Health Science Clinical Research

Comparison Between Computed Tomography (CT) Scan and Magnetic Resonance Imaging (MRI) in Preoperative Pedicle Screw Measurement of Subaxial Cervical Spine

Jakkrit Keeratiruangrong — 2024-06-30

ABSTRACT
Objective: The aim of study is to compare the morphology of subaxial cervical pedicles (C3-7 cervical pedicles) in computed tomography (CT) Scan and magnetic resonance imaging (MRI) and assess the ability of MRI for preoperative pedicle screw planning.
Methods: The retrospective cohort study included the CT scan and MRI of 10 patients (100 subaxial cervical pedicles) who are over 18-year-old patient that performed in Uttaradit hospital during January 2022-December 2023. This study compares the pedicle parameters (Outer pedicle width (OPW), Outer pedicle height (OPH), Pedicle axis Length (PAL) and Pedicle transverse angle (PTA)) between CT scan which is gold standard for assessing the bony structure and MRI.
Results: The overall parameters included OPW, OPH and PAL of subaxial cervical pedicle morphology in MRI are significantly less than in CT scan. (4.40±1.00 vs 5.32±0.85, 4.72±0.93 vs 5.98±0.84, 31.51±2.35 vs 33.03±3.20 millimeter) (P<0.001) except PTA that is no significant difference between 2 groups (39.77±3.91 vs 39.22±3.64 degree) (P=0.254). The mean difference of OPW, OPH and PAL between two groups are 0.92 ± 0.63, 1.26 ± 0.84 and 1.53 ± 2.57 millimeter which are significant correlation (r=0.776,
0.552, 0.611) (P<0.001). Bland-Altman plots show limit of agreement (LoA) range from -0.32 to 2.16, -0.39 to 2.91 and -3.50 to 6.56.
Conclusions: Pedicle size in MRI is smaller than CT scan. So, it is safely to perform the pedicle screw fixation if pedicle parameters in MRI are large enough. The PTA in MRI can be guiding the direction of screw insertion as same as in CT scan. However, surgeon should be aware of short screw length when using parameter in MRI.
Keywords: Subaxial cervical spine, Pedicle screw, Computed tomography, Magnetic resonance imaging

Assessment of Total Dust and Pulmonary Function among Workers at a Stone Milling Factory in Surat Thani province

Chattamat Sangpariman — 2024-06-30

ABSTRACT
Objective: To study on the concentration of the total dust in workplace, evaluation of pulmonary function among workers and classify pulmonary function among workers in each workplace of stone milling
Methods: A cross-sectional descriptive research conducted in a stone mill, Surat Thani Province. Sample consisted of 24 employees and the workplace of 5 departments; consisting of the crushed stone, the office, the maintenance, the truck parking area and the weighing stones. The study was carried out between November 2022 - March 2023, to tal dust samples were collected and analyzed of workplace
by using NIOSH Methods No. 0500 at 8-hour work period including occupational lung function tests of workers in each departments were by using spirometer.
Results: The highest total dust concentration of workplace had of 2.05 ± 1.13 mg/m3. However, the total dust concentration of the workplace in every department did not exceed the standards of OSHA and ACGIH. Occupational lung function test results of most employees, they were normal with an average FVC (Predicted) at 89.67% (S.D. ±11.15), FEV1 at 90.67% (S.D. ±11.59), FVC1/FEV1 at 101.91%
(S.D.±7.16). Classified by type of lung function had normal of 23 workers, accounting for 95.84%, and restrictive abnormality of 1 workers, accounting for 4.16% as crushed stone.
Conclusions: Therefore, entrepreneurs should have surveillance of risk section for dust exposure form work and raising awareness of wearing dust protection equipment to reduce dust exposure among workers.
Keywords: total dust, pulmonary function, stone milling

The Effect of the development of donor recruitment integrated plan of the Regional blood centre XI in 2022 on the blood component distribution effectiveness to the hospital

Amornrat Ruangtong — 2024-06-30

ABSTRACT
Objective: To study the results of the evaluation of blood supply to hospitals and study the results of using the development of donor recruitment integrated plan of the Regional blood centre XI in 2022 on the blood component distribution effectiveness to the hospitals.
Methods: This research is a quasi experimental research, Created recruitment integrated plan, collected data the number of blood procurement and blood component distribution of the Regional blood centre XI in 2022, the data was analyzed by descriptive statistics and compared data with t-test independent.
Results: The total number of blood procurement in 2022 was 17,007 units. It was increase when compared to that of the previous years without integration program. however, there was no statistically significant difference (p>0.05). For the distribution of blood components to hospitals, it appeared that the distribution of cryoprecipitate, fresh frozen plasma, platelet product and red cell product were 100, 99.7, 99.5 and 75.0% respectively.The distribution of red cell product was 19,611 units . It was increase when compared to that of the previous years without integration program. however, there was no statistically significant difference (p>0.05).
Conclusions: Although the total number of blood procurement in 2022 increased statistically insignificantly. However, the approach to integrated planning still needs to be continuously improved and developed. To increase blood donors ensure sufficiently stock of blood to efficiently and timely distribute to patient
Keywords: donor recruitment Integration, Red cell product, Blood component distribution

Analgesic efficacy of IPACK block plus adductor canal block compare to adductor canal block alone in Total knee arthroplasty: A randomized control study

yuwarin kositworakitkun — 2024-06-26

ABSTRACT
Objective: To compare the analgesic efficacy of IPACK block plus Adductor canal block with Adductor canal block after total knee arthroplasty.
Methods: After ethical approval from Uttaradit Hospital, A total 22 patients undergoing knee replacement surgery with spinal anesthesia were randomized into 2 groups, ADB (n=11) and Group2 IPACK block (n=11). Group ADB receives Adductor canal block for analgesic control after Total knee arthroplasty and Group IPACK block receives IPACK block with Adductor canal block. The study analgesic efficacy was recorded by pain score (NRS = Numerical rating scale) and morphine consumption 24 hr after surgery. The study found out the physical therapy and complications from intervention and pain medications after Total knee arthroplasty. Data were analyzed using a p-value <0.05 considered to be statistically significant.
Results: Pain score in group IPACK block was lower than ADB group 24 hr after TKA with statistically significant (3.82 compared to 5.09, p=0.03). The morphine consumption was lower in IPACK group 24 hr after surgery (10.64 mg compared to 14.55 mg, p=0.027) but there is no statistical significance. Patients in both groups can do the physical therapy on Day 1 after surgery and the complications after
surgery are not statistically significant.
Conclusions: A combination of IPACK block and adductor canal block can lower pain score than Adductor canal block after total knee arthroplasty under spinal anesthesia and there are no severe complications in both groups.
Keywords: Total knee arthroplasty (TKA), Adductor canal block, IPACK block (Interspace between the popliteal artery and the capsule of the posterior knee)

Antimicrobial Susceptibility Testing Patterns of Neisseria gonorrhoeae in Uttaradit Hospital During 2018-2023

Wipha Noitachang — 2024-06-30

ABSTRACT
Objective: To study the antimicrobial susceptibility testing of N.gonorrhoeae isolates from patients was treated at Uttaradit hospital during 2018-2023
Methods: A total of 150 N. gonorrhoeae isolates from patients was treated at Uttaradit Hospital during October 2018 and September 2023. Antimicrobial susceptibility test was performed by the standard disk diffusion test and E-test method for azithromycin, ceftriaxone, cefixime, ciprofloxacin, penicillin, tetracycline, and spectinomycin. The data was analyzed by descriptive statistics such as average, percentage, standard deviation, range of minimal inhibitory concentration (MIC range), MIC₅₀ and MIC₉₀.
Results: It was found that the resistance rates of ciprofloxacin, tetracycline and penicillin were 98.0%, 94.0% and 92.0%, respectively. The prevalent rate of multi-drug resistance was also high (86.7%). All isolates were still susceptible to azithromycin with MIC range, MIC50 and MIC₉₀ of ≤0.016-0.25 mg/L, 0.125, and 0.25 mg/L, respectively. The isolates were also susceptible to ceftriaxone and cefixime with low MIC levels. The MIC range, MIC₅₀ and MIC₉₀ of ceftriaxone were ≤0.002-0.125 mg/L, 0.004 and 0.008 mg/L, respectively while the MIC range of cefixime was ≤0.016-0.064 mg/L and MIC₅₀ and MIC90 of <0.016 and 0.016 mg/L, respectively.
Conclusions: The N.gonorrhoeae isolates were not found decreased susceptibility to azithromycin, ceftriaxone and cefixime. This antimicrobial susceptibility surveillance in each hospital is needed for patient management and prevention and control of the emergence and spread of antibiotic-resistant in the future.
Keywords: N. gonorrhoeae, gonorrhoeae ,antimicrobial resistant, surveillance

The Prevalence of Pre-hospital Delay among Acute Ischemic Stroke in Chonburi Hospital

Pakpoom Nuengjumnong — 2024-06-30

ABSTRACT
Objective: Acute ischemic stroke (AIS) has a high mortality and morbidity rate that associated with delay prehospital period. In Thailand, the overall delayed pre-hospital period rate is high. However, data on the prevalence of delayed pre-hospital period at Chonburi hospital is limited.
Methods: This retrospective cohort study collected data from acute ischemic stroke patients who dmitted at Chonburi Stroke Center between August 2022 and November 2022. Patients were stratified by the pre-hospital period, and the primary outcome was the prevalence. The secondary outcome was the factor influencing pre-hospital delay.
Results: In total, 189 patients were enrolled in the study, 67.2% patients arrived after 4.5 hours of onset. Patients with awakening with symptoms 3.85 (95% CI 1.69-8.77, p=0.001) and onset location at home 2.99 (95% CI 1.25-7.14, p=0.14).
Conclusions: The prevalence of delayed pre-hospital period in Chonburi hospital was high. Education effort is the urgent main issue to reduce pre-hospital period.
Keywords: Acute ischemic stroke, Pre-hospital delay, Prevalence, Factor

Day 4 beta-hCG changing for predict the response of methotrexate treatment in ectopic pregnancy

Panupun Homkrun — 2024-06-30

ABSTRACT
Objective: To evaluated the association between the change of day 1 to and day 4 post-treatment serum beta human chorionic gonadotropin (beta hCG) changing levels and the predicting methotrexate (MTX) treatment success in ectopic pregnancy.
Methods: Retrospective cohort study was performed in 61 ectopic pregnancy patients who received methotrexate since 1 January 2014 to 31 December 2023. Participants were categorized according to treatment success or treatment failure. Treatment success for this study was defined as beta hCG level on day 7 decreased more than 15% from level on day 4. Changes in day 4 from day 1 beta hCG of both groups were evaluated as predictor of treatment success through receiver operating characteristic
(ROC) curve analysis.
Results: A total of 61 patients with ectopic pregnancy were treated with methotrexate. The treatment success rate was 78.7% (n = 48/61). Beta hCG changing on day 4 can predicted the success of methotrexate treatment with area under the curve 0.904, P-value <0.01, 95% confidence interval 0.812-0.996. Any rise < 11.55% was identified as an optimal cut off with sensitivity 89.6 specificity 84.6 positive
predictive value 95.6 negative predictive value 68.8
Conclusions: The change of day 1 to day 4 post-treatment serum beta human chorionic gonadotropin (beta hCG) levels can predict methotrexate treatment success in ectopic pregnancy with any rise <11.55% was identified as an optimal cut off.
Keywords: ectopic pregnancy/ beta-hCG/ methotrexate/ treatment success