Journal of the Medical Association of Thailand

Background: Chemodenervation (CD) involves injecting drugs such as phenol, botulinum toxin, or alcohol to reduce muscle spasticity. However, they interfere with daily activities of children with cerebral palsy (CP). Rehabilitation residency training in Thailand currently requires performing a minimum of five CD procedures. However, the effect of this policy on post-training practice is unknown. Objective: To explore the influence of CD training during residency on post-training clinical practice and their current use of it in treating CP patients...

Objective: To explore the changes in the prevalence of smoking behavior, attitudes, and cessation training among medical students after the establishment of the Thai Health Professional Alliance against Tobacco (ThaiPAT) and its major campaigns by using the nationwide Global Health Professions Student Surveys (GHPSS). Material and Method: Multiple cross-sectional studies were conducted after three major campaigns were launched between 2007 and 2011, the Deans’ Summit on Tobacco Control, implemented tobacco control into the medical curriculum, and 100% smoke-free hospitals and medical schools...

Background: Although social-ecological models and multi-level interventions have been recommended for implementing the holistic self-management support for patients with type 2 diabetes, they are complex, costly, and need long-term effort. A more realistic approach would be to identify and implement a single or limited leverage point(s) that is most effective and feasible to create change. Objective: To assess the independent relationships of the social-environmental supports with self-management behaviors in Thai patients with type 2 diabetes...

Background: Life-Build-Line (LBL) is a new exercise device that is convenient, and not so expensive. Together with the style of movement, it may boost one to adhere to the exercise regimen and thereby promote better health. However, no study has proved its exercise intensity and effect on substrate utilization. Objective: To investigate exercise intensity in healthy sedentary women using LBL and measure their substrate utilization during exercise. The former session was determined by measuring absolute [i...

Background: Outcomes of the different management in severe laryngomalacia (LM) have not been evaluated. Objective: To identify the management practices and to evaluate the outcomes in patient with severe LM. Material and Method: The medical records of LM at Queen Sirikit National Institute Child Health between January2007 and December 2012 were retrospectively reviewed. Results: Severe LM 69.8% (30/43) were found in patients diagnosed with LM...

Background: Difficult intubation is more frequent in obese than in lean patients. The GlideScope® is a videolaryngoscope that provides a laryngoscopic view equal to or better than a direct laryngoscope in non-obese patients. Objective: To compare the intubation time between the GlideScope® and the McIntosh laryngoscope in obese patients. Material and Method: The authors randomly allocated 46 obese patients (BMI >28 kg/m2) with the American Society of Anesthesiologists physical status I to III, scheduled for elective surgery under general anesthesia with oroendotracheal intubation into either the McIntosh group (Group M) or the GlideScope® group (Group G)...

Objective: We evaluated the results of single event multilevel surgery for treatment of contractures of lower extremities in spastic diplegic cerebral palsy patients in Phramongkutklao Hospital. Material and Method: The present study included 40 patients (23 boys, 17 girls, mean age 8.9 years) with spastic diplegic cerebral palsy, who underwent single event multilevel surgery for the treatment of soft tissue contractures in lower extremities secondary to spasticity between 2006 and 2009...

Objective: The patellar tracking is an important factor that affect range of motion after total knee arthroplasty (TKA). Intraoperative patellar maltracking during TKA can be improved by performing lateral release. We hypothesized that TKA with patellar maltracking after undergoing lateral release can increase intraoperative range of flexion. Material and Method: A prospective study was conducted on 110 knees that underwent computer assisted TKA. The patellar tracking was assessed with no thumb test technique...

Background: Modified Robert Jones bandage and intermittent cold pack are commonly used for postoperative care in arthroscopic anterior cruciate ligament reconstruction (ACLR). However, no study has been done to compare the postoperative pain and functional outcome of both methods in ACLR. Objective: To compare the postoperative pain and functional outcome of a modified Robert Jones bandage and intermittent cold pack in ACLR. Material and Method: Forty patients scheduled for ACLR were included...

Background: Keloids have been one of the most concerning problems in cosmetic surgery. Current treatments still provide unpredictable outcomes. Interestingly, one molecular study of Botulinum Toxin A (BTXA) has found the inhibitive effect of fibroblast growth factor (TGF-β), which explain the mechanism of keloid formation. Objective: To study the efficacy of BTXA in preventing keloids formation for clinical use. Material and Method: Prospective randomized controlled trial study was conducted on 25 patients between March 2014 and June 2015...

Background: Percutaneous coronary intervention (PCI) has been and continues to be standard treatment in patients with coronary artery disease. The data for demographic and outcomes in Thailand are limited. Objective: To study data and characteristics relating to patients, the procedure, and outcomes of percutaneous coronary intervention in the Thai population. Material and Method: The Thai Percutaneous Coronary Intervention Registry (TPCIR) was established in 2006, consisting of 27 hospitals in Thailand that perform the PCI procedure...

Background: The incidence, prevalence, clinical phenotypes, and treatment response of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are varying in the world literature. There have been no epidemiologic studies of CIDP in Thai adult patients. Objective: To determine clinical characteristics, phenotypes, electrophysiological tests, and treatment response of CIDP in Thai adult patients and to find factors associated with disease outcome after treatment...

Background: Neonatal jaundice is a common problem in newborns. Inadequate breastfeeding jaundice is an important consideration for the neonatal jaundice. Early breastfeeding initiation and good breastfeeding practices may help to prevent neonatal jaundice. Objective: To find the association of breastfeeding practices, the time to initiate breastfeeding, the breastfeeding frequency, breast milk volume, and appropriate latching with neonatal jaundice at the early postpartum...

Gestational gigantomastia is a rare disorder characterized by rapidly progressive hypertrophy of the breast tissue during pregnancy. Its prevalence is approximately 1:100,000, and although the etiology of this condition remains unclear, it may be related to hormonal change. This study reports the case of a 39-year-old pregnant woman at 22 weeks of gestation with massive enlargement of bilateral breasts (gigantomastia) and presents the sonographic findings of this rare condition which shows different parenchymal patterns from those of normal breasts and is uncommonly seen...

Background: Breakfast skipping is considered to be an unhealthy eating habit and is linked with several health issues, including obesity, type 2 diabetes mellitus, and metabolic syndrome (MetS). Few studies on the breakfast consumption habits of hospital personnel have been carried out. Objective: This study aimed to determine the prevalence of breakfast skipping among Rajavithi Hospital personnel. Quality of life, knowledge of the importance of eating breakfast, and patterns of breakfast consumption were also assessed...

No abstract text is available yet for this article.

Background: Sleep is one of the basic needs of human beings and is important to their health. Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements, and psychological stress and poor sleep are highly prevalent in resident and fellowship training; however, they are not well documented and have not yet been taken seriously. Objective: This study aimed to determine the prevalence of poor sleep and associated factors in resident and fellowship training in Rajavithi Hospital, a tertiary referral hospital in Bangkok, Thailand...

Background: Breast cancer is the most common cancer in Thai women. Current treatments of breast cancer aim not only at complete cure but also at maintaining the patients’ quality of life. Mastectomy is still a standard procedure for removal of cancer, but nowadays the patient has many modalities to choose from in order to achieve cosmetic satisfaction. Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is one of the options; however, it is a complicated procedure because of its resultant longer operative time, decrease in abdominal wall strength, and unpredict ability of blood supply in some areas...

Background: Necrotizing fasciitis (NF) is a rapidly progressive inflammatory infection of the fascia. Early diagnosis of NF is essential, as delayed diagnosis leads to higher rates of amputation and mortality. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score is used to obtain early diagnosis in order to reduce morbidity and mortality rates. Objective: The laboratory risk indicator for necrotizing fasciitis (LRINEC) score was introduced in 2004 and is useful in achieving early recognition of necrotizing fasciitis...

Background and Objective: The success rate of I-131 therapy for hyperthyroidism is dependent on several factors. The aim of the present study was to evaluate the success rates, and the factors which affected them, in patients with hyperthyroidism at Rajavithi Hospital who received I-131 therapy with doses based on thyroid gland weight (gram), clinical findings, and 3-hour radioiodine uptake (3-hr RAIU). Material and Method: A retrospective study was performed of 305 hyperthyroid patients who received initial I-131 therapy at the Nuclear Medicine Department of Rajavithi Hospital, Bangkok between January 2010 and December 2014...