Journal of Health Science and Medical Research <div class="container-fluid"> <div class="row"> <div class="col-sm-3"><img src="/public/site/images/somjot/Cover-JHSMR-v2.jpg"></div> <div class="col-sm-9">&nbsp; <table> <tbody> <tr> <td style="width: 20px;">&nbsp;</td> <td> <p>Journal of Health Science and Medical Research is an online, quarterly peer reviewed scientific journal published by Prince of Songkla University. This journal aims to publish original article, review article, case reports in all aspects of basic and applied medical and health sciences. Manuscripts submitted to Journal of Health Science and Medical Research will be accepted on the understanding that the author must not have previously submitted the paper to another journal or have published the material elsewhere. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.</p> <p><strong>Frequency: </strong>4 issues per year (Jan-Mar, Apr-Jun, Jul-Sep and Oct-Dec)</p> </td> </tr> </tbody> </table> </div> </div> </div> Journal of Health Science and Medical Research, Faculty of Medicine, Prince of Songkla University, Thailand en-US Journal of Health Science and Medical Research 2586-9981 Cutaneous Manifestations in Chikungunya Disease <p>-</p> Kumpol Aiempanakit ##submission.copyrightStatement## 2019-02-12 2019-02-12 1 3 10.31584/jhsmr.201939 Evaluation of an Epidemiological Surveillance System for Preterm Birth and Low Birth Weight in Southern Thailand <p><strong>Objective:</strong> To assess the prevalence and management of preterm birth and low birth weight (LBW) infants, including the exploration of known risk factors for preterm birth and LBW, recorded in field testing of a web-based surveillance system of maternal-newborn health in southern Thailand.<br><strong>Material and Methods:</strong> The data of 2,459 women who delivered in six community hospitals and two referral hospitals in Songkhla province, southern Thailand were extracted from the field testing records of an experimental surveillance system. The incidences of preterm and LBW and their management with attributed factors to the specific problems and associated factors were analyzed by univariate analysis and multiple logistic regression.<br><strong>Results:</strong> The incidences of preterm birth and LBW were 5.6% and 9.8%, respectively. Maternal age, parity, preeclampsia, antenatal care visits, birth attendant and type of hospital were significantly associated with the incidence of preterm birth or LBW. Of women with preterm birth, 8.4% received a tocolytic and 25.3% received corticosteroids. Half of the women with preterm birth were investigated for infection. More than half of the LBW births were related to a preterm condition and most of the LBW infants were appropriately resuscitated, given appropriate hypothermia prevention and early feeding, and infection prevention measures applied. Approximately 25.0% of the preterm and LBW infants had adverse fetal outcomes. Well-known limited factors were found in few cases of preterm and LBW infants.<br><strong>Conclusion:</strong> The incidence of preterm and LBW births and their management can be monitored in a timely way from a web-based surveillance system.</p> Tippawan Liabsuetrakul Kali Defever Jitti Lawantrakul Nungrutai Saeaib Krantarat Peeyananjarassri Mavamarie Cooper Monir Islam ##submission.copyrightStatement## 2018-11-19 2018-11-19 5 15 10.31584/jhsmr.201933 Effectiveness of using the Centering Teen Pregnancy Program on Postpartum Depression among Adolescent Mothers: A Posttest Only Quasi-experimental Design using a Comparison Group <p><strong>Objective:</strong> To examine the effectiveness of the Centering Teen Pregnancy Program on postpartum depression among adolescent mothers.<br><strong>Material and Methods:</strong> Study sample was 60 adolescent mothers who attended a prenatal care clinic and delivered at a tertiary hospital in Thailand. Convenience sampling was used to select the participants. Thirty participants were assigned into the intervention group and the comparison group. The comparison group received standard nursing care. The intervention group received the Centering Teen Pregnancy Program. Research instruments consisted of the Centering Teen Pregnancy Program, which was modified from the original Nursing Practice Guideline for Teenage Pregnancy, and research questionnaires including demographic data sheets, maternal and infant health records, and the Center for Epidemiologic Studies Depression Scale. All the research instruments were content validated and tested for reliability. Independent t-test and chi-square were used for data analysis.<br><strong>Results:</strong> The average depression score was statistically significantly lower in the intervention group than in the comparison group. Postpartum depression was experienced by 23.2% of adolescent mothers in the comparison group but by only 3.3% in the intervention group.<br><strong>Conclusion:</strong> The Centering Teen Pregnancy Program was effective in reducing postpartum scores and lowering the number of women having postpartum depression. Therefore, the introduction of the Centering Teen Pregnancy Program and the training of healthcare providers to integrate the Centering Teen Pregnancy Program into the standard care for the prevention of postpartum depression are recommended.</p> Pongsri Jitmanowan Chompunut Sopajaree Suphaphorn Utsaha Tassanee Na phikun ##submission.copyrightStatement## 2018-12-07 2018-12-07 17 24 10.31584/jhsmr.201934 Improvement of the Osmotic Fragility (OF) Test in α Thalassemia 1 Screening for HIV-1 Infected Patients by The New Cutoff Values of MCV and MCH <p><strong>Objective:</strong> To evaluate the efficiencies of the standard α thalassemia screening regimen in human immunodeficiency virus (HIV) infected patients and improve the efficiencies of this screening regimen using new cutoff values.<br><strong>Material and Methods:</strong> A screening process using the osmotic fragility (OF) test, the old cutoff values of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) at &lt;80 fL and &lt;22 pg, and the new cutoff values at &lt;87 fL and &lt;29 pg was performed in 300 HIV infected patients. After which, a genetic study was performed to detect common α thalassemia 1 genes deletions composed of Southeast Asian and THAI deletions and also for hemoglobin constant spring and hemoglobin Pakse mutations for α thalassemia 2 carriers. Screening efficiency was estimated by sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).<br><strong>Results:</strong> Sensitivity, specificity, PPV, and NPV of the original regimen for thalassemia screening in HIV infected patients were at 50.0%, 95.0%, 39.0% and 96.8%, respectively, demonstrating a high false positivity in HIV-1 infected populations. Therefore, new cutoff values for MCV and MCH were proposed at &lt;87 fL and &lt;29 pg, due to the highest value found in α thalassemia 1 carriers with HIV-1 infection. These new cutoff values showed higher sensitivity, specificity, PPV, and NPV at 100.0 92.6%, 46.2%, and 100.0%, respectively, and thus enhanced thalassemia screening efficiency in HIV-1 infected patients.<br><strong>Conclusion:</strong> Incorporation of the OF test and the new cutoff values for MCV and MCH improve the efficiencies of α thalassemia 1 screening in HIV-1 infected patients. This helps reduce the cost of confirming positive test results in α thalassemia screening.</p> Sarayot Rareongjai Sitthichai Panyasai Santipap Sooncharoen Soraya Mol-ar Orathai Pongtussanahem ##submission.copyrightStatement## 2018-12-14 2018-12-14 25 34 10.31584/jhsmr.201935 P-cadherin and CD10 Expression to Distinguish between Ductal Carcinoma in Situ and Invasive Ductal Carcinoma of the Breast <p><strong>Objective:</strong> To use placental cadherin (P-cadherin) and cluster of differentiation 10 (CD10) immunohisto chemical staining, to separate ductal carcinoma in situ (DCIS) from invasive ductal carcinoma (IDC).<br><strong>Material and Methods:</strong> DCIS (n=48), equivocal (n=18), and IDC grade 1 (n=17) cases were evaluated by using immunohisto chemical staining, with P-cadherin and CD10 for identifying the myoepithelial cells.<br><strong>Results:</strong> P-cadherin is positive in myoepithelial cells in almost all cases of DCIS (79.0%), and equivocal groups (61.0%). CD10 also shows a positive result in most cases of DCIS (98.0%) along with equivocal groups (72.0%). Both, P-cadherin and CD10 are negative in all cases of IDC grade 1. P-cadherin shows a high percentage of positivity in luminal cell in DCIS (83.0%), equivocal group (100.0%) and IDC grade 1 (88.0%). CD10 shows a low positive in the luminal cell of most cases of DCIS (13.0%), equivocal group (6.0%) and IDC grade 1 (0.0%). CD10 is positive in myofibroblastic cells in approximately 30.0% of all cases, but P-cadherin shows all negative staining.<br><strong>Conclusion:</strong> P-cadherin and CD10 show high sensitivity for detecting the myoepithelial cells, but P-cadherin has a lower specificity, due to it having more luminal cells expression. Therefore, P-cadherin may be helpful for diagnosis in some cases that have a high expression of CD10 in myofibroblastic cells.</p> Kanet Kanjanapradit Sittipong Wangsawibul ##submission.copyrightStatement## 2019-01-03 2019-01-03 35 42 10.31584/jhsmr.201936 The Effectiveness of Clinical Guidelines in the Diagnosis of Lynch Syndrome Compared to Microsatellite Instability and Immunohistochemistry Analyses in Southern Thailand <p><strong>Objective:</strong> This study aims to assess the accuracy of Amsterdam II criteria (AMII) and Revised Bethesda Guidelines (RBG) compared to molecular tests in Thai patients.<br><strong>Material and Methods</strong>: One hundred eighty-one patients were enrolled. Demographic data and pathological features and locations of tumors were recorded. Family history of the patients was reviewed by AMII and RBG. Tissue samples were collected and molecular testing was tested by microsatellite instability (MSI) analysis and immunohistochemistry (IHC). Statistical analysis was used to estimate the sensitivity and specificity of AMII and RBG compared to molecular testing.<br><strong>Results:</strong> Of the patients, 2.8% fulfilled the AMII criteria and 28.1% met the RBG criteria. Molecular testing showed 16.57% and 13.8% of the samples lost at least 1 out of 4 mismatch repair (MMR) proteins in the IHC test. In addition, 10.5% of patients had both microsatellite instability high (MSI-H) and loss of protein MMR expression. The sensitivity and specificity of AMII were 6.7% and 98.0%, respectively, while for the RBG they were 70.0% and 82.1%, respectively.<br><strong>Conclusion:</strong> The present study suggests that for patients who complete the AMII, doctors should be highly suspicious of Lynch syndrome, due to its high specificity. The RBG is useful for screening for Lynch syndrome and the selection of individuals for further molecular testing.</p> Thitipat Thavornpattanapong Kanet Kanjanapradit Surasak Sangkhathat Worrawit Wanitsuwa ##submission.copyrightStatement## 2019-01-18 2019-01-18 43 50 10.31584/jhsmr.201938 A Study of Entrance Surface Air Kerma for Patients Undergoing Chest and Abdomen from Digital Radiography at Chulabhorn Hospital <p><strong>Objective:</strong> The main purpose of this study was to investigate the typical dose for standard-sized patients in chest (posteroanterior; PA) and abdomen (anteroposterior; AP) digital radiography.<br><strong>Material and Methods:</strong> The air kerma was measured by the ionization chamber (Radical Corporation, model 10X6-6) in X-ray equipment manufactured by General Electric Healthcare Definium 8000 System for different kilovoltage peak (kVp) settings in each X-ray examination. The entrance surface air kerma (ESAK) was determined in 422 mediumsized patients in different projections: chest (PA) and abdomen (AP), according to the recommended protocol of the International Atomic Energy Agency Technical Report Series Number 457 (Technical Reports Series No. 457 “Dosimetry in Diagnostic Radiology: An International Code of Practice).<br><strong>Results</strong>: The mean entrance surface air kerma values for chest (PA) radiography in female and male patients were 0.08 milligray (mGy) and 0.09 mGy, respectively and for abdomen (AP) radiography for both genders were 0.98 mGy and 1.06 mGy, respectively.<br><strong>Conclusion:</strong> The mean entrance surface air kerma values of this study were less than the diagnostic reference levels from the IAEA 1996, Korea 2007, United Kingdom 2010 and Japan 2015, in all projections. Patient doses (ESAK) in chest (PA) and abdomen (AP) digital radiography at Chulabhorn Hospital were less than the other guidelines, because of the use of a high kVp technique for the chest and the automatic exposure control for the abdomen. Furthermore, Thai people are smaller than Westerners. We studied in digital radiography only that literally provides lowest radiation dose compares with screen film and computed radiography.</p> Atchara Promduang Napapong Pongnapang Napat Ritlumlert Sutthirak Tangruangkiat Monchai Phonlakrai ##submission.copyrightStatement## 2019-02-12 2019-02-12 51 60 10.31584/jhsmr.201940 Pulmonary Sequestration as an Incidental Finding of Pediatric Abdominal Ultrasound - Two Cases <p>Abdominal ultrasound (US) is a commonly indicated examination in pediatrics. However, lung bases are often not thoroughly examined. Pulmonary sequestration is mostly detected prenatally, but also postnatally – incidentally or with the appearance of recurrent pulmonary infections. It can be detected by US, yet our research has not found a single reported case where sequestration was incidentally detected by US, without any previous knowledge of its existence. Here, we report on 2 such cases of pulmonary sequestrations detected during routine pediatric abdominal US. Tubular anechogenic structure above the left hemidiaphragm should bring attention to the potential diagnosis of pulmonary sequestration.</p> Jovan Lovrenski ##submission.copyrightStatement## 2018-11-08 2018-11-08 61 66 10.31584/jhsmr.032 Current Management of Difficult Central Venous Access in Pediatric Patients <p>The central venous catheter (CVC) has become an integral part of various long term parenteral therapies including chemotherapy and parenteral nutrition. In pediatric patients with a long term CVC, multiple repeated accesses and catheter-related complications may lead to difficulty in reestablishment of a line. Strategies in CVC management in these patients should begin with choosing an appropriate catheter according to its purpose, choosing the right access site and prompt treatment of potential complications, especially catheter-related thrombosis. In patients with severe restriction of the superior vena cava and its tributaries, end-stage central venous access is diagnosed. Management of this situation requires a multidisciplinary team and alternative routes of venous access including access through small collateral veins, or through an unusual vein such as the hepatic vein or a gonadal vein, and/or use of alternative surgical techniques. This article provides a comprehensive review regarding the current approach and surgical options in pediatric patients with end-stage central venous access.</p> Surasak Sangkhathat Wongsakorn Chaochankit ##submission.copyrightStatement## 2019-01-15 2019-01-15 67 80 10.31584/jhsmr.201937