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> en-US (Pote Sriboonlue) (Sompong Chantakram) Mon, 23 Sep 2019 13:50:56 +0700 OJS 60 Laparoscopic Radical Prostatectomy: Initial Experience in Srinagarind Hospital <p><strong><u>Background and objective:</u></strong> The standard treatment for clinically localized prostate cancer is surgery, radical prostatectomy. With the gaining acceptance of minimally invasive surgery, laparoscopic radical prostatectomy (LRP) has been determined to be an effective procedure in an experienced surgeon's hands. This study reported initial experience of LRP in Srinagarind hospital.</p> <p><strong><u>Methods:</u></strong> &nbsp;Medical records of 20 patients with clinically localized prostate cancer who underwent LRP by a single urologist in Srinagarind hospital between October 2016 to February 2019 were retrospectively reviewed. Patient characteristics, operative and peri-operative details, post-operative complications, and oncological outcomes were assessed.</p> <p><strong><u>Results:</u></strong> The median age was 67.5 years (57-76). The mean pre-operative prostate specific antigen level was 14.1 ng/mL (6-39). Seven patients were treated with GnRH agonist before the operation. The median operative time and blood loss were 180 min (120-330) and 400 ml (100-2000), respectively. Only one operation had to be converted &nbsp;to open surgery as a result of hemodynamic instability. The median hospital stay was 5 days and no one had to be readmitted. Fourteen patients (70%) were margin negative in the pathological specimen.</p> <p><strong><u>Conclusion:</u></strong> From this preliminary study, LRP is safe and feasible, with acceptable oncological outcomes for early prostate cancer in Srinagarind hospital.</p> Wichien Sirithanaphol, Ukrit Rompsaithong, Pakorn Kiatsopit, Supanut Lumbiganon, Kachit Pachirat ##submission.copyrightStatement## Thu, 19 Sep 2019 00:00:00 +0700 Laparoscopic Myomectomy Outcomes: an Experience in Srinagarind Hospital <p><strong><u>Objective</u></strong><u>:</u> To evaluate the intraoperative and postoperative outcomes of laparoscopic myomectomy in Srinagarind Hospital.</p> <p><strong><u>Methods</u></strong><u>:</u> Retrospective data regarding laparoscopic myomectomy were collected between July 2018 and June 2019 from the hospital operating room records and the histopathology database. We found records of 11 women who had undergone laparoscopic myomectomy using a similar technique and examined their demographic data (age, body weight, height, parity), presenting symptoms, preoperative GnRH agonist used, and operative details such as type and number of myomas, size of the largest myoma, and perioperative and postoperative outcomes.</p> <p><strong><u>Results:</u></strong> The mean age <u>+</u> SD and mean BMI <u>+</u> SD were 35.5 <u>+</u> 5.1 years and 22.7 <u>+</u> 3.7 kg/m<sup>2</sup>, respectively. The most common indications were hypermenorrhea and dysmenorrhea/pelvic pain. The procedure was completed laparoscopically in 10 of the 11 women (90.9%). The mean amount of intra-operative blood loss <u>+</u> SD and the mean operative time <u>+</u> SD were 320.0 <u>+</u> 249.8 ml. and 155.4 <u>+</u> 23.4 minutes, respectively. The median length of postoperative hospital stay was 3 days (IQ 3-4). No postoperative complications, such as surgical site infection, urinary tract infection, pulmonary complications, cardiac complications, or reoperation, were noted. One of the patients became pregnant after the procedure (9.1%)</p> <p><strong><u>Conclusions</u></strong><u>:</u> Laparoscopic myomectomy is a minimally invasive procedure that requires advanced skills. Preoperative evaluation is important in deciding the type of procedure to be performed. In our experience, laparoscopic myomectomy is safe and is effective in preserving the uterus.&nbsp;</p> Amornrat Temtanakitpaisan, Teerayut Temtanakitpaisan ##submission.copyrightStatement## Thu, 19 Sep 2019 00:00:00 +0700 Development of Using Alberta Stroke Program Early CT Score (ASPECTS) in Acute Ischemic Stroke Patients Yasothon Hospital <p><strong><u>Background and Objective:</u></strong> &nbsp;Stroke is a health problem and major cause of disability and death worldwide. Computed tomography (CT) of the brain is importance for evaluate acute ischemic stroke patients. The aimed of this study was to develop guideline of using CT images by Alberta Stroke Program Early CT Score (ASPECTS ) in acute ischemic stroke patients in Stroke Fast Track.</p> <p><strong><u>Method:</u></strong> This research and development study was performed in Yasothon hospital. There were three phases of study.&nbsp; Phase 1: Reviewed medical records and CT images of the brain in acute ischemic stroke from January-June 2018 in Stroke Fast Track of 120 patients. Phase 2: Develop guideline of using ASPECTS in patients and trial in January-March 2019 of 72 patients&nbsp; by 14 interns &nbsp;and 7 internists who conducted activities according to the development guideline. Phase 3: Evaluate the post test of development guideline.</p> <p><strong><u>Result:</u></strong> Reviewing of data revealed median of CT initiation and CT interpretation time was 29 minutes which longer than the goal according to the American Heart Association/ American Stroke Association (AHA/ASA) treatment guideline. Median of Door to CT interpretation time was 36 minutes. The Better ASPECTS group had severity and stroke outcome at discharge better than the Worse ASPECTS group it was statistically significant. Group of Hyperdense MCA sign had worse stroke outcome. Post test according to development guideline revealed good concordance between radiologists and interns (ICC=0.820, 95% CI=0.712-0.887). CT initiation and CT interpretation Door to CT interpretation was statistically significant lower than before development. The most opinions of interns and internist for the development were at a high level and the most.</p> <p><strong><u>Conclusion:</u></strong> Development of using ASPECTS in acute ischemic stroke patients improved examination time and interpretation of radiology .There was CT&nbsp; interpretation guideline in acute ischemic stroke . The relevant personnel agreement with the development were at a high level and &nbsp;the most.</p> Anintita Pornmanee, Luxanawadee Mahiwan ##submission.copyrightStatement## Thu, 19 Sep 2019 00:00:00 +0700 Assessment of Central Arterial Stiffness in Healthy Thais by Non-invasive Technique <p><strong><u>Background and Objective:</u></strong> Central arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. Carotid-femoral pulse wave velocity (cfPWV) is regarded as the gold standard marker of central arterial stiffening. However, there is limited information available on the values of cfPWV in Thai population. Therefore, the current study aimed to measure the normal values of cfPWV in healthy Thais.</p> <p><strong><u>Methods:</u></strong> A total of 163 identified healthy subjects (82 female, 81 male), aged 20-60 years were recruited in this study. The subjects were divided into 4 age groups with 10-year intervals. Blood pressures of peripheral and central arteries and cfPWV were measured non-invasively by using the applanation tonometry.</p> <p><strong><u>Results:</u></strong> The systolic blood pressure and pulse pressure of central artery increased progressively with age. The mean values of cfPWV in men and women were increased with age. Moreover, cfPWV was correlated with age and central blood pressure.&nbsp;</p> <p><strong><u>Conclusion:</u></strong> The present study provides normal values of cfPWV in healthy, normotensive and non-metabolic disorder subjects. A pronounced increase in cfPWV was demonstrated in healthy Thais aged over 50 years. &nbsp;</p> Kiattisak Chaiprom, Weerapon Sangartit, Orapin Pasurivong, Veerapol Kukongviriyapan, Watchara Boonsawat, Arunrat Srithawong, Jirawat Wattanapanyawech, Upa Kukongviriyapan ##submission.copyrightStatement## Thu, 19 Sep 2019 00:00:00 +0700 CYP1A1 m1 Polymorphism Could Increase Risk for Cervical Cancer in Oral Contraceptive Users <p><strong><u>Background and Objectives:</u></strong> &nbsp;HPV infection is the main cause for cervical cancer. However, contraceptive use and genetic background may raise a risk of developing cervical cancer. <em>CYP1A1</em> plays an important role in <em>carcinogenic detoxification</em>.&nbsp;Therefore, genetic polymorphism in <em>CYP1A1 </em>may affect role of <em>CYP1A1</em> leading to difference in susceptibility to cancer. The aim of this study was to investigate the association between <em>CYP1A1</em> m1 polymorphism combined with oral contraceptives and cervical cancer risk in Northeastern Thai women.</p> <p><strong><u>Methods:</u></strong> &nbsp;The case-control study of women volunteers were divided into 2 groups, cervical cancer group (n=204) and healthy control group (n=204). DNA was extracted from white blood cells. <em>CYP1A1 </em>m1 polymorphism was detected by PCR-RFLP. Association between<em> CYP1A1 </em>m1 polymorphism combined with oral contraceptive use and cervical cancer risk was examined by uni-, multivariate logistic regression.</p> <p><strong><u>Results:</u></strong> &nbsp;Carriers of CC genotype of <em>CYP1A1 </em>m1 had 10-fold increased cervical cancer risk among women who take oral contraceptives for 5-10 years (95% CI=0.66-530.47, <em>p</em>=0.0455).&nbsp;</p> <p><strong><u>Conclusions: </u></strong>&nbsp;Our result suggests that <em>CYP1A1 </em>m1 polymorphism is associated with increased risk of cervical cancer in women who use oral contraceptives for long term.</p> Mayuree Wongpratate, Wannapa Settheetham Ishida, Sophida Phuthong, Sitakan Natphopsuk ##submission.copyrightStatement## Thu, 19 Sep 2019 00:00:00 +0700 Reported Adverse Drug Reaction of Oral Sildenafil in the Treatment of Pulmonary Arterial Hypertension in the Pediatrics with Congenital Heart Disease <p><strong><u>Background and objective</u></strong><strong>: </strong>Sildenafil has been used off-label for treatment pulmonary arterial hypertension associated with congenital heart disease (APAH-CHD) in pediatric patients but it is not approved by United States Food and Drug Administration (USFDA) and Thai Food and Drug Administration in the pediatric population. Thus, this study aimed to investigate the adverse drug reactions of sildenafil for the treatment of APAH-CHD in pediatric patients.</p> <p><strong><u>Methods</u></strong>: This study was a retrospective study in children under 18 years old with APAH-CHD who receiving sildenafil treatment at Queen Sirikit Heart Center of the Northeast, Khon Khan University during January 2009 to December 2014. Adverse drug reactions, duration of treatment and dosing of sildenafil data were collected by chart review.</p> <p><strong><u>Results</u></strong>: There were 112 patients included in the study. There were 8 patients (7.1%) with 8 adverse drug events reported during the treatment period, headache in 5 patients and epistaxis in 3 patients.</p> <p><strong><u>Conclusions</u></strong><u>:</u> The use of sildenafil seems to be safe in the treatment of APAH-CHD in children under 18 years old. The common ADRs were headache and epistaxis without any serious adverse event reported.</p> Wannabhorn Srimanee, Seehapong Petcharat, Yupaporn Prechagoon ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Analgesic Effect among Three Drug Regimens for Local Infiltration Analgesia after Total Knee Arthroplasty <p><strong><u>Background and Objectives:</u></strong> Total knee arthroplasty (TKA) is a major procedure which causes severe pain. Adequate pain management promotes rehabilitation and shortens hospital stay. There are several methods for controlling pain after TKA. One of the techniques is local infiltration analgesia (LIA), which is done by injecting the combination of drugs into periarticular tissue. However, variety of drugs can be used for LIA. We aimed to evaluate the postoperative analgesic effect of three different regimens of LIA in TKA patients.</p> <p><strong><u>Methods</u></strong><u>:</u> &nbsp;Retrospective study was conducted in patients who underwent TKA between January 1, 2015 and December 31, 2017 and received one of three different regimens of LIA (group 1; bupivacaine 200 mg plus ketorolac 30 mg and morphine 8 mg, group 2; bupivacaine 200 mg plus ketorolac 60 mg and adrenaline 0.03 mg and group 3; bupivacaine 200 mg plus ketorolac 60 mg, morphine 8 mg and triamcinolone 40 mg) Postoperative morphine consumption, numeric rating pain scores (NRS) at 24 and 48 h and additional analgesic drugs were recorded for assessing pain efficacy. Adverse events were also recorded.</p> <p><strong><u>Results:</u></strong> Sixty patients were enrolled, of which 18, 29 and 13 patients received gr.1, 2 and 3 regimen, respectively. Patients’ characteristics were comparable. Postoperative morphine consumption at 24 and 48 h were not different [16.9(12.1), 13.1(8.7) and 12.4(11.1), p = 0.39 and 28.2(15.9), 24.5(14.2) and 22.7(15.6), p = 0.57). Postoperative NRS at rest and on movement were similar at 24 h [3.3(3.1), 2.4(2.5) and 2.3(2.5), p=0.44 and 5.5(3.2), 4.1(3.1) and 4.4(2.1), p=0.28] and at 48 h [2.5(2.5), 2.4(2.2) and 1.8(2.0), p=0.62 and 5.2(1.9), 4.5(2.3) and 4.2(2.1), p=0.39]. All adverse events were similar and no serious complications occurred.</p> <p><strong><u>Conclusions:</u></strong> The all three drug regimens of LIA for TKA can relieved postoperative pain to mild pain. The analgesic effect and adverse events were not different among groups.</p> Aumjit Wittayapairoj, Kriangkrai Wittayapairoj, Paphatsara Phuangpraphan, Malinee Wongswadiwat, Yuwadee Huntula ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Effect of Houttuynia cordata Thunb. Extract in High-Fat Diet-Induced Obese Rats <p><strong><u>Background and Objective</u></strong><strong>: </strong>Obesity is a significant health problem and associated with diabetes mellitus, dyslipidemia, and hypertension. Herbal supplementation is considered as a complementary method for obesity control. Therefore, the objective of this study was to investigate the effects of <em>Houttuynia cordata</em> Thunb. extract (HTE) on weight gain, hyperglycemia, insulin resistance, leptin, and dyslipidemia in high-fat diet-induced obese rats.</p> <p><strong><u>Methods</u></strong><strong>: </strong>Twenty-four male Sprague-Dawley rats were divided into three groups. Each group was fed with different diet for 12 wks. The first group was fed a standard diet of rat chow, the second was fed a high-fat diet (HFD), and the third was fed an HFD containing 1% HTE. Body weight and food intake were measured throughout the study. Adipose tissue weight, blood sugar, insulin, lipid profiles, and leptin were measured after the experiment.</p> <p><strong><u>Results</u></strong><strong>: </strong>The addition of HTE to the HFD significantly prevented weight gain (p&lt;0.05). In addition, treatment with HTE resulted in a remarkable reduction in adipose tissue weight, blood sugar, insulin resistance, and leptin (p&lt;0.05). The HTE treatment also significantly improved dyslipidemia (p&lt;0.05). However, no statistically significant change in insulin levels was observed after the HTE treatment.</p> <p><strong><u>Conclusions</u></strong><strong>: </strong>HTE exhibited anti-obesity effect, decreased fat accumulation in adipose tissue, restored hyperglycemia, insulin resistance and dyslipidemia, and reduced leptin in HFD-induced obese rats. Thus HTE is suggested as a possible alternative treatment for obesity.</p> Orathai Tunkamnerdthai, Paradee Auvichayapat, Surachat Chaiwiriyakul ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Prevalence of Irritant Contact Dermatitis in Semiconductor Factory Workers Who Occupationally Wore Natural Rubber Finger Cots <p><strong><u>Background and Objective:</u></strong> The semiconductor factory workers who exposed to many irritants such as solvents, acids, alkalis and flux was the high risk of occupational irritant contact dermatitis<strong>.</strong> This study aimed to estimate the prevalence of the semiconductor factory workers who occupationally wore natural rubber finger cots<strong>.</strong>irritant contact dermatitis (ICD) in</p> <p><strong><u>Methods:</u></strong> A descriptive study was conducted. The study population included 1,218 workers who occupationally wore &nbsp;natural rubber finger cots. A total of 367 workers were recruited as study samples. The skin symptoms and the associated factors were collected from the medical records and the existing completed questionnaires. Additives containing in finger cots were analyzed by HPLC (High Performance Liquid Chromatography) technique. The descriptive statistics were presented as proportion, mean (SD), median (IQR) and the prevalence were presented as percentage with 95% confidence interval (95%CI).</p> <p><strong><u>Results:</u></strong> The prevalence of irritant contact dermatitis in semiconductor factory workers was 11.4% (95%CI 8.2,15.5) 15.3% of workers who wore natural rubber finger cots which were always washed by dish washing liquid was diagnosed ICD&nbsp; compared to 1 (1.0%) worker who wore natural rubber finger cots which were always washed by hand washing soap. The finger cots analysis by HPLC found 3 leachable rubber additives such as Tetramethylthiuram disulfide (TMTD), Zinc diethyldithiocarbamate (ZDEC) and 2,2 Dibenzthiazyl disulfide (MBTS) from finger cots washed by either hand soap and dish washing liquid, but higher in dish washing liquid washed finger cots.</p> <p><strong><u>Conclusion :</u></strong> The prevalence of irritant contact dermatitis in semiconductor factory workers who occupationally wore natural rubber finger cots was 11.4% . The possible agents were rubber additives.</p> Attasit Rattanarak, Naesinee Chaiear, Jitladda Sakdapipanich, Jinjutha Wiriyanantawong, Phanumas Krisorn ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Prevalence and Factors Affecting Musculoskeletal Disorders among Thai Ancient Goldsmith Workers in Sukhothai Province <p><strong><u>Background and objective:</u></strong> Musculoskeletal disorders (MSDs) are one of the health problems that can be encountered among Thai ancient goldsmith workers. The inappropriate posture is one of the factors which cause the work-related injury among this worker. This study aimed to examine factors related to musculoskeletal disorders. <strong><u>Methods:</u></strong> This was a descriptive study, collecting data by using the interview which is divided into two sections; personal information factors and work-related factors among Thai ancient goldsmith workers at Si-Satchanalai district Sukhothai province. The study samples were 124 Thai ancient goldsmith workers. Data analysis was performed using descriptive statistics and logistic regression of which the results were depicted via adjusted OR (OR<sub>adj</sub>) at the 95% confidence interval.<strong><u>Results:</u></strong> The most ancient goldsmith workers were female (66.1%), with an average age of 37.17 years and most of them were high school graduates. The prevalence of musculoskeletal disorders in the past 12 months and 7 days were 75.0% and 34.7%, respectively. The most painful positions were the lower back, neck, shoulder and upper arm. From this study the most affecting factors on the musculoskeletal disorders found were working in the position of the muscle contraction or must be exerted continuously for 3-5 minutes and the work that always exerts force or pressure<strong><u>Conclusion:</u></strong> There is a high prevalence of musculoskeletal disorders among Thai ancient goldsmith workers. Therefore, there should be a campaign for entrepreneurs to promote knowledge of safety in the workplace. As well as modification of the production process or using modern tools to help workers. Together with encouraging workers to realize of their safety and health to increase efficiency of correcting and reducing ergonomic problems in the future.</p> Juthamas Tarmperm, Amarin Kongtawelert, Dusit Sujirarat, Petcharatana Bhuanantanondh ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Health Risk Assessment of Inhalation Exposure to Respirable Dust among Workers in a Rice Mill in Kamphaeng Phet Province <p><strong><u>Background and Objective</u></strong><u>:</u> Dust represents a significant occupational problem among rice mill workers, especially respirable dust of aerodynamic diameter ≤10 µm.&nbsp; It can penetrate into the lower part of respiratory system. The objective of this study was to determine the health risk assessment of inhalation exposure to respirable dust among workers in a rice mill in Kamphaeng Phet province. Moreover, factors affecting health risk were examined.</p> <p><strong><u>Methods</u></strong>: Data were collected from 44 workers of a rice mill in Kamphaeng Phet Province. Collected data were divided into 2 parts: 1) Inhalation exposure to respirable dust was collected in breathing zone of the workers via personal sampling technique for a full period of work and analyzed by gravimetric method, in accordance to NIOSH Manual of Analytical Method number 0600; 2) Personal characteristics and working characteristics were collected using questionnaire. All of data were assessed health risk according to United States Environmental Protection Agency (U.S. EPA). Simple regression analysis was used to analyze the factors affecting health risk.</p> <p><strong><u>Results</u></strong>: The results showed that most of workers were female (65.9%). Their average respirable dust exposure within the breathing zone was 0.0788 ± 0.0623 mg/m<sup>3</sup>. The results of health risk assessment of inhalation exposure to respirable dust in terms of non-cancer effect indicated that the average hazard quotient was 0.56 ± 0.42. Furthermore, 90.91% of workers had hazard quotient in low level. This study found that 2 factors had a significant effect on hazard quotient i.e., respirable dust exposure (p &lt; 0.001) and working experience (p = 0.032).&nbsp;</p> <p><strong><u>Conclusion</u></strong>: The finding revealed that a risk management program is necessary in order to reduce and control the risks to an acceptable risk i.e. decreasing the respirable dust exposure, especially in the experienced workers.</p> Tadpong Tantipanjaporn, Nattakan Srisakultiew, Benjamas Sukhantho1 ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 The Effect of Chrysin on Memory Impairments in Aging Rats Induced by D-galactose <p><strong><u>Background and Objective:</u></strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Brain aging is one of aging problems that affects to the neural stem cells in the subgranular zone (SGZ) of the dentate gyrus (DG) in hippocampus, which exhibits cognitive impairments. D-galactose (D-gal) could induces neuronal apoptosis caused by oxidative stress and inflammation. It is used in several brain aging studies. Chrysin, one of flavonoid, has many neuroprotective effects that can improve memory. This study investigated the effects of chrysin on memory impairments in aging rats induced by D-gal.</p> <p><strong><u>Methods:</u></strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Male Sprague Dawley rats were divided into 6 groups; control, D-gal, chrysin 10, chrysin 30, D-gal + chrysin 10 and D-gal + chrysin 30 groups. D-gal (50 mg/kg) was administrated by intraperitoneal (i.p.) injection. Chrysin (10 and 30 mg/kg) was administrated by oral gavage. Both of D-gal and chrysin were administrated for 8 weeks. After treatments, the body weight and locomotor activity were determined. The memories were evaluated using novel object location (NOL) and novel object recognition (NOR) tests.</p> <p><strong><u>Results:</u></strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results showed that the body weight and locomotor activity did not significant differences among all groups. In the memory tests, control, chrysin 10, chrysin 30, D-gal + chrysin 10 and D-gal + chrysin 30 groups showed significant differences to discriminate the novel location and object in the NOL and NOR tests. In contrast, D-gal group showed no significant difference of discrimination in the both tests.</p> <p><strong><u>Conclusion:</u></strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong>This study demonstrates that D-gal induced memory impairments. However, chrysin could attenuated the memory impairments caused by D-gal.</p> Ram Prajit, Nataya Sritawan, Kornrawee Suwannakot, Salinee Naewla, Anusara Aranarochana, Apiwat Sirichoat, Wanassanan Pannangrong, Jariya Umka Welbat ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 The Cut-off Scores of the Three-time Stand and Walk Test to Predict the Risk of Falls in Community-Dwelling Elderly Thais <p><strong><u>Background and objective</u></strong><u>:</u> This study aimed to explore optimal cut-off scores of the three-time stand and walk test (TTSW) in elderly Thais.</p> <p><strong><u>Methods:</u></strong> Based on the physiological changes, participants were divided into 3 age groups; 60-69 years, 70-79 years, and 80 years or more. The total of 186 participants (62 participants per age group) were interviewed and subjective examined for their demographics, health status and their history of falls within the past 6 months. All participants were divided into 2 groups: falls and non-falls. Thereafter, participants were performed the TTSW for 3 trials, and the mean values obtained from 3 trials were used for statistical analyses.</p> <p><strong><u>Results</u></strong><strong><u>:</u></strong> Most of study participants were female. There was no significant difference in body mass index between falls and non-falls. Participants in the fall group had a significantly higher mean TTSW scores than those in the non-fall group (<em>p</em>&lt;0.001). The mean cut-off scores of TTSW in each age group were 14.00, 14.13, and 15.30 seconds, respectively, with high sensitivity, specificity, predictive accuracy and area under receiver operating characteristic (ROC) curve of the TTSW test in each group.</p> <p><strong><u>Conclusions</u></strong><strong><u>:</u></strong> This study concluded that the cut-off scores of the TTSW in each age group could be used as a criterion value for assessing the risk of falling in community-dwelling elderly participants.</p> Arunrat Srithawong, Winut Duangsanjun, Puttipong Poncumhak ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Predictive Equations for Peak Cough Flow in Healthy Senior Persons <p><strong><u>Objective and objectives:</u></strong> Measurement of peak cough flow (PCF) is a simple, convenient and noninvasive method providing the indices of cough efficiency. However, physical factors that affecting PCF are not clearly determined. Therefore, the aim of this study was to analyze the factors contributing to PCF for establishing a set of regression equations for community-dwelling senior adults.</p> <p><strong><u>Method</u></strong><u>:</u> One hundred and thirty healthy participants including 65 men and 65 women were recruited in this study.&nbsp; The PCF was performed by a quick, short, and most vigorous possible cough after a maximal inspiration on the peak flow meter. The highest values of those three measurements were recorded, individually.</p> <p><strong><u>Results:</u></strong> The PCF values were lower in women than in men. Moreover, the PCF was correlated with age, height, waist circumference, and weight in both genders. The predictive equations in men and women were as follow: PCF (all subjects) = 364.996 + [91.577 Gender] – 3.772 Age (year)] + [3.190 Weight (kg)],</p> <p>PCF<sub>men</sub> = 440.178 - 4.060 x (age) + 3.830 x (weight) (R<sup>2</sup>=0.357, P=0.005) and PCF<sub>women</sub> = 398.268 - 3.428 x (age) + 2.127 x (weight) (R<sup>2</sup>=0.231, P=0.006).</p> <p><strong><u>Conclusion:</u></strong> Age and weight factors are considered as covariates for PCF measurement. Furthermore, these equations could be used to calculate the predictive values of PCF for the healthy senior persons in clinical practice.</p> Arunrat Srithawong, Puttipong Poncumhak, Sirintip Kumfu, Tichanon Promsrisuk ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Development of Extended Medication Labels for clients in Manorom Hospital, Chainat Province <p><strong><u>Background and Objective</u></strong>: Misunderstanding of extended medication labels of clients may result in incorrect drug use and harmful. This study aimed to develop the extended medication label for 6 items of chronic diseases medicine.</p> <p><strong><u>Methods</u></strong>: Research and development was used to designed the study. To develop the 6-prototype extended medication labels of chronic disease. 280 sample were for understanding assessment of extended labels by interview. Data analysis by descriptive statistics.<br><strong><u>Results</u></strong>: The 6 extended medication labels of chronic disease including allopurinol, amlodipine, enalapril, glipizide, metformin and simvastatin. The extended medication labels Obtained from the development&nbsp; of the extended medication labels, the prototype of the RDU hospital project. There is no label on the preparation of the first time that the patient has a level of understanding through the specified criteria. (At least 80 percent) must be improved until the criteria can be passed. The 4 out of 6 labels, including allopurinol, amlodipine, enalapril and glipizide, were adjusted 2 times.&nbsp; There were adjusted 3 times in labels of metformin and simvastatin for level of understanding from sample at ≥ 80%</p> <p><strong><u>Conclusions</u></strong>: The development of extended medication labels from prototype extended medication labels of the RDU Hospital project increase the level of understanding of client. This may lead to drug use the correct and suitable and Reduce error of the patient's medication</p> Toungporn Pratumrat, Chanthonrat Sitthiworanan ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Situation of Questionnaire Used in Hand Function Assessment by Physical Therapist <p><strong><u>Background and Objective:</u></strong> The pathological conditions of hand are barriers to work and affect the daily activities. Physical therapists are responsible for assessment, planning treatment goals and providing treatment to the patients. But, there is no standard of hand function assessment to used in health service.</p> <p><strong><u>Methods:</u></strong> This was a cross-sectional survey research. The samples were 336 physical therapists who has at least 1 year working experiences in government hospitals and were selected by multi-stage sampling. The researchers sent the letters of request to the sample group to respond to the questionnaire by mail.&nbsp; They can choose answering either online or paper-based questionnaire and sent it back by mail within 2 weeks due date. The questionnaire, validated by 3 experts for content validity, has 2 parts: 1) characteristics of respondents, and 2) questionnaire or instrument for hand area assessment of patient.</p> <p><strong><u>Results:</u></strong>&nbsp; Of 366 questionnaires sent, 155 (34.23%) with completed responses were returned. The most common musculoskeletal disease at hand was Carpal tunnel syndrome.&nbsp; The top 3 frequently used assessment tools were goniometer (38.30%), pain scale (30.40%) and muscle manual testing (27.00%).&nbsp; The most common neurological disease at hand found was stroke and the top 3 frequently used assessment tools were hand function test (27.80%), muscle manual testing (24.30%), and the Barthel activity of daily living index questionnaire (17.40%).</p> <p><strong><u>Conclusion:</u></strong> Various assessment tools for hand function were used by physical therapists. Therefore, standard tools for hand function assessment should be determined to support quality patient care with shared standard information.</p> Suparat Sooktho, Saksit Sripa, Sawaeng Watcharathanakij ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Four Main Components of Phikud Navakot Promote Cholesterol Metabolism Through LDLR, HMGCR, SR-BI and ApoA-I Genes <p><strong><u>Background and Objectives:</u></strong> Ya-Hom Navakot (NY), a combination of fifty-four Thai medicinal herbs, has been used as a traditional medicine for decades especially when dizziness and fainting. Phikud Navakot (PN), nine selected herbal remedies from those components in NY, regulates <em>HMGCR</em> and <em>LDLR</em> genes leading to enhance cholesterol homeostasis. The cholesterol-lowering effect of PN is found to be more potent than that observed in NY. Hence, the objective of this study was to assess the cholesterol-lowering effect of all nine individual herbal extracts of PN which might be used as an alternative treatment for hypercholesterolemia.</p> <p><span style="text-decoration: line-through;">&nbsp;</span></p> <p><strong><u>Methods:</u></strong> Lipid lowering effect of the ethanolic extract of all nine individual herbal extracts of PN was examined focusing on expression of the genes encoding<em> LDLR</em>, <em>HMGCR</em>, <em>SRBI</em> and <em>ApoAI</em> in HepG2 cells by quantitative real-time PCR (qRT-PCR).</p> <p><strong><u>Results:</u></strong> The ethanolic extracts from all nine individual herbs of PN were found to downregulate expression of the <em>HMGCR</em> gene comparing with the effect of simvastatin. The extracts of Kot Soa (<em>Angelica dahurica</em>; AD), Kot Khamao (<em>Atractylodes lancea</em>; AL), and Kot Jatamansri (<em>Nardostachys jatamansi</em>; NJ) could additionally upregulate the <em>LDLR</em> and <em>SRB1</em> genes. Kot Chulalumpa (<em>Artemisia pallens</em>; AP) increased the expression of the <em>ApoA1</em> gene.</p> <p><strong><u>Conclusions:</u></strong> Cholesterol-lowering effect of PN was attributable to the four ingredients of PN which possessed high capability to decrease cholesterol production, maintain cholesterol balance, and promote cholesterol clearance via regulation of the <em>HMGCR</em>, <em>LDLR</em>, and <em>ApoAI</em> genes, respectively. Hence, PN might be an alternative tool to reduce cholesterol level in the future.&nbsp;</p> Napatara Tirawanchai, Sudarat Supapornhemin, Anchaleekorn Somkasetrin, Jiraporn Jantaravinid, Kanchana Kengkoom, Sumate Ampawong ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Effectiveness of Artificial Cheeks for Bag Mask Ventilation in Elderly Patients Receiving General Anesthesia Bussarin Sriyanaluk, Niranuch Siripunt, Maliwan Oofuvong ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700 Learning Resources in the 21st Century for Promoting Lifelong Learning in Medical Education <p>Learning resources help students learn new knowledge and skills. The examples of learning resources are textbooks, colleagues and journals. To prepare self-directed and lifelong learning, students should know how to use learning resources effectively. Using resources should be in a sequence of searching, evaluation, decision, and application. After the students use evidence in learning resources, they will have direct experience. Instructors and medical schools should explore problems and obstacles of using learning resources to help students fulfil their learning need.</p> Krishna Suvarnabhumi, Sujitra Jorajit ##submission.copyrightStatement## Mon, 23 Sep 2019 00:00:00 +0700