Vajira Medical Journal : Journal of Urban Medicine

A Decade of Invasive Candida Infection in Neonates: A Retrospective Study at a Tertiary Neonatal Intensive Care Unit in Thailand (2008–2018)

Pathaporn Prempraphan, Manisara Puengwongtrakul — Wed, 29 May 2024 00:00:00 +0700

OBJECTIVE: To determine the epidemiology of invasive candida infection in the neonatal intensive care unit (NICU) at a tertiary care center in Thailand over 10 years.
METHODS: A retrospective descriptive study was conducted. Participants were enrolled from all neonates diagnosed with invasive candidiasis infection (ICI) in Vajira Hospital between 2008 and 2018. Demographic data, microbiological results, and neonatal outcomes were reviewed.
RESULTS: During the study period, 9,031 neonates were admitted to the NICU. A total of 14 neonates were diagnosed with ICI, giving a prevalence of 1.5 cases per 1,000 infants admitted to the level II and III NICU. The median (IQR) gestational age and birth weight were 28.5 weeks (27.0, 31.0) and 1,053 g (850.0, 1,586.5), respectively. In all, 10 (71.4%) and 8 (57.1%) neonates had positive blood and urine cultures, respectively. All infants had negative cerebrospinal fluid cultures. Among 14 neonates diagnosed with ICI, 7 (50.0%) neonates had positive cultures for Candida albicans. The overall mortality rate of neonates with ICI was 21.4%.
CONCLUSION: ICI exhibits a low incidence rate within Vajira Hospital. This occurrence is demonstrably associated with prematurity, extremely low birth weight infants, and a demonstrably high mortality rate.

Correlation between Various Factors and Pain in Gynecological Cancer Patients within the First 24 Hours Post-Operation: A Study in an Urban-Based Tertiary Medical Center

Thu, 06 Jun 2024 00:00:00 +0700

OBJECTIVE: To investigate various pain factors in patients with gynecological cancer who have undergone different types of elective hysterectomy.
METHODS: In this retrospective study, data on pain assessment were collected from gynecological cancer patients who underwent elective total abdominal hysterectomy or total laparoscopic hysterectomy surgeries (with associated surgery) between January 2019 and December 2022 at Vajira Hospital. The data were gathered starting from 24 hours after the procedures.
RESULTS: The pain assessment was evaluated using the Numerical Rating Scale (ranging from 0 to 10, representing low to severe pain) during the first 24 hours after the surgery. The results revealed that several factors, such as cancer location, prior surgical history, and body weight, influenced the intensity and onset of pain. However, different types of surgery did not have a significant impact on pain assessment. Moreover, patients with cancer lesions in the endometrium experienced an early onset of severe pain. Additionally, patients without previous surgical experience and those who are obese should receive additional attention in terms of pain management.
CONCLUSION: This study sheds light on evidence-based factors that influence pain intensity and/or pain onset, including cancer location, prior surgical history, and body mass index. Understanding these factors can contribute to more effective pain management strategies for gynecological patients’ post-surgery.

Prevalence of Problematic Internet Use and Related Factors in Children with Attention Deficit Hyperactivity Disorder and Non-Attention Deficit Hyperactivity Disorder

Ruaywan Santiwes, Dussadee Ngernlangtawee — Tue, 18 Jun 2024 00:00:00 +0700

OBJECTIVE: To compare the prevalence of problematic internet use (PIU) in attention deficit hyperactivity disorder (ADHD) and non-ADHD children and explore the related factors and effects of PIU in children.
METHODS: A cross-sectional study was done. ADHD and non-ADHD participants aged 7-15 years old with current internet use were enrolled. A self-report questionnaire collected child and parental demographic data, internet use, and related data. An internet addiction scale was used.
RESULTS: A total of 127 participants were enrolled, including 56 ADHD participants and 71 non-ADHD participants. The rate of possible PIU and PIU (possible PIU/PIU) in the ADHD group was 60.7% and 61.5% in the non-ADHD group. In the ADHD group, internet usage time ≥ 21 hours per week was a significant related factor to possible PIU/PIU (adjusted odd ratio 27.08, 95% confidence interval 2.35 – 312.04). Male was significant related factor to possible PIU/PIU in the non-ADHD group (adjusted odd ratio 4.25, 95% confidence interval 1.25 - 14.47). School level, grade, online gaming or social media exposure, and parental internet restriction were non-significant related factors in both groups. Children with possible PIU/PIU had significantly more positive depressive symptoms than the normal internet use group (p = 0.006).
CONCLUSION: The results indicate a higher rate of possible PIU/PIU in both groups and a significant relation with depressive symptoms. In routine practice, we should clarify this issue and provide education to families and children with or without ADHD to prevent internet related problems.

Global Warming and Parasitic Infection in Urban Communities: A Systematic Review

Viriya Pankao, Pathanin Chantree, Pongsakorn Martviset — Fri, 19 Apr 2024 00:00:00 +0700

Global climate change is an important global issue; it influences not only the environment but also human health. Parasitic infection is one of the most recognized infectious diseases generally observed in rural areas of developing countries in tropical and subtropical zones of all continents. Interestingly, there are few reports on parasitic infections in the temperate zone; however, climate change provides a wide warming area optimal for the survival of several parasites. This situation leads to the spread of parasitic pathogens and their vectors in other zones around the world that they lack access to optimal healthcare. Moreover, the urban community shares a lot of the population in several developed and developing countries, which generally have a better sanitary system when compared with rural areas. Furthermore, there could have been a slight chance of parasitic infections in the past in these urban communities. For several reasons, the association between climate change and parasitic infection in urban areas has caught research interest. Hence, this systematic review proves the increased prevalence of parasitic infections in urban areas worldwide in the last decade. The most prevalent parasites were vector-borne parasites, which directly suggests their relationship with climate change. Our findings can benefit healthcare providers and governors who must address this situation. In conclusion, parasitic infections in urban areas should be an increasing concern given their increased likelihood because of climate change.

The Past and Present Situation of Opisthorchis viverrini Infection in Thailand

Saiwasan Buathong, Lakhanawan Charoensuk, Picha Suwannahitatorn — Tue, 30 Apr 2024 00:00:00 +0700

Opisthorchis viverrini, a major foodborne trematode, remains a major public health concern in Thailand, particularly in the northern and northeastern provinces. O. viverrini can be transferred to people and reservoir hosts through the consumption of uncooked cyprinid fish with metacercariae. Chronic infection with O. viverrini can lead to a severe condition known as cholangiocarcinoma (CCA). According to the Nationwide Hospital Admission Database, Thailand has experienced the highest incidence of CCA globally in recent years. Particularly, between 2009 and 2013, there was an incidence rate of 14.6 cases per 100,000 individuals within the population and a corresponding mortality rate (MR) of 14%. In addition, high incidence rates of CCA were reported in Khon Kaen Province from 1989 to 2018, with a rate of 36.1 per 100,000 person-years in men and 14.4 per 100,000 person-years in women. Despite the reduction in the overall prevalence of O. viverrini at the national level, several studies have indicated that the infection remains highly prevalent in some communities in the northeastern and northern regions. Some communities have demonstrated a prevalence of O. viverrini exceeding 20%, and rates reaching as high as 45.7%. Therefore, in populations with a high prevalence, programs to control this parasite should be implemented, including monitoring eating habits. This review article provides a comprehensive overview of the current distribution of O. viverrini in Thailand, outlining its pathophysiology, background, and preventive and control strategies. In addition, this review suggests that individuals in high-risk communities should act to eradicate liver fluke, as this is crucial for the overall health of the community.

Preventive Dentistry in Children with Special Needs: Narrative Review

Prakasit Wannapaschaiyong, Nattha Ketudat, Sitthiphon Bunman — Thu, 06 Jun 2024 00:00:00 +0700

Children with special healthcare needs face a high prevalence of dental and oral health problems due to unique challenges in maintaining oral hygiene. Preventive dentistry, which encompasses practices and strategies aimed at maintaining optimal oral health and preventing dental caries, periodontal disease, and other oral conditions, is therefore of utmost importance for this vulnerable group. This narrative review compiles the dental health concerns commonly encountered in these children and outlines preventive strategies to address them. Common dental issues encountered in this population include dental caries, gingival inflammation, tooth erosion, and attrition. Factors contributing to these problems range from motor impairments limiting brushing ability, food preferences, bruxism, gastroesophageal reflux disease, and side effects of certain medications. Effective preventive measures involve early dental visits, appropriate oral hygiene routines, judicious use of fluoride toothpaste and supplements, dietary modifications, and cessation of nighttime bottle-feeding. Specific recommendations are provided for caregivers, such as selecting the right toothbrush, maintaining proper brushing techniques, and monitoring fluoride intake based on age and risk factors. Interdisciplinary collaboration between pediatricians, dentists, and other healthcare professionals is crucial in identifying potential dental issues and providing tailored preventive care for children with special needs.