เวชบันทึกศิ ริราช
ี่� 15 ฉั่� 1 มกราคม - ม่นาคม 2565
SIRIRAJ MEDICAL BULLETIN
ISSN 2697-4436
https://he02.tci-thaijo.org/index.php/
simedbull/issue/current
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0-2419-2884
Email
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4 ี ่� 15 ฉั่� 1 มกราคม - ม่นาคม 2565
Original Article
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Siriraj Medical Bulletin
Case Series: The Eect of Court-Type
Thai Traditional Massage and Hot
Herbal Compression Combined with
Standard Rehabilitation Treatment
in Stroke Patients
Wipavee Jongkoldee*, Chanticha Darunsawat*, Thanapak Chaowpeerapong*, Supakij
Suwannatrai*, Kamontip Harnphadungkit**, Pravit Akarasereenont*
*Center of Applied Thai Traditional Medicine, **Department of Rehabilitation Medicine, Faculty of Medicine
Siriraj Hospital, Mahidol University, Bangkok, Thailand
Siriraj Medical Bulletin 2022;15(1): 5-11
Abstract
Objective: To study the effect of Court-type Thai Traditional Massage (CTTM) and Hot Herb-
al Compression (HC) with Standard Rehabilitation Treatment (ST) in stroke patients.
Material & Methods: Medical records of 10 patients who had been treated with combined
ST, CTTM and HC were retrospectively reviewed.
Results: A total of 10 cases were reported, 6 males (60%) and 4 females (40%), mean age
of 62.5±12.7 years, 8 cases of ischemic stroke, and 2 cases of hemorrhagic stroke. Duration of
illness was 2 to 240 weeks (37.4±72.8 weeks) with signs and symptoms found as followed; weak-
ness in 2 cases (20%), weakness with spasticity in 2 cases (20%), weakness with pain in 3 cases
(30%) and 3 cases (30%) of weakness, pain and spasticity. After ST, CTTM and HC 2-3 times/week
for 1-4 weeks, it was found that 9 out of 10 cases had increase motor power grade, 3 out of 5 cas-
es had decrease spasticity, 4 out of 6 cases had lower pain score. All patients had improvement in
Barthel Index scores and no adverse incidents reported.
Conclusion: Court-type Thai Traditional Massage and Hot Herbal Compression combined
with Standard Rehabilitation Treatment was safe and possibly beneficial to stroke patients.
Keywords: stroke; weakness; court-type Thai traditional massage; hot herbal compression;
rehabilitation
Correspondence to: Thanapak Chaowpeerapong
Email: thanaphak.cha@mahidol.edu
Received: 29 June 2021
Revised: 16 August 2021
Accepted: 26 August 2021
http://dx.doi.org/10.33192/smb.v15i1.251281
6 ี ่� 15 ฉั่� 1 มกราคม - ม่นาคม 2565
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1
3
5
6
8
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*, *, *,
**, *
*, **
7
Siriraj Medical Bulletin
6
6
11
13
16
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Original Article
11
9
Siriraj Medical Bulletin
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Original Article
NO.
weak-
ness
spas-
ticity
pain
HC
HC
CTTM
3
2 66
5
3 61
3
4 56
8
5
5
6
3
7
3
8
5
9 55
85
6
11
Siriraj Medical Bulletin
No.
Shoulder
abduction
extensors
extensors
extensors
extensor
Shoulder
Hip
Joint
5 5 5 5 5 5 5 5 5 5 N/A N/A 5 5 5 5 2
3 N/A N/A 2 N/A N/A N/A N/A N/A N/A
2
2 3 2 3 2 3 2 3 2 3 N/A N/A 2 3 2 3
N/A N/A N/A N/A N/A N/A
3 7 4 9 2 2 2 2 2 N/A 2 3 4 3 2 N/A N/A
4 5 2 2 2 3 4 4 2 N/A N/A
5 7 6 4 4 3 4 3 4 2 2 4 3 N/A 4 3 N/A N/A N/A N/A N/A N/A
6 8 5 6 3 4 4 4 5 4 4 3 4 4 N/A N/A 5 5 5 5 N/A N/A
7 5 5 3 2 3 2 3 2 3 2 N/A N/A N/A 2 3 5 N/A N/A
8 6 4 N/A 3 4 4 2 4
9 7 4 5 3 5 3 4 3 4 2 N/A N/A 4 5 5 N/A N/A
3 5 7 4 4 4 4 4 4 4 4 N/A N/A N/A N/A 5 4 5 5 N/A N/A
15
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Original Article
The Quality of Life and Satisfaction
between High Cost Component
Project and Standard Component
Service in Transtibial Prosthesis at
Siriraj Hospital
Khemisa Engmahassakul*, Paweena Aekwattanaphol*, Marisa Amattayakul*,
Kamontip Harnphadungkit**
*Sirindhorn School of Prosthetics and Orthotics Faculty of Medicine Siriraj Hospital, Mahidol University,
**Rehabiliation medicine Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Siriraj Medical Bulletin 2022;15(1): 12-21
Abstract
Objective: To compare the quality of life in transtibial amputee between the ones using
standard service component (standard group) and the ones using high-cost component (high-cost
group) in SSPO clinic at Siriraj Hospital
Material & Methods: Descriptive study that interviewed the participants by telephone
covering participants’ general information, patient satisfaction and quality of life questionnaires
(WHOQOL and Thai EQ-5D-5L)
Results: This research had 114 amputees (average age 60 years old) that divided into two
groups in terms of 74 in standard group and 40 in the high-cost group. The quality of life between
both groups was not difference (p=0.568) while the educational level, and patients’ functional
ability before they received their prosthetics (k-level) were found statistically significant difference
(p=0.008 and p<0.001, respectively). In standard group, the most educational level was the lower
elementary school and k-level 3 were higher than another group. Psychological domain was signifi-
cant in the standard group (60.2%) compared with high cost (47.5%). Multiple regression analysis,
k-level 3 and patients’ wearing prosthetics per day were positively related to the psychological
domain (p=0.021 and 0.024). In addition, patient satisfaction questionnaire and another quality of
life domain were not statistically significant.
Conclusion: The comparison of transtibial amputee’s quality of life in both groups was not
significant. K-level and patients’ wearing prosthetics per day improved quality of life.
Keywords: disability; transtibial prosthesis; quality of life; Sirindhorn School of Prosthetics
and Orthotics; high cost
Correspondence to: Khemisa Engmahassakul
Email: eng.khemisa@gmail.com
Received: 21 June 2021
Revised: 20 July 2021
Accepted: 18 August 2021
http://dx.doi.org/10.33192/smb.v15i1.251332
13
Siriraj Medical Bulletin
*, *, *, **
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P-value
1
3
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P-value
19
Siriraj Medical Bulletin
B Std.Err P-value 95% CI
20 15 1 - 2565
Original Article
3
16
ń
3
3
6
5
3
ń
21
Siriraj Medical Bulletin
The Comparison Study Between
the Ecacy of Fresh Herbal
Compression and Dried Herbal
Compression in Patients with Neck
and Back Pain: A Randomized Trial
Suphawadee Tangchitchareon, Panitsupa Chuachang, Chaveewan Jaiveerawattana,
Akadet Onsa-ard, Ueamphon Suwannatrai, Manmas Vannabhum, Pravit Akarasereenont
Center of Applied Thai Traditional Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
Siriraj Medical Bulletin 2022;15(1): 22-30
Abstract
Objective: To compare the efficacy of fresh herbal compression with dry herbal compres-
sion for treatment in Lom -Plai-Pata-Khad Sanyan 4 of neck/back – neck or upper back pain.
Material&Methods: 206 subjects were divided randomly to fresh hot herbal compress
treatment group (N=103) and dry hot herbal compress treatment group (N=103). The hot herbal
compressed was applied on neck and upper back 45 minutes, 3 times for 1 week (1
st
, 3
rd
and 5
th
day). The pain scores, numeric rating scale (NRS: 0-10) were recorded before - after and follow
up in 14±2 day. The satisfaction was asked after 5
th
day.
Results: The pain scores were reduced significantly difference before and after treatment
both groups on 1
st
, 3
rd
and 5
th
day (p-value <0.001). The reducing pain, score reducing <2 levels
showed no significant difference between fresh and dry hot herbal compress treatment. Mean
differences of pain scores between fresh and dry hot herbal compress treatment on 1
st
, 3
rd
and
5
th
day were no significantly difference. The satisfaction result showed significant difference in
smell, heat and soften of fresh hot herbal compress treatment.
Conclusion: The fresh or dry hot herbal compress can be used for reliving muscular pain
in the Lom-Plai-Pata-Khad Sanyan 4 of neck/back or other muscular diseases that depended on
convenience and usage properly.
Keywords: Thai traditional medicine: hot compress: herb: muscle pain
Correspondence to: Panitsupa Chuachang
E-mail: panitsupa.chu@mahidol.edu
Received: 31 August 2021
Revised: 11 October 2021
Accepted: 23 October 2021
http://dx.doi.org/10.33192/smb.v15i1.253056
22 15 1 - 2565
Original Article
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23
Siriraj Medical Bulletin
1
Zingiber montanum
Curcu-
ma zedoaria Cymbopogon citratus
Dryobalanops aromatica
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6
16
Zingiber monta-
num
Zingiber
montanum
25
Siriraj Medical Bulletin
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Original Article
18
p-value
27
Siriraj Medical Bulletin
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Original Article
κ
29
Siriraj Medical Bulletin
# p < 0.001$ p < 0.001
*p < 0.05
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Original Article
* p < 0.05 and ** p < 0.001
31
Siriraj Medical Bulletin
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Siriraj Medical Bulletin
Nursing Care for Patient with
Severe Acute Pancreatitis
Wanna Supawachirakul*, Surat Thongyoo**
*Medical intensive care unit, Department of Nursing, Siriraj Hospital, Faculty of Medicine Siriraj Hospital
Mahidol University, **Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University,
Bangkok, Thailand
Siriraj Medical Bulletin 2022;15(1): 31-37
Abstract
Severe Acute Pancreatitis (SAP) is a critical and serious condition in gastrointestinal system.
The disease can affect various organ systems, lead to organs failure and increase mortality rate,
especially if a lack of appropriate treatment and immediate responses occurs. The failure of the
circulatory system leads to ineffective tissue perfusion, organ failure, and death The critical illness
condition may cause anxiety for the patients and family members. This article aims to present
holistic nursing guideline for the severe acute pancreatitis patients and patients’ family in term of
management on awareness and monitoring of patient's condition. The guideline includes assess-
ment and monitor of fluid resuscitation, level of consciousness, respiratory distress, prognosis of
disease, and management of pain and intra-abdominal pressure. The nursing goals are to provide
patients with adequate tissue perfusion to prevent organ failure, or facilitate recovery of organ fail-
ure, as well as prevent further complications to reduce mortality rate, and improve the quality of
life of the patients.
Keywords: acute pancreatitis; nursing; critical
Correspondence to: Wanna Supawachirakul
E-mail: wanna.sup@mahidol.ac.th
Received: 2 July 2021
Revised: 22 August 2021
Accepted: 1 September 2021
http://dx.doi.org/10.33192/smb.v15i1.250760
32 15 1 - 2565
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Review Article
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6
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18
1
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Siriraj Medical Bulletin
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Siriraj Medical Bulletin
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Original Article
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Review Article
Siriraj Vaccination Pathway against
Tetanus-Diptheria-Pertussis in
Pregnancy
Pattarawan Limsiri*, Chenchit Chayachinda**, Surasith Chaithongwongwatthana**,
Pareeda Tuanwaena***
*Maternal and Fetal Medicine Unit, Department of Obstetrics and Gynaecology, **Unit of Gynaecologic
Infectious Diseases and Female STDs, Department of Obstetrics and Gynaecology, Faculty of Medicine
Siriraj Hospital, Mahidol University, Bangkok, Thailand, *** Division of Infectious Disease in Gynecology
and Obstetrics (InDiGO), Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Siriraj Medical Bulletin 2022;15(1): 38-47
Abstract
Despite the fact that Tetanus-Diphtheria-Pertussis vaccine has been included in the national
Extended Program of Immunization for over 40 years, the mortality rate remains remarkable, espe-
cially among children aged 0-4 years. Moreover, the incidence of pertussis, as well as its mortality,
appears to be rising in recent years. As a solution, the recommendation by various academic bod-
ies to vaccinate pregnant women with Tetanus-Diphtheria-Pertussis vaccine for each pregnancy
during gestational age of 27-36 weeks has been launched. The maternal-generated immunity as
an in-utero passage of antibody to the fetus which will last for the first six months of vulnerability
window period has long evidently been promising. According to a systematic review, the effective-
ness of preventing pertussis infection in infants was 69-91%, the prevention of infant’s admission
was 91-94% and the prevention of infant deaths was 95%. Siriraj pathway for maternal immuniza-
tion against Tetanus-Diphtheria-Pertussis has been proposed for the convenience of applicability
to Thailand context. In the past, if a pregnant woman had not been boosted against tetanus for
more than 10 years, three doses of tetanus vaccine would be needed. According to this review,
only one dose booster with dT or Tdap is sufficient and the booster dose should be scheduled to
give pregnant women a Tdap at recommended time when needed.
Keywords: pertussis vaccine; tetanus-diphtheria-pertussis vaccine; pregnancy; prevention; vac-
cination
Correspondence to: Pattarawan Limsiri
E-mail: pattarawan.lim@mahidol.ac.th
Received: 5 August 2021
Revised: 18 August 2021
Accepted: 2 September 2021
http://dx.doi.org/10.33192/smb.v15i1.252557
1
Clostidium tetani
3
39
Siriraj Medical Bulletin
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**, ***
* -, **
-
, *** -
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Coryne-
bacteriaceae diphtheriae
Bordetella pertussis
coccobacilli
5
41
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5 8 5
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B.
pertussis
8
11
B. pertussis
13
15
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Siriraj Medical Bulletin
Nursing Care of Pregnant Patients
Infected with Covid-19 in Medical
Ward
Panaree Supaen*, Raveewan Sangprasert**, Piyarat Chimruang***, Pattarawalai
Talungchit****
*Medical Nursing Department, Department of Nursing, Siriraj Hospital, **Obstetrics and Gynecological
Nursing Department, Department of Nursing, Siriraj Hospital, Bangkok, ***Department of Nursing, Thonburi
2 Hospital, Bangkok, ****Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital,
Mahidol University, Bangkok
Siriraj Medical Bulletin 2022;15(1): 48-55
Abstract
Novel Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syn-
drome -Coronavirus-2 (SARS-CoV-2). It is an emerging disease that was discovered and the first
confirmed case was reported in Wuhan, China since December 2019. It is a highly contagious
disease that is spreading rapidly around the world and resulting in the number of infections and
deaths of the world’s population. It is transmitted from person to person through droplets in the
nose or mouth when coughing or sneezing or touching objects contaminated with the virus. When
an infection occurs, it results in complications of many systems, especially the respiratory sys-
tem. Each patient’s symptoms are different. Some patients are asymptomatic and some patients
have severe symptoms resulting in respiratory failure. The World Health Organization (WHO) has
declared it a Public Health Emergency of International Concern (PHEIC). The number of infected
people in Thailand is not likely to decrease. Many infected people have severe symptoms that lead
to death. Nurses play an important role in caring for and monitoring complications. Especially in
groups with risk conditions such as pregnant patients. The use of the nursing process in holistic
patient care will provide the best care. It is appropriate and covers physical and mental aspects.
Reduce the incidence of complications and mortality for mother and child. And allowing the preg-
nancy to continue until the full term is delivered safely.
Keywords: COVID-19; pregnancy; nursing process; holistic care
Corresponding author: Panaree Supaen
E-mail: Panaree.sup@mahidol.ac.th
Received: 26 August 2021
Revised: 3 November 2021
Accepted: 10 November 2021
http://dx.doi.org/10.33192/smb.v14i4.252443
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* , **
- , ***
2 , ****
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3A 3B
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Siriraj Medical Bulletin
Perioperative Medication
Management in Joint Replacement
Surgery
Wuttirat Thummawut*, Sarakorn Laongkaew**
*Department of pharmacy, Faculty of medicine Siriraj Hospital , Mahidol University, **Clinical Pharmacy
Department, Pharmacy Division, Bangkok Hospital Headquarters, Bangkok, Thailand
Siriraj Medical Bulletin 2022;15(1): 56-63
Abstract
Joint replacement surgery is recognized as high-risk bleeding operation. Hence, the
perioperative management of antithrombotic and anti-rheumatic drug is very important in order
to balance postoperative bleeding, thromboembolic risk and risk of prosthetic joint infection.
Antithrombotic drug consists of anticoagulant and antiplatelet. In the first step, physician has to
evaluate thromboembolic risk in case patients have to stop taking antithrombotic drug. Physi-
cian should advise patients who take anticoagulant warfarin to stop taking it for 4-5 days before
operating a surgery. However, for high thromboembolic risk patients, they should take bridging
therapy in order to reduce thromboembolic effect. For patients who take direct oral anticoag-
ulant (DOAC), they should stop taking DOAC for 2-4 days before surgery; there is no necessity
to provide bridging therapy. For patients who take antiplatelet drugs, they should stop taking it
for 5-7 days prior to surgery. Next step is to resume taking antithrombotic drug after operation
when bleeding risk has diminished. Anti-rheumatic drug especially biological agents have a ten-
dency to increase risk of infection after surgery, thus a very good plan in drug dosing cycle must
be aligned with surgery schedule. After surgery for 14 days, patients should resume taking bio-
logical anti-rheumatic agents in case there are no surgical site infection, systemic infection, and
wound healing problem.
Keywords: perioperative medication management; antithrombotic drug; anti-rheumatic drug;
joint replacement surgery
Correspondence to: Wuttirat Thummawut
Email: phakbung.mr@gmail.com
Received: 15 November 2021
Revised: 2 December 2021
Accepted: 6 December 2021
http://dx.doi.org/10.33192/smb.v15i1.253859
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* , **
3
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Anticoagulants
13
15
18
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ɑ
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Siriraj Medical Bulletin
Hydrotherapy Based Exercise
for Non-Specic Low Back Pain
Paramet Peerachotikphun*, Phurichaya Werasirirat**
*Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok,
**Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
Siriraj Medical Bulletin 2022;15(1): 64-69
Abstract
Low Back Pain (LBP) is one of the most current causes to physical functions, psychological
stress, and economy. Clinical practice guidelines for LBP can be divided into three main categories;
education, drug therapy, and non-medical intervention. The recent guidelines recommend the use of
exercise for the management of LBP problems. Hydrotherapy is an alternative exercise program to
achieve rehabilitation for LBP. Water properties include buoyancy, viscosity and hydrostatic pressure,
which can be applied with stretching, strengthening and endurance exercise. Hydrotherapy exercise
procedures consist of warm up, exercise and cool down phase. This program can reduce the risk of
injury and disability due to safer and low risks.
Keywords: low back pain; hydrotherapy; exercise
Correspondence to: Paramet Peerachotikphun
Email: paramet_pera@hotmail.com
Received: 6 October 2021
Revised: 3 December 2021
Accepted: 8 December 2021
http://dx.doi.org/10.33192/smb.v15i1.253173
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*
, **
1
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เวชันึกิิาช
ัดิม์ โดยอุมัิของคณะกรรมการ
คณะแทยศาสร์ศิริราชยาบาล
มหาิทยาลัยมหิดล
เวชันึกิิาช
เวชันึกิิาช
วัตุปะสง์
กำาหนดออก
ะกาัดกาวาสาออนไลน์
https://he02.tci-thaijo.org/index.php/simedbull/index
