Journal of Medicine and Health Sciences
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Item แบบจำลองภาวะขาดเลือดของสมองทั้งสมอง และสมองบางส่วน (Experimental models of global and focal cerebral ischemia)(Journal of Medicine and Health Sciences, 2011-03-07) Pongmayteegul, SirinunThe purpose of this article is to briefly review an experimental animal model of brain ischemia which provides excellent opportunities for understanding the pathophysiology and neuroprotective strategies in human. The global (cardiac arrest) and focal (cerebral ischemia) are two common types found in human, which lead into death and permanent disabilities. The global ischemia represented when cerebral blood flow is reduced throughout all of the brain, whereas focal cerebral ischemia occurred by a reduction of cerebral blood flow to a specific region of the brain. Utilizing the experimental animal model can elucidate the process of cerebral ischemia. In order to achieving the study’s purpose, choosing a proper model and adjusting variable factors of the procedure, lesion site and timing, would provide an appropriate results towards various aims.Item รายงานผลภาพเอกซเรย์คอมพิวเตอร์ของมะเร็งต่อมหมวกไตชนิดนิวโรบลาสโตมาในผู้ป่วยเด็กที่พบร่วมกับภาวะต่อมน้ำเหลืองโตในช่องท้องจำนวนมาก(Journal of Medicine and Health Sciences, 2011-03-07) Angthong, Wirana; Varavithya, Vithya; Leelasithorn, VichitNeuroblastoma is the tumor of sympathetic nervous system that derives from primordial neural crest cells. Neuroblastoma is the third most common pediatric malignancy after leukemia and central nervous system tumors. This article reported atypical computed tomographic findings of neuroblastoma with massive intra-abdominal and retroperitoneal lymphadenopathy. The authors reported a 2-year-old girl who presented with abdominal distension and fever. Ultrasonographic examination showed a large heterogeneous echogenic mass at right suprarenal region. Contrast enhanced computed tomography (CT) of the whole abdomen revealed an ill-defined inhomogeneous enhancing mass at right adrenal gland with internal calcification. There were massive intra-abdominal and retroperitoneal lymphadenopathy. Pathological diagnosis showed the poorly differentiated neuroblastic tumor. This article reported atypical CT findings and reviews natural history, histological findings, biological features, and radiographic appearances.Item การศึกษาค่าปกติของการชักนำกระแสประสาทของเส้นประสาท median, ulnar, radial, sural, common peroneal และ tibial ที่ศูนย์การแพทย์สมเด็จพระเทพรัตนราชสุดาฯ สยามบรมราชกุมารี(Journal of Medicine and Health Sciences, 2011-03-07) Aramrussameekul, WoraphonThe objective of this study was to determine the normative values of sensory Nerve Conduction Studies (NCS) of the median, ulnar, radial and sural nerves and motor NCS of the median, ulnar, common peroneal and tibial nerves in order to determine a standard reference value in the Electrodiagnosis Laboratory at HRH Princess Maha Chakri Sirindhorn Medical Center. We recruited 50 healthy adult volunteers (25 males, 25 females; the mean age was 23.22± 4.02 years). The result showed the mean sensory onset latency of the radial nerve at 10 cm. was 2.07 ± 0.30 msec, median at 13 cm. was 2.25 ± 0.30 msec, ulnar at 13 cm. was 2.28 ± 0.35 msec, and sural at 10 cm. was 2.13 ± 0.36 msec. 2. The mean motor onset latency of the median nerve was 3.44 ±0.72 msec, ulnar was 2.96 ± 0.66 msec, common peroneal was 3.94 ± 1.23 msec and tibial was 3.56 ± 1.08 msec.Item การใช้สมุดบันทึกการปฏิบัติงานทางคลินิกเพื่อประเมินการเรียนรู้ทางสูติศาสตร์นรีเวชวิทยา ( Assessment of student’s clinical skill in Obstetrics and Gynecology: logbook versus Objective Structure Clinical Examination.)(Journal of Medicine and Health Sciences, 2011-03-07) Puapornpong, Pawin; Hamontri, Suttha; Raungrongmorakot, Kasem; Natee, Jiraprapa; Banyongwijai, Panatda; Srisasue, WandeeWhile the training of clinical skills is a requirement for medical study, it is necessary to evaluate whether a student receives enough learning experience. Besides a standard test, the objective structure clinical examination (OSCE), another way to assess the clinical experience of student is the evaluation of the number of patients whom the medical student has take care, which is recorded in a logbook. In this study, the Department of Obstetrics and Gynecology , Faculty of Medicine, Srinakharinwirot University aimed to examine the relationship between the number of studied cases as shown in the student’s logbook and the score that the student got from OSCE. The data of number of patients were collected from 106 logbooks of 4th year medical students that were handed in the department after the 8-week training session in 2008. It was shown that the average number of cases of low risk pregnancy and high risk pregnancy that were taken care per a student were 9.0±3.4 and 5.7±3.7, respectively. The average number of labor cases that were attended by a student was 10.4±3.0. The average number of operative obstetric cases that were attended by a student was 16.7±4.3. The average number of obstetric cases that were attended by a student in obstetric operative room was 5.9±2.3. The average number of obstetric inpatient cases that were taken care per a student was 8.9±2.7. The average number of gynecologic outpatient cases that were taken care per a student was 11.8±11.5. The average number of obstetric cases that were attended by a student in gynecologic operative room was 5.5±2.4. The average number of gynecologic inpatient cases that were taken care per a student was 5.8±1.9. The average number of frequency of evening on-duty was 8.5±0.9. These data revealed that the students should practice the clinical skills from enough number of patients. However, the average score of total students from OSCE was only 53.4±9.7 percent. The statistical tests also showed that there was no relation between the numbers of studies cases and the scores taken by OSCE. Therefore, the criteria for checking the student’s logbook should be evaluated and adjusted for better assessment of clinical training in the department.Item Editalral(Journal of Medicine and Health Sciences, 2011-03-07) -, EditalralItem การศึกษาลักษณะรูปร่างสามมิติของเซลล์บุผิวในหลอดลมของสัตว์เลี้ยงลูกด้วยนมด้วยกล้องจุลทรรศน์อิเลคตรอนชนิดส่องกราด (Surface topography of tracheal cells of common tree shrew (Tupaia glis))(Journal of Medicine and Health Sciences, 2011-03-07) Panyarachun, Busaba; Ngamniyom, Arin; Anupunpisit, Vipavee; Mahasitthiwat, Visan; Intaratat, NoppadolThe surface morphology of the luminal surface of tracheal epithelial cell was demonstrated by mean of scanning electron microscopy. The trachea was investigated that the ciliated cells, non-ciliated cells, and goblet cells (mucous cells) were clearly observed in three dimensions. The ciliated cell provided long cilia to protect lung from foreign body. The goblet cells which lined the mucous membrane were also over the cilia and entraped foreign body in the inspired air. This mucus substance was fused the particles and was propelled by cilia outward. It led to protect lung from invasion. The non-ciliated cells or microvillus cells were covered with short microvilli. They were believed that the microvilli surface were important in regulate the volume of the tracheobronchial secretion. Our results confirm that the morphology of each cell was related to the function for conducting airway.Item Retinal Pigment Epithelium (เซลล์เยื่อบุจอตาชั้นนอก)(Journal of Medicine and Health Sciences, 2011-02-01) Somneuk Nilbu-ngaRetinal pigment epithelium (RPE) is a single layer of the cuboidal epithelium which situates at the outermost layer of the retina. RPE is developed from cranial neuroectoderm. Its functions are to adsorb light and eradicate outer segment of the photoreceptor cells. RPE also forms part of the blood-retinal barrier. There is evidence that RPE can produce vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF). Therefore, VEGF is essential for stimulation of neovascularization whereas PEDF inhibits of angiogenesis. RPE have been cultured and tested whether they could be the progenitor cells for treatment of some retinal diseases. This review aimed to summarize information of RPE in term of development, function, transplantation and its future application of retinal therapy.Item Editorial(Journal of Medicine and Health Sciences, 2010-09-16) Editor -Item Personal Aspects and Physical Fitness Improvement: of Police Officers (คุณลักษณะส่วนบุคคล กับการพัฒนาสมรรถภาพทางกายของข้าราชการตำรวจจังหวัดนนทบุรี)(Journal of Medicine and Health Sciences, 2010-09-16) Dan SuwannarujiPhysical fitness provides the ability of cardiovascular, respiratory and musculoskeletal systems to function efficiently and effectively. This study investigated the influence of the health promotion project of RTPD during 2007-2008 on physical fitness improvement among 1,311 police officers in Nonthaburi Province. The data of the police officers who were not able to pass the physical fitness test (q-value) were reported and analyzed through chi-square test with p-value of 0.05 and odds ratio (OR) with 95%confidence interval. The results showed that several personal aspects, including age and physical activity, affected physical fitness with statistically significance. (p-value=0.001 and 0.002, respectively) Those who were in older age group (52-60 yrs) and those who work with less physical activities (accessory job) had lower physical fitness compared to other groups with OR of 2.59 (1.47-4.55) and 1.61 (1.06 -2.46) respectively. Additionally, q-value significantly changed in proportion with increasing age. Nevertheless, health promotion project was found to have the positive effect on physical fitness improvement with OR of 0.71 (0.54-0.94). According to the longitudinal study after 6-month period of well-operated project, the results showed that main job with higher physical activities and being in higher police rank (commissioned officers) supported the physical fitness improvement with RR of 0.04 (0.002 -0.76) and 2.09 (1.20 -3.63), respectively. In conclusion, older age and less physical activity render the physical fitness decline. However, the health promotion project is useful for physical fitness improvement. Work activity and police rank are two factors influencing physical fitness improvement.Item Reconstruction of a large full-thickness abdominal wall defect using free latissimus dorsi muscle flap: A case report (การปิดผนังหน้าท้องโดยใช้กล้ามเนื้อ latissimus dorsi: รายงานผู้ป่วย 1 ราย)(Journal of Medicine and Health Sciences, 2011-02-01) Poonpissamai SuwajoRepairing of complex abdominal wall defects challenges both general and reconstructive surgeons. For the large-full-thickness defects, distant flaps or free tissue transfer is required to restore the abdominal wall. In this report, a patient with large abdominal defect following excision of a large peripheral nerve sheath tumor was reconstructed by free latissimus dorsi flap. The reconstruction was successful although revascularization was performed one day later. The patient recovered well with no abdominal wall weakening after 4-month follow-up.Item Editorial(Journal of Medicine and Health Sciences, 2011-02-03) Editor -Item การปรับเปลี่ยนพฤติกรรมและการใช้ยาในช่วงเดือนถือศีลอดของผู้ป่วยมุสลิมที่เป็นโรคเบาหวานชนิดที่ 2 (Lifestyle modification and drug administration among Thai Muslim patients with diabetes mellitus type 2 during Ramadan)(Journal of Medicine and Health Sciences, 2011-02-08) Chaturon Tangsangwornthamma; Saipin Hathirat; Wajana LeelapattanaUnderstand the lifestyle modification and the drug administration among Thai Muslim patients with diabetes mellitus type 2 during Ramadan. The in-depth semi-structured interview was conducted during September – November 2007. Content analysis was performed by 2 researchers independently before making the conclusion together. Total of 20 Muslim patients age between 39-77 years in Nakhon Nayok province were interviewed. It was found that most patients didn’t prepare before fasting in Ramadan month. All intended to fast every years but only one could fast strictly throughout the whole holy month each year. The patients assessed their own health while fasting by consideration of acute illness rather than their underlying DM. They didn’t think that DM had significant impact on their fasting. Moreover, they thought that fasting in Ramadan helped them control their blood sugar. There were only several pantients who thought that multiple DM drugs, especially insulin would have an effect on their fasting. Physician was the important factor which impacted on their fasting. However, none of patients had suggestion from their physicians for using drugs and adjusting lifestyle modification during Ramadan. Moreover, some were inhibited to fast or to take ritual fruit for this time. Patients adjusted drugs and dose by themselves. Many had hypoglycemic-like symptoms but not severe. In addition, all Thai Muslim patients with DM type II adjusted their lifestyles and intake of drugs by themselves during Ramadan without physician’s suggestion, which led to mild hypoglycemic-like symptoms in most patients. Therefore, we recommended that physicians working in Muslim community should be cultural-sensitive to ask and give them an advice on how to modify medical intervention which proper to Muslim life during Ramadan month.Item ความเหมาะสมของโปรแกรมตรวจสุขภาพประจำปี ตามเกณฑ์อายุ 35 ปี (Suitable of annual health check-up programs as divided by age of 35 years)(Journal of Medicine and Health Sciences, 2011-02-03) Kittipong KongsomboonAnnual health check-up program is useful for early detection of diseases, which will facilitate successful treatment and improve prognosis. In addition, it helps reducing the cost of treatment. For the government officers, the annual check-up fee is paid, according to age groups, by The Comptroller General’s Department, Ministry of Finance. However, the tests include in the check-up programs may not appropriate for person of less than 35 years of age. The objective of this study was to evaluate how suitable the health check-up program as divided by age of 35 years due to the regulations of The Comptroller General’s Department, Ministry of Finance. The study design was cross-sectional. Data were collected from 466 persons who visited the health promotion center, Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center from July, 2007 to December, 2008. The dataset of fasting blood sugar, blood lipid, renal function, liver function, and blood uric acid were divided into two groups: less than 35 years and equal to or over 35 years. Qualitative data and quantitative data were compared by Chi-square test and T-test, respectively at p-value of less than 0.05. The results showed that 57.1% of subjects were female. The average age was 43.9 years. The values of blood pressure, waist circumference, chest X-ray, stool occult blood, and fasting blood sugar were significantly different between two age groups. Fasting blood sugar, blood lipid, renal function, liver function, and blood uric acid were not statistical difference between age \< 35 years and age \> 35 years. In conclusion, hypertension, abdominal obesity, abnormal chest X-ray, stool occult blood, and high blood sugar were mostly found at older age. It was recommended that the health check-up program which be select by age 35 years old, should be adjusted.Item ผลของการเชียร์เบ่งคลอดต่อผลลัพธ์ของการคลอดEffect of maternal bearing-down cheering on labor outcomes(Journal of Medicine and Health Sciences, 2011-02-03) Kanittha Sukchamnan; Uraiwan Khongsin; Khanittha Sanboonsong; Pawin Puapornpong; Wichian ManolertthewanTeaching of bearing-down method and cheering during childbirth were performed in the hospitals in Thailand for many years without evidence-based of effectiveness. The aim of this study was to compare labor outcome between maternal bearing-down cheering and off-cheering. Fifty nulliparous pregnant women with low risk of complications who came to the labor room at HRH Princess Maha Chakri Sririndhorn Medical Center in Nakhon Nayok province were included in this study. They were divided into 2 groups: maternal bearing-down cheering and off-cheering, 25 cases in each group. Both groups were taught the same bearing-down method; however, only the former group was coached the rhythm of bearing-down by labor assistants. Labor outcomes including the duration of second stage of labor, neonatal birth weight and Apgar score were recorded. It was found that in maternal bearing-down cheering group, the mean of second stage of labor duration was 15.16±9.91 minutes. The mean of neonatal birth weight was 3055.60±57.09 grams. The means of Apgar score at 1st, 5th and 10th minutes were 8.36±1.29, 9.88±0.44 and 10±0, respectively. In the off-cheering group, the mean of second stage of labor duration was 15.60±12.70 minutes. The mean of neonatal birth weight was 3054±54.54 grams. The means of Apgar score at 1st, 5th and 10th minutes were 8.56±0.87, 9.88±0.33 and 10±0, respectively. Therefore, maternal bearing-down cheering was no significant effect on the duration of the second stage of labor and Apgar score.Item New agents for treatment of pelvic endometriosis (ยาชนิดใหม่สำหรับการรักษาเยื่อบุโพรงมดลูกเจริญผิดที่ในอุ้งเชิงกราน)(Journal of Medicine and Health Sciences, 2011-02-01) Tanitra Tantitamit; Maethaphan KitporntheranuntEndometriosis is an estrogen dependent disorder that needs long term treatment. The primary goal of treatment is to alter the growth and activity of endometriotic lesions by inhibiting ovulation and/or inducing atrophic endometrium. Increasing knowledge of the pathogenesis of endometriosis at the molecular and cellular levels has given the opportunity to develop new therapeutic agents. Which have greater efficacy and flexibility than traditional treatments. The new agents are classified as anti-estrogen, anti-progesterone, angiogenesis inhibitors, immunomodulating agents and anti-inflammatory drugs. This review focuses on the new experimental approaches to the medical treatment of pelvic endometriosis.Item มะเร็งลำไส้ใหญ่และลำไส้ตรง Colon and rectal cancer(Journal of Medicine and Health Sciences, 2011-02-03) Bunlung MuyphuagColorectal cancer is the third most common cancer and a leading cause of death. Recent advances in techniques and tools for detection and treatment lead to early diagnosis and increase overall survival. Risk factors of colorectal cancer include advanced age, family history of cancers of the colon, rectum, ovary, endometrial, or stomach. Patients usually present with bowel habit changes or mucous bloody stool. Others may develop acute colonic obstruction or perforation. Treatment of choice is surgery, with adjuvant chemo-radiation in selected cases.Item Editorial(Journal of Medicine and Health Sciences, 2010-09-20) Editor -Item Management of isolated synchronous splenic metastasis from obstructing colon cancer: First case report in Thai female.(Journal of Medicine and Health Sciences, 2011-02-03) Thawatchai Tullavardhana; Prinya Akranurakkul; Witoon UngkitphaiboonThe authors report a case of a patient with isolated synchronous splenic metastasis from obstructing colon cancer. A 43 year old Thai female presented with abdominal distension and obstipation. CT scan of whole abdomen demonstrated a mass located at the splenic flexure and an isodense mass at the superior pole of the spleen, which was considered to be an isolated splenic metastasis. With the presumptive diagnosis of obstructing colon cancer at splenic flexure with isolated splenic metastasis. The patient underwent total colectomy with ileorectal anastomosis concomitant with splenectomy. These procedures are a successful curative option and safe for the management of this condition. Adjuvant chemotherapy following the operation to achieve long term survival and long term follow up with monitoring of serum CEA levels, CT scan of abdomen and colonoscopy are necessary for long-term follow up.Item โครงหลอดเลือดละเอียดในต่อมฮาร์เดอร์เรี่ยนของกระแต Microvasculature of the Harderian Gland in the Common Tree Shrew (Tupaia glis)(Journal of Medicine and Health Sciences, 2011-02-03) Somneuk Nilbu-nga; Wisuit PradidarcheepThe blood supply of the Harderian gland in common tree shrew of both sexes were studied using vascular corrosion cast technique in conjunction with scanning electron microscope. It was found that the gland received the arterial blood from a branch of ophthalmic artery, which gave rise to arterioles located in each glandular lobule. Each arteriole further branched into capillary plexuses that were organized into lobular appearance. Two capillary types were observed in this Harderian gland, which are small round and large irregular sinusoidal capillaries with fenestrations. The venous blood from this gland first drained into the orbital venous sinus locating between the glandular convex surface and the wall of the orbit, and finally to the ophthalmic vein. The presence of the particular vascularization together with electron dense granules and numerous stubby microvilli at the basal portion of the acinar cells suggest that the Harderian gland in the common tree shrews may possibly in endocrine function.Item วิธีการใหม่ในการรักษาโรคอ้วนด้วยวิธีฝังเข็ม Acupuncture: A novel remedial contrivance for obesity(Journal of Medicine and Health Sciences, 2011-02-03) Lakkana Rerksuppaphol; Sanguansak RerksuppapholObesity is one of the metabolic syndromes involving vital systems. The global approach towards obesity also includes acupuncture- a Chinese medicinal therapy. Though acupuncture is being implicated for obesity management, it hasn’t been fully appraised. This review paper was aimed to evaluate the description and studies on acupuncture usage in obesity and critical analysis of the same. To achieve this aim, literature search was used as the methodology of the review. Acupuncture acts by releasing serotonin, beta-endorphin and enkaphaline. Studies showed that acupuncture was effective in treating obesity and induce weight loss. However, acupuncture was not used alone as a treatment arm in studies, showing its effectiveness as adjunctive therapy. Some studies revealed no significant difference in using acupuncture or diet and exercise. The available studies were also of poor quality; this actually opens debate on effectiveness of acupuncture. In future well-planned clinical trial for efficacy of acupuncture in obesity is a pressing need.