Pub Date : 2023-11-01DOI: 10.33192/smj.v75i11.265331
Nirmalya Manna, Shibasish Banerjee, Ankush Banerjee, Arup Chakraborty, Debasis Das
Objective: Smartphone addiction has become an emerging problem among the youth, especially among medical students in India. It has the potential to hamper their sleep quality as well act as a precipitating factor for depression. This study thus assessed the magnitude of smartphone addiction, excessive daytime sleepiness and depression among undergraduate medical students in Kolkata and elicited its determinants. Materials and Methods: This cross-sectional study was conducted among 204 undergraduate medical students in a selected medical college of Kolkata from March to June 2023. Smartphone addiction, daytime sleepiness and depression was assessed using the SAS-SV, EPSS and PHQ-9 questionnaires. Logistic regression analysis was undertaken to determine the associated factors of smartphone addiction, while Spearman’s correlation coefficient was estimated to find the relationship of smartphone addiction with depression and daytime sleepiness. Results: Approximately 29.4% participants were addicted to smartphone, 45.5% were suffering from excessive daytime sleepiness. The depression scores on the PHQ-9 scale showed a mean value of 8.15 (±4.72). Factors significantly associated with smartphone addiction were increasing age (AOR=1.23, 95%CI=1.12-2.21), male gender (AOR=2.12, 95% CI=1.36-3.45) and duration of smart phone usage >6 hours per day (AOR=1.92, 95%CI=1.23-2.45). Smartphone addiction showed positive correlation with both daytime sleepiness (ρ =0.5, p-value<0.05) and depression (ρ=0.23, p-value=0.001) Conclusion: Utmost care should be taken for promoting good mental health and wellbeing among medical students. Motivation and counselling sessions along with peer support groups can help in combating this addictive behaviour and depressive symptoms.
{"title":"Smartphone Addiction, Daytime Sleepiness and Depression among Undergraduate Medical Students: A Cross-sectional Study in a Medical College of Kolkata, India","authors":"Nirmalya Manna, Shibasish Banerjee, Ankush Banerjee, Arup Chakraborty, Debasis Das","doi":"10.33192/smj.v75i11.265331","DOIUrl":"https://doi.org/10.33192/smj.v75i11.265331","url":null,"abstract":"Objective: Smartphone addiction has become an emerging problem among the youth, especially among medical students in India. It has the potential to hamper their sleep quality as well act as a precipitating factor for depression. This study thus assessed the magnitude of smartphone addiction, excessive daytime sleepiness and depression among undergraduate medical students in Kolkata and elicited its determinants. Materials and Methods: This cross-sectional study was conducted among 204 undergraduate medical students in a selected medical college of Kolkata from March to June 2023. Smartphone addiction, daytime sleepiness and depression was assessed using the SAS-SV, EPSS and PHQ-9 questionnaires. Logistic regression analysis was undertaken to determine the associated factors of smartphone addiction, while Spearman’s correlation coefficient was estimated to find the relationship of smartphone addiction with depression and daytime sleepiness. Results: Approximately 29.4% participants were addicted to smartphone, 45.5% were suffering from excessive daytime sleepiness. The depression scores on the PHQ-9 scale showed a mean value of 8.15 (±4.72). Factors significantly associated with smartphone addiction were increasing age (AOR=1.23, 95%CI=1.12-2.21), male gender (AOR=2.12, 95% CI=1.36-3.45) and duration of smart phone usage >6 hours per day (AOR=1.92, 95%CI=1.23-2.45). Smartphone addiction showed positive correlation with both daytime sleepiness (ρ =0.5, p-value<0.05) and depression (ρ=0.23, p-value=0.001) Conclusion: Utmost care should be taken for promoting good mental health and wellbeing among medical students. Motivation and counselling sessions along with peer support groups can help in combating this addictive behaviour and depressive symptoms.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"18 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":"135565236","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.v75i11.264451
Pattraporn Vangchanachai, Suttipong Tianwattanatada, N. Namviriyachote, Vich Thampanya, Natthida Owattanapanich, K. Chinaroonchai, Suchada Kittidacha, Anchan Ketmek, P. Muangman
Objective: The primary objective of this study is to compare the healing rate between AP soap and 4% Chlorhexidine solution in superficial second-degree burn wounds. The secondary objectives include the analgesic effect and moisturization of these two products. Materials and Methods: Data was collected between 2019 and 2021. Patients aged 18 years and above, with superficial second-degree burns including at least 20% of TBSA, and admitted to the Burn Unit within 24 hours of injury were included. They were randomly assigned to two groups: Andrographis paniculata with Perilla oil liquid soap group (AP group) and 4% Chlorhexidine group (control group). The measurements included percentage of epithelialization, pain score during wound cleansing, itching score after wound cleansing, and dry skin specified symptoms. All patients received standard care for burn wound treatment. Results: A total enrollment was 23 patients in this study (12 in the AP group and 11 in the control group). The median age was 38.5 years. There were no statistically significant differences in age, %TBSA, and initial wound size between both groups (p > 0.05). Although the healing time was similar in both groups, (18.5 vs. 20.1, p=0.347), the AP group had a significantly lower pain score than the control group (4.7 vs. 5.4, p=0.020). Moreover, the AP group demonstrated significant improvements in itching score and SRRC score at 14 days compared to the control group (5.1 vs. 6.0, p 0.039 and 1.08 vs. 1.55, p 0.020, respectively). There were no adverse effects during this study. Conclusion: Patients treated with Andrographis paniculata with Perilla oil liquid soap experienced less pain and better moisturization compared to those treated with the standard 4% chlorhexidine solution, while achieving a comparable healing rate. A future large-scale prospective trial is recommended.
{"title":"Clinical Efficacy of Andrographis paniculata Extracted Scrub Compared With 4% Chlorhexidine Scrub in Burn Wounds: A Prospective Randomized Controlled Trial","authors":"Pattraporn Vangchanachai, Suttipong Tianwattanatada, N. Namviriyachote, Vich Thampanya, Natthida Owattanapanich, K. Chinaroonchai, Suchada Kittidacha, Anchan Ketmek, P. Muangman","doi":"10.33192/smj.v75i11.264451","DOIUrl":"https://doi.org/10.33192/smj.v75i11.264451","url":null,"abstract":"Objective: The primary objective of this study is to compare the healing rate between AP soap and 4% Chlorhexidine solution in superficial second-degree burn wounds. The secondary objectives include the analgesic effect and moisturization of these two products. Materials and Methods: Data was collected between 2019 and 2021. Patients aged 18 years and above, with superficial second-degree burns including at least 20% of TBSA, and admitted to the Burn Unit within 24 hours of injury were included. They were randomly assigned to two groups: Andrographis paniculata with Perilla oil liquid soap group (AP group) and 4% Chlorhexidine group (control group). The measurements included percentage of epithelialization, pain score during wound cleansing, itching score after wound cleansing, and dry skin specified symptoms. All patients received standard care for burn wound treatment. Results: A total enrollment was 23 patients in this study (12 in the AP group and 11 in the control group). The median age was 38.5 years. There were no statistically significant differences in age, %TBSA, and initial wound size between both groups (p > 0.05). Although the healing time was similar in both groups, (18.5 vs. 20.1, p=0.347), the AP group had a significantly lower pain score than the control group (4.7 vs. 5.4, p=0.020). Moreover, the AP group demonstrated significant improvements in itching score and SRRC score at 14 days compared to the control group (5.1 vs. 6.0, p 0.039 and 1.08 vs. 1.55, p 0.020, respectively). There were no adverse effects during this study. Conclusion: Patients treated with Andrographis paniculata with Perilla oil liquid soap experienced less pain and better moisturization compared to those treated with the standard 4% chlorhexidine solution, while achieving a comparable healing rate. A future large-scale prospective trial is recommended.","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":"139302594","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.v75i11.264786
Ignasia Andhini Retnowulan, Marini Stephanie, N. Rahadiani, R. A. Syaiful, E. Krisnuhoni
Objective: Although histological grade and microvascular invasion are known predictors for patient survival and recurrence in hepatocellular carcinoma (HCC), their relationship with various clinical and histomorphological features of HCC remains unclear. Materials and Methods: Medical records were retrieved from 61 patients who were diagnosed with HCC from 2008-2018. Clinical and histomorphological variables that were hypothesized to be associated with histological grade and microvascular invasion were analyzed statistically using the Chi-square test or the Fisher’s exact test as alternatives. Multivariate analysis was performed with logistic regression model. Results: The majority of the patients had well to moderately-differentiated HCC (67.2%) with some of them presenting microvascular invasion (57.4%). Alpha-fetoprotein level (AFP) ≥100 ng/ml (p=0.036), tumor size >7cm (p=0.031) and mitotic index ≥5 per 10 high power field (p=0.009) were significantly correlated with poorly-differentiated HCC. Mitotic Index ≥5 per 10 high power field was an independent factor for poorly differentiated HCC. Meanwhile BCLC stage B and mitotic index were also an independent factor for the presence of microvascular invasion. Conclusion: Larger tumor size and higher mitotic index was significantly correlated and independent factors for poorly differentiated HCC and microvascular invasion. In biopsy specimens for which the microvascular invasion is difficult to assess, histological grade, tumor size and mitotic index may be beneficial to depict the prognosis of patients with HCC.
{"title":"Hepatocellular Carcinoma's Characteristics in an Endemic Country: A Closer Examination of Tumor Grade and Microvascular Invasion","authors":"Ignasia Andhini Retnowulan, Marini Stephanie, N. Rahadiani, R. A. Syaiful, E. Krisnuhoni","doi":"10.33192/smj.v75i11.264786","DOIUrl":"https://doi.org/10.33192/smj.v75i11.264786","url":null,"abstract":"Objective: Although histological grade and microvascular invasion are known predictors for patient survival and recurrence in hepatocellular carcinoma (HCC), their relationship with various clinical and histomorphological features of HCC remains unclear. Materials and Methods: Medical records were retrieved from 61 patients who were diagnosed with HCC from 2008-2018. Clinical and histomorphological variables that were hypothesized to be associated with histological grade and microvascular invasion were analyzed statistically using the Chi-square test or the Fisher’s exact test as alternatives. Multivariate analysis was performed with logistic regression model. Results: The majority of the patients had well to moderately-differentiated HCC (67.2%) with some of them presenting microvascular invasion (57.4%). Alpha-fetoprotein level (AFP) ≥100 ng/ml (p=0.036), tumor size >7cm (p=0.031) and mitotic index ≥5 per 10 high power field (p=0.009) were significantly correlated with poorly-differentiated HCC. Mitotic Index ≥5 per 10 high power field was an independent factor for poorly differentiated HCC. Meanwhile BCLC stage B and mitotic index were also an independent factor for the presence of microvascular invasion. Conclusion: Larger tumor size and higher mitotic index was significantly correlated and independent factors for poorly differentiated HCC and microvascular invasion. In biopsy specimens for which the microvascular invasion is difficult to assess, histological grade, tumor size and mitotic index may be beneficial to depict the prognosis of patients with HCC.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139305089","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: This retrospective cohort study aimed to assess the efficacy and safety of low-dose atropine eye drops in retarding myopic progression among school-age children at Siriraj hospital. Materials and Methods: The medical records of 248 myopia-diagnosed patients were reviewed. All patients were received low-dose atropine eye drops and had at least one follow-up visit within 1 year after the treatment initiation. Spherical equivalent (SE) measurements were collected at pre- and post-treatment visits, as well as any reported side effects. Comparing the SE changes observed between the pre- and post-treatment periods, as well as between the two different concentrations of atropine was analyzed. Results: A total of 495 eyes were analyzed, with 461 eyes receiving 0.01% atropine eye drops and 32 eyes being administered 0.05%. The demographic data between two groups showed no significant difference. The comparison of SE change one year prior to and one year after treatment in the 0.01% and 0.05% group yielded a p-value of less than 0.001 and 0.003, respectively, (SE change are -0.38 (-0.75-0.00) and -0.25 (-0.72-(-0.25)) in the 0.01% and 0.05% group, respectively). However, the between-group comparison of SE change at 6 months and 1 year showed no significant difference. Regarding side effects, one-third of the eyes in the 0.05% group (37.5%) experienced adverse effects while only eight eyes (1.7%) in the 0.01% group reported side effects. Conclusion: This research contributes support to the effectiveness of employing low-dose atropine for the treatment of myopia in Thai children. Nonetheless, it is worth noting that the use of 0.05% atropine was associated with a higher incidence of side effects.
{"title":"Efficacy of Atropine Eye Drops for Suppressing Myopia Progression in Thai Children","authors":"Thammanoon Surachatkumtonekul, Pinpilai Jutasompakorn, Sirawadee Wiriyaudomchart, Kiatthida Hokierti, Jureeporn Sri-in","doi":"10.33192/smj.v75i11.264383","DOIUrl":"https://doi.org/10.33192/smj.v75i11.264383","url":null,"abstract":"Objective: This retrospective cohort study aimed to assess the efficacy and safety of low-dose atropine eye drops in retarding myopic progression among school-age children at Siriraj hospital. Materials and Methods: The medical records of 248 myopia-diagnosed patients were reviewed. All patients were received low-dose atropine eye drops and had at least one follow-up visit within 1 year after the treatment initiation. Spherical equivalent (SE) measurements were collected at pre- and post-treatment visits, as well as any reported side effects. Comparing the SE changes observed between the pre- and post-treatment periods, as well as between the two different concentrations of atropine was analyzed. Results: A total of 495 eyes were analyzed, with 461 eyes receiving 0.01% atropine eye drops and 32 eyes being administered 0.05%. The demographic data between two groups showed no significant difference. The comparison of SE change one year prior to and one year after treatment in the 0.01% and 0.05% group yielded a p-value of less than 0.001 and 0.003, respectively, (SE change are -0.38 (-0.75-0.00) and -0.25 (-0.72-(-0.25)) in the 0.01% and 0.05% group, respectively). However, the between-group comparison of SE change at 6 months and 1 year showed no significant difference. Regarding side effects, one-third of the eyes in the 0.05% group (37.5%) experienced adverse effects while only eight eyes (1.7%) in the 0.01% group reported side effects. Conclusion: This research contributes support to the effectiveness of employing low-dose atropine for the treatment of myopia in Thai children. Nonetheless, it is worth noting that the use of 0.05% atropine was associated with a higher incidence of side effects.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139293811","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 : 2023-10-01DOI: 10.33192/smj.v75i10.264037
Paveena Somboon, Surat Kulapatana, Wattana B. Watanapa, Tanchanok Chattaris, Phatadon Sirivongrangson, Panomporn Livikorn, Thongchai Nonthadid, Poungpetch Hussarin
Objective: Heart rate variability (HRV) and baroreflex sensitivity (BRS) are influenced by various internal and external factors, making it necessary to establish universal reference values. We aimed to identify independent factors affecting short-term HRV parameters and BRS, as well as determine appropriate reference ranges, which are lacking in Asian populations. Materials and Methods: A total of 117 healthy Thai participants (aged 20-72 years; final n=117) were recruited based on strict criteria, including normal medical history, physical examination (ascertained by a physician), and normal blood profile. Spontaneous 5-minute HRV parameters (time and frequency domains) and spontaneous cross-correlation BRS were measured. Results: Age and resting heart rate (HR) are independently and inversely correlated with BRS and all HRV parameters, except LFnu (normalized low-frequency component) and LF/HF ratio (ratio of low- to high-frequency component). Sex differences were observed only in LF, which was higher in men. However, multiple regression analysis showed that sex did not significantly contribute as an independent variable to either HRV or BRS. Remarkably, BRS exhibited moderate to strong correlations with all HRV values, indicating its prominent role in influencing HRV and surpassing the impact of age. Conclusion: Age and resting HR were identified as independent factors influencing 5-minute HRV and BRS. Our findings suggest that decreased baroreflex function associated with aging may contribute to reduced HRV among the elderly. Furthermore, we established reference ranges for each 5-minute HRV parameter and BRS, categorized by age group (20-39, 40-59, and ≥60 years old). These reference values offer valuable clinical insights, particularly for Asian populations where such normative ranges were previously unavailable.
{"title":"Heart Rate Variability and Baroreflex Sensitivity: Factors and Reference Ranges","authors":"Paveena Somboon, Surat Kulapatana, Wattana B. Watanapa, Tanchanok Chattaris, Phatadon Sirivongrangson, Panomporn Livikorn, Thongchai Nonthadid, Poungpetch Hussarin","doi":"10.33192/smj.v75i10.264037","DOIUrl":"https://doi.org/10.33192/smj.v75i10.264037","url":null,"abstract":"Objective: Heart rate variability (HRV) and baroreflex sensitivity (BRS) are influenced by various internal and external factors, making it necessary to establish universal reference values. We aimed to identify independent factors affecting short-term HRV parameters and BRS, as well as determine appropriate reference ranges, which are lacking in Asian populations. Materials and Methods: A total of 117 healthy Thai participants (aged 20-72 years; final n=117) were recruited based on strict criteria, including normal medical history, physical examination (ascertained by a physician), and normal blood profile. Spontaneous 5-minute HRV parameters (time and frequency domains) and spontaneous cross-correlation BRS were measured. Results: Age and resting heart rate (HR) are independently and inversely correlated with BRS and all HRV parameters, except LFnu (normalized low-frequency component) and LF/HF ratio (ratio of low- to high-frequency component). Sex differences were observed only in LF, which was higher in men. However, multiple regression analysis showed that sex did not significantly contribute as an independent variable to either HRV or BRS. Remarkably, BRS exhibited moderate to strong correlations with all HRV values, indicating its prominent role in influencing HRV and surpassing the impact of age. Conclusion: Age and resting HR were identified as independent factors influencing 5-minute HRV and BRS. Our findings suggest that decreased baroreflex function associated with aging may contribute to reduced HRV among the elderly. Furthermore, we established reference ranges for each 5-minute HRV parameter and BRS, categorized by age group (20-39, 40-59, and ≥60 years old). These reference values offer valuable clinical insights, particularly for Asian populations where such normative ranges were previously unavailable.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"08 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135457666","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: 68Ga can be routinely produced by a 68Ge/68Ga generator without the need for a cyclotron. It is recommended to replace the 68Ge/68Ga generator after 250 elutions or 12 months of shelf-life whichever endpoint is reached first. However, a 68Ge/68Ga generator that has gone past its recommended lifespan can still be further used as a 68Ga source for 68Ga-labeled radiopharmaceuticals for use in animal experiments. To ensure the quality of 68Ga eluates, we aimed to evaluate the efficacy and safety of the ITM (Isotope Technologies München) 68Ge/68Ga generator in our institute after its recommended shelf-life. Materials and Methods: A 21-month-old ITM 68Ge/68Ga generator was eluted using 4.0 ml of 0.05 M HCl. The 68Ga elution yields were calculated, and 68Ge breakthrough was measured at least 48 h after elution in an aliquot amount using a multichannel analyzer (MCA) with a high-purity germanium probe. Metal impurities in the 68Ga eluates were analyzed by ICP-MS. Results: The elution yield of 68Ga was 35.2 ± 8.1%; n = 5 (decay corrected). 68Ge breakthrough from the ITM 68Ge/68Ga generator was below the detectable level. The average amounts of the metallic ions 57Fe, 66Zn, 203Pb, 60Ni, and 63Cu were 18.60, 9.86, 2.42, 0.52, and 0.47 µg/GBq, respectively. Conclusion: The ITM 68Ge/68Ga generator demonstrated consistent and reliable 68Ga elution profiles with an absence of either 68Ge breakthrough or other metal contaminants in the eluent samples as verified by the manufacturer. The use of the ITM 68Ge/68Ga generator could be extended past its recommended shelf-life to prepare 68Ga radiopharmaceuticals that are considered safe and suitable for use in animal experimentation and other applications.
目的:68Ga可以在不需要回旋加速器的情况下由68Ge/68Ga发生器常规产生。建议在250次洗脱或保质期12个月后更换68Ge/68Ga发生器，以先达到的终点为准。然而，超过其推荐寿命的68Ge/68Ga发生器仍然可以进一步用作68Ga标记的放射性药物的68Ga源，用于动物实验。为了确保68Ga洗脱液的质量，我们旨在评估ITM(同位素技术公司)68Ge/68Ga发生器在推荐保质期后的有效性和安全性。材料与方法:用4.0 ml 0.05 M HCl洗脱21个月的ITM 68Ge/68Ga发生器。计算68Ga的洗脱率，并在等量洗脱后至少48 h，使用带有高纯度锗探针的多通道分析仪(MCA)测量68Ge的突破。用ICP-MS对68Ga洗脱液中的金属杂质进行了分析。结果:68Ga的洗脱率为35.2±8.1%;N = 5(衰减修正)。ITM 68Ge/68Ga发生器的68Ge突破低于可检测水平。金属离子57Fe、66Zn、203Pb、60Ni和63Cu的平均含量分别为18.60、9.86、2.42、0.52和0.47µg/GBq。结论:ITM 68Ge/68Ga发生器显示出一致和可靠的68Ga洗脱剖面，并且经制造商验证，洗脱样品中没有68Ge突破或其他金属污染物。ITM 68Ge/68Ga发生器的使用可以延长其推荐的保质期，以制备被认为安全且适合用于动物实验和其他应用的68Ga放射性药物。
{"title":"Evaluation of the Efficacy and Safety of the ITM 68Ge/68Ga Generator After its Recommended Shelf-life","authors":"Tossaporn Sriprapa, Thanete Doungta, Nopparath Sakulsamart, Nilmanee Taweewatthanasopon, Lanyawat Madputeh, Pitima Ragchana, Napamon Sritongkul, Malulee Tantawiroon, Somlak Kongmuang, Benjapa Khiewvan, Shuichi Shiratori","doi":"10.33192/smj.v75i10.264289","DOIUrl":"https://doi.org/10.33192/smj.v75i10.264289","url":null,"abstract":"Objective: 68Ga can be routinely produced by a 68Ge/68Ga generator without the need for a cyclotron. It is recommended to replace the 68Ge/68Ga generator after 250 elutions or 12 months of shelf-life whichever endpoint is reached first. However, a 68Ge/68Ga generator that has gone past its recommended lifespan can still be further used as a 68Ga source for 68Ga-labeled radiopharmaceuticals for use in animal experiments. To ensure the quality of 68Ga eluates, we aimed to evaluate the efficacy and safety of the ITM (Isotope Technologies München) 68Ge/68Ga generator in our institute after its recommended shelf-life. Materials and Methods: A 21-month-old ITM 68Ge/68Ga generator was eluted using 4.0 ml of 0.05 M HCl. The 68Ga elution yields were calculated, and 68Ge breakthrough was measured at least 48 h after elution in an aliquot amount using a multichannel analyzer (MCA) with a high-purity germanium probe. Metal impurities in the 68Ga eluates were analyzed by ICP-MS. Results: The elution yield of 68Ga was 35.2 ± 8.1%; n = 5 (decay corrected). 68Ge breakthrough from the ITM 68Ge/68Ga generator was below the detectable level. The average amounts of the metallic ions 57Fe, 66Zn, 203Pb, 60Ni, and 63Cu were 18.60, 9.86, 2.42, 0.52, and 0.47 µg/GBq, respectively. Conclusion: The ITM 68Ge/68Ga generator demonstrated consistent and reliable 68Ga elution profiles with an absence of either 68Ge breakthrough or other metal contaminants in the eluent samples as verified by the manufacturer. The use of the ITM 68Ge/68Ga generator could be extended past its recommended shelf-life to prepare 68Ga radiopharmaceuticals that are considered safe and suitable for use in animal experimentation and other applications.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135458925","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 study the pain-reducing effect of music therapy and aromatherapy with ginger essential oil (GEO; Zingiber officinale Roscoe) in the first stage of labor. Materials and Methods: This randomized controlled trial was conducted from May to October 2022 in the delivery room of Thammasat University Hospital in Thailand. Participants were nulliparous pregnant women who came with actual labor pain and cervical dilation of 3 cm. They were divided into three groups: control, music, and aromatherapy. The control group received intrapartum care according to hospital guidelines, while participants in the music group listened to a "Musical Journey through Pregnancy" music playlist, and the aromatherapy group inhaled GEO. A visual analog scale was used for pain assessment every 2 hours. Interventions and pain assessment continued until the end of the first stage of labor or until cesarean section was indicated. Results: Three hundred pregnant women were recruited. The mean age of the participants was 27.7 years old, and no difference in BMI among the three groups. Participants in the music and aromatherapy group had statistically significantly less labor pain than participants in the control group when cervical dilation was between 4 and 7 cm (6,1±0.7, 1.9±0.7, 2.6±0.4 when cervical dilation was 4-5 cm and 8.0±0.7, 2.8±0.4, 3.6±0.3 when cervical dilation was 6-7 cm in the control, music, and aromatherapy groups, respectively (p < 0.001). However, at cervical dilation of 8-10 cm, there was no difference among the three groups regarding labor pain. Both intervention groups had significantly shorter labor time and less estimated blood loss during vaginal delivery than the control group (p < 0.001). Conclusion: Music and aromatherapy decreased labor pain, labor time, and estimated blood loss compared to the control group.
{"title":"Efficacy of Music Therapy and Zingiber officinale Roscoe Aromatherapy for Reducing Pain during the First Stage of Labor: A Randomized Controlled Trial","authors":"Pontip Paoin, Pichita Prasongvej, Athita Chanthasenanont, Titchayakorn Niumpradit, Densak Pongrojpaw, Komsun Suwannarurk","doi":"10.33192/smj.v75i10.263860","DOIUrl":"https://doi.org/10.33192/smj.v75i10.263860","url":null,"abstract":"Objective: To study the pain-reducing effect of music therapy and aromatherapy with ginger essential oil (GEO; Zingiber officinale Roscoe) in the first stage of labor. Materials and Methods: This randomized controlled trial was conducted from May to October 2022 in the delivery room of Thammasat University Hospital in Thailand. Participants were nulliparous pregnant women who came with actual labor pain and cervical dilation of 3 cm. They were divided into three groups: control, music, and aromatherapy. The control group received intrapartum care according to hospital guidelines, while participants in the music group listened to a \"Musical Journey through Pregnancy\" music playlist, and the aromatherapy group inhaled GEO. A visual analog scale was used for pain assessment every 2 hours. Interventions and pain assessment continued until the end of the first stage of labor or until cesarean section was indicated. Results: Three hundred pregnant women were recruited. The mean age of the participants was 27.7 years old, and no difference in BMI among the three groups. Participants in the music and aromatherapy group had statistically significantly less labor pain than participants in the control group when cervical dilation was between 4 and 7 cm (6,1±0.7, 1.9±0.7, 2.6±0.4 when cervical dilation was 4-5 cm and 8.0±0.7, 2.8±0.4, 3.6±0.3 when cervical dilation was 6-7 cm in the control, music, and aromatherapy groups, respectively (p < 0.001). However, at cervical dilation of 8-10 cm, there was no difference among the three groups regarding labor pain. Both intervention groups had significantly shorter labor time and less estimated blood loss during vaginal delivery than the control group (p < 0.001). Conclusion: Music and aromatherapy decreased labor pain, labor time, and estimated blood loss compared to the control group.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135459141","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: This study aimed to assess the effects of AFA and its associated factors, especially those coexisting with hyperandrogenism or PCOS, on QoL using the Dermatology Life Quality Index (DLQI). Materials and Methods: A retrospective cross-sectional study was conducted on AFA patients who had been treated between May 2018 and January 2020. Dermatologists had performed history taking and determined the clinical severity of the acne, and gynecologists had identified PCOS. Aggravating factors and DLQI were self-reported by the patients. Results: A total of 208 AFA patients, aged 31.8±7.1 years on average, were included. The mean DLQI score was 8.0±5.4 (range: 0-23). Patients with moderate to severe acne had significantly higher total DLQI scores compared to those with almost clear to mild acne (P=0.043). Similarly, patients who reported acne aggravated by diet, androgenetic alopecia, or perioral and chin lesions had significantly higher total DLQI scores (P=0.025, P=0.049, and P=0.014, respectively). However, PCOS and hirsutism did not significantly impact QoL. The aspect most affected was feeling embarrassed and self-conscious, with significantly greater impacts observed in patients with moderate to severe acne compared to mild acne. The daily activities of patients with androgenetic alopecia were significantly impacted in terms of their choice of clothes and sexual difficulties. Conclusion: AFA mostly had a moderate to extremely large effect on patients’ QoL. Knowing the factors influencing QoL, such as acne severity, dietary aggravation of acne, and androgenetic alopecia, may enable physicians to improve the QoL of patients.
{"title":"Associated Factors of Quality of Life in Adult Female Acne Coexisting with Hyperandrogenism and Polycystic Ovarian Syndrome using the Dermatology Life Quality Index","authors":"Pattriya Jirawattanadon, Leena Chularojanamontri, Yanisorn Nanchaipruek, Panicha Chantrapanichkul, Papapit Tuchinda, Kanokvalai Kulthanan","doi":"10.33192/smj.v75i10.264327","DOIUrl":"https://doi.org/10.33192/smj.v75i10.264327","url":null,"abstract":"Objective: This study aimed to assess the effects of AFA and its associated factors, especially those coexisting with hyperandrogenism or PCOS, on QoL using the Dermatology Life Quality Index (DLQI). Materials and Methods: A retrospective cross-sectional study was conducted on AFA patients who had been treated between May 2018 and January 2020. Dermatologists had performed history taking and determined the clinical severity of the acne, and gynecologists had identified PCOS. Aggravating factors and DLQI were self-reported by the patients. Results: A total of 208 AFA patients, aged 31.8±7.1 years on average, were included. The mean DLQI score was 8.0±5.4 (range: 0-23). Patients with moderate to severe acne had significantly higher total DLQI scores compared to those with almost clear to mild acne (P=0.043). Similarly, patients who reported acne aggravated by diet, androgenetic alopecia, or perioral and chin lesions had significantly higher total DLQI scores (P=0.025, P=0.049, and P=0.014, respectively). However, PCOS and hirsutism did not significantly impact QoL. The aspect most affected was feeling embarrassed and self-conscious, with significantly greater impacts observed in patients with moderate to severe acne compared to mild acne. The daily activities of patients with androgenetic alopecia were significantly impacted in terms of their choice of clothes and sexual difficulties. Conclusion: AFA mostly had a moderate to extremely large effect on patients’ QoL. Knowing the factors influencing QoL, such as acne severity, dietary aggravation of acne, and androgenetic alopecia, may enable physicians to improve the QoL of patients.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135459364","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: The study evaluates the prevalence of burnout and the associated risk factors among Thai anesthesiology residents. Materials and Methods: This cross-sectional study was conducted by an online questionnaire and sent 385 anesthesiology residents in Thailand. The questionnaire consisted of a consent form, personal information, potential risk factors of burnout, and the Thai version of the Copenhagen Burnout Inventory-Student Survey (CBI-SS). Results: A total of 248 respondents completed the questionnaire. The overall prevalence of burnout among Thai anesthesiology residents was 35.5%. Sleeping for 5-6 hours (odds ratio 3.68, 95% CI 1.40 to 9.68, p = 0.008), sleeping less than 5 hours (odds ratio 6.89, 95% CI 1.90 to 24.92, p = 0.003), along with dissatisfaction and the idea of discontinuation of training, were associated with higher burnout (odds ratio 8.38, 95% CI 3.65 to 19.25, p < 0.001 and odds ratio 3.11, 95% CI 1.57 to 6.18, p = 0.001, respectively). Compared to first-year residents, second-year residents exhibited a lower risk of burnout (odds ratio 0.32, 95% CI 0.134 to 0.76, p = 0.009) while no significant difference among third-year residents (odds ratio 0.54, p = 0.17, 95% CI 0.25-1.17). Conclusion: The prevalence of burnout among Thai anesthesiology residents was high. Sleeping less than 7 hours, experiencing dissatisfaction, and contemplating discontinuation of training were associated with a higher risk of burnout, while being a second-year resident lowered the risk.
目的:了解泰国麻醉科住院医师职业倦怠的患病率及相关危险因素。材料与方法:本横断面研究采用在线问卷调查的方式进行，共向泰国385名麻醉科住院医师发送问卷。问卷包括同意表、个人信息、倦怠的潜在危险因素和泰国版的哥本哈根倦怠量表-学生调查(CBI-SS)。结果:共有248名被调查者完成问卷。泰国麻醉科住院医师的总体倦怠率为35.5%。睡眠5-6小时(优势比3.68,95% CI 1.40 ~ 9.68, p = 0.008)、睡眠不足5小时(优势比6.89,95% CI 1.90 ~ 24.92, p = 0.003)以及不满意和停止训练的想法与较高的倦怠相关(优势比8.38,95% CI 3.65 ~ 19.25, p <0.001，优势比3.11,95% CI分别为1.57 ~ 6.18,p = 0.001)。与第一年住院医师相比，第二年住院医师表现出较低的倦怠风险(优势比0.32,95% CI 0.134 ~ 0.76, p = 0.009)，而第三年住院医师之间无显著差异(优势比0.54,p = 0.17, 95% CI 0.25 ~ 1.17)。结论:泰国麻醉科住院医师职业倦怠的发生率较高。睡眠不足7小时，经历不满，考虑停止培训与较高的倦怠风险相关，而第二年住院医师降低了风险。
{"title":"Burnout and Associated Factors among Thai Anesthesiology Residents","authors":"Neranchala Soonthornkes, Orattha Sakornwattananon, Jitpanu Jirapitakkul, Winitra Nuallaong","doi":"10.33192/smj.v75i10.264582","DOIUrl":"https://doi.org/10.33192/smj.v75i10.264582","url":null,"abstract":"Objective: The study evaluates the prevalence of burnout and the associated risk factors among Thai anesthesiology residents. Materials and Methods: This cross-sectional study was conducted by an online questionnaire and sent 385 anesthesiology residents in Thailand. The questionnaire consisted of a consent form, personal information, potential risk factors of burnout, and the Thai version of the Copenhagen Burnout Inventory-Student Survey (CBI-SS). Results: A total of 248 respondents completed the questionnaire. The overall prevalence of burnout among Thai anesthesiology residents was 35.5%. Sleeping for 5-6 hours (odds ratio 3.68, 95% CI 1.40 to 9.68, p = 0.008), sleeping less than 5 hours (odds ratio 6.89, 95% CI 1.90 to 24.92, p = 0.003), along with dissatisfaction and the idea of discontinuation of training, were associated with higher burnout (odds ratio 8.38, 95% CI 3.65 to 19.25, p < 0.001 and odds ratio 3.11, 95% CI 1.57 to 6.18, p = 0.001, respectively). Compared to first-year residents, second-year residents exhibited a lower risk of burnout (odds ratio 0.32, 95% CI 0.134 to 0.76, p = 0.009) while no significant difference among third-year residents (odds ratio 0.54, p = 0.17, 95% CI 0.25-1.17). Conclusion: The prevalence of burnout among Thai anesthesiology residents was high. Sleeping less than 7 hours, experiencing dissatisfaction, and contemplating discontinuation of training were associated with a higher risk of burnout, while being a second-year resident lowered the risk.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135457674","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: Long-acting injectable (LAI)-aripiprazole and LAI-paliperidone palmitate are both second-generation antipsychotics that have been introduced to increase drug compliance in patients. These attributes are expected to enhance drug compliance, particularly in stable patients. The previous studies demonstrated that the efficacy of LAI-aripiprazole and LAI-paliperidone palmitate is controversial. Nevertheless, the costs of treatments and adverse events of both LAI-aripiprazole and LAI-paliperidone palmitate are unlikeness. As there had been no previous cost-effectiveness studies comparing the use of LAI-aripiprazole and LAI-paliperidone palmitate in Thailand, this study was carried out to investigate the matter. Materials and Methods: This study analysed the cost-effectiveness of LAI-aripiprazole compared with LAI-paliperidone palmitate in the treatment of stable schizophrenia, by using the Markov model from a societal perspective. Results: The total cost of treatment with LAI-aripiprazole and LAI-paliperidone palmitate was 1,334,919.05 baht and 1,329,818.79 baht, respectively, while the quality-adjusted life years (QALYs) were both 16.35 years. Life-year of the treatment with LAI-aripiprazole and LAI-paliperidone was 24.27 years and 24.25 years, respectively. The cost-effectiveness ratios (CER) of the treatment with LAI-aripiprazole and LAI-paliperidone palmitate were 81,652.85 baht/QALY gained and 81,330.94 baht/QALY gained, respectively. Conclusion: In Thailand, the treatment of stable schizophrenia with LAI-aripiprazole was shown to provide similar benefits to LAI-paliperidone palmitate in terms of QALYs, despite being more costly. Comparatively, LAI-aripiprazole exhibited better clinical efficacy and led to a longer average life expectancy than LAI-paliperidone. Treatment with LAI-aripiprazole may be dominant strategy, especially with a 2% reduction in drug cost. The results could contribute to appropriate decision-making by policymakers.
{"title":"Cost-Effectiveness Analysis of Long-acting Injectable Once-monthly of Aripiprazole Compared with Long-acting Injectable Once-monthly Paliperidone Palmitate for the Treatment of Stable Schizophrenia Patients in Thailand","authors":"Piyanut Ueapanjasin, Wiwat Thavornwattanayong, Jadesada Lertsirimunkong, Kamolpat Chaiyakittisopon","doi":"10.33192/smj.v75i10.264770","DOIUrl":"https://doi.org/10.33192/smj.v75i10.264770","url":null,"abstract":"Objective: Long-acting injectable (LAI)-aripiprazole and LAI-paliperidone palmitate are both second-generation antipsychotics that have been introduced to increase drug compliance in patients. These attributes are expected to enhance drug compliance, particularly in stable patients. The previous studies demonstrated that the efficacy of LAI-aripiprazole and LAI-paliperidone palmitate is controversial. Nevertheless, the costs of treatments and adverse events of both LAI-aripiprazole and LAI-paliperidone palmitate are unlikeness. As there had been no previous cost-effectiveness studies comparing the use of LAI-aripiprazole and LAI-paliperidone palmitate in Thailand, this study was carried out to investigate the matter. Materials and Methods: This study analysed the cost-effectiveness of LAI-aripiprazole compared with LAI-paliperidone palmitate in the treatment of stable schizophrenia, by using the Markov model from a societal perspective. Results: The total cost of treatment with LAI-aripiprazole and LAI-paliperidone palmitate was 1,334,919.05 baht and 1,329,818.79 baht, respectively, while the quality-adjusted life years (QALYs) were both 16.35 years. Life-year of the treatment with LAI-aripiprazole and LAI-paliperidone was 24.27 years and 24.25 years, respectively. The cost-effectiveness ratios (CER) of the treatment with LAI-aripiprazole and LAI-paliperidone palmitate were 81,652.85 baht/QALY gained and 81,330.94 baht/QALY gained, respectively. Conclusion: In Thailand, the treatment of stable schizophrenia with LAI-aripiprazole was shown to provide similar benefits to LAI-paliperidone palmitate in terms of QALYs, despite being more costly. Comparatively, LAI-aripiprazole exhibited better clinical efficacy and led to a longer average life expectancy than LAI-paliperidone. Treatment with LAI-aripiprazole may be dominant strategy, especially with a 2% reduction in drug cost. The results could contribute to appropriate decision-making by policymakers.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509161","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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