Burapha Journal of Medicine 2018-08-30T12:02:01+07:00 รศ.พญ.สมจิต พฤกษะริตานนท์ Open Journal Systems <p>&nbsp;&nbsp;&nbsp;&nbsp;คณะแพทยศาสตร์ มหาวิทยาลัยบูรพา ได้จัดทำวารสารบูรพาเวชสาร โดยมีวัตถุประสงค์เพื่อเป็นสื่อกลางในการเผยแพร่ผลงานวิชาการทางการแพทย์ ด้านวิทยาศาสตร์การแพทย์ วิทยาศาสตร์สุขภาพ ด้านสาธารณสุข การศึกษาทางคลินิก และการวิจัยที่ก้าวหน้าทันสมัย ซึ่งบทความที่ตีพิมพ์รับทั้งบทความภาษาไทยและอังกฤษ ออกเผยแพร่ปีละ ๒ ฉบับ (มกราคม - มิถุนายน และ กรกฎาคม - ธันวาคม)</p> Dengue hemorrhagic fever situation in Ban Bueng, Chon Buri Province 2018-08-07T11:09:40+07:00 กาญจนา พิบูลย์ สุรัตน์ ตันศิริ ธรรมวัฒน์ ุปวงษาพัฒน์ <p><strong>bjective</strong> This study aimed to investigate the dengue hemorrhagic fever (DHF) situation in the community of Ban Bueng District, Chon Buri Province.</p> <p><strong>Methods</strong> A sample of 207 households from Moo 1 Nongchak Sub-district, Ban Bueng District, Chon Buri Province were surveyed. A set of standardized questionnaires consisted of dengue hemorrhagic fever awareness, preventive behavior and community participatory prevention. The house index (HI, percentage of houses positive for larvae) and containers index (CI, percentage of containers positive for larvae) were identifiedfor prevalence of dengue fever transmission. The data was analyzed by using descriptive statistics.</p> <p><strong>Results</strong> The research found that almost all of the samples (99.05%) had high levels of dengue hemorrhagic awareness. Half of them (49.80%) had high and moderate levels of dengue hemorrhagic fever preventive behavior and the majority (98.10%) had low level of participation in dengue hemorrhagic fever prevention activities in the community. For the surveillance of vector in the community, it was found that 64.73 percent of houses infested with larvae (HI) and 50 percent of water-holding containers infested with larvae (CI).</p> <p><strong>Conclusion</strong> Along with the higher house index (HI) and container index (CI) than standard criterion, as well as the moderate preventive behavior and low level of community participatory prevention activities, the community would increase a higher risk of DHF transmission. Therefore, the primary data from this study can be used to develop dengue hemorrhagic prevention model in this community.</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## Outcome of quick Sequential (Sepsis-related) Organ Failure Assessment criteria compare with Chachoengsao’s Sepsis Screening criteria in patient with infection at Bangpakong hospital 2018-08-30T12:02:01+07:00 คมกฤช สุทธิฉันท์ มยุรี พิทักษ์ศิลป์ สมจิต พฤกษะริตานนท์ <p><strong>Objective</strong> To compare the mortality rate, referral rate, revisit rate and length of stay in the hospital of sepsis and septic shock patients after diagnosed by quick Sequential (sepsis-related) Organ Failure Assessment criteria (qSOFA) and Chachoengsao’s Sepsis Screening criteria (as standard criteria)</p> <p><strong>Methods</strong> Analytical study with historical control group. Study group (n = 49) were patients who were diagnosed sepsis by qSOFA criteria from January 1 to April 30, 2017, and patients who were diagnosed sepsis by Chachoengsao’s Sepsis Screening criteria from July 1 to December 31, 2016 as historical control group (n = 49). Data was analyzed by proportion different test (Z-test) and Cox regression Breslow method for ties.</p> <p><strong>Results</strong> Mortality rate in the study group was less than historical control group (RD = - 4.87%; 95% CI = -0.14, 0.04). Referral rate in study group was higher than historical control group (RD = 4.08%; 95% CI = -0.12, 0.20), and revisit rate was less than historical group (RD = -5.40%; 95% CI = -0.12, 0.01). All of these were not show statistically significant.The sepsis patients in study group were less likely to be hospitalized significantly(Hazard ratio (HR) = 0.57; 95% CI = 0.35, 0.93, p = 0.026).</p> <p><strong>Conclusion</strong> Sepsis patients whose diagnosed by qSOFA criteria were less likely to be hospitalized than patients those diagnosed by standard criteria. The qSOFA criteria could be decreased the mortality rate and revisit rate, and increased referral rate, but were not show statistically significant</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## Effect of development of trauma system on outcome of major trauma patient in Prachinburi Province 2018-08-07T15:47:08+07:00 ชาติชาย คล้ายสุบรรณ <p><strong>Objective</strong> To determine the effect of development of trauma system on outcome of major trauma patient in Prachinburi Province</p> <p><strong>Methods</strong> A retrospective cohort study was conducted before development, from October 2015 to September 2016, and then after development of trauma system, from October 2016 to September 2017. The outcome measurements were mortality rate, excess mortality (the difference between observed and expected death as measured by the TRISS methodology), and Door to Operating Room (OR) time.</p> <p><strong>Results</strong> A total of 547 patients from the before-development group (BDG), and 668 patients from the after-development group (ADG) were identified.The mortality rate was significantlydecreased from 15.17% to 10.03%, and the average Door to OR time was significantlydeclined from 89.85±20.1 to 72.48±18.2 (p=0.001) in ADG. Z statistic based on TRISS methodology was 3.48 (p&lt;0.001) in BDG and 1.98 (p=0.04) in ADG indicated that both group had excess mortality.</p> <p><strong>Conclusions</strong> Development of trauma system in Prachinburi Province significantlydecreased the mortality rate, and Door to OR time. However, the result of higher observed mortality than expected based on the TRISS methodology suggests that continuous quality improvement is necessary for improving our trauma care.</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## The risk assessment of waste management system from hazardous chemicals in microbiology laboratory 2018-08-07T15:59:54+07:00 นันทวรรณ จินากุล <p><strong>Objective</strong> To identify the hazard and evaluate the risk of chemical waste management in microbiology laboratory, which is used as the guidelines for improving the chemical safety laboratory in Faculty of Pharmacy, Mahidol University.</p> <p><strong>Methods</strong> We evaluated the hazard risks in laboratory using “checklist technique” referenced to ESPReL checklist document focusing on waste management system used in national research universities (NRUs) were evaluated. Moreover, “checklist technique” was also used to evaluate the hazard probability and severity of related situation following the criteria of risk assessment in biological safety guidelines launched by the Center for Occupational Safety, Health and Environment Management (COSHEM), Mahidol University. Finally, we performed risk management plans and related documents (plan for controlling risk level 2 and plan for decreasing risk level 3 and 4) were performed.</p> <p><strong>Results</strong> We found that there was no specificarea for storing waste (risk level 2). The laboratory did not have the proper cabinet for collecting more than 10 gal (38 L) flammablewaste (risk level 4). The standard criteria of the amount of waste accepted for storing in laboratory was not mentioned (risk level 3). Moreover, we did not do reuse and recycle in waste management (risk level 2) and there was no protocol for treating waste before released (risk level 3). All of data collected above were used to announce the risk-controlling and risk-decreasing plan.</p> <p><strong>Conclusion</strong> The short-term plans for reducing and controlling risks are emergency-managing plan, fire-fighteprocedures, chemical spill management, the record of emergency and accidental circumstances, the standard protocols for waste management and providing the proper information for eliminating chemical waste as well as findingout space(s) for centered waste collection. All plans should be evaluated every 3 months. Additionally, the long-term plans are emergency-controlling plan, the critically alert plan, the procedure for calling tree, how to response to critical situation and for procedure saver, launching business continuity plan, conducting the workshop for chemical laboratory safety, the reduction of using and occupying harmful chemicals, the changing of working processes to reduce harmful chemical usage, the recycle of chemicals and emphasizing the best practice of chemical waste management as well&nbsp;as the project for training staff in term of knowledge, understanding and evoking the positive attitude to community and environment.&nbsp;</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## Investigation of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) in street hawker at Bangsaen beach in Chonburi Province 2018-08-07T16:14:31+07:00 ณัฐภาณินี ถนอมศรีเดชชัย พรทิพย อิ่มเกียรติ อ้อมบุญ วังยายฉิม กิตติ เกษมสุข มารุต ตั้งวัฒนาชุลีพร <p><strong>Objective</strong> To determine for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) from palm and after the hand of hawkers stall food at Bangsaen beach, Chonburi provience</p> <p><strong>Method</strong> A hundred and twenty six samples were cultured, identifiedby conventional method and test of antimicrobial susceptibility by disk diffusion method.</p> <p><strong>Results</strong> It was found that methicillin-susceptible Staphylococcus aureus (MSSA) and vancomycin-susceptible Enterococci (VSE) were detected from 1 of 126 samples (0.79%) and 5 of 126 samples (3.97%), respectively.</p> <p><strong>Conclusion</strong> MRSA and VRE were not detected from all of samples. The results of this study did not reveal the distribution of MRSA and VRE among hawkers at Bangsean beach. However, the lacks of presence of MRSA and VRE in from this study do not indicate that its prevalence should be ignored, especially due to its increase in several countries.</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## Survey of health provision by primary care cluster in Tak Province: Expectation, utilization of health service, and satisfaction of the target patients and caregivers 2018-08-07T16:27:57+07:00 วัสนา ศรีวิชัย <p><strong>Background</strong> The 2017 Constitution of the Kingdom of Thailand requires the state to provide public with effective health services. The quality and standards of care must be continually improved. Thus, the Ministry of Health has reformed every levels of health service system. To strengthen primary health care system, primary care clusters (PCC) have been developed throughout the country, including Tak Province. Therefore, monitoring the performance of primary care clusters by developing a survey tool to understand the operational situation is needed.</p> <p><strong>Objectives</strong> To study the performance outcome of primary care clusters in Tak Province and develop a performance appraisal for empowering to ensure the success of this policy.</p> <p><strong>Methods</strong> Survey study using questionnaire was done among target population who were registered with the two initially established PCC in Tak province. The four primary target populations of the PCC project were 1) the home-bound and/or bed-bound elderly or caregivers, 2) the disabled, 3) the chronically ill patients and 4) palliative group or caregivers. Convenience samples were selected during patient care at PCC between March 1, 2018 to April 30, 2018. For bed-bound elderly, disable and palliative group or caregivers were interviewed at home. Questionnaire consisted of personal characteristics of target groups, their health status during past 3 months, caregivers’ opinion, quality and satisfaction of health service using rating scale from 1 point (less satisfy) to 5 points (the most satisfy). The data was analyzed by using descriptive statistics.</p> <p><strong>Results</strong> Most of the samples were elderly female (65.8 %) with dependent status. During the past three months, health status was stable at 51.6 %. They expected to improve their health status at 67.4 %. Chronically ill patients were improved more than 80 %. They satisfiedwith the health services system provided in PCC, and the integrated community/society services at the average of more than 3.5 points.</p> <p><strong>Conclusions</strong> The research revealed that the current Primary Care Cluster and the integrated community/society services in Tak Province can be judged as positive, where, the target groups are moderately to very satisfy with the service provided. It is recommended that the policy of seamless health services in primary care level should further focus its services on patients&nbsp;with chronic diseases, the elderly, caregivers, and the importance of health promotion and disease prevention.</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## Increasing of risk in bone loss among people living with HIV and It principle of nutritional care process 2018-08-07T16:37:06+07:00 อลงกต สิงห์โต <p>&nbsp; &nbsp; People living with HIV (PLHIV) are needed to receiving the antiretroviral drug therapy (ART) to suppress the viral load level for preventing opportunistic infection. Nowadays, most of PLHIV in Thailand can accessed the health care service to receive the ART, however, reports showed that nutritional status of PLHIV can be affected by ARTs side effect. Bone loss, decrease of bone mass density, is the main outcome resulted from ART side effect usually found in PLHIV who receive long term ART. In addition, inadequate intake of calcium according to the guideline was repeatedly report in Thai people. Therefore, PLHIV with ART possibly are higher risk in bone loss than healthy people due to ART side effect. The basic nutritional care process to prevent bone loss is to encourage PLHIV to improve their nutritional habits. PLHIV need consuming food sources of calcium, vitamin D, magnesium, and phosphorus too. The Medical Nutritional Therapy (MNT) process conducted by the registered dietitian to support nutritional status of patients in variety diseases and conditions is one of the alternative way need to consider as using in nutritional support to improve bone health among PLHIV. However, further study is needed to investigate the effective of MNT and length of receiving the MNT to improve bone health among PLHIV.</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## Cataract in diabetes patients 2018-08-07T16:41:54+07:00 ลักษณาพร กรุงไกรเพชร <p>People with diabetes carry a higher risk of blindness more than people without diabetes. The most common causes of visual loss are diabetic retinopathy and cataract. The cataract refers to clouding of the lens of the eye. The cataracts tend to develop earlier in people with diabetes. The lens are situated immediately behind the pupil, which are usually entirely transparent in young people. With advancing age, the lens may become cloudy and vision can be impaired. The previous studies found that the visual acuity of diabetic patients is improved after cataract surgery. Cataract surgery in diabetes patients with minimal or without retinopathy carries the same good prognosis as cataract surgery in people without diabetes. However, diabetic patients have higher complication rate after surgery more than non-diabetic patients.</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement## Association between flat foot and knee pain 2018-08-07T16:48:00+07:00 พิมลพรรณ ทวีการ วรรณจักร คุณาวุฒิ วรรณจักร <p>&nbsp; &nbsp;Flat foot is a very common condition in childhood and older adult. Causes of flatfoot disease include congenital flatfoot and acquired flatfoot. It leads to the biomechanical changing of the ankle, knee, hip joint and back. The effects of flatfoot can cause plantar fasciilitis, heel pain, and ankle tendinitis. It also leads to knee and back pain in the future because it increases load stress on lower extremities including knee joints. Therefore, flatfoot does not only affect on the foot itself, but also other joints. So flatfoot evaluations are important and lead to specifictreatment and exercise for flatfoot. These include correct malalignment in lower extremities and prevent health problems in the future.</p> 2018-08-07T00:00:00+07:00 ##submission.copyrightStatement##