Vajira Medical Journal: Journal of Urban Medicine

11-22

Authors: Kannikar Booranavanich, Krit Cheawcharnprapan

Objective: To determine risk factors related to the mother, labor and newborn toward the occurrence rate of perinatal asphyxia in the Faculty of Medicine Vajira Hospital. Study design: Case control study. Methods: The sample group covered 450 subjects of life birth newborns divided into study group of 150 subjects (apgar score at 1 minute was 7) and control group of 300 subjects (apgar score at 1 minute more than 7) (ratio 1:2). Results: There were 5 risk factors associated with perinatal asphyxia including placenta previa [Odds Ratio(OR) 4.54, 95% CI 2.961-6.973], birth weight less than 2,500 grams (OR 3.20, 95% CI 2.156-5.227), fetal distress (OR 3.11, 95% CI 2.041-4.741), mother younger than 20 years old (OR 2.51, 95% CI 1.252-5.024) and gestational age less than 34 weeks (OR 2.07, 95% CI 1.758-4.612). Conclusion: According to the study, there were 5 risk factors associated with perinatal asphyxia that difficult to changing or prevention. However, knowing the newborn at risk of perinatal asphyxia is useful to prepare an appropriate neonatal resuscitation.

33-40

Authors: Supakit Chartchaiyarerk

Objective: To compare the result of appendicitis treatment between laparoscopic surgery (LA) and open surgery (OA). In term of duration of hospital stay, intraoperative time, postoperative pain, hospital and medical expenses. Materials and methods: A retrospective study by reviewing medical records of appendicitis patients who were treated from 1st January, 2011 to 31st December, 2013. The data included personal information, intraoperative details, postoperative details and the data of those was analyzed and was compared between open and laparoscopic surgery. Results: From the collecting data, 560 patients (433 patients from open surgery and 122 from laparoscopic surgery were studied retrospectively. According to this study, laparoscopic appendectomy was associated with a less blood loss (10 mL in LA and 19 mL in OA, p-value = 0.017, 95% CI = -16.181-(-1.564)), shorter hospital stay (3.1 in LA and 3.6 in OA, p-value = 0.039, 95% CI = -0.969-(-0.004)), and lower postoperative pain from day 1 to day 3 (p-value = <0.001, 95% CI = -0.673-(-0.327), p-value = <0.001, 95% CI = -0.948- (-0.521), and p-value = <0.001, 95% CI = -1.421-(-0.894), respectively). In contrast, intraoperative time in laparoscopic surgery was longer than open surgery significantly (73 min in LA and 54 min in OA, p-value = <0.001, 95% CI = 14.096- 23.566) and cost was higher, too (p-value = <0.001, 95% CI = 7819-11891 ). All factors were statistically significant. Conclusion: The treatment of appendicitis by using laparoscopic surgery provides a better result in the term of duration of hospital stay, recovering time, postoperative pain but it requires more operative time and more cost too.

59-70

Authors: Jariya Chuensirimongkol, Walaya Tupanich, Suteekarn Chaiyalap, Chanipa Yoryuenyong, Siriporn Kruttakart

This research aimed to examine perception towards Family Care Team project of disabled, elderly, chronic and palliative care patients in Bangkok; and to explore Family Care Team operations in Bangkok. Research population were disabled, elderly, chronic and palliative care patients living in Bangkok. A sample of 374 cases living in Taling Chan district, Ladphrao district, Bangplad district, Dusit district, Thonburi district and Bang Sue district were selected to the study. Research tools comprised a questionnaire of perception towards Family Care Team project and a questionnaire of operation performance in accordance with Family Care Team criteria adapted from a questionnaire created by Prof.Dr.Paiboon Suriyawongpaisan and staff (2015) used in the study of Assessment of health policy on promoting family care team with Cronbach’s alpha coefficient reliability at 0.78. Statistics used to analyze the data were frequency, percentage, mean, and standard deviation. The results of the study were as follows. 1. Perception towards Family Care Team project of disabled, elderly, chronic and palliative care patients in Bangkok revealed that 63.6% of samples received information about Family Care Team from Health team, 20.1% of samples knew name of doctors of Family Care Team, and 5.6% of samples knew telephone numbers of doctors of Family Care Team. 2. Operation performance of Bangkok Family Care Team resulted as follows. 1) For service access, 93.3% of samples found it was convenient to receive healthcare service at the public health center they regularly visited, 58.8% of samples indicated the public health center they regularly visited provided part-time clinic, and 50% of samples were able to contact Family Care Team for their health problem. 2) For disease prevention, 50-80% of samples received information about disease prevention and healthcare in all aspects, 35% of samples were informed about cancer screening and 42% of samples received flu vaccine. 3) For disease screening, most samples received healthcare services to measure their blood pressure measurement 70-90%, weight, blood glucose and blood cholesterol. 4) For data access and care coordination, 85.6% of samples found that it was convenient to seek for data file as well as samples were able to see personal file and asked for a copy of their examination records when they needed (26.2% and 20.6% respectively). Moreover, 28.3% of samples were helped with appointment and transfer for specialist visits and 24.9% of samples indicated that their specialist doctor visits were monitored. 5) For patient-centered care services, most samples showed their opinions were respectful and they got detail explanation for their doubts (92% and 90.2% respectively) whereas 31.3% of samples got a home-visit. 6) For self-care supporting system, samples revealed that Family Care Team provided ongoing follow-up appointment and explained about complications, diseases, how to conduct home self-care, treatment options, in addition, they invited them to join health promotion activities (65.5-71.1%). Also,59.4% of samples indicated that Family Care Team visited their house to give advice and help.