Chonburi Hospital Journal-วารสารโรงพยาบาลชลบุรี

Masthead

2024-04-29T23:00:12+07:00

Quiz

2024-04-11T13:14:59+07:00

Chief complaint: A 73 years old Thai female presented with mass at left retromolar area for 6 weeks.

History of Present Illness: 6 weeks ago, she came to a dental clinic for a new denture. A dentist found a reddish soft tissue mass at left retromolar area. She denied any symptoms. So, the dentist sent her to oral and maxillofacial department, Cholburi hospital.

Physical Examination:

Her vital signs is stable and no fever. A 1 cm. reddish sessile mass with smooth surface at left retromolar mucosa. It had soft to firm in consistency. It did not fix with adjacent structure. The bruit or thrill was not present. She did not pain or paresthesia. The lesion as shown

The Letermovir: New drug for prophylaxis and treatment in cytomegalovirus

2024-03-11T11:50:27+07:00

Cytomegalovirus (CMV) is a common virus that can cause serious complications in people with weakened immune systems, such as those who have undergone hematopoietic cell transplantation (HSCT) or organ transplantation. CMV can lead to pneumonia, urinary tract infections, brain infections, and organ rejection. Current CMV antiviral drugs, such as ganciclovir, valganciclovir, cidofovir, and foscarnet, work by inhibiting the activity of the CMV DNA polymerase enzyme, which prevents the virus from replicating. However, these drugs have significant side effects, including bone marrow suppression and nephrotoxicity. In 2017, the U.S. Food and Drug Administration (FDA) approved letermovir as a new CMV antiviral drug. Letermovir works by inhibiting the activity of the terminase complex, a protein essential for CMV replication. Letermovir is effective in reducing CMV infection after HSCT or organ transplantation, and it also reduces mortality in these patients. In addition, letermovir has the important advantage of not having bone marrow suppression or nephrotoxicity, so it does not increase the risk of complications in patients with weakened immune systems. Conclusion Letermovir is a new, effective, and safe option for CMV antiviral therapy in patients who have undergone HSCT or organ transplantation.

Key words: CMV, Letermovir, HSCT, organ Transplantation

The Effects of the Application of the Protection Motivation Theory Program on Intention to Cervical Cancer Screening among Women Aged 30 to 60 years, Chawang Crown Prince Hospital, Chawang District, Nakhon Si Thammarat Province

2023-06-21T11:49:53+07:00

The quasi-experimental research aimed to investigate the effects of the application of the protection motivation theory program on intention to cervical cancer screening. The samples were women aged 30 to 60 years old in responsibility of Chawang Crown Prince Hospital. The samples were divided into 2 groups, 23 participants each. The experimental group received the program for 8 weeks. The control group received a session on cervical cancer education. The experimental instrument was the application of the protection motivation theory program. The data were collected using questionnaires consisting of general information questionnaires, perception of cervical cancer prevention assessment form and intention to cervical cancer screening assessment form. Data were analyzed using descriptive statistics, Wilcoxon (matched-pairs) signed-ranks test and Mann-Whitney U test.

The results showed that: after receiving the program, the experimental group had a significantly better perception of cervical cancer prevention and intention to cervical cancer screening than before receiving the program (p < 0.05) and better than the control group (p < 0.05). It indicated that this program improved the intention to cervical cancer screening. Therefore, health professionals should apply in the services model to solve cervical cancer screening among other target groups.

Keywords : Protection Motivation Theory; Cervical Cancer, Cervical Cancer Screening; Women Risk Group

The Empyema Thoracis in Samut Prakan Hospital

2023-10-17T09:50:25+07:00

Background : Empyema thoracis is a disease with a high rate of mortality and morbidity. There is a high length of hospital stay and high costs. Therefore, the researcher would like to study and collect patient data to find appropriate treatment and summarize the results of treatment. To develop better treatment.

Objects : Predict outcome for patients with empyema thoracis, and compare outcome between patients who received chest tube drainage before surgery and the patients who had surgery without chest tube drainage.

Method : This is retrospective cohort study from medical records of 37 patients who were diagnosed empyema thoracis at Samut Prakan Hospital from 1 July 2022 to 30 June 2023. Collect data from basic characteristics of patients, treatment options, length of hospital stay and result. Used for statistical analysis.

Results : There were 37 patients, the average age was 56 year, 75% were male. The leading cause of empyema thoracis was pneumonia (91%). Treatment was decortication 23 cases (62%). 13 (56%) cases were performed without prior ICD. Average time between chest tube drainage to decortication was 8 days. The average length of hospital stay was 16 days. Average length of hospital stay in groups of chest tube drainage with decortication was 29 days and average length of hospital stay in group of decortication alone was 20 days. Two patients were died (5%) with severe septicemia. The patients who received decortication had longer hospital stay than those who did not received decortication (p<0.02)

Conclusion : Empyema thoracis is more common in male than female. Patients had co-morbidities and disabilities before treatment. The quick decision to decortication can reduce length of hospital stay.

The Prevalence and Risk Factors of Diabetic Macular Edema in Diabetic Retinopathy Patient in Chumphon Khet Udomsakdi Hospital

2023-10-24T14:10:18+07:00

Background : The main cause to decrease vision in diabetic retinopathy patients is diabetic macular edema. Recently, This disease tend to be increase in people while it had limited knowledge about factors of diabetic macular edema in Thailand.

Objectives : To investigate prevalence and risk factors that effect to diabetic macular edema in diabetic retinopathy patients in Chumphon Khet Udomsak Hospital, Thailand.

Method : A retrospective cohort study was conducted by a review medical record of diabetic retinopathy patients in Chumphon Khet Udomsak Hospital from 1 January 2021 to 30 September 2021. The analysis of prevalence and risk factors relate to diabetic macular edema from diabetic retinopathy were performed by multivariate logistic regression analysis

Results : 15 diabetic retinopathy patients from 273 patients (5.49%) and 2 risk factors that relate to diabetic macular edema including hyperlipidemia (Adj OR = 10.28, 95% CI = 1.31 – 80.33, p = 0.026) and fasting blood glucose is greater than or equal to 200 mg/dL (Adj OR = 4.32, 95% CI = 1.45 – 12.85, p = 0.008).

Conclusion : Prevalence of diabetic macular edema in Chumphon Khet Udomsak Hospital, Thailand was 5.49%. From this patients, there were 2 risk factors that relate to diabetic macular edema including hyperlipidemia and fasting blood glucose is greater than or equal to 200 mg/dL.

Keywords : Diabetic macular edema, Diabetic retinopathy

The Change of the Transverse Dimension and the Postoperative Stability of Intraoral Vertical Ramus Osteotomy.

2024-03-11T12:03:20+07:00

Objectives : To study the transverse dimension change , the postoperative stability and the postoperative complications of intraoral vertical ramus osteotomy.

Materials and Methods: The patients who underwent intraoral vertical ramus osteotomy at the Department of Oral and Maxillofacial Surgery in Chonburi Hospital between 2014 and 2022 were selected. Data were collected from the patients' charts, and radiographic images, and analyzed through statistical and cephalometric analysis. Descriptive analysis, Fisher's exact test, and the paired sample t-test were used.

Results: Fifty-five patients (15 males and 40 females) with a mean age of 26.98 years (ranging from 17 to 41 years) were included in the study. Twelve patients were selected for facial width analysis. The preoperative facial width was 93.1±6.95 millimeters. The difference in facial width between preoperative and one year postoperative was 1.95±5.75 millimeters , between preoperative and two years postoperative was 2.37±3.51 millimeters, and there was no statistically significant difference (P < 0.05). Thirteen patients were selected for postoperative stability analysis. The difference in lower incisal position between one month and one year postoperatively was -0.35±2.03 millimeters , between one month and two years postoperatively was 0.55±0.68 millimeters, and No statistically significant difference was found (P<0.05). Of the 109 rami studied, altered sensation of the lower lip and chin was reported in 21.9% (23/105 rami) for less than one year, and 4.76% (5/105 rami) for one year or more. Condylar luxation was reported in one of the 109 rami (0.92%).

Conclusion : The study concluded that the procedure had a low incidence of complications, produced stable results, and did not increase facial width.

The Polymethylmethacrylate Cranioplasty Using Low-Cost 3D Printing Technology: Clinical Trial

2024-03-11T12:07:16+07:00

Objectives : Various materials are available for cranioplasty, but a consensus on the best options has not yet been reached. The most utilized material is Polymethylmethacrylate (PMMA). However, there are certain drawbacks associated with its use. Firstly, the manual molding process can be challenging, potentially resulting in an asymmetrical implant that does not resemble the original skull's aesthetic. Secondly, the exothermic reaction occurring during the procedure poses a risk of brain tissue injury. Fortunately, introducing 3D printing technology offers a solution to these PMMA-related disadvantages. This study aimed to evaluate the clinical outcomes, cosmetic results, and complications associated with in-hospital fabrication of 3D-printed cranioplasties.

Materials and Methods : This is a prospective study incorporating a historical control group. The prospective group (3D printing) encompasses patients who underwent cranioplasty utilizing prefabricated 3D-printed PMMA implants within the period of August 2021 to July 2022 (n=16). The control group consisted of 17 consecutive patients who had undergone cranioplasty two years prior. Comparisons between the two groups were performed using the chi-square test for categorical data and the student’s t-test for continuous data. The clinical endpoint was analyzed by multivariable Gaussian regression for correlated data.

Results : In the 3D printing group, the mean operative time was 60.50 minutes compared to 112.06 minutes in the conventional group (P<0.001). Intraoperative blood loss was 153.12 cc in the 3D printing group and 250.0 cc in the conventional group (P=0.041). The length of stay was significantly shorter in the 3D printing group (3.94 days) compared to the conventional group (8.65 days) (P<0.001). The mean cosmetic score was higher in the 3D printing group (4.75) than in the conventional group (3.05) (P<0.001). Seizures occurred in 1 case (6.25%) in the 3D printing group and 7 cases (41.18%) in the conventional group (P=0.009). The rate of wound complications did not differ between the two groups (18.75% and 17.65%, respectively; P=1.00).

Conclusions : The 3D-printed PMMA implants resulted in superior clinical outcomes, fewer seizures, and excellent aesthetics. Their manufacturing process was both simple and cost-effective. Based on these findings, we conclude that the presented 3D printing technique is a favorable choice for cranioplasty.

Keywords: 3D printing, cranioplasty, polymethylmethacrylate, custom implants, cranial defect

Table of content

2024-05-18T11:59:42+07:00

Letter from Editor

2024-05-01T22:14:36+07:00

Dear readers,

Chonburi Hospital Journal No. 1 of 2024 has been released to readers. This issue has several interesting manuscripts, including the effect of the program on the application of prophylactic motivation theory on the intention to undergo cervical cancer screening among women aged 30 - 60 years, Chawang Crown Prince Hospital, Chawang District, Nakhon Si Thammarat Province, treatment of pleural gonorrhea in Samut Prakan Hospital, prevalence and risk factors for macular edema in diabetic retinopathy patients undergoing treatment at Chumphon Khet Udomsak Hospital, changes in translateral dimension and stability after intraoral surgery. Vertical Remus Ostiotomi, Clinical Research to Study the Effects of Craniotomy Surgery Using Cheap 3D Printing Technology, Case Report 1 is surgery to treat melanoma of the oral mucosa. One academic revival article is Letermovir: A New Drug for the Prevention and Treatment of Cytomegalovirus Infections. One special article is Global Warming and Climate Change and ends with an interesting story by Ms. Natarada. Men Liam on Thai Midwifery Wisdom

Finally, the editorial team would like to thank everyone for their interest and submission of the article, as well as everyone who supported and helped make this issue of Chonburi Hospital Journal a success.

Instruction

2024-04-29T23:03:22+07:00

The Global Boiling is Coming

2024-04-26T12:28:46+07:00

In July 2023, the Secretary-General of the United Nations announced that the temperature of the Earth's surface and ocean temperatures are at record highs, signaling that we are beginning to end the era of "global warming" and declaring that the world is entering the era of "global boiling", demonstrating the intensification of the problem of climate change. The increase in greenhouse gas (GHG) is getting hotter every year, and an increase in global temperature by just 1 degree will result in more severe climate change. Severe rains, melting polar ice, high sea levels The flow of ocean currents will change, leading to future disasters that may be even more severe. It also affects health, including illness from air pollution and drought. Flood injuries and deaths, as well as deaths from extreme weather, are even more alarming than any other factor.

The Thai midwifery wisdom

2024-04-09T14:12:19+07:00

Thai Midwifery In the past, it has played a role in taking care of maternal and infant health from pre-pregnancy to postpartum, including psychological care. It is a care like kinship. It is a knowledge that has been passed down in each locality, a science and art that connects traditions and cultures. Those who perform Thai midwifery duties are called "nettle doctors" (the word nettle comes from Mahathera nettle, author of textbooks on maternity). Nettle healers are different, such as the North. It's called "Mother Mechanic." Shan people call it "Mae Kep" in the Northeast. It is called "Doctor Answer Crouch", in the South it is called "Doctor Mae Tan", Thai Muslims are called "Table Bidae" because each region of Thailand has different terrain. Thus, maternal and infant health care wisdom varies in some details, but with the same purpose.

The Surgical Treatment of Oral Mucosal Melanoma: A Case Report

2023-06-29T11:27:55+07:00

Malignant melanoma is a rare form of epithelial cancer that has aggressive characteristics and a very low survival rate. It can spread rapidly and is often found on the hard palate and maxillary ridge. Clinically, lesion may present single or multiple as a pigmented macular or proliferative lesion to a non-pigmented lesion on the skin, mucous membrane. Thickened tumor tissue determines the treatment and prognosis of cancer. The TNM staging system is used to classify the disease into three stages, which may require surgical intervention, radiation therapy, chemotherapy, or palliative care in conjunction with radiation and chemotherapy. The purpose of this case report was to describe a patient who had melanoma skin cancer in the lower gums and had undergone surgery, lymph node dissection, and radiation therapy. After a two-year follow-up, the patient was in normal condition, with no recurrence or other complication.

Keywords : surgery, oral malignant melanoma, pigmented, wide excision

The Global Warming and Climate Change

2024-05-07T01:22:44+07:00

Our planet has gas as an element of the atmosphere, enveloping the Earth's surface. It acts to prevent ultraviolet (UV) rays from reaching the earth's surface too much. It allows shortwave rays from the sun to penetrate the Earth's surface and absorbs long-wave rays in the hot infrared. (Thermal Infrared Range) that radiates from the Earth's surface. It generates heat and retains it in the atmosphere. before releasing heat back to the Earth's surface, allowing little heat loss to go into deep space. A condition in which the atmosphere envelops the Earth's surface. It acts like a greenhouse, calling the world's enveloping gases "Greenhouse gases" (GHG) and the conditions in which the atmosphere retains heat inside the Earth. By allowing only a small portion of the heat loss to go out of the earth is called the "Greenhouse effect".

The greenhouse effect is vital for maintaining global temperature levels. Without the greenhouse effect, the Earth would be so cold that life would become unhabitable. The average temperature on the Earth's surface will be negative, around -20 degrees Celsius. The world must have the right amount of greenhouse gases. In the past, greenhouse gases came from naturally occurring activities, creating thermal balance in the atmosphere. Keep the world warm. It has a temperature suitable for all life on the Earth's surface. Both humans, plants and animals, as well as the existence of nature on Earth. On the other hand, if there is an excessive amount of greenhouse gases. It is also causing the planet to increase in heat. Global temperatures may rise to levels that are detrimental to the existence of living beings. and nature on the planet.

Today, the amount of greenhouse gases enveloping our planet is rapidly increasing. from air pollution. The destruction of the ozone layer, which protects the Earth's surface, occurs. This makes heat radiation less likely to reflect back off Earth. Ultraviolet rays increasingly come through and touch the Earth's surface. Then reflect the Earth's surface back as more infrared radiation or heat waves. This large amount of greenhouse gases absorbs more of the heat generated. So our planet is getting hotter. As the heat rises , it affects the natural way and the original climate, causing "climate change" to cause variability in various phenomena on Earth. Call it "global warming." Historically, it's not like there hasn't been climate change. It's just that the changes that occur are often slow. It takes a long time, hundreds-thousands of years. but in the last 150 years since the Industrial Revolution. Climate change is happening fast. The world is rising very fast. Since human activities are the main part, it has been found to be associated with a large increase in the amount of three major greenhouse gases : carbon dioxide (CO₂). Nitrous oxide (N₂O) and methane (CH₄)

Global warming" is a specific term for the incidence of global climate change. The average temperature of near-surface air in both the surface and ocean surface at any time of the world is rising. Since the second half of the 20th century, climate change is a change in average weather, which includes all characteristics related to the weather, such as temperature, rain, wind, etc. The United Nations Framework Convention on Climate Change (UNFCCC) uses the term "climate change" for climate change as a direct or indirect consequence of human activities. That changes the composition of the atmosphere. The term "climate variability" is used for changes caused by other causes, while the term "climate variability" is used in the Intergovernmental Panel on Climate Change (IPCC). mean Climate change due to natural variations or human activities that increase the amount of greenhouse gases in the atmosphere. This causes the greenhouse effect to be more severe than it should naturally be, and as a result, the air temperature around the Earth's surface rises.

Global Warming

2024-04-30T16:32:48+07:00