Vajira Medical Journal : Journal of Urban Medicine <p>Vajira Medical Journal : Journal of Urban Medicine (Vajira Med J) is the official&nbsp;medical journal of the Faculty of Medicine Vajira Hospital,&nbsp;Navamindradhiraj University. The journal was established in 1957 and, since 2018 , has been regularly published 6 issues per&nbsp;year (January-February, March-April, May-June, July-August, September-October and November-December) and one supplemental issue . The aim is to provide medical knowledge, medical education,&nbsp;and other biomedical sciences information in various types of&nbsp;publications: original article, case report, and review article.&nbsp;</p> <p>A Key focus of Vajira Med J is on basic and clinical&nbsp;science in urban medicine, including but not limited to&nbsp;epidemiology, etiology, pathogenesis, diagnosis and&nbsp;management for a better health of urban population.</p> Faculty of Medicine Vajira Hospital en-US Vajira Medical Journal : Journal of Urban Medicine 0125-1252 Level of Knowledge about “Spit don’t rinse” Brushing Technique and The Affective Factors among Dental Patients in Faculty of Medicine Vajira Hospital, Navamindradhiraj University <p><strong>Objective</strong>: survey the level of knowledge about “spit don’t rinse” brushing technique and study factors</p> <p>affecting the level of knowledge of “spit don’t rinse” brushing technique of dental patients in Faculty of</p> <p>Medicine Vajira Hospital, Navamindradhiraj University.</p> <p><strong>Methods</strong>: The cross-sectional survey of 385 dental patients in Faculty of Medicine Vajira Hospital,</p> <p>Navamindradhiraj. The level of knowledge of “spit don’t rinse” brushing technique and factors were collected</p> <p>using an online questionnaire created by the researchers. Frequency, percentage, mean and standard deviation</p> <p>were calculated and compared the level of knowledge about “spit don’t rinse” brushing technique among the</p> <p>different groups by using Chi-squared test statistics. Multiple logistic regression analysis statistics were used</p> <p>to analyze relationship between factors and the level of knowledge about “spit don’t rinse” brushing technique.</p> <p><strong>Results</strong>: Overall mean knowledge score of 5.3 ± 2.73. The results showed that 76.6% of dental patients had</p> <p>low level of knowledge about “spit don’t rinse” brushing technique. Comparisons made between different sex,</p> <p>age, education, occupation and the experience learning brushing technique “spit don’t rinse” were statistically</p> <p>significant in level of knowledge. After the multiple logistic regression analysis, the following factors were</p> <p>moderate/high level of knowledge about “spit don’t rinse” brushing technique: higher bachelor education level</p> <p>(Adjusted OR = 8.87, 95%CI: 1.66 - 46.40, p-value = 0.011) and the experience learning about “spit don’t rinse”</p> <p>brushing technique (Adjusted OR = 3.56, 95%CI: 1.22 - 10.37, p-value = 0.020).&nbsp;&nbsp;</p> <p><strong>Conclusion</strong>:&nbsp; The dental patients in Faculty of Medicine Vajira Hospital, Navamindradhiraj University &nbsp;&nbsp;&nbsp;&nbsp;</p> <p>do not understand and follow the correct procedures of “spit don’t rinse” brushing technique. Dental</p> <p>practitioners should be able to provide “spit don’t rinse” brushing technique knowledge effectively to</p> <p>prevent dental caries and promote oral health, which will reduce the prevalence of dental caries in Bangkok.</p> <p>&nbsp;</p> <p>&nbsp;</p> Jitima Uearattanavong Donhathai Sittipongporn Copyright (c) 2022 Vajira Medical Journal : Journal of Urban Medicine 2022-10-31 2022-10-31 66 5 311 320 10.14456/vmj.2022.31 Low Back Pain Prevalence and Associated Factors among Medical Students <p><strong>Objective:</strong> To investigate the prevalence of low back pain (LBP) and its associated factors among Thai medical students at a single university in Thailand.</p> <p><strong>Methods:</strong> Using an anonymous self-administered survey, we collected demographic data and details of LBP and associated disability (modified Oswestry disability questionnaire [MODQ]). This was distributed online to medical students between January and March 2022. Univariate and multivariate analyses were conducted, and odds ratios (ORs) and confidence intervals (CIs) were reported.</p> <p><strong>Results:</strong> Of the 150 eligible students, 146 responded (91 female, mean age 21.6 ± 1.8 years). The prevalence of lifetime LBP and significant LBP were 81 (55.5%) and 55 (67.9%), respectively. Assessed by the MODQ, 92.4% of students suffered mild disability due to LBP, which correlated with severity (r<sub>s</sub> = 0.600, p &lt; 0.001). Alcohol drinking (OR 2.9, 95%CI 1.1–7.7), being underweight (&lt;18 kg/m<sup>2</sup>; OR, 14.8; 95%CI, 1.9–117.1), not drinking caffeine (OR, 0.3; 95%CI 0.1–0.8), and a family history of LBP (OR, 3.1; 95%CI, 1.2–8.3) were significantly associated with significant LBP in the univariate analysis. In the multivariate analysis, family history (aOR, 3.5; 95%CI, 1.1–11.1) and being underweight (aOR, 15.6; 95%CI, 1.7–141.2) were independently associated with LBP.</p> <p><strong>Conclusion:</strong> LBP was common among medical students and was associated with both low weight (&lt;18 kg/m<sup>2</sup>) and having a family history of LBP. MODQ is practical for evaluating LBP disability</p> Kritsana Kientchockwiwat Sirikarn Tangcheewinsirikul Copyright (c) 2022 Vajira Medical Journal : Journal of Urban Medicine 2022-10-31 2022-10-31 66 5 321 330 10.14456/vmj.2022.32 Mammographic and Ultrasonographic Features of Male Breast Cancer <p><strong>Objective:</strong> To determine mammographic and ultrasonographic features of male breast cancer.</p> <p><strong>Methods:</strong> A retrospective study was conducted on consecutive men who underwent mammography and ultrasonography at the Diagnostic Breast Cancer Center in Vajira Hospital from January 1, 2010 to December 31, 2019. Clinical information, mammographic and ultrasonographic findings, method of tissue diagnosis, and pathological results were retrospectively reviewed. Then, the incidence of male breast cancer was analyzed.</p> <p><strong>Results:</strong> A total of 41 men underwent mammography in the institution during the study period with a median age of 68 (interquartile range, 58–76) years. Three patients were diagnosed with breast cancer (7.3%), with circumscribed high-density mass being the most common mammographic finding in the cancer group and gynecomastia in the benign group. Ultrasonographic finding in the cancer group showed a solid hypoechoic mass in 1 patient and complex mass with solid-cystic components in 2 patients. Tissue diagnosis and pathological results were observed in 6 patients. Breast cancer was found in 3 patients (invasive ductal carcinoma in 2 and intraductal papillary carcinoma in 1 patient) and benign pathology of gynecomastia in 3 patients. The incidence of male breast cancer in this study was 7.3%.</p> <p><strong>Conclusion :</strong> Male breast cancer commonly presents as a high-density mass with circumscribed margin in a subareolar location on mammography and as a solid hypoechoic mass or a complex mass with solid-cystic components on ultrasonography. As a result, a circumscribed mass on mammography with cystic components on ultrasound in a male patient should be suspected of malignancy.</p> Wiraporn Kanchanasuttirak Copyright (c) 2022 Vajira Medical Journal : Journal of Urban Medicine 2022-10-31 2022-10-31 66 5 331 338 10.14456/vmj.2022.33 Ten-Year Review of Outcomes after Surgery, Radiation, or Active Surveillance for Localized Prostate Cancer <p><strong>Objective:</strong> Prostate cancer is the second most common male cancer worldwide and the fifth leading cause of death in Thailand. This research aimed to evaluate the overall survival and disease-free survival of patients with localized prostate cancer who received different treatment options for the adjustment of future treatment policies.</p> <p><strong>Method:</strong> This retrospective cohort study was conducted using secondary data analysis and phone checkup. The population included patients diagnosed with localized prostate cancer (T1 and T2) and treated by laparoscopic radical prostatectomy, radiation therapy, or active surveillance at Vajira Hospital from December 2009 to December 2019. Survival and disease-free survival were analyzed.</p> <p><strong>Results:</strong> The median overall survival was 8.60 years (95% CI, 7.95–9.24) in the laparoscopic radical prostatectomy group and 7.98 years (95% CI, 6.13–9.82) in the radiation group. No statistically significant difference was found between these two treatments (p = 0.53). The median disease-free survival was 8.45 years (95% CI, 7.73–9.18) in the laparoscopic radical prostatectomy group and 5.89 years (95% CI, 5.60–6.18) in the radiation group. Statistically significant difference was found between these two treatments (p &lt; 0.001).</p> <p><strong>Conclusion:</strong> The disease-free survival in the laparoscopic radical prostatectomy group was significantly higher than that in the radiation group (p &lt; 0.001). The overall survival was the same for both groups.</p> Chadet Toncharoen Umaphorn Nuanthaisong Copyright (c) 2022 Vajira Medical Journal : Journal of Urban Medicine 2022-10-31 2022-10-31 66 5 339 344 10.14456/vmj.2022.34 Outcomes of Interrupted Suturing Techniques for Wrist Fistulas <p><strong>Objective:</strong> In this study, we evaluated the results of our interrupted anastomosis operations.</p> <p><strong>Methods:</strong> A retrospective review was conducted on consecutive operations for interrupted anastomosis wrist AVF performed by staff surgeons from January 2005 to December 2018.</p> <p><strong>Results:</strong> Among the 50 cases, 45 (90%) were successful. The primary failure rate was 10%, and the maturation time required for the fistula to develop was 8.14 weeks. Patency rates were 79%, 70%, and 62% at the end of the 1<sup>st</sup>, 3<sup>rd</sup>, and 5<sup>th</sup> years, respectively. Anastomotic aneurysm was the second most common complication.</p> <p><strong>Conclusion:</strong> Interrupted anastomosis increases the opportunity for the construction of a successful wrist AVF and is a reliable, safe technique with a high patency rate.</p> waigoon stapanavatr Yuthapong Wongmahisorn Copyright (c) 2022 Vajira Medical Journal : Journal of Urban Medicine 2022-10-31 2022-10-31 66 5 345 352 10.14456/vmj.2022.35 Blood Loss-Related Functional Outcome in Post-Operative Total Knee Arthroplasty: Prospective Cohort Study <p><strong>Objective:</strong> Current blood management programs for knee arthroplasty recommend avoiding blood transfusions and setting criteria for hemoglobin (Hb) &lt; 7 g/dl or &lt; 8 g/dl inpatients who have cardiac diseases or specific situations that do not concern the pre-operative HB level. This cutoff is safe for hemodynamically stable patients and those without cardiovascular complications. However, no study has shown the result of functional outcome, which is the primary objective of total knee arthroplasty (TKA).</p> <p><strong>Methods:</strong> We conduct an 18-month prospective cohort study on patients diagnosed with primary OA knee and indicated for surgical treatment with total knee arthroplasty at a single medical school hospital. Patients were divided into two groups of HB loss &lt;20% or ≥20%. Timed up and go information was collected and compared at pre-operative period and post operative day 1, 2, 3 and 14.</p> <p><strong>Results:</strong> A total of 154 patients were analyzed. No significant different in patient characteristics was found between the Hb loss &lt;20% group (group 1, n=120) and HB loss ≥20% group (group 2, n=34). Comparison of mean TUG between the two groups found no significant difference on post-operative day 1 (81.34 ± 20.09 and 84.99 ± 25.59 (P=0.45)), 2 (56.85 ± 11.12 and 59.06 ± 13.67 (P=0.39)), 3 (44.14 ± 8.20 and 45.66 ± 9.19 (P=0.35)) and 14 (31.92 ± 6.02 and 34.04 ± 5.99 (P=0.07)).</p> <p><strong>Conclusion:</strong> No significant difference in physical outcomes was found between the two groups. Current blood transfusion criteria after total knee arthroplasty can be used without concern about the physical outcome at the early post-operative period.</p> Pruk Chaiyakit Tawipat Watcharotayangkoon Copyright (c) 2022 Vajira Medical Journal : Journal of Urban Medicine 2022-10-31 2022-10-31 66 5 353 360 10.14456/vmj.2022.36 Incidence of Prostate Cancer in Physical Checkup Population with Rising of Serum Prostatic Specific Antigen <p><strong>Objective:</strong> To assess the prevalence of prostate cancer in northern Thailand.</p> <p><strong>Methods:</strong> This study was performed with a cohort study at the health check-ups clinic at University of Phayao Hospital from July 2021 until October 2021. In total, prostate gland check-ups and Prostate-specific antigen (PSA) screening was made available to 350 patients aged at least 45 years, and a number of parameters were recorded: International prostate symptom score (IPSS), Body mass index (BMI), Digital Rectal Examination (DRE) and Quality of Life score (QOL) score. Those patients whose PSA level was more than 4 ng/ml were advised to have a transrectal ultrasound (TRUS) biopsy of prostate. The cancer detection rate was determined on the basis of reported symptoms and the IPSS. Comparisons among data were assessed via the Chi-square test, while Spearman correlation was used to compare the PSA level and the Gleason score.</p> <p><strong>Results:</strong> For the study subjects, the median age was 63 years (45-81); median BMI was 23.4 (18.2-32.4) kg/m2, median IPSS score was 11(0-32); median QOL score was 2(0-6); and median PSA was 1.23 (0.12-125.7) ng/ml. Upon biopsy, 7.54% of the sample participants (26/350) could be determined to have prostate adenocarcinoma. A majority of those cases exhibited localized lesions. Participants who considered themselves to have abnormal urination were more likely to also have prostate cancer. Only one prostate cancer case was discovered in a participant with mild LUTS, as indicated by IPSS below 8. Typically, prostate cancer occurred more frequently in males with high IPSS scores.</p> <p><strong>Conclusion:</strong> The PSA screening approach detected prostate cancer in 7.54% of healthy physical check-ups population. A majority of these cancer cases were already presenting symptoms. Patients with LUTS should be made aware of prostate cancer and PSA testing may be offered in such patients.</p> krittin Naravejsakul Tharadon Pothisa Nunthakarn Saenrak Copyright (c) 2022 Vajira Medical Journal : Journal of Urban Medicine 2022-10-31 2022-10-31 66 5 361 368 10.14456/vmj.2022.37