Vajira Medical Journal: Journal of Urban Medicine

85-96

Authors: Athaphon Kerdaunsuksri, Puritat Sangtongpanichakull

Objective: This research determined the foundations of personal and social support factors associated with self - care behaviors of older adults in the elderly club at Ratchaphiphat Hospital, Medical Service Department of the Bangkok Metropolitan Administration, Bangkok, Thailand. Methods: A Cross - sectional study design was conducted in 247 elderly person from March 1, 2017 to July 28, 2017. Data were collected by interview. The instrument was the questionnaire was developed by the researcher that qualified by the expertise improving content validity and reliability was test by using Cronbachs’alpha coefficients was more confidence 0.70 consists of 3 parts (general characteristics, social support factors and self-care behavior of people). Descriptive statistics were applied to describe general characteristics and point biserial correlation coefficient. Results: Research result was summarized among 247 persons who were in the elderly club, Ratchaphiphat Hospital as follows: General characteristics: Three - fourths of the participants were female 175 women (70.9%), aged between 70-75 years were 65 persons (26.6%), 165 persons (66.8%) had underlying diseases, marital status was 132 persons (53.2%), the elementary graduated were the common education level [89 persons (36.6%)], there were 150 persons (62%) had no occupation, most of them earn 1,001-5,000 baht per month were 65 persons (41.4%) Social support factors: The social support factors of the participants was related to the elderly self-care behaviors that was statistically significant of <0.01. Self-care behaviors: The self-care behaviors were high level at X = 4.08 SD±0.601 Conclusion: The Factors were statistically significant difference in personal factors, social support factors, and self-care behaviors of the participants including disease factor which correlated to positive self-care behaviors at a moderate level.

109-116

Authors: Vasin Chotivanich, Pinyaphan Putkham

Background: Vitamin D is important in the absorption of calcium in the gastrointestinal tract. It plays role in promoting the accumulation of calcium in the bones and muscles. Major resources of vitamin D are in the diet, such as liver, fish, salmon, and eel. Vitamin D-synthesis through the skin is activated by sunlight. Even though Thailand is located near the equator, between latitudes 5 ° 40 ‘N - 20 ° 30’ N sunlight, there is a report about the situation of vitamin D deficiency in the country. NCCN recommended that patients receiving aromatase inhibitors get vitamin D and calcium supplements. These results provided the data of vitamin D and calcium levels in Thai postmenopausal patients. The prescription for vitamin D and calcium supplements should be given. in those patients who received aromatase inhibitor. Objective: To study the prevalence of vitamin D deficiency and calcium in postmenopausal women in the urban areas. Methods: A cross-sectional, descriptive study was conducted in the postmenopausal patients without underlying diseases related to gastrointestinal absorption in Vajira Hospital. The information about the underlying disease, age, sex, menopausal period, serum calcium, and serum 25 – hydroxyvitamin D was collected and analyzed by statistical software (SPSS version 18). Outcome: Postmenopausal women according to the National Comprehensive Cancer Network criteria in the urban areas have a low level of serum calcium and serum 25-hydroxyvitamin D. The supplements of Vitamin D and calcium in these patients are necessary. Results: 107 cases of postmenopausal women were recruited. They are postmenopausal women aged 52-90 years old. The mean serum 25 –hydroxyvitamin D level among the postmenopausal women was 17.05 ng/mL and mean serum calcium level was 8.4 mg/dL. The prevalence of vitamin D deficiency and calcium deficiency in postmenopausal women was 93 percent and 63 percent, respectively. Conclusion: There is a high prevalence of vitamin D deficiency and calcium deficiency among postmenopausal urban women. This study supports the guideline of the National Comprehensive Cancer Network to supplement calcium and vitamin D for all patients who received aromatase inhibitor.

125-132

Authors: Piyasak Vitayaburananont, Pruchwilai Nuchpramool

Objectives: To assess level of pain intensity (Numerical Rating Scale) in patients who underwent elective general surgery, colorectal surgery, urological surgery, ENT surgery, plastic surgery and orthopedic surgery at recovery room, arrival to ward, 4th, 8th, 16th, 32nd and 48th hour post-operatively using pre-printed post-operative pain order prescribed by surgeon. Secondary outcome is to study the incidence of serious adverse events after administering opioid such as deep sedation (Sedation Score=3) or respiratory depression (Respiratory rate <10/min) during using this pre-printed post-operative pain order protocol. Study design: Descriptive study Subject: Data was obtained during January to March, 2017 with sample size of 370 patients. Methods: Personal and clinical information, types of surgery, anesthetic techniques and pain score at recovery room, arrival to ward, 4th, 8th, 16th, 32nd and 48th hour post-operatively were collected for analysis. Using descriptive statistics such as frequency, percentage, mean and standard deviation. Main outcome measures : Pain score at various time interval during 48 hours post-operative period. Results : From 370 participants, 187 male patients (50.54%), median age was 54.3 ±14.82 years and 183 female patients (49.46%), median age was 55.5 ±14.96 years. Patients’ mean pain score at recovery room was 3.94 ±4.31, arrival to ward was 3.06 ±2.89, 4th hour post-operatively was 3.03 ±2.62, 8th hour post-operatively was 3.11 ±2.50, 16th hour post-operatively was 2.58 ±2.28, 24th hour post-operatively was 2.31 ±2.12, 32nd hour post-operatively was 1.89 ±2.10 and 48th hour post-operatively was 1.25 ±1.61 respectively. And during this study we found no incidence of serious complications regarding using opioid such as deep sedation or respiratory depression. Conclusion : Patients who were prescribed post-operative pain order using pre-printed order by surgeon for elective general surgery, colorectal surgery, urological surgery, ENT surgery, plastic surgery and orthopedic surgery had mean pain score at recovery room 3.94 ±4.31, arrival to ward 3.06 ±2.89, 4th hour post-operatively 3.03 ±2.62, 8th hour post-operatively 3.11 ±2.50, 16th hour post-operatively 2.58 ±2.28, 24th hour post-operatively 2.31 ±2.12, 32nd hour post-operatively 1.89 ±2.10 and 48th hour post-operatively 1.25 ±1.61 respectively. And we found no incidence of serious complications regarding opioid administration for pain relief. Thus we support the usage of pre-printed post-operative pain order prescribed by surgeon in the hospital.

145-158

Authors: Nithikoon Aksorn, Ittisak Subrungruang, Lakhanawan Charoensuk, Picha Suwannahitatorn, Thanyaros Sinsophonphap, Sutiwat Poonyakariyakorn, Teeradon Karndee, Pannawat Arunotong, Parnrada Juicharoen, Warunyoo Prasitnok

Objective: To determine the prevalence of parasitic infection and health risk behaviors among Buddhist monks Methods: Thirty-six stool samples were collected from monks fromWat Thewarat Kunchon Worawihan, Wat Ratchapha Tikaram Worawihan, Wat Prasat Bunyawat and Wat Bot Samsen. All stool samples were microscopically examined using simple smear and formalin-ethyl acetate concentration technique (FECT). The information regarding health risk behaviors associated to parasitic infection was assessed using questionnaires. Data were analyzed using descriptive statistics. Results: The prevalence of parasitic infection was 5.55% comprised the pathogenic protozoan Giardia intestinalis (2.78%) and non-pathogenic protozoan Entamoeba coli (2.78%). Helminth infection was not found. Regarding the health risk behaviors associated to parasitic infection, most of the participants have never had eaten raw or undercooked fish (97.06%), salt-fermented fish (63.64%), raw or undercooked pork (90.62%) and raw or undercooked beef (87.50%). Concerning preventive behaviors, more than half always wore shoes when going outside the temple (69.44%), almost all of them drink bottled water (90.91%), majority of them wash their hands sometimes before eating (66.66%), always washing hands after defecation (69.44%) and after touching pets or stray animals (62.5%). Regarding prevention of the spread behaviors, all monks used sanitary latrine (100%) but the knowledge about parasitic infection was only moderate (51.43%). Most of the participants have never had their stool examination for parasitic infection (91.7%) and more than half (62.86%) have never had anthelmintics. Conclusion: Although the prevalence of parasite infections among monks is low but the risk behaviors of parasitic infection is still apprehensive. Therefore, monks should be encouraged to enhance healthcare knowledge for health risk reduction including promote appropriate hygiene for the prevention of parasitic infection. These results can be applied for health care planning and promoting the health of monks in the community in the future.