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://tci-thailand.org/" 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> en-US Chusak.oka@mahidol.ac.th (Assist. Prof. Dr. Chusak Okascharoen) kanyaphakfon@gmail.com (Kanyaphak  Sakaew) Fri, 27 Dec 2019 14:20:53 +0700 OJS http://blogs.law.harvard.edu/tech/rss 60 Editor's Note https://www.tci-thaijo.org/index.php/ramajournal/article/view/231410 <p style="text-align: justify;">“Salami Publication” or “Segmented Publication” is a practice of splitting reporting of a research project into several publications. The extent of this practice is ranged from outright duplication to partial similarity in hypothesis, methodology, and results.<sup>1</sup> This practice may be classified as self-plagiarism or redundant publication which depended on intention of authors.<sup>2</sup> Theoretically, this practice can be considered as appropriate practice in 2 following situations:</p> <p style="text-align: justify;">1)&nbsp;&nbsp; The research project is very large such as umbrella research (small research projects linked together under a common organizational and thematic objectives) or large cohort study as Framingham Heart Study. The reason is simply the results of such studies are too large to put in one publication.</p> <p style="text-align: justify;">2)&nbsp;&nbsp; Longitudinal cohort studies that have several follow-up data to report over period of times.</p> <p style="text-align: justify;">Other reasons that are not fit to these situations usually be considered as unethical. These unethical manners are including intention to increase number of publications, misleading readers about number of studies in literature, and wasting of limited resources in peer-reviewing and publication.</p> <p style="text-align: justify;">There are quite several debate over this practice. From a survey of Medical Journal Editors, severity of salami publication is ranged from no action to rejection and inform to authors’ institutes.<sup>3</sup></p> <p style="text-align: justify;">In practical recommendation, this practice should be avoided. In case that authors believe it is justified to segmented reporting of research findings, authors should clearly state in cover letter to editor and clearly specify in text of manuscript about segmented reporting. Authors need to aware that only referencing in citation list is not adequate.</p> Chusak Okascharoen ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/231410 Mon, 30 Dec 2019 00:00:00 +0700 Distinguishing Infiltrative Transitional Cell Carcinoma From Other Infiltrative Lesions of the Kidneys on Multidetector Computed Tomography https://www.tci-thaijo.org/index.php/ramajournal/article/view/176646 <p style="text-align: justify;"><strong>Background:</strong> The infiltrative renal growth pattern is either characteristic of certain prototype transitional cell carcinomas (TCCs) or other mimickers. Specific computed tomography (CT) features may be used to differentiate TCCs from other overlap findings. Accurate early diagnosis is important to improve treatment outcome and prevent morbidity and mortality from delayed specific treatment.</p> <p style="text-align: justify;"><strong>Objective:</strong> To determine the multidetector computed tomography (MDCT) features that discriminate infiltrative TCCs from other infiltrative renal lesions.</p> <p style="text-align: justify;"><strong>Methods:</strong> A retrospective review was performed on patients with infiltrative, proven renal lesions on CT from January 2008 to July 2014. Individual CT sequences were analyzed for lesion number, location, size, and density on unenhanced and nephrographic phase scans. Final diagnoses were confirmed by histopathology or clinical or imaging follow-up after treatment. The CT findings of intrarenal TCCs and mimics were compared by using logistic regression analysis.</p> <p style="text-align: justify;"><strong>Results:</strong> In 73 patients, there were 18 (24.6%) TCCs, 2 (2.7%) renal cell carcinomas (RCCs), 11 (15.1%) lymphomas, 15 (20.5%) renal parenchymal metastases, 17 (23.3%) infections, and 10 (13.7%) other diagnosis. Compared to non-TCCs, intrarenal TCCs were more likely to be solitary lesion, lack intralesional calcification, less avidly enhance in nephrographic phase and infiltrate pelvicalyceal and perinephric tissue (<em>P</em> &lt; .05).</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Five MDCT features including solitary lesion, absence of calcification and poor absolute, relative enhancement, pelvicalyceal system involvement, and perinephric tissue invasion were significantly associated with intrarenal and infiltrative TCCs.</p> <p style="text-align: justify;">&nbsp;</p> Pornphan Wibulpolprasert, Sasiwimon Jungtheerapanich, Bussanee Wibulpolprasert ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/176646 Tue, 31 Dec 2019 00:00:00 +0700 The Amelioration of Nutritional Status and Phase Angle, Safety, and Satisfaction in Tube-Fed Patients With Ready-to-Use Blenderized Diet With Chicken and Pumpkin https://www.tci-thaijo.org/index.php/ramajournal/article/view/191337 <p style="text-align: justify;"><strong>Background:</strong> The requirement of a hospital-made, blenderized diet, as a generally used and complete polymeric formula, is increasing beyond supply availability and accessibility. A ready-to-use blenderized diet with chicken <br> and pumpkin in a retort pouch was developed from regular use formula by nutritionists and dietitians to solve these problems. However, its clinical outcomes should be evaluated.</p> <p style="text-align: justify;"><strong>Objectives:</strong> To assess the efficacy and safety of a ready-to-use blenderized diet, and to examine the satisfaction of patients and caregivers.</p> <p style="text-align: justify;"><strong>Methods:</strong> Thirty adult patients in Ramathibodi Hospital with absolute tube feeding were included in a pre-post treatment comparative study and fed with the study formula for 14 days. Body composition measurements, nutritional status, clinical parameters, and biochemical tests were collected at baseline and day 14 after feeding. Complications were monitored daily. Satisfaction was evaluated at day 14.</p> <p style="text-align: justify;"><strong>Results:</strong> This study reported statistically significant improvements in nutritional status (<em>P</em> &lt; .001), albumin (<em>P </em>= .003), prealbumin (<em>P</em> = .007), total lymphocytic count (<em>P</em> = .004), and phase angle (<em>P</em> = .02) after 14-day feeding. No major complications were reported. Satisfaction of product use was evaluated in the level of satisfied (27%) and very satisfied (73%).</p> <p style="text-align: justify;"><strong>Conclusions:</strong> The present study revealed that a ready-to-use blenderized diet with chicken and pumpkin was efficacious in ameliorating nutritional status, nutrition-related blood tests, and phase angle without any major complications.</p> <p style="text-align: justify;">&nbsp;</p> Kulapong Jayanama, Piyanuch Maitreejorn, Thanwarin Tangsermwong, Pariya Phanachat, Prapimporn Chattranukulchai, Patcharavee Tanlakit, Daruneewan Warodomwichit ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/191337 Tue, 31 Dec 2019 00:00:00 +0700 Medical Students’ Attitude in Patient Safety: A Survey From a Tertiary Hospital in Thailand https://www.tci-thaijo.org/index.php/ramajournal/article/view/164317 <p style="text-align: justify;"><strong>Background:</strong> Understand patient safety attitude in medical students is important and useful to improve teaching on patient safety at undergraduate level.</p> <p style="text-align: justify;"><strong>Objective:</strong> To assess the attitude on patient safety in clinical year medical students.</p> <p style="text-align: justify;"><strong>Methods:</strong> A cross-sectional survey was conducted in 4th to 6th year medical students in Maharat Nakhon Ratchasima Hospital from August to September 2018. The 26-item Attitudes toward Patient Safety Questionnaire (APSQ) was sent via Google Forms to medical students for voluntary, anonymous answer. The 9 topics of patient safety culture were collected and analyzed.</p> <p style="text-align: justify;"><strong>Results:</strong> There were 106 of 128 medical students responded to the questionnaire. In 9 topics of safety culture, the highest positive attitude in medical students was working hours as an error cause (76.1%). Meanwhile, the lowest positive attitude was professional incompetence as an error cause (26.9%). Neither academic year nor grade point average (GPA) of medical students was associated with positive attitude score. Half of medical students reported a positive attitude of the importance of patient safety in the curriculum.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Medical students had positive attitude of patient safety. Perspective in systems thinking of patient safety should be emphasized in patient safety education of medical students.</p> <p>&nbsp;</p> Watanyu Parapiboon, Piyaporn Sittitaworn, Sorarat Lermanuworat ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/164317 Tue, 31 Dec 2019 00:00:00 +0700 Intellectual Property and Medical Innovation Research Utilization at the Faculty of Medicine Ramathibodi Hospital, Mahidol University https://www.tci-thaijo.org/index.php/ramajournal/article/view/183612 <p style="text-align: justify;"><strong>Background: </strong>&nbsp;In order to increase the potential use of intellectual property innovations of the Faculty of Medicine Ramathibodi Hospital, Mahidol University, it is necessary to know the intellectual property information and utilization. In the past, there has been no systematic study to be used as a guide to leverage intellectual property for social and commercial purposes. Currently, there is no clear information to improve operations and support.</p> <p style="text-align: justify;"><strong>Objectives:</strong> To study the number of intellectual property and their utilization in the Faculty of Medicine Ramathibodi Hospital, Mahidol University.</p> <p style="text-align: justify;"><strong>Methods: </strong> This retrospective study was conducted between the academic year 2007 to 2018 by using secondary data of intellectual property for data collection and analysis. The numbers of intellectual property were categorized by year, type of intellectual property and type of utilization. Data were analyzed using descriptive statistics.</p> <p style="text-align: justify;"><strong>Results: </strong> There were 146 intellectual properties including 52 petty patents (35.62%), 1 invention (0.69%), 9 product designs (6.16%) and 84 copyrights (57.53%), whereas 25 pending process of patents. The utilization of intellectual property was 51.72% for use for social purposes, 36.55% for academic use, and only 11.73% for commercial use.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> The utilization of intellectual property at the Faculty of Medicine Ramathibodi Hospital, Mahidol University was mainly for academic and community uses. Use for commercial purposes was relatively low but there is potential for application provided that inventors receive suitable encouragement and have intellectual property knowledge to develop innovations that lead to concrete use.</p> <p style="text-align: justify;">&nbsp;</p> Suwitcha Theplawan, Chagriya Kitiyakara ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/183612 Tue, 31 Dec 2019 00:00:00 +0700 Prevalence of Condom Use and Its Related Factors Among Men Who Have Sex With Men in Thailand https://www.tci-thaijo.org/index.php/ramajournal/article/view/207154 <p style="text-align: justify;"><strong>Background:</strong> The new challenge of human immunodeficiency virus (HIV) prevention exists in men who have sex with men (MSM) and becomes the key population accounting for the vast majority of new HIV infections worldwide. Consistent condom use has been proved to be effective to prevent HIV transmission. Promoting the use of condom is needed; however, knowledge on what factors relevant to the performance of this behavior among MSM in Thailand is limited.</p> <p style="text-align: justify;"><strong>Objectives:</strong> To examine the prevalence rate of condom use among MSM in Thailand, and to identify related factors of its use.</p> <p style="text-align: justify;"><strong>Methods:</strong> Participants were recruited using convenience sampling with inclusion criteria. The data were collected using an online questionnaire and then analyzed using chi-square test and Spearman rank correlation.</p> <p style="text-align: justify;"><strong>Results:</strong> A total of 153 data sets from participants were included in the analysis. The average age was 27.4 ± 5.8 years. The HIV positivity was 6.5%, and consistent condom use was 55.6%. The correlational analysis showed that age (<em>P</em> = .03), intention, attitude, subjective norms, and perceived behavioral control (<em>P</em> &lt; .01) were significantly correlated with consistent condom use.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> The interventions proposed to promote consistent condom use among MSM should focus on increasing intention, attitude, subjective norms, and/or perceived behavioral control, especially among young MSM in Thailand.</p> <p style="text-align: justify;">&nbsp;</p> Sirinan Prakot, Sasisopin Kiertiburanakul, Poolsuk Janepanish Visudtibhan ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/207154 Tue, 31 Dec 2019 00:00:00 +0700 Proliferative Myositis: A Comprehensive Review of 33 Case Reports https://www.tci-thaijo.org/index.php/ramajournal/article/view/204125 <p style="text-align: justify;">Proliferative myositis, a rare reactive intramuscular myofibroblastic proliferation, is not well recognized in clinical practice. It overgrows within a few weeks and expands the space between the muscle causing infiltrative-like border mimicking sarcoma. Knowledge of the natural history and pathology of proliferative myositis is essential in order to prevent misdiagnosis and unnecessary surgical resection. Thirty-three reported cases of proliferative myositis in PubMed and Web of Science databases from 2000 to 2018 had been reviewed with the main emphasis in clinical presentation, radiological and pathological findings, treatment, and prognosis. Both males (19 cases) and females (14 cases), predominantly the middle-aged and senior adults, were affected. Upper extremity and shoulder girdle were commonly involved. The chief complaint varied from either painful or painless mass. The traumatic injury was reported as a significant predisposing factor. The lesion typically proliferated and separated muscle bundle. Ultrasonography of the lesion revealed a characteristic “checkerboard pattern” on transverse view. The definite diagnosis was based on the demonstration of spindle-shaped fibroblast/myofibroblast admixed with giant ganglion-like cells in the biopsy. Immunohistochemistry may be useful diagnostic tool when the histopathology was inconclusive. Misdiagnosis of sarcoma occurred due to its rapid growth and infiltrative-like border. Watchful management without surgery was sufficient because of the potential for spontaneous regression. Thoroughly clinical examination and appropriate investigations, including imaging and histopathology, are crucial.</p> <p style="text-align: justify;">&nbsp;</p> Pannawat Trerattanavong, Chinnawut Suriyonplengsaeng, Jariya Waisayarat ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/204125 Tue, 31 Dec 2019 00:00:00 +0700 RAMA TAP Block Sheet https://www.tci-thaijo.org/index.php/ramajournal/article/view/196360 <p style="text-align: justify;">Postoperative analgesia is an important aspect of anesthesia care since pain problems affect both physical and mental derangement, resulting in delayed recovery. Transversus abdominis plane block (TAP block) can be performed in the abdominal wall area using ultrasound-guided technique. The TAP block is a peripheral nerve block designed to anesthetize the nerves supplying the anterior abdominal wall. Nowadays, the TAP block could also be used to reduce the need for postoperative opioid use, to extend the period of first analgesia request, and to provide more effective pain relief while decreasing opioid related side effects such as sedation and postoperative nausea and vomiting. Realizing the need to create an innovation, Ramathibodi Hospital anesthesia team has introduced the RAMA TAP block sheet, which is a transparent plastic sheet with 2 square-sided holes. The RAMA TAP block sheet is designed to facilitate anesthesiologist during TAP block procedure and reduce contamination risk from gauzes in surgical area. This innovation could potentially allow the anesthesiologist to visualize both sides of abdominal walls as well as the midline of abdomen clearly so that a good injection site with local anesthetic to skin can be located. The RAMA TAP block sheet is an inexpensive, practical and highly efficient invention that could be sterilized.</p> <p style="text-align: justify;">&nbsp;</p> Jittima Jiarpinitnun ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/196360 Tue, 31 Dec 2019 00:00:00 +0700 Chronic Dyspepsia Due to an Unusual Cause Outside the Gastrointestinal Tract: A Case Report https://www.tci-thaijo.org/index.php/ramajournal/article/view/136668 <p style="text-align: justify;">The majority of cases with dyspepsia usually have normal gastroscopic finding, so some unusual causes may be easily neglected under the umbrella of nonulcer dyspepsia as in this case. We report a 64-year-old Thai patient who suffered from dyspepsia and fatigue for many years. Her latest physical examination was unremarkable. Although she did not have any warning signs, many abdominal investigations including the ultrasonography, computerized tomography, barium enema with air contrast, esophagogastroduodenoscopy, and colonoscopy were repeatedly performed in different hospitals and all revealed unremarkable. The last esophagogastroduodenoscopy showed only mild acute gastritis that was not expected to account for the many-year dyspepsia and fatigue. The unusual and rare causes of long term dyspepsia were extensively investigated. Finally, she was found to have serum cortisol less than 0.8 <img title="\small \dpi{90} \small \mu g/dL" src="https://latex.codecogs.com/gif.latex?\dpi{100}&amp;space;\fn_phv&amp;space;\small&amp;space;\dpi{90}&amp;space;\small&amp;space;\mu&amp;space;g/dL">, normal serum calcium, phosphorus, and electrolytes but minimally abnormal thyroid function test. Therefore, she was diagnosed as having adrenal insufficiency and concurrent subclinical hyperthyroidism. She was fully treated with many dyspeptic drugs such as pantoprazole, sucralfate, simethicone, ondansetron, and intravenous hydrocortisone infusion 300 mg a day. She responded well to therapy in 2 days and was discharged home with oral prednisolone 15 mg a day with many dyspeptic drugs. Adrenal insufficiency is a very rare entity and most cases have no specific signs and symptoms, so it could be easily overlooked as the very rare and unusual cause of chronic dyspepsia. In this report, the association between the adrenal insufficiency <img title="" src="https://latex.codecogs.com/gif.latex?">and the gastrointestinal upset is discussed.</p> <p style="text-align: justify;">&nbsp;</p> Lickhasit Saenglootong, Somchai Insiripong ##submission.copyrightStatement## https://creativecommons.org/licenses/by-nc-nd/4.0 https://www.tci-thaijo.org/index.php/ramajournal/article/view/136668 Tue, 31 Dec 2019 00:00:00 +0700