The Bangkok Medical Journal

Chronic Silicosis as the Potential Consequence of Short-Term Exposure to Silica: A Case Report

Thu, 29 Feb 2024 00:00:00 +0700

Silicosis is an irreversible occupational lung disease caused by inhaling respirable crystalline silica. Silicosis poses a major public health challenge worldwide. The International Labour Organization (ILO) and the World Health Organization (WHO) have established a program to eliminate silicosis by 2030. However, despite these efforts, silicosis cases are still rising and reemerging in various industries and sectors. The authors report a case of chronic silicosis with a history of short-term silica exposure in a mining worker in Nakorn Sri Thammarat province, Thailand. The patient later developed progressive dyspnea and an abnormal chest radiograph. At present, the patient is undergoing supportive treatment, and his clinical symptom has been stable. This case study aims to raise awareness regarding the potential risks of chronic silicosis associated with relatively short-term duration of respirable crystalline silica exposure.

Chronic Idiopathic Granulomatous Mastitis in a Male Patient

Tapanutt Likhitmaskul, Suphatcharee Aroonsiriwattana — Thu, 29 Feb 2024 00:00:00 +0700

Idiopathic granulomatous mastitis is a rare inflammatory disease of the breast, typically occurs in reproductive age women with a history of pregnancy and breastfeeding. Furthermore, it is exceedingly rare in males. As the clinical signs and symptoms with radiological imaging of idiopathic granulomatous mastitis can imitate two common breast diseases, mastitis with abscess and inflammatory breast cancer, a tissue biopsy is required for clear diagnosis. Given the rarity and unknown etiology of the disease, an ideal treatment method has not been established. Conservative treatment with immunosuppressive therapy has proven good efficacy. However, in recurrent cases and cases unresponsive to conservative or medical treatment, the surgical options, such as surgical wide excision and/or mastectomy, should be considered. In this case report, we present a male patient diagnosed with left idiopathic granulomatous mastitis. We review and discuss the clinical presentation, imaging, diagnosis, and management of this patient that eventually was treated successfully with wide local excision.

Intradiploic Epidermoid Cyst Mimics a Bone Tumor: A Case Report

Samasuk Thammachantha,MD, Sarunya Yuthagovit, Sunisa Hangsapruek — Thu, 29 Feb 2024 00:00:00 +0700

Intradiploic epidermoid cysts are cysts are a rare condition rare condition, located in the diploe of skull, caused by remnants of embryonic ectoderm. Most of intradiploic epidermoid cysts presented with small asymptomatic mass at head. We described the importance of considering such lesions in the differential diagnosis, especially when dealing with patients presenting with chronic sinusitis and airway obstruction. A 66-year-old male patient presented with history of chronic sinusitis and airway obstruction for few years. CT and MRI evaluation revealed an extra-dural well-defined mass at right temporal area of skull. Surgical resection was performed and histological examination has shown a cystic structure lined by squamous epithelium and containing laminated keratin material, which are consistent with epidermoid cyst. Because of variable radiological image findings, distinguishing epidermoid cyst from bone tumor and tumor-like lesion is difficult. Due to the rarity of this lesion, clinicians should be familiar with this disease. The total excision of the cyst along with its capsule is crucial to prevent the recurrence and potential complications.

Effects of the Health Promotion Model Development Program on the Quality of Life of the Elderly using Local Wisdom and Ways of Life

Thu, 29 Feb 2024 00:00:00 +0700

OBJECTIVES: This quasi-experimental design aims to study effects of the health promotion model development program on the quality of life (QOL) of the elderly using local wisdom and ways of life

MATERIALS AND METHODS: Health promotion model, development program, and QOL of the elderly using local wisdom. The way of life consists of 1) food according to nutritional principles that are local foods; 2) exercise using local materials or games; and 3) stress management that is consistent with the religion and cultural beliefs of the community. The sample group consisted of elderly people aged ≥ 60 years in Bang Khla District Chachoengsao Province, divided into intervention groups, and a control group of 30 people per group. Data were collected using questionnaires for the period from July 2022 to February 2023. Chi-square and Paired Samples T-test comparing results before and after within the experimental group (EG) and Independent Samples T-test.

RESULTS: The study found the elderly benefitted, in terms of health and QOL, when applying wisdom and ways of life. Food consumption in the experimental group (EG) (2.80 ± 0.31) and in the control group (CG) (4.06 ± 0.27), exercise in EG (1.86 ± 0.77) and CG (4.54 ± 0.25), and mental and spiritual health in the EG (2.60 ± 0.39) and CG (3.76 ± 0.49), when tested statistically, they were significantly different at p < 0.001 level in terms of QOL of the EG (2.88 ± 0.67) and CG (3.92 ± 0.84) significantly different at p < 0.001 level.

CONCLUSION: From the results of the study, it is recommended that the primary health service system apply activities for the elderly to promote health and develop QOL using local wisdom and ways of life.

Accuracy of MRI with Cinematic 3D Volume Rendering Reconstruction in Helping the Diagnosis of Partial Thickness Subscapularis Tendon Tear

Thu, 29 Feb 2024 00:00:00 +0700

OBJECTIVES: This study aimed to figure the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy in diagnosis of rotator cuff tears (RCT) using magnetic resonance imaging (MRI) with additional Cinematic three-dimension volume rendering (3D VR) reconstruction.

MATERIALS AND METHODS: A retrospective review of the all-ar throscopic proven cases of RCT, provisionally diagnosed via clinical and MRI findings since May 2020 to Mar 2021, were collected. Cinematic 3D VR re construction of the rotator cuffs was performed subsequently from the MRI images. The accuracy of MRI with Cinematic 3D VR reconstruction as com pared to the conventional MRI alone was calculated.

RESULTS: Fifty-seven subjects were enrolled into the study, included 35 male and 22 female subjects. The average age was 60.58 ± 9.52 years old. Majority of the surgery side was right shoulder (56.1%). Fifty-two cases (91.23%) had supraspinatus tendon tear; 22 cases of full-thickness tear (42.3%) and 30 cases of partial-thickness tear (57.7%). Two cases had no treatment for supraspinatus tendon, 3 cases underwent debridement, and 47 cases received arthroscopic repair of supraspinatus tendon. Thirty-nine subscapularis tendon tear cases (68.42%) consisted of 4 cases of full-thickness tear (10.26%) and 35 cases of partial-thickness tear (61.4%). Seventeen cases underwent debridement, 17 cases underwent single row repair of the subscapularis tendon, and 5 cases received double row repair. Detecting of partial-thickness torn supraspinatus tendon, MRI with 3D VR revealed no further benefit from conventional MRI alone, in terms of any improving sensitivity, specificity, PPV, NPV or even accuracy. However, sensitivity, PPV and accuracy for depicting subscapularis tendon tear were increased. The full-thickness tear of both supraspinatus and subscapularis tendons showed no significant difference of sensitivity, specificity, PPV, NPV and accuracy between MRI with 3D VR and MRI alone.

CONCLUSION: The use of MRI with 3D VR technique may aid in detection of partial-thickness subscapularis tendon tear, increased sensitivity, PPV and accuracy, as compared to conventional MRI alone. Further new 3D reconstruction techniques should be promising for improving post processing time consume and be more user friendly, resulting in clearly recognized rotator cuff tear for both radiologists and orthopedists.

A comparison of Patient Care Skills and Clinical Decision Making among Registered Nurses in Bangkok Hospital Rayong

Thu, 29 Feb 2024 00:00:00 +0700

OBJECTIVES: This research compared patient care skills and clinical decision-making among registered nurses (RNs) who received the Nursing Supervision System.

MATERIALS AND METHODS: A cross-sectional study was conducted in a sample group consisting of 96 professional nurses working at Bangkok Hospital Rayong (BHR) with a 1-year work experience or more in inpatient work groups in 12 departments, and 16 heads/deputy heads of departments who are responsible for being supervisors in the nursing supervision system. The tools used to collect data were a patient care skills assessment and a satisfaction assessment using the nursing supervision system. Data were analyzed using descriptive statistics and ANOVA.

RESULTS: The results of the research found that the mean scores for patient care skills and clinical decision-making after using the nursing supervision system were significantly higher according to competency level, both overall and in each area, which were significantly different (p < 0.05). The level of satisfaction with the use of the nursing supervision system for those receiving supervision is at a high level (4.48). Satisfaction with the use of the nursing supervision system in terms of supervisors was at the highest level (4.77).

CONCLUSION: The nursing supervision system has an impact on the development of patient care skills and clinical decision making among RNs.

Compliance with Trauma Care Algorithms and Survival of Trauma Patients in Network of Private Hospitals in Thailand

Chanin Pundee, Wassana Siriwanitchaphan, EKKIT SURAKARN,MD — Thu, 29 Feb 2024 00:00:00 +0700

OBJECTIVES: The study aimed to examine the correlation between compliance with trauma care algorithms and the survival of trauma patients within a network of private hospitals in Thailand.

MATERIALS AND METHODS: This retrospective study reviewed trauma registry data and medical records from twelve designated hospitals from January 1, 2019, to December 31, 2022. The study assessed compliance with trauma care algorithms for specific injuries and analyzed the association with survival rates, adjusting for injury severity using the Injury Severity Score (ISS).

RESULTS: Out of 2,592 trauma cases, 1,823 (70.33%) were included for analysis based on algorithm relevance. The study discovered that compliance (80-100%) with the trauma care algorithms was significantly associated with higher survival rates, particularly for severely injured patients (ISS 25-75). After adjusting for Injury Severity Score (ISS), the correlation’s 95% confidence interval (CI) was 2.48, with a significant p-value of 0.048, indicating a statistically significant improvement in survival rates with higher compliance levels.

CONCLUSION: Compliance with trauma care algorithms significantly impacts the survival rates of trauma patients. High compliance rates are associated with better outcomes, emphasizing the need for rigorous adherence to established care protocols in trauma management.

Kratom Use and Health Literacy of Kratom for User: A Narrative Review

Aussadawut Yothasupap, Sitthiphon Bunman, Aphicha Nomsiri — Thu, 29 Feb 2024 00:00:00 +0700

Kratom is a tropical plant native to Southeast Asia. The delisting of kratom as a narcotic in many countries has significantly increased its accessibility, leading to greater experimentation with its usage. The kratom has the potential for pain relief, euphoria, and addiction to opioids. However, misuse, especially through potent mixtures like 4×100, can lead to adverse effects such as nausea, vomiting, and dizziness. Responsible use and health literacy are crucial for addressing concerns and preventing misuse, emphasizing the need for accurate information on kratom’s traditional and modern applications. This review aims to provide a comprehensive perspective on the effects of kratom use, usage patterns, clinical care guidelines for kratom users, and health literacy related to kratom use. A searched Pubmed, ScienceDirect, Google scholar, Scopus, and Thailand journal citation index center databases using appropriate search strategies for each database. After the screening, all relevant studies were included. Improper usage of kratom can detrimentally impact users’ health, manifesting side effects akin to both stimulant and opioid consumption, such as tachycardia, blushing, anxiety, agitation, loss of appetite, and polyuria. Therefore, promoting health literacy is essential for individuals using kratom responsibly to ensure a better understanding of its potential risks and benefits.

Developmental of 6 Cancer Risk Assessment Questionnaire; CRAQ-6 (Thai Version)

Thu, 29 Feb 2024 00:00:00 +0700

OBJECTIVES: This medical study is to create a user-friendly and comprehensible Thai version questionnaire for the risk-based assessment of six primary cancers in Thailand. The questionnaire is designed to be easily administered as a self-test or interpreted by individuals proficient in the Thai language. The overarching aim is to enhance non-instrumental cancer screening within non-hospital-based settings, encouraging individuals identified as having cancer risk to seek early screening at hospitals. This proactive approach aims to conduct risk assessments, mitigating the risk of delayed cancer diagnoses and promoting preventive measures before the onset of symptoms.

MATERIALS AND METHODS: The methodology employed in this medical study involved a systematic review of the latest updated clinical practice guidelines from international entities, including NCCN, Standard textbooks. This comprehensive review was conducted in collaboration with the Thailand National Cancer Institute and relevant departments of the Thailand Royal College of Surgeons. Subsequently, a prototype questionnaire in Thai was developed. Expert consultation was sought from individuals associated as the Index of item-Objective Congruence (IOC) who specialize in each specific cancer and possess a minimum of five years of experience in the respective field; this involved engaging five experts per cancer risk assessment questionnaire. The refined questionnaire underwent linguistic refinement by consulting with linguists. Finally, the comprehensibility and effectiveness of the questionnaire were assessed through discussions with classified volunteers.

RESULTS: The self-evaluation Cancer Risk Assessment Questionnaire, acronymically known as CRAQ-6 from “Crack” and “Sick,” was successfully developed through standard scientific tool development. It exhibited high understandability across all educational levels among volunteers, although certain sections required additional reading for optimal comprehension.

CONCLUSION: In conclusion, the CRAQ-6 Questionnaire, developed using rigorous scientific tools for Thai contexts, demonstrates overall understandability across diverse educational levels. However, specific sections may require assistance from another reader for optimal comprehension. Ongoing refinement is essential to ensure its effectiveness in diverse research and clinical contexts.