Objective: Bedaquiline is recommended by World Health Organization (WHO) to treat Drug-Resistant Tuberculosis (DR-TB). Bedaquiline is chosen due to its efficacy and safety in numerous studies. One adverse event that could happen is QT interval prolongation, which increases the risk of Torsade de Pointes (TdP) and leads to death. This study aimed to discuss the knowledge on the effect of bedaquiline on before-after and changes of QT interval. Materials and Methods: This systematic review based on PRISMA guidelines through PubMed, Cochrane, Science Direct, ProQuest, Google Scholar, and Epistemonikos until April 10, 2023. The keywords used was (“Bedaquiline” AND “QT Interval”). We implemented inclusion and exclusion criteria by PICOS framework then assessed the studies by Joanna Briggs Institute (JBI) critical appraisal checklist tools. Results: From 1.170 articles, eleven articles met the criteria. In total 2449 patients assessed in this study. Most of the studies carried out treatment duration of 6 months. There was a change in the mean QT interval between 11ms to 52.5ms in patients using bedaquiline from the beginning to the end of treatment. The mean QT interval after treatment ranges from 409.7ms – 464.5ms. Conclusion: The use of bedaquiline requires attention to the ECG before and during therapy. Regular monitoring is necessary to prevent QT prolongation.
{"title":"Bedaquiline Effect Towards QT Interval in Drug Resistant Tuberculosis (DR-TB): A Systematic Review","authors":"Arya Marganda Simanjuntak, Rahmadini Aulia, Dhewa Triguna Banjarnahor, Riski Dimas Harianja, Indra Yovi","doi":"10.33192/smj.v75i9.263683","DOIUrl":"https://doi.org/10.33192/smj.v75i9.263683","url":null,"abstract":"Objective: Bedaquiline is recommended by World Health Organization (WHO) to treat Drug-Resistant Tuberculosis (DR-TB). Bedaquiline is chosen due to its efficacy and safety in numerous studies. One adverse event that could happen is QT interval prolongation, which increases the risk of Torsade de Pointes (TdP) and leads to death. This study aimed to discuss the knowledge on the effect of bedaquiline on before-after and changes of QT interval. Materials and Methods: This systematic review based on PRISMA guidelines through PubMed, Cochrane, Science Direct, ProQuest, Google Scholar, and Epistemonikos until April 10, 2023. The keywords used was (“Bedaquiline” AND “QT Interval”). We implemented inclusion and exclusion criteria by PICOS framework then assessed the studies by Joanna Briggs Institute (JBI) critical appraisal checklist tools. Results: From 1.170 articles, eleven articles met the criteria. In total 2449 patients assessed in this study. Most of the studies carried out treatment duration of 6 months. There was a change in the mean QT interval between 11ms to 52.5ms in patients using bedaquiline from the beginning to the end of treatment. The mean QT interval after treatment ranges from 409.7ms – 464.5ms. Conclusion: The use of bedaquiline requires attention to the ECG before and during therapy. Regular monitoring is necessary to prevent QT prolongation.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344676","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 : 2023-09-01DOI: 10.33192/smj.v75i9.264058
Varis Manomaivong, Prakasit Wannapaschaiyong, Sudarat Sirisakpanit, Jeeranan Kantasorn, Jariya Tarugsa, N. Piyaphanee, S. Chantaratin
Objective: Psychological comorbidity in children with enuresis is common and its screening is recommended. A brief validated screening instrument is needed for a busy medical practice. This study focused on the development of the Thai Behavioral and Emotional Screening Tool for children with Enuresis (TBEST-E) and aimed to examine its psychometric properties. Materials and Methods: Using the Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) as a template, the 15-item with a yes/no answer format of the TBEST-E was developed for the screening of emotional problems (7 items), attention and hyperactivity/impulsivity problems (3 items each), and oppositional defiant symptoms (2 items). The parents of the children with enuresis completed the TBEST-E and the behavioral rating scale “Thai Youth Checklist” (TYC). The optimal cut-off for further assessment, the sensitivity, and the specificity the TBEST-E were identified using receiver operating characteristic (ROC) curves. Results: After an adaptation following comments from three child psychiatrists, the TBEST-E showed a content validity of 0.9, an internal consistency of 0.71. A total of 33 children with enuresis (median age = 9, interquartile range = 6.5-11 years) were recruited. Further assessment was indicated when one of the following occurred; at least 3 emotional problems; 3 attention problems; or 2 hyperactivity/impulsivity together with 2 oppositional defiant symptoms. The overall sensitivity and specificity were 0.88 and 0.71 respectively with the accuracy of 0.84 (95% CI = 0.68-0.95). Conclusion: The TBEST-E is time-efficient and has acceptable psychometric properties in early detection of common psychological problems in children with enuresis.
{"title":"Validity and Reliability of a Thai Behavioral and Emotional Screening Tool for Children with Enuresis (TBEST-E)","authors":"Varis Manomaivong, Prakasit Wannapaschaiyong, Sudarat Sirisakpanit, Jeeranan Kantasorn, Jariya Tarugsa, N. Piyaphanee, S. Chantaratin","doi":"10.33192/smj.v75i9.264058","DOIUrl":"https://doi.org/10.33192/smj.v75i9.264058","url":null,"abstract":"Objective: Psychological comorbidity in children with enuresis is common and its screening is recommended. A brief validated screening instrument is needed for a busy medical practice. This study focused on the development of the Thai Behavioral and Emotional Screening Tool for children with Enuresis (TBEST-E) and aimed to examine its psychometric properties. Materials and Methods: Using the Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) as a template, the 15-item with a yes/no answer format of the TBEST-E was developed for the screening of emotional problems (7 items), attention and hyperactivity/impulsivity problems (3 items each), and oppositional defiant symptoms (2 items). The parents of the children with enuresis completed the TBEST-E and the behavioral rating scale “Thai Youth Checklist” (TYC). The optimal cut-off for further assessment, the sensitivity, and the specificity the TBEST-E were identified using receiver operating characteristic (ROC) curves. Results: After an adaptation following comments from three child psychiatrists, the TBEST-E showed a content validity of 0.9, an internal consistency of 0.71. A total of 33 children with enuresis (median age = 9, interquartile range = 6.5-11 years) were recruited. Further assessment was indicated when one of the following occurred; at least 3 emotional problems; 3 attention problems; or 2 hyperactivity/impulsivity together with 2 oppositional defiant symptoms. The overall sensitivity and specificity were 0.88 and 0.71 respectively with the accuracy of 0.84 (95% CI = 0.68-0.95). Conclusion: The TBEST-E is time-efficient and has acceptable psychometric properties in early detection of common psychological problems in children with enuresis.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"214 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345603","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 : 2023-08-01DOI: 10.33192/smj.v75i8.263320
Yupa Nakkinkun, Tussnem Binhama, Yaowaluk U-pratya, T. Rungjirajittranon, T. Ruchutrakool
thawed samples with plasma stored at 2–8 °C for 24–96 hours. Materials and Methods: Plasma from healthy subjects with normal coagulation times and VWF panels was stored at -20 °C for one week. After thawing (at 0 hours), VWF:antigen (VWF:Ag), VWF:glycoprotein Ib binding assay (VWF:GPIbM), and VWF:collagen binding assay (VWF:CB) were assayed. The remaining plasma was stored at 2–8 °C and assayed at 24, 48, 72, and 96 hours. Differences between levels at baseline and 24, 48, 72, and 96 hours were deemed significant when P was < 0.05. Results: Thirty-five samples were enrolled, with 25 from healthy subjects (VWF:Ag levels > 0.50 kIU/L). Median levels (interquartile range) were as follows: VWF:Ag = 0.91 (0.72–1.06) kIU/L; VWF:GPIbM = 0.85 (0.69–1.04) kIU/L; and VWF:CB = 0.78 (0.62–0.97) kIU/L. VWF:Ag remained stable for 72 hours, while VWF:GPIbM decreased significantly after thawing. VWF:CB declined after 48 hours at 2–8 °C. Similar stability trends were observed in 10 additional samples from VWD patients (VWF:Ag = 0.42 (0.36–0.46) kIU/L). Conclusion: VWF:Ag and VWF:CB are stable in thawed plasma for 72 hours. VWF:GPIbM is less stable and should not be kept longer than 24 hours. Immediate testing of VWF:GPIbM after thawing is recommended.
{"title":"The Effects of Storage Time at 2–8 Degrees Celsius on the Stability of von Willebrand Factor in Thawed, Platelet-Poor Plasma","authors":"Yupa Nakkinkun, Tussnem Binhama, Yaowaluk U-pratya, T. Rungjirajittranon, T. Ruchutrakool","doi":"10.33192/smj.v75i8.263320","DOIUrl":"https://doi.org/10.33192/smj.v75i8.263320","url":null,"abstract":"thawed samples with plasma stored at 2–8 °C for 24–96 hours. Materials and Methods: Plasma from healthy subjects with normal coagulation times and VWF panels was stored at -20 °C for one week. After thawing (at 0 hours), VWF:antigen (VWF:Ag), VWF:glycoprotein Ib binding assay (VWF:GPIbM), and VWF:collagen binding assay (VWF:CB) were assayed. The remaining plasma was stored at 2–8 °C and assayed at 24, 48, 72, and 96 hours. Differences between levels at baseline and 24, 48, 72, and 96 hours were deemed significant when P was < 0.05. Results: Thirty-five samples were enrolled, with 25 from healthy subjects (VWF:Ag levels > 0.50 kIU/L). Median levels (interquartile range) were as follows: VWF:Ag = 0.91 (0.72–1.06) kIU/L; VWF:GPIbM = 0.85 (0.69–1.04) kIU/L; and VWF:CB = 0.78 (0.62–0.97) kIU/L. VWF:Ag remained stable for 72 hours, while VWF:GPIbM decreased significantly after thawing. VWF:CB declined after 48 hours at 2–8 °C. Similar stability trends were observed in 10 additional samples from VWD patients (VWF:Ag = 0.42 (0.36–0.46) kIU/L). Conclusion: VWF:Ag and VWF:CB are stable in thawed plasma for 72 hours. VWF:GPIbM is less stable and should not be kept longer than 24 hours. Immediate testing of VWF:GPIbM after thawing is recommended.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139352365","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 : 2023-08-01DOI: 10.33192/smj.v75i8.262661
W. Tan, G. Lin
Objective: The present study aimed to explore the perspectives and learning experiences of undergraduate dental students during the Covid-19 pandemic using a qualitative approach. Materials and Methods: The current study used a qualitative focus group approach based on the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus groups were carried out using a piloted interview topic guide. A convenient sampling was adopted to include undergraduate year 3 to year 5 dental students who had attended regular face-to-face session before the pandemic. Each session consisted of 6 to 8 participants who were randomly assigned, and the sessions lasted for about 30 to 45 minutes. The interviews were recorded and transcribed verbatim. Content analysis using a deductive approach was employed to the focus group data. All the final codes were refined and agreed by all members of the research team. Results: Four main themes with their respective subthemes were identified through the coding process, namely change in study life balance, online learning, interpersonal relationship, and concern for future. Conclusion: Dental students faced numerous challenges during the Covid-19 pandemic, both mentally and academically. Academicians must reconsider and re-evaluate the curriculum, including the mode of delivery, as total eradication of the virus is not likely to be possible in the foreseeable future.
{"title":"Dental Students' Perspectives and Learning Experiences during the Covid-19 Outbreak: A Qualitative Study","authors":"W. Tan, G. Lin","doi":"10.33192/smj.v75i8.262661","DOIUrl":"https://doi.org/10.33192/smj.v75i8.262661","url":null,"abstract":"Objective: The present study aimed to explore the perspectives and learning experiences of undergraduate dental students during the Covid-19 pandemic using a qualitative approach. Materials and Methods: The current study used a qualitative focus group approach based on the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus groups were carried out using a piloted interview topic guide. A convenient sampling was adopted to include undergraduate year 3 to year 5 dental students who had attended regular face-to-face session before the pandemic. Each session consisted of 6 to 8 participants who were randomly assigned, and the sessions lasted for about 30 to 45 minutes. The interviews were recorded and transcribed verbatim. Content analysis using a deductive approach was employed to the focus group data. All the final codes were refined and agreed by all members of the research team. Results: Four main themes with their respective subthemes were identified through the coding process, namely change in study life balance, online learning, interpersonal relationship, and concern for future. Conclusion: Dental students faced numerous challenges during the Covid-19 pandemic, both mentally and academically. Academicians must reconsider and re-evaluate the curriculum, including the mode of delivery, as total eradication of the virus is not likely to be possible in the foreseeable future.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139353020","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 : 2023-08-01DOI: 10.33192/smj.v75i8.263395
Araya Satdhabudha, Chonnikarn Parnthong, P. Surapolchai, Tasama Pusongchai, W. Satayasai, Jassada Buaboonnam, Phakatip Sinlapamongkolkul
Objective: To compare the prevalence of HS and quality of life in non-transfusion dependent thalassemia (NTDT) and Transfusion dependent thalassemia (TDT) patients and to identify risk factors associated with HS in pediatric thalassemia. Materials and Methods: We conducted a cross-sectional study of pediatric thalassemic patients aged from 6 months - 18 years between January 2020 and October 2020, at Thammasat University Hospital, Thailand. Results: There were 141 thalassemia patients (35 TDT and 106 NTDT), aged 7 months-18 years, 73 (51.8%) were male. Sixty-eight patients (48.2%) reported snoring; 28 patients (19.9%) had HS; the remaining 40 patients (28.4%) had simple snoring. The prevalence of HS was not significantly different between TDT and NTDT group (6 (17.1%) VS 22 (20.8%); P= 0.527). Quality of life assessed by OSA-18 score was not significant difference between TDT and NTDT groups (51.3 ± 18.8 VS 45.7 ± 11.4; P=0.141). The associating risk factors for the development of HS after multivariate logistic analysis were nasal congestion, and male gender, with an adjusted OR of 5.3 and 3.0, respectively. Conclusion: Prevalence of HS was increased in children with thalassemia. Factors such as nasal congestion and male gender were strongly associated with HS in this population. The quality of life assessment using the OSA-18 questionnaire indicated that thalassemia children generally exhibited a good quality of life. Additionally, our study observed relatively low serum ferritin levels in comparison to previous studies. The standard care provided for TDT patients, includes regular blood transfusion and effective iron chelation, may contribute to slowing down the degree of nasopharyngeal narrowing in thalassemia patients.
{"title":"Habitual Snoring in Pediatric Thalassemia Disease; Prevalence, Quality of Life and Risk Factors","authors":"Araya Satdhabudha, Chonnikarn Parnthong, P. Surapolchai, Tasama Pusongchai, W. Satayasai, Jassada Buaboonnam, Phakatip Sinlapamongkolkul","doi":"10.33192/smj.v75i8.263395","DOIUrl":"https://doi.org/10.33192/smj.v75i8.263395","url":null,"abstract":"Objective: To compare the prevalence of HS and quality of life in non-transfusion dependent thalassemia (NTDT) and Transfusion dependent thalassemia (TDT) patients and to identify risk factors associated with HS in pediatric thalassemia. Materials and Methods: We conducted a cross-sectional study of pediatric thalassemic patients aged from 6 months - 18 years between January 2020 and October 2020, at Thammasat University Hospital, Thailand. Results: There were 141 thalassemia patients (35 TDT and 106 NTDT), aged 7 months-18 years, 73 (51.8%) were male. Sixty-eight patients (48.2%) reported snoring; 28 patients (19.9%) had HS; the remaining 40 patients (28.4%) had simple snoring. The prevalence of HS was not significantly different between TDT and NTDT group (6 (17.1%) VS 22 (20.8%); P= 0.527). Quality of life assessed by OSA-18 score was not significant difference between TDT and NTDT groups (51.3 ± 18.8 VS 45.7 ± 11.4; P=0.141). The associating risk factors for the development of HS after multivariate logistic analysis were nasal congestion, and male gender, with an adjusted OR of 5.3 and 3.0, respectively. Conclusion: Prevalence of HS was increased in children with thalassemia. Factors such as nasal congestion and male gender were strongly associated with HS in this population. The quality of life assessment using the OSA-18 questionnaire indicated that thalassemia children generally exhibited a good quality of life. Additionally, our study observed relatively low serum ferritin levels in comparison to previous studies. The standard care provided for TDT patients, includes regular blood transfusion and effective iron chelation, may contribute to slowing down the degree of nasopharyngeal narrowing in thalassemia patients.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139352803","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 : 2023-08-01DOI: 10.33192/smj.v75i8.263447
Prakasit Wannapaschaiyong, Amornrat Penphattarakul, Pat Rojmahamongkol, Sureelak Sutchritpongsa
Objective: This study examined the correlation between primary caregivers’ psychosocial factors and self-esteem in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A cross-sectional study involving primary caregivers and their children with ADHD, aged 8-15, was conducted from September 2022 to February 2023. The children’s self-esteem was assessed using the Five-Scale Test of Self-Esteem for Children. Primary caregivers’ psychosocial factors were assessed using the Attitude of Parenting Questionnaire, Parenting Style and Dimension Questionnaire, Patient Health Questionnaire-9, and Generalized Anxiety Disorder 7-item. Descriptive statistics and multivariable linear regression were used to determine the associations among variables. Results: The study included 66 pairs of children and adolescents with ADHD and their primary caregivers. The study found 53% of caregivers screened positive for depression, while 16.7% screened positive for anxiety. Almost all caregivers (90.9%) adopted an authoritative parenting. The mean self-esteem score in participants with ADHD was 39.23±8.99. Younger caregivers, those with an education level below a bachelor’s degree, higher monthly income, positive screening for depression, and lower attitudes toward parenting scores were significantly associated with low self-esteem scores in their children. Conclusion: Age, education level of caregivers, and monthly family income were significantly correlated with the self-esteem of children and adolescents with ADHD. The attitudes of caregivers towards parenting and depression in caregivers also impacted self-esteem of children with ADHD under their care. Thus, strategies aimed at promoting positive caregiving attitudes, regular screening of caregivers for depression, and providing appropriate treatment are recommended to enhance self-esteem in children and adolescents with ADHD.
{"title":"The Relationship Between Primary Caregivers’ Psychosocial Factors and Self Esteem in Children and Adolescents with ADHD: An Exploratory Crosssectional Study","authors":"Prakasit Wannapaschaiyong, Amornrat Penphattarakul, Pat Rojmahamongkol, Sureelak Sutchritpongsa","doi":"10.33192/smj.v75i8.263447","DOIUrl":"https://doi.org/10.33192/smj.v75i8.263447","url":null,"abstract":"Objective: This study examined the correlation between primary caregivers’ psychosocial factors and self-esteem in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A cross-sectional study involving primary caregivers and their children with ADHD, aged 8-15, was conducted from September 2022 to February 2023. The children’s self-esteem was assessed using the Five-Scale Test of Self-Esteem for Children. Primary caregivers’ psychosocial factors were assessed using the Attitude of Parenting Questionnaire, Parenting Style and Dimension Questionnaire, Patient Health Questionnaire-9, and Generalized Anxiety Disorder 7-item. Descriptive statistics and multivariable linear regression were used to determine the associations among variables. Results: The study included 66 pairs of children and adolescents with ADHD and their primary caregivers. The study found 53% of caregivers screened positive for depression, while 16.7% screened positive for anxiety. Almost all caregivers (90.9%) adopted an authoritative parenting. The mean self-esteem score in participants with ADHD was 39.23±8.99. Younger caregivers, those with an education level below a bachelor’s degree, higher monthly income, positive screening for depression, and lower attitudes toward parenting scores were significantly associated with low self-esteem scores in their children. Conclusion: Age, education level of caregivers, and monthly family income were significantly correlated with the self-esteem of children and adolescents with ADHD. The attitudes of caregivers towards parenting and depression in caregivers also impacted self-esteem of children with ADHD under their care. Thus, strategies aimed at promoting positive caregiving attitudes, regular screening of caregivers for depression, and providing appropriate treatment are recommended to enhance self-esteem in children and adolescents with ADHD.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"165 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139352302","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: There is a trend toward expanding pediatric age range. At the borderline age of 15-18 years, the characteristics of patients requiring intensive care admission in low- and middle-income countries are unknown. Our institution recently changed the cut-off age for pediatric care from 15 to 18 years. The objective of this study was to determine the characteristics, outcomes and bed utilization of patients aged 15-18 years admitted to pediatric intensive care unit (PICU) after this change. Materials and Methods: This is an observational study at a tertiary medical PICU. Patients aged 15-18 years admitted to PICU in 2019-2020 were eligible. Medical records were reviewed. Results: There were 1030 PICU admissions from all age groups. Fifty-two patients aged 15-18 years were admitted, with a total of 68 admissions. Eighty-seven percent had chronic conditions. The most common acute conditions were septic shock and infection, the most common chronic conditions were systemic lupus erythematosus (SLE) and hematologic malignancies. Forty-seven percent required mechanical ventilation, 36% required vasoactive medications and 27% required continuous renal replacement therapy. PICU mortality rate in patients aged 15-18 years old was significantly higher than that in the younger age group (13.24% vs 3.64%, p = 0.002). Hospital mortality rate was 22%. Conclusion: Patients aged 15-18 years requiring PICU admission had high prevalence of chronic conditions and high mortality risk. Special attention should be given to the care of this group. The most common acute conditions were septic shock and infection. The most common chronic conditions were SLE and hematologic malignancies.
{"title":"Characteristics, Outcomes and Bed Utilization of 15-to-18-Year-Old Adolescents in a Pediatric Intensive Care Unit in Thailand","authors":"Suvikrom Law, Thakoon Butpech, Suwannee Phumeetham, Nutnicha Preeprem, Kawewan Limprayoon","doi":"10.33192/smj.v75i8.263097","DOIUrl":"https://doi.org/10.33192/smj.v75i8.263097","url":null,"abstract":"Objective: There is a trend toward expanding pediatric age range. At the borderline age of 15-18 years, the characteristics of patients requiring intensive care admission in low- and middle-income countries are unknown. Our institution recently changed the cut-off age for pediatric care from 15 to 18 years. The objective of this study was to determine the characteristics, outcomes and bed utilization of patients aged 15-18 years admitted to pediatric intensive care unit (PICU) after this change. Materials and Methods: This is an observational study at a tertiary medical PICU. Patients aged 15-18 years admitted to PICU in 2019-2020 were eligible. Medical records were reviewed. Results: There were 1030 PICU admissions from all age groups. Fifty-two patients aged 15-18 years were admitted, with a total of 68 admissions. Eighty-seven percent had chronic conditions. The most common acute conditions were septic shock and infection, the most common chronic conditions were systemic lupus erythematosus (SLE) and hematologic malignancies. Forty-seven percent required mechanical ventilation, 36% required vasoactive medications and 27% required continuous renal replacement therapy. PICU mortality rate in patients aged 15-18 years old was significantly higher than that in the younger age group (13.24% vs 3.64%, p = 0.002). Hospital mortality rate was 22%. Conclusion: Patients aged 15-18 years requiring PICU admission had high prevalence of chronic conditions and high mortality risk. Special attention should be given to the care of this group. The most common acute conditions were septic shock and infection. The most common chronic conditions were SLE and hematologic malignancies.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"163 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139352491","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 : 2023-08-01DOI: 10.33192/smj.v75i8.262655
Angkana Apichartvorakit, P. Euasobhon, Suksalin Booranasubkajorn, Supakij Suwannatrai, Manmas Vannabhum, Darunee Rattanawongsamathakul, Sawita Prasartpornsirichoke, P. Akarasereenont, A. Asavamongkolkul
Objective: Neuropathic pain management involves both pharmacological and non-pharmacological interventions. Despite this, no prior research has demonstrated the efficacy of court-type Thai traditional massage (CTTM) for neuropathic pain relief. This study aimed to investigate the potential benefits of CTTM in alleviating neuropathic pain. Materials and Methods: A preliminary single-blind randomized controlled trial was conducted on 28 participants with peripheral neuropathic pain, who were equally assigned to 2 groups. Both groups received standard drug treatment; however, the intervention group additionally received CTTM and hot herbal compression, while the active control group only received HHC. The adjuvant treatments were administered twice weekly for 4 weeks (V1-V8). A follow-up was conducted 4 weeks posttreatment (V9). Outcome measures were assessed at V1, V4, V8, and V9 using a numerical rating scale and the Thai versions of the Neuropathic Pain Symptom Inventory, the Brief Pain Inventory, and the EQ‑5D‑5L health questionnaire. Results: The data revealed that the intervention and active control groups had statistically significant differences in their pain intensity scores (P < 0.001), total neuropathic pain intensity scores (P = 0.001), and utility of health scores (P = 0.007) during the follow-up period. When comparing outcomes between V1 and V8, the groups exhibited significant differences in pain reduction (P = 0.003) and quality of life (P = 0.027). Conclusion: This study provides initial evidence supporting the potential benefits of CTTM in alleviating peripheral neuropathic pain and improving quality of life. Future research should further investigate the application of CTTM in managing peripheral neuropathic pain conditions.
{"title":"Court-Type Thai Traditional Massage for Patients with Intractable Peripheral Neuropathic Pain: a Randomized Controlled Trial","authors":"Angkana Apichartvorakit, P. Euasobhon, Suksalin Booranasubkajorn, Supakij Suwannatrai, Manmas Vannabhum, Darunee Rattanawongsamathakul, Sawita Prasartpornsirichoke, P. Akarasereenont, A. Asavamongkolkul","doi":"10.33192/smj.v75i8.262655","DOIUrl":"https://doi.org/10.33192/smj.v75i8.262655","url":null,"abstract":"Objective: Neuropathic pain management involves both pharmacological and non-pharmacological interventions. Despite this, no prior research has demonstrated the efficacy of court-type Thai traditional massage (CTTM) for neuropathic pain relief. This study aimed to investigate the potential benefits of CTTM in alleviating neuropathic pain. Materials and Methods: A preliminary single-blind randomized controlled trial was conducted on 28 participants with peripheral neuropathic pain, who were equally assigned to 2 groups. Both groups received standard drug treatment; however, the intervention group additionally received CTTM and hot herbal compression, while the active control group only received HHC. The adjuvant treatments were administered twice weekly for 4 weeks (V1-V8). A follow-up was conducted 4 weeks posttreatment (V9). Outcome measures were assessed at V1, V4, V8, and V9 using a numerical rating scale and the Thai versions of the Neuropathic Pain Symptom Inventory, the Brief Pain Inventory, and the EQ‑5D‑5L health questionnaire. Results: The data revealed that the intervention and active control groups had statistically significant differences in their pain intensity scores (P < 0.001), total neuropathic pain intensity scores (P = 0.001), and utility of health scores (P = 0.007) during the follow-up period. When comparing outcomes between V1 and V8, the groups exhibited significant differences in pain reduction (P = 0.003) and quality of life (P = 0.027). Conclusion: This study provides initial evidence supporting the potential benefits of CTTM in alleviating peripheral neuropathic pain and improving quality of life. Future research should further investigate the application of CTTM in managing peripheral neuropathic pain conditions.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139352919","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 : 2023-08-01DOI: 10.33192/smj.v75i8.262259
Korakot Sirimai, Tripop Lertbunnaphong, Catthaleya Suwanthananon, M. Warnnissorn, Nalinee Panichyawat
Objective: Office endometrial biopsy using an endometrial cell sampler is an accepted method of obtaining endometrial tissue for histopathologic evaluation in women with abnormal uterine bleeding (AUB). Manual vacuum aspiration (MVA) is considered an alternative method, but data specific to the use of MVA is limited. This study aimed to evaluate the efficacy of MVA compared to endometrial cell sampler for diagnosing causes of AUB. Materials and Methods: This prospective study enrolled women aged ≥35 years who presented with AUB during August 2015 to June 2016. For each patient, endometrial biopsy using an endometrial cell sampler was first performed followed by MVA. Correlation of endometrial histopathology between methods were analyzed using Kappa statistic. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated. Results: Of the 162 patients enrolled, the data from 151 women were analyzed. Correspondence of histopathologic finding between tissue obtained from endometrial cell sampler and MVA was 72.8% (Kappa: 0.51). Correspondence of histopathologic finding between tissue obtained from MVA and the final most severe pathology used for treatment decision was 84.1% (Kappa: 0.72). MVA diagnosed all cases of malignancy, but endometrial cell sampler missed one case of malignancy. The overall sensitivity, specificity, PPV, and NPV of MVA was 84.5%, 100%, 100%, and 91.2%, respectively. Conclusion: The histopathologic findings of MVA were in good agreement with those of endometrial cell sampler, and MVA had high accuracy for diagnosing endometrial pathology. MVA is suggested as a reliable alternative procedure for endometrial biopsy in women with AUB.
{"title":"Correlation between Manual Vacuum Aspiration and Endometrial Cell Sampler in Abnormal Uterine Bleeding","authors":"Korakot Sirimai, Tripop Lertbunnaphong, Catthaleya Suwanthananon, M. Warnnissorn, Nalinee Panichyawat","doi":"10.33192/smj.v75i8.262259","DOIUrl":"https://doi.org/10.33192/smj.v75i8.262259","url":null,"abstract":"Objective: Office endometrial biopsy using an endometrial cell sampler is an accepted method of obtaining endometrial tissue for histopathologic evaluation in women with abnormal uterine bleeding (AUB). Manual vacuum aspiration (MVA) is considered an alternative method, but data specific to the use of MVA is limited. This study aimed to evaluate the efficacy of MVA compared to endometrial cell sampler for diagnosing causes of AUB. Materials and Methods: This prospective study enrolled women aged ≥35 years who presented with AUB during August 2015 to June 2016. For each patient, endometrial biopsy using an endometrial cell sampler was first performed followed by MVA. Correlation of endometrial histopathology between methods were analyzed using Kappa statistic. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated. Results: Of the 162 patients enrolled, the data from 151 women were analyzed. Correspondence of histopathologic finding between tissue obtained from endometrial cell sampler and MVA was 72.8% (Kappa: 0.51). Correspondence of histopathologic finding between tissue obtained from MVA and the final most severe pathology used for treatment decision was 84.1% (Kappa: 0.72). MVA diagnosed all cases of malignancy, but endometrial cell sampler missed one case of malignancy. The overall sensitivity, specificity, PPV, and NPV of MVA was 84.5%, 100%, 100%, and 91.2%, respectively. Conclusion: The histopathologic findings of MVA were in good agreement with those of endometrial cell sampler, and MVA had high accuracy for diagnosing endometrial pathology. MVA is suggested as a reliable alternative procedure for endometrial biopsy in women with AUB.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139352149","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 evaluate the outcomes of therapeutic penetrating keratoplasty (TPK) performed for severe fungal keratitis. Materials and Methods: Medical records of all patients who underwent TPK in Siriraj Medical Center between April 2010 and July 2020 were culled, and those in which fungal pathogens were definitively identified were studied. Patient records with follow up less than three months were excluded. Patient demographic data, outcome measures and complications following TPK were recorded. The primary outcome was eradication of the fungal infection. Secondary outcomes were preservation of anatomical integrity, graft survival and achievement of visual acuity (VA) greater than or equal to 3/60. Results: Sixty patients met the study criteria and were included in the analysis. The mean patient age was 56 (range: 23-79) years, and most patients were men (46, 77%). The mean follows up time was 30.87 months (range1.61-122.71). Fifteen eyes (25%) sustained corneal perforation before undergoing TPK. Graft survival was 30% at 1 year, 18% at 5 years, and 11% at 10 years. The most common organism was fusarium (23 patients, 38%). The median duration from presentation to surgery was 14 (8-21) days. Disease eradication was achieved in 44 patients (73%) and VA better than 3/60 was achieved in 14 (23%). Anatomical integrity was maintained in 46 (76%) eyes. Repeat PKP was performed in 15 patients (25%), most commonly for recurrent infection. Conclusion: TPK offers a good chance of disease eradication and maintenance of anatomical globe integrity and is a reasonable therapeutic option in patients with severe fungal infection.
{"title":"Therapeutic Penetrating Keratoplasty for Severe Fungal Keratitis in a Thai Tertiary Care Center","authors":"Sathiya Kengpunpanich, P. Prabhasawat, Chencho Gem, Chareenun Chirapapaisan, Wipawee Booranapong, Panotsom Ngowyutagon","doi":"10.33192/smj.v75i8.261688","DOIUrl":"https://doi.org/10.33192/smj.v75i8.261688","url":null,"abstract":"Objective: To evaluate the outcomes of therapeutic penetrating keratoplasty (TPK) performed for severe fungal keratitis. Materials and Methods: Medical records of all patients who underwent TPK in Siriraj Medical Center between April 2010 and July 2020 were culled, and those in which fungal pathogens were definitively identified were studied. Patient records with follow up less than three months were excluded. Patient demographic data, outcome measures and complications following TPK were recorded. The primary outcome was eradication of the fungal infection. Secondary outcomes were preservation of anatomical integrity, graft survival and achievement of visual acuity (VA) greater than or equal to 3/60. Results: Sixty patients met the study criteria and were included in the analysis. The mean patient age was 56 (range: 23-79) years, and most patients were men (46, 77%). The mean follows up time was 30.87 months (range1.61-122.71). Fifteen eyes (25%) sustained corneal perforation before undergoing TPK. Graft survival was 30% at 1 year, 18% at 5 years, and 11% at 10 years. The most common organism was fusarium (23 patients, 38%). The median duration from presentation to surgery was 14 (8-21) days. Disease eradication was achieved in 44 patients (73%) and VA better than 3/60 was achieved in 14 (23%). Anatomical integrity was maintained in 46 (76%) eyes. Repeat PKP was performed in 15 patients (25%), most commonly for recurrent infection. Conclusion: TPK offers a good chance of disease eradication and maintenance of anatomical globe integrity and is a reasonable therapeutic option in patients with severe fungal infection.","PeriodicalId":37270,"journal":{"name":"Siriraj Medical Journal","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139353055","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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