Region 11 Medical Journal

Sensitivity and Specificity of Colposcopy Directed Biopsy for the Diagnosis of High Grade Lesions Retrospective Study at Vachira Phuket Hospital

Chintana Singhawannakul — 2024-09-20

Background: Colposcopy is a standard for the early diagnosis of cervical intraepithelial neoplasia (CIN) and to plan treatment.¹ The accuracy of colposcopy varies in different reports depending on experience. A 2023 meta-analysis study reported sensitivity of 68 percent and specificity of 93 percent.

Objectives: To produce descriptive statistics for sensitivity and specificity of colposcopy directed biopsy (CDB) and colposcopy impression (CI) compared with final pathological diagnosis.

Method: Data was retrospectively collected from January 2019 to July 2021. CI reports and pathological reports of CDB were compared with a final pathological diagnosis from either the loop electric excision procedure (LEEP) or hysterectomy.

Results: 264 patients underwent a colposcopy procedure during this study. 90 patients underwent LEEP only 66 patients who reported adequate colposcopy were included in the study. CDB for detected high-grade lesions (HGL) had 83.3 percent sensitivity and 91.6 percent specificity. Colposcope impression had 75 percent sensitivity and 74 percent specificity.

Conclusion: CDB for the diagnosis of HGL has high sensitivity and specificity. Multiple biopsy procedures should be undertaken to improve accuracy.

The effectiveness of using range order opioid analgesic management approach for the prevention of Opioids-Induced Advancing Sedation (OIAS) in patients after thoracic surgery

Tippawun Ruttanapun — 2024-09-25

Background: Managing pain using opioids through a range of prescriptions is flexible. So that nurses can use opioids to control pain in each patient. Therefore, the administration of opioids is inappropriate, including frequency, size, and without consideration of other risk factors in patients that cause opioid overdose and there is no continuous monitoring. This resulted in the incidence of the complications to be Opioids-Induced Advancing Sedation (OIAS)

Objectives: To study the results of using guidelines for administering range order opioids to prevent OIAS in post-thoracic surgery patients.

Method: It is developmental research. This is the phase of testing the effectiveness of the guidelines (Step 8 of the National Health and Medical Research Council's Clinical Guideline Development Conceptual Australia Framework). The sample group is Thoracic surgery patients receiving epidural opioid pain relievers There were 62 people aged 18-60 years, divided into a control group and an experimental group, 31 people each. Data were collected by following up prospectively and comparing the results with traditional care. Data were analyzed using descriptive statistics. and independent statistics.

Results: The mean pain scores between the control group and the experimental group 24 hours after surgery were not significantly different at the .05 level, but after 48 hours and 72 hours of surgery, the mean pain scores between the control group and the experimental group were not significantly different at the .05 level. Statistically significantly different (p < .05). The number of OIAS events decreased from 6 times to 1 time and when comparing the differences. It was found that there was a statistically significant difference (p < .05).

Conclusion: Guidelines for administering opioid pain relievers in phases Helps reduce and prevent the occurrence of OIAS in patients after thoracic surgery.

The Effectiveness of Nursing Care for Hypothermia Program in Severe Injury Patients in Emergency Department

Thipsuda Phomdontre — 2024-09-25

Background: Accidental injury is a life-threatening health problem in global and Thailand. Hypothermia is a factor that increases the death rate in severe injured patients. Therefore, the researcher was interested in studying the results of the hypothermia nursing program in severe injury patients.

Objectives: Compare the average body temperature of severe injury patients between the control group and the experimental group.

Method: This research is quasi-experimental research (two-group pretest-posttest design). The sample groups are ISS score ≥ 16, aged 18-60 years, body temperature ≤ 36 C, total 52 severe injury patients, a control group of 26 samples received usual nursing care and experimental group of 26 samples received nursing care for hypothermia program. Two instruments were used for data collection. Content validity of the instruments were examined by 3 experts. The data were analyzed using descriptive statistics, independent t-test and repeated measures ANOVA.

Results: The mean body temperature of the experimental group after receiving the program ( = 36.72, S.D. = 0.31) was higher than that of the control group with a significantly (p <.05). The difference in mean body temperature after using the program was significantly (p < .05) during time 2, 3 and 4.

Conclusion: Nursing care for hypothermia program in severe injury patients in emergency department (ED) as a guideline for increases body temperature.

Utilizing Line Notify to Promote Self-Care in type 2 diabetic patients at Thampannara Hospital, Nakhon Si Thammarat Province

Wuttisak Pridasak — 2024-09-26

Background: Patients with uncontrolled diabetes experience unfavorable cardiovascular complications. Therefore, patients need knowledge and skills to control blood sugar effectively for achieving treatment goals. Utilizing health technology becomes a suitable and accessible option in the current era.

Objectives: To study the effectiveness of the Line Notify application on glycemic control (HbA1c levels) and medication adherence in patients with type 2 diabetes.

Method: This quasi-experimental study divided 66 participants into experimental and control groups, equally. Tools included blood sugar levels and medication adherence to study the effects of Line Notify application in providing knowledge and monitoring diabetes type 2 patients. Data analysis employed Chi-square, Independent t-test, and Paired t-test.

Results: Significant statistical differences (P-value <0.001) were found in blood sugar levels and medication adherence between the Line Notify application group and the control group after 3 and 6 months of study.

Conclusion: The Line Notify application can effectively provide diabetic self-care and self-monitoring of blood glucose.