Greater Mekong Subregion Medical Journal

Acute Fever with Painful Swelling of Leg in Alcoholic Cirrhosis Patient

2024-11-05T21:02:36+07:00

Patients with liver cirrhosis are susceptible to bacterial infection. The common infection sites are spontaneous bacteremia, urinary tract infection, pneumonia, soft tissue infection and spontaneous bacterial peritonitis. Gram-negative bacteria such as Escherichia coli and Klebsiella spp. were the most common microorganisms causing bacteremia in cirrhotic patients. Vibrio, Aeromonas, and Campylobacter spp. occasionally caused bacteremia in cirrhotic patients, but these individuals are at great risks for invasive infections. The vibrios are found in marine and surface waters. Aeromonads are inhabitants of aquatic ecosystems, worldwide, and are found in fresh and brackish waters. The campylobacters are found in many species of animals, including many domesticated animals. Here we report a case of soft tissue infection from Aeromonas hydrophila in liver cirrhosis patient which caused rapidly progressive septicemia and shock.

The Holistic Care for Heat Exhaustion Patients Associated with Excessive Body Mass Index: A Case Study

2024-05-02T21:17:23+07:00

The world today is being greatly impacted by global climate change and warming. Extremely hot weather usually occurs in Asia during the summer months of April and May and is associated with high humidity. People who may be at risk from these conditions include occupations that require working outdoors, such as military and police occupations that require training in the sun and other occupations such as street sweepers and first responders. For factory workers who must work outdoors, heat exhaustion is a condition that is second only to heat stroke, which can be differentially diagnosed by the neurological symptoms and a core body temperature of more than 40⁰C. However, if the person who provides initial aid does not think about heat exhaustion and does not provide the correct first aid the condition may increase in severity and become heat stroke, which can be life-threatening. Heat exhaustion is caused by a loss of body water and minerals. If the person is unable to cool down quickly this allows the heat to affect the brain and muscular function, leading to heat stroke. This leads to muscle breakdown (rhabdomyolysis) causing acute kidney injury and hyperkalemia. Severe cardiac arrhythmias can cause sudden death. Patients may have symptoms of vomiting, headache, dizziness, gasping for breath, shortness of breath from the various internal organ dysfunctions.

Comparative Study on the Detection of Short Chain Fatty Acids in Fecal Samples from Patients with Type 2 Diabetes Mellitus: An Insight into Diabetic Kidney Disease Compared with Normal Kidney Function

2024-11-07T18:38:28+07:00

Background: The role of the gut microbiota in metabolic health was increasingly recognized. Short-chain fatty acids (SCFAs) – including propionic acid, acetic acid and butyric acid – are vital metabolites produced by gut microbiota. These SCFAs play a pivotal role in energy metabolism, glucose homeostasis, and systemic inflammation. The link between gut microbiota and human health, especially in the context of metabolic disorders like Type 2 Diabetes Mellitus (T2DM) and Chronic Kidney Disease (CKD), has garnered significant attention in recent years.

Objective: This study aimed to compare the levels of SCFAs in fecal samples from three distinct patient groups: 1) Type 2 diabetic patients with diabetic kidney disease, 2) Type 2 diabetic patients with normal kidney function, and 3) Hypertensive patients without diabetes with normal kidney function.

Materials and Method: A total of thirty-nine participants were involved in this research, categorized into three distinct groups. Fecal samples were collected, immediately frozen, and processed for the extraction of SCFAs. The concentrations of SCFAs were determined using a gas chromatography-mass spectrometry (GC/MS) system.

Results: The study evaluated the concentrations of three pivotal SCFAs in stool samples across the three patient groups. While there were nuanced variations in the concentrations of acetic, butyric and propionic acids among the groups, an ANOVA test revealed no statistically significant differences in SCFA concentrations among them.

Conclusion: While this study provides foundational insights into the SCFA landscape across specific health conditions, the absence of significant disparities prompts contemplation. The multifactorial nature of SCFA production, influenced by disease states, diet, genetics and other environmental factors, underscores the need for further investigative depth. Future research might delve deeper into the potential therapeutic implications of modulating gut microbiota and SCFA profiles in managing metabolic disorders.

Exploring Constraints in Logistics Operations of Public Hospitals in Mountainous Areas of Northern Thailand

2024-08-24T20:06:46+07:00

Background: Thai public hospitals in highland rural areas are experiencing difficulties in logistics operations due to the mountainous geography and scarcity of resources compared to hospitals in the city center.

Objective: This paper aims to explore the constraints in logistics operations that Thai public hospitals located in rural mountainous areas are experiencing.

Materials and Method: A qualitative study using 3 case study hospitals from three highland border cities in northern Thailand was conducted in this study. The onsite observation and interviews were conducted at the hospital to explore operational constraints in seven logistics activities based on the framework of the World Health Organization.

Results: All sample hospitals have no centralized logistics coordination system, while I.T. systems cannot integrate the data between front and back-office systems. The inventory system of all hospitals cannot access the actual use rate of medicines and medical supplies. The systematic forecasting procedure of future consumption and the warehouse storage system does not exist. Lastly, transportation operations are faced with long driving times on dangerous roads, and there is a risk of landslides when servicing patients’ referral systems to the urban hospital.

Conclusion: The result of this paper is an initial step in an attempt to reduce the gap between populations in the rural-urban quality of life through better hospital operations by exploring and understanding constraints experienced by mountainous public hospitals.

Application of Preventive Medicine in Traffic Medicine

2024-09-10T16:45:04+07:00

the study of traffic medicine, readers need to have a basic understanding of the meaning, boundaries, and branch of preventive medicine as well as concepts and theories associated with preventive medicine, which forms the basis of traffic medicine in order to be able to choose the best principles for treating any health issues. The purpose of this article is to provide an overview of local and international preventive medicine works, various branches of preventive medicine, and the main theories of the nature history of disease, preventive strategies, epidemiologic triad, and spectrum of prevention as well as the applications in traffic medicine. It then provides knowledge and understanding of the fundamental principles of preventive medicine, which is the foundation for higher education in traffic medicine.