The Bangkok medical journal最新文献

{"title":"Long Head Biceps Superior Capsular Reconstruction : Available option for Irreparable Rotator Cuff tear (Case Report )","authors":"Sukree Khumrak","doi":"10.31524/BKKMEDJ.2020.22.004","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.22.004","url":null,"abstract":"primary less retracted edges of the the anterior and posterior margins are usually reparable, the central portion of the with the greatest retraction be irreparable. are treatment such as conservative treatment, arthroscopic debridement tenotomy, rotator cuff partial repair, patch augmentation, reverse total shoulder arthroplasty, and superior capsular reconstruction. capsular reconstruction is a treatment option for relatively patients with irreparable massive cuff tear because the superior capsule acts as a better restraint to proximal migration of the humeral head, and is considered to be a key static stabilizer. This concept explains why the can relieve severe pain and improve disability from irreparable massive rotator cuff tears. tensor fascia lata, and reported that it can be used very easily during arthroscopic shoulder surgery because of the proximity of this tendon, and that donor-site morbidity can be avoided. Abstract Large and massive rotator cuff tears often pose challenges when trying to repair the injury, and can sometimes be irreparable. Superior capsular reconstruction was recently introduced as an effective procedure for maintaining the static stability of the shoulder joint in order to prevent the progression to cuff tear arthropathy. We described the technique of superior capsular reconstruction using local long head of biceps tendon as an alternative to tensor fascia lata or dermal allograft.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48108977","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":"Pediatric Radiation Dose from 64 Slices-MDCT in Abdomen after Using the New Pediatric CT Scanning Protocol at Phramongkutklao Hospital","authors":"Suvicha Khampunnip, Sutiporn Khampunnip, Kaywalin Sutthipong, Supakajee Saengruang-orn","doi":"10.31524/BKKMEDJ.2020.21.014","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.21.014","url":null,"abstract":"OBJECTIVES: To study the radiation dose in pediatric patients after using a new pediatric computed tomography (CT) scanning protocol at Phramongkutklao Hospital as compared with the historical data and with reference level recommended by International Commission on Radiological Protection (ICRP). MATERIALS AND METHODS: This study was a prospective and descriptive study. The study target population were all consecutive patients aged <15 year-old who had received a 64-slice computed tomography of the abdomen from January 2015- August 2016 using the new protocol. The control group was patients in the same age group performing CT scan of abdomen in the past before using the new protocol. RESULTS: Total of 29 children were included in the analysis, 13 were male and 16 were female. The third quartile of the dose-length product (DLP) (75 th percentile) was 125.0, 228.0, 305.6 and 381.0 mGy.cm for the patients < 1, 1 to < 5, 5 to < 10 and 10 to <15 year-old respectively. These DLP values were significantly lowered than previously reported in Thailand in almost patient age groups. CONCLUSION: The radiation dose that our pediatric patients received from undergoing CT scan of abdomen was acceptable after using the new protocol. Data collection in future studies including a higher number of patients and longer follow-up time may be helpful.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48269643","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":"Use of Narrow Band Imaging in diagnosis of Unexplained Hemoptysis; A Case Report: Endobronchial Telangiectasia","authors":"Winai Boweja","doi":"10.31524/BKKMEDJ.2020.22.002","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.22.002","url":null,"abstract":"R ecurrent nonmassive hemoptysis is one of the common outpatient visits in a pulmonary clinic and, in many cases, the cause of hemoptysis remains unknown. We describe a case of recurrent nonmassive hemoptysis of an unknown cause, which was eventually diagnosed as endobronchial telangiectasia using narrow band imaging during bronchoscopy. Abstract Nonmassive hemoptysis is a frequently encountered consultation at the pulmonary clinic and a few cases are commonly inconclusive. We present a case of unexplained chronic nonmassive hemoptysis, which was finally diagnosed as endobronchial telangiectasia, a rare cause of hemoptysis. Endobronchial telangiectasia can lead to massive hemoptysis, which occasionally can be missed by a casual examination during Flexible bronchoscopy, and these patients may undergo multiple diagnostic procedures before the diagnosis is established. Using narrow band imaging during flexible bronchoscopy can help the pulmonologist to identify the culprit lesions, which would otherwise be missed.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49550734","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":"Neonatal Migratory Polycyclic Erythema of Urticaria Associated with Alprostadil: A Case Report","authors":"Thitinun Ruknoo, Jintakarn Kasemsri Na Ayutthaya, Krittiya Stonsaovapak","doi":"10.31524/BKKMEDJ.2020.22.003","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.22.003","url":null,"abstract":"A full-term male neonate was diagnosed with complex heart disease. His diagnosis included Taussig-Bing anomaly, TGA, large subpulmonic VSD, large PDA, severe coarctation, and interrupted aortic arch. The patient was transferred to our institution, a super-tertiary care for probable management within 5 hours after birth. The 3.3 kg infant was delivered by cesarean section. Cyanosis was noted at birth. The hypoxemia and cyanosis did not improve after using an oxygen mask with bag (oxygen saturation 80%). Intubation with subsequent mechanical ventilation was initiated in this case. Ampicillin and cefotaxime were administered for possible early neonatal sepsis. An echocardiogram revealed dextro-Transposition of the great arteries (d-TGA), large subpulmonic VSD, left aortic arch, large PDA, hypoplastic aortic arch, severe coarctation, and interrupted aortic arch. Alprostadil was started within 3.5 hours after birth. Arterial switch operation (ASO) was planned. The patient’s intravenous medications included dopamine, dobutamine, fentanyl, furosemide, calcium gluconate, sodium bicarbonate, potassium chloride, ampicillin, cefotaxime, and heparin. Abstract The aim of this study was to report a case of neonatal migratory polycyclic erythema of urticaria associated with alprostadil. A full-term male neonate with complex heart disease was diagnosed. The patient had a Taussig-Bing anomaly, transposition of the great arteries (TGA), large subpulmonic ventricular septal defect (VSD), large patent ductus arteriosus (PDA), severe coarctation and interrupted aortic arch. The patient developed an adverse drug reaction during alprostadil infusion. Following the reaction, alprostadil was administered at sequentially reduced doses, and the patient eventually became tolerant of alprostadil. The patient successfully continued therapy with no further reactions or recurrences. No adverse drug reactions developed during infusion until the patient was discharged from the hospital and was transferred to a tertiary care hospital for cardiothoracic surgery.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42111318","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":"Type of Mass Media Exposure Effects on ZIKA-Related Knowledge and Behavior among Pregnant Women in Thailand","authors":"I. Siramaneerat, S. Mungkhamanee, Wannisa Raksamart, Supit Boonlab, Pimnapat Bhomkittipich, Wanjai Lamprom","doi":"10.31524/BKKMEDJ.2020.21.002","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.21.002","url":null,"abstract":"OBJECTIVES: To assess the impact of exposure to ZIKA information, knowledge and preventive behavior from mass media among pregnant women in a health district zone in Thailand. MATERIALS AND METHODS: The sample comprised pregnant women aged between 18-45 years old, from Health Promotion Center Region 5. The sample size was estimated using 95% confidence interval levels to appropriately represent pregnant women. Valid responses were collected from 395 participants. The sample selection was divided into two stages. First, we randomly selected four provinces from the eight provinces and then selected the district health promotion center in each province. Second, we selected a specific number of pregnant women using a proportional sampling selection. The total number of samples was 395 cases. Furthermore, a multivariate regression linear was applied to analyze the effect of the independent variables towards the dependent variable. RESULTS: The study showed that occupation, mass media exposure from internet media and personal sources had a significant effect on ZIKA-related knowledge. Moreover, education level, pregnancy check-up, mass media exposure from electronic, print and personal sources had led to a significantly higher practice of ZIKA-preventive behavior. The independent variables showed the variation of ZIKA-related knowledge and preventive behavior of 11% and 31%, respectively. CONCLUSION: These results show that mass media can play an important role in helping to prevent transmission of ZIKA. Mass media can bring positive results at the community level, which will often involve ZIKA discussions between families and neighbors, and eventually leads to changes in behavior.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48979239","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":"Development of BDMS Utilization Review Technology (BURT): An Artificial Intelligence Tool Using Thai Natural Language Processing to Assess Appropriateness of Hospitalization","authors":"Jinhatha Panyasorn, Piemchok Banomyong, Kusuma Phetchunsakul, Noppadol Phengpinit, Varut Wiseschinda, C. Kunanusont","doi":"10.31524/bkkmedj.2020.21.012","DOIUrl":"https://doi.org/10.31524/bkkmedj.2020.21.012","url":null,"abstract":"OBJECTIVES: To develop an effective artificial intelligence (AI) driven platform to optimize the process of assessing appropriateness of hospitalization. MATERIALS AND METHODS: Anonymized data of 22,020 insured-patient admissions in a BDMS network hospital were included to build a prediction model based on a comprehensive guideline for appropriate hospitalization. To develop Thai Natural Language Processing (NLP) model, 77,707 sentences from medical records were used and separated into two datasets, 80% for training and 20% for testing. A combined NLP and rule-based algorithms formed an AI engine and outputs were displayed using a web-based application. An expert panel of five Utilization Management (UM) physicians had several collaborative discussions to fine tune the NLP model, application of clinical criteria, and classification engine. Eventually, NLP model in the latest version (BURT1.1), had satisfactory features with overall higher than 99% accuracy, precision, recall, and F1. RESULTS: Performance of BURT1.1 was assessed using 300 cases randomly selected from the main dataset, against other methods, including concurrent review by UM nurses at the participating hospital, and UM nurses at Bangkok Hospital Headquarters (BHQ). Agreement upon UM Physician Panel consensus was set as one of the performance indicators, and BURT1.1 showed a favorable outcome with the highest rate of agreement (86%) among all the methods. The precision rate was 99% as compared to insurance claim approval status. Additionally, dramatic time savings were achieved with 0.59 second of processing time as compared to 10-15 minutes per case by conventional manual review. CONCLUSION: BURT1.1 should be effectively implemented as an automatic daily tool to screen inappropriate hospitalization. It can immediately identify patients at high risk of inappropriate hospitalization that require further assessment by UM nurse, thus providing feedback to attending physicians on the completeness and quality of documentation, with parallel notification to UM physicians. Ultimately, BURT1.1 can contribute to increase UM efficiency, speeding up the claim process, reducing health care costs due to unnecessary hospitalization, and reduction of claim denials.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44562327","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":"Transaxillary Approach for First Rib Resection in Combined Neurogenic and Vascular Thoracic Outlet Syndrome with Elongated C7 Transverse Process and Status Post Breast Implantation: A Case Report","authors":"Padungkiat Tangpiroontham","doi":"10.31524/BKKMEDJ.2020.22.006","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.22.006","url":null,"abstract":"She complained of the inability to put on make-up properly as an initial symptom. She was evaluated by an orthopedist who attempted to perform steroid injection at her wrist without clinical improvement. Upon physical examination, it revealed severe atrophy of right thenar and hypothenar muscle as well as weakness of intrinsic muscle of hand (Figure 1). It also showed numbness of right hand and distal forearm. Her radial pulse became absent upon neck extension and Abstract Combined neurogenic and arterial Thoracic Outlet Syndrome (nTOS and aTOS) is a rare disease. First rib resection with scalenectomy is a mainstay of treatment. TOS results from pathology in the interscalene triangle. Many etiologies were described as its contributing factors, however, to the author’s knowledge, axillary breast implantation had not yet been described. In patients who have mild anatomical pathology, scar formation from axillary surgery may aggravate TOS symptoms. The author wishes to present a case of mild elongated C7 transverse process that then underwent breast implantation, subsequently developed combined nTOS and aTOS, successfully managed through transaxillay first rib resection and scalenectomy.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44657550","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":"Effect of Implementing Clinical Nursing Practice Guideline for Mild Traumatic Brain Injury at Bangkok Pattaya Hospital","authors":"Chanthika Thitasawadchaikan, Apinya Siripitayakunkit, Sawai Norasan, Decha Kinthorn","doi":"10.31524/BKKMEDJ.2020.21.005","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.21.005","url":null,"abstract":"OBJECTIVES: The objective of this study is to evaluate the effects of implementing clinical nursing practice guidelines in mild traumatic brain injury patients at Bangkok Pattaya Hospital. (CNPG) MATERIALS AND METHODS: In this quasi-experimental study there was one group design. Participants were 40 mild traumatic brain injury patients who fulfilled the inclusion criteria. Patients were treated according to clinical nursing practice guidelines. Data were collected using a set of questionnaires, including demographic information, the Rivermead post-concussion symptoms questionnaire, the Rivermead head injury follow up questionnaire and satisfaction questionnaire. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test. RESULTS: Patients with mild traumatic brain injury and post-concussion symptoms have been affected with an impact on daily life ranging from mild to moderate. The symptoms were improved within 2, 4 and 6 weeks after the onset, respectively. The functional performance was significantly increased ( p < 0. 05) within 2, 4 and 6 weeks after traumatic brain injury. The satisfaction of patients with nursing care was at a high level. CONCLUSION: The CNPG can improve patient outcomes by minimizing complications and enhancing the functional performance of mild traumatic brain injury patients.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44934534","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":"Clinicopathological Study of 72 Periapical Lesions from Vietnamese Patients","authors":"C. V. Le, P. Thunyakitpisal, R. Chaisuparat","doi":"10.31524/BKKMEDJ.2020.21.004","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.21.004","url":null,"abstract":"OBJECTIVES: This retrospective study evaluated the clinical and histopathological features of 72 periapical lesions in Vietnamese patients. MATERIALS AND METHODS: Seventy- two periapical lesions obtained from 72 patients after periapical surgery due to unsuccessful root canal retreatment of anterior teeth were histologically analyzed and classified as periapical granulomas, periapical cysts, and periapical scars. The demographic data: patient’s age, gender, and lesion sites were also recorded. RESULTS: The mean age was 34.74 years, with a range from 12-65. Of these lesions, 53 cases were found in the maxilla and 19 cases in the mandible. The lesions occurred more frequently in the third to fourth decade of life and the most involved tooth was the lateral incisor. Periapical granulomas accounted for 45 cases (62.5%), followed by periapical cysts with 27 cases (37.5%). Of the 27 periapical cysts, 96.3% of the cases were lined with stratified squamous epithelium and the remaining with respiratory epithelium. The prevalence of cholesterol clefts, foamy histocytes, and dystrophic calcification in the periapical cyst was 22.2%, 29.6%, 25.7%, and 8.8%, 11.1%, 51.1% in the periapical granuloma, respectively. One periapical cyst contained a foreign body (3.7%). Only two periapical granulomas demonstrated mixed acute and chronic inflammation. CONCLUSION: All cases were identified as benign lesions with the most common type being periapical granuloma. The data of this study also confirms the importance of histological examination to establish an accurate diagnosis to eradicate a malignant lesion that may be present in the periapical region of teeth.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49285822","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":"Valacyclovir Non-Oliguric Acute Kidney Injury: a Case Report of 84 Year-Old Female","authors":"Surachai Roongtanapirom","doi":"10.31524/BKKMEDJ.2020.22.007","DOIUrl":"https://doi.org/10.31524/BKKMEDJ.2020.22.007","url":null,"abstract":"","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42873086","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}