https://he01.tci-thaijo.org/index.php/BMJ/issue/feed Buddhachinaraj Medical Journal 2021-01-28T13:56:34+07:00 Nanthiya Tanthachun tnanthiya@gmail.com 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> https://he01.tci-thaijo.org/index.php/BMJ/article/view/247291 Editor’s Note 2021-01-25T09:56:30+07:00 Nanthiya Tanthachun tnanthiya@gmail.com 2021-01-25T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247296 Relationship of Bullet Trajectory, Types of Bullet, Gunshot Residues in Suicide and Homicide from Forensic Autopsy 2021-01-28T13:56:34+07:00 Narin Soravisut fon_34210@hotmail.com Nontakran Srisuwan nomail@helplis.org Sunadtha Jullabut nomail@helplis.org Sirinnapa Panyajoom nomail@helplis.org Sittikorn Duangtip nomail@helplis.org <p>The autopsy results of firearm deaths from forensic doctors are very important and affect the cases.<br>However, the knowledge of the trajectory of ammunitions in relation to the manners of death in Thailand is<br>still partially studied. This study aimed to study bullet trajectory, bullet types, and gunshot residuals which<br>relate to manners of death from gunfire injuries. This retrospective case control study was carried out by<br>using documents from forensic identification data of gunfire injuries by the Forensic Department at Lampang<br>Hospital from Jan 1, 2015-June 9, 2019. We found 113 people died from gunfire injuries, 22 of them were<br>suicides which were all men and 91 were homicides, 78 people were male (85.7%). In the suicides, both<br>handguns and shotguns, most ranges of suicide were at contact range (81.8%) with probable found gunshot<br>residual in the wound. The trajectory fires from the front, passing through the upper left side of the body<br>compared to the normal position. As for homicides, more than half used handgun by shooting at a distance<br>and no gunshot residual were found. It also had a variety of trajectories. In conclusion, suicide may be used<br>trajectories to tell the manner of death</p> 2020-12-30T00:00:00+07:00 Copyright (c) 2021 https://he01.tci-thaijo.org/index.php/BMJ/article/view/247301 Therapeutic Effects between Lumbar Traction combined Hot Pack with Mckenzie Exercise versus Lumbar Traction combined Hot Pack in Low Back Pain from Lumbar Disc Herniation Patients 2021-01-25T12:10:08+07:00 Nantawan Pinmas Nantawan56@hotmail.com <p>Back pain is a common symptom. This experimental study aimed to compare therapeutic effects<br>between lumbar traction combined hot pack with McKenzie exercise and lumbar traction combined<br>hot pack in herniated nucleus pulposus patients, in Buddhachinaraj Phitsanulok Hospital during March<br>2020 to October 2020. These patients were divided into two groups, 30 patients in each group. The first<br>group underwent lumbar traction combined hot pack with McKenzie exercise. Another underwent lumbar<br>traction combined hot pack. The results of treatment were compared by chi-square test, chi-square test for<br>linear trend, Mann Whitney U test and Wilcoxon signed rank test with significant level at 0.05. There were no<br>difference in sex, age, education, occupation, average pre-treatment pain and disability scores in both<br>groups. Disability scores after treatment in group one was lower than group two with statistically significant.<br>The reduction of pain and disability scores between two groups were also statistically significant. The average<br>of pain and disability scores pre-post treatment in two groups were also statistically significant. In conclusion,<br>both groups are effective treatments for lumbar disc herniation patients, but lumbar traction combined<br>hot pack with McKenzie exercise is more effective than lumbar traction combined hot pack</p> 2021-01-25T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247305 Factors affecting Clinical Decision Making for Electrophysical Agents (EPAs) Usage 2021-01-25T15:20:43+07:00 Parinya Lertsinthai Parinyal@nu.ac.th Jirapat Kamhaeng nomail@helplis.org Jutawat Nakponkam nomail@helplis.org Chaiphon Chiangraeng nomail@helplis.org Opor Veerapun nomail@helplis.org Rumrada Inthachom nomail@helplis.org <p>Electrophysical agents (EPAs) are core part of professional physical therapy and increases in the<br>new modalities over time. This study aimed to investigate availability, frequency of usage and factors on<br>decision for EPAs usage by physical therapists (PTs) at Health Region 2, Ministry of Public Health, Thailand<br>with electronic questionnaires. Questionnaires were randomly sent to PTs working at 58 hospitals. A total<br>of 151/221 (68%) questionnaires were returned. Frequency, percentage and correlation coefficient were used<br>to describe. The ultrasonic therapy machine and hydrocollator unit were the highest both availability<br>and frequency of usage. Decision making regarding the usage of EPAs was found to be multiple factors<br>especially, internal factors. The pathology knowledge, electrophysical agent knowledge and past clinical<br>experience were important internal factors affecting the use of EPAs application and found significant<br>positive relationship between internal factors. The external factors that influence the decision to use EPAs<br>were the availability of EPAs and research to support the use of treatment. In conclusion, Thai PTs are<br>likely to make decisions of the EPAs usage which are strongly impacted by knowledge, clinical experience,<br>available equipment and research evidence factors</p> 2021-01-25T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247315 Andrographis paniculata Replacement Antibiotics Used among Upper Respiratory Tract Infection Patients in Primary Care Cluster Network 2021-01-25T16:21:40+07:00 Phattharit Tiloklurs reef094@hotmail.com Wiroj Wannapira nomail@helplis.org Suthichart Mongkhol nomail@helplis.org <p>Antibiotic-resistant bacteria has long been a serious health problem for Thai population. The main<br>cause is the excessive use of antibiotics. Having an appropriate treatment option is the ideal solution for<br>both patients and their providers. This survey study was to investigate the effects of Andrographis paniculata<br>in patients with upper respiratory tract infections (URI) in primary care three clusters network, Buddhachinaraj<br>Phitsanulok Hospital. In 120 patients with URI were studied from November 2019 to January 2020.<br>The research tool was questionnaire. The data were presented as frequency, percentage, mean and<br>standard deviation. The results from taking Andrographis paniculata for five days was 60.0%. After following<br>treatment for seven days found that cured rate was 58.4%, incurred rate was 40.8%. Coughing symptom<br>was the most frequency, 63.3%. For patients who did not heal and change the treatment, they were found<br>to continue treatment at the clinic, bought antibiotics from grocery stores and drugstores 28.6%, 22.4%,<br>and 14.3% respectively. In conclusion, Andrographis paniculata is suitable herb for URI. The knowledge<br>and understanding should be created for the public to be widely used in order to reduce the use of inappropriate<br>antibiotics.</p> 2021-01-25T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247318 Monitoring of Adverse Drug Reactions in Patients Receiving 2 types of RAS Blockage (ACEI/ARB) in the Treatment of Hypertension 2021-01-27T10:45:19+07:00 Wanida Khanadnid wanida_knt@hotmail.com <p>The combination of Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor<br>Blockers (ARBs) in hypertension treatment is one of indicators in hospital project promotes Rational Drugs<br>Use. The hypertensive treatment guidelines in general practice 2019 does not recommend combination<br>of ACEIs and ARBs because of increasing risk of adverse drug reactions. This research was to compare<br>occurrence of hyperkalemia in patients receiving ACEIs and ARBs compared with patients receiving only one<br>group of ACEIs or ARBs. Medical records database was collected, most of patients were female (49.6%),<br>older than 70 years (51%). About half (52.2%) of patients treated with ACEIs and ARBs had hypertension<br>alone while 35% of patients who received ACEIs had chronic kidney disease with hypertension and 52.9%<br>of patients receiving ARBs had chronic kidney disease with hypertension. About four-fifths of three groups<br>of patients had normal blood potassium levels. However, combination of ACEIs and ARBs group had one<br>quarter of incidence of mild hyperkalemia. Therefore, median of serum potassium levels in three groups<br>were not different. Patient's comorbidity and drug contraindications should be considered for appropriate<br>medication. ACEIs and ARBs should not be used together because of increasing risk of hyperkalemia rather<br>than using one group of ACEIs or ARBs.</p> 2021-01-25T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247319 The Associated Factors for Permanent Cerebrospinal Fluid Shunting in Thalamic Hemorrhage Patients with Intraventricular Extension 2021-01-26T09:35:21+07:00 Warin Yuyangket warinneuro@gmail.com <p>Thalamic hemorrhage with intraventricular hemorrhage may lead hydrocephalus. The surgical<br>treatment of choice is temporary external ventricular drainage and/or permanent cerebrospinal fluid<br>(CSF) shunting. The purpose of this comparative and analytic study from medical records was to<br>determine the associated factors which patients may need permanent CSF shunting procedure. Total of<br>81 patients had thalamic hemorrhage with intraventricular extension undergone surgical treatment at<br>Buddhachinaraj Phitsanulok Hospital between 1st October 2016 and 30th September 2019 were included.<br>The mean age of patients was 63.7 years, 42 patients (51.9%) were men and age less than 60 years<br>were 41 (50.6%). Procedure in 72 patients (88.9%) had temporary external ventricular drainage, permanent<br>CSF shunting in 16 patients (19.8%) and both procedures in seven patients (8.6%). On the first computerized<br>tomography of brain, mean Evans index and Bicaudate index were 0.30 and 0.25 in 33 patients (40.7%)<br>and 49 patients (60.5%) respectively. Thalamic obstruction was found 87.7% and panintraventricular<br>hemorrhage was occurred in most patients (90.1%). Blood leaked in ventricular more than 30 mL in 39 patients<br>(48.1%). In conclusion, the patients who had undergone temporary external ventricular drainage and volume<br>of blood leak in ventricular more than 30 mL are associated factors for permanent CSF shunting</p> 2021-01-25T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247325 Development of Diabetes and Hypertension Screening System with Community Network Participation in Urban Primary Care Cluster 2021-01-26T09:57:05+07:00 Sasitorn Sripotong sasitorn_med@hotmail.com Siriphan Theerakarn nomail@helplis.org Wiroj Wannapira nomail@helplis.org <p>Ministry of Public Health has reformed the NCDs screening model to be congruent for general<br>population and also has developed an effective mechanism of community network participation. This action<br>research was conducted in P-A-O-R principle four step 1) Plan 2) Act 3) Observe 4) Reflect and aimed<br>to develop of diabetes and hypertensive screening system with community network participation between<br>fiscal year 2016-2018 in persons with diabetes and hypertension. Patient aged over 35 years who lived in<br>Phitsanulok Municipality were screened by blood sugar and blood pressure measure. The results of this<br>study showed that the screening system had been developed which increased coverage of screening<br>services and increased proactive screening service in communities both in office hours and out of office<br>hours by the participation of community network. In fiscal year 2016 and 2018 the percentage of receiving<br>blood sugar and blood pressure screening among persons aged over 35 years had increased from 6.3%<br>to 16.6% and from 5.4% to 18.9% respectively. Thus, this development of screening system increases<br>diabetes and hypertension screening rate of people in urban areas.</p> 2021-01-26T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247328 Complications of Cranioplasty Using Autologous Bone Graft versus Synthetic Bone Tissue following Decompressive Craniectomy for Traumatic Brain Injury 2021-01-26T11:53:44+07:00 Anecha Poolsawat drblackjack@hotmail.com Ekkapot Jitpun nomail@helplis.org <p>Decompressive craniectomy is the essential surgical procedure to reduce intracranial pressure and<br>decrease mortality rate of the patients. Frontoparietotemporal craniectomy defect after wide decompressive<br>craniectomy was replaced with cranioplasty at the proper time. The purpose of this study was to compare<br>complication rates of cranioplasty between using autologous bone graft versus synthetic bone tissue<br>(polymethyl methacrylate: PMMA) in decompressive craniectomy patients. This retrospective study<br>was including skull defect patients from decompressive craniectomy in the Buddhachinaraj Phitsanulok<br>Hospital between July, 2013 to June, 2019. Ninety-one patients were included, 31 (34.1%) patients in<br>autologous bone graft group and 60 (65.9%) patients in synthetic bone tissue group. The overall<br>complication rate was statistically different in autologous bone graft group (8 patients out of 31: 28.5%)<br>compared with the synthetic bone tissue group (3 patients out of 60: 3%). There was higher rate of surgical<br>site infection in autologous bone flap group (6 patients: 19.3%) than synthetic bone tissue group (2 patients:<br>3.3%), which was also statistically different. In conclusion, cranioplasty using autologous bone graft shows<br>higher complications and rate of infection statically significant than synthetic bone tissue</p> 2021-01-26T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247329 Treatments of Common Cancers in Elderly Patients 2021-01-26T12:16:12+07:00 Thapana Trakoolsirisak meen_meen_15@hotmail.com Teerayuth Namkanisorn nomail@helplis.org <p>Cancer is the disease characterized by uncontrolled growth of abnormal cells in the body. Cancer<br>cells can spread to surrounding tissues and adjacent organs. It is the second leading cause of death globally,<br>accounting for an estimated 9.6 million deaths in 2018. Since cancer is more common in elderly patients,<br>who are different from the younger patients in the sense of side effects caused by cancer treatment, the<br>selection of treatment in this age group is significant. The treatment of cancer in elderly patients should<br>require screening tools and comprehensive geriatric assessment. According to Prapokklao Hospital-based<br>Cancer Registry from 2015-2019, the top three cancers in men aged 60 and older were lung cancer, liver<br>cancer and colorectal cancer, respectively. For women, the top three cancers were breast cancer, colorectal<br>cancer and lung cancer, respectively. In this article, we reviewed samples of screening tools and treatments<br>of common cancers in the elderly patients consisted of lung cancer, colorectal cancer, breast cancer and liver<br>cancer</p> 2021-01-26T00:00:00+07:00 Copyright (c) https://he01.tci-thaijo.org/index.php/BMJ/article/view/247330 The Role of Peer in Assisting Their Friends with Adolescent Depression 2021-01-26T12:29:04+07:00 Rawipat Pullarp aladinny@gmail.com Archin Songthap nomail@helplis.org <p>Depression is an increasing psychological problem in adolescents which causing violent behavior,<br>learning problem, emotional disorders, use of drugs, and finally leading to suicide. This article is intended to<br>show the importance of the role of friends in helping their friends with depression by using the MAST principle<br>(M: Monitor, A: Activity, S: Support, T: Treatment). According to the MAST which is presented information<br>about 1) the role of friends to help observing and monitoring depression (Monitor), 2) the role of friends in<br>promoting physical and mental activities (Activity), 3) the role of friends in supporting friends (Support),<br>and 4) the role of friends to encourage friends to receive treatment (Treatment). The adolescents are<br>those who have physical, emotional and social changes. These are the risk factors in depression. Since the<br>symptoms may be similar to general sad emotions which is difficult to notice. Therefore, they are unable to be<br>helped immediately. Moreover, the important problem is inaccessibility to adolescents with depression. Therefore,<br>the role of friends is important in supporting and influence their friends in various aspects more than others.<br>Including, the friends could notice, monitor, do the activities together, encourage each other, and support<br>friends to receive treatment. These contribute to those who have depression feel more self-valued and<br>continue living with the happiness</p> 2021-01-26T00:00:00+07:00 Copyright (c)