Ramathibodi Medical Journal https://www.tci-thaijo.org/index.php/ramajournal <p>Ramathibodi Medical Journal (RMJ) publishes article on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics. We welcome submissions from authors worldwide.</p> <p>ISSN 0125-3611 (Print)&nbsp;</p> <p>ISSN 2651-0561 (Online)</p> <p>Indexed in:&nbsp;&nbsp;<strong>&nbsp;&nbsp;<a title="ASEAN CITATION INDEX" href="https://www.asean-cites.org/" target="_blank" rel="noopener"><img src="/public/site/images/nuanphan_cha2/aci-logo-v41.png" width="100" height="40"></a>&nbsp; &nbsp;&nbsp;</strong><a title="ศูนย์ดัชนีการอ้างอิงวารสารไทย:Thai Citation Index (TCI) centre" href="https://www.kmutt.ac.th/jif/public_html/" target="_blank" rel="noopener"><img title="tci" src="/public/site/images/tci_admin/tci.png" width="86" height="38" border="0"></a>&nbsp;&nbsp; &nbsp;<a title="Crossref" href="https://search.crossref.org/?q=ramathibodi&amp;container-title=Ramathibodi+Medical+Journal" target="_blank" rel="noopener"><img src="/public/site/images/nuanphan_cha2/images.png" width="77" height="50">&nbsp;</a>&nbsp; &nbsp;&nbsp;<a title="Google Scholar" href="https://scholar.google.co.th/citations?user=N7b2p9MAAAAJ&amp;hl=th&amp;authuser=1" target="_blank" rel="noopener"><img src="/public/site/images/nuanphan_cha2/scholar_logo_64dp_(1).png" width="155" height="26"></a></p> Faculty of Medicine Ramathibodi Hospital, Mahidol University, THAILAND en-US Ramathibodi Medical Journal 0125-3611 Editor’s Note https://www.tci-thaijo.org/index.php/ramajournal/article/view/205248 <p style="text-align: justify;">Recently, our journal received a complaint about unethical conduct of research in one of our articles. We have published “Editorial expression of concern” on the website regarding the complaint.<sup>1</sup> The investigation was formally organized by Faculty of Medicine Ramathibodi Hospital, Mahidol University. The results of investigation reveal quite a few problems, one of which is honorary authorship. The author informed that the reason was to comply to culture of distributing authorship credit among colleagues.</p> <p style="text-align: justify;">“Honorary authorship” is also named as “gifted authorship”, “unmerited authorship”, or “guest authorship”. This is the practice of yielding authorship credit to those with unsubstantial contribution to the work. This practice of honorary authorship may be defined as a type of research misconduct by some organization.<sup>2</sup> Wislar et al<sup>3</sup> have reported frequency of honorary authorship ranging from 12% - 23% in 6 major medical journals. Underlying reasons may be varying from coercion from senior faculty or intention to boost credibility of the paper. Culture was suspected to be a cause that cannot be explained by linguistic reasons.<sup>4</sup></p> <p style="text-align: justify;">There are concordant criteria of authorship based on contribution by International Committee of Medical Journal Editors (ICMJE)<sup>5</sup> and Committee on Publication Ethics (COPE).<sup>6</sup>&nbsp;The criteria are as followed:<br>1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work<br>2) Drafting the work or revising it critically<br>3) Final approval of the version to be published<br>4) Agreement to be accountable for all aspects of the work</p> <p style="text-align: justify;">According to this incidence, RMJ will require all author to disclose their contributions to the submitted manuscript. This procedure is to follow guideline of publishing and educate authors about the proper practice.</p> Chusak Okascharoen ##submission.copyrightStatement## 2019-06-28 2019-06-28 42 2 Neuropsychiatric Symptom Clusters and Quality of Life Among Patients With Stroke https://www.tci-thaijo.org/index.php/ramajournal/article/view/168578 <p style="text-align: justify;"><strong>Background:</strong> There are relatively few reports of neuropsychiatric symptom clusters which affect the quality of life in patients with stroke.<br><strong>Objective:</strong> To study neuropsychiatric symptom clusters and the relationship between neuropsychiatric symptom clusters and quality of life among patients with stroke.<br><strong>Methods:</strong> This descriptive study conducted in 140 patients with stroke at Sanpasithiprasong Hospital, Ubon Ratchathani, Thailand; they were selected purposively. Data were collected through patient general and clinical information, the neuropsychiatric symptoms assessment, and the 12-item stroke-specific quality of life scale conducted from September 2018 to January 2019. <br><strong>Results:</strong> The results illustrated that 12 neuropsychiatric symptoms of patients with stroke embraced 3 symptom clusters were psychosis clusters, behavioral problems clusters, and mood disturbance clusters. (average frequency = 1.58, 2.37, 2.49; and average severity = 2.08, 2.73, 2.82, respectively). Among 3 symptom clusters, psychosis (<em>r</em> = 0.289; <em>P</em> &lt; .01), behavioral problems (<em>r</em> = 0.719; <em>P</em> &lt; .01), and mood disturbance <em>(r</em> = 0.716; <em>P</em> &lt; .01) clusters were statistically significantly associated with all aspects of quality of life.<br><strong>Conclusions:</strong> This study showed that neuropsychiatric symptom, especially behavioral problems and mood disturbance clusters were correlated with quality of life among patients with stroke.</p> Vachira Posai Ploenta Pipatsombat Pramote Thangkratok ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 1 11 10.33165/rmj.2019.42.2.168578 Comparison of Otoacoustic Emissions in Asymptomatic Diabetes Mellitus and Normal Hearing Control Groups https://www.tci-thaijo.org/index.php/ramajournal/article/view/139031 <p style="text-align: justify;"><strong>Background: </strong>Diabetes mellitus (DM) is a chronic metabolic disorder. Previous studies reported the hearing impairment of diabetes patients as a progressive bilateral symmetrical sensorineural hearing loss (SNHL) of gradual onset which predominantly affected the higher frequencies, and found that diabetic patients had unsatisfactory hearing thresholds than nondiabetics in the same age group. For the use of evoked otoacoustic emissions (EOAEs) as a clinical test of hearing, EOAEs are sound which can be recorded in the outer ear canal and give objective information about preneural, mechanical elements of the cochlear function.</p> <p style="text-align: justify;"><strong>Objective:</strong> To compare the otoacoustic emissions of asymptomatic DM patients with a normal hearing control group.</p> <p style="text-align: justify;"><strong>Methods:</strong> All subjects received a routine audiologic evaluation which consisted of pure-tone air-bone conduction tests, tympanograms, and stapedius acoustic reflex tests. OAEs were measured in 30 asymptomatic diabetic patients with a mean age of 55.73 years and an age-matched 30 subjects normal hearing control group with a mean age of 50.87 years.</p> <p style="text-align: justify;"><strong>Results:</strong> The pure-tone thresholds at 3, 4, 6, and 8 kHz; transient-evoked otoacoustic emissions (TEOAEs) amplitudes at 1, 1.5, 2, and 3 kHz; and the distortion product otoacoustic emissions (DPOAEs) amplitudes at 1, 1.5, 2, 3, 4, and 6 kHz were significantly different (<em>P</em> &lt; .05) between the asymptomatic and control groups.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> This study suggested that diabetic patients had a significant hearing impairment. SNHL is gradually progressive and is a common condition in DM patients and their thresholds for hearing are higher at higher frequencies.</p> Suwimol Ruencharoen Chanchai Jariengprasert Montip Tiensuwan Chardpraorn Ngarmukos ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 12 20 10.33165/rmj.2019.42.2.139031 Comparison of Quality of Life and Nasal Symptoms in Chronic Rhinitis Patients Between Before and After Treatment https://www.tci-thaijo.org/index.php/ramajournal/article/view/149814 <p style="text-align: justify;"><strong>Background:</strong> Chronic rhinitis is a common disease which impacts the quality of life. The symptom of diseases could be controlled after treatment. However, the difference in the quality of life and symptoms after 3 months of treatment is not documented.</p> <p style="text-align: justify;"><strong>Objective:</strong> To compare the quality of life in chronic rhinitis patients before and at 3 months after treatment.</p> <p style="text-align: justify;"><strong>Methods:</strong> Prospective study in new cases of chronic rhinitis patients at adult allergy clinic, Ramathibodi Hospital, from August 2017 to March 2018. Assessment of quality of life and nasal symptoms was performed by using the short form 36 health survey questionnaire (SF36) and the rhinoconjunctivitis quality of life questionnaires (RCQ36). Descriptive statistic, <em>t</em> test, and Wilcoxon signed rank test were applied in the data analysis.</p> <p style="text-align: justify;"><strong>Results:</strong> Of 127 patients, 65.4% were female. Chronic rhinitis was classified as allergic rhinitis, non-allergic rhinitis, and unspecified rhinitis in 72.4%, 18.9%, and 8.7%, respectively. The result of the study showed that there was statistically significant improvement in the quality of life (SF36 and RCQ36 ) and the decrease of nasal and other symptoms score after 3 months of period treatment in chronic rhinitis patients (<em>P </em>&lt; .05).</p> <p style="text-align: justify;"><strong>Conclusions:</strong>&nbsp;The improvement in the quality of life (SF36 and RCQ36) and the decrease in nasal and other symptoms were documented after 3 months of treatment in chronic rhinitis patients.&nbsp;</p> Malinee Tongdee Nichapha Dechapaphapitak Thanuchporn Kafaksom Umaporn Udomsubpayakul Chamard Wongsa Wannada Laisuan ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 21 29 10.33165/rmj.2019.42.2.149814 A Comparison of Quality of Life in Adults With Voice Disorders Before and After Voice Therapy https://www.tci-thaijo.org/index.php/ramajournal/article/view/102568 <p style="text-align: justify;"><strong>Background: </strong>Previous studies have documented the effectiveness of voice therapy in terms of voice quality outcomes rather than quality of life outcomes.</p> <p style="text-align: justify;"><strong>Objective: </strong>To compare the quality of life among patients with voice disorders, before and after voice therapy.</p> <p style="text-align: justify;"><strong>Methods: </strong>Thirty-six patients with voice disorders who visited the Speech Clinic at Ramathibodi Hospital from March 2013 to January 2015 were enrolled. Thirty minutes per session within 10 weeks period of voice therapy program were used. The voice therapy approaches included direct and indirect therapy. The outcomes of this study were measured using Dr. Speech software version 5 for acoustic analysis and the Voice Handicap Index in Thai version for quality of life. Data was analyzed by descriptive and inferential statistics (Paired<em> t</em> test).</p> <p style="text-align: justify;"><strong>Results:</strong> The total participants were 36 patients with a mean age of 51.31 years. They were divided to 4 groups according to the causes of voice disorders that were 18 patients for structural cause, 8 patients for functional cause, 6 patients for neurological cause, and 4 patients for inflammatory cause. The results for both voice quality and quality of life after voice therapy improved and showed statistically significant differences (<em>P</em> &lt; .05). The patients with all causes of voice disorders were statistically significant differences in total the Voice Handicap Index scores (<em>P</em> &lt; .05). Moreover the structural causes group exhibited statistically significant differences in all subscales (<em>P</em> &lt; .05) but the others causes groups were not statistically significant differences in emotional subscale for functional causes, physical subscale for neurological causes, and functional subscale for inflammatory cause (<em>P </em>&gt; .05)</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Voice therapy might be an effective treatment to decrease the severity of voice disorders in role of voice quality and quality of life, especially voice disorders from structural causes.</p> Tipwaree Aueworakhunanan Kalyanee Makarabhirom Dechavudh Nityasuddhi ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 30 37 10.33165/rmj.2019.42.2.102568 Knowledge, Self-Efficacy, Self-Management Behavior of the Patients With Predialysis Chronic Kidney Disease https://www.tci-thaijo.org/index.php/ramajournal/article/view/119901 <p style="text-align: justify;"><strong>Background:</strong> Chronic kidney disease (CKD) is an emerging global public health problem. Control of risk factors and prevention of complications can delay the progression to end-stage renal disease. Self-efficacy and self-management behavior in patients with predialysis CKD has not been investigated in Nepal.</p> <p style="text-align: justify;"><strong>Objectives:</strong> To describe knowledge of CKD, self-efficacy, and self-management behavior in patients with predialysis CKD and to determine the relationships between knowledge in CKD and self-efficacy with self-management behavior.</p> <p style="text-align: justify;"><strong>Methods:</strong> Ninety-seven predialysis CKD patients visiting nephrology clinic of a tertiary care hospital in Kathmandu, Nepal were recruited from November 2016 to December 2016. Questionnaires comprised of sociodemographic data, CKD knowledge, self-efficacy, and self-management behavior questionnaires were used. Data were analyzed, using descriptive statistics and Pearson product moment correlation coefficient.</p> <p style="text-align: justify;"><strong>Results:</strong> The mean age of 97 participants was 45.67 years. There were 3 stages of CKD among participants: stage G4 (54.64%), stage G3 (42.27%), and stage G2 (3.09%), respectively. Hypertension was the most common comorbidity (81.44%) followed by diabetes mellitus (30.92%). Predialysis CKD patients had a moderate level of knowledge on CKD and self-efficacy and high level of self-management behavior. There were positive relationships between knowledge in CKD and self-management behavior (<em>r</em> = 0.52;<em> P</em> &lt; .05), and between self-efficacy and self-management behavior (<em>r</em> = 0.39; <em>P</em> &lt; .05).</p> <p style="text-align: justify;"><strong>Conclusions:</strong> This study suggested that education, counseling, workshop to increase the knowledge, self-efficacy, and self-management behavior might be helpful for the predialysis CKD patients. Healthcare providers can educate, motivate, and train the patients to practice self-management behavior to delay the progression of CKD.</p> Satchina Moktan Sirirat Leelacharas Wonnapha Prapaipanich ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 38 48 10.33165/rmj.2019.42.2.119901 Prevention of Clinical Laboratory Test Error: Pre-analytical Error https://www.tci-thaijo.org/index.php/ramajournal/article/view/142535 <p style="text-align: justify;">Laboratory test errors are classified into 3 categories: 1) pre-analytical error, 2) analytical error, and 3) post-analytical error. Most errors occur during pre-analytical step, usually caused by human error. The errors make laboratory result unreliable, following with the improper patient care by increasing cost, misdiagnosis, inappropriate treatment, and unexpected complication (even death). Therefore, the implementation of regulation to improve the sample handling process by accurate identification, contamination control, appropriate collection and transportation, is necessary to reduce the errors. In addition, awareness of test’s limitation and communication with laboratory service, when the result is not consistent with clinical manifestation, are also the important factors. The above measures should lead to the appropriate interpretation of laboratory result, following with the effective patient care. Apart from the laboratory test errors, the test itself could give falsely positive or falsely negative results. Therefore, the appropriate laboratory use based on indication is the vital part to minimize unnecessary consequences.</p> <p>&nbsp;</p> Apirom Vongsakulyanon ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 49 62 10.33165/rmj.2019.42.2.142535 Chronic Pain Management in Older Adults https://www.tci-thaijo.org/index.php/ramajournal/article/view/136135 <p style="text-align: justify;">Chronic pain in the elderly usually has negative impacts on physical and psychological status, therefore, early diagnosis and treatment should be performed. The principle of chronic pain management is assessment of pathophysiology which leads to different choices of treatment. Furthermore, chronic pain management in the elderly should be combined nonpharmacological such as cognitive-behavioral therapy and pharmacological treatment in order to increase efficacy of pain control. Pharmacological management for chronic pain is composed of 3 categories including nonopioid analgesics, opioid analgesics, and adjuvant medications. The strategies of pharmacological treatment in the elderly are consideration of start with a low dose and slow titration. Moreover, physicians and pharmacists should be aware of drug-drug interactions, drug-disease interactions, as well as adverse drug reactions and events during treatment.</p> <p>&nbsp;</p> Sirasa Ruangritchankul Orapitchaya Krairit ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 63 78 10.33165/rmj.2019.42.2.136135 Carcinoma of the Esophagus in Patient With Psoriasis: A Case Report https://www.tci-thaijo.org/index.php/ramajournal/article/view/134293 <p style="text-align: justify;">Psoriasis is an immune-mediated, genetic inflammatory disease predominantly affecting the skin and joints. Although various cancers including lymphoma, nonmelanoma skin cancer, and lung cancer among psoriasis patients are more commonly found than the general population; carcinoma of the esophagus has never been reported. The aim of this report was to describe a case of carcinoma of esophagus that was diagnosed in a psoriatic patient. A 50-year-old Thai male presented with epigastric fullness, progressive dysphagia, vomiting, and weight loss for 2 kg within one month. Physical examination revealed multiple erythematous plaques 1 - 3 cm on the trunk and limbs. He had been diagnosed as psoriasis for a year and treated with topical creams. The esophagoscopy revealed the cancer at the lower end of the esophagus that was proved to be poorly to moderately differentiated carcinoma. The computerized tomography of the chest including the upper abdomen showed the esophageal tumor abutting the left bronchus and aorta with multiple lymphadenopathy. He was diagnosed with T3N2M1 stage that was treated with supportive gastrostomy followed by palliative radiotherapy and chemotherapy. Because the carcinoma of esophagus has been hardly reported in psoriatic patients, it could not be easily concluded whether these two entities may have relationship or they just happen by chance.</p> <p>&nbsp;</p> Likhasit Sanglutong Noppawan Vipatakul Somchai Insiripong Kasipot K.Seesuvan ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 2019-06-28 2019-06-28 42 2 79 84 10.33165/rmj.2019.42.2.134293