Vajira Medical Journal: Journal of Urban Medicine

243-254

Authors: Nathamon Pansuksawat, Pinailug Tantilipikorn Earde, Patcharee Kooncumchoo, Bunyong Rungroungdouyboon, Noppol Pramodhyakul

Objective: To determine the effects of I-Walk (Robotic-assisted gait device) training compared with over-ground walking training on motor impairments assessed by lower extremity scores, lower extremity angles during walking, and gait performances in patients with chronic stroke. Methods: A single blinded randomized controlled trial was conducted. Twenty four chronic stroke patients were randomly assigned into two groups; experimental group (n=12) and control group (n=12). For gait performances, patients in an experimental group received I-Walk training, while those in a control group received over-ground walking training. The duration of training was 60 min per day, 3 days per week for 8 weeks. The outcome measures included motor impairments assessed by the Fugl-Meyer Assessment of Lower Extremity (FMA-LE) scores, lower extremity angles during walking (hips, knees, ankles), and gait performances (step length, cadence, walking speed, stride length, and step length symmetry ratio). All variables were measured before and after the training period. Results: There was a statistically significant difference in motor impairments assessed by the FMA-LE scores, lower extremity angles during walking on hips and knees, as well as gait performances, including step length, cadence, and walking speed, between the experimental and the control groups (p<0.05). In particular, the statistically significant changes were demonstrated in motor impairments assessed by the FMA-LE scores, lower extremity angles during walking on hips, knees, and ankles, as well as gait performances, including step length, cadence, walking speed, stride length, and step length symmetry ratio, before and after the I-Walk training in the experimental group (p<0.05). Conclusions: The I-Walking training could yield a statistically significant improvement of motor impairments assessed by FMA-LE scores, lower extremity angles during walking, and gait performances in chronic stroke patients. Nonetheless, further studies are recommended to elucidate and ratify the effective outcomes in patients with other stages of stroke, different ranges of lower extremity, and various spatiotemporal parameters.

263-274

Authors: Busaba Supawattanabodee, Woraphot Chaowawanit, Thanaporn Kittisiam, Budsaba Wiriyasirivaj, Siriwan Tangjitgamol

To evaluate the knowledge and attitudes of Bangkok Metropolitan women towards Human Papillomavirus (HPV) vaccinations. Thai women aged 25–65 years old who had lived in Bangkok for 5 years or over were invited to the study. Participants were asked to complete the questionnaire. 4,405 of 5,000 women completed the questionnaires. Approximately two-thirds of women had heard about HPV vaccination (61.4%). Approximately two-thirds of them had correct answers about the causes or risk factors of cervical cancer (65.7%), including HPV as an etiologic agent (67.4%). However, only few understood the relationship of HPV and cervical cancer (2.8%) or the types of HPV (6.2%). Regarding knowledge of cervical cancer and HPV, a quarter knew the method of HPV transmission (25.6%). Although most accepted the HPV vaccination (78.6%), only one-third knew about the particular groups of women who would benefit from this vaccination (34.6%). In conclusion, more than half of women knew about the cause of cervical cancer and HPV vaccine. However, only a few women knew about the relationship between HPV and cervical cancer or the types of HPV.

287-296

Authors: Somnimit Luengratsameerung

Objective: To study the relationship between serum ferritin levels and biochemical markers of bone turnover in postmenopausal women. Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Bangkok, Thailand. One hundred and twenty four postmenopausal Thai women were recruited from menopause clinic between December 2015 and March 2016. The inclusion criteria were age 40 years or more, body mass index (BMI) of 19-30 kg/m2, not use menopausal hormone therapy (MHT) within the last 3 months, adequate cessation period of any bone antiresorptive agent, no underlying disease which possibly associated with chronic anemia, and no history of steroid hormone, anabolic agent, or anticoagulant use. The subjects were excluded if their blood specimens were unsuccessfully collected or incompletely analyzed. Two kinds of biochemical markers of bone turnover were selected to study. The first one was a bone-formation marker, called procollagen type I N- terminal propeptide (P1NP) and the second was a bone-resorption marker, namely C-terminal cross-linked telopeptide of type I collagen (CTx). Each marker was evaluated its relationship to serum ferritin. Results: After recruitment, one subject was excluded because her blood specimen was loss during transfer, therefore 123 cases were left for analysis. Mean (SD) age, BMI, duration of menopause, and number of parity of the overall subjects were 56.8 (4.2) years, 24.3 (3.1) kg/m2, 7.1 (5.3) years, and 1.3 (1.1), respectively. Mean (SD) serum ferritin, P1NP, and CTx levels were 147.75 (95.11), 63.90 (16.70), and 0.463 (0.154) ng/ml, respectively. Serum ferritin levels were negatively correlated with P1NP and with CTx levels (r = -0.149, p = 0.099 and r = -0.038, p = 0.677, respectively). Conclusion: Serum ferritin levels had non-significant inverse relationship with P1NP and CTx levels in postmenopausal women. The long-term effects of low iron storage on biochemical markers of bone turnover are needed to be further evaluated.