Siriraj Medical Journal

Association between Grit and Burnout among Clinical Medical Students

Nirucha Thamwiriyakul — 2025-02-01

Objective: The purpose of this study was to determine the relationship between grit and burnout among clinical medical students.

Material and Methods: A cross-sectional descriptive study was conducted between December 2023 and January 2024 at the Chonburi Medical Education Center. Data from 106 clinical medical students were gathered using the 8-item Short Grit scale and the Maslach Burnout Inventory General Survey. Descriptive statistics, Pearson’s correlation, and logistic regression were used to analyze the data.

Results: Among the 106 clinical medical students, 52.8% met the criteria for burnout syndrome. 44.3% had high levels of emotional exhaustion and 32.1% had high levels of depersonalization. However, most of these medical students had moderate levels of total grit, passion, and perseverance. Pearson’s correlation analysis showed that total grit and perseverance scores were negatively correlated with emotional exhaustion and positively correlated with personal accomplishments. Further analysis using multivariate logistic regression revealed that burnout syndrome in clinical medical students was significantly associated with high-demand ward responsibility (AOR 3.189, p = 0.012) and low levels of total grit (AOR 7.147, p = 0.023).

Conclusion: Burnout is prevalent among clinical medical students, particularly among those with high-demand ward responsibilities and low grit levels. Higher grit, especially perseverance, is associated with reduced emotional exhaustion and greater personal accomplishments. Enhancing grit may help mitigate burnout among this population.

Effectiveness of a Brain Training Program on the Cognitive Function of Sepsis Survivors: A Randomized Controlled Trial Study

Jutarat Kiangsungnoen — 2025-03-01

Objective: This study aimed to evaluate the effectiveness of a brain training program designed to enhance the cognitive function of sepsis survivors.

Materials and Methods: We conducted a single-blind randomized controlled trial at a tertiary care hospital involving 67 participants aged over 18 years with participants randomly assigned to two groups, an experimental group (n=33) receiving the brain training program, and a control group (n=34) receiving standard care only. We measured cognitive function at three different time points: Baseline, Week 6, and Week 12, using the Thai Mental State Examination for testing and repeated measure ANOVA for statistical analysis.

Results: The experimental group had a higher mean cognitive function score at Week 6 posttest than at pretest. At Week 12, the mean cognitive function score increased significantly compared with that at pretest (F = 442.279, p < .001) and the experimental group had a higher mean cognitive function score than the control group (F = 104.905, p < .001).

Conclusion: The brain training program significantly increased the cognitive function levels of sepsis survivors in 6–12 weeks. The result of this study shows the benefits of a brain training program in increasing cognitive functions. Therefore, such a brain training program should be implemented among sepsis survivors to improve their cognitive functions.

Immunohistochemical Markers Associated with Meningioma Recurrence: A Systematic Review

Renindra Ananda Aman — 2025-03-01

Objective: This study aimed to determine the role of immunohistochemical markers in the recurrence of surgically treated meningiomas.

Materials and Methods: We conducted a comprehensive search of the PubMed, ScienceDirect, Cochrane, and Google Scholar databases to locate studies published within the past decade. The inclusion criteria for this study were patients aged ≥ 18 years who had undergone surgical treatment for meningioma. Studies that were not written in English, case report studies, case series studies, literature review studies, and studies involving patients who received treatments other than surgery or multimodal therapy were excluded. All studies that met the inclusion criteria were subjected to critical appraisal.

Results: Four studies comprising 3176 cases of meningioma cases were included in the analysis. Multivariate analysis showed that two immunohistochemical markers (COX-2 and MIB-1/Ki-67) were independent variables of meningioma recurrence. This study also found no statistical differences between grade I and II meningiomas with respect to the overexpression of COX-2 and MIB-1/Ki-67. The second study compared the nonrecurrence/relapse (non-R/R) and recurrence/relapse (R/R) groups and found a significant correlation between MIB-1 percentage, intensity, histoscore, and p53 percentage, regardless of tumor grade. The third study found that mitosin and topoisomerase IIa were significant predictors of recurrence but not MIB-1. The fourth study demonstrated that H3K27me3 loss is significantly associated with more aggressive meningiomas.

Conclusion: Our study showed that MIB-1/Ki-67, COX-2, p53, topoisomerase IIa, mitosin, and H3K27 are independent variables and reliable markers for predicting meningioma recurrence.

The Effect of the Thai Herbal Suksaiyad Formula on Platelet Aggregation in Healthy Volunteers: A Quasi-experimental, Single-dose Study

Titchaphorn Palo — 2025-02-01

Objective: To investigate the effects of the Thai Herbal Suksaiyad formula (SSF) on platelet aggregation in healthy volunteers.

Material and Methods: In a quasi-experimental study, thirty healthy volunteers received a single dose of 2,000 mg SSF. Blood samples were taken at 0, 3, 6, and 24 hours after SSF administration for platelet aggregation analysis using aggregometry. Platelets were induced with epinephrine, adenosine diphosphate, and collagen.

Results: SSF significantly decreased platelet aggregation at 3 and 6 hours post-administration. Sub-analysis revealed no significant differences between males and females. SSF significantly decreased platelet aggregation in normal and hyperaggregation groups but had no effect on the disaggregation group. The effect of SSF was short-lived, reverting to pre-dose values after 24 hours for all agonists. Adverse events included flatulence (1 participant) and diarrhea (1 participant).

Conclusion: Caution is advised when using SSF in patients with blood disorders. Potential herb-drug interactions between SSF and drugs that impact platelet aggregation, such as aspirin, should be closely monitored. These interactions could result in fluctuations that may enhance or diminish the effectiveness of concurrent antiplatelet therapies, potentially increasing the risk of bleeding or decreasing therapeutic outcomes.

Platelet Rich Plasma as a Potential Treatment for Melasma: A Review

Silvia Valentina — 2025-03-01

Melasma impacts millions of individuals globally. It is characterized by hyperpigmented macules that predominantly affect the centrofacial region. Although not medically dangerous, melasma can significantly diminish quality of life and overall well-being. Current therapeutic approaches offer varying degrees of efficacy, tolerance, and outcomes, underscoring the need for further research to identify treatments that are both effective and safe. Platelet-rich plasma (PRP), an autologous plasma enriched with a high concentration of platelets, has gained attention in the medical field for its regenerative properties and favorable benefit-risk profile. In dermatology and aesthetic medicine, PRP has demonstrated efficacy in applications such as wound healing, skin rejuvenation, alopecia, acne scarring, and, more recently, pigmentation disorders. This review explores the potential of PRP as a treatment modality for melasma, suggesting that PRP, whether used as an adjunctive or standalone therapy, may significantly enhance treatment outcomes. Nevertheless, despite promising evidence supporting its use, further research is required to establish robust biomolecular mechanisms and evaluate the long-term safety and efficacy of PRP in managing melasma.