Srinagarind Medical Journal <p>Frequency : in every&nbsp;two months; on February, April, June, August, October&nbsp;and December. Policy is to encourage distribution of scientific information in medical and health sciences. It publishes seven types of article; medical innovation, original article, case report, review article, conference, symposium and letter to editor.</p> Faculty of Medical, Khon Kaen University en-US Srinagarind Medical Journal 0857-3123 Renal Dialysis Refusal in End-Stage Renal Disease Patients Under Universal Health Coverage Scheme in Uttaradit Province <p><strong><u>Background and Objective:</u></strong> Almost half of end-state renal disease patients under universal health coverage scheme in Uttaradit &nbsp;province rejected dialysis despite receiving counseling from the multidisciplinary team from 2015 to 2017, which has been a barrier to treatment. This study aimed to understand patients’ decision making regarding dialysis rejection.</p> <p><strong><u>Methods:</u></strong> A qualitative study was then conducted based on semi-structure in-depth interviews with explanatory model and non-participatory observation with 36 ESRD (End-Stage Renal Disease) patients under universal coverage scheme who rejected dialysis in Kidney Disease Center at Uttaradit hospital during January to March 2018. These data were examined using content analysis.</p> <p><strong><u>Results:</u></strong> Most patients could not describe chronic kidney disease and dialysis based on biomedical knowledge. However, patients had a model of thinking, definition and the decision to reject dialysis based on their beliefs, experience and individual context. There were five explanatory models, which were; dialysis indicated impending death, dialysis made independent life impossible, dialysis reduced the ability to care for their family, dialysis was a shackle, and dialysis decreased the remaining quality of life.</p> <p><strong><u>Conclusion:</u></strong>&nbsp; Patients’ view, dialysis is not just a treatment but it is liked to living and context with constraints. So the multidisciplinary team should understand, respect the decision of the patients and treat patients holistically.</p> Apiradee Apiwatnakorn Sasitorn Chaiprasitti ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 546 551 The Impact of Self-Management Support by a Multidisciplinary Team on Delaying Chronic Kidney Disease Progression in Primary Care, Khon Kaen Regional Hospital <p><strong><u>Background and Objective</u></strong><strong>: </strong>Chronic kidney disease (CKD), a global health problem issue, remains associated with high morbidity and mortality. This study aimed to study the effects of self-management support by multidisciplinary teams to delay chronic kidney disease.</p> <p><strong><u>Methods:</u></strong> This was a quasi-experimental research. One group was tested before and after the experiment. The study group were 100 CKD stages II–IV patients which randomized into self-management support by a multidisciplinary team and followed up for 12 months. The program consisted of problem solving, held experience-sharing sessions based on case studies, changing food consumption behavior, rational drug use, exercise, and home visits to encourage individual empowerment. The data-collecting instruments were self-management behavior interview and clinical outcomes. The data were analyzed using descriptive statistics and paired t-test.</p> <p><strong><u>Results</u></strong><strong>:</strong> &nbsp;The mean age of participants was 69.71 years. The <em>comorbidities</em> were&nbsp;44.21 % of <em>diabetes mellitus</em> with hypertension<em>. </em>After the program, the participants had an average score of self-management behavior and estimated glomerular filtration rate increased significantly at the level of p &lt;.05 (57.39, 51.68 ml/min/1.73 m<sup>2</sup>). In addition, the average blood pressure level was lower than before the experiment with statistical significance at p &lt;.05 (127.92 / 71.02, 136.32 / 75.20 mm Hg). &nbsp;However, BMI and waist circumference were not <em>different (p&gt;.05). </em></p> <p><strong><u>Conclusion</u></strong><strong>:</strong> Self-management support by a multidisciplinary team helps improve clinical outcomes for CKD patients.</p> Paisarn Trisirichok Langporn Uttarasart Waratip Kankarn ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 552 558 The Outcome of Glomerular Disease Treatment after Kidney Biopsy at Roi Et Hospital, Roi Et Province, Thailand <p><strong><u>Background and Objective:</u></strong> Chronic kidney disease is a major public health problem in Thailand and trend to be increasing every year. Patients with chronic kidney disease have to pay a big amount of budget for treatment each year. The objective of this study was to study the effectiveness of treatment of patients with glomerular disease by considered kidney biopsy pathology reported, patients clinical, and laboratory blood and urine examination reports.&nbsp;</p> <p><strong><u>Methods</u></strong><strong>:</strong> This study were collected data from medical records of 38 patients with glomerular disease and got kidney biopsy and treatment at Roi Et hospital during January 1, 2015 to December 31, 2018 and considered for kidney biopsy pathology reported, patients clinical, and laboratory blood and urine examination reports.&nbsp; Statistical analyses were used descriptive statistics and paired t-test.</p> <p><strong><u>Results:</u></strong> Of 38 cases most of them were male 68.31 %, mean age 38. 37±15.54, body mass index between 18.5-22.9 kg/m<sup>2</sup> (50.00%), diabetes mellitus 42.11%, &nbsp;and hypertension 20.15%. Most of &nbsp;pathological reported were Lupus nephritis class IV 18.42%, and Immunoglobulin A nephropathy18.42%. &nbsp;After 6 months of &nbsp;surgery follow up the results showed that the found Creatinine mean was 1.11± 2.47 mg/dl, Estimated glomerular filtration rate (eGFR) mean was 74.59±42.18, &nbsp;Albumin mean was 3.66±0.75 mg/dl, Cholesterols mean was 203.13±75.67 mg/dl and Urine protein to creatinine ratio (UPCR) mean was 1.20±1.97g/gCr. The comparison of blood chemical tests between before and after 6 months surgery cholesterols level was found decreased significantly (p &lt;0.001).</p> <p><strong><u>Conclusion:</u></strong> Overall patients with glomerular disease after treatment were clinical getting better and after 6 months of surgery cholesterols level was significantly decreases.</p> Surachat Jaroonpipatkul Narongchai Sangsa Nuntiput Putthanachote ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 559 564 Radiation Dose and Dose Distribution from Fluoroscopy: Phantom Study <p><strong><u>Background and Objective:</u></strong> Knowing the level of radiation dose will be a radiation protection guideline for patients and staffs. The purposes of this study were to define a conversion factor for optically stimulated luminescence (OSL) dosimeters and to measure the skin equivalent dose from four fluoroscopic techniques; barium swallow (BS), upper GI (UGI), barium enema (BE) and voiding cystourethrography (VCUG). The charts of radiation dose distribution from fluoroscope were plotted.</p> <p><strong><u>Methods:</u></strong> OSL dosimeters were attached on the phantom and irradiated with different x-ray energies. The conversion factors were calculated. Then, OSL dosimeters were placed on the organs of Rando phantom to measure the radiation equivalent dose. Finally, OSL dosimeters were placed on the column surrounding the fluoroscope to measure the scattered radiation.</p> <p><strong><u>Results:</u></strong> The relationship between energy and count was follow the equation y = 126531e<sup>-0.0151x</sup>. The highest skin equivalent doses were at abdomen (18 mSv) from barium enema technique, breast received the radiation dose at 8 mSv from barium swallow examination and the radiation dose of 17 mSv from upper gastrointestinal study. The voiding cystourethrography produced the highest radiation dose to uterus at 12 mSv. Moreover, the highest scattered radiations were from the middle of couch.</p> <p><strong><u>Conclusions:</u></strong> Knowing the radiation dose at radiosensitive organs, such as eye lens and thyroids, help the staffs to aware of the danger of exposing to radiation. Radiation staffs can avoid the high radiation area and the use of radiation protection can reduce the radiation.</p> Thanatip Chandaeng Kemiga Kuepitak Panatsada Awikunprasert Vithit Pungkun Jittiporn Kianprasit ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 565 573 The Three-Dimensional Modeling from Computed Tomography Images by Three-Dimensional Printing <p><strong><u>Background and Objective</u></strong><strong>: </strong>The 3D printing could be applicable in many fields. In this study, 3D models were constructed and printed according to size and shape of acrylic phantom. This study aimed to test the accuracy of 3D modeling for 3D printing.</p> <p><strong><u>Methods</u></strong><strong>: </strong>The acrylic phantom was scanned by CT equipment storing data in a DICOM image format. Then the 3D model was created for 3D printing. Evaluate the results from the 3D model printed against the acrylic phantom, by assessing shape and size with sighting and measuring the width, length and height of each layer, and compare the differences by percent error.</p> <p><strong><u>Results</u></strong><strong>: </strong>When visual assessment was performed, the 3D model and acrylic phantom, had &nbsp;the same size and shape. And the width, length, and height of each layer had a percent error less than 2 percent.</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> In this study, to create and print 3D models had a size and shape expectation of less than 2 percent, error.</p> Por.Nopparat Thedpitak ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 574 577 Effects of the Eye-Hand Co-ordination Exercise with Modern Music on Fitness Balance based of Elderly People <p><strong><u>Background and Objective:</u></strong><strong>&nbsp;</strong>The elderly people has a deterioration of &nbsp;physical performance of the body, especially the balance which is one of the risk factors for falls in the elderly. The exercise will be one of the factors that could help protect falls, so the elderly must do exercise continuously and in an appropriate length of time. The researcher has created a safe exercise program that can be performed in every area, saving and having fun. Therefore, the purpose of this study was to compare balance ability of the elderly between the experimental and the control group.</p> <p><strong><u>Method:</u></strong><strong>&nbsp;</strong> This study was the quasi-experimental design,&nbsp;and the 60 healthy elderly, whose ages are between 60-69 years old, were divided into the experimental and control groups by 30 elderly in each group. The experimental group received&nbsp;the training of the eye-hand coordination exercise with modern music for 12 weeks&nbsp;while the control group live normally. Both groups had balance tests including 8-Foot Up-and-Go Test. The elderly were tested before training, after 6-week training and after 12-week training. The two-way repeated measures ANOVA&nbsp;was used to analyze the data.</p> <p><strong><u>Results:</u></strong><strong>&nbsp;</strong>It was found that the balance ability resulted from the 8-Foot Up-and-Go Test between the experimental and the control groups had the average scores at the significant different&nbsp;(F =&nbsp;13.95, p &lt;&nbsp;0.05).&nbsp;Moreover, the average scores of before training, after 6-week training and 12-week training were significantly different at the level of 0.05 (F = 33.95, p &lt;0.05), so it can be mentioned that the experimental group had better balance development than the control group.&nbsp; The variables of &nbsp;times and groups were statistical significance correlated (F = 19.18, p &lt;0.05).</p> <p><strong><u>Conclusion:</u></strong><strong>&nbsp;</strong>The training of the eye-hand coordination exercise with modern music for 12 weeks&nbsp;can increase the balance of movable and immovable abilities properly.</p> Austtasit Chainarong Chulaporn Sota ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 584 589 Anti-Hemorrhoidal Activity of Pluchea indica Leaves Aqueous Extract in Croton Oil-Induced Hemorrhoids in Experimental Animals <p><strong><u>Background and Objective:</u></strong> <em>Pluchea indica</em> (L.) Less (“Khlu” in Thai) is traditionally used as a folk medicine for the treatment of many diseases and <em>Pluchea indica</em> leaves tea is quite famous and used to help cure hemorrhoids without any scientific evidences. This study focuses on the investigation of the effects of aqueous extract of <em>Pluchea indica</em> leaves on the movement of gastrointestinal tract in mice and the croton oil-induced hemorrhoid in rats.</p> <p><strong><u>Methods:</u></strong> The effects of <em>Pluchea indica</em> leaves aqueous extract<strong> (</strong>PIE<strong>) </strong>at the doses of 50, 100 or 150 mg<strong>/</strong>kg on whole gut transit time and intestinal transit rate in male ICR mice were tested using the charcoal test. Male Wistar rats were forced fed with PIE at 50 mg/kg/day once daily for 10 consecutive days. On day 5, the animals were induced to be hemorrhoids by inserted cotton bud swab soaked with cotton oil preparation (100 μl) into the anus.&nbsp; Rats were killed on day 11, anus and spleens are removed and weighed and macroscopic changes of the rectum were observed.</p> <p><strong><u>Results:</u></strong> Oral administration of PIE at either 50, 100 or 150 mg<strong>/</strong>kg had no effect on whole gut transit time or intestinal transit rate in mice<strong>. </strong>PIE at 50 mg<strong>/</strong>kg<strong>/</strong>day could significantly attenuate the severity of the croton oil<strong>-</strong>induced hemorrhoids in rats as seen by a significant reduction of spleen and rectum weights and the severity of the rectal damage was significantly reduced<strong>. &nbsp;</strong></p> <p><strong><u>Conclusions:</u></strong> The result of this study supported the effectiveness of the traditional use of <em>Pluchea indica</em> leaves tea in the treatment of hemorrhoids. However, at the doses tested, no effect on the gastrointestinal movement was seen.</p> Koneouma Senvorasinh Kutcharin Phunikhom Jintana Sattayasai ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 590 594 The Guardian’s Beliefs on Psychotropic Medications Adherence of Autistic Pediatric Patients <p><strong><u>Background and Objectives:</u></strong><strong> &nbsp;</strong>Patient adherence and factors related to adherence directly and indirectly affect treatment of autistic pediatric patient.&nbsp; <strong>&nbsp;</strong>The aims of this research were to identify the adherence level of psychotropic medications in autistic patients and factors affecting patient adherence to psychotropic medications.</p> <p><strong><u>Methodology:</u></strong> A cross-sectional descriptive study was conducted in guardians of patients with Autism Spectrum Disorder (ASD) who attended psychiatric out-patient clinic at Srinagarind hospital during January to August 2017. The instruments consisted of 1) general information of guardians 2) general information of autistic patients 3) Medication Taking Behavior in Thai (MTB-Thai) which had Cronbach’s alpha coefficient at 0.62&nbsp; 4) Beliefs about medicines questionnaire (BMQ) which had Cronbach’s alpha coefficient 0.73 &nbsp;5.) Electronic Data Capture and Coding Tool for Medication Regimen Complexity program. Data were analyzed by Mann-Whitney U test, Spearman’s rho correlation and multiple logistic regression.</p> <p><strong><u>Results:</u></strong> There were 106 guardians included in this study. Most guardians were female (79.2%), the average age was 42.7 ± 8.9 years old, mother (73.6%), completed bachelor's degree (50.9%), government officers/state enterprise officers (32.1%) and married (75.5%). In term of medication adherence, 61 guardians (57.5%) showed high level and 29 guardians (27.4%) showed medium level of medication adherence.&nbsp; The major causes of medication adherence were due to the unintentional behaviors such as forgetfulness.&nbsp; General-Harm scale of belief about medication had significantly negative correlation with medication adherence (r<sub>s</sub>=-0.295, p=0.016).&nbsp; &nbsp;Guardians who don’t believe in the harm of medicine will have a significantly higher score in medication adherence than those who have such beliefs (p = 0.049). Whereas other factors were not significantly correlation.</p> <p><strong><u>Conclusions</u></strong><u>:</u> 57.5% of the guardians had adherence score in high level. General-Harm scale of belief about medication is the factor that affect adherence score significantly. Long-term study should be done to be a further study to identify other causes and factors.</p> Nungruthai Sooksai Theera Rittirod Niramol Pachanasoontorn Somjit Maneekanonta Nilawan Chaiyo Spapitch Samtong Raviwan Pienwittayapun Chernporn Navanukraw ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 595 601 The Effect of α-Galactosylceramide, Specific Antigen for iNKT Cells, on Cytokine Profiles in BALB/c Mice <p><strong><u>Background and Objective:</u></strong> Invariant natural killer T (iNKT) cells are T cells subset that can secrete various cytokines respond to lipid or glycolipid antigens presented by CD1d on antigen presenting cells. α-Galactosylceramide (α-GalCer), the specific antigen for iNKT cells, can activate iNKT cells to secrete both proinflammatory and regulatory cytokines to activate the other immune cells. This study aimed to investigate the kinetic of cytokines in BALB/c mice at several time points after α-GalCer injection.</p> <p><strong><u>Methods:</u></strong> BALB/c mice were intraperitoneal injected with 1µg of α-GalCer per mouse and collected the blood samples at time points 1, 2, 4, 6, 12 and 24 hours post-injection. The samples were determined the cytokine levels by Cytometric Bead Array.</p> <p><strong><u>Results:</u></strong> GM-CSF, IFN-γ and IL-4 were the major cytokines detected in high levels in the early time point. IFN-γ was the highest cytokine levels. IL-10, IL-13 and IL-17A were low levels at the early time points and increased at the late time points. However, the levels were not high when compared to major cytokines.</p> <p><strong><u>Conclusions:</u></strong> The consequence after single dose injection of α-GalCer in BALB/c mice showed the cytokines kinetic in each time-point and IFN-γ was the highest detectable cytokine. From the cytokine kinetic studied, this experiment is an alternative model could be used as data for the α-GalCer experimental design in various diseases.</p> Thitinan Kasetthat Rasana W. Sermswan Hiroshi Watarai Surasakdi Wongratanacheewin ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 602 607 Tangeretin Alleviates L-NAME Induced Vascular Dysfunction in Rats <p><strong><u>Background and Objective:</u></strong> Tangeretin is a flavonoid compound found in citrus fruits.&nbsp; Several biological activities of tangeretin have been revealed including; anti-neurodegeneration, anti-inflammation, and anti-oxidation. This study was to investigate the effects of tangeretin on vascular function in L-NAME-treated rats.&nbsp;</p> <p><strong><u>Methods:</u></strong> Rats were divided into 4 groups. Groups I; rats treated with L-NAME (40 mg/kg) in drinking water only, Groups II and III; rats treated with L-NAME together with tangeretin (15 and 30 mg/kg, respectively), Groups IV; &nbsp;control rats were received only distilled water (n=7/each group). At the end of experiment, vascular responses to electrical field stimulation (EFS) and vasoactive agents in mesenteric vascular beds and aortic rings were evaluated.</p> <p><strong><u>Results:</u></strong> A significant increase in contractile response to electrical EFS was observed in the mesenteric vascular bed isolated from L-NAME-treated rats (p&lt;0.05).&nbsp; Tangeretin reduced the augmented response to EFS in L-NAME-treated rats comparing to those of untreated rats (p&lt;0.05).&nbsp; However, the contractile response to exogenous norepinephrine was not different among groups.&nbsp; Vasorelaxation responses to acetylcholine (ACh) in the mesenteric vascular beds and aortic rings were significantly blunted in L-NAME-treated rats compared to control rats (p&lt;0.05).&nbsp; Treatment with tangeretin improved the vasorelaxation response to ACh in L-NAME-treated rats compared to untreated rats (p&lt;0.05).&nbsp; There was no significant difference in the</p> <p>vasorelaxation responses to sodium nitroprusside among groups.</p> <p><strong><u>Conclusions:</u></strong> The results of this study indicated that tangeretin suppresses sympathetic nerve mediated contractile response and improves endothelium-dependent vasorelaxtion in L-NAME-treated rats. &nbsp;</p> Chutamas Wunpathe Putcharawipa Maneesai Sarawoot Bunbupha Thewarid Berkban Parichat Prachaney Upa Kukongviriyapan Poungrat Pakdeechote ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 608 613 Whole Grain Essential Oil Reduces Blood Pressure by Increasing Nitric Oxide Level and Alleviating Oxidative Stress in Nitric Oxide Deficient Hypertensive Rats <p><strong><u>Background and Objective</u></strong><strong>:</strong> Hypertension is the important risk factor for cardiovascular disease (CVD). Oxidative stress is associated with the development of hypertension. Consumption of dietary antioxidants appears to decrease blood pressure, improve endothelial function and reduce the risk of CVD. Whole grain essential oil (WEO) possesses strong antioxidant property and has been reported to reduce the CVD risk. This study aimed to evaluate the antihypertensive property of WEO using a rat model of nitric oxide (NO) deficiency hypertension.&nbsp;&nbsp;&nbsp;&nbsp;</p> <p><strong><u>Methods</u></strong><strong>: </strong>Male Sprague-Dawley rats received a nitric oxide synthase (NOS) inhibitor, N<sup>ω</sup>-nitro-L-arginine methyl ester (L-NAME) at dose of 50 mg/kg/day in drinking water for 3 weeks. WEO (1 or 2 ml/kg/day) were intragastrically administered during L-NAME administration.</p> <p><strong><u>Results</u></strong><strong>:</strong> A markedly increased arterial blood pressure, elevated hindlimb vascular resistance and decreased hindlimb blood flow were found in L-NAME-induced hypertensive rats (p &lt; 0.05). Enhanced vascular superoxide production, increased oxidative stress and decreased NO metabolites (NOx) levels were also found in L-NAME-treated rats. Concurrent treatment with WEO resulted in a dose-dependent improved hemodynamic status and significantly reversed the L-NAME-induced oxidative stress and suppression of NO production (p &lt; 0.05).</p> <p><strong><u>Conclusions</u></strong><strong>:</strong> The data revealed that WEO is an effective antioxidant that helps to reduce high blood pressure. The antihypertensive effects of WEO are likely to be mediated by increasing antioxidant activities and restoring NO bioavailability.</p> Gulladawan Jan-on Ketmanee Senaphan Weerapon Sangartit Poungrat Pakdeechote ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 614 619 Oral Status and Oral Health Behavior among Health Personnel in Suwannakuha District Nongbualamphu Province <p><strong><u>Background and objectives</u></strong><strong>:</strong> Health personnel are the person who provide treatment, provide health advice to the public and be the role model of health. Therefore, health personnel should have appropriate health behavior and proper oral status. This study aimed to explore oral status, oral health behavior and factors related to oral health behavior of health personnel in Suwannakuha district, Nongbualamphu province.</p> <p><strong><u>Methods</u></strong><strong>:</strong> This cross-sectional descriptive study was conducted among health personnel in Suwannakuha district, Nongbualamphu province from May to October 2018. Samples were drawn by stratified random sampling according to occupational characteristics. Oral health status, oral health behavior and factors were collected using the questionnaires created by the researchers. Data were analyzed by using frequency, percentage, mean and standard deviation. Chi-square and independent t-test statistics were used to analyze relationship between the factors and oral health behavior.</p> <p><strong><u>Results</u></strong><strong>:</strong> From 177 health personnel, about 1/3 had extracted the functional tooth, more than 1/3 had dental caries and more than 3/5 had periodontitis. 75% of health personnel had inappropriate dental check-up behavior, 57% had inappropriate oral hygiene care behavior and 41% had inappropriate eating/teeth- misuse behavior. The results showed that oral health attitude and occupational characteristics were related to all 3 behavior. Oral health knowledge was related to dental check-up and oral hygiene care behavior. Oral self-perception and health leadership values ​​were related to oral hygiene care and eating/teeth-misuse behavior. Duty in providing oral health advice was related to dental check-up behavior.</p> <p><strong><u>Conclusion</u></strong><strong>:</strong> Health personnel in Suwannakuha district Nongbualamphu province should receive dental treatment and promoting oral health behavior by changing attitudes, providing oral health knowledge, raise awareness of their own oral health perception, supporting health leadership values ​​and duty in providing oral health advice. Promoting oral health behavior should consider the differences in the occupational characteristics of personnel as well.</p> Alisa Tirarattanasompoch Pirasut Rodanant Komsun Lapauthaya ##submission.copyrightStatement## 2019-11-13 2019-11-13 34 6 620 627 Effectiveness of Artificial Cheeks for Bag Mask Ventilation in Elderly Patients Receiving General Anesthesia <p><strong><u>Background and Objective</u></strong>: Lack of teeth and sunken cheeks could cause bag-mask ventilation difficulty in anesthetized elderly patients &nbsp;because of inadequate air-tight seal. Those are the reason why we invented artificial cheeks to solve the problems. The purposes of this study were to evaluate the effectiveness of using artificial cheeks during bag-mask ventilation.</p> <p><strong><u>Methods</u></strong><strong>:</strong> The process of &nbsp;investigation were divided into 3 steps. First step was artificial cheeks invention. Second step was the devices &nbsp;application for with patients, and third step was evaluation &nbsp;by using questionnaire from anesthesia personnels who had used artificial cheeks. The respondents were asked to evaluate all 6 aspects; 1) good sealness 2) easy to ventilate 3) convenience to use &nbsp;4) easy cleanness &nbsp;5) easy storage and 6) overall satisfaction. The evaluated&nbsp; scales included the followings; 4&nbsp; =&nbsp; excellent, 3 = good, 2 = fair, 1 = poor. The sample size calculation was based on the effectiveness of using artificial cheeks of at least 90 %, so the total sample size was 40.</p> <p><strong><u>Results</u></strong>: The overall score of effective assessment (80-90%) evaluated by respondents was 3.2-3.25. The average of &nbsp;highest score of all aspects (&gt;90%) was easy cleanness 3.7-3.9 &nbsp;whereas the average of&nbsp; lowest score was &nbsp;good sealness (3.2).&nbsp;</p> <p><strong><u>Conclusion</u></strong>: The effectiveness of using artificial cheeks for bag-mask ventilation in elderly patients were moderate to high. &nbsp;The artificial cheeks can be used to assist bag-mask ventilation in anesthetized elderly patient.</p> Bussarin Sriyanaluk Niranuch Siripunt Maliwan Oofuvong ##submission.copyrightStatement## 2019-11-18 2019-11-18 34 6 578 583 Comparison of Prevalence of Liver Fluke Infection, Knowledge and Prevention Behavior between Risk Groups of Rural and Urban Community Around Water Reservoir Area <p><strong><u>Principle and Objectives:</u></strong> The increasing of incidence of liver fluke infection was found due to food consumption behavior factor which related to insufficient knowledge and different of social-cultural characteristics. Therefore, comparison of the prevalence of liver fluke infection, knowledge and prevention behavior between risk groups of &nbsp;rural and urban community around water reservoir area&nbsp; were studied.</p> <p><strong><u>Method:</u></strong>&nbsp; Cross-sectional analytical study was used in people aged 40 years old and above, the sample size was calculated by proportional estimate equation with 101 people in each group. The data was collected by questionnaire. Kato's thick smear technique was applied for liver fluke infection test. The chi square test was used in this research with OR, 95% CI OR</p> <p><strong><u>Results:</u></strong> Most of the participants in both groups were men with age between 40-49 yrs. with marital status and had elementary education. The average monthly incomes lower than 3,000 baht per month and worked in agricultural. Most of them used to eat fish the community reservoir, used to check liver fluke infection in 3 years and used to eat risk foods. The comparison of the prevalence, knowledge and risk behaviors associated with liver fluke infection was found significantly different at p= .015, .035 and &lt;.001, respectively. The results revealed that&nbsp;the prevalence and risk behavior of liver fluke infection in the risk group of urban community was lower than rural community but the knowledge was higher than rural community.</p> <p><strong><u>Conclusions:</u></strong> the prevalence and risk behavior of liver fluke infection in the risk group of rural area was higher than the risk group in the urban area but the knowledge was lower. Therefore, promoting of knowledge and activities to change the risk behaviors of liver fluke infection among the people lives in rural community around water reservoir area shoud be performed.</p> Prasert Prasomruk ##submission.copyrightStatement## 2019-11-18 2019-11-18 34 6 628 634 Risk Management of Anesthetic Nurses for Patients undergoing Anesthesia in Songklanagarind Hospital <p><strong><u>Background and Objective</u></strong>: Proper risks management could reduce the incident of adverse events that may occur to patients who have anesthesia. The purposes of this prospective descriptive study were to examine&nbsp; levels of perception in risk management of anesthetic nurses for patients undergoing anesthesia in Songklanagarind hospital.</p> <p><strong><u>Methods:</u></strong> A total of 62 anesthetic nurses working in Songklanagarind hospital more than 1 year were recruited. The questionnaires were constructed by the researchers. The questionnaires&nbsp; were consisted of 2 parts: anesthetic nurses demographic data and level of perception in risk management of patients undergoing anesthesia, The questionnaires were validated by three experts, yielding content validity indiced of 0.88 and 0.89 respectively, and&nbsp; was examined using Cronbach’s alpha coefficient giving values of 0.97 and 0.94, respectively.</p> <p><strong><u>Results:</u></strong> The overall mean total score of anesthetic nurses in risk management for patients undergoing anesthesia was in an excellent level (4.65 ± 0.37) whereas the risk management for adverse event was in good level (4.41 ± 0.50).</p> <p><strong><u>Conclusion: </u></strong>The overall perception of anesthetic nurses in risk management including risk management of adverse event&nbsp; was excellent and might be related with the quality improvement of patient safety during anesthesia</p> Nussara Dilokrattanaphichit Wipharat Juthasantikul Pannipa Phakam Maliwan Oofuvong ##submission.copyrightStatement## 2019-11-18 2019-11-18 34 6 535 641 Body Tanpura Therapy : An Alternative Music Instrumental Therapy for Taking Care of the End–stage Patients <p>Music Therapy is one of the disciplines that has been used in taking care of the end of life patients since 1970, and it has been accepted worldwide currently. The Body Tanpura is an instrument that was applied from “Tanpura”, the ancient India music instruments. It was developed in respect to the requirement of a German music therapist who used it in providing music therapy to the coma patients that have to stay in bed.&nbsp;&nbsp;&nbsp;</p> <p>Results of research studies have revealed that the use of Body Tanpura in music therapy had positive impacts on physical health and mental health of the patients. It made the patients felt relax, calm, stimulated blood circulation, encourage positive mood, decrease depression symptom, and create the will to live. The use of this instrument also helped reduce the tension among the patient’s relatives with others.</p> <p>The effectiveness of the Body Tanpura has made this instrument an interesting choice for worldwide music therapist. Moreover, the idea of modifying Tanpura to be appropriate with the patients’ body, can be an inspiration and a sparking of the idea for Thai therapists in adjusting Thai musical instruments to be appropriate in providing therapy to the patient. This adaptation may encourage better result in the music therapy, as well as, will help extend the knowledge of the music therapy science in the future.&nbsp;</p> Vich Boonrod ##submission.copyrightStatement## 2019-11-18 2019-11-18 34 6 642 648 Occupational Health Hazards among Solid Waste Collectors and Prevention <p>Solid waste collectors (SWCs) is an occupation that has risk of being exposed to health threats from various factors including health risk factors such as physical, chemical, biological, biomechanics injury and psychosocial hazards from working environment. Since, SWCs contribute to the handling, lifting, pouring waste containers and separate in the rear of the trucks through their daily collection work, as well as vehicle trucks maintenance. In addition, if solid waste collectors lack of knowledge, awareness, carelessness, the over working periods per weeks and non-personal protective equipment. As a result, it may be also cause injury&nbsp; and health symptoms. Hence, this review article focuses on explain about the occupational health hazard in environment workplace and preventions of themselves can be benefit for local administration governance’s participatory training approaches to prevent and reduce health risks and safety in their work.</p> Sarawut Sangkham Chumlong Arunlertaree ##submission.copyrightStatement## 2019-11-18 2019-11-18 34 6 649 657