Ramathibodi Medical Journal https://he02.tci-thaijo.org/index.php/ramajournal <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="https://www.asean-cites.org/" 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="https://tci-thailand.org/" 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="https://search.crossref.org/?q=ramathibodi&amp;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="https://scholar.google.co.th/citations?user=N7b2p9MAAAAJ&amp;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> Faculty of Medicine Ramathibodi Hospital, Mahidol University, THAILAND en-US Ramathibodi Medical Journal 0125-3611 Editor's Note https://he02.tci-thaijo.org/index.php/ramajournal/article/view/242958 <p style="text-align: justify;">As the middle of 2020, the coronavirus disease 2019 (COVID-19) situation is still dire in many parts of the world, and the number of cases is continuously rising. COVID-19 has made changes to many things in our society, so-called “New Normal.” In the scientific publication, COVID-19 has exposed previous ignorant loophole, peer-review process.</p> <p style="text-align: justify;">On June 4, two articles from the highest profiled medical journals (<em>The New England Journal of Medicine</em> and <em>The Lancet</em>) were retracted due to issue of data validation.<sup>1, 2</sup> Both articles got data from a healthcare analytics company called Surgisphere. The company claimed to house a system of fully integrated data from the electronic health records of at least 671 hospitals across six continents with thousands of patients’ data. However, it seems unlikely that the data exist as advertised. After rushing to the publication of anything titled COVID-19 as most the journals, there were many concerns from correspondents around the world sent to journal editors. Both journals have conducted official investigations and Surgisphere refused to show the raw data.</p> <p style="text-align: justify;">&nbsp;Not only the retractions of both articles, but also one of the authors was terminated the faculty appointment from The University of Utah.<sup>3</sup></p> <p style="text-align: justify;">In case that our readers are interesting in retraction of research paper about COVID-19. There is a continuously updated list maintained by Retraction Watch website.<sup>4</sup></p> <p style="text-align: justify;">In the aftermath, some may concern why peer review process did not identify the articles as questionable. How did the reviewers miss what, in retrospect, seems obvious? Currently, peer review process is the main quality-control system for the integrity of the medical literature. But journal editor is equally important as “the first line of defense against fraudulent, hyped, deceptive, or just plainly bad papers.”<sup>5</sup></p> <p style="text-align: justify;">&nbsp;</p> Chusak Okascharoen Copyright (c) 2020 Ramathibodi Medical Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2020-06-30 2020-06-30 43 2 Visceral Fat Quantitated From CT Colonography Is Associated With the Presence of Colorectal Polyps https://he02.tci-thaijo.org/index.php/ramajournal/article/view/240071 <p style="text-align: justify;"><strong>Background: </strong>An adenomatous polyp is known as a precancerous lesion of colorectal cancer. Detection and removal of adenomatous polyps are essential for colon cancer prevention. Previous studies have found the association between obesity and adenomatous polyp using many parameters.</p> <p style="text-align: justify;"><strong>Objective: </strong>To determine the association between visceral fat visualized on computed tomography (CT) colonography (CTC) and colorectal polyps.</p> <p style="text-align: justify;"><strong>Methods: </strong>This retrospective case-control study consisted of 280 adult subjects who underwent colon cancer screening by CTC at Ramathibodi Hospital; 129 cases with CT detected colorectal polyps who underwent polypectomy within 6 months, and 151 control subjects who were negative for significant polyps on CTC. Visceral fat areas of all subjects were measured on CT at the umbilical level by a semiautomatic method. Statistical analysis was performed to ascertain associations with the presence of colorectal polyps.</p> <p style="text-align: justify;"><strong>Results: </strong>Of 280 adult subjects, there were classified into 4 groups; no polyps (n = 151), hyperplastic polyp (n = 23), low-risk adenomatous polyp (n = 75), and high-risk adenomatous polyp (n = 31). The mean visceral fat areas in 4 groups were 125.1 ± 55.7 cm<sup>2</sup>, 140.2 ± 63.8 cm<sup>2</sup>, 147.9 ± 74.2 cm<sup>2</sup>, and 156.6 ± 63.7 cm<sup>2</sup>, respectively. There were statistically significant differences in these means visceral fat between the no polyp group and both the low-risk and high-risk adenomatous polyp groups. In multivariate analyses, subjects who had visceral fat areas more than 168.60 cm<sup>2</sup> were more likely to have polyps than subjects whose visceral fat areas were less than 93.65 cm<sup>2</sup> (<em>P</em> &lt; .05).</p> <p style="text-align: justify;"><strong>Conclusions: </strong>Visceral fat was positively associated with the presence of adenomatous colorectal polyps.</p> <p style="text-align: justify;">&nbsp;</p> Saowanee Srirattanapong Yasinee Panyawaraporn Wichan Prasertsilpakul Jiraporn Laothamatas Copyright (c) 2020 Ramathibodi Medical Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2020-06-30 2020-06-30 43 2 1 8 10.33165/rmj.2020.43.2.240071 The Study of the Yield of DNA Extracted From Hairs of Postmortem Cases https://he02.tci-thaijo.org/index.php/ramajournal/article/view/224635 <p style="text-align: justify;"><strong>Background:</strong> Problems frequently occur from hair extraction are low concentration and impurity of DNA.</p> <p style="text-align: justify;"><strong>Objective: </strong>To assess the Phenol/Chloroform/Isoamyl alcohol method for extracting DNA from hair roots.</p> <p style="text-align: justify;"><strong>Methods:</strong> Hairs from 30 postmortem cases were collected. In each case, 5 and 10 hair roots were extracted DNA by Phenol/Chloroform/Isoamyl alcohol. The amount and purity of DNA (A260/280) were detected by NanoDrop spectrophotometer. The quality of DNA was examined using polymerase chain reaction (PCR). Amount of DNA was analyzed compared with gender, age, and manner of death.</p> <p style="text-align: justify;"><strong>Results:</strong> The amount and purity of DNA extracted from 10 hair roots were slightly better than 5 hair roots (<em>P</em> &gt; .05). The mean (range) of DNA concentration was 200.4 (35.2 - 799.6) ng/µL from 10 hair roots vs 148.2 (21.7 - 571.5) ng/µL from 5 hair roots in 30 µL volume whereas the mean (range) of A260/280 was 1.61 (1.31 - 1.99) in 10 hair roots vs 1.54 (1.32 - 1.90) in 5 hair roots. The results from NanoDrop showed no difference among various gender, age, and manners of death.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> DNA can be extracted from hair by Phenol/Chloroform/Isoamyl alcohol. The quantity and quality of DNA were good enough for personal identification by PCR. DNA extracted from 10 hair roots is better than 5 hair roots.</p> <p style="text-align: justify;">&nbsp;</p> Kanchana Sujirachato Suranan Tirawatnapong Nurhasnee Mimae Sirirat Inon Adisuk Kaewdouengdee Wisarn Worasuwannarak Copyright (c) 2020 Ramathibodi Medical Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2020-06-30 2020-06-30 43 2 9 18 10.33165/rmj.2020.43.2.224635 An Analysis of Services Utilization and Medical Care Charge in Pesticide Poisoned Patients Using the National Health Security Office Database https://he02.tci-thaijo.org/index.php/ramajournal/article/view/240957 <p style="text-align: justify;"><strong>Background:</strong> As the results of the high pesticides use, pesticide poisoning is an important health problem in Thailand. Most studies are about pesticide use behavior and health impact, but lack of studies that indicate the impact economically.</p> <p style="text-align: justify;"><strong>Objective:</strong> To analyze the services and medical care charge of patient diagnosed with pesticide poisoning at the hospitals.</p> <p style="text-align: justify;"><strong>Methods:</strong> This study was a cross-sectional descriptive study using data from the National Health Security Office both outpatients and inpatients. Data was collected during the year 2016 - 2018 and selected according to ICD-10 diagnosis code T60.0-T60.9 (Toxic effect of pesticides), but excluding code X68 (Intentional self-poisoning by and exposure to pesticides). Data were analyzed using descriptive statistics.</p> <p style="text-align: justify;"><strong>Results:</strong> During the year 2016 - 2018, the majority was inpatient (97.0%), and diagnose with toxic effect of herbicide and fungicides (47.9%). The average cost per person per year of inpatient care was ฿7740, ฿11 048 and ฿9641, by year respectively. While the average cost per person per year of outpatient care was ฿1651, ฿1482, and ฿1668, respectively. The common types of poisoning were herbicide and fungicides, followed by organophosphate and carbamate poisoning.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> The majority of patients affected by pesticides are inpatients who were poisoned by herbicide and fungicides with higher medical cost than outpatients. However, the causes of the highest average cost of treatment and the highest number of visits are organophosphate and carbamate insecticides.</p> <p style="text-align: justify;">&nbsp;</p> Jetsadapong Uanpromma Punyanuch Suwangbutra Nilawan Upakdee Copyright (c) 2020 Ramathibodi Medical Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2020-06-30 2020-06-30 43 2 19 29 10.33165/rmj.2020.43.2.240957 Factors Related to Treatment Compliance Among Patients With Heart Failure https://he02.tci-thaijo.org/index.php/ramajournal/article/view/239889 <p style="text-align: justify;"><strong>Background:</strong> Treatment compliance can not only prevent complications among patients with heart failure but also improve their health, quality of life, decrease hospitalization, and mortality rate.</p> <p style="text-align: justify;"><strong>Objective:</strong> To examine the treatment compliance among patients with heart failure, and identify factors related to treatment compliance.</p> <p style="text-align: justify;"><strong>Methods:</strong> The descriptive correlational study was carried out in 112 participants by a random sampling technique in the Cardiovascular Department, C Hospital, Vietnam. Data were collected during June to August 2019. Four instruments were used: 1) Demographic and clinical conditions; 2) the Revised Heart Failure Compliance Scale; 3) Mini Mental State Examination (MMSE); and 4) the Japanese Heart Failure Knowledge Scale (JHFKS). Data were analyzed by chi-square test and Spearman rank correlation.</p> <p style="text-align: justify;"><strong>Results:</strong> Among 54.5% of participants were demonstrated treatment compliance. Compliance with the medication and routine checkup were high (&gt; 80%), whereas doing exercise, fluid restriction and weighing daily were low (43.8%, 33.8%, and 16.1%, respectively). Factors included gender, education level, numbers of hospitalization during the past year, comorbidities, heart failure knowledge, and cognitive function were significantly related to treatment compliance (<em>P</em> &lt; .05).</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Patients should enhance heart failure knowledge in order to improve treatment compliance. By doing this, heart failure patients were supplied information about the disease when they are hospitalized. Patients with cognitive impairment were also paid attention to improve treatment compliance.</p> <p style="text-align: justify;">&nbsp;</p> Hoang Thi Ngoc Sen Tran Thi Tuyet Linh Duong Thi Kieu Trang Copyright (c) 2020 Ramathibodi Medical Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2020-06-30 2020-06-30 43 2 30 40 10.33165/rmj.2020.43.2.239889 Satisfactory Assessment for Performance of Orthopaedic Research Service https://he02.tci-thaijo.org/index.php/ramajournal/article/view/227132 <p style="text-align: justify;"><strong>Background:</strong> Orthopaedic research service needs to be evaluated its effectiveness.</p> <p style="text-align: justify;"><strong>Objective:</strong> To assess customer satisfaction of effectiveness in orthopaedic research service.</p> <p style="text-align: justify;"><strong>Methods</strong>: A cross-sectional study was conducted among staffs, residents, fellows, and officers who used orthopaedic research service between June 2018 and June 2019. Customers who provided incomplete data were excluded. Baseline characteristics such as gender, highest education, types of employment, and positions were collected. Satisfaction of effectiveness of research service was assessed using the 23-item questionnaire with 8 dimensions; responsibilities, competency, diligence, public interests, creativity, communication, service mind, and productivity.</p> <p style="text-align: justify;"><strong>Results:</strong> From 80 participated customers, there were 61 males (76.25%), and 56 residents (70%). Customers satisfied at a good-excellent level in service mind (95.30%), diligence (94.80%), communication (94.75%), public interests (94.60%), productivity (94.50%), responsibility (94.13%), competency (94.13%), and creativity (93.80%). Baseline characteristics were not significantly associated with satisfaction.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Customers satisfied orthopaedic research service at the good-excellent level more than 93%. Improvement of responsibility, competency, and creativity may increase customer satisfaction.</p> <p style="text-align: justify;">&nbsp;</p> Yaowaret Tangsopa Patarawan Woratanarat Chanika Angsanuntsukh Copyright (c) 2020 Ramathibodi Medical Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2020-06-30 2020-06-30 43 2 41 50 10.33165/rmj.2020.43.2.227132 Nontraditional Biomarkers for Cardiovascular Disease in Patients With Chronic Kidney Disease https://he02.tci-thaijo.org/index.php/ramajournal/article/view/230208 <p style="text-align: justify;">Cardiovascular disease (CVD) is the leading cause of death among patients who have chronic kidney disease (CKD). Nowadays, CKD per se is considered one of the coronary heart disease (CHD) risk equivalents. Apart from traditional CVD risk factors, there are several possible determinants for CVD in patients with CKD, for example, uremic toxins, increased inflammatory stage, abnormal bone mineral metabolism, and positive calcium balance. In this narrative review, we offer a summary of the extensively studied biomarkers for CVD in patients with CKD, including uremic toxins (p-cresol, indoxyl sulfate, and advanced glycated end products), and a novel indicator of arterial stiffness, cardio-ankle vascular index (CAVI), which is an independent prognostic predictor for CVD. For the uremic toxins, we reviewed their metabolisms, particularly, how the reduced renal function in CKD patients affect their clearance and their clearance with dialysis. Also, we pay attention to the recent evidence on how those uremic toxins contribute to CVD and their clinical associations. We do not include the possible treatment targeting at those uremic toxins. As for the novel indicator of arterial stiffness, we reviewed the clinical application of CAVI in comparison to the standard indicator for arterial stiffness, pulse wave velocity.</p> <p style="text-align: justify;">&nbsp;</p> Ittikorn Spanuchart Arkom Nongnuch Youg Liu Copyright (c) 2020 Ramathibodi Medical Journal https://creativecommons.org/licenses/by-nc-nd/4.0 2020-06-30 2020-06-30 43 2 51 60 10.33165/rmj.2020.43.2.230208