.\u0000\u0000In the context of circulatory physiology during anesthesia, cardiac output, blood pressure, and tissue perfusion hold paramount importance. The present article highlights how anesthesia-induced alterations in vascular tone and cardiac function could influence circulation and tissue oxygenation, impacting parameters like blood pressure, heart rate, and ETCO2. Monitoring these parameters provides essential data for assessing circulatory status, guiding anesthesia management, and averting complications.\u0000\u0000ETCO2 monitoring has evolved into a standard practice in anesthesia and critical care settings, offering real-time, non-invasive insights. The present article delved into the extensive clinical applications, challenges, and future directions of ETCO2 monitoring. Encompassing fundamental principles, technological nuances, clinical implications, limitations, and avenues for research, this article advanced the understanding of this monitoring technique and its positive impact on patient care.\u0000\u0000The present article also discussed how ETCO2 levels reflect alveolar ventilation, providing critical data for assessing ventilation adequacy, readiness for extubation, and identification of impending respiratory distress. Furthermore, it delved into how ETCO2 levels serve as an indicator of cardiac output and tissue perfusion, guiding management strategies in various shock states and offering prognostic insights during CPR.\u0000\u0000Challenges and limitations associated with ETCO2 monitoring were clarified, with emphasis on technical considerations, patient populations with specific challenges, and potential interpretation pitfalls. The article outlines the exciting future directions of ETCO2 monitoring, encompassing wearable technology, remote monitoring capabilities, artificial intelligence integration, and potential applications beyond traditional realms.\u0000\u0000Keywords: Anesthesia; Capnography; Critical care; End-tidal carbon dioxide; ETCO2 monitoring","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Low Vitamin D Level in Adults with Epilepsy: A Cross-sectional Study at a Single Tertiary Neurological Center in Thailand","authors":"","doi":"10.35755/jmedassocthai.2024.4.13961","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2024.4.13961","url":null,"abstract":"Background: Epilepsy has a wide-ranging impact on the quality of life in patients of all age groups. Reduced levels of active vitamin D contribute to various bone diseases and may influence seizure control. Nevertheless, the risk factors for low vitamin D levels in patients with epilepsy remain inconclusive and are not well-established. The limited number of studies in Thailand may not be sufficient to provide guideline recommendations for screening vitamin D levels in adults with epilepsy.\u0000\u0000Objective: To evaluate the prevalence and risk factors of low vitamin D levels in Thai adults with epilepsy taking long-term antiepileptic drugs. To provide supporting recommendations for screening vitamin D levels in patients with epilepsy for early diagnosis and appropriate vitamin supplementation.\u0000\u0000Materials and Methods: The present study was a cross-sectional study conducted on 87 adults with epilepsy aged 18 to 76 years who were followed up at the Neurological Institute of Thailand between March and October 2023. Patients with comorbidities affecting vitamin D metabolism were excluded from the study. Baseline demographic data, epilepsy-related information, and anti-seizure medication information were analyzed. Blood tests for vitamin D for 25-hydroxyvitamin D [25(OH)D], calcium, phosphorus, and albumin were performed.\u0000\u0000Results: The prevalence of low vitamin D levels was 85%, including deficiency at 37% and insufficiency at 48%, with the mean (±SD) of serum 25(OH)D being 21.9±7.60 ng/mL. Multivariate analyses revealed that female was significantly associated with low vitamin D levels, adjusted OR 4.97 (95% CI 1.23 to 20.05). There was no significant association among epilepsy-related information, anti-seizure medications, and low vitamin D levels.\u0000\u0000Conclusion: The prevalence of low vitamin D levels in the present study was significantly higher than that observed in the previous studies, which is consistent with the findings of the recent studies in many countries. The authors strongly recommend screening for vitamin D levels in Thai adults with epilepsy, particularly in females. Early diagnosis and management of this condition are beneficial for patients with epilepsy and can help mitigate the various complications resulting from low vitamin D levels.\u0000\u0000Keywords: Epilepsy; Low vitamin D level; Vitamin D deficiency; Vitamin D insufficiency; Antiseizure medications; Prevalence; Risk factors","PeriodicalId":511594,"journal":{"name":"Journal of the Medical Association of Thailand","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}