Buddhachinaraj Medical Journal
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Item Teenage Pregnancy and Adolescent Motherhood in Phetchabun Province: 2008(Buddhachinaraj Medical Journal, 2011-03-10) Witayathawornwong, Punpit; Petchabun Provincial Public Health Office; Sahamaethapat, Kannika; Petchabun Provincial Public Health Office; Suriyawong, Chanphen; Petchabun Provincial Public Health OfficeCurrently, incidences of teenage pregnancy are dramatically rising. This prospective descriptive study wasmainly aimed to analyze the comprehensive factors including knowledge, attitudes, value, perception and readinessin teenage pregnancy labored in 11 public hospitals in Phetchabun Province. The study was conducted during 1st February Through 30 th June 2008. Four hundred and fifty five under 20-year-old pregnant women were enrolled in the study. Age and income were analyzed with independent t-test. Occupation, marital status, living with couple and complications of pregnancy and delivery were analyzed by Pearson chi-square test with significant level at 0.05. Teenage pregnant women had low level in knowledge, perception, and information about pregnancy and delivery. However, attitudes and value of pregnancy and delivery were in middle level. There were more than half unwanted pregnancy in teenage pregnancy, resulted from poor family planning. Wanted pregnancy was older, had more occupation, higher income and living with couple than unwanted pregnancy (p = 0.011, 0.002, \< 0.001 and \< 0.001, respectively). Unwanted pregnancy had more complications (p \< 0.001). In conclusion, official and private sector should prevent this problem by educate primary and secondary students about sex education and family planning.Item What’s in Liver?(Buddhachinaraj Medical Journal, 2011-03-10) Porncharoenpong,, Suchat; Department of Anatomical Pathology, Buddhachinaraj Phitsanulok Hospitalno abstractItem Outcome of Elderly Pregnancy in Sukhothai Hospital(Buddhachinaraj Medical Journal, 2011-03-10) Techasueb, Ratinan; Department of Obstetrics and Gynecology, Sukhothai HospitalElderly pregnant women (35 years or more of age) is high risk that may effect to delivery course and fetus morethan young pregnancy (younger than 35 years). But some studies failed to confirm this association. This historicalcohort study collected data from Labor Room of Sukhothai Hospital from October 1, 2008 to September 30, 2009about delivery and fetal outcomes in every singleton pregnancy. There were 268 elderly pregnancy (average age 37.91+ 2.3 years) and 1,789 young pregnancy with verage age 24.60 + 5.48 years. Elderly pregnancy had significantly high risk to hypertensive disorder in pregnancy, diabetes mellitus, placenta previa and higher in cesarean section rate [RR 3.4 (95%CI 2.2, 5.2), RR 2.7 (95%CI 1.3, 5.7), RR 3.3 (95%CI 1.5, 7.3), RR 1.4 (95%CI 1.2, 2.11)], respectively. So surveillance this condition is necessary since antenatal care.Item ผลของการใช้สื่อวีดิทัศน์ “ดั่งดอกไม้บาน” ต่อความวิตกกังวลของสตรีก่อนตัดมดลูก(Buddhachinaraj Medical Journal, 2011-03-10) ทัดเที่ยง, เสาวคนธ์; Buddhachinaraj Phitsanulok Hospital; เลี่ยมสกุล, อุษาวดี; Buddhachinaraj Phitsanulok Hospital; พฤกษานันท์, สุพัตราno abstractItem 14th Ottawa Conference Hyatt Regency Miami, Florida, USA(Buddhachinaraj Medical Journal, 2011-03-10) Dansawang, Sa-ang; Buddhachinaraj Phitsanulok Hospitalno abstractItem Effectiveness of Tranexamic Acid for Blood Conservation of Total Knee Arthroplasty in Phichit Hospital(Buddhachinaraj Medical Journal, 2011-03-10) Prathinthong, Witaya; Department of Orthopaedic Surgery, Phichit HospitalIntraoperative and postoperative blood loss in total knee arthroplasty (TKA) associated with shock or complicationfrom allogenicblood transfusions. The objective of this study was to assess effectiveness of tranexamic acid forblood conservation strategy after TKA by comparing the patients with and without tranexamic acid (TA)administered. In an experimental research, 111 patients who had minimal invasive surgery for TKA in PhichitProvincial Hospital between May 2005 until July 2010 were randomized. Treatment group, 54 patients wereadministered with TA. Control group, 57 patients were not administered with TA. The patient demographic dataand laboratory characteristics were analyzed, presented by frequency, percentage then compared withchi-square and Fisher’s exact test. The median of intraoperative, postoperative blood loss and allogenicbloodtransfusions were compared by Mann-Whitney U test with significant level at 0.05, and also compared risk ratio(RR) of these conditions. The results showed that intraoperative blood loss, total postoperative blood loss andallogenic blood transfusions were significantly lower in treatment group. The risk ratio of intraoperative blood lossand transfusion requirementwere less in treatment group [RR 0.39 (95%CI 1.29, 2.42) of intraope rative blood loss and RR 0.32 (95%CI 0.22, 0.55) of transfusion requirement]. The results indicate that tranexamic acid can reduce blood loss and transfusion requirements in total knee arthroplasty.Item The Use of the Cell Saver(Buddhachinaraj Medical Journal, 2011-03-10) Suwanakitch, Prawpan; Department of Cardio-Thoracic-Technology, Allied Health Science Faculty, Naresuan University, PhitsanulokCell saver was first commercially available in 1968. At that time, there were many problems such ascontaminated blood, anti-coagulated blood, air embolism and renal failure. There is now improved anddeveloped continuously until the machine is performing well. Major benefit of using Cell saver is donor bloodreduction. Therefore, it can reduce transmitted disease from blood such as AIDS and hepatitis. In Thailand,the Cell saver is available used in open heart surgery, but not another surgery and other indications. This articlepresents the principle of working, indications, contraindications, the advantages and disadvantages of Cellsaver using.Item Results of Total Laparoscopic Hysterectomy between Obese Patients and Non-obese Patients(Buddhachinaraj Medical Journal, 2011-03-10) Chaijaroen, Somjet; Department of Obstetric \& Gynecology, Uttaradit HospitalThere is an increase in incidence of obese Thai females. Total laparoscopic hysterectomy may be difficult toperform in an obese patient. The objective of this analytic study was to compare the results of total laparoscopichysterectomy between obese patients and non-obese patients. All cases of total laparoscopic hysterectomyperformed in January 2007 to June 2010 for benign gynecologic conditions at Uttaradit Hospital were reviewed.There were 194 patients divided by BMI into group I 74 obese patients (BMI \> 25 kg/sq.m.) and group II 120non-obese patients (BMI \< 25 kg/sq.m.). There was no difference in both groups regarding duration of operation,estimated blood loss, length of hospital stay and complications. It can be concluded that total laparoscopichysterectomy is feasible and safe in most obese patients similar to those for non-obese patients.Item Results of Post cesarean Delivery Pain Relief between Oral Tramadol and Intravenous Morphine: A Randomized Controlled Trial(Buddhachinaraj Medical Journal, 2011-03-10) Nathongchai, Supachai; Department of Obstetrics \& Gynecology, Somdejprachaotaksinmaharaj HospitalPostcesarean delivery pain often occurs, so postcesarean delivery mothers have to receive analgesia. Opiatederivative analgesia may cause side effects. This experimental study aimed to determine and compare whetheroral analgesia with tramadol or intravenous morphine provides superior analgesia after planned cesarean deliveryin all more than 18-year old mothers with labor pain. One hundred and fifteen patients were studied atSomdejprachaotaksinmaharaj Hospital between February 2009 to May 2010. The scheduled cesarean deliverywas designed randomly to receive either oral analgesia with tramadol or intravenous morphine. At 6 and 24 hoursafter the procedure, pain was assessed on a visual analog pain scale of 0 to 10. Nausea, emesis, pruritus,drowsiness, ambulation and oral fluid intake were also assessed. Patients who used oral analgesia experiencedmore pain at 6 and 24 hours after cesarean delivery, but they had less nausea and drowsiness at 6 hours.Conclusion, oral analgesia with tramadol may offer inferior pain control after cesarean delivery but less sideeffects than morphine. Consideration should be given to expand the use of oral analgesia in patients immediatelyafter cesarean delivery and complete recovery.Item Asthmatic Patients’ Quality of Life in Asthma Clinic, Buddhachinaraj Phitsanulok Hospital(Buddhachinaraj Medical Journal, 2011-03-10) Memano, Somporn; Outpatient Department, Buddhachinaraj Phitsanulok HospitalAsthma cannot be cure, need continuous treatment but low mortality rate. Quality of life represents true result oftreatment. The objective of this analytic study was to compare asthmatic patients’ quality of life according to sex,age, education, occupation, income, marital status, duration and severity of disease. The data were collected from100 asthmatic patients attending Asthma Clinic at Buddhachinaraj Phitsanulok Hospital during August 2008, usinga questionnaire for demographic characteristics and modified WHOQOL-BRIEF-THAI form for quality of life.Data were analyzed and presented in frequency and percentage for demographic characteristics. Comparingmean of quality of life with demographic characteristics by 95% confidence interval. Most of the patients hadmedium level of overall quality of life and other domains, but good level in psychological domain. The governmentasthmatic officers had better quality of life than non-occupation and other occupation groups in psychological andenvironment domains. About half of the asthmatic patients had intermittent persistent symptoms, so there was nodifference in quality of life according to severity of disease. The results can conclude that severity of disease is theonly factor that can improve patients’ quality of life.Item Editor’s Note(Buddhachinaraj Medical Journal, 2011-03-10) Tanthachun, Nanthiya; Buddhachinaraj Phitsanulok HospitalNo abstractItem Outcomes of Treatment of Femoral Shaft Fracture by Minimally Invasive Plate Osteosynthesis in Phichit Hospital(Buddhachinaraj Medical Journal, 2011-03-10) Latthithanathum, Naiyarat; Department of Orthopedics, Pichit HospitalAlthough intramedullary nailing has standardized the management of femoral shaft fracture, but MIPO (minimallyinvasive plate osteosynthesis) is an alternative treatment in patient who intramedullary nailing is contraindicated.From June 2008 to June 2010, all patients with femoral shaft fractures who intramedullary nailing werecontraindicated and treated by MIPO using a locking compression plate (LCP) were reviewed. There were 20patients, MIPO were done by the author only. Twenty fractures (100%) healed without complication. The averagetime for full weight bearing was 10.80 weeks (range 6-12 weeks). The average time for stable three of fourcortices bridging callus (complete healing) was 21.60 weeks (range 16-24 weeks). There was no plate failure, nowound healing complications or infections. The results show that this technique is reproducible and effective forthe treatment of femoral shaft fractures when intramedullary nailing is contraindicated.Item Teenage Pregnancy and Adolescent Motherhood in Phetchabun Province: 2008(Buddhachinaraj Medical Journal, 2011-03-10) Witayathawornwong, Punpit; Petchabun Provincial Public Health Office; Sahamaethapat, Kannika; Petchabun Provincial Public Health Office; Suriyawong, Chanphen; Petchabun Provincial Public Health OfficeCurrently, incidences of teenage pregnancy are dramatically rising. This prospective descriptive study wasmainly aimed to analyze the comprehensive factors including knowledge, attitudes, value, perception and readinessin teenage pregnancy labored in 11 public hospitals in Phetchabun Province. The study was conducted during 1st February Through 30 th June 2008. Four hundred and fifty five under 20-year-old pregnant women were enrolled in the study. Age and income were analyzed with independent t-test. Occupation, marital status, living with couple and complications of pregnancy and delivery were analyzed by Pearson chi-square test with significant level at 0.05. Teenage pregnant women had low level in knowledge, perception, and information about pregnancy and delivery. However, attitudes and value of pregnancy and delivery were in middle level. There were more than half unwanted pregnancy in teenage pregnancy, resulted from poor family planning. Wanted pregnancy was older, had more occupation, higher income and living with couple than unwanted pregnancy (p = 0.011, 0.002, \< 0.001 and \< 0.001, respectively). Unwanted pregnancy had more complications (p \< 0.001). In conclusion, official and private sector should prevent this problem by educate primary and secondary students about sex education and family planning.Item Clinical Course of Perinatal HIV-infected Children in Chiangrai Prachanukroh Hospital(Buddhachinaraj Medical Journal, 2011-03-10) Preedisripipat, Kanchana; Department of Pediatrics, Chiangrai Prachanukroh Hospital; Maneerat, Noodchanee; Department of Pediatrics, Chiangrai Prachanukroh Hospital; Yodsuwan, Chaniporn; Department of Pediatrics, Chiangrai Prachanukroh Hospital; Hansudewechakul, Rawiwan; Department of Pediatrics, Chiangrai Prachanukroh HospitalEven though prevention of mother to child transmission (PMTCT) program has been implemented for 10 years,HIV-infected children are still found. This historical cohort study was conducted to describe disease manifestationand survival of perinatally HIV-infected children whom were born in Chiangrai Prachanukroh Hospital betweenJanuary 2000 to December 2009. There were twenty-five HIV-infected children, eight of them have receivedantiretroviral (ARV) therapy with 99.4% average adherence. ARV group had 37.5% side effects. Viral load wasundetectable after ARV therapy 9 months. Mean age of illness in ARV group was similar to non ARV group(20.1 months and 21.7 months, respectively). Sixty four percent of illness were found in HIV-infected children(16 of 25). Severe clinical conditions (category C) were diagnosed in non ARV group. All of them died at meanage 13.4 months by pneumonia probable P. jiroveci pneumonia (PCP), diagnosis by clinical criteria. High incidence rate of death were not received zidovudine (AZT) at birth, breast feeding and CD4 cellcount \< 350 cell/cu mm (p \< 0.05). The risk ratio of death in these groups were 54.75, 11.15 and 9.7, respectively.In conclusion, children who are not received zidovudine (AZT) at birth, breast feeding, low CD4 cell count \< 350cell/cu mm, severe clinical conditions (category C) and non ARV therapy are associated with high mortality rateand high risk ratio of death among perinatally HIV-infected children.Item The Efficacy of Phrae Hospital Back School Program for Chronic Low Back Pain Patients(Buddhachinaraj Medical Journal, 2011-03-10) Chaikeaw, Watchara; Department of Physical Medicine and Rehabilitation, Phrae Hospital; Wiengkum, Pattira; Outpatient Room, Phrae Hospital; Suankool, Piyarat; Department of Physical Medicine and Rehabilitation, Phrae Hospital; Chaikeaw, Kanshanita; Department of Physical Medicine and Rehabilitation, Phrae Hospital; Singkham, Arthit; Department of Physical Medicine and Rehabilitation, Phrae HospitalChronic low back pain is a major health and economic problem that if patients do not have proper treatment it mayturn into disability. Treatment in a crowed busy general hospital may be ineffective because of inadequateavailable time to provide insight for these patients. Back school program is generally accepted in many settingsthat yield fair to good results. Rehabilitation Department of Phrae Hospital has used group education programfor back pain patients since 2006. The randomized controlled trial study was designed to confirm the efficacy ofthis currently back school program between January to November 2010. Patients fulfill in criterions wererandomly selected into 27 controlled and 31 tested group. Tested group had received back pain lecture, coachingfor proper common daily activities, back strengthening and stretching exercise while controlled group receivedstandard treatments. Flexible generalized least-squared (FGLS) statistics was used for analysis.Pain relief and functional status were significantly improved more than the controlled. The flexibility and strengthof back muscles were slightly improved but not different. So, back school program should be promoted toimprove efficacy of pain relief and functional status in chronic low back pain patients with self care of patients andtheir families.Item The Effects of Thai Herbal Compress on Knee Osteoarthritis Pain among Elderly(Buddhachinaraj Medical Journal, 2011-03-10) Phromjuang, Kornwika; Buddhachinaraj Phitsanulok Borommarajonnani college of NursingMany elderly experiences knee osteoarthritis pain, which decreases quality of life. This quasi-experimental studyaimed to analyze the effect of Thai herbal compresses among purposive sampling elderly with knee osteoarthritispain in Phitsanulok Province, twenty elderly in each group. The experimental group used Thai herbal compressesin a warm ball with a temperature no greater than 45ํ th th th week but no statistical significance. Utilizing Thai herbal compress could improve knee osteoarthritis pain, diminish health care utilization, increase health promotion and enhance quality of life.week of treatments (p \< 0.001). Elderly who used Thai herbal compresses decreased knee osteoarthritis pain more than elderly in thecontrol group at the 4week. Descriptive statistics, paired t-test, and independent t-test were applied to address the researchquestions. Compared to baseline, both groups decreased osteoarthritis pain after 4 C for about 20 minutes at least twice a week for a total of 4 weeks or 8 times. The control group did not use Thai herbal compresses, but received other pain relief treatments.Both groups were evaluated by Wong–Baker’s Visual Analog Scale (VAS) pain rating scale at baseline and atthe 4Item Wonder Clamp 2009(Buddhachinaraj Medical Journal, 2011-03-10) อุทัย, นุชจรี; Buddhachinaraj Phitsanulok Hospitalno abstractItem ผลของการให้ข้อมูลก่อนผ่าตัดแก่ผู้ป่วยในโรงพยาบาลพุทธชินราช พิษณุโลก(Buddhachinaraj Medical Journal, 2011-03-10) กล้าณรงค์, ศิริลักษณ์; Buddhachinaraj Phitsanulok Hospital; พราวพันธุ์, ปารณno abstractItem Item การส่งเสริมการบริโภคผักและผลไม้ปลอดสารพิษในชุมชนต้นแบบเศรษฐกิจพอเพียง:การเปลี่ยนแปลงของผลลัพธ์สุขภาพ(Buddhachinaraj Medical Journal, 2011-03-10) อ่อนดี, ประสิทธิ์; อ่อนดี, นภาพร; ทองโต, เสถียรno abstract