Journal of the Medical Association of Thailand

Background: Levofloxacin, a fluoroquinolone, is an isomer of ofloxacin with an extensive spectrum of antimicrobial efficacy. In common with other fluoroquinolones, the main pharmacokinetic/pharmacodynamic (PK/PD) index that correlates with its therapeutic efficacy is the area under the plasma time-concentration curve (AUC)/the minimum inhibitory concentration (MIC) ratios. Objective: To evaluate the population PK and determine the efficacy of various dosage regimens in achieving the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of oral levofloxacin when prescribed as the switching therapy after intravenous levofloxacin treatment...

Background: Major depressive disorder (MDD) is the important cause of disability in the world. Major depressive patients that are not respond to the first and second drugs are about 67% and 33%, respectively. Therefore the effective treatment is urgently needed. Objective: To examine the effect of Buddhist mindfulness meditation combined with standard treatment on depression and quality of life in major depressive patient compared to the control group. Material and Method: It was a quasi experimental study...

OBJECTIVE: To describe trends in Thailand's antiretroviral treatment (ART) program performance assessed by HIV drug resistance early warning indicators (EWIs), as recommended by WHO, between 2009 and 2013. MATERIAL AND METHOD: Seven EWIs were monitored, viral load (VL) testing coverage, VL suppression, retention in ART, lost to follow-up (LTFU), antiretrovirals (ARVs) dispensing practices, on-time pill pick-up, and pharmacy stock-outs. Data from ART adult patients in National Health Security Office Scheme were analyzed except for pharmacy stock-outs, which were reported from hospitals...

Background: Sitafloxacin is a newly approved oral fluoroquinolone in Thailand for treatment of respiratory tract and urinary tract infections. Initial in vitro susceptibility testing showed its effect on Escherichia coli with extended-spectrum betalactamases (ESBL), Klebsiella pneumoniae with ESBL, Pseudomonas aeruginosa, and carbapenem resistant Acinetobacter baumannii Objective: To retrospectively review in vitro susceptibility to sitafloxacin on clinical isolates from HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University (SWU) and Samitivej Sukhumvit Hospital (SVH)...

OBJECTIVE: To identify the risk factors of post-operative sore throat (POST) with and without hoarseness (PH) after general anesthesia. MATERIAL AND METHOD: A retrospective cohort case-controlled study was done at Siriraj Hospital, Mahidol University, Bangkok, Thailand. Two thousand six hundred anesthetic records from between July 2013 and January 2014 were retrieved. Inclusion criteria were complete records of patients older than 18 years and elective surgery under general anesthesia longer than 30 minutes using endotracheal intubation (ETT) or Laryngeal mask airway (LMA)...

Background: One of the limitations in imageless navigation is the variability in bony landmark registration among surgeons. If the bony landmark registration is different among surgeons, the final cup position determined by the navigation will also be different. Objective: To determine intra and inter-observer reliability of the bony landmark registration in three surgeons with varying experience in imageless navigation total hip arthroplasty (THA) in semilateral decubitus position...

Objective: To compare and evaluate the efficacy of ginger (Zingiber officinale Roscoe) extracts in NLC for treatment of osteoarthritis of knee compared to 1% diclofenac gel as an active control. Material and Method: One hundred twenty patients age 50 to 75 years with OA knee, based on the American College of Rheumatology (ACR) criteria were randomized into two groups receiving ginger extracts in NLC and control 1% diclofenac gel for 12 weeks. The efficacy of treatment was monitored at 4, 8, and 12 weeks by using the WOMAC composite index and the Patient Global Assessment (PGA)...

Background: An extensive full-thickness wound need a graft, sometime very large. However, donor sites are often limited. Dermal substitutes are among the tissue-engineered products applied to clinical use. PoreSkin, a human acellular dermal matrix (hADM) manufactured by the Faculty of Medicine, Chulalongkorn University, is the first human dermal substitute developed in Thailand. Objective: Assess the safety and ability in achieving durable and definitively cosmetic coverage using PoreSkin...

Background: Enhanced recovery after surgery (ERAS) has been accepted as the program to improve the surgical outcomes. This program has been increasingly utilized in liver resection. Objective: To evaluate the outcomes of patients underwent liver resection by applying ERAS program. Material and Method: All patients underwent liver resection between January 2007 and April 2011 at King Chulalongkorn Memorial Hospital were included into the present study...

Background: Reintubation, following an unsuccessful extubation from mechanical ventilation is traumatic to the infant and the family. However, 20 to 40% of infants fail extubation and reintubation. Objective: Determine the optimal predictors of readiness for extubation in low birth weight infants during endotracheal tubecontinuous positive airway pressure (ET CPAP) for three minutes. The primary outcome was reintubation within 72 hours of extubation and the secondary outcomes were the causes and risk factors of reintubation...

Objective: To develop a reliable and valid treatment outcome checklist for the measurement of ADHD treatment for children in a clinical setting. Material and Method: The behavior indicators to assess the treatment outcomes of ADHD children were researched and developed by using multi-informants perspectives. The present study involved a qualitative study and two rounds of the Modified Delphi Techniques. In the first process, 11 parents/guardians of ADHD children aged 6 to 18 years were given a semi-structured interview on their expectation towards treatment outcomes at the Child and Adolescent Mental Health Rajanagarindra Institute...

Background: Several trials have verified the benefits of stroke unit (SU) in acute stroke care worldwide. Objective: Compare clinical outcomes and costs of care in acute ischemic stroke patients who were ineligible for thrombolytic treatment (recombinant tissue plasminogen activator-rt PA) in a primary stroke center. Material and Method: A prospective study was conducted in acute ischemic stroke patients, aged 15 years old and above, presenting within 72 hours of onset...

Objective: Explore the characteristics of insomnia in persons with heart failure and identify the predictive factors of insomnia in patients with heart failure. Marital and Method: A predictive correlational research design was used. Three hundred forty heart failure patients followed-up at heart clinics, outpatient departments of 10 tertiary hospitals from all regions in Thailand, were selected by multi-stage random sampling. Data were collected between July 2009 and January 2010...

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease. The cause of the disease is related to multiple factors and involves immune responses. To the best of our knowledge, the relationship between the production of interleukin-2 (IL-2) and Nck adaptor molecule gene expression by lymphocytes in patients with SLE has not been studied. Objective: Assess the association between IL-2 levels and Nck mRNA gene expression in CD3/CD28 and PHA/PMA stimulated peripheral blood mononuclear cells (PBMCs) from SLE patients compared with those from healthy donors...

Background: Paraspinal extramedullary hematopoiesis (EMH) is uncommon, but it is one of major complications of increased morbidity in patients with thalassemia. Objective: To develop a clinical risk score for predicting paraspinal extramedullary hematopoiesis in patients with thalassemia. Material and Method: A retrospective study was conducted in adult patients with thalassemia at Srinagarind Hospital, Khon Kaen University (KKU) and Udonthani Hospital, Thailand...

Background: Postpartum hemorrhage (PPH) is major cause of morbidity and mortality globally. Although the majority of PPH could be avoided through the use of pharmacologic prevention during the third stage of labor, the maternal mortality rate from PPH is unchanged and the blood transfusion rate is increasing. In rural hospital or primary care unit, most health care workers are general practitioners and intern doctors, they are inexperienced in managing PPH case and lack of medication, blood component, medical instrument, and surgical team...

Objective: To evaluate the effect of supportive information on anxiety levels in women awaiting amniocentesis results. Material and Method: Women underwent amniocentesis were randomized into two groups according to whether they did (group A) or did not (group B) receive supportive information. Anxiety levels were measured using the Spielberger State-Trait Anxiety Inventory at four time points, (1) after amniocentesis, (2) before phoning for test result appointment confirmation, (3) after phoning, during which supportive information was given to group A, and (4) before receiving the test results...

Background: Intrapartum electronic fetal monitoring (EFM) has widely been used to monitor mothers in labor who are at risk in clinical practice. There is little evidence to describe the association between EFM categories based on the newly proposed National Institute of Child Health and Human Development (NICHD) 2008 criteria and neonatal outcomes. Objective: To investigate the association between intrapartum cardiotocogram categories based on the NICHD 2008 and early neonatal outcomes Material and Method: Intrapartum EFM tracings of 120 singleton pregnant women of equal or more than week gestation were evaluated according to NICHD 2008 guidelines...

Background: Ephedrine is often used as nasal decongestant. Yet, the clinical study of intranasal ephedrine is scarce. In addition, the study tools may affect the measurement of the nasal patency. This problem has not been concerned. Objective: To investigate the nasal responses after using a single-dose of calibrated ephedrine nasal spray in Thai healthy male volunteers. The study also compared the differences between two methods of nasal patency measurement. Material and Method: Healthy males (n = 20) were recruited in a randomized, crossover, 2-day study...

Objective: To evaluate the clinical factors that associated with cognitive decline among Thai adults. Material and Method: The cross-sectional study was performed between March 2015 and September 2015 at The Princess of Naradhiwas Memorial Hospital. Three hundred ten Thai government officers received annual health check-ups according to standard government protocol. All subjects checked their cognitive performance focus in memory and calculation by physicians. The subjects were divided in two groups according to memory and calculation score, using the cutoff value at tenth percentile...