Pub Date : 2023-12-01DOI: 10.33192/smj.v75i12.265648
Nicholas Andrian Singgih, Jacinda Risha Oktaviani, William Adipurnama, Cecilia Noviyanti Salim, Kevin Tandarto, A. F. Purnomo, E. Manuputty
Objective: The Double-J (DJ) ureteral stent is essential in urology but can lead to Ureteral Stent-Related Symptoms (USRS), prompting research into various therapies to enhance patient comfort. The purpose of this study is to assess the efficacy of pregabalin, solifenacin, or combined therapy on ureteral stent-related symptoms. Materials and Methods: We conducted thorough searches in four databases, which included PubMed, Cochrane, EBSCO, and ProQuest. PRISMA Guideline 2020 was applied in this study. The risk of bias was assessed using Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0. Results: Ten studies consisting of 1477 participants were included in this study. Solifenacin monotherapy could significantly decrease total USSQ (mean difference (MD) -16.62; p=0.001), urinary symptoms (MD -9.16; p=0.002), and sexual matters (MD -0.81; p=0.002). Pregabalin monotherapy could significantly decrease pain (MD -7.29; p<0.00001). Compared to solifenacin monotherapy, combination therapy of pregabalin and solifenacin could significantly decrease total USSQ (MD -12.40; p <0.0001), urinary symptoms (MD -1.88; p=0.007), pain (MD -6.82; p<0.00001), sexual matters (MD -0.77; p <0.00001), and additional problems (MD -1.51; p=0.0007). Conclusion: Combination therapy of pregabalin and solifenacin had the best advantages in lowering USRS, especially urinary symptoms, pain, sexual matters, and some other additional problems.
{"title":"Efficacy of Pregabalin, Solifenacin, or Combination Therapy for Ureteral Stent Related Symptoms: A Systematic Review and Meta-Analysis","authors":"Nicholas Andrian Singgih, Jacinda Risha Oktaviani, William Adipurnama, Cecilia Noviyanti Salim, Kevin Tandarto, A. F. Purnomo, E. Manuputty","doi":"10.33192/smj.v75i12.265648","DOIUrl":"https://doi.org/10.33192/smj.v75i12.265648","url":null,"abstract":"Objective: The Double-J (DJ) ureteral stent is essential in urology but can lead to Ureteral Stent-Related Symptoms (USRS), prompting research into various therapies to enhance patient comfort. The purpose of this study is to assess the efficacy of pregabalin, solifenacin, or combined therapy on ureteral stent-related symptoms.\u0000Materials and Methods: We conducted thorough searches in four databases, which included PubMed, Cochrane, EBSCO, and ProQuest. PRISMA Guideline 2020 was applied in this study. The risk of bias was assessed using Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0.\u0000Results: Ten studies consisting of 1477 participants were included in this study. Solifenacin monotherapy could significantly decrease total USSQ (mean difference (MD) -16.62; p=0.001), urinary symptoms (MD -9.16; p=0.002), and sexual matters (MD -0.81; p=0.002). Pregabalin monotherapy could significantly decrease pain (MD -7.29; p<0.00001). Compared to solifenacin monotherapy, combination therapy of pregabalin and solifenacin could significantly decrease total USSQ (MD -12.40; p <0.0001), urinary symptoms (MD -1.88; p=0.007), pain (MD -6.82; p<0.00001), sexual matters (MD -0.77; p <0.00001), and additional problems (MD -1.51; p=0.0007).\u0000Conclusion: Combination therapy of pregabalin and solifenacin had the best advantages in lowering USRS, especially urinary symptoms, pain, sexual matters, and some other additional problems.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"71 S316","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138622707","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}
Pub Date : 2023-12-01DOI: 10.33192/smj.v75i12.265453
Nicolas Daniel Widjanarko, Anthony Ekaputra, Jessica Felicia Ang
Objective: Pamidronate is one of the main therapies for Fibrous Dysplasia (FD), with documented enhancements in patients' clinical characteristics. Nevertheless, its usage has yielded inconclusive results. Therefore, this review aimed to investigate pamidronate’s impact on several clinical and biochemical outcomes in FD patients. Materials and Methods: This review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, ProQuest, Wiley, and EBSCO search databases were used to search the literature. Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-I) was applied for quality assessment of the included studies and Review Manager (RevMan) 5.4 was employed in performing the meta-analysis. Results: There are eight and seven studies used in the meta-analysis and systematic review, respectively. The results showed there are two studies with a low risk of bias and six with a moderate category. All papers included in this meta-analysis showed significant differences in the reduction of bone pain (p<0.00001) and serum alkaline phosphatase (SAP) (p=0.04) after pamidronate treatment compared to the before-treatment groups. Conclusion: The findings of this study indicated that pamidronate therapy had been proven to significantly reduce bone pain and increase SAP in FD patients. However, trials with more age-specific samples and a lower risk of bias should be carried out to determine the statistical significance of overall results.
目的:帕米膦酸钠是纤维结构不良(FD)的主要治疗方法之一，有文献证明可改善患者的临床特征。然而，它的使用产生了不确定的结果。因此，本综述旨在探讨帕米膦酸盐对FD患者的几种临床和生化结果的影响。材料和方法:本综述按照系统评价和荟萃分析的首选报告项目(PRISMA)指南进行。使用MEDLINE、ProQuest、Wiley和EBSCO检索数据库检索文献。采用ROBINS-I (Risk of Bias In non - random Studies of Interventions)对纳入的研究进行质量评价，采用Review Manager (RevMan) 5.4进行meta分析。结果:分别有8项和7项研究用于meta分析和系统评价。结果显示，有两项研究具有低偏倚风险，六项研究具有中等偏倚风险。纳入meta分析的所有论文均显示，与治疗前相比，帕米膦酸钠治疗后骨痛减轻(p<0.00001)和血清碱性磷酸酶(SAP) (p=0.04)有显著差异。结论:本研究结果表明，帕米膦酸盐治疗可显著减轻FD患者骨痛，增加SAP。然而，应该进行更多年龄特异性样本和较低偏倚风险的试验，以确定总体结果的统计显著性。
{"title":"A Systematic Review and Meta Analysis of Non-Randomized Interventional Studies on the Pamidronate Treatment Efficacy for Patients with Bone Fibrous Dysplasia","authors":"Nicolas Daniel Widjanarko, Anthony Ekaputra, Jessica Felicia Ang","doi":"10.33192/smj.v75i12.265453","DOIUrl":"https://doi.org/10.33192/smj.v75i12.265453","url":null,"abstract":"Objective: Pamidronate is one of the main therapies for Fibrous Dysplasia (FD), with documented enhancements in patients' clinical characteristics. Nevertheless, its usage has yielded inconclusive results. Therefore, this review aimed to investigate pamidronate’s impact on several clinical and biochemical outcomes in FD patients.\u0000Materials and Methods: This review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, ProQuest, Wiley, and EBSCO search databases were used to search the literature. Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-I) was applied for quality assessment of the included studies and Review Manager (RevMan) 5.4 was employed in performing the meta-analysis.\u0000Results: There are eight and seven studies used in the meta-analysis and systematic review, respectively. The results showed there are two studies with a low risk of bias and six with a moderate category. All papers included in this meta-analysis showed significant differences in the reduction of bone pain (p<0.00001) and serum alkaline phosphatase (SAP) (p=0.04) after pamidronate treatment compared to the before-treatment groups.\u0000Conclusion: The findings of this study indicated that pamidronate therapy had been proven to significantly reduce bone pain and increase SAP in FD patients. However, trials with more age-specific samples and a lower risk of bias should be carried out to determine the statistical significance of overall results.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"151 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621491","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}
Pub Date : 2023-12-01DOI: 10.33192/smj.v75i12.265452
Archie F. Iskandar, Nicolas Daniel Widjanarko, Felicia Grizelda Suryatenggara, Rosalia Sylfiasari, Leonardo Leonardo, Nadhea Debrinita Surya, Christian Ardianto
Objective: PCOS or Polycystic Ovarian Syndrome, a multifaceted disorder marked by disruptions in endocrine and metabolic processes, influences reproductive age women. The most commonly used criteria for diagnosing this condition are the Rotterdam 2003 and the National Institutes of Health Consensus 1990 guidelines. Recent studies are currently focusing on novel biomarkers, such as adiponectin and leptin to gain deeper insights on the intricate pathophysiology of PCOS. Therefore, this review aimed to consolidate the importance of the A:L (adiponectin to leptin) ratio as a potential and promising biomarker for PCOS. Materials and Methods: The method followed the PRISMA 2020 guidelines. Furthermore, MEDLINE, Proquest, and EBSCOhost databases were used to obtain eligible studies published up to February 2023. This study was registered in PROSPERO on April 2, 2023 with registration number CRD42023411754. ESHRE/ASRM or Rotterdam Guideline was used as the diagnosis criteria for women with PCOS. To examine the studies' heterogeneity, the I2 statistic and Cochran's Q test were utilized. Meanwhile, the evaluation on publication bias visually employed a funnel plot and was confirmed through Egger's test and rank correlation test. Data analysis was conducted with JASP 0.17.1, and statistical significance was characterized as a p-value below 0.05. Results: In the systematic review, a total of nine studies were incorporated, and seven studies were used in the subsequent meta-analysis. Each paper showcased a reduced A:L ratio in women with PCOS, with a standardized mean difference (SMD) among PCOS and control groups of 0.49 (CI: 0.37 - 0.61). The residual heterogeneity test yielded a p-value of 0.069, and no publication bias indication both pre and post intervention (p=0.002). Conclusion: Referring to the findings, the A:L ratio was notably lower in PCOS patients. Consequently, the A:L ratio holds promise as a novel and potential biomarker for PCOS.
{"title":"Systematic Review and Meta-Analysis on Role of Adiponectin to Leptin Ratio in Women with Polycystic Ovarian Syndrome","authors":"Archie F. Iskandar, Nicolas Daniel Widjanarko, Felicia Grizelda Suryatenggara, Rosalia Sylfiasari, Leonardo Leonardo, Nadhea Debrinita Surya, Christian Ardianto","doi":"10.33192/smj.v75i12.265452","DOIUrl":"https://doi.org/10.33192/smj.v75i12.265452","url":null,"abstract":"Objective: PCOS or Polycystic Ovarian Syndrome, a multifaceted disorder marked by disruptions in endocrine and metabolic processes, influences reproductive age women. The most commonly used criteria for diagnosing this condition are the Rotterdam 2003 and the National Institutes of Health Consensus 1990 guidelines. Recent studies are currently focusing on novel biomarkers, such as adiponectin and leptin to gain deeper insights on the intricate pathophysiology of PCOS. Therefore, this review aimed to consolidate the importance of the A:L (adiponectin to leptin) ratio as a potential and promising biomarker for PCOS.\u0000Materials and Methods: The method followed the PRISMA 2020 guidelines. Furthermore, MEDLINE, Proquest, and EBSCOhost databases were used to obtain eligible studies published up to February 2023. This study was registered in PROSPERO on April 2, 2023 with registration number CRD42023411754. ESHRE/ASRM or Rotterdam Guideline was used as the diagnosis criteria for women with PCOS. To examine the studies' heterogeneity, the I2 statistic and Cochran's Q test were utilized. Meanwhile, the evaluation on publication bias visually employed a funnel plot and was confirmed through Egger's test and rank correlation test. Data analysis was conducted with JASP 0.17.1, and statistical significance was characterized as a p-value below 0.05.\u0000Results: In the systematic review, a total of nine studies were incorporated, and seven studies were used in the subsequent meta-analysis. Each paper showcased a reduced A:L ratio in women with PCOS, with a standardized mean difference (SMD) among PCOS and control groups of 0.49 (CI: 0.37 - 0.61). The residual heterogeneity test yielded a p-value of 0.069, and no publication bias indication both pre and post intervention (p=0.002).\u0000Conclusion: Referring to the findings, the A:L ratio was notably lower in PCOS patients. Consequently, the A:L ratio holds promise as a novel and potential biomarker for PCOS.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"114 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138609564","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}
Pub Date : 2023-12-01DOI: 10.33192/smj.v75i12.265475
Chaisak Dumrikarnlert, Lertchai Wachirutmangur, S. Udomphanthurak, C. Rattanabannakit, P. Srivanitchapoom, V. Senanarong
Objective: We explored whether plasma α-syn be used as a potential biomarker for synucleinopathies. Materials and Methods: α-syn levels in plasma from 54 Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) patents, 31 Alzheimer’s disease dementia (AD), and 29 controls were measured by enzymelinked immunosorbent assay (ELISA). Results: The mean age of the synucleinopathies group, the AD group, and the normal controls was 72.70, 74.26, and 62 years old. The median plasma α-syn levels in the synucleinopathies group, AD group and controls were 9.72 (4.41-25.30), 16.78 (7.68-51.41) and 16.65 (10.37-32.72) ng/ml, respectively (Independent-Samples Kruskal-Wallis test, p = 0.026). The α-syn levels in the synucleinopathies group were lower than those of AD and controls. There was a fair correlation between plasma α-syn levels and the sum of the Unified Parkinson’s Disease Rating Scale (UPDRS) part 3 (spearman correlation coefficient r = -0.261, p = 0.021) but not with cognition measured by Thai Mental Status Examination (TMSE). The area under the receiver operating characteristic curve (ROC) was 0.710 between the PDD and DLB vs non synucleinopathies group (AD and normal controls) (SE = 0.052, p ≤ 0.001). At the cut-off levels of 11.4 ng/ml indicated a sensitivity of 58% (95% CI 43.21-71.81%), specificity of 84.78% (95% CI 71.13-93.66%), positive predictive value (PPV) of 80.56%, a negative predictive value (NPV) of 65% and a precision of 70.83%. Conclusion: The present results suggest that plasma α-syn could be a potential biomarker to differentiate synucleinopathies from Alzheimer’s disease and the elderly with normal cognition.
目的:探讨血浆α-syn是否可作为突触核蛋白病的潜在生物标志物。材料与方法:采用酶联免疫吸附试验(ELISA)检测54例帕金森病痴呆(PDD)和路易体痴呆(DLB)患者、31例阿尔茨海默病痴呆(AD)患者和29例对照患者血浆α-syn水平。结果:突触核蛋白病组、AD组和正常对照组的平均年龄分别为72.70岁、74.26岁和62岁。突触核蛋白病组、AD组和对照组血浆α-syn水平中位数分别为9.72(4.41 ~ 25.30)、16.78(7.68 ~ 51.41)、16.65 (10.37 ~ 32.72)ng/ml(独立样本Kruskal-Wallis检验，p = 0.026)。突触核蛋白病组α-syn水平低于AD组和对照组。血浆α-syn水平与统一帕金森病评定量表(UPDRS)第3部分总分有较好的相关性(spearman相关系数r = -0.261, p = 0.021)，但与泰式精神状态检查(TMSE)的认知水平无显著相关性。PDD和DLB组与非突触核蛋白病组(AD和正常对照)的受试者工作特征曲线下面积(ROC)为0.710 (SE = 0.052, p≤0.001)。在11.4 ng/ml的临界值水平下，敏感性为58% (95% CI 43.21 ~ 71.81%)，特异性为84.78% (95% CI 71.13 ~ 93.66%)，阳性预测值(PPV)为80.56%，阴性预测值(NPV)为65%，精密度为70.83%。结论:血浆α-syn可能是区分突触核蛋白病与阿尔茨海默病及认知正常老年人的潜在生物标志物。
{"title":"Plasma Alpha Synuclein as a Potent Biomarker of Diseases with Synucleinopathies","authors":"Chaisak Dumrikarnlert, Lertchai Wachirutmangur, S. Udomphanthurak, C. Rattanabannakit, P. Srivanitchapoom, V. Senanarong","doi":"10.33192/smj.v75i12.265475","DOIUrl":"https://doi.org/10.33192/smj.v75i12.265475","url":null,"abstract":"Objective: We explored whether plasma α-syn be used as a potential biomarker for synucleinopathies.\u0000Materials and Methods: α-syn levels in plasma from 54 Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) patents, 31 Alzheimer’s disease dementia (AD), and 29 controls were measured by enzymelinked immunosorbent assay (ELISA).\u0000Results: The mean age of the synucleinopathies group, the AD group, and the normal controls was 72.70, 74.26, and 62 years old. The median plasma α-syn levels in the synucleinopathies group, AD group and controls were 9.72 (4.41-25.30), 16.78 (7.68-51.41) and 16.65 (10.37-32.72) ng/ml, respectively (Independent-Samples Kruskal-Wallis test, p = 0.026). The α-syn levels in the synucleinopathies group were lower than those of AD and controls. There was a fair correlation between plasma α-syn levels and the sum of the Unified Parkinson’s Disease Rating Scale (UPDRS) part 3 (spearman correlation coefficient r = -0.261, p = 0.021) but not with cognition measured by Thai Mental Status Examination (TMSE). The area under the receiver operating characteristic curve (ROC) was 0.710 between the PDD and DLB vs non synucleinopathies group (AD and normal controls) (SE = 0.052, p ≤ 0.001). At the cut-off levels of 11.4 ng/ml indicated a sensitivity of 58% (95% CI 43.21-71.81%), specificity of 84.78% (95% CI 71.13-93.66%), positive predictive value (PPV) of 80.56%, a negative predictive value (NPV) of 65% and a precision of 70.83%.\u0000Conclusion: The present results suggest that plasma α-syn could be a potential biomarker to differentiate synucleinopathies from Alzheimer’s disease and the elderly with normal cognition.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138609983","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}
Objective: To determine the cancer detection rate (CDR) of magnetic resonance imaging ultrasound fusion prostate biopsy (MRI/US fusion prostate biopsy) in Thailand. The secondary aim was to estimate the number needed to biopsy (NNB) for each prostate lesion in a targeted biopsy, classified by Prostate Imaging-Reporting and Data System (PI-RADS). Materials and Methods: The data of 1,039 consecutive patients who underwent a MRI/US fusion prostate biopsy at Siriraj Hospital between September 2017 and February 2021 was included and retrospectively reviewed. Those included had previous negative biopsies and were biopsy naïve. The data was analyzed to find the detection rate and NNB. Results: The overall detection rate of MRI/US fusion prostate biopsy was 58.71%, whereas that of systematic biopsy was 45.72%. Clinically significant prostate cancer (csPCa) (Gleason score ≥ 3+4) detection rate of MRI/US fusion prostate biopsy was 51.01%. When categorized by PI-RADS category 3, 4, and 5 were 12.16%, 44.98%, 85.71% respectively. NNB in targeted biopsy of PI-RADS 3, 4, and 5 were 8, 7, and 3 times sequentially. Positive predictive factors for prostate cancer (PCa) detection were age, prostate-specific antigen density (PSAD) and PI-RADS, whereas prostate volume was a negative predictive factor. Conclusion: This study supports the role of MRI/US fusion prostate biopsy in PCa detection and should not avoid systematic biopsies. The higher the PI-RADS was, the greater the csPCa detection rate. NNB is helpful in guiding the least amount of biopsied cores for each lesion.
{"title":"Cancer Detection Rate of MRI Ultrasound Fusion Prostate Biopsy in 1,039 Patients and Number Needed to Biopsy in Targeted Lesion","authors":"Sivakorn Choomark, Pubordee Aussavavirojekul, Varat Woranisarakul, Sittiporn Srinualnad","doi":"10.33192/smj.v75i11.265361","DOIUrl":"https://doi.org/10.33192/smj.v75i11.265361","url":null,"abstract":"Objective: To determine the cancer detection rate (CDR) of magnetic resonance imaging ultrasound fusion prostate biopsy (MRI/US fusion prostate biopsy) in Thailand. The secondary aim was to estimate the number needed to biopsy (NNB) for each prostate lesion in a targeted biopsy, classified by Prostate Imaging-Reporting and Data System (PI-RADS). Materials and Methods: The data of 1,039 consecutive patients who underwent a MRI/US fusion prostate biopsy at Siriraj Hospital between September 2017 and February 2021 was included and retrospectively reviewed. Those included had previous negative biopsies and were biopsy naïve. The data was analyzed to find the detection rate and NNB. Results: The overall detection rate of MRI/US fusion prostate biopsy was 58.71%, whereas that of systematic biopsy was 45.72%. Clinically significant prostate cancer (csPCa) (Gleason score ≥ 3+4) detection rate of MRI/US fusion prostate biopsy was 51.01%. When categorized by PI-RADS category 3, 4, and 5 were 12.16%, 44.98%, 85.71% respectively. NNB in targeted biopsy of PI-RADS 3, 4, and 5 were 8, 7, and 3 times sequentially. Positive predictive factors for prostate cancer (PCa) detection were age, prostate-specific antigen density (PSAD) and PI-RADS, whereas prostate volume was a negative predictive factor. Conclusion: This study supports the role of MRI/US fusion prostate biopsy in PCa detection and should not avoid systematic biopsies. The higher the PI-RADS was, the greater the csPCa detection rate. NNB is helpful in guiding the least amount of biopsied cores for each lesion.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"226 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135566360","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}
Objective: Sexual health is an important issue in a holistic approach in general clinical practice. Inappropriate sexual history taking could lead to improper clinical management. This study aimed to examine perceptions of practice, attitudes toward sexual history taking and their associated factors among final year medical students in southern Thailand. Materials and Methods: This cross-sectional survey was conducted between September and October 2022, using a self-reported questionnaire via Google forms. The self-reported questionnaire consisted of questions related to the practice and attitude toward sexual history taking (α = 0.90 and 0.71, respectively), as well as perceptions of the undergraduate medical training on taking a sexual history (α = 0.91). Descriptive data analysis and multiple logistic regression was conducted by using Program R. Results: Of 91 participants, most were male and Buddhist (54.9% and 87.9%). In general, most medical students rated their proficiency in sexual history taking skills as fair-to-good across all aspects. The majority showed a positive attitude toward sexual history taking (68.1%) and reported that contraception was the main reason that they usually have such discussions with female patients (36.3%), while the prevention of sexual transmitted diseases (STDs) was the most common issue during annual examinations, and when with patients with suspected STDs (27.5% and 49.5%). Male medical students and those who perceived good-to-very good knowledge and well-to very well-trained skills of sexual history taking were significantly associated with more regular sexual history taking. [adjusted OR (95%CI) = 4.51(1.19-17.11) and 5.3 (1.51-18.65), respectively] Moreover, students with a good attitude toward sexual history taking were significantly associated with a perceived good-to-very-good training in both history taking and communication skills. Conclusion: Most medical students exhibited a positive attitude toward sexual history taking, and they stated that birth control and STDs symptoms were typically the primary subjects they discussed with patients in general. There was a significant association between being male, a perception of good knowledge and well-trained skills, and a more consistent practice of sexual history taking. Additionally, medical students who displayed a good attitude towards taking sexual history significantly showed a perception that they had received sufficient training in both the areas of history taking and communication skills.
{"title":"Self-evaluation of Sexual History Taking Skills Among Medical Students in Southern Thailand","authors":"Thareerat Ananchaisarp, Jirayu Likitkamchorn, Jirapat Jitsaard, Natthanit Srisuriya, Natvara Panichkittikul, Porramat Chuthong, Pongsakorn Khanphakdee, Peraya Tekasakul, Rossawan Sahuankeaw, Sarawut Piyarattanayothin, Panya Chamroonkiadtikun, Chonnakarn Jatchavala","doi":"10.33192/smj.v75i11.264811","DOIUrl":"https://doi.org/10.33192/smj.v75i11.264811","url":null,"abstract":"Objective: Sexual health is an important issue in a holistic approach in general clinical practice. Inappropriate sexual history taking could lead to improper clinical management. This study aimed to examine perceptions of practice, attitudes toward sexual history taking and their associated factors among final year medical students in southern Thailand. Materials and Methods: This cross-sectional survey was conducted between September and October 2022, using a self-reported questionnaire via Google forms. The self-reported questionnaire consisted of questions related to the practice and attitude toward sexual history taking (α = 0.90 and 0.71, respectively), as well as perceptions of the undergraduate medical training on taking a sexual history (α = 0.91). Descriptive data analysis and multiple logistic regression was conducted by using Program R. Results: Of 91 participants, most were male and Buddhist (54.9% and 87.9%). In general, most medical students rated their proficiency in sexual history taking skills as fair-to-good across all aspects. The majority showed a positive attitude toward sexual history taking (68.1%) and reported that contraception was the main reason that they usually have such discussions with female patients (36.3%), while the prevention of sexual transmitted diseases (STDs) was the most common issue during annual examinations, and when with patients with suspected STDs (27.5% and 49.5%). Male medical students and those who perceived good-to-very good knowledge and well-to very well-trained skills of sexual history taking were significantly associated with more regular sexual history taking. [adjusted OR (95%CI) = 4.51(1.19-17.11) and 5.3 (1.51-18.65), respectively] Moreover, students with a good attitude toward sexual history taking were significantly associated with a perceived good-to-very-good training in both history taking and communication skills. Conclusion: Most medical students exhibited a positive attitude toward sexual history taking, and they stated that birth control and STDs symptoms were typically the primary subjects they discussed with patients in general. There was a significant association between being male, a perception of good knowledge and well-trained skills, and a more consistent practice of sexual history taking. Additionally, medical students who displayed a good attitude towards taking sexual history significantly showed a perception that they had received sufficient training in both the areas of history taking and communication skills.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139295856","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}
Pub Date : 2023-11-01DOI: 10.33192/smj.v75i11.265066
Prakasit Wannapaschaiyong, Sineenat Teekavanich
Objective: This study aimed to determine the average age at diagnosis and the characteristics associated with the age of children at the diagnosis of autism spectrum disorder (ASD) at Sawanpracharak Hospital. Materials and Methods: A retrospective cross-sectional study was conducted from May 2023 to July 2023. Data were collected from the medical patient files of all children diagnosed with ASD between 2020 to 2022. Descriptive analysis was used to examine the characteristics of the children and their caregivers, and the children’s age at diagnosis. Factors associated with the age at diagnosis were assessed by chi-square test analysis. Results: In total, 100 patient records with complete information were collected. The average age at the diagnosis of ASD was 4.57± 1.61 years old, with 60% of the patients diagnosed after four years of age. Social communication deficit symptoms, including non-response to name and lack of pointing out objects of interest, were significantly associated with an early ASD diagnosis (p-value = 0.023 and 0.002, respectively). Being a firstborn child and the presence of delayed development were found to delay the diagnosis of ASD meaning it occurred at a later age (p-value = 0.002 and 0.019, respectively). However, sex, the caregiver’s education, and socioeconomic status were not related to the age at diagnosis. Conclusion: Most children with ASD who received treatment at Sawanpracharak Hospital were diagnosed late. Being a firstborn child, poor response to name being called, lack of pointing out objects of interest, and delayed development were related to the age of the children at ASD diagnosis. Differences in diagnostic age based on sociodemographic and clinical characteristics indicate the need for coordinated measures for the early detection of ASD.
{"title":"Factors Associated with Age at Diagnosis of Autism Spectrum Disorder in Pediatric Patients at Sawanpracharak Hospital, Thailand","authors":"Prakasit Wannapaschaiyong, Sineenat Teekavanich","doi":"10.33192/smj.v75i11.265066","DOIUrl":"https://doi.org/10.33192/smj.v75i11.265066","url":null,"abstract":"Objective: This study aimed to determine the average age at diagnosis and the characteristics associated with the age of children at the diagnosis of autism spectrum disorder (ASD) at Sawanpracharak Hospital. Materials and Methods: A retrospective cross-sectional study was conducted from May 2023 to July 2023. Data were collected from the medical patient files of all children diagnosed with ASD between 2020 to 2022. Descriptive analysis was used to examine the characteristics of the children and their caregivers, and the children’s age at diagnosis. Factors associated with the age at diagnosis were assessed by chi-square test analysis. Results: In total, 100 patient records with complete information were collected. The average age at the diagnosis of ASD was 4.57± 1.61 years old, with 60% of the patients diagnosed after four years of age. Social communication deficit symptoms, including non-response to name and lack of pointing out objects of interest, were significantly associated with an early ASD diagnosis (p-value = 0.023 and 0.002, respectively). Being a firstborn child and the presence of delayed development were found to delay the diagnosis of ASD meaning it occurred at a later age (p-value = 0.002 and 0.019, respectively). However, sex, the caregiver’s education, and socioeconomic status were not related to the age at diagnosis. Conclusion: Most children with ASD who received treatment at Sawanpracharak Hospital were diagnosed late. Being a firstborn child, poor response to name being called, lack of pointing out objects of interest, and delayed development were related to the age of the children at ASD diagnosis. Differences in diagnostic age based on sociodemographic and clinical characteristics indicate the need for coordinated measures for the early detection of ASD.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139294354","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}
Frontal fibrosing alopecia (FFA) is a slowly progressive cicatricial alopecia that can result in permanent hair loss, so early diagnosis and treatment is crucial. However and of concern, a standard treatment regimen for FFA has not yet been established. In an attempt to remedy this gap, we conducted this study to investigate the efficacy and safety of combined 308-nm excimer laser with intralesional corticosteroid (ILC) compared to ILC alone to treat FFA. The results of our study revealed that the combination of 308-nm excimer laser and ILC was not superior to ILC alone for treating FFA. Moreover, side effects, including erythema and postinflammatory hyperpigmentation, were reported in both groups.
{"title":"Efficacy and Safety of Combination 308-nm Excimer Laser and Intralesional Corticosteroid versus Intralesional Corticosteroid Monotherapy in the Treatment of Frontal Fibrosing Alopecia: A Pilot Study","authors":"Rattapon Thuangtong, Supisara Wongdama, Nuttagarn Jantanapornchai, Chadakan Yan, Kanchalit Thanomkitti, Daranporn Triwongwaranat","doi":"10.33192/smj.v75i11.265185","DOIUrl":"https://doi.org/10.33192/smj.v75i11.265185","url":null,"abstract":"Frontal fibrosing alopecia (FFA) is a slowly progressive cicatricial alopecia that can result in permanent hair loss, so early diagnosis and treatment is crucial. However and of concern, a standard treatment regimen for FFA has not yet been established. In an attempt to remedy this gap, we conducted this study to investigate the efficacy and safety of combined 308-nm excimer laser with intralesional corticosteroid (ILC) compared to ILC alone to treat FFA. The results of our study revealed that the combination of 308-nm excimer laser and ILC was not superior to ILC alone for treating FFA. Moreover, side effects, including erythema and postinflammatory hyperpigmentation, were reported in both groups.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"13 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135714568","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}
Pub Date : 2023-11-01DOI: 10.33192/smj.v75i11.265055
Katunyou Mahamongkol, Malik Hajidae, Pubordee Aussavavirojekul, T. Hansomwong, S. Srinualnad
Objective: Among the various postoperative outcomes following robotic-assisted laparoscopic radical prostatectomy (RARP), positive surgical margins (PSMs) are a significant prognostic factor associated with biochemical recurrence (BCR). Many surgical techniques are available for RARP; however, the technique proposed in this study may improve surgical outcomes. This study aims to evaluate the incidence of post-operative PSMs in patients diagnosed with clinically localized prostate cancer at Siriraj Hospital using the retro-apical urethral dissection approach with a 30-degree-lens flip-up technique. Materials and Methods: A retrospective review of 2,114 consecutive patients who underwent RARP with the conventional technique was conducted using Siriraj Hospital’s database, from January 2007 to June 2022. Propensity score matching was employed to select a group of 284 men from the total cohort of 2,114 patients who underwent conventional radical prostatectomy (Group 1) for comparison against another group of 284 patients who underwent the retro-apical dissection technique (Group 2). The incidence of PSMs was then evaluated in each group. Results: Of the 568 patients, PSMs were observed in 219 patients. The overall incidence of PSMs decreased from 128 cases (45.1%) in Group 1 to 91 cases (32.0%) in Group 2 (p-value <0.01). Similar results were seen in the subgroup of patients with pT2 staging who had PSMs (52 cases vs 24 cases, p-value <0.01). PSMs occurred mostly at the apex with a total of 112 cases (52.1%). Conclusion: The retro-apical urethral dissection approach with a 30-degree-lens flip-up technique is associated with a lower risk of overall PSMs and the trend of apical PSMs, indicating its clinical significance.
{"title":"The Impact of Retro-apical Urethral Dissection Approach Technique on Positive Surgical Margins in Robotic-assisted Laparoscopic Radical Prostatectomy: A Study in Thailand","authors":"Katunyou Mahamongkol, Malik Hajidae, Pubordee Aussavavirojekul, T. Hansomwong, S. Srinualnad","doi":"10.33192/smj.v75i11.265055","DOIUrl":"https://doi.org/10.33192/smj.v75i11.265055","url":null,"abstract":"Objective: Among the various postoperative outcomes following robotic-assisted laparoscopic radical prostatectomy (RARP), positive surgical margins (PSMs) are a significant prognostic factor associated with biochemical recurrence (BCR). Many surgical techniques are available for RARP; however, the technique proposed in this study may improve surgical outcomes. This study aims to evaluate the incidence of post-operative PSMs in patients diagnosed with clinically localized prostate cancer at Siriraj Hospital using the retro-apical urethral dissection approach with a 30-degree-lens flip-up technique. Materials and Methods: A retrospective review of 2,114 consecutive patients who underwent RARP with the conventional technique was conducted using Siriraj Hospital’s database, from January 2007 to June 2022. Propensity score matching was employed to select a group of 284 men from the total cohort of 2,114 patients who underwent conventional radical prostatectomy (Group 1) for comparison against another group of 284 patients who underwent the retro-apical dissection technique (Group 2). The incidence of PSMs was then evaluated in each group. Results: Of the 568 patients, PSMs were observed in 219 patients. The overall incidence of PSMs decreased from 128 cases (45.1%) in Group 1 to 91 cases (32.0%) in Group 2 (p-value <0.01). Similar results were seen in the subgroup of patients with pT2 staging who had PSMs (52 cases vs 24 cases, p-value <0.01). PSMs occurred mostly at the apex with a total of 112 cases (52.1%). Conclusion: The retro-apical urethral dissection approach with a 30-degree-lens flip-up technique is associated with a lower risk of overall PSMs and the trend of apical PSMs, indicating its clinical significance.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139300568","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}
Pub Date : 2023-11-01DOI: 10.33192/smj.v75i11.264260
R. Ruangtrakool, Sasabong Tiyaamornwong
Objective: The purpose of this study was to find incidence of infection-related complications and the optimal volume and duration (days) of rectal NSS irrigation that would result in the low post-operative complications following transanal endorectal pull-through (TERPT) in patients with Hirschprung’s disease. Materials and Methods: We conducted a retrospective chart reviews of 131 patients diagnosed with Hirschsprung’s disease who underwent TERPT at Siriraj Hospital between January 2006 and December 2020. Results: Infection-related complications were observed in 23(17.6%) patients, comprising 22(16.8%) cases of anastomotic strictures, 3(2.3%) cases of anastomotic leakages, and 2(1.5%) cases of intraabdominal collections. The median (Q1, Q3) volume of NSS irrigation (ml/kg/day) for those without complications (38.1 (33.9,50)) and those with complications (39.5 (35,45)) was statistically identical (p = 0.945). Similary, the median duration of for both groups was the same (p = 0.854). The mean (SD) volume of irrigated NSS in those with leakage (55.6 (32.7)) and those without leakage (44.3 (17.9)) showed no statistically significant difference (p = 0.291). Patients with post-operative stricture received the same amount of irrigated NSS (40.7 (11.9)) as those without stricture (45.4 (19.2)) (p = 0.138). Similarly, those with hyponatremia received the same amount of irrigated NSS as those without hyponatrema (p = 0.475). Conclusion: The volume of rectally irrigated NSS did not correlate with infection-related complications such as anastomotic leakage, stricture and intraabdominal collection. However, this study observed a low complication rate, thus, future research should cover a larger population.
{"title":"Incidence of Infection-related Complications and Optimal Saline Irrigation Volume for Preoperative Bowel Preparation to Reduce Postoperative Infections in Hirschsprung’s Disease","authors":"R. Ruangtrakool, Sasabong Tiyaamornwong","doi":"10.33192/smj.v75i11.264260","DOIUrl":"https://doi.org/10.33192/smj.v75i11.264260","url":null,"abstract":"Objective: The purpose of this study was to find incidence of infection-related complications and the optimal volume and duration (days) of rectal NSS irrigation that would result in the low post-operative complications following transanal endorectal pull-through (TERPT) in patients with Hirschprung’s disease. Materials and Methods: We conducted a retrospective chart reviews of 131 patients diagnosed with Hirschsprung’s disease who underwent TERPT at Siriraj Hospital between January 2006 and December 2020. Results: Infection-related complications were observed in 23(17.6%) patients, comprising 22(16.8%) cases of anastomotic strictures, 3(2.3%) cases of anastomotic leakages, and 2(1.5%) cases of intraabdominal collections. The median (Q1, Q3) volume of NSS irrigation (ml/kg/day) for those without complications (38.1 (33.9,50)) and those with complications (39.5 (35,45)) was statistically identical (p = 0.945). Similary, the median duration of for both groups was the same (p = 0.854). The mean (SD) volume of irrigated NSS in those with leakage (55.6 (32.7)) and those without leakage (44.3 (17.9)) showed no statistically significant difference (p = 0.291). Patients with post-operative stricture received the same amount of irrigated NSS (40.7 (11.9)) as those without stricture (45.4 (19.2)) (p = 0.138). Similarly, those with hyponatremia received the same amount of irrigated NSS as those without hyponatrema (p = 0.475). Conclusion: The volume of rectally irrigated NSS did not correlate with infection-related complications such as anastomotic leakage, stricture and intraabdominal collection. However, this study observed a low complication rate, thus, future research should cover a larger population.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302836","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}
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