Ramathibodi Medical Journal

Ultrasound in Patients With Clinically Suspected Submandibular Gland Disease

Phatthawit Tangkittithaworn — 2024-12-25

Background: The submandibular gland is quite common to be affected by various disease processes in all age groups that may be difficult to differentiate clinically. Its superficial location makes it readily accessible to ultrasound evaluation.

Objective: To evaluate sonographic features of abnormal submandibular gland.

Methods: Ultrasound images and medical records of patients who presented with clinically suspected submandibular gland disease at a single institution were retrospectively reviewed. Demographic data, final diagnoses, further management, and sonographic findings were evaluated.

Results: Eighty-one patients were identified, 56 females and 25 males (mean [SD] age, 53 [16] years; range, 1 - 87 years). The main presenting symptoms were palpable mass (31 [38.3%]) and pain (23 [28.4%]) involving the left (30 [37.0%]), the right (27 [33.3%]), and bilateral submandibular area (24 [29.6%]). Only 6 patients (8.1%) underwent further imaging. The most common final diagnoses were acute sialadenitis (38 [46.9%]), Sjögren syndrome (14 [17.3%]), tumor (6 [7.4%]), and stone (4 [4.9%]). Submandibular glands were normal in 17 of 81 patients (21%); 9 of 17 (52.9%) had abnormal lymph nodes. Among various disease entities, a significant correlation was found between Sjögren syndrome and small gland size, stone and ductal dilatation, and abnormal lymph nodes with enlarged nodal size (P < .001).

Conclusions: Two-thirds of the patients had inflammatory/infectious diseases, with tumor and stone in minority. Certain ultrasound findings can suggest diagnosis. Less than 10% underwent further imaging, suggesting that ultrasound can be used to detect and guide further management of submandibular disease.

Quality of Life in Patient of the Comprehensive Diabetes Care Clinic, Family Medicine, Ramathibodi Hospital

Maneenuch Manchu — 2024-12-25

Background: Diabetes has been increasingly prevalent around the world. It causes acute and chronic consequences that affect the physical, psychological, and overall quality of life. This study describes patients’ quality of life, which is necessary to improve diabetes care.

Objective: To investigate the quality of life of diabetic patients in the comprehensive diabetic care clinic, Family Medicine outpatient unit, Faculty of Medicine Ramathibodi Hospital.

Methods: Survey the quality of life of diabetes patients receiving care from the comprehensive diabetes care clinic, Family Medicine outpatient unit, Faculty of Medicine Ramathibodi Hospital, from April 1, 2023, to July 31, 2023. Thirty-three cases were evaluated using the WHOQOL-BREF-THAI questionnaire.

Results: The overall quality of life in the sample group had an average total score of 103.18 (SD 11.11), and the majority (81.8%) had an excellent overall quality of life. Environmental and psychological health were determined at “good” levels (84.8% and 63.6%, respectively), while physical health and social relationships were determined at “moderate” levels (57.6% and 54.5%, respectively).

Conclusions: The quality of life of diabetes patients who received health care at the comprehensive diabetes care clinic was at a “good” level. Information obtained from the questionnaire could be used to evaluate the quality of holistic care further and guide how to improve diabetic patient’s quality of life.

Satisfaction and Perceptions of an Interactive E-Book for Online Learning in an Epidemiology Course Among Nursing Students in Thailand

Pramote Thangkratok — 2024-12-25

Background: Interactive e-books, which incorporate multimedia elements, have had a positive impact on students’ learning achievements. There has been limited research on the impact of interactive e-books on nursing students’ satisfaction and perceptions, particularly in online learning in epidemiology courses.

Objective: To describe nursing students’ satisfaction and perceptions regarding an interactive e-book for online learning in an epidemiology course.

Methods: This study utilized a descriptive research design. Secondary data analysis collected nursing students’ satisfaction and perceptions from existing evaluation forms regarding the interactive e-book used in the epidemiology course for the 2020 academic year, completed by 196 second-year nursing students from a nursing institution in Thailand. The quantitative data was analyzed by using descriptive statistics, and qualitative data was analyzed by using content analysis.

Results: The results indicated that the mean satisfaction score for the interactive e-book was at a very high level, with a score of 4.53 out of 5. Furthermore, the mean scores of the content, system, and utility aspects were at very high levels. The content analysis related to the perception of the interactive epidemiology e-book among nursing students was categorized into 5 themes: 1) concise content and easy-to-understand, 2) effective presentation, 3) interactive quizzes to verify correct answers and build understanding, 4) easy use and access anywhere at any time, and 5) increased motivation to study.

Conclusions: This study has demonstrated that interactive e-books positively enhanced nursing students’ satisfaction and learning in an epidemiology course during the COVID-19 pandemic, suggesting further research on their effectiveness in various educational outcomes.

Pyronaridine – the Current Antimalarial Standing Up to Parasite Resistance

Saranya Auparakkitanon — 2024-12-25

Pyronaridine, an aza-9-anilinoacridine schizonticide, was synthesized in China 54 years ago and since 2012 has been prescribed globally in combination with artesunate, marketed under the name Pyramax. Artesunate is an analog of artemisinin, a sesquiterpene lactone with an endoperoxide moiety, extracted from Artemisia annua L., and used as an herbal remedy in Chinese traditional medicine to treat jungle fever, also discovered in China at nearly the same time. Pyramax is one of the safest and most efficacious forms of artemisinin combination therapy (ACT) for treating uncomplicated Plasmodium falciparum malaria in adults and children. This narrative review explains the mechanism of action of pyronaridine, why it remains effective against P. falciparum even though the parasite has evolved resistance or tolerance to all other antimalarial drugs used in clinical practice, and suggests possible antiplasmodial deaza-pyronaridine (acridine) analogs that could be used should pyronaridine becomes ineffective.

Advance Care Planning in Older Adults

Thagoon Kanjanopas — 2024-12-25

Advance care planning (ACP) is a process that empowers patients to communicate their healthcare wishes, goals, and preferences with family and healthcare providers, in anticipation of a time when they may be unable to express these themselves. Effective ACP upholds patient autonomy, enabling individuals to actively participate in decisions about their end-of-life care. This enhances the quality of life for both patients and their caregivers while alleviating the burden on families. Despite its recognized importance, healthcare providers often initiate ACP discussions only in the advanced stages of illness, limiting time for preparation and emotional adjustment. Furthermore, both healthcare providers and the general public often fear engaging in conversations about death and dying, which presents a significant barrier to ACP. Initiating these conversations earlier, preferably before a crisis occurs, allows individuals to express their preferences, values, and goals for care. This ultimately leads to more personalized and meaningful healthcare decisions.

The Role and Responsibilities of Data Professionals in Healthcare Organization

Ratchainant Thammasudjarit — 2024-12-25

Healthcare organizations are increasingly embracing data-driven approaches to enhance patient care, reduce costs, comply with regulations, and drive innovation through data analytics. Such approaches require collaboration between data professionals. Having data professionals such as data scientists, data analysts, data engineers, and machine learning engineers together and managing them to work on a given task is the new challenge for healthcare organization that usually employs domain experts who have data skills at the beginner to intermediate level. Such a practice might work on a small scale. However, for the enterprise level, the large scale of data in cloud environment requires much more than just an intermediate level. This article describes the role and responsibilities of data professionals to contribute to a healthcare organization with illustrative examples from an analytic project. This article would guide healthcare organizations to acquire the right data professionals to the right tasks.