Buddhachinaraj Medical Journal 2020-03-05T14:14:01+07:00 Nitipat Bussabarati Open Journal Systems <p style="text-align: justify;"><strong>Buddhachinaraj Medical Journal</strong> mission is to publish medical, medical education and public health articles reporting the results of original research, clinical studies, review articles, medical innovations, journal synopsis, conference papers, letters to the editor, question &amp; answer and other appropriate articles.</p> <p style="text-align: justify;">&nbsp;</p> Editor’s Note 2019-11-17T10:25:09+07:00 นิธิพัฒน์ บุษบารติ <p>no abstract</p> 2019-11-17T00:00:00+07:00 Copyright (c) The Effect of Tramadol for Control Postoperative Shivering After Spinal Anesthesia 2020-03-05T14:14:01+07:00 กัลยา หวังเรืองสถิตย์ <p>The aim of this study was to compare dose of tramadol in the treatment of post-anesthetic shivering (PS) after spinal anesthesia. In this prospective, randomized, double-blind study, 144 patients who undergoing elective surgery under the spinal anesthesia with developed to the shivering. The patients were randomly assigned to receive tramadol 0.5 mg/kg (group 1) and tramadol 1 mg/kg (group 2). The primary outcome was evaluated at 15 minutes after intravenous injection with tramadol and were observed for a recurrence of the shivering within 4 hours. Secondary outcomes included complication. The results showed that, the control rate was success defined with no shivering in groups 1 and 2 were 91.8 % and 93.0 % (p = 0.790). The recurrence rate of the shivering was 12.3% in groups 1 and 11.3% in group 2 respectively (p = 0.844). Nausea and vomiting were found to be significantly lower in group 1 than group 2 (4.1% vs. 18.3%; p = 0.007 and 1.4% vs. 9.9%; p = 0.026 respectively). There was no difference in the other side effects. In conclusion, the treatment of post-anesthetic shivering by use of 0.5 mg/kg and 1 mg/kg of tramadol has no difference results but fewer nausea and vomiting in tramadol 0.5 mg/kg.</p> 2019-08-31T00:00:00+07:00 Copyright (c) 2019 Buddhachinaraj Phitsanulok Hospital Medical Students' Reading Behavior on Academic Achievement 2019-11-17T15:59:00+07:00 ธิติมา เงินมาก สุดารัตน์ เจริญสันติ ชมพูนุท บุญโสภา <p>Reading is most important for medical students' learning. This prospective cohort study had aimed to find out how the reading behavior of medical students leads to success in academic achievement. The study used a questionnaire and the student's pediatric grades for data collection from 4th to 6th year medical students at Department of Pediatrics, Naresuan University Hospital in the academic year 2017. There were 90 medical students, 40 (44.4%) male and 50 (55.6%) female. Most students' preferred time was at night and after midnight (00.30-06.00 am.), 48 (53.3%). The most common characteristics of reading and memorizing were note-taking 43.2%, reading alone 29.6% and reading with friends 12.5%. There was no correlation between time for reading and character of reading with pediatric grades. In conclusion, most medical students read after midnight, used note-taking and reading behavior has no correlation with academic achievement</p> 2019-08-31T00:00:00+07:00 Copyright (c) Predictors Of Depression Among Older Adult With Chronic Disease in Thapla District 2019-11-17T12:00:45+07:00 ปริญ มั่นเข็มทอง <p>This analytic research aimed to study predictive factors of depression scale among older adult with chronic disease In Thapla district. Sample consisted of 410 older persons with chronic disease. Data collected from August to November 2018, by interviewing using 5 questionnaires of demographic variable, ability of activity daily living, family relationship, social activity and Thai Geriatric Depression Scale. Statistics including frequency percentage Pearson's product moment and multiple regression were used for data analysis. The results showed that the most of the older adult with chronic disease were woman (60.2%), 61-70 years (64.4%), married status (70%), unemployee (43.2%), one chronic disease (54.6%) and long-term 6-10 years of chronic disease (40.5%). The 4 factors were social support scale, age, number of disease and ability of activity daily living scale cound jointly predict 30.6% of variance of depression scale in older adult with chronic disease</p> 2019-08-31T00:00:00+07:00 Copyright (c) Nursing Care System Development for Sepsis and Septic Shock Patients 2019-11-17T12:28:43+07:00 ปัญญา เถื่อนด้วง นาตยา คำสว่าง <p>Sepsis and septic shock patients have a chance to shock and death. Then, this research and development had aims to develop nursing care system of sepsis and septic shock and study outcome of nursing care system of sepsis and septic shock in Buddhachinaraj Phitsanulok Hospital between february to September 2019. Process of development have four steps. First, problem analysis and planning. Second, develop nursing care system by provide sepsis clinical nursing practice guideline (CNPG) and primary nursing service system. Third, conduct nursing care system of sepsis and septic shock to implementation. Forth, evaluation outcome of nursing care system of sepsis and septic shock. Analysis data with frequency, percent, mean, standard deviation and chi square test, t-test statistics. The result showed that post development mean of knowledge and competency practice follow CNPG-Sepsis were higher than pre development. Patients get to take hemoculture antibiotics intravenous fluid vasopressor and recovery organ dysfunction pre and post development were different with significant. Thus, administration nurse should take this nursing care system to nursing practice for sepsis and septic shock patients overall hospital to improve patients safety</p> 2019-08-31T00:00:00+07:00 Copyright (c) The Development of the Clinical Supervision Model of Head Nurses at General Hospital in Regional Health 2 2019-11-17T16:14:35+07:00 รุ่งทิพย์ สวัสดี สุทธีพร มูลศาสตร์ <p>Effectively supervision of the head nurses need appropriateness. This research and development aimed to study the situation of supervision, to development of supervision model and to evaluate the appropriateness of the clinical supervision model of head nurses at one General Hospital in Regional Health 2. The study of the situation and the development of the supervision model using group discussions with 8 head nurses in each group that leader for over 1 year, assess the suitability of the model by 100 nurses who have worked in this hospital for over 1 year, sampling by simple random without replacing. The tool wasa focus group guideline to study the situation of supervision and develop a clinical supervision model based on the seven eyes supervision model. Data were analyzed using content analysis principles. The questionnaires for the supervision model reliability was 0.98 Data were analyzed using descriptive statistics.The situation of supervision found that the head nurses did not supervise about patient care, lack of confidence in supervision, need guidelines,planning and supervision manualThe clinical supervision model consists of 7 clinical supervision includes: the patients, nursing interventions, relationship between patients and registered nurses, registered nurse, relationship between registered nurses and head nurses, head nurses, and the context supervision. The appropriateness of the clinical supervision model was rated at the high level,it should be developed into a supervision manual. Organize training and try it out in the wards.</p> 2019-08-31T00:00:00+07:00 Copyright (c) Quality of life of the Elderly in Royal Dental Implant Project 2019-11-17T14:16:59+07:00 วิรัช บรรเจิดพงศ์ชัย <p>Loss of all teeth are important issue affect health's elderly. Having complete denture can increase Quality of Life (QOL) especially eating. However, in the long term,patient still have problem with lower denture. Due to resorption of bone. Implant (Ball type) is necessary to attach with lower denture in oral health condition. Aim to assess quality of life both before and after have ball implant of the Royal Implant project. A comparative study of observationalintervention had been design. Study focus on elderly 83 cases in Uttaradit hospital. Data collected in nine years (2008-2017) by interview general information,denture quality and Oral Impact Daily Performance (OIDP) index. Data analyzed by descriptive statistics and GEE regression. QOL before had ball implant score was 47.52 ± 15.91% and after inserted six months, QOL score was 28.50 ± 10.41% with significant difference (95% CI) 19.02% (-16.22 to -21.84), p -value &lt; 0.001. Elderly has lower denture with ball implant promote QOL and should be an alternative treatment for elderly patient</p> 2019-08-31T00:00:00+07:00 Copyright (c) Clinical Outcomes of Intra-Operative Soak with Tranexamic Acid in Total Knee Replacement Surgery 2019-11-18T11:34:43+07:00 ศักรินทร์ ธนเกียรติสกุล <p>The major problem of total knee arthroplasty for the degenerative knee is blood loss after the operation. This retrospective study aimed to survey the clinical outcomes especially blood loss after total knee arthroplasty in Buddhachinaraj Phitsanulok hospital, from January 2010 to March 2018. Fifty osteoarthritic patients who had total knee arthroplasty were enrolled. They had received tranexamic acid 250 mg. plus normal saline 50 mL. soak intra-operation within 10 minutes period. The amounts of blood loss after operation in all the patients were recorded by vacuum drainage volume until the drainage were removed. The number of patients who required blood replacement, length of stay in hospital and the complications were also recorded. The descriptive statistics were analyzed by percentage, mean, standard deviation and range. The results showed that, the post-operative blood loss in the drainage was average 613 +/- 262.06 mL. Only one patient required blood transfusion. The hospital length of stay was average 7 days (7.290+/-6.23 days) and there was no complication found. In conclusion, the total knee arthroplasty with intra-operative soak with tranexamic acid can reduce blood loss and safe for patients</p> 2019-08-31T00:00:00+07:00 Copyright (c) The Effects of Behaviour change Program on Incomplete Oral Antibiotics Administration in Respiratory Tract Infection Patients 2019-11-17T16:00:52+07:00 สมศักดิ์ วงค์วาร วธู พรหมพิทยารัตน์ <p>Incomplete oral antibiotic usage is the major problem of drug administration, cause treatment failure or drug resistant. This quasi-experimental research had aimed to examine the effects of behaviour-change program on incomplete oral antibiotics administration in respiratory tract infection patients in Bangrakam Hospital, Phitsanulok province, Thailand. The sample were 60 in-patients of respiratory infection that divided into experimental group and control group that each group was 30 subjects. The experimental group received the behaviour change program that application of a Health Belief Model to modify behavior of the patients who took under-dosage of antibiotics. The control group received standard care. Data were collected by using interview form before and after intervention in both groups. Data analysis was performed by using percentage, mean, standard deviation, independent t-test and paired t-test. Significant level was set at 0.05. Results revealed that after the experimentation, the experimental group had mean scores regarding perceived susceptibility of health risk, severity of respiratory infection form incomplete dosage of antibiotics, perceived benefits and barrier of complete oral antibiotics, knowledge of antibiotics and complete oral antibiotics administration behaviours in treatment of respiratory tract infection, significantly higher than that before the program. The experimental group also had mean scores of all variable significantly higher than that of the control group. Therefore, the behaviour change program on incomplete oral antibiotics administration in respiratory tract infection is effective to modify behaviour of patients who took incomplete dosage of antibiotics. The health personnel can apply this program for reduce problem of incomplete oral antibiotics administration</p> 2019-08-31T00:00:00+07:00 Copyright (c) Efficacy and Safety of Turmeric in Active Rheumatoid Arthritis Patients Received Maximum Dose of DMARDS or DMARD-Intolerance 2019-11-18T11:35:52+07:00 อังคณา นรเศรษฐ์ธาดา <p>Curcumin, an active ingredient of turmeric, is known potent anti-inflammatory and anti-rheumatic properties. Rheumatoid arthritis (RA) is a chronic destructive joint disease. Many patients with severe forms of the disease remain unresponsive to non-steroidal anti-inflammatory drugs and disease modifying anti-rheumatic drugs (DMARDS) or DMARD-intolerance. This study conducts a randomized control study to assess the efficacy and safety of turmeric compare with placebo in Buddhachinaraj Hospital Phitsanulok. Fifty active rheumatoid arthritis patients who take maximum dose of DMARDS or DMARD-intolerance were randomized into two groups with patients receiving turmeric (2gm/d) and placebo for 8 weeks. The primary endpoints were reduction in Disease activity score (DAS) 28. The secondary endpoints were American College of Rheumatology (ACR) criteria for reduction in tenderness and swelling of joint counts. Patients in turmeric group showed statistically significant reduction in their DAS28 and ACR scores (ACR20, 50 and 70). Turmeric treatment did not related with any adverse events. This study provides the safety and efficacy of turmeric treatment in refractory RA, and highlights the need for future large-scale trials to validate these findings</p> 2019-08-31T00:00:00+07:00 Copyright (c) Pregnancy with Ovarian Dysgerminoma 2019-11-17T15:32:44+07:00 อรรถยา รัตนแก้ว <p>A case report of pregnant woman 16+1 weeks of gestation, 19-year-old, with woman present with left ovarian tumor at Buddhachinaraj Phitsanulok Hospital. Her diagnosis was pregnancy 16 weeks of gestation with a left ovarian tumor. Her treatment was left salpingo-oophorectomy and peritoneal washing. After surgery, she has no complications. Pathological report was dysgerminoma stage IA. She was followed up by close monitoring. After that, she delivered at 39 weeks of gestation by normal delivery. A baby was normal active female, weigh 3,020 grams, no complication. Ovarian cancer in pregnancy is quite rare. From the case study of this patient, we can be used as a standard for antenatal care for pregnant women who come at Buddhachinaraj Hospital, Phitsanulok. Pregnant women should perform ultrasound in the first trimester not only for gestational age but also for check both ovaries. We recommend tocolytic drug for prevent preterm labor in case of pregnant woman who need gynecologic surgery in second trimester</p> 2019-11-17T00:00:00+07:00 Copyright (c) Loneliness in Older Persons: Nurses' Roles 2019-11-17T15:45:31+07:00 จารุวรรณ ก้านศรี อุทัยวรรณ แก้วพิจิตร ชุติมา มาลัย ณัฐธัญญา ประสิทธิ์ศาสตร์ <p>Loneliness is a sense caused from change of interpersonal relationship. It can affect health status of older persons both in physical and psychosocial aspects. Factors related to loneliness included sex, age, status, living alone,physical changes, decrease social role, and low self-esteem. Treatments include both reducing factors and causes of loneliness in older persons with holistic nursing.This article presents the types of loneliness. Causes of loneliness in the elderly factors related to loneliness of older persons, the impact of loneliness on the health of older persons, assessment of loneliness in older persons, guidelines for loneliness management in older persons and nurses' roles in caring for loneliness in older persons. In order to be a guideline for caring loneliness in older persons for well-beingand happiness</p> 2019-08-31T00:00:00+07:00 Copyright (c) Psychiatric Nurses' Roles on Mental Health Promotion for Schizophrenic Patients' Caregivers in Local Communities 2019-11-17T15:55:54+07:00 ศิริญพร บุสหงษ์ โปรยทิพย์ สันตะพันธ์ุ ทัตภณ พละไชย <p>Schizophrenia is a chronic mental disease that the number of patients is increasing every year. According to the Department of Mental Health's policy, patients suffering from this disease should return to the community, cared by their families and communities as soon as possible and emphasized on participation of the local communities and the network partners. But taking care of schizophrenic patients make the caregivers felt discouraged, worried and stressful with what they were working on. Thus, mental health promotion for the caregivers of schizophrenic patients is also crucial. Because, if they have strong mental health, the treatment for the patients will be of good quality. This article presents issues on mental health of those who taking care of the schizophrenic patients and psychiatric nurses' roles on mental health promotion among the caregivers in order to develop and strengthen their mind, ready for any situations affecting their mind, manage stress and adjust themselves happily with the society</p> 2019-08-31T00:00:00+07:00 Copyright (c)