Biomedical Sciences and Clinical Medicine https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ <table style="table-layout: fixed;" border="0" width="100%" cellspacing="0" cellpadding="0"> <tbody> <tr> <td class="ST09" valign="top" width="60" height="30"> <p style="font-size: 12px;">Welcome to the Biomedical Sciences and Clinical Medicine (BSCM). It is with great pleasure that I invite you to explore our journal, where we are committed to fostering a culture of inclusivity and scientific excellence. At BSCM, our mission is to advance biomedical knowledge and clinical practice. We are dedicated to bridging the gap between research and clinical application, ensuring that innovative discoveries translate into practical benefits for patients and healthcare systems worldwide. Our journal serves as a hub for multidisciplinary collaboration, bringing together researchers, clinicians, and scholars from around the world. Here, groundbreaking research and pioneering ideas are exchanged, driving forward the progress of medical science.</p> <p style="font-size: 12px;">We are proud to have achieved international recognition, with BSCM now indexed in the SCOPUS database, including all manuscripts from 2022 onwards. We currently have over 64 documents indexed in SCOPUS, covering issues from Vol. 61 No. 1 (2022) to the present. In response to the growing number of high-quality submissions, we have increased the number of articles published per issue from 6 to 8. Additionally, we have updated our Editorial Team for the 2024-2027 term, bringing together esteemed professionals whose expertise and dedication are integral to advancing the fields of biomedical and clinical sciences. There insights and commitment will undoubtedly enhance the scholarly impact of BSCM.</p> <p style="font-size: 12px;">I warmly invite you to consider submitting your work to BSCM. We welcome original articles, review articles, case reports, and short communications. Even brief laboratory work that offers significant new findings is valued. Whether you are an experienced practitioner, an innovative researcher, or someone eager to explore the frontiers of medical knowledge, we extend a warm invitation to join us on this enlightening journey. Please take note of our updated “Submission Checklist” in the Author Guidelines to ensure your manuscript meets our standards. </p> <p style="font-size: 12px;">Thank you for your interest in BSCM. We look forward to your continued support and contribution to the ever-evolving landscape of biomedical and clinical research.</p> </td> <td class="HL10" width="5"> </td> <td class="ST07 " valign="Top" width="30" height="30"> <p><img src="https://he01.tci-thaijo.org/public/site/images/cmmj_medcmu2/bscm-cover-for-web-issn-01-2e4b55ddf320ce72403844d1346a6343.jpg" alt="" width="213" height="301" /></p> </td> </tr> </tbody> </table> <table> <tbody> <tr> <td style="font-size: 12px;" colspan="2"><strong>Biomedical Sciences and Clinical Medicine (BSCM)</strong></td> </tr> <tr> <td style="font-size: 12px;"><strong>Journal Abbreviation:</strong></td> <td style="font-size: 12px;">Biomed. Sci. Clin. Med.</td> </tr> <tr> <td style="font-size: 12px;"><strong>Online ISSN:</strong></td> <td style="font-size: 12px;">2774-1079</td> </tr> <tr> <td style="font-size: 12px;"><strong>Start year:</strong></td> <td style="font-size: 12px;">2022 Biomedical Sciences and Clinical Medicine, Current name</td> </tr> <tr> <td> </td> <td style="font-size: 12px;">2010 Chiang Mai Medical Journal, old name</td> </tr> <tr> <td> </td> <td style="font-size: 12px;">1961 Chiang Mai Medical Bulletin, old name</td> </tr> <tr> <td style="font-size: 12px;"><strong>Language: </strong></td> <td style="font-size: 12px;">English</td> </tr> </tbody> </table> <p style="font-size: 12px;"> </p> <p><img src="https://he01.tci-thaijo.org/public/site/images/cmmj_medcmu2/s--35389477-de7b01b01b00898657a612eab674218b.jpg" alt="" width="200" height="199" /></p> <p style="font-size: 12px;"><strong>Editor-in-Chief:</strong> <a href="https://www.scopus.com/authid/detail.uri?authorId=6602093623" target="_blank" rel="noopener">Pornngarm Dejkriengkraikul, Ph.D.</a> <br />Professor, Faculty of Medicine, Chiang Mai University, Thailand</p> Biomedical Sciences and Clinical Medicine, Faculty of Medicine, Chiang Mai University en-US Biomedical Sciences and Clinical Medicine 2774-1079 Calcium Distribution Patterns of the Aorta as Predictors of Significant Coronary Artery Disease in Patients with Moderate to Severe Aortic Stenosis https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/268734 <p style="font-weight: 400;"><strong>OBJECTIVE</strong> Computed tomography (CT) of the aortic valve and aorta has gained a greater role in planning for aortic valve replacement (AVR). However, when AVR is planned, invasive coronary angiography remains the standard investigation. Whether the calcium distribution pattern in the aorta predicts the significant presence of coronary artery disease (CAD) in patients undergoing AVR remains unclear. This study evaluated the correlation between the calcium distribution pattern from the CT aorta to predict significant CAD in patients with symptomatic moderate to severe aortic stenosis undergoing AVR.</p> <p style="font-weight: 400;"><strong>METHODS </strong>This retrospective study included candidates for AVR either with transcatheter replacement (TAVR) or surgical replacement (SAVR) at a single tertiary-care center between 2017 and 2022. The calcium distribution patterns from the left ventricular outflow tract up to the descending aorta were analyzed from the non-contrast CT of the aorta. Significant CAD was identified from invasive coronary angiography and was defined as 50% diameter stenosis (DS) of the left main and 70% DS of the proximal left anterior descending artery. Multivariate logistic regression analysis was performed to identify the calcification pattern associated <br />with the significant CAD.</p> <p style="font-weight: 400;"><strong>RESULTS </strong>In total, 110 patients were included in the analysis. Among them, 40 patients (36.4%) were candidates for TAVR, while 70 patients (63.6%) were candidates for SAVR. The prevalence of significant CAD was 12.7%. Baseline characteristics were similar between patients with and without CAD, with the exception of a higher prevalence of chronic kidney disease in the CAD group (42.9% vs. 19.8%, <em>p</em> = 0.01). The presence of calcium at the ostium of the coronary artery and descending aorta was an independent predictor of significant CAD (OR 3.44, 95% CI1.30-9.10, <em>p</em> = 0.01 and OR 12.03, 95% CI 1.14-126.84, <em>p</em> = 0.04).</p> <p><strong>CONCLUSIONS </strong><span style="font-weight: 400;">This pilot study showed that calcium at the ostium of the coronary artery and descending aorta from non</span><span style="font-weight: 400;">-</span><span style="font-weight: 400;">contrast CT aorta was associated with significant CAD in patients with moderate to severe AS</span><span style="font-weight: 400;">. </span><span style="font-weight: 400;">Further study with more subjects be needed to confirm the findings</span><span style="font-weight: 400;">. </span></p> Tasalak Thonghong Sivayos Deetes Pannipa Suwannasom Srun Kuanprasert Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2025-02-02 2025-02-02 64 1 1 11 Correlation between the Nutrition Alert Form (NAF) and the Mini Nutritional Assessment Short-Form (MNA-SF) in Hip Fracture Patients https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/271261 <p><strong>Objective</strong> Malnutrition in hip fracture patients can lead to poorer outcomes. The Mini Nutritional Assessment Short-Form (MNA-SF) is a <br />reliable tool for identifying malnutrition risk. This study aimed to assess the correlation between the Nutrition Alert Form (NAF) and MNA-SF, using either body mass index (BMI) or calf circumference (CC) scores, in adult inpatients with hip fractures. Additionally, the study sought to correlate NAF scores with other nutrition parameters and comorbidities.</p> <p><strong>Methods </strong>A cross-sectional study was conducted at Khon Kaen Hospital, involving hip fracture patients. Spearman’s rank correlation coefficient (r) was utilized for analysis, with the NAF including patient-directed questions and either BMI (NAF-BMI) or total lymphocyte count (NAF-TLC) when BMI data were unavailable.</p> <p><strong>Results </strong>A total of 152 patients were included in the analysis. The mean age was 68.0±16.7 years, with 31.6% being male. Mean body weight and BMI were 55.1±11.9 kg and 22.2±3.8 kg/m², respectively. MNA-SF (BMI) and MNA-SF (CC) identified 44.1% and 79.6% of patients, respectively, as at-risk for malnutrition, while NAF-BMI and NAF-TLC identified 27.6% and 40.1%, respectively. Moderate correlations were observed between NAF-BMI and MNA-SF (BMI) (r = - 0.57, <em>p</em> &lt; 0.05) and MNA-SF (CC) (r= - 0.58, <em>p</em> &lt; 0.05). NAF-BMI, NAF-TLC and MNA-SF (CC) were also moderately correlated with the Charlson Comorbidity Index.</p> <p><strong>Conclusions </strong>NAF-BMI and NAF-TLC are both effective screening tools for identifying malnutrition risk in hospitalized hip fracture patients, demonstrating good correlation with MNA-SF as established nutrition screening tools. </p> <p> </p> Chanita Unhapipatpong Teppitugs Punsiha Kittipong Sessumpun Kanokarn Chupisanyarote Narachai Julanon Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2024-12-26 2024-12-26 64 1 12 22 Predicting Hospital Admission of Patients at Triage in the Emergency Department at Lampang Hospital https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/271159 <p><strong>Objective</strong> This study aims to develop a model that can help predict the likelihood of hospital admission for patients at the triage point in Lampang Hospital’s Emergency Department.</p> <p><strong>Methods </strong>The study was designed around Clinical Prediction Rules and was conducted as a retrospective cohort study using data from July 2021 to January 2022 input through the Smart ER program. Patients were categorized into two groups: admit and discharge. Statistical <br />analysis involved both univariable and multivariable logistic regression analyses, presenting discrimination values with area under the receiver operating characteristic (AUROC), testing precision with a calibration plot, analyzing internal validation using the Bootstrapping method, and creating a risk curve to find the balanced cutoff point. The study then divided the predictions into one of three groups: Admit, Consult, and Discharge. Decision curve analysis (DCA) was performed and an application was developed and integrated into the Smart ER program for real- time analysis.</p> <p><strong>Results </strong>Out of 37,474 patients screened, 18,056 were excluded leaving 19,418 patients eligible for complete case analysis. Predictors of hospital admission included age, emergency level, vital signs, mode of hospital arrival, and prominent symptoms according to criteria-based dispatch (CBD) (criteria-based dispatch). The Admission Model showed an AUROC of 0.8934 (95% CI, 0.8890-0.8980); the calibration plot demonstrated that predicted values closely matched actual observed values; internal validation using the Bootstrapping method yielded a C-statistic of 0.8920 (95% CI, 0.888-0.895); and the balanced risk curve indicated over admission at 3.8% and over discharge at 3.7%.</p> <p><strong>Conclusions </strong>The Admission Model provides high AUROC and precision values. The model’s three-group division is likely to be beneficial in practical application. </p> Noppadon Seesuwan Thanin Lokeskrawee Suppachai Lawanaskol Jayanton Patumanond Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2024-12-18 2024-12-18 64 1 23 32 Feasibility of Large Multi-Leaf Collimator in Stereotactic Radiosurgery/Stereotactic Radiotherapy: A Single Center Experience https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/271545 <p><strong>Objective</strong> This study investigated the feasibility of using a large multi- leaf collimator (MLC) in a C-arm based linear accelerator for stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT).</p> <p><strong>Methods </strong>Patient Specific Quality Assurance was conducted on 69 patients treated with a single lesion SRS/SRT measuring dose distribution using patient-specific plans with SRS MapCHECK<sup>®</sup>. Statistics were used to analyze the significance of correlation among dosimetric parameters, included Conformity Index (CI), Gradient Index (GI), plan complexity, and Gamma passing rate (GPR) in an absolute dose (AD) and relative dose (RD). confidence limit (CL) was also calculated to evaluate the performance of a large multileaf collimator (MLC) in SRS/SRT.</p> <p><strong>Results </strong>Planning target volumes (PTVs) ranged between 0.34 cm<sup>3</sup> and 30.42 cm<sup>3</sup>. The study found a value of CI<sub>ICRU</sub>, CIPaddick, and GI of 1.29 ± 0.17, 0.77±0.10 and 5.24±2.18 (mean±SD), respectively, significant correlations were found between PTV sizes and dosimetric parameters. Values of GPR<sub>2</sub><sub>%/</sub><sub>2mm</sub> were 92.42±3.74 (AD), 96.38±3.24 (RD), whereas GPR<sub>2</sub><sub>%/</sub><sub>1mm </sub>were 82.03±6.69 (AD), 89.64±7.26 (RD). No significant correlation was found between plan complexity and GPR. CL values were 85.09% (AD), 90.03% (RD) for GPR<sub>2</sub><sub>%/</sub><sub>2mm</sub> and 68.92% (AD), 75.41% (RD) for GPR2<sub>%/</sub><sub>1mm</sub><sub>.</sub> </p> <p><strong>Conclusions </strong>This study assessed the feasibility of using a large MLC for a single lesion SRS/SRT across various PTV sizes. The values of CI and GI decreased for a small lesion. While the large MLC performed adequately across different PTV sizes, the CL value of RD GPR at 2%/1 mm fell below 90%. This indicates that the contribution of PTV margin might be consi-dered for a large MLC in SRS/SRT</p> Akanit Chaiyapong Anirut Watcharawipha Wannapha Nobnop Anupong Kongsa Bongkot Jia-Mahasap Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2024-12-16 2024-12-16 64 1 33 43 A Diagnostic Clinical Prediction Rule for Predicting Hip Subluxation/ Dislocation in Patients with Cerebral Palsy https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/271488 <p><strong>Objective</strong> Hip subluxation/dislocation, a common problem in patients with cerebral palsy (CP), needs to be diagnosed with hip radiography. However, patients with cerebral palsy in a rural or country border areas may not have access to a radiographic screening program due to transportation difficulties and cost. This study aims to develop a clinical prediction rule (CPR) for diagnostic prediction of hip subluxation/dislocation in patients with CP for use as a risk-screening tool.</p> <p><strong>Methods </strong>This is a cross-sectional diagnostic CPR development study. Data were obtained from medical and radiologic records of patients with CP who had undergone outpatient follow-up at a 750-bed general hospital between January 2017 and December 2023. Clinical predictive factors were medical records plus hip subluxation/dislocation diagnoses using the migration percentage (MP), with ≥ 33% indicating hip subluxation and ≥ 90% indicating hip dislocation. Multivariable logistic regression analysis was used for choosing predictive variables and rating their coefficient. Both discriminative and calibration aspects of the performance of the CPR were evaluated using both a development and an internal validity model.</p> <p><strong>Results </strong>Among the 69 patients with CP in the study, the mean (SD) age was 113 (242) months. Of the 69 patients, 30 were diagnosed with hip subluxation/dislocation, a prevalence of 43%. Using multivariable logistic regression analysis, a simple CPR performance calibration system was <br />developed which included three factors: age ≥ three years (1 point), female sex (1 point), non-ambulatory status (Gross Motor Function Classification System (GMFCS) levels IV and V) (2 points). The discriminative ability of the CPR, evaluated using the area under the receiver operating characteristic curve (AuROC), was 0.776 (95%CI: 0.668-0.884) and the calibration curve showed acceptable performance in both the development and the internal validation models.</p> <p><strong>Conclusions </strong>Our diagnostic CPR for predicting hip subluxation/dislocation in patients with CP provides acceptable discriminative and calibration performance. This CPR may be used to evaluate the risk of hip subluxation/dislocation in settings where hip radiography is not available. Further external validation studies are needed to confirm the robustness of the performance before applying this CPR in other clinical settings. </p> Atcharee Kaewma Sintip Pattanakuhar Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2024-12-23 2024-12-23 64 1 44 53 Detection of JunB and C-FLIP Psoriasis Genes Using the Reverse Transcriptase in-situ PCR Technique https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/268737 <p><strong>Objective</strong> Psoriasis is a chronic skin disease and considered a multifactorial condition as it is caused by several risk factors; including genetic and environmental interactions. This study aimed to examine localization the expression of <em>JunB </em>and <em>c</em><em>-</em><em>FLIP </em>psoriasis genes at the mRNA cellular level using reverse transcriptase <em>in</em><em>-</em><em>situ</em> PCR (<em>in</em><em>-</em><em>situ</em> RT-PCR).</p> <p><strong>Methods </strong>The <em>in</em><em>-</em><em>situ </em>RT-PCR technique was used to amplify the targeted mRNA from the formalin-fixed and paraffin-embedded tissues of three psoriasis patients. The localization of <em>JunB </em>and <em>c</em><em>-</em><em>FLIP </em>mRNA expression was achieved using <em>in</em><em>-</em><em>situ </em>RT-PCR along with the immunodetection technique. An immunohistochemistry profiler was used to count the pixels including the percentage contributions.</p> <p><strong>Results </strong>Hematoxylin and eosin staining revealed the presence of parakeratosis, acanthosis, spongiosis and inflammatory cells. The staining analysis outcomes from <em>in</em><em>-</em><em>situ </em>RT-PCR and immunohistochemistry detection showed that the <em>c</em><em>-</em><em>FLIP </em>genes and <em>JunB </em>genes were significantly expressed in the surrounding nucleus area at the cellular level of the psoriasis tissue. <em>JunB </em>and <em>c</em><em>-</em><em>FLIP </em>mRNA scored positively in the the immunohistochemical analysis.</p> <p><strong>Conclusions </strong>RT <em>in</em><em>-situ </em>PCR can be a tool for identifying mRNA cellular gene expression. <em>JunB </em>and <em>c</em><em>-FLIP </em>gene expression are significantly present in psoriasis. </p> Mohd Nazil Salleh VASUDEVAN RAMACHANDRAN Henkie Isahwan Ahmad Mulyadi Lai Siti Aminah Ismail Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2025-01-15 2025-01-15 64 1 54 62 The Relationship between Hyperuricemia and Anemia in Postmenopausal Korean Women https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/271857 <p><strong>Objective</strong> The present study was conducted to assess the association of hyperuricemia and anemia in premenopausal and postmenopausal Korean women.</p> <p><strong>Methods</strong> Data from 9,239 adults (aged ≥ 20 years) in the Korean National Health and Nutrition Examination Survey VII (2016–2018) were analyzed.</p> <p><strong>Results</strong> After adjustment for related variables (including age), the odds ratio (OR) of hyperuricemia (uric acid [UA] &lt; 6.0 mg/dL), using the normal group (hemoglobin [Hb] ≥ 12.0 g/dL) as a reference, was statistically significantly positively associated with the anemia group (Hb &lt; 12.0 g/dL) in postmenopausal women (OR, 1.615; 95% CI, 1.187–2.198). In premenopausal women, after adjustment for the related variables (except age), the OR of hyperuricemia, with a normal group as a reference, was significantly inversely associated with the anemia group (OR, 0.583; 95% CI, 0.348–0.975). However, with further adjustment for age, hyperuricemia was no longer associated with anemia (OR, 0.679; 95% CI, 0.402–1.148).</p> <p><strong>Conclusions</strong> Hyperuricemia is positively associated with anemia in postmenopausal women but not in premenopausal women. </p> Hyun Yoon Sun Gyu Kim Mi Young Gi Ju Ae Cha So Young Park Cho Hee Park Hyun Ho Sung Eun Sook Han Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2024-12-16 2024-12-16 64 1 63 72 Validity and Internal Consistency of the Thai Version of a Revised Skin Management Needs Assessment Checklist in People with Spinal Cord Injury: Initial psychometric studies https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/270708 <p style="font-weight: 400;"><strong>OBJECTIVE</strong> This study aims to cross-culturally translate the revised Skin Management Needs Assessment Checklist (revised SMnac) into Thai (revised SMnac-TH), to evaluate its content validity and internal consistency and to determine the relationship between the revised SMnac-TH score and the occurrence of pressure injuries.</p> <p style="font-weight: 400;"><strong>METHODS </strong>The study design is a descriptive cross-sectional study. It was conducted at the Inpatient and Outpatient Rehabilitation Medicine Department of Maharaj Nakorn Chiang Mai Hospital, involving one hundred twenty-five Thai people age &gt; 18 years old with spinal cord injury. The French version of the revised SMnac was translated into Thai following the standard guidelines for translation and cross-cultural adaptation. The content validity was evaluated by six experts in rehabilitation medicine. Each of the participants completed the revised SMnac-TH. The internal consistency was measured using Cronbach’s alpha coefficient. Logistic regression analysis was used to evaluate the relationship between the revised SMnac-TH score and the occurrence of pressure injuries.</p> <p style="font-weight: 400;"><strong>RESULTS </strong>The index of item-objective congruence (IOC) of each item ranged from 0.83-1.00. The Cronbach’s alpha coefficient of the questionnaire was 0.923. The logistic regression analysis showed no correlation between the revised SMnac-TH score and the occurrence of pressure injuries.</p> <p style="font-weight: 400;"><strong>CONCLUSIONS </strong>The revised SMnac-TH demonstrated high content validity and internal consistency. It proves to be a useful tool for evaluating pressure injury-related knowledge and skin protective behaviors among Thai individuals with spinal cord injury. </p> <p><strong> KEYWORDS </strong> pressure injury, spinal cord injury, patient education</p> Chutimon Soonthornthum Paksupa Prommueang Siam Tongprasert Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2025-01-16 2025-01-16 64 1 73 80 Endoscopic Placement of Sengstaken-Blakemore Tube Effectively Reduces Esophageal Rupture Resulting from Tube Malposition: A Propensity Score Analysis https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/273432 <p><strong>Objective</strong> This study aimed to evaluate the effectiveness of endoscopically assisted Sengstaken-Blakemore tube placement in reducing the tube malposition rate and resulting complications.</p> <p><strong>Methods </strong>Data was collected on 45 patients with massive esophageal variceal bleeding who underwent Sengstaken-Blakemore tube placement between January 2011 and December 2017 at our institute. This retrospective study compared the malposition rate, complication rate, and treatment outcome between the conventional blind technique (n = 28) and the endoscopically assisted technique (n = 17), using propensity score analysis to account for differences in baseline characteristics.</p> <p><strong>Results </strong>The rate of malpositioning of the Sengstaken-Blakemore tubes was significantly higher in the conventional blind technique group, while there were no incidents of malpositioning in the endoscopically assisted technique group (25% vs. 0%; <em>p</em> = 0.034). All cases of tube malpositioning in the conventional blind technique group resulted in esophageal perforation, while no perforation occurred in the endoscopically assisted group. The propensity score analysis showed that endoscopic placement was significantly better than the conventional method for esophageal rupture (adjusted RR = 0.78, 95% CI = 0.68–0.91, <em>p</em> = 0.002), but not significantly better for death rate (adjusted RR = 0.68, 95% CI = 0.38–1.21, <em>p</em> = 0.186).</p> <p><strong>Conclusions </strong>Endoscopic-assisted Sengstaken-Blakemore tube placement can effectively reduce esophageal ruptures resulting from tube malpositioning. </p> Suwan Sanmee Sirikan Limpakan (Yamada) Wasana Ko-iam Bandhuphat Chakrabandhu Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0/ 2024-12-26 2024-12-26 64 1 81 89