Journal of Health Science and Medical Research

Anesthesia For Patients Receiving Single-Lung Transplantation in Non-Pulmonary Surgical Intervention: A Case Report

Thu, 28 Mar 2024 00:00:00 +0700

With improvements in the survival rate following lung transplantation, lung transplant recipients occasionally undergo subsequent non-pulmonary surgical interventions that are not directly related to their pulmonary disease. Both anesthesia and surgical procedures can affect the transplanted lungs and other organs in such patients. Moreover, these patients may show pulmonary function impairment; depending on the type of surgery and anatomical site. An adequate understanding of the physiology of the transplanted lung, careful preoperative evaluation and preparation, appropriate utilization of airway equipment, and proper management of intraoperative fluids and ventilation are crucial for superior perioperative outcomes.

A Revitalising Approach towards Aging: Unveiling the Potential Use of Probiotics for Wellness in Elderly Populations

Thu, 28 Mar 2024 00:00:00 +0700

Probiotics have emerged as a potential alternative for treating various diseases affecting general population. Mounting data suggests that probiotics can be beneficial for older individuals, who often have weakened immune systems and are more susceptible to illnesses. Dysbiosis commonly occurs in elderly individuals, which is implicated as a major reason for various diseases. The effectiveness of probiotics is influenced by the specific strain and the dosage administered. Extensive studies have shown how probiotics affect prevalent issues, such as functional bowel diseases and other gastrointestinal disorders. Probiotics exert their effects by synthesizing different microbial peptides, such as bacteriocins, antibiotics, lipopolysaccharides, short-chain fatty acids, butyric acid, propionic acid and other specific secretory metabolites. The common probiotics that are found to benefit the health of elderly populations include Lactobacillus, Bifidobacterium lactis, Bacillus subtilis, Bifidobacterium longum and Bifidobacterium breve Further research is necessary to delve into the mechanism of action for both existing and novel probiotic strains for use in combating or aiding in diseases. Genetically, modified probiotics can be potentially used in the future to deliver immunity-restoring genes and as oral mode of vaccination in humans. Fecal microbiota transplantation has been gaining interest, used to restore gut conditions, and has also been linked to alleviating neurodegenerative diseases. The focus of this review was to present the available evidence on the immunomodulatory effects of probiotics in the elderly population; aiming to gain a better understanding of their mechanism of action and to assess the progress made in utilizing probiotics as therapeutic interventions.

BRCA1 Expression and Its Combined Low Expression with PARP1 and ERCC1 Predict Chemotherapeutic Response in Ovarian Cancer

Jarukit Tantipisit, Nungrutai Saeaib, Paramee Thongsuksai — Thu, 28 Mar 2024 00:00:00 +0700

Objective: This study aimed to evaluate the associations of immunohistochemical expressions of various deoxyribonucleic acid repair proteins, either individually or combined, with the response to platinum-based chemotherapy and overall survival in epithelial ovarian cancer.
Material and Methods: This retrospective cohort study included patients with epithelial ovarian cancer who were treated by primary cytoreductive surgery with adjuvant platinum-based chemotherapy at Songklanagarind Hospital between January 2008 and December 2019. Immunohistochemistry analysis of breast cancer type 1 (BRCA1), poly (ADP-ribose) polymerase 1 (PARP1), X-ray repair cross-complementing 1 (XRCC1), and excision repair cross-complementation group 1 (ERCC1) expression was performed. Logistic regression was used to evaluate factors associated with chemotherapeutic response and Cox regression was applied for survival analysis.
Results: Chemotherapeutic response was achieved in 205 of 249 patients (82.3%). Low BRCA1 expression was associated with good response (odds ratio [OR] 5.01, 95% confidence interval [CI] 1.78–14.1) and favorable overall survival (hazard ratio 0.61, 95% CI 0.38–0.98). PARP1, XRCC1, and ERCC1 showed no significant predictive or prognostic roles; however, combined low expression of PARP1/BRCA1 (OR 7.62, 95% CI 1.69–34.31) and ERCC1/BRCA1 (OR 6.98, 95% CI 1.5–32.52) additively enhanced response compared to high/high expressions.
Conclusion: This study provides evidence that epithelial ovarian cancer (EOC) with low BRCA1 expression is more likely to be responsive to platinum-based therapy and is associated with favorable overall survival compared to tumors with high BRCA1 expression. The study supports a potential therapeutic strategy involving co-depletion of PARP1/BRCA and ERCC1/BRCA1 expression, although additional studies are needed.

Microbial Characteristics of Lower Respiratory Tract Infections in Patients Referred from Primary Care Hospitals

Thu, 28 Mar 2024 00:00:00 +0700

Objective: This study investigated the microbiological characteristics of severe lower respiratory tract infection patients not respond to initial treatment, and were transferred to a tertiary-level hospital.
Material and Methods: This was a multicenter, prospective study conducted across four hospitals: Cho Ray, Pham Ngoc Thach, Gia Dinh People’s Hospital, and Can Tho Central General Hospital. Sputum specimens were collected shortly after admission and subjected to culture and real-time PCR testing.
Results: Out of the 252 patients, 170 (67.4%) met the criteria for analysis and identification of pathogenic microorganisms. The most frequently isolated pathogens were Streptococcus pneumoniae (S. pneumonia) and Haemophilus influenzae (H. influenzae), comprising of 27.0% and 13.1%, respectively. Antibiotic susceptibility testing was conducted on 55 patients (32.3%). Among these cases, there were 16 instances of S. pneumoniae, 10 cases of Staphylococcus aureus (S. aureus), 10 cases of Pseudomonas aeruginosa (P. aeruginosa), 14 cases of gram-negative enteric bacteria, 2 cases of H. influenzae, 1 case of Moraxella catarrhalis (M. catarrhalis), 1 case of Enterococcus faecium, and 1 case of M. pneumoniae. The antibiogram results revealed significant findings; including a 70% prevalence of extended-spectrum beta-lactamase and 90% occurrence of Methicillin-Resistant Staphylococcus aureus. The data also indicated high resistance rates; such as 90% resistance to erythromycin, 40-80% to ciprofloxacin, 30-80% to ceftazidime, and 30-40% to imipenem.
Conclusion: Pathogens associated with LRTIs referred from primary care hospitals encompass S. pneumonia, H. influenza, and S. aureus. At our facility, piperacillin, imipenem, amikacin, vancomycin, and linezolid emerged as the most effective antibiotics for addressing these LRTIs.

Assessing the Impact of Feeding Stray Dogs on Stray Dog-Related Issues: A Community-Based Study in Songkhla, Thailand

Thu, 28 Mar 2024 00:00:00 +0700

Objective: Increasing stray dog populations have transformed stray dog issues from a third-world problem to a global public health priority. This study aimed to determine factors related to feeding stray dogs and other factors that can impact stray dog-related issues.
Material and Methods: This community-based cross-sectional study was conducted in Songkhla, Thailand, from the 4th to the 29th of January 2021. Data was collected via phone interviews. Logistic regression was performed to measure the association between the independent variables and problems related to stray dogs.
Results: Among 168 participants, 137 (81.5%) reported having experienced a negative impact in connection with problems caused by stray dogs. The most common problem was garbage scavenging (62.5%), which predominantly occurred between 18:00 and midnight. Feeding stray dogs was significantly associated with stray dog-related problems (odds ratio [OR]=3.94 with a 95% confidence interval [CI] 1.26-17.41).
Conclusion: Providing food to stray dogs causes problems and is also prohibited by law. It is important for media, community leaders, and other influential groups to create awareness and foster cooperation among communities to address this issue.

Medicinal Plant Cultivation: Current Scenario, Challenges, and Opportunities from Indian Farmer’s Perspective

Dibya Sundar Panda, Ranjan Kumar Giri — Thu, 28 Mar 2024 00:00:00 +0700

Objective: Plants are the source of medicine in Ayurvedic, allopathic & Unani systems. Globally 72000-77000 (17-18%) of the world’s flora is currently utilized for medicinal purposes. More than 200 therapies employed by different cultures to treat physical and psychological ailments use medicinal plants as curative medicines, substantiating the immense scope for commercial medicinal plant cultivation. This present study was undertaken to find out the difficulties, challenges and opportunities in medicinal plant cultivation from the perspective of farmers in the state of Odisha, India, and to suggest possible support that could promote medicinal plant cultivation.
Material and Methods: A survey was conducted among 700 farmers using a questionnaire containing 15 items related to socioeconomic status, challenges and opportunities.
Results: The study revealed that the education of most of the farmers was below high school; 61% of the participants had their own land, with 10 to 15 years of farming experience. The majority were not into medicinal plant cultivation. The major challenges for medicinal plant cultivation were found to be marketing, finance, climate, lack of experience and training, government support and labour. Support from the government will encourage the medicinal plant cultivation.
Conclusion: Many of the farmers are not aware of the demands and support schemes by the government. Serious gaps were seen in availing government support schemes in medicinal plant cultivation by farmers, leading to limited success and productivity. There is a need to create awareness among the farmers regarding the benefits of medicinal plant cultivation and related training programmes to increase production and productivity of medicinal plants substantially. Support from the government will encourage medicinal plant cultivation.

Prehospital Time Intervals in Thailand during COVID-19

Patiman Chanrak, Kanthika Kraisawat — Thu, 28 Mar 2024 00:00:00 +0700

Objective: To determine the effect of the coronavirus disease, 2019 (COVID-19) pandemic on the prehospital time intervals of emergency medical services (EMS) in Thailand.
Material and Methods: This retrospective cohort study analyzed the prehospital time intervals of EMS in Thailand; from January 1, 2019 to September 30, 2021 using data obtained from the national EMS database. Patients with incomplete medical records, prehospital time intervals <1 or >300 minutes, and those admitted between January 1 and March 31, 2020 were excluded. Data were compared between the following groups: Group 1, pre-COVID-19; Group 2, first- and second-wave of COVID-19; and Group 3, third-wave of COVID-19: Kruskal–Wallis, Wilcoxon rank-sum, and chi-square tests were used.
Results: A total of 3,863,153 patients were enrolled into this study. The median total prehospital time was significantly longer in Group 2 when compared to Group 1, [25 (17,34) vs. 24 (17,33) minutes, p-value<0.001]; longer on-scene time, [4 (2,7) vs. 3 (2,6) minutes, p-value<0.001]; shorter transportation time, [10 (6,17) vs. 11 (6,18) minutes, p-value<0.001]. The median total prehospital time [27 (19,37) vs. 25 (17,34) minutes, p-value<0.001], response time [8 (5,14) vs. 7 (4,11) minutes, p-value<0.001], and transportation time were significantly longer in Group 3 than in Group 2 [11 (6,18) vs. 10 (6,17) minutes, p-value<0.001].
Conclusion: The EMS prehospital time intervals in Thailand during COVID-19 were significantly longer in both the non-trauma and trauma subgroups. Appropriate pre-hospital strategies and monitoring should be developed to manage future pandemics.

Effectiveness of a Developed In-House Breast Phantom in Enhancing the Knowledge of Mammographic Positioning in Radiologic Technology Students: A Quasi-Experimental Study in Thailand

Thu, 28 Mar 2024 00:00:00 +0700

Objective: This study aimed to develop an in-house breast phantom, and assess students’ knowledge and satisfaction after using it for mammographic positioning training.
Material and Methods: The breast phantom was designed in a half-body shape, and constructed primarily using gelcoat resin, polyurethane foam, and thermoreversible gel. Additionally, silicone type RA-210, known for its high flexibility, tensile strength, elongation at break (620%), and ability to revert to its original shape, was incorporated. This study evaluated the effectiveness of the breast phantom utility in improving students’ knowledge through a nine-item questionnaire; employing a one-group pre-post design. The participants, consisting of 63 Radiologic Technology students, whom rated their satisfaction with the phantom for training purposes using a five-point Likert scale.
Results: The mean knowledge score for the breast phantom positioning significantly improved from 5.35±1.61 points (pretest) to 7.32±1.20 points (post-test), following training (p-value<0.001). The students expressed high overall satisfaction with this training aid (4.49±0.58 points).
Conclusion: Our breast phantom demonstrates its potential as an effective educational tool that enhances Radiologic Technology students’ understanding of mammographic positioning. However, further research is warranted to develop more advanced phantoms and to explore alternative experimental designs for effective teaching methods.

Emergency Department Length of Stay and in-Hospital Mortality of Non-Traumatic Patients in a University Hospital

Thu, 28 Mar 2024 00:00:00 +0700

Objective: To assess the emergency department length of stay (EDLOS) and mortality in each Emergency Severity Index (ESI) triage level. In addition to identifying the cut-off point of EDLOS to predict 72-hour in-hospital mortality among adult non-traumatic patients in the ED of a university hospital.
Material and Methods: A cross-sectional study was conducted by retrieving patient data from the hospital information system; from January 1, 2014, to December 31, 2018. Patient characteristics, EDLOS, and in-hospital mortality rates were analyzed using the R program. The cut-off values of EDLOS, via the area under the curve for the best prediction of 72-hour in-hospital mortality in patients at different ESI levels, were analyzed by multivariate analysis. Statistical significance was defined as a p-value of ≤0.05.
Results: Data from 71,247 patients with 123,356 visits were enrolled. EDLOS significantly decreased across ESI levels and the in-hospital mortality rates were highest in ESI 1, followed by ESI 2 and ESI 3. The predictive ability of EDLOS was the highest for ESI 4, followed by ESI 3. The cut-off point of EDLOS at 3.58 hours showed the best sensitivity, which was a significant risk factor for mortality after adjusting for other significant variables. An EDLOS longer than 4 hours was a significant factor for poor survival in patients with ESI 2 and ESI 3.
Conclusion: A practical cut-off point of 4 hours EDLOS can be used to predict 72-hour in-hospital mortality. Healthcare providers in the ED should consider EDLOS as a safety indicator for quality assurance.

Cardiovascular Biomarkers and Blood Pressure at 6 Weeks and 6-12 Months Postpartum in Women With or Without Hypertensive Disorders During Pregnancy: A Prospective Study

Thu, 28 Mar 2024 00:00:00 +0700

Objective: To measure and compare cardiovascular biomarkers and blood pressure in women with hypertensive disorders of pregnancy (HDP) to those with normotensive pregnancies evaluated at 6 weeks and 6-12 months after delivery.
Material and Methods: A prospective cohort study of postpartum women following HDP and normotensive pregnancies at 6 weeks and 6-12 months postpartum was conducted. Postpartum blood pressure and cardiovascular biomarkers including body mass index (BMI), levels of serum high-sensitivity C-reactive protein (hs-CRP), creatinine, glucose, glycated hemoglobin, low-density lipoprotein cholesterol, and levels of urine microalbumin/creatinine ratio (UACR), sodium, and potassium were quantified.
Results: A total of 118 women involving 40 with previous preeclampsia (PE), 27 with gestational hypertension (GHT), 10 with chronic hypertension (CHT) during recent pregnancy, and 41 normotensive pregnancies were enrolled at 6 weeks postpartum, of whom 73 (61.9%) completed the study at 6-12 months postpartum. Women in the PE and GHT groups had significantly elevated blood pressure, serum hs-CRP and hypertension at 6 weeks and 6-12 months postpartum. Both the PE and CHT groups had an increase in UACR at 6-12 months postpartum. Multivariate linear regression showed that a history of PE and GHT was independently and persistently associated with increased postpartum blood pressure.
Conclusion: Women with HDP had increased blood pressure, risk of hypertension, and increased levels of biomarkers associated with cardiovascular risk at both 6 weeks and 6-12 months postpartum, including serum hs-CRP and UACR. Women with HDP should be counselled about cardiovascular risks as early as 6 weeks postpartum.

Factors Associated with Burnout Syndrome among Clinical Medical Students at Chonburi Hospital, Thailand

Supitcha Thamissarakul, Wasana Hongkan, Prakasit Wannapaschaiyong — Thu, 28 Mar 2024 00:00:00 +0700

Objective: Burnout syndrome causes chronic fatigue, loss of motivation, despair, decreased work performance, and depression. Clinical medical students risk developing burnout syndrome due to long-term learning pressure, responsibilities for patient care and night shifts. This study aimed to examine the factors associated with burnout syndrome among clinical medical students at Chonburi Hospital.
Material and Methods: A cross-sectional study was conducted from July 2022 and January 2023. Data were collected using the Maslach Burnout Inventory General Survey among 106 medical students. Descriptive statistics, chi-square, ANOVA, and the independent t-test were used to investigate the association among variables.
Results: Severe burnout syndrome was not found among clinical medical students. High emotional exhaustion was the most common burnout symptom among these medical students (53.8%). While 27.3% had high depersonalization, no medical students had low personal accomplishment. The factor related to high emotional exhaustion was 4th-year medical students. At the same time, the factors associated with high depersonalization were fourth-year medical students, males, and low accumulated grade point averages (GPAX).
Conclusion: The prevalence of severe burnout was not found among clinical medical students at Chonburi Hospital. However, males, fourth-year medical students, and low GPAX were risk factors for burnout symptoms. Therefore, screening, monitoring, and providing help to these at-risk medical students to reduce their chances of severe burnout should be encouraged.

Evaluation of Safety of Spinal Anaesthesia in Patients Receiving Perioperative Antithrombotic Therapy Undergoing Infrainguinal Revascularisation Surgeries: A One-Year Prospective Clinical Research

Thu, 28 Mar 2024 00:00:00 +0700

Objective: To evaluate anaesthetic outcome, patient outcome and timing of perioperative antithrombotic therapy in relation to intrathecal injection in patients undergoing infrainguinal revascularisation surgery, for peripheral artery disease (PAD) in spinal anaesthesia.
Material and Methods: A one-year prospective observational study was conducted; from May 2019 to May 2020, in a tertiary care centre. This included all consecutive patients undergoing infrainguinal revascularisation surgery for PAD under spinal anaesthesia. Preoperative antithrombotics were stopped, as per standard guidelines, to achieve a normal coagulation profile before spinal anaesthesia. Perioperative data related to the patients, antithrombotics, anaesthesia, surgery, and complications were recorded. Primary outcomes measured were anaesthetic outcome in terms of spinal success and spinal safety. Secondary outcomes measured were timing of perioperative antithrombotic therapy in relation to intrathecal injection and patient outcomes defined as: good, morbidity or mortality.
Results: A total of 102 patients were evaluated, with a mean age of 54.69±16.36 years (91% males, 9% females): 58% had medical comorbidities. A single dose of intravenous (IV) unfractionated heparin (5,000-7,500 IU) was given intraoperatively at 24.97±3.69 minutes after intrathecal injection. Anaesthetic outcome was good in all patients; in terms of spinal safety (100%), as none of the patients developed spinal related complications. All had spinal success (100%), as no patient required conversion to general anaesthesia. Postoperatively, 98% (100) of patients had good outcomes, and mortality only occurred in 2% (2) of patients.
Conclusion: Spinal anaesthesia is safe and effective for infrainguinal revascularisation surgery. If the patient has a normal preoperative coagulation profile, and the timeline to stop antithrombotic therapy is strictly followed, administration of IV unfractionated heparin (5,000-7,500 IU); at approximately 25 minutes after intrathecal injection, was found to be safe.

Factors Associated with COVID-19 Vaccine Hesitancy in Georgia

Milord Shengelia, Tengiz Verulava — Thu, 28 Mar 2024 00:00:00 +0700

Objective: The prevention of Coronavirus Disease-19 (COVID-19) is most effectively achieved through vaccination. However, the issue of vaccine hesitancy and distrust is a challenge that is experienced globally. The objective of this research is to investigate the distrust of the COVID-19 vaccine and the barriers that prevent individuals from deciding to be vaccinated.
Material and Methods: This study utilized a qualitative research design, specifically in-depth interviews, to obtain data from respondents that have not yet received any COVID-19 vaccine.
Results: Three main categories relating to vaccination difficulties were identified: lack of confidence, complacency, and disadvantage. The lack of confidence pertains to concerns regarding the effectiveness and safety of the vaccine. Complacency involves the perception that the virus is not harmful and does not pose a significant threat. Lastly, disadvantage encompasses the problem of the availability of immunization services, time, distance, and similar factors.
Conclusion: This research evaluated the effectiveness, safety, necessity, and availability of the COVID-19 vaccine under these categories. The findings of this study suggest that people’s decision to vaccinate is influenced by their distrust of the vaccine’s effectiveness and safety as well as their skepticism regarding the actual need for vaccination. These individuals are not entirely against vaccination and partially recognize its benefits. However, they are uncertain about the outcome of immunization and harbor doubts about the vaccine’s safety; particularly since it was developed in a relatively short period of time. Additionally, the possibility of side effects and adverse health effects were also a significant cause for concern.

Seminal Plasma Examination Test Result Agreements Using the WHO Manual Recommendation: With Semi-Automatic and Automatic Methods

Thu, 28 Mar 2024 00:00:00 +0700

Objective: To analyze the suitability of the measurement results of neutral alpha-glucosidase and fructose in seminal plasma, between the manual method recommended by the World Health Organization (WHO) Sixth Edition and the semi-automatic method, using Biosystems BTS 350 and the automatic method using Biosystems A15.
Material and Methods: This study involved 47 subjects at the Andrology Outpatient Department of Dr. Soetomo General Academic Hospital; from October 2022 and February 2023. The measurement of neutral alpha-glucosidase and fructose levels in seminal plasma was conducted, via three different approaches: the manual method, as recommended by the WHO Sixth Edition, the semi-automatic Biosystems BTS 350, and the automatic Biosystems A15. The manual method recommended by the WHO Sixth Edition was employed as the reference system.
Results: The average disparity in neutral alpha-glucosidase levels among the manual method, as recommended by the WHO Sixth Edition, compared to the semi-automatic and automatic methods were recorded as: -1.0215 IU/l and-2.3428 IU/l, respectively. Similarly, the fructose levels exhibited differences of -2.1234 mmol/l and 2.2834 mmol/l. Notably, within the method comparisons, 44 values of neutral alpha-glucosidase levels fell within the limit of agreement, while fructose levels showed 44 and 45 values within the agreement limit.
Conclusion: The results obtained from the manual method, as recommended by the WHO Sixth Edition, demonstrated agreement with the measurements of neutral alpha-glucosidase and fructose obtained when using both the semiautomatic and automatic methods.

Nurse’s Attitudes and Perceptions Towards Medical Cannabis Legalization in Thailand

Thu, 28 Mar 2024 00:00:00 +0700

Objective: To determine the attitudes and perceptions among nurses towards legalization of cannabis for medical use in Thailand.
Material and Methods: This anonymous, cross-sectional paper and online survey was conducted from May 2020 to November 2021. Data collection was done using the Cannabis as Medicine: Thai Nurse’s Attitudes and Perceptions Survey. Descriptive statistics were used to analyze the data.
Results: This study included 287 Thai registered nurses across Thailand. The top 3 positive attitudes and perceptions among the nurses were: 1) currently, most patients use or intend to use cannabis oil, 2) it’s not uncommon if nurses with advanced cancer decide to use cannabis oil, and 3) a patient’s values and beliefs in cannabis oil can them feel better. The top 3 negative attitudes and perceptions were: 1) cannabis reduces tumor growth in advanced cancer stages, 2) nurses administer medical cannabis as other medications; and (3) nurses like taking care of patients with the nonmedicinal use of cannabis.
Conclusion: Thai registered nurses were more likely to have negative attitudes towards medical cannabis. The respondents required to increase their knowledge about medical cannabis. Understanding Thai nurses’ attitudes and perceptions towards medical cannabis use is necessary to see their insider views, the difficulties they face, and provide room for improvement to enhance the benefits and safety of medical cannabis use. Future research with larger sample sizes is recommended to strengthen the quality of evidence.

Association Between Periodontal Pathogens and Severity of Periodontal Diseases Among Adolescents in Kunming City: China

Jie Xu, Nuntiya Pahumunto, Supawadee Naorungroj, Rawee Teanpaisan — Thu, 28 Mar 2024 00:00:00 +0700

Objective: To investigate the association between periodontal pathogens and periodontal status among adolescents in Kunming City.
Material and Methods: A total of 560 adolescents from five high schools within five urban districts in Kunming participated in this study. Clinical periodontal examination was assessed, and the levels of Porphyromonas gingivalis (P. gingivalis), Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Prevotella intermedia (P. intermedia), and Fusobacterium nucleatum (F. nucleatum) in saliva samples were examined using a real-time polymerase chain reaction (PCR). The relationship between periodontal pathogens and the severity of periodontal disease was investigated using multivariate logistic regression analysis.
Results: The presence of P. gingivalis, A. actinomycetemcomitans, and P. intermedia was positively correlated with the extent of probing depth, clinical attachment level (CAL), and bleeding on probing. P. gingivalis and A. actinomycetemcomitans were detected at approximately 55-58% among adolescents with healthy periodontal status. P. gingivalis and A. actinomycetemcomitans were detected in all adolescents diagnosed with periodontitis (stage I or II), which was an increased number compared to healthy adolescents. It was found that P. gingivalis (odd ratio (OR)=7.03, 95% confidence interval (CI) 3.77-13.11) and A. actinomycetemcomitans (OR=5.37, 95% CI 2.73-10.57) were strongly associated with stage II periodontitis. F. nucleatum had no significant relationship with the occurrence of gingivitis and periodontitis.
Conclusion: P. gingivalis, A. actinomycetemcomitans, and P. intermedia are important microbiological risk factors for periodontal diseases in adolescents.

Development, Validity, and Reliability of an Easy-to-Use Nutrition Counseling Tool for Thai Outpatients with Liver Cirrhosis

Thu, 28 Mar 2024 00:00:00 +0700

Objective: We developed a simple nutritional counseling tool for adults with liver cirrhosis, aiming for doctors, nurses, and patients as the tool’s primary users.
Material and Methods: The tool was created in a booklet design and based on the European Society of Parenteral and Enteral Nutrition guideline, which comprises four parts, knowledge about cirrhosis, consequences of malnutrition, nutritional recommendations, and calculation of dry body weight and appropriate daily nutritional requirements. Content validity was assessed by three hepatologists using the item objective congruence (IOC) index wherein a score ≥0.5 indicated valid content. Face validity was evaluated by three doctors, three nurses, one dietitian, and three patients for readability, coherence, understandability, and attractiveness using a rating score of 0-10. A reliability test to calculate dry body weight and carbohydrate and protein intake per meal using an intraclass correlation coefficient (ICC) was conducted to determine the agreement among seven doctors and three nurses (inter-raters) using a total of nine case scenarios.
Results: The contents of the booklet were valid (IOC: 1.00 for all 19 items). For face validity, the scores for readability, coherence, attractiveness, and understandability were 7.6, 8.6, 9, and 8.6 out of 10, respectively. The overall comments showed that the new instrument was attractive and convenient. All doctors and nurses correctly calculated the dry body weight, and carbohydrate and protein intake for nine case scenarios, indicating excellent agreement (ICC: 1.0, p-value<0.001).
Conclusion: The novel nutritional counseling booklet is valid and shows excellent reliability among healthcare providers in calculating body status and nutritional requirements.