Royal Thai Army Medical Journal

ศูนย์เวชศาสตร์ทหาร โรงพยาบาลพระมงกุฎเกล้า และวิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า

2024-01-26T09:53:26+07:00

Snake antivenoms in Thailand

2024-01-26T10:19:01+07:00

Amblyopia and its current treatment

2023-07-04T21:10:30+07:00

Amblyopia is a condition in which vision is reduced from the average. It may be only on one side or both eyes. Poor visual development from birth to eight years of age, affecting the process of interpreting images in the brain, leads to this condition. Strabismus, refractive error, and vision-obscuring disorders are among the risk factors. The diagnosis is based on visual acuity deterioration using age-based criteria. The treatment starts with eliminating the disease that obscures vision. Correction of abnormal eyesight and encouraged the use of the lazy eye. Early treatment would have better results. Initially, the treatment consisted of wearing eyeglasses and eye patching or eye drops. The treatment has been developed to stimulate the use of the abnormal eye, which has good results. This disease, even if treated until the symptoms get better, there is a chance of recurrence. Long-term monitoring is required.

Caregiver burden in caregivers of older persons

2024-01-25T15:30:01+07:00

Worldwide, the geriatric population has rapidly increased. Many older adults live with multiple comorbidities such as cancer, cerebrovascular disease and dementia which contribute to impaired activity of daily living and increased dependence. Therefore, caregiver play a major role in long-term supporting and caring these susceptible persons, leading to increased caregiver burden in caregivers. The prevalence of caregiver burden is 20% to 80% based on population setting. The most common risk factors of caregiver burden are financial problem and patients’ severe physical and psycho-behavioral problems. The burden results in adverse consequences including increased health deterioration, and diminish care provision and quality of life. Caregiver burden is usually underdiagnosed; hence, comprehensive assessment and suitable instruments should be applied for accurate diagnosis in clinical practice. Non-pharmacological treatment such as psychoeducation and cognitive-behavioral therapy play important roles in the reduction of caregiver burden. Therefore, we aimed to update the diverse points of caregiver burden in caregivers of older persons such as definition, prevalence, risk factors, consequences, diagnosis and management.

The Co-creation Process for Enhancing the Potential of Collaborative Learning in the Context of Health Professions

2024-01-02T08:58:30+07:00

Collaborative learning is a learning method that depends on collaboration between students. Nevertheless, in current educational practices, these learning patterns are often designed solely by instructors, which may not align with diverse needs of all students. Student engagement directly affects the quality of collaborative learning. Co-creation, as a method, not only enhances student engagement in the learning process but also improves the design of various learning activities. This article aims to present principles, types, components, strengths, and considerations for co-creation in various contexts, as well as practical applications to promote collaborative learning patterns within the specific context of each institution.

Co-creation relies on the collaborative efforts of learners, educators, stakeholders and patients in developing teaching and learning practices, emphasizing the importance of equal inputs from all parties. This collaborative approach can result in teaching and learning practices that are well-suited to the context of all stakeholders involved. Nevertheless, co-creation presents various considerations, from student to institutional levels. For example, there is a need to establish an effective collaboration between students and teachers, requiring adaptability to maximize efficacy. Therefore, initiating co-creation should be approached thoughtfully and systematically. Moreover, if executed appropriately, co-creation can lead to a better understanding among learners, stakeholders, and patients, enabling the design of collaborative learning patterns tailored to the context of each institution, and even facilitating wider adoption across other institutions.

Keywords: co-creation, collaborative learning, student engagement, medical student

Risk Factors for Potential Persistent Lung Abnormality on Chest Radiographs in Post COVID-19 Patients

2023-06-10T17:55:14+07:00

Background: Most COVID-19 pneumonia survivors develop abnormal chest radiographs (CXR) that progress to interstitial lung disease. This study aimed to identify potential risk factors for persistent CXR abnormalities in post COVID-19 patients. Methods: The study included hospitalized COVID-19 pneumonia patients at Phramongkutklao Hospital between July 2021 and June 2022. At 12 weeks after discharge, CXR were evaluated based on the extent of abnormal infiltration, using a scoring system. The primary objective was to determine risk factors during COVID-19 infection associated with persistent CXR abnormalities at 12 weeks. Results:120 patients included (56% male; mean age 58 years), 76 (63%) exhibited persistently abnormal CXR at 12 weeks after discharge. The group with persistent CXR abnormalities had significantly higher mean age (62 vs. 52 years, p < 0.001), longer hospital stays (21 vs. 14 days, p < 0.001), higher rates of hypertension (61.8 vs. 27.3%, p < 0.001), dyslipidemia (44.7 vs. 27.4%, p = 0.04), use of oxygen support (85.5 vs. 45.5%, p < 0.001), and use of HFNC or NIV (44.7 vs. 15.9%, p < 0.001) compared to the group with complete resolution. Laboratory revealed significantly elevated levels of serum LDH (p < 0.001), CRP (p = 0.002), and peak CRP (p = 0.001) in the group with persistent CXR abnormalities. Multivariable analysis identified a longer hospital stay (>14 days), hypertension, use of oxygen therapy (HFNC, NIV, or ETT), and serum LDH levels >250 U/L as significant factors associated with CXR abnormality. Conclusion: A longer hospital stays > 14 days, hypertension, use of oxygen therapy, and serum LDH > 250 U/L were identified as risk factors for persistent CXR abnormality from COVID-19 at 12 weeks.

Distribution of ABO and RhD blood groups among Thai neonates born at Phramongkutklao hospital

2022-11-22T17:09:01+07:00

Background: Among the blood group antigens identified, ABO and Rh(D) are the most important in transfusion medicine. ABO blood group antigens are the most immunogenic followed by D antigen in the Rh blood group system. These blood groups frequency distribution varies among different regions and races of the world. Objective: This study aimed to identify the frequency distribution of ABO group and Rh(D) antigen among Thai neonates at Phramongkutklao hospital. Material and methods: A retrospective cross-section studies were conducted from January 01/2012 to December 31/2021 at Blood Bank Division, Department of Pathology, Phramongkutklao hospital. Data were collected from blood blank data registration system and descriptive statistical results were presented in number (frequency) and percentage. Result: Among 7,803 Thai neonates, 54.24% were males, the most common blood group was blood group O (36.23%), followed by B (35.68%), A (21.31%), and AB (6.78%). By considering ABO and Rh(D) blood groups together, blood group O with Rh(D) positive (36.09%) was the predominant blood group, followed by B with Rh(D) positive (35.60%), A with Rh(D) positive (21.22%), AB with Rh(D) positive (6.77%), O with Rh(D) negative (0.14%), B with Rh(D) negative (0.08%), A with Rh(D) negative (0.02%), and AB with Rh(D) negative (0.01%). Conclusion: This study showed that blood group O was the predominant followed by B, A, and AB, and most of Thai neonates had Rh(D) positive (99.74%). About 54.24% of the total studied neonates were male.

Keywords: ABO blood group, Rh(D) blood group, Neonate, Frequency

Correlation of Post COVID-19 fatigue condition and Vitamin D deficiency in Thai older people

2023-12-07T23:47:07+07:00

Background Due to the COVID-19 pandemic, more than 600 million people have been infected worldwide. Patients who recover from COVID-19 may experience long-term symptoms in 10-20% of cases, with the most common symptom being fatigue, which can affect daily life, especially in the older people. Studies have shown that low vitamin D levels are associated with severe COVID-19 infection and that vitamin D can suppress inflammation and help repair organs after COVID-19 infection. However, no studies have yet investigated the relationship between fatigue after COVID-19 infection and vitamin D levels .

Objectives To study correlation of Post COVID-19 fatigue condition and Vitamin D deficiency in

Thai older people . Therefore, we investigated the vitamin D levels of Thai volunteers aged 60-75 years with COVID-19 infection, divided into two groups: those diagnosed with fatigue after COVID-19 infection and those without at Outpatient department and Primary care unit of Phramongkutklao Hospital. between January to December 2023.

Results Vitamin D levels were significantly lower in the group with fatigue after COVID-19 infection than in the control group (Mean 28.10 ng/mL and 41.30 ng/mL, p = 0.0001748, Mann-Whitney U test) . There was no correlation between vitamin D levels and VAS fatigue scores in the group with fatigue (R = -0.1, p = 0.520) . People with diabetes, coronary heart disease, and high blood lipids had no significant difference in vitamin D levels compared to those without these diseases (p-value = 0.087, 0.584 and 0.136).

Conclusion This study suggests that low vitamin D levels may be a risk factor for fatigue after COVID-19 infection. Vitamin D supplementation may be an option to prevent or treat this condition, but further research is needed to confirm this relationship and test the effectiveness of vitamin D in treating fatigue after COVID-19 infection.

A Case of Photo-onycholysis induced by Doxycycline

2024-01-29T05:08:06+07:00

Photo onycholysis is separation of the nail plate from the nail bed after exposure to ultraviolet light and may involve one or more nails. Pain in the nail bed or tips of the fingers and toes is often the first symptom with subsequent progression to subungual erythema, subungual hemorrhage, and onycholysis. Onycholysis develops after a variable period. We reported a case of 21-year-old military who presented with 1 month of distal onycholysis of fingernails after using of doxycycline for 2 weeks. Based on history, physical examination and laboratory investigation, the patient was diagnosed with doxycycline induced photo-onycholysis.

Editorial

2024-04-23T11:25:16+07:00