Vajira Medical Journal: Journal of Urban Medicine

Number 5, 2020

313-324
Patency Rate of Superficial Temporal Artery-Middle Cerebral Artery Bypass in Vajira Hospital

Authors: Somkiat Wongsuriyanan, Kitiporn Sriamornrattanakul

Abstract

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Objective: To describe and evaluate the patency rate of superficial temporal artery-middle cerebral artery (STA-MCA) bypass for treatment of patients with cerebrovascular diseases and brain tumors at Vajira Hospital. Methods: This was a retrospective descriptive study in patients with cerebrovascular diseases and brain tumors who received STA-MCA bypass at Faculty of Medicine Vajira Hospital between May 2015 and September 2019. Type of diseases, bypass techniques (single or double bypass) and bypass patency were collected from medical records. The surgical techniques and one illustrative case were also described. Results: Thirty-three patients received STA-MCA bypass for 37 operations and 55 anastomoses. Operations with single bypass and double bypass were 51.4 and 48.6%, respectively. The most common indication for STA-MCA bypass was intracranial aneurysms (37.8%). Patency rate were 94.6% and 92.7% for number of operations and anastomoses respectively. For single bypass, patency rate was 89.5%. In cases of double bypass, patency rate were 100% and 94.4% for number of operations and anastomoses respectively. Conclusion: With our knowledge, this study is the research that report the highest number of STA-MCA bypass procedure and is the first issue to study the patency rate of STA-MCA bypass in Thailand. STA-MCA bypass has a high patency rate in immediate period (within 48 hours) after surgery, especially for double bypass.

325-332
Coronal Tibial Slope of Thai Adults in Faculty of Medicine Vajira Hospital, Navamindradhiraj University

Authors: Songwut Thitiboonsuwan, Surapoj Meknavin

Abstract

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Number of views: 6

Objective: To determine the coronal tibial slope of Thai adults in Faculty of Medicine Vajira Hospital, Navamindradhiraj University Methods: This study was a descriptive study. Forty-eight Thai adults, aged 18-40 years, in Faculty of Medicine, Vajira Hospital, Navamindradhiraj University were recruited. There were 24 males and 24 females. Anteroposterior hip-knee-ankle films were obtained. Coronal tibial slopes and other parameters were measured. Results: Mean age of the participants was 25.7 +/- 3.4 years. Mean coronal tibial slope was 3.4 +/- 1.7 degrees. Mean knee valgus proximal angle was 4.7 +/- 0.6 degrees. Mean hip-knee-ankle angle was 0.4 +/- 2.5 degrees of varus. Mean mechanical axis deviation 1.0 +/- 7.9 millimeters medially to mechanical axis of lower extremity. Mean ratio of femoral length to height was 0.26 +/- 0.01. Conclusions: The coronal tibial slope in Thai is approximately as same as the literature but the knee valgus proximal angle is different which is about 5 degrees. An orthopaedic surgeon may consider his surgical technique of total knee arthroplasty by cutting the distal femur at 5 degrees of valgus in extension with classic alignment or 8 degrees of valgus in extension with anatomical alignment

333-344
Prevalence of Sarcopenia in Heart Failure and Its Associated Factors: A Systematic Review

Authors: Chitima Kulchanarat, Kornanong Yuenyongchaiwat

Abstract

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Number of views: 9

Objective: Heart failure has been associated with sarcopenia; however, no systematic review was reported regarding the prevalence and the association of sarcopenia in heart failure. Therefore, the study aimed to systematically review the prevalence and factors associated with sarcopenia in heart failure. Methods: The literature searched on both international databases e.g., The Cochrane Library, Science Direct, PubMed and Scopus from 2007 to October 2019 in English language journals. The inclusion criteria were cross sectional study or cohort studies. Participants were 18 years and older who had diagnosed heart failure and sarcopenia. Kappa score was used to measure the agreement of two independent reviewers and National institute of health was used to test the quality assessment of observational cohort and cross-sectional studies. Results: A total of 258 studies, six studies were included in this review. A total number of the participants was 1,936. Most of the participants were > 65 years old (66.7%). The prevalence of sarcopenia in heart failure was 19.5%-36%. Age, male gender, lower body mass index and low physical activity were associated with sarcopenia in heart failure patients. Conclusion: The high prevalence of sarcopenia was observed in patients with heart failure. However, gender, age, body mass index and physical activity were associated with sarcopenia.

345-356
The Study on Thailand’s Particulate Matter 2.5 (PM 2.5) Management in Accordance with The World Health Organization (WHO) Guidelines

Authors: Wichittraphon Sukcharoen, Phitchakorn Tangaromsuk, Mooktapa Sontiatchara, Kotchaphon Waithayakul, Chirayu Savedkairop, Jidapa Poopongpet, Ratarat Kengkoom, Sakkarin Bhubhanil, Sarawut Lapmanee

Abstract

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Objective: To study Thailand’s particulate matter 2.5 (PM 2.5) management in line with the World Health Organization (WHO) guidelines. Methods: This academic article aims to review about the health effects of PM 2.5 and study Thailand’s solutions. The plan is to analyze national policies, national development plans, environmental situation reports, air pollution and dust management in Thailand and sample countries, namely China, Japan, and Vietnam in conformity with the WHO guidelines covering six areas, i.e. industry, energy, transport, urban planning, power generation, municipal and agricultural waste management. Results: PM 2.5 affects free radicals balance, induces inflammation in lung tissue and cell death, as well as causes respiratory and cardiovascular disorders. However, Thailand has adopted PM 2.5 solution measures in line with the WHO guidelines and performed in the same way as other sample countries to control PM 2.5. Conclusions: As PM 2.5 is harmful to health, Thailand has introduced urban pollution management methods followed the WHO guidelines to reduce health problems and enhance people’s quality of life.

357-364
Evaluation of Health Promotion Program of the Elderly Club in Nonthaburi Municipality

Authors: Piyawadee Ngamdee, Wongpun Limpaseni, Petch Rawdaree

Abstract

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Objective: The purpose of this research is to study elderly health promotion methods, assessed health promotion programs and recommend action plan of elderly club to the relevant department. Study design: Descriptive research Methods: We assess the health promotion model of the elderly club by using the CIPP model. Data were collected from 3 specific study groups that participated in the activities through interviews and questionnaires. The 3 specific study groups consist of 11 Rewadee zone 1 elderly club committee members, 60 elderly people and 56 elderly relatives. Results: The health promotion of the elderly club is assessed in 4 aspects, namely context, input, process and productivity. In context aspect, the objective of establishing an elderly club is suitable for problems and needs in the community. The elderly and people in community have a place to exercise and have the most expectation in health. In input aspect, the health promotion of the elderly has supporting factors such as knowledgeable personnel, sufficient budget and equipment. The committee structure is clear as according to the regulations of the elderly association of Thailand. In terms of processes, the most of activities of elderly club set by the public health center 4, Nonthaburi municipality are distributed thoroughly and on time. In productivity aspect, the elderly who participated in the activities are able to perform daily activities better, good quality of life without financial problems and are satisfied with club. The elderly club has 3 main activities, including social activities, health activities and activities for public benefit. Conclusions: the elderly club are clearly useful in terms of promoting elderly health. The government should support the establishment of elderly club in the community to proceed continuously and efferently.

365-370
A Case of X-Linked Agammaglobulinemia Presenting with Recurrent Pneumonia and Bronchiectasis

Authors: Sirasuda Sommanus

Abstract

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Recurrent infection especially recurrent sinopulmonary tract infection is a typical clinical condition for referral to pediatrician. Patients with recurrent pneumonia should be evaluated for underlying diseases including asthma, congenital heart diseases, gastroesophageal reflux, foreign body aspiration, structure anomalies, cystic fibrosis and immunodeficiency. Our one patient with recurrent pneumonia had hypoglobulinemia, low number of circulating B cell with deficiency of CD19 B cell, absence of tonsils and recurrent pneumonia requiring hospitalization. PCR and sequencing revealed mutation of Bruton tyrosine kinase (Btk) gene on Xq22, suggested that he had X-linked agammaglobulinemia (XLA). The appropriate treatment of XLA was good hygiene care, treatment of infection and prophylactic therapy with intravenous immunoglobulin. This report should alert the pediatrician and general practitioners to consider the diagnosis of primary immunodeficiency diseases. The early diagnosis and proper management can prevent comorbidity diseases and improve quality of patient’s life.