Royal Thai Air Force Medical Gazette

Effect of the Combination of Sitagliptin and Insulin in Comparison to Insulin on Mortality in Hospitalized Patients with SARs-CoV-2 Infection in Bhumibol Adulyadej Hospital

Gp.Capt. somchodok Chakreeyarat, Kristin Phanpaisal — Sat, 28 Dec 2024 00:00:00 +0700

Introduction: The COVID-19 virus is a coronavirus that can spread rapidly and causes severe inflammation of the respiratory system leading to respiratory failure and death. Approximately one-third of patients who die from COVID-19 infection are also diagnosed with diabetes. Moreover, fifteen to thirty – five percent of patients infected with COVID-19, who are admitted to the in-patient department Bhumibol Adulyadej Hospital, have hyperglycemia. Diabetes is, therefore, associated with COVID-19 infection and may be a major comorbidity in the rapid spread of the virus. Sitagliptin is an oral DPP-4 inhibitor used for the treatment of patients with type 2 diabetes and is effective in lowering HbA1c levels. Sitagliptin does not cause weight gain, and there are very few side effects. Therefore, sitagliptin is commonly used in the patients with type 2 diabetes.

Objectives: To comparison the effect sitagliptin plus insulin with standard of care (insulin alone) on the mortality rate and clinical improvement in COVID-19 patients with type 2 diabetes.

Methods: This study was a randomized controlled trial, open-label, which collected data from the patients with diabetes or diagnosed with diabetes while receiving treatment for COVID-19 at Bhumibol Adulyadej Hospital during May-September 2021. Patients were randomized to receive sitagliptin plus insulin or insulin alone and was follow-up for a period of 1 month. Patient baseline data, laboratory findings and mortality rate were analyzed by comparing the relationships between various factors. Data were analyzed using Chi-square test or T-test.

Results: A total of 66 patients were eligible and enrolled into study, of which 9 died, 4 (12.1%) of the patients treated with sitagliptin plus insulin and 5 people received insulin. From the analysis, it was found that patients treated with sitagliptin plus insulin were less likely to die compared with patients treated with insulin, but the difference was not statistically significance. (Odds ratio, 0.772 95% CI; 0.188 – 3.175; p-Value = 0.720).

Conclusion: In type 2 diabetic patients infected with COVID-19 admitted to the in-patient department, Bhumibol Adulyadej Hospital, there was no statistical differences in mortality rate and clinical improvement between the sitagliptin-treated group and the standard of care.

Establishing Family Folders for Royal Thai Air Force “Thung Sikan Model”

Gp.Capt. Kanyika Wanvimonsuk , Jureeruk Khamcharoen, Flg.Off. Nawa Seehanam — Sat, 28 Dec 2024 00:00:00 +0700

Abstract

The establishment of the Family Folder for Royal Thai Air Force (RTAF) personnel "Thung SiKan Model," aims to survey and gather data on infrastructure and health status, as well as to enhance the process of providing proactive medical services to RTAF personnel and their families living in the Thung Sikan flats and the area around Don Mueang Railway Station. The data collection includes general and health information and major health problems, which allows for the identification of health problems and the implementation of relevant projects to address these issues based on the community’s needs. As well as the mission of Air Force Medical Department’s “better health services for RTAF” through proactive health promotion and prevention. This model is designed to serve as a prototype for other RTAF communities to establish health registries within their respective areas.

Research and Development of a Device for Reducing Temperature in Heat Stroke Patients

Kotsakorn Sodasri — Sat, 28 Dec 2024 00:00:00 +0700

Introduction: This study aimed to develop a heat stroke life-saving device that can be used effectively and reduce the danger and complications for patients with this condition. In patients with heat stroke, the body temperature should be decreased by 0.2 degrees Celsius/minute. As a result, a device was developed to lower the body temperature to that level.

Methods: A group of 17 individuals were selected to perform activities that would generate heat within the body without posing any risk. They were treated with the device, which is a cooling blanket. Another 1 week later, the same 17 people were treated as a control group using a body wipe method. The data collection was a temperature recording before and after the intervention, which recorded the changes every 5 minutes. The data was analyzed using descriptive statistics and using the Chi-square test for categorical variables and the T-test for continuous independent variables. The ANOVA test was used to test the difference in temperature after the experiment in the experimental and control groups.

Results: The average temperature levels before the intervention of the two groups were not significantly different, while the average temperature after the intervention of both groups was statistically significantly different. When the average temperature reduction of both the experimental and control groups was compared, it was found that the average temperature reduction in the experimental group was significantly greater than the control group (p < 0.001). When considering the number of study participants who were able to reduce the temperature ≥ 0.2 degrees Celsius/minute, it was found that in the experimental group, there were 15 out of 17 people (88.2%), while in the control group, there were 2 out of 17 people (11.8%), which was a statistically significant difference (p < 0.001).

Conclusions: This study on the development of heat stroke temperature reduction devices found that they effectively reduced the body temperature of heat stroke patients by ≥ 0.2 degrees Celsius/minute, ensuring safety and prevent complications. As a result, these devices are valuable for military medical units and those involved in recruiting new soldiers.

Editorial Notic

Gp.Capt.Pongsathorn Gojaseni — Sat, 28 Dec 2024 00:00:00 +0700