The Bangkok medical journal最新文献

{"title":"Measuring Health Literacy Among People Living with HIV in a Medical University Hospital: A Cross-Sectional Study","authors":"Sitthiphon Bunman, Prakasit Wannapaschaiyong, Narongpon Dumavibhat, Tirathat Virojskulchai, Aphicha Nomsiri, Anan Malarat, Sonthaya Saiyasalee","doi":"10.31524/bkkmedj.2023.21.007","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.21.007","url":null,"abstract":"OBJECTIVES:  The study aimed to evaluate the level of health literacy among people living with HIV.  MATERIALS AND METHODS: A cross-sectional survey was conducted among HIV-infected adult patients. We recruited 530 adults with HIV patients. The level of health literacy was evaluated with the Thai version of the HIV-HLT. RESULTS: The participants had an average age of 42.66 ± 11.26 years. The majority of the participants are male (65.8%). 92.6% had straight sexual orientation. 57.6% of participants had been diagnosed with HIV infection for more than five years. 86.6% had a CD4 count of more than 200 cells/cm3, and 68.7% had a viral load of less than 20 copies/ml. Most participants (62.1%) had adequate HIV health literacy. The CD4 count of greater than 200 cells/cm3 and viral load of less than 20 copies/ml were also associated with adequate health literacy. Moreover, participants with no previous history of opportunistic infections within the past six months were associated with adequate HIV health literacy. CONCLUSION: HIV health literacy is significantly associated with CD4 count and viral load outcomes. Therefore, educating patients about the disease and treatment is crucial in reducing the negative consequences of the disease.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343136","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":"A Retrospective Study of Prescribing Error Associated with The Computerized Prescribing System and The Handwritten Prescribing System Among Prescriptions in a Private Hospital, Chiang Mai Province","authors":"Jintapak Prakob, Panatda Maturapanee, Wipada Pianmongkon, Mullika Nenpang","doi":"10.31524/bkkmedj.2023.21.003","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.21.003","url":null,"abstract":"OBJECTIVES: To compare prescribing errors arising from prescribing drugs by computerized prescribing system and handwritten prescribing system and to explore the possible factors that cause prescribing errors between the two systems. MATERIALS AND METHODS: : A retrospective study collected data from outpatient prescriptions at Bangkok Hospital Chiang Mai from January 1- December 31, 2019 by a simple random sampling method. A total of 18,211 drug prescriptions were included in this study which consisted of prescribing the drug with the computerized prescribing system and the handwritten prescribing system. The data obtained were analyzed by frequency distribution, percentage, mean and standard deviation. Factors that caused discrepancies in prescribing drugs during computerized prescribing and handwritten prescriptions were tested by means of Chi-square test. A value of 0.05 odds ratio and 95% Confident interval was considered statistically significant. RESULTS: In this study, the discrepancy from the handwritten prescribing system was 2.6 % higher than that of the computerized prescribing system (0.24%). The study was also classified by the severity of the discrepancy which demonstrate both systems experienced the highest severity on a scale of 0 (Near miss event) by 2.6 % for the handwritten prescribing system and 0.2 % for the computerized prescribing system. In addition, the top three discrepancy errors from computerized prescribing were wrong time, wrong dose and wrong quantity at 0.07%, 0.06% and 0.05 %, respectively. As for the handwritten prescribing system, the discrepancy errors were wrong time, wrong quantity and wrong dose at 1.24%, 0.56% and 0.35%, respectively. CONCLUSION: There were significant differences in the proportion of errors in the group of the handwritten prescribing system and the computerized prescribing systems (OR = 0.091, p < 0.05); namely, the risk of errors by the computerized prescribing systems was reduced by 91% compared with the handwritten prescribing system. However, there were no statistically significant differences in physician ‘s work experience, departments, and age groups.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136342886","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":"The Influence of Knowledge Management, Safety Climate, and Information Technology Capabilities on a Smart Emergency Logistics System: A Study of BDMS Emergency Services","authors":"Kritwaroj Patchetphokin, Prayong Meechaisue, Norapol Chinuntdej, Donya Chaimongkol","doi":"10.31524/bkkmedj.2023.21.002","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.21.002","url":null,"abstract":"OBJECTIVES: This research is to study a causal relationship model of knowledge management (KM), safety climate (SCL), and information technology capabilities (ITC) that affect the smart emergency logistics system (SELS) at the emergency services network at Bangkok Dusit Medical Services Public Company Limited (BDMS). MATERIALS AND METHODS: This research used the mixed-methods research technique: starting first with a qualitative research approach, via in-depth interviews with senior executives, managers, employees, and specialists in emergency services, totaling 16 people, and; by collecting a questionnaire completed by 378 people at EMS-BDMS. Data were analyzed using descriptive statistics and inferential statistics with structural equation modeling. RESULTS: From the study, it was found that KM, SC, and ITC had a positive influence on SELS. The analysis of the structural equation model found that it was in line with the empirical data and scored at a good level. The Cronbach’s alpha coefficient confidential score was between 0.82 - 0.94. CONCLUSION: This research shows that the development and mobilization of emergency care with KM, SCL, and ITC as SELS forms an innovative model (Kritwaroj Model) of the SELS.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343170","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":"Barriers to the Uptake of Cataract Surgery in Lumbini Nepal and Aranyaprathet Thailand","authors":"Pornchai Simaroj, Ravee Phol, Sorawis Chalalai, Rosita Phol","doi":"10.31524/bkkmedj.2023.27.001","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.27.001","url":null,"abstract":"Health care access is the ability to obtain healthcare services such as prevention, diagnosis, treatment, and management of disease, illness, disorders, and other health-impacting conditions. For healthcare to be accessible it must be affordable and convenient. Many people do not have access to adequate healthcare. This is the situation for many in developing countries, but we also see lack of access to health services in developed countries like the United States. Healthcare professionals, institutions, and governments face difficult choices when providing adequate and equitable healthcare. Inaccessibility to healthcare is a public policy issue and, many people feel, a moral issue. Three important themes in healthcare access are: the problem of poverty, the many barriers to healthcare access, and the question of healthcare resource allocation. These themes generate controversies about the role and alleviation of poverty, how to overcome access barriers, and how to fairly allocate limited resources to those most in need.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343171","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":"A Retrospective Review of Real-life Practice of Intravenous Immunoglobulin Usage in Autoimmune Neurological Disease","authors":"Kongkiat Kulkantrakorn, Pakkapon Kanjanavithayakul","doi":"10.31524/bkkmedj.2023.21.001","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.21.001","url":null,"abstract":"OBJECTIVES: To review the prescription of Intravenous immunoglobulin (IVIg) in neurological disease regarding its efficacy, prescription pattern, indication and treatment outcome. MATERIALS AND METHODS: We studied IVIg usage and treatment outcomes by reviewing the prescription database and medical records from 2013 to 2019 at Thammasat University Hospital (TUH), which is the university hospital in the lower central region of Thailand, and records at Bangkok International Hospital (BIH), part of the largest private hospital network in Thailand. RESULTS: IVIg was used in 28 patients in TUH and 86 patients in BIH. The diagnoses were Guillain-Barré syndrome (GBS) (50%), myasthenia gravis (MG) crisis (23%) and chronic inflammatory demyelinating polyneuropathy (CIDP) (6%). 39.5% of patients were prescribed IVIg apart from those prescribed in line with the Thailand national list of essential medicine (NLEM) indication. The major cause of NLEM deviation is usage beyond reimbursement guidelines, but the dose of IVIg administered is within standard guidelines. IVIg usage and treatment outcomes were similar in both hospitals in the case of GBS and MG. Both groups show beneficial outcomes from IVIg. BIH used IVIg often as first line treatment for CIDP, but TUH used IVIg as subsequent therapy after failure of corticosteroid administration. TUH preferred plasmapheresis combined with a high dose steroid for neuromyelitis optica spectrum disorder (NMOSD) and autoimmune encephalitis reflecting the cost of therapy and reimbursement guidelines. CONCLUSION: IVIg is still the mainstay treatment of GBS and MG crisis in Thailand. The outcome of GBS and MG crisis is similar in both hospitals. Private hospitals seem to have more off label use and often used IVIg as a first line therapy in CIDP, NMOSD and autoimmune encephalitis. Reimbursement guidelines and NLEM have a major impact on prescription patterns.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343146","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":"Minimally Invasive Screw Cement Augmentation in Pedicle Technique (MIS CAPT) for Spine Fixation in Osteoporosis Fragility Fracture and Non-Fracture Patient: Surgical Technique, Indication and 1-year Outcome Evaluation","authors":"Dr.TAYARD BURANAKARL, Sarush Nimmankiatkul, Patchara Pornsopanakorn, Kanoknard Jaisanuk","doi":"10.31524/bkkmedj.2023.21.005","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.21.005","url":null,"abstract":"OBJECTIVES: The aim of this study is to describe novo technique of cemented augmentation with percutaneous pedicle screws called “Minimally Invasive Screw Cement Augmentation in Pedicle Technique (MIS CAPT)” which can be used with ordinary percutaneous screws in both fracture and non-fracture osteoporotic fragile bone patients. MATERIALS AND METHODS: Sixty-six cases of HIV negative who were suspected of pulmonary tuberculosis were recruited, sputum examination of acid fast stain and culture, chest x-ray, urine TB LAM were sent, bronchoscopy and washing and biopsy were performed among 12 cases. RESULTS: The patients were divided into the non-fracture group (n = 12) and the fracture group (n = 12). Mean ages of patient were over 70 years old. Mean estimated blood loss and the operative time were lower in the fracture group than those of the non-fracture group (107.5 vs. 758.3 ml and 174.7 vs. 405.5 min., respectively). All patients in the fracture group were discharged from intensive care unit within 24 hours, while 25% of the non-fracture were unable. The mean time to start ambulation in the fracture and the non-fracture group was 17.5 and 48.5 hours, respectively. The hospital stay was approximately 7–9 days in both groups. All patients had no postoperative neurological complications or infections. Minor cement leakage (9.4%) was found in the fracture group without any effect on health or outcome. Within 1-year follow-up, no loosening was found in all MIS CAPT screws and in the fracture group, only 2.8-degree loss of kyphosis reduction was presented in the fracture group. CONCLUSION: It is concluded that MIS CAPT is an effective-versatile minimally invasive spinal fixation technique in osteoporotic or fragility bone conditions. The outcome is excellent in terms of successful operation, minimal complications, and rigid fixation in both fracture and non-fracture elderly fragility bone patients.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343012","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":"A retrospective Comparison of Hypothermia Proportion Among Newborns Using General Postnatal Nursing Practice versus Baby Warm Practice Guideline","authors":"Chirachaya Yawichai, Monrudee Morpanursery, Narawitree Teetuan","doi":"10.31524/bkkmedj.2023.21.006","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.21.006","url":null,"abstract":"OBJECTIVES: To investigate the proportion of neonatal hypothermia this study compares newborns who received General Postnatal Nursing (GPN) Practice based on previous clinical practice guidelines with those who received Baby Warm Practice (BWP) Guideline based on the latest guidelines for preventive neonatal hypothermia. MATERIALS AND METHODS: : The study sample consisted of newborn medical records of newborns who were delivered at Bangkok Hospital Chiang Mai between May 1, 2016 and April 30, 2018, with gestational age between 37 and 42 weeks, in good health, and with an Apgar score of more than 7. The study was analyzed and the proportion of neonatal hypothermia occurrence between the group that received care according to the GPN practice and the group that received care according to the BWP Guideline were compared. RESULTS: A total of 315 neonates who met the selection criteria and had complete data were included in this research project. They were divided into two groups, BWP Guideline group (n = 157, 49.84%) and GPN Practice group (n =158, 50.16%), according to the predefined criteria. The basic demo- graphic characteristics of the two groups were found to be different. The Apgar score at 1 minute was 8 in 30 neonates (19%) in BWP Guideline group, which was higher than the 15 neonates (9.5%) in GPN Practice group. The Apgar score at 5 minutes was 10 in 100 neonates (63.7%) in BWP Guideline group, which was lower than the 118 neonates (74.7%) in GPN Practice group. The temperature in the delivery room and operating room was less than 22 °C in 89 neonates (56.68%) in BWP Guideline group, which was lower than the 140 neonates (88.6%) in GPN Practice group. The temperature in the transition room was less than 24 °C in 13 neonates (8.28%) in BWP Guideline group, which was lower than the 32 neonates (20.25%) in GPN Practice group. The study found that there were 3 neonates (1.9%) in BWP Guideline group and 7 neonates (4.4%) in GPN Practice group with low body temperature, and there was no significant difference between the two groups (p = 0.336). CONCLUSION: The BWP Guidelines for preventing neonatal hypothermia in newborns have been updated to emphasize continuous warmth provision (The Warm Chain), increasing prevention of heat loss from the newborn’s body, increasing the ambient temperature, and using plastic caps (Baby Warm Cap) to prevent heat loss from newborn’s head. These guidelines result in a lower proportion of neonatal hypothermia compared to the previous guide- lines. Both groups, however, did not differ significantly in the incidence of neonatal hypothermia.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343336","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":"Urine TB LAM as a Tool for Helping Diagnosis and Follow Up of Treatment Response of Pulmonary Tuberculosis","authors":"Sawang Saenghirunvattana, Thiti Sricharoenchai, Sirintip Sricharoenchai","doi":"10.31524/bkkmedj.2023.21.004","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.21.004","url":null,"abstract":"OBJECTIVES: To evaluate role of urine Tuberculosis Lipoarabinomannam (TB LAM) in making a diagnosis among human immunodeficiency virus (HIV) negative patients with pulmonary tuberculosis. MATERIALS AND METHODS: Sixty-six cases of HIV negative who were suspected of pulmonary tuberculosis were recruited, sputum examination of acid fast stain and culture, chest x-ray, urine TB LAM were sent, bronchoscopy and washing and biopsy were performed among 12 cases. RESULTS: Thirty-six patients were finally diagnosed as tuberculosis. The sensitivity of urine TB LAM was 66.7%, specificity was 90%. CONCLUSION: TB LAM should be used as an add-on to clinical judgement in combination with other tests. Keywords: urine TB LAM, pulmonary tuberculosis","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343137","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":"Gemella haemolysans Native Valve Endocarditis","authors":"Supitcha Ongkittikul, Suchai Kanjanatarayont","doi":"10.31524/bkkmedj.2023.22.003","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.22.003","url":null,"abstract":"Gemella haemolysans is a rare pathogen in cases of infective endocarditis. We report a case of G. haemolysans infective endocarditis in a 93-year-old woman with preexisting heart valves disease. The blood culture grew G. haemolysans and the echocardiogram revealed a 1.0cm x 0.49cm mobile mass attached to anterior mitral leaflet. Her condition improved after 6 weeks of intravenous ceftriaxone.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136342892","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":"Sonography and MRI Appearance of Proximal Long Head Biceps Tendon","authors":"Thanis Saksirinukul","doi":"10.31524/bkkmedj.2023.23.001","DOIUrl":"https://doi.org/10.31524/bkkmedj.2023.23.001","url":null,"abstract":"This article delves into the intricate anatomical structure and diagnostic imaging of the proximal long head biceps tendon, shedding light on its complexities and pathologies. Employing both ultrasound (us) and magnetic resonance imaging (MRI), the study illustrates the normal appearance of the tendon and explores detailed imaging findings for identifying abnormalities. The discussion encompasses tendinopathy, tears, biceps reflection pulley lesions, and superior labrum anterior-to- posterior lesions. By elucidating these aspects, the article aims to enhance diagnostic accuracy and inform treatment planning for a spectrum of conditions involving the proximal long head biceps tendon. The proximal long head biceps tendon is a complex anatomical structure in shoulder imaging. Pathologies of the biceps tendon and adjacent structures, such as rotator cuff tendons and labrum, can affect treatment options and strategies. Secondary biceps tendon injury is more common than primary biceps tendon injury -biceps tendon injury is coexisted with rotator cuff tendon tear in 90% approximately. Diagnostic imaging as MRI is the preferred modality for visualizing all parts of the biceps tendon and detecting abnormalities. Ultrasound is also easily accessible and can provide good visualization of some parts of the proximal biceps tendon. This article discusses how to identify abnormalities on both MRI and ultrasound findings, for diagnosis and treatment planning.","PeriodicalId":92144,"journal":{"name":"The Bangkok medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343759","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}