Ramathibodi Medical Journal 2021-12-27T16:59:05+07:00 Assist. Prof. Dr. Chusak Okascharoen Open Journal Systems <p>Ramathibodi Medical Journal (RMJ) publishes article on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics. We welcome submissions from authors worldwide.</p> <p>ISSN 0125-3611 (Print)&nbsp;</p> <p>ISSN 2651-0561 (Online)</p> <p>Indexed in:&nbsp;&nbsp;<strong>&nbsp;&nbsp;<a title="ASEAN CITATION INDEX" href="" target="_blank" rel="noopener"><img src="/public/site/images/nuanphan_cha2/aci-logo-v41.png" width="100" height="40"></a>&nbsp; &nbsp;&nbsp;</strong><a title="ศูนย์ดัชนีการอ้างอิงวารสารไทย:Thai Citation Index (TCI) centre" href="" target="_blank" rel="noopener"><img title="tci" src="/public/site/images/tci_admin/tci.png" width="86" height="38" border="0"></a>&nbsp;&nbsp; &nbsp;<a title="Crossref" href=";container-title=Ramathibodi+Medical+Journal" target="_blank" rel="noopener"><img src="/public/site/images/nuanphan_cha2/images.png" width="77" height="50">&nbsp;</a>&nbsp; &nbsp;&nbsp;<a title="Google Scholar" href=";hl=th&amp;authuser=1" target="_blank" rel="noopener"><img src="/public/site/images/nuanphan_cha2/scholar_logo_64dp_(1).png" width="155" height="26"></a></p> Comparison of Machine Learning With Logistic Regression for Prediction of Chronic Kidney Disease in the Thai Adult Population 2021-12-27T08:03:27+07:00 Ratchainant Thammasudjarit Punnathorn Ingsathit Sigit Ari Saputro Atiporn Ingsathit Ammarin Thakkinstian <p style="text-align: justify;"><strong>Background:</strong> Chronic kidney disease (CKD) takes huge amounts of resources for treatments. Early detection of patients by risk prediction model should be useful in identifying risk patients and providing early treatments</p> <p style="text-align: justify;"><strong>Objective:</strong> To compare the performance of traditional logistic regression with machine learning (ML) in predicting the risk of CKD in Thai population.</p> <p style="text-align: justify;"><strong>Methods:</strong> This study used Thai Screening and Early Evaluation of Kidney Disease (SEEK) data. Seventeen features were firstly considered in constructing prediction models using logistic regression and 4 MLs (Random Forest, Naïve Bayes, Decision Tree, and Neural Network). Data were split into train and test data with a ratio of 70:30. Performances of the model were assessed by estimating recall, C statistics, accuracy, F1, and precision.</p> <p style="text-align: justify;"><strong>Results:</strong> Seven out of 17 features were included in the prediction models. A logistic regression model could well discriminate CKD from non-CKD patients with the C statistics of 0.79 and 0.78 in the train and test data. The Neural Network performed best among ML followed by a Random Forest, Naïve Bayes, and a Decision Tree with the corresponding C statistics of 0.82, 0.80, 0.78, and 0.77 in training data set. Performance of these corresponding models in testing data decreased about 5%, 3%, 1%, and 2% relative to the logistic model by 2%.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Risk prediction model of CKD constructed by the logistic regression, Neural Network, and Random Forest have comprehensible discrimination performance, but the logistic regression tends to have lower overfitting compared to Neural Network, and Random Forest.</p> <p style="text-align: justify;">&nbsp;</p> 2021-12-27T00:00:00+07:00 Copyright (c) 2021 Ramathibodi Medical Journal Efficacy of RAMA Mobile Video Laryngoscope (RAMA-mVL) for Tracheal Intubation in Manikin: A Randomized Study 2021-12-27T08:03:31+07:00 Panvilai Tangkulpanich Natsinee Athinartrattanapong Porawin Ussawapitanon Phanorn Chalermdamrichai Jarupol Tuangsirisup <p style="text-align: justify;"><strong>Background:</strong> Video laryngoscope (VL) is a tool that has increased the intubation success rate, but it is expensive and difficult to carry outside the hospital. Ramathibodi mobile Video laryngoscope (RAMA-mVL) thus was invented for having effectiveness equivalent to the current device and lower price.</p> <p style="text-align: justify;"><strong>Objective:</strong> To determine the effectiveness of intubation by comparing between RAMA-mVL and McGrath<sup>®</sup>.</p> <p style="text-align: justify;"><strong>Methods:</strong> This study conducted a randomized, single-blinded study in manikin comparing RAMA-mVL and McGrath<sup>®</sup>. Medical personnel with intubation experiences were included and will be trained in 2 devices before performing the procedures. Intubation success rate, time to intubation, satisfaction, and the cost between both VLs were compared.</p> <p style="text-align: justify;"><strong>Results:</strong> A total of 208 persons were enrolled in the research, 104 in each group. The first pass succession rate for intubation by using both VLs is 100%. Time to intubation using RAMA-mVL was significantly less than that of McGrath<sup>®</sup> (mean [SD], 9.12 [4.28] and 11.19 [5.04] seconds, respectively; <em>P = </em>.002). The 5-point Likert scale in satisfaction rate on the easy to build in RAMA-mVL and McGrath<sup>®</sup> were mean (SD) of 4.88 (0.32) and 4.23 (0.96) points respectively (95% CI, 0.46 - 0.85; <em>P &lt;</em> .001). Additionally, the cost of RAMA-mVL was cheaper than McGrath<sup>®</sup>.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> The first pass intubation success rate in a manikin of RAMA-mVL is equivalent to McGrath<sup>®</sup>. The cost of RAMA-mVL is cheaper.</p> <p>&nbsp;</p> 2021-12-27T00:00:00+07:00 Copyright (c) 2021 Ramathibodi Medical Journal Factors Related to Muscle Cramps During Hemodialysis in End-Stage Renal Disease Patients 2021-12-27T08:03:32+07:00 Wilaiporn Akkabut Sutasiny Junhoaton Wariya Boonchanta Morakot Arbmanee Atiporn Ingsathit Pannawat Mongkolrattakul <p style="text-align: justify;"><strong>Background:</strong> Muscle cramps are a common complication during hemodialysis that can cause patients extremely painful.</p> <p style="text-align: justify;"><strong>Objective:</strong> To determine factors related to muscle cramps during hemodialysis in patients with end-stage renal disease.</p> <p style="text-align: justify;"><strong>Methods:</strong> A descriptive correlational study was conducted in end-stage renal disease patients undergoing hemodialysis at Hemodialysis Center, Faculty of Medicine Ramathibodi Hospital between February and March 2020. Data collection instruments included muscle cramps report form, demographic questionnaire, and factors related to muscle cramps questionnaire. Data were analyzed using descriptive statistics and multiple logistic regression.</p> <p style="text-align: justify;"><strong>Results:</strong> A total of 44 patients were recruited in the study. The mean age was 63.3 years. A total of 458 muscle cramps during hemodialysis assessments were recorded in the one month. The result showed that 45 muscle cramps (9.8%) occurred during hemodialysis. Factors significantly related to muscle cramps during hemodialysis included interdialytic weight gain (≥ 3.5 kilograms) (OR, 4.5; <em>P</em> &lt; .001), experiencing cramps before hemodialysis (OR, 25.5; <em>P</em> &lt; .001), and high serum bicarbonate concentration (OR, 5.6; <em>P</em> = .005).</p> <p style="text-align: justify;"><strong>Conclusions:</strong> This study found that 9.8% of patients reported muscle cramps during hemodialysis. Interdialytic weight gain, having cramps before hemodialysis, and serum bicarbonate concentration were significantly related to muscle cramps during hemodialysis in patients with end-stage renal disease.</p> <p style="text-align: justify;">&nbsp;</p> 2021-12-27T00:00:00+07:00 Copyright (c) 2021 Ramathibodi Medical Journal Drug Use Evaluation Among Elderly Patients With History of Falling in Geriatric Assessment Clinic, Ramathibodi Hospital 2021-12-27T16:59:05+07:00 Muanjan Wannasitthichok Chitima Boongird Thunyarat Anothaisintawee Kittiya Theangjit <p style="text-align: justify;"><strong>Background:</strong> Drug use evaluation as an intervention approach for fall prevention has an effect on most drug-related outcomes. Geriatric assessment clinic provides comprehensive care in elderly patients. All prescribed or non-prescribed medications were evaluated by pharmacists.</p> <p style="text-align: justify;"><strong>Objective:</strong> To study the drug and drug-related problem among elderly patients with history of falling.</p> <p style="text-align: justify;"><strong>Methods:</strong> This is a cross-sectional study of elderly patients with history of fallings. Demographic data, health information, history of falls, and drugs use evaluation were obtained from their medical records in year 2010 to 2020. Linear regression model was used to examine the multivariate correlates to number of fallings.</p> <p style="text-align: justify;"><strong>Results:</strong> A total of 183 patients with history of falling were studied. Of this, 97 had recurrent falls. Most patients (77%) had more than 5 underlying diseases and over half (55%) had dementia. Drug-related problem were found 69.4%, 4 in 5 of patients used 5 types of the medications or more. The diabetes drugs were found to increase risk of recurrent falls significantly (OR [95% CI], 2.11 [1.03 - 4.33]; <em>P</em> &lt; .05).</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Most elderly patient with history of falling have drug-related problem (69.4%) and multiple morbidities including dementia. The diabetes drugs were 2 times significantly increased risk of recurrent falls. This study highlights the important of drugs management in this vulnerable group of elderly patients.</p> <p style="text-align: justify;">&nbsp;</p> 2021-12-27T00:00:00+07:00 Copyright (c) 2021 Ramathibodi Medical Journal Technologies-Enhanced Anatomical Study in Undergraduate Medical Students in One of the Medical Schools in Thailand 2021-12-27T08:03:34+07:00 Pakpoom Thintharua Permphan Dharmasaroja <p style="text-align: justify;">Anatomy is an essential preclinical subject of undergraduate medical education. The traditional practical studies on cadavers are widely used in medical schools. It enhances active and deep learning, preparing students for clinical practice. However, the high costs, the time-consuming, and the health problems from chemical hazards, to which the staff exposed are considered. Computer-based learning (CBL) technologies can increase the efficiency of students in understanding anatomy. This review provides an overview of CBL technologies such as Anatomage table 7.0, zSpace, Complete Anatomy app, and 4D Interactive Anatomy that prepare Ramathibodi medical students for enhanced anatomical understanding and self-learning. The integration methods between traditional cadaveric dissection and the CBL in the curriculum can enhance the classroom experience, student engagement, learning, retention, and improvement of Ramathibodi medical student’s knowledge in anatomy.</p> <p style="text-align: justify;">&nbsp;</p> 2021-12-27T00:00:00+07:00 Copyright (c) 2021 Ramathibodi Medical Journal A Rare Variation of Retroaortic Left Renal Vein Draining into Left Common Iliac Vein 2021-12-27T16:58:43+07:00 Sitthichok Fangmongkol <p style="text-align: justify;">A 24-year-old woman without underlying disease presented with right lower abdominal pain for a day. The patient’s clinical symptoms were suspected acute appendicitis and underwent multidetector computed tomography. There is diffuse enlarged appendix with diffuse wall thickening and enhancement as well as minimal surrounding fat stranding. Mild thickened peritoneum is also observed. There is no fluid collection or free air. The radiologist diagnosed acute appendicitis without complication. Incidentally, the patient was found a rare anatomical variation of the retroaortic left renal vein draining into left common iliac vein. Patient underwent appendectomy. We would like to present a characteristic imaging of the renal vein variations.</p> <p>&nbsp;</p> 2021-12-27T00:00:00+07:00 Copyright (c) 2021 Ramathibodi Medical Journal