Siriraj Medical Journal

160-167

Authors: Anun Chaikoolvatana, Ph.D. (Pharm.D), Penpak Pheunpha, Ph.D., Petchnapa Puchcharanapaponthorn, R.N.,Cholada Chaikoolvatana, RN, Ph.D., Nawaporn Saisingh, M.Sc., Preeyanuch Suwannakoot, R.N., Boonyada Mingkhwan, R.N.

Objective: It aimed to evaluate the effectiveness of the initial smoking cessation services at a military-based hospital in northeastern Thailand. Methods: It was a prospective, descriptive design. Totally, there were 1,094 conscripts who participated in the 6-month cessation program. Patient history data was collected via a patient history record divided into three different periods of time at, 1st visit, 2nd visit (3-months), and 3rd visit (6-months). Each participant underwent ‘going cold turkey’ with tobacco cessation approach. Sociodemographic characteristics and continuous variables (e.g., age, duration of smoking) were analyzed via descriptive statistics. Spearman correlation coefficient was used for the relation between predictor and dependent variables (quit success). The relations between sociodemographic data and the prospects of quitting smoking were analyzed via multiple logistic regression. Results: Most participants were males (99.84%), and regular drinkers (55.50%). They usually smoked 12.37 cigarettes per day. For first visit, every participant underwent ‘going cold turkey’ with tobacco cessation approach to quit smoking (from 1st to 3rd visit). An average CO level was 3.23 ppm. Around twelve percent of participants used 0.5% sodium nitrate mouthwash. At the second visit (3-months), numbers of cigarettes decreased to 5.48 cigarettes per day and numbers of participants were decreased to 792 personnel. Only 150 persons continue to quit smoking (18.95%). At the last visit (6-months), a total number of participants were 688 personnel. Numbers of cigarettes were decreased to 5.48 cigarettes per day. Only 78 persons completely quit smoking (11.34%), and approximately 18.02% of participants still used 0.5% sodium nitrate mouthwash. Additionally, only three sociodemographic data including, CO level, duration of counseling, and use of first line treatment were statistically related to the prospects of quitting smoking (p<.05, .001 respectively). The equation of the prospect of quit smoking was statistically related to those sociodemographic characteristics. Conclusion: Tobacco cessation services in a military-based hospital were well received and short term outcomes of conscripts seeking help was encouraging. The integration of tobacco cessation with existing healthcare services in the military-based hospitals is necessary. Finally, further evaluations of the effectiveness of cessation services among conscripts in the military-based hospitals need to be conducted.

173-180

Authors: Tanyaluck Thientunyakit, M.D., Thonnapong Thongpraparn, M.D., Nopparat Phongsawat, M.D.

Objective: To compare the left ventricular ejection fraction (LVEF) estimation using two commercial software packages used in our hospital and factors which may correlate to LVEF result. Methods: LVEF results using EF analysis (GE Healthcare, Wisconsin, USA) and Syngo MI (Siemens Medical Solution USA Inc., Illinois, USA) in 120 patients were compared. The correlation and difference of LVEF analysis between software packages were evaluated using correlation coefficient and Bland-Altman analysis, respectively. Potential factors for significant difference in LVEF were identified by regression analysis. Results: The mean LVEF estimated by two software packages were highly correlated (ICC =0.853) and statistically significant (p<0.001). Subgroup analysis in each individual software showed slight decrease in correlation of LVEF between software packages (ICC=0.791-0.793), but still had statistical significance (p<0.001). Intraand inter-operator variability assessments showed very high correlation of LVEF obtained from both software packages with statistical significance (p<0.001). Factors correlated with significant difference in LVEF were end diastolic area, end systolic count, end systolic area, and background count. Conclusion: LVEF analysis from GBP study using different software packages is highly correlated with only minimal difference, thus, it may be reasonably interchangeable during follow up without significant clinical impact. However, operators should be aware the importance of precise left ventricular and background region generation to prevent technical errors.

187-191

Authors: Prapun Aanpreung, M.D., Piyavadee Leksrisakul, M.D., Paisal Parichatikanond, M.D.

Neonatal hemochromatosis (NH) is a rare disease causing severe liver failure in neonate. Gestational alloimmune liver disease was recently proposed as an etiology. We present a unique case of a male infant with severe cholestasis soon after birth. Preliminary diagnosis of NH was made by detecting high serum ferritin level along with demonstrating iron deposition in hepatic tissues by magnetic resonance imaging (MRI). Despite being treated with blood exchange transfusions, antioxidant and chelating agents when NH was diagnosed around 2 months of age, he continued to have increasing bilirubin level and worsening coagulopathy. Eventually, he died from severe infection and liver failure at 5 months of age. His autopsy showed siderosis of liver and pancreas, which supported the diagnosis of NH. The specific treatments for NH should be initiated as early as possible once the diagnosis has been made, so that improved clinical outcome may be expected.

196-204

Authors: Aranya Jutiviboonsuk, Ph.D.

Andrographis paniculata (Burm.f.) Wall. ex Nees, commonly known as Fa-tha-lai-jone is an herbal medicine in The National List of Essential Drugs A.D.2013. The aerial part of the plant is used for treatment of non-infectious diarrhea and common cold. A. paniculata extract and its major active component, andrograpolide, have various pharmacological activities. Therefore co-administration of A. paniculata with conventional drugs may cause unpleasant interactions. This article reviews the role of A. paniculata and its active component that influences drug interactions including the effect on phase I and phase II metabolizing enzymes as well as drug transporter protein. Furthermore the data of pharmacokinetic and pharmacodynamic interactions on some clinical drugs are also included.