Chonburi Hospital Journal-วารสารโรงพยาบาลชลบุรี

Masthead

2025-01-01T20:01:59+07:00

Table of content

2025-01-01T19:48:52+07:00

The Empathy in Medical Student of Medical Education Center, Chonburi Hospital

2024-03-13T16:16:09+07:00

Background: Understanding patients' feelings (Empathy) is an important quality in every doctor-patient relationship. There are still few research studies in this area among personnel in government hospitals under the Thai Ministry of Public Health. The research team is interested in studying the understanding of patients' feelings that are related to the factors of interest to reflect problems and promote the development of the Bachelor of Medical curriculum.

Objective: To examine the level of professional skill : empathy by Jefferson Scale of Physician Empathy (JSPE) Thai version for medical students in Chonburi Hospital, and to study differences and relationships between empathy scores and group of factors including sex, grade score, duration of sleep per day, duration of night shift work per month, level of stress, level of burn out and participation to Chonburi Hospital’s ethical activities.

Method: This research was a cross-sectional study that was conducted between October to December 2023. 106 Clerkship medical students (4^th to 6^th year) in Chonburi Hospital were enrolled. Jefferson Scale of Physician Empathy Student Version (JSPE-S) was used to represent the level of empathy. Other factors are collected by using the Stress Test (ST-5) and Burnout Test that were developed by the Department of Mental Health. JSPE scores were calculated and compared with characteristic factors, stress level, and burnout level.

Result: There were 49 responses or 46.22% of the population. The median empathy score of medical students in Chonburi Hospital was 99 (interquartile range 90, 108). Interval 91-95 was the highest frequency from a total score of 140. The analysis compared with factors, there were statistically significant differences in empathy scores in females and 5^th year with P-values 0.025 and 0.033 respectively. In the multiple linear regression model, females and the highest level of stress had an inverse relationship with Jefferson's score by P-value 0.011 and 0.05 respectively.

Conclusion: From the factors that were studied including sex, grade score, duration of sleep per day, duration of night shift work per month, level of stress, level of burn out and participation to Chonburi Hospital’s ethical activities, there were only sex and stress level being inverse associated with empathy level.

Keywords : Empathy, Medical Student, Patient care

The Effects of Thai Massage in Office syndrome Patients with Thai Yoga Exercise.

2023-09-27T10:07:34+07:00

This research was a quasi-experimental research. The purpose of this study was to compare the level of pain before and after a Thai Massage with Thai Yoga Exercise for the treatment office syndrome patients and study of adverse reactions from massage program. Participants were 30 office syndrome patients whom were treated at Thai traditional medicine clinic Chonburi hospital. Measures included demographic data, Visual rating scales (VRS) and study of adverse reactions from massage program. The intervention were conducted from June to July 2019. Data were analyzed using frequency, percentage, mean, standard deviation, median and one group repeated measure Wilcoxon test. The results found that before entering the program and after entering the program. The samples had different pain levels statistically significant (p = 0.000) lowering in the level of pain after the massage programs. Pain level when head down with chin touching chest. ( = 6.70 and = 3.33) Pain level in head-up position. ( = 6.03 and = 2.93) Pain level when tilting ear close to the left shoulder. ( = 6.57 and = 2.87) Pain level when tilting ear close to the right shoulder. ( = 6.60, and = 2.80) and not found adverse reactions from massage program.

Conclude this research, the massage program can reduce pain in myofascial pain syndrome. Therefore, this massage program could serve as a practice guideline for patients in Thai traditional medicine clinics.

Keywords : Office syndrome, Thai massage, Thai yoga exercise, Visual rating scale

Clinico-Pathological Quiz

2025-01-01T23:54:30+07:00

Instruction

2025-01-01T20:06:58+07:00

Chonburi Hospital Journal

2025-01-01T19:55:18+07:00

Flood and The Related Diseases

2024-12-23T14:45:05+07:00

Floods are a terrible natural disaster and difficult to deal with, causing problems with houses and damaged property. as follows The problem of rotten waterlogging in various areas, the problem of fresh sea water causes fish to run aground and die. The garbage problem causes a lot of garbage to be thrown away after the water recedes. The problem of a large number of people losing their jobs due to flooding in some factories makes it impossible to work. The economic problem is poor because some products cannot be produced, causing a loss of trade balance, and one of the major problems that will arise is health problems because water always carries dirt and germs. There are many types of illnesses that may accompany flooding that should be watched out for, such as foot bites. Dengue fever, leptospirosis, gastrointestinal diseases. Respiratory diseases

2024 is a turning point in the world. When the hot temperature broke a new record, it was the first year that the global temperature rose by more than 1.5 degrees Celsius. Compared to the pre-industrial era. During the 1850s–1900s (1850–1900), when humans began to use fossil fuels on an industrial scale, and from 1940–2024, the climate is warming in all continents and ocean basins . The most above-average temperatures are in northern Canada, as well as the central and western United States. Northern Tibet, Japan and Australia Meanwhile, the temperature is below average. It is found in Greenland and Iceland.

Many scientists believe that such a temperature change (more than 1.5 degrees Celsius) will cause a significant and irreversible change in the condition of the Earth, namely the collapse of the Greenland Ice Sheet. Erosion of the West Antarctic Ice Sheet Tropical coral reefs began to die and the permafrost melted. Scientists also expect severe effects to occur again. If the average temperature of the world rises by 2.0 °C from the pre-industrial average temperature,

ENSO phenomenon in the first 6 months of 2024 (January-June) Thailand is facing hot weather, rising temperatures, and rainfall as a result of the El Niño phenomenon, which has caused a lot of damage to agricultural products, especially economic crops such as rice, cassava, and sugarcane . El Niño is weakening into a neutral state, but it is strong enough to change to La Niña, causing temperatures to drop across the country, causing heavier than usual rainfall, and rainfall of 15.0-16.0% more than normal. Thailand faces an increasing risk of flash floods, especially flood-prone areas (Flood beds), causing floods. The northern and southern regions of Thailand are facing the worst flooding situation in years, causing no damage to homes.

Thailand is facing the risk of the influence of storms and monsoons, which, although not directly entering Thailand, may move into neighboring countries and later disintegrate or change direction, but can still influence rainfall in Thailand. Warm currents and monsoon winds from the Pacific Ocean have increased rainfall, as can be seen from the Pacific Decadal Oscillation (PDO) and the Pacific Decadal Oscillation Index. The Western Pacific Monsoon with negative values and a downward direction, indicating more rainfall. Meanwhile, the western part of Thailand will face the influence of the storm. Warm currents and monsoon winds from the Indian Ocean will increase rainfall. Indications from the Indian Ocean Dipole (IOD) Index and the The Indian Monsoon Index is negative and bearish as well.

However, Areas in the North Central Region The Northeast and parts of the South are classified as high-risk areas. Especially the Lower North, which is a waterway through it, and the Central Region, which is a catchment area and a repetitive flood area. If a flood occurs, it will cause additional damage to the agricultural sector after the damage caused by the drought at the beginning of the year. The damage will cover agricultural land. building house Consumer goods, as well as transportation routes and various utilities.

The Status Epilepticus following Local Anesthetic Toxicity and Phenytoin induced Dyskinesia: A Case Report

2024-06-10T11:39:58+07:00

Phenytoin is effective antiseizure medication which frequently prescribed in clinical practice. Involuntary movements are a less familiar complication of treatment with phenytoin and include tremor, asterixis, myoclonus and tardive dyskinesia. A case report of 6-year-old boy was refered from private hospital with history of accidental falling and he had lacerated wound at both forearm from stone cuts and during stitched suture at emergency room he had developed symptoms of convulsive status epilepticus. He received diazepam 5 mg intravenous 2 doses (0.3 mg/kg) and loading dose of phenytoin 400 mg (21.6 mg/kg) intravenous and stop seizure. He was unconscious and need intubated. He was refered to Chonburi hospital and was given maintenance dose 5 mg/kg/day intravenous of phenytoin. The second day of admission he was noted to have abnormal movement as tardive dyskinesia consisting of facial grimacing, tongue protrusion, eyebrow elevation and limbs dyskinesia. General and neurological examination were normal. Blood test and cerebrospinal fluid exam were normal. We reviewed history of patient’s treatment and all drugs usage and found that he was injected 2% lidocaine amount of 10 cc or 200 mg (10.8 mg/kg) for local anesthesia during stitched wounds, his body weight 18.5 kg which over than toxic dose of Lidocain is 4.5 mg/kg. Conclusion that lidocaine toxicity caused convulsive statue epilepticus and phenytoin was immediately discontinued. The tardive dyskinesia resolved after withdrawal of phenytoin. The patient returned to normal in the third day of admission.

Keywords : Local anesthetic toxicity, status epilepticus, Phenytoin-Anticonvulsants, Tardive dyskinesia

The HIV Incidence in Tuberculosis Patients, Samut-Prakan

2023-07-19T11:16:10+07:00

Objectives: 1) To explain demographic data of tuberculosis (TB) patients. 2) To examine the incidence of HIV-positive TB patients. 3) To investigate the relationship between gender occupation between HIV-negative and HIV-positive TB patients. 4) To compare means of age and Body Mass Index (BMI) between HIV-negative and HIV-positive in TB patients.

Method: A retrospective survey study was performed. Data were collected from the Samut-Prakan Public Health database center in 2022. All 1,135 TB patients were used as a sample (census). Patients who refused to test for HIV were excluded from this study.

Results: Of all 1,135 (100%) TB patients, only 705 (62.11%) consented to test for HIV. Among 705 TB patients, 598 (84.82%) were HIV-negative, and 107 (15.18%) were HIV-positive; therefore, the incidence rate of HIV-positive TB patients was 15.18%. Female had HIV-negative 196 (27.80%), female had HIV-positive 25 (3.55%), male HIV-negative 402 (57.02%), male had HIV-positive 82 (11.63%). Gender was significantly associated with HIV-positive (p = 0.043*, Odd ratio = 1.646); males had 1.646 chances to have HIV-positive than females. However, occupation was not significantly associated with HIV-positive (p = 0.444). The means of age and BMI of HIV-positive patients were significantly less than patients with HIV-negative (p < 0.001*, 0.026*, ANOVA). The most organs that TB infected were 609 (86.38%) lungs, 47 (6.68%) lymph nodes, and 31 (4.40%) pleura. Comorbid diseases with TB patients were 107 (15.18%) HIV-positive, 38 (5.39%) diabetes, and 1 (0.14%) COPD. The majority of the occupations of TB patients were 408 (57.87%) unemployed, 264 (37.45%) employees, and 9 (1.28%) in agriculture. Male had HIV-positive 82 (11.63%) whereas female had HIV-positive 25 (3.55%).

Conclusion: The incidence rate of HIV in TB patients was 15.18%. In TB patients, males had a 1.646 more chance to have HIV+ than females; however, occupations had no association with HIV disease. The TB patients who were HIV-positive were significantly older and less weight than HIV-negative patients.

Keywords : TB, HIV, Incidence of HIV

The Treatment Outcomes and Related Factors of Inhaled Nitric Oxide in Newborns with Persistent Pulmonary Hypertension at Chonburi Hospital

2024-09-10T10:59:31+07:00

Background: Persistent pulmonary hypertension of the newborn (PPHN) leads to neonatal respiratory failure and death. Currently, inhaled nitric oxide (iNO) is one of the treatments for PPHN. Research on the outcomes of iNO treatment and the factors that affect those outcomes is important for developing more effective care processes for newborns with PPHN.

Objective: To investigate nitric oxide inhalation therapy results and factors predicting treatment outcomes in newborns with PPHN.

Methods: This historical cohort study collected data from newborns with PPHN who received iNO treatment in Chonburi Hospital from September 2019 to September 2023. Chi square test, independent t-test, and logistic regression analysis were used to analyze the factors associated with the outcome of iNO therapy with statistical significance p<0.05.

Results: Ninety-two newborns with PPHN received iNO therapy. The neonatal mortality rate after iNO treatment was 33.7%. The factors affecting the mortality rate included higher heart rate (AOR 1.04, 95%CI 1.01, 1.07) and higher oxygen index (AOR 1.03, 95%CI 1.01, 1.06) when starting iNO therapy, and pulmonary hemorrhage (AOR 4.63, 95%CI 1.37, 15.67).

Conclusions: Newborns with PPHN who were treated with iNO therapy have a survival rate of 66.3%. Factors that associated with treatment outcomes include heart rate and oxygen index before starting therapy, and the existence of pulmonary hemorrhage.

Keywords : Persistent pulmonary hypertension of the newborn, Inhaled nitric oxide therapy, Mortality rate, Related factors of treatment outcome

The Efficiency of the “Suksaiyas” Medicine Formula on Insomnia Patients.

2024-09-10T10:37:06+07:00

Insomnia is a common health issue that affects the quality of life, leading to cardiovascular diseases and increasing the risk of depression. Pre-Experimental Research is a one-group experimental study aimed at studying the effectiveness of the treatment of patients with insomnia and adverse reactions to the treatment. The sample group consists of patients with insomnia from the integrated medical cannabis clinic at Chonburi Hospital. A total of twenty-five people. The researchers collected sleep quality data from April 2023 to February 2024 using general information about the research participants, depression assessment (9Q), the Thai version of the Pittsburgh Sleep Quality Index, the Suanprung Stress Test, Adverse drug reaction and Laboratory blood tests. Analyze the data using descriptive statistics and sleep quality analysis with a paired t-test and repeated measure ANOVA, setting the statistical significance level at a P-value less than 0.05. This study, it was found that patients with insomnia had an average sleep quality score (Thai-PSQI score) before and after treatment with the “Suk Sai-Yad” formula. The average Thai-PSQI scores before treatment, after 2 weeks of treatment, and after 1 month of treatment were 15.84±1.72, 13.32±4.88, and 8.64±2.80, respectively. Follow-up results after stopping the medication for 1 month showed average Thai-PSQI scores after stopping the medication at weeks 1, 2, and 3 and after stopping the medication for 1 month were 7.32±2.06, 7.44±2.24, 7.48±2.10, and 7.44±2.04, respectively (a Thai-PSQI score of 5 or less indicates good sleep quality). The comparison of sleep quality results showed that the average sleep quality scores were significantly different (p < 0.05). Laboratory blood tests before and after treatment with the “Suk Sai-Yad” formula showed average liver function (AST) values of 27.80±10.99 and 32.92±6.85, respectively, and average liver function (ALT) values of 25.00±15.22 and 34.84±10.49, respectively, which increased significantly (p < 0.05). The average glomerular filtration rate (GFR) before and after treatment was 80.16±12.53 and 81.56±12.12, respectively, with no statistical difference (p > 0.05).

Research findings indicate that patients with insomnia have improved sleep quality. The medication does not make them drowsy more easily but helps them sleep longer, increasing their sleep duration. They do not feel fatigued after waking up, and their quality of life has improved. However, the use of the “Suk Sai-Yad” medicine must be strictly and cautiously indicated, especially in elderly patients, as the herbs in the “Suk Sai-Yad” formula may affect the liver function. Therefore, regular monitoring and liver function tests are necessary, along with further research. These study results are beneficial for the development and continuation of the “Suk Sai-Yad” research. The study procedures can also be used to establish guidelines for integrated medical cannabis assessment and treatment.

Keywords : “Suk Sai-Yad” medicine formula, insomnia, Quality of sleep, Cannabis for Medical

The effects of gibson's empowerment theory application program of village health volunteers with promoting among the bedridden elderly PhangThiam Sub-district, PhraThongkham District, NakhonRatchasima Province.

2024-03-11T10:49:36+07:00

This quasi-experimental research aimed to the effects of Gibson's empowerment theory application program of village health volunteers with promoting among the bedridden elderly Phang Thiam Sub-district, Phra Thong Kham District, Nakhon Ratchasima Province. The samples were divided into two groups. The experimental group consisted of 35 village health volunteers who received program of Gibson’s empowerment theory and the control group consisted of 35 village health volunteers who received regular health promoting programs by simple random sampling for 12 weeks. The instruments were program of applying Gibson's empowerment theory, questionnaire and skills assessment. Frequencies, percentage, mean, standard deviation, paired samples t-test and independent samples t-test were applied to data analysis.

The results of this study were as follows:

1) After receiving the program of applying Gibson's empowerment theory the village health volunteers, there was significant improvement of “knowledge, health promoting and health prevention skills and environmental management skills” in the experimental group at 0.01 level. t – test equals 10.97, 19.84 and 8.66 respectively.

2) After receiving the program of applying Gibson's empowerment theory the village health volunteers, there was significant improvement of “knowledge, health promoting and health prevention skills and environmental management skills” in the experimental group compared to the control group at 0.01 level. t – test equals 14.94, 18.40 and 8.32 respectively.

The researcher suggest that brining this program to expand training to provide knowledge to related people, such as families and communities, to care for the elderly and is followed Continuous management of knowledge and skills to provide quality care for bedridden elderly people.

Keywords : empowerment, village health volunteers, promoting, bedridden elderly

The Prevalence and Clinical Characteristics of Steroid Non-Responsive Immune Thrombocytopenia Patients in Chonburi Hospital

2024-12-10T12:38:35+07:00

Background: Immune Thrombocytopenia (ITP) is defined as platelet count < 100,000 cells per microliter in the absence of other causes of thrombocytopenia. Steroids remain the first-line therapy for ITP. The majority of patients respond to steroid therapy. However, 20-30% of the patients fail to respond and require alternative therapy with close monitoring of treatment.

Objectives: This study aimed to investigate the prevalence and factors associated with non-response to steroid treatment.

Methods: This study was a retrospective study including ITP patients aged ³ 15 years, who were treated with steroids as first-line treatment at hematology clinic or internal medicine inpatient ward at Chonburi hospital between 1 January 2017 and 31 December 2022. Data collection included age, gender, underlying disease, severity of bleeding and platelet count at time of diagnosis and after 4 weeks of treatment. Blood test results for HBsAg, Anti-HCV, Anti-HIV, ANA and the response status to steroids after 4 weeks were recorded. The study aimed to identify the factors associated with non-response to steroid treatment using Risk difference regression analysis.

Results: Of 168 ITP patients, 25 (14.88%) were non-responsive to steroid treatment. The mean age was 38 years. The majority of patients (73.8%) were female. From the multivariate analysis, we demonstrated that patients without bleeding or with non-severe bleeding at time of diagnosis [adjusted risk difference 0.14, p < 0.01], positive HBsAg [adjusted risk difference -0.21, p < 0.01] and positive ANA patients [adjusted risk difference -0.11, p = 0.04] were associated with non-response to steroid treatment.

Conclusion: The prevalence of steroid non-responsive ITP patients in Chonburi Hospital was 14.88%. Patients without bleeding or with non-severe bleeding at time of diagnosis, positive HBsAg and positive ANA patients were associated with non-response to steroid treatment, however further study is needed to determine the association.

Keywords : Immune thrombocytopenia, ITP, Steroids

Drug Allergy and Cross Reactivity between Drugs

2024-12-26T15:29:42+07:00

"Drug Allergy" is an adverse reaction caused by the body's immune reaction to a drug that is part of an Adverse Drug Reaction (ADR). It is common, usually not severe. Symptoms are related to the dose used, while allergic reactions to drugs [Type B (Bizarre) ADR] are the result of the body's immune system reaction, which varies from person to person. However, there is currently pharmacogenetic data that can detect genetic variation that causes people who have received drugs into the body to respond to allergies to certain drugs. Drug allergy Rare Symptoms are not related to the dose used, and there is a chance of mild to severe symptoms that can be fatal. Especially if you have received a drug with a history of allergies and then have a recurrent allergic reaction or intolerance to the same group.

Letter from Editor

2025-01-01T20:16:28+07:00

Dear readers,

The 3rd issue of the Chonburi Hospital Journal of 2024 has been released to readers. This edition contains many interesting original works, including the incidence of HIV infection in tuberculosis patients. Samut Prakan Province, treatment results and related factors, Effect of Nitric Oxide Inhalation Therapy of Neonates with Pulmonary Hypertension at Chonburi Hospital, Effectiveness of Treatment of Insomnia Patients with Herbal Medicine Recipes, Effect of Application of Gibson Empowerment Theory Program by Village Public Health Volunteers to promote health Bedridden elderly, Prevalence and clinical characteristics of patients with thrombocytopenia due to immune intolerance who do not respond to steroid therapy. In Chonburi Hospital. One patient reported that seizures continued due to local anesthesia poisoning and phenytoin and seizures. One academic rehabilitation article is drug allergy and surveillance of drug allergies in the same group. One special article is a study on understanding the patient's feelings of clinical medical students. Chonburi Hospital and ended with an interesting story of Mr. Korthiraporn, Raj and Mr. Panastha Sandang. Re: Effect of Thai Massage and Hermit Bending on Pain Levels of Patients with Office Syndrome Chonburi Hospital

Finally, the editorial staff would like to thank everyone who has paid attention and submitted articles for publication, as well as everyone who has supported and helped to make this journal of Chonburi Hospital successful in the eyes of readers.