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 Prevalence of Violence among High School Students in Hat Yai Municipality, Southern Thailand: ICAST-CI Thai Version Study <p><strong>Objective:</strong> To determine the prevalence and risk factors of school violence among Thai high school students using a Thai version of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-Children: Institute Version (ICAST-CI). <br><strong>Material and Methods:</strong> A cross-sectional study was conducted at two high schools in Hat Yai municipality, Songkhla, southern Thailand with 480 students. Univariate logistic regression analysis was used to assess the risk factors associated with school violence. <br><strong>Results:</strong> Overall, 88.8% of the students reported experiencing violence at school in their lifetimes. The prevalences of psychological, physical and sexual violence were 84.0%, 66.9% and 30.6%, respectively. The most commonly reported violence patterns among each form of violence were swearing (87.8%), slapping on hand/arm (66.4%), and showing pornography (67.3%), respectively. Students with good school performance tended to report psychological violence [odds ratio (OR)=3.03, 95% confidence interval (CI)=1.13-8.07] whereas students aged &gt;15 years were less likely to report physical violence (OR=0.47, 95% CI=0.31-0.71). Sexual violence was reported more among male students (OR=1.71, 95% CI= 1.12-2.61) and students aged &gt;15 years regardless of gender (OR=1.58, 95% CI=1.04-2.39). Students were more likely to be reported as a perpetrator than teachers in most patterns of violence.<br><strong>Conclusion:</strong> The prevalence of school violence among high school students in Hat Yai municipality, southern Thailand, is significant. and the patterns of violence are similar to other ICAST-CI studies. Violence at school should be recognized as a serious problem, and preventive measures should be implemented nationwide.&nbsp;</p> Sasivara Boonrusmee Tansit Saengkaew Nannapat Pruphetkaew Somchit Jaruratanasirikul ##submission.copyrightStatement## 2018-09-07 2018-09-07 247 257 10.31584/jhsmr.2018.36.4.20 Prevalence of Under-Prescription in Elderly Type 2 Diabetic Patients in the Primary Care Unit of a University Hospital <p><strong>Objectives:</strong> This study aimed to assess the prevalence of under-prescription among elderly type 2 diabetic patients in the primary care unit of a university hospital in southern Thailand and identify the associated factors. <br><strong>Material and Methods:</strong> A 1-year retrospective medical record review was conducted in elderly type 2 diabetic patients treated continuously in the primary care unit. Under-prescription was the primary outcome assessed from criteria developed from the START criteria (2015), Thailand’s clinical practice guideline for diabetes (2014), and for hypertension (2015). <br><strong>Results:</strong> This study included 458 medical records that fit our inclusion criteria. The median age was 69.1 years old and more than 80% of them had a comorbidity of dyslipidemia or hypertension. The prevalence of under-prescription in elderly type 2 diabetic patients was 84.5%. The most commonly omitted medication was aspirin for primary prevention of cardiovascular disease. An increased number of medications received and having cardiovascular disease was associated with a lower risk of under-prescription. <br><strong>Conclusion:</strong> The prevalence of the omission of beneficial medications in elderly type 2 diabetic patients in the primary care unit of a university hospital was high, especially under-prescription of aspirin for primary prevention of cardiovascular disease.</p> Thareerat Ananchaisarp Namfon Duangkamsee Bongkot Burapakiat Theerapat Buppodom Ukrit Rojanusorn Kesinee Katawatee Pongnarin Nawalerspunya Teerat Siriwong Puri Haruthaiborrirux Krittithee Saktiwarawat ##submission.copyrightStatement## 2018-09-17 2018-09-17 259 267 10.31584/jhsmr.2018.36.4.22 Prevalence of the Z515 (Palliative Care) Diagnosis from the ICD-10 System in Cancer Patients and the Relationship between Treatment and Cost in Songklanagarind Hospital <p><strong>Objective:</strong> To determine the prevalence of use of the diagnostic system ICD-10 code Z515 in patients diagnosed with cancer and the relationship between treatment and cost in Songklanagarind Hospital during the 2012-2016 period.<br><strong>Material and Methods:</strong> A retrospective descriptive study was performed in patients who were diagnosed as code Z515 in Songklanagarind Hospital from 2012-2016. Data were collected through the Hospital Information System (HIS), and the patients were divided into 2 groups based on whether they were Inpatient Department (IPD) or Outpatient Department (OPD). From the HIS, data concerning sex, age, the right of access to healthcare services, date of diagnosis, first and last department that diagnosed the Z515 code, other departments that diagnosed the same code, other codes diagnosed besides Z515, the latest treatment received, number of regularly-used medications, symptoms that persisted according to the most recent record, ward name, duration of hospitalization (for IPD cases), and the average cost of treatment were recorded on data extraction forms and analyzed as percentages with 95% confidence interval and odds ratios.<br><strong>Results:</strong> The prevalence of the diagnostic code Z515 in cancer patients during the study period was 0.2% in both inand outpatients. For outpatient the relationship between average cost and number of medications and average cost and type of treatment were statistically significantly different, while for inpatients the difference was not statistically significant.<br><strong>Conclusion:</strong> In Songklanagarind Hospital the use of code Z515 is very low, even though we know that all cancer patients should get the best palliative care support and the earlier we diagnose them as palliative, the better the care they will receive. Therefore, if the doctors are aware of this code, the patient will receive the best care in their end stages of life, and that would make them and their families feel happier. Moreover, our hospital will get reimbursement from the government&nbsp;to get more resources. Hence, more patients can be helped. Songklanagarind Hospital should undertake some kind of program to ensure all physicians are aware of code Z515 and how to use it in order to provide the best care for end-of-life patients.</p> Orapan Fumaneeshoat ##submission.copyrightStatement## 2018-09-27 2018-09-27 269 276 10.31584/jhsmr.201824 A Study on the Comparison of Burnout Syndrome, Among Medical Doctors in the Restive Areas and Non-Restive Areas of the South Thailand Insurgency <p><strong>Objective:</strong> This study aims to compare burnout syndrome as well as the associated factors among doctors, who work at, secondary and tertiary-care hospitals either: in the restive areas of Thailand’s southern insurgency, and the nonrestive areas of nearby provinces.<br><strong>Material and Methods:</strong> This was a cross-sectional designed study, which was conducted in order to survey all doctors, who worked at hospitals, located in lower, southern Thailand from; January to April 2018. The questionnaire used; The Maslach Burnout Inventory (MBI) Thai version questionnaire. The data was analyzed by descriptive statistics. The factors associated with burnout syndrome were analyzed by using chi-square test and logistic regression.<br><strong>Results:</strong> The total number of participants were; 245 medical doctors. Fifty-eight percent of them were females, whilst 42.0% were males, and most of them were single (50.2%). The mean age of the participants was; 35.9 years, and 30.2% of them worked more than 40 hours per week. The total prevalence of Burnout syndrome among them was; 99.6%, with the highest score found to be in the emotional exhaustion section. There were no differences in burnout syndrome between, those who worked in restive areas and those who worked in non-restive areas of Thailand’s southern insurgency, grade point average (GPA), perceived sleep/rest quality and perceived work stress were related to emotional exhaustion, while types of specialty, work hour/week and family relationships were associated with depersonalization. The sample size was not adequate for the personal accomplishment part analysis.<br><strong>Conclusion:</strong> Almost all medical doctors, who worked at either secondary or tertiary-care hospitals in the lower, southern areas of Thailand, suffered from burnout, only 1 physician did not. The factors associated to burnout syndrome are; work hours per week, GPA, type of specialty, perception of sleeping/rest quality, perception of having stress from work and family relationships.</p> Kreuwan Jongborwiwat Jarurin Pitanupong Chonnakarn Jatchavala ##submission.copyrightStatement## 2018-10-05 2018-10-05 277 289 10.31584/jhsmr.201825 Pain, Stress and Anxiety of Chronic Pain Patients Prior to, During and After Political Turmoil in Thailand <p><strong>Objective:</strong> Thailand was plagued with serious political turmoil for many years. We would like to know whether this turmoil has had an impact on our chronic pain patients in terms of intensity of pain, stress and anxiety, as well as daily living and sleep.<br><strong>Material and Methods:</strong> Patients with at least 3 months of pain prior to 31 October 2013 (the date that the demonstrations started) were enrolled in this study. The data were collected from the patients who attended our pain clinic from December 2014 to May 2015. The patients were asked to complete a questionnaire on their severity of pain, stress and anxiety for the 3 different stages: prior to the demonstrations (period 1), during the demonstrations (period 2) and under military dictatorship or after the demonstrations (period 3).<br><strong>Results:</strong> There were 120 patients, 49 males (40.8%) and 71 females (59.2%). The mean age was 56.3±15.8 years old (range 18-88). The majority were Buddhist (108 patients, 90.0%) while 11 patients (9.2%) were Muslim and 1 patient (0.8%) was Christian. The mean duration of pain prior to the beginning of the demonstrations was 62.8 months (range 3-324 months). Regarding the pain score, the mean maximum pain score was significantly different between periods 1 (8), 2 (7.7) and 3 (6.8) (p-value&lt;0.001). Regarding the anxiety score, the mean maximum anxiety score was significantly different between periods 1 (3.8), 2 (4.8) and 3 (2.9) (p-value=0.03). Regarding the stress score, the mean maximum stress score was significantly different between periods 1 (3.8), 2 (4.4) and 3 (2.8) (p-value=0.02). Using multiple logistic regression analysis, no factors (gender, age, religious, duration of pain and levels of anxiety and stress) were found to have contributed to the reduction of pain intensity.<br><strong>Conclusion:</strong> The demonstrations during the political turmoil did not increase the severity of pain but led to higher levels of stress and anxiety. On the other hand, under the military dictatorship, lower pain scores as well as stress and anxiety levels in chronic pain patients attending our pain clinic have been found.</p> Sasikaan - Nimmaanrat Tippawan Liabsuetrakul ##submission.copyrightStatement## 2018-10-17 2018-10-17 291 298 10.31584/jhsmr.201827 Factor Associated with Abnormal Ankle-Brachial Index Among Diabetic Patients in Songklanagarind Hospital: A Retrospective Cohort Study <p><strong>Objective:</strong> To find the correlation between type 2 diabetic patients who had abnormal ankle-brachial index (ABI) among factors affected diabetes and cardiovascular outcomes including acute coronary syndrome (ACS), myocardial infarction (MI), coronary revascularization stroke, renal replacement therapy, leg revascularization and limb amputation <br><strong>Material and Methods:</strong> Retrospective cohort study collecting the data of 548 diabetic patients examined ABI at Outpatient Departments from 1st January 2009 to 31st December 2015. <br><strong>Results:</strong> From 548 medical records including only normal-ABI group and low-ABI group, we found that hypertension, chronic kidney disease (CKD), smoking, history of previous MI, history of previous stroke and age were the significant associated factor of low-ABI. The survival analyses revealed the significantly higher rate of ACS, MI, and coronary revascularization in low-ABI group (p-value=0.04, &lt;0.01, &lt;0.01 respectively) after exposed to low-ABI around 4 years. However, the study found no significant difference of other outcomes between the 2 groups. <br><strong>Conclusion:</strong> Songklanagarind’s diabetic patients with low-ABI were associated with the significantly higher rate of multiple cardiovascular risk factors including hypertension, CKD, smoking, history of previous MI, history of previous stroke and age and they tend to significantly experience more ACS, MI and coronary revascularization after 4 years exposed to low-ABI.</p> Supakorn Sripaew Thanittha Sirirak ##submission.copyrightStatement## 2018-10-22 2018-10-22 299 306 10.31584/jhsmr.201828 Beau’s Lines Resulting from Taxane Chemotherapy <p>Nail abnormalities are frequently found in oncologic patients who have undergone chemotherapy. Although these changes do not require treatment, they could influence the treatment plan and the patient’s quality of life. Some nail disorders lead to severe complications. Herein, the author reports on a patient with advanced breast cancer who received multiple kinds and cycles of chemotherapy. She developed multiple, parallel, transverse grooves, compatible with Beau’s lines, on the nail plate of all her fingernails and toenails. This report aims to further the knowledge of medical students, physicians, and healthcare providers regarding the nails of patients who receive chemotherapy.</p> Kumpol Aiempanakit ##submission.copyrightStatement## 2018-10-10 2018-10-10 307 310 10.31584/jhsmr.201826 Antimicrobial Resistance: Genetic Perspectives and Implications <p>The emergences of antimicrobial-resistant bacteria is raised as a serious global concern. Several interventions are used to solve these issues while those beneficial results are still unclear. The pursuit of knowledge through the nature of antimicrobial resistance seem to be the principal to deal with these problems. Recent researches with advanced technologies elucidate the present characteristics as well as predict their evolutions. Molecular data on developing antimicrobial resistance guides to the appropriate clinical practices and transmission prevention. The plenty data on genetic mobile materials are served to clarify several phenomenon and explain the failure of several interventions for controlling antimicrobial resistance. In this review, we focus on the findings of phenotypic and genotypic data of antimicrobial resistance based established advanced researches. We emphasize to apply of those knowledge to routine practices and policy making for control the current situations antimicrobial resistance.</p> Sarunyou Chusri Apichai Tuanyok ##submission.copyrightStatement## 2018-09-12 2018-09-12 311 322 10.31584/jhsmr.2018.36.4.21 Chronic Obstructive Pulmonary Disease and Extrapulmonary Effects: Cognitive Impairment <p>Chronic Obstructive Pulmonary Disease (COPD) is a public health problem which is increasing worldwide. Comorbidities usually occur in patients with COPD because COPD affects the physiological functions in a systemic manner. It has been reported that the ratio of cognitive impairment in COPD patients is higher than that of age-matched populations. Cognitive impairment thus has been proposed as a clinical manifestation in patients with COPD. Understanding all aspects of COPD and the effects of cognitive impairment on health outcomes for COPD patients therefore is essential for developing a holistic treatment.</p> Nitita Piya-amornphan Anoma Santiworakul Jiraphat Nawarat ##submission.copyrightStatement## 2018-10-22 2018-10-22 323 333 10.31584/jhsmr.201829 Reviewer Acknowledgement, 2018 Jitti Hanprasertpong ##submission.copyrightStatement## 2018-09-08 2018-09-08 335 337 Index <p>--</p> JHSMR Authors Index ##submission.copyrightStatement## 2018-09-08 2018-09-08 339 343