Krabi Medical Journal

Prevalence of Maxillofacial Injuries in Krabi Hospital: An 14 year Retrospective Study

pansak sansappan — Fri, 17 Jan 2025 00:00:00 +0700

This research is a retrospective study conducted on a sample group of 979 patients with jaw and facial bone injuries who received treatment at Krabi Hospital from January 1, 2009, to December 31, 2022. The research instruments included general patient information forms, data on injury causes, treatment details, surgical information, and hospital stay duration records from the Department of Oral and Maxillofacial Surgery at Krabi Hospital. Descriptive data analysis was employed using various statistical methods, including frequency, percentage, mean, standard deviation, median, minimum, and maximum values. The Chi-square test was used to analyze the relationship.

Demographics: The majority of patients were male (70.7%). The most common age group was 11-20 years (26.5%), followed by 21-30 years (23.9%). The primary occupation was laborers (42.4%). Injury Causes: The leading cause was motorcycle accidents (71.9%), especially in Mueang Krabi District area, followed by physical assault (9.5%). Injury Locations The most common injury site was the mandible (30.7%), followed by the zygomatic bone (25.2%). The most frequent mandibular fracture site was the Para symphysis region (54.3%).Treatment Methods: Treatments included dental splinting (33.6%) and surgical metal plate fixation (20.5%). Hospital Stay Duration: The majority of patients stayed in the hospital for 1-5 days (54.3%). There was a statistically significant relationship between the locations of jaw and facial bone injuries and hospital stay duration (p<0.001).

Community Mobilization for Road Traffic Injury Management in the Ban Nam Tai Bo Community, Ban Na Sub-district, Srinakarindra District, Phatthalung Province

Mon, 20 Jan 2025 00:00:00 +0700

This research was a participatory action research aimed to promote and develop the participation of community leaders for road traffic injury management in the Ban Nam Tai Bo community, to evaluate the community participation of leaders for road traffic injury management, and to evaluate the safe driving behavior of people in the community, including driving backwards and wearing helmets of people in the Ban Nam Tai Bo community. Ban Na Sub-district, Srinakarindra District Phatthalung Province before and after the operation. The sample in this study were 24 community leaders and 53 household representatives. The intervention took for 3 months, using questionnaire data and collected using descriptive statistics such as number, percentage, mean, standard deviation, and using inferential statistics such as Wilcoxon signed-ranks test and Paired Sample Test statistics.

The results showed that after the implementation of the participation of community leaders in road accident management, it was better than before the implementation. Statistically significant (p <0.001) After the implementation of the driving behavior, the driving behavior was better than before the implementation p < 0.001) and the behavior of wearing a helmet was found to be statistically significant (p < 0.001). Suggestions should be based on a community-based participatory process. There were continuous monitoring, evaluation and reflection of information on actions by community members in managing road accidents on their own and empowering them to modify safe driving behavior.

Healthy Public Policy Implementation Evaluation: A Case Study of Mobilizing the Organic Rice Development Strategy in Phatthalung Province

Mon, 20 Jan 2025 00:00:00 +0700

Evaluation of the mobilizing of the organic rice development strategy in Phatthalung province was a research and evaluation. It was an evaluation of the implementation phase. The population in this research conducted research in the leading group for mobilized the organic rice strategy in Phatthalung province. The selection criteria are those who participate in mobilized the organic rice strategy. This study aimed to evaluate the implementation of the organic rice development policy, and evaluate the effectiveness of the organic rice development strategy of Phatthalung Province. The population in this research conducted research in the leading group in Mobilized the organic rice strategy in Phatthalung Province. Collected data by observation, group discussions, semi-structured interviews, in-depth interviews, and questionnaires. The data were analyzed quantitatively with descriptive statistics and inferential statistics such as Spearman's correlation coefficient, and point biserial correlation coefficient. The qualitative data used content analysis.

As the results, shown that the mobilized of the strategic plan of organic rice in Phatthalung province The Organic Agriculture Strategic Plan was announced and driven. Ecotourism and community lifestyle were the trend of alertness and interested in health has resulted in an increase in consumer demand. A committee was appointed to drive and the progress of the implementation was monitored through a meeting of the heads of government departments of the province. There was coordination between the agencies responsible for driving. There was a more qualitative and standardized development process of farmer groups. Farmer enterprises were more interested and alert. There was a trend of organic farming, conscious agriculture, and merit agriculture, and the group of rice farmers has expanded and was interested in organic farming. More organic rice. Farmers see more health and well-being benefits. The level of participation in the development of the organic rice development strategy was statistically significant. (rsm = 0.523, p < 0.05). The number of support agencies in driving the development of organic rice into practice is statistically significant. (rsm = 0.491, p < 0.05), and implementation of the organic rice development strategic plan (rsm = 0.496, p < 0.05), and the implementation of the Organic Rice Development Strategic Plan (rsm = 0.496, p < 0.05), and the recognition of the organic rice development strategy were statistically significant (rsm = 0.771, p < 0.05). The proposal to drived the development of organic agriculture in a spatially integrated manner in terms of production, yield management, processing, marketing, and consumption, and there should be a policy to create a safe organic agriculture logo in Phatthalung Province.

Efficacy of intravenous nalbuphine on spinal morphine prevention pruritus after Caesarian delivery

Worapun Rittidet — Mon, 20 Jan 2025 00:00:00 +0700

The purpose of this research was to study the Efficacy of intravenous nalbuphine on spinal morphine prevention pruritus after Caesarian delivery. The sample consisted of 120 elective Caesarian patients; receive 0.2 mg spinal morphine, 3 mg intravenous nalbuphine prevention pruritus after Caesarian delivery. Collection data were retrospective Caesarian section chart review from October to December 2023, Use the pruritus assessment form. Reliability of the tools was tested using Cronbach’s alpha coefficient yielding values of 0.89 respectively. Data were analyzed using descriptive, frequency statistics, percentage, mean, standard deviation and Pearson’ s Product Moment Correlation.

The results of this study revealed as follows : The majority of the sample group was 26-30 years old (45.83%), 53.33% weighed 70-80 kilograms. 72.5% the surgery period was 30-45 minutes, 42.5% received Nalbuphine after 5-10 minutes of spinal morphine and 40.83% followed by 11-15 minutes. 78.33% pruritus after Caesarian delivery to epidural morphine > 12 hours and 15.83% followed by < 6 hours. 98.33% pruritus on the face and body. the severity of itching was level 1(53.33%) and 46.67% there was no pruritus at all and 98.33% no medication was required to relieve itching. There were no complications from the use of Nalbuphine(98.33%). Nausea and vomiting after surgery were reported in 1.67 percent. Correlation analysis Weight and duration of intravenous nalbuphine administration after spinal morphine were found to have a statistically significant positive relationship with itch severity at a high level (r = 0.910 and 0.801).

Conclusion: weight and duration of intravenous nalbuphine administration after spinal morphine are related to the severity of pruritus.

Comparison of HARMS2-AF score and CHA2DS2-VASc score in prediction of postoperative atrial fibrillation after non- cardiac surgery

Marut Thongpan — Fri, 03 Jan 2025 00:00:00 +0700

Presence of postoperative atrial fibrillation (POAF) is associated with increased morbidity and mortality. However, prediction of POAF is limited. We sought to determine whether HARMS₂-AF score and CHA₂DS₂-VASc score was of any predictive value in risk of POAF in patient underwent non-cardiac surgery. We conducted a retrospective study including adult patients in sinus rhythm who underwent non-cardiac surgery and were subsequently admitted to the intensive care unit (ICU) between January 1, 2022, and December 31, 2023. All patients had been continuously monitored with ECG at least 24 hours. Comparison of the efficacy of the HARMS₂-AF score with the CHA₂DS₂-VASc score in predicting postoperative atrial fibrillation is the primary outcome of this study. Logistic regression analysis was performed with HARMS₂-AF score and CHA₂DS₂-VASc score. ROC curve was utilized to assess predictor of POAF. Secondary outcomes were incidence of ischemic stroke, myocardial infarction, arterial thromboembolism or death within 90 days after surgery.

One hundred and seventy-two patients developed POAF (21 of 172 patients, 12.2%). CHA₂DS₂-VASc score showed higher predictive value comparison to HARMS₂-AF score (AUC 0.79 versus 0.616, respectively p=0.02) and patients with CHA₂DS₂-VASc score ≥ 3 had 8.29 times increased risk of POAF(sensitivity 71.4%, specificity 76.8%). The composite outcome of ischemic stroke, myocardial infarction, arterial thromboembolism, or death within 90 days was significantly higher in the POAF group (38% vs. 26%), underscoring the clinical significance of postoperative atrial fibrillation.

CHA₂DS₂-VASc score is better than HARMS₂-AF score in prediction of POAF after non-cardiac surgery and the CHA₂DS₂-VASc score is easily for identifying patients at high risk for postoperative atrial fibrillation.

The Relationship between impostor phenomenon and self-esteem in The Strengthening tract medical students in Naresuan university, Thailand

Kusuma Islam, Chayanut Jittdharm, Rujapha Petcharoen , Research Taksin — Wed, 08 Jan 2025 00:00:00 +0700

The objective of this research was to study the relationship between self-depreciation and self-esteem. of the group of medical students who graduated with a bachelor's degree and took leave to study at Naresuan University. This study was a cross-sectional descriptive research among clinical medical students. Naresuan University. Data were collected using an online questionnaire using a simple random sampling method. Analyze data with ready-made programs using descriptive statistics and inferential statistics, including Chi-square test, Fisher's exact test, and Pearson correlation.

It was found that there were 122 respondents, most of whom had scores in the high risk group of having self-depreciation (88.5%). Higher years had more groups at risk of self-depreciation than those in the lower years. Lower than statistical significance at the .05 level. Self-deprecation and self-esteem were inversely related (r= -.746, P= 0.002). Age was inversely related to self-esteem scores. in oneself (r= -.179, P= 0.048), but varied according to the self-impairment score (r= .197, P= 0.030) with statistical significance.

Guidance activities or educational policies should be implemented. In order to create awareness of self-exploration to understand the problem of self-depreciation.

Effects of Guidelines Discharge Planning on Diabetes Patients Using D-METHOD model at Khien-Sa Hospital

่Jiraporn audoomkitpipat, Putamart Puksuntorn — Wed, 15 Jan 2025 00:00:00 +0700

Abstract

การวิจัยเป็นแบบการวิจัยกึ่งทดลอง มีวัตถุประสงค์เพื่อศึกษาผลการใช้แนวปฏิบัติในการวางแผนการจำหน่าย ผู้ป่วยโรคเบาหวาน ใช้รูปแบบ D-METHOD โรงพยาบาลเคียนซา กลุ่มตัวอย่าง คือ ผู้ป่วยโรคเบาหวาน ที่มารับการรักษาในแผนกผู้ป่วยในโรงพยาบาลเคียนซา อำเภอเคียนซา จังหวัดสุราษฎร์ธานี คัดเลือกแบบเฉพาะเจาะจง จำนวน 30 คน ระหว่างเดือนพฤศจิกายน 2566–มกราคม 2567 เครื่องมือที่ในการวิจัย คือ แนวปฏิบัติการวางแผนจำหน่ายผู้ป่วยโรคเบาหวาน โดยใช้รูปแบบ D-METHOD เครื่องมือเก็บรวบรวมข้อมูล ได้แก่ 1) แบบบันทึกข้อมูลส่วนบุคคลและภาวะสุขภาพ เป็นแบบสอบถามเลือกตอบและเติมคำ 2) แบบทดสอบความรู้เกี่ยวกับโรคเบาหวาน 3) แบบประเมินความพึงพอใจของผู้ป่วยในการบริการที่ได้รับการวางแผนการจำหน่ายผู้ป่วยโรคเบาหวาน โดยใช้รูปแบบ D-METHOD และ 4) แบบประเมินความพึงพอใจของสหวิชาชีพในการใช้แนวปฏิบัติในการวางแผนการจำหน่ายผู้ป่วยโรคเบาหวาน โดยใช้รูปแบบ D-METHOD ผลการวิจัย พบว่า ความรู้โรคเบาหวานก่อนทดลองคะแนนค่าเฉลี่ย 11.45 ส่วนเบี่ยงเบนมาตรฐาน(SD) 0.80 หลังทดลองค่าเฉลี่ย 14.93 ส่วนเบี่ยงเบนมาตรฐาน 0.12 ส่วนต่างระดับความรู้ค่าเฉลี่ยที่เพิ่มขึ้น 3.48 คิดเป็นร้อยละ 100 ความพึงพอใจของผู้ป่วยในการบริการของผู้ป่วยโรคเบาหวาน ค่าเฉลี่ย 4.22 ส่วนเบี่ยงเบนมาตรฐาน 0.48 ความพึงพอใจของสหวิชาชีพ ค่าเฉลี่ย 4.11 ส่วนเบี่ยงเบนมาตรฐาน 0.46 ผลลัพธ์ทางคลินิกในการลดอุบัติการณ์การกลับมารักษาซ้ำในโรงพยาบาลของผู้ป่วยโรคเบาหวาน พบว่า ค่าระดับน้ำตาลในเลือด ก่อนทดลองค่าเฉลี่ย 214.73 หลังทดลองค่าเฉลี่ย 146.83 ค่าเฉลี่ยระดับน้ำตาลในเลือดลดลง 88.37 ระยะเวลาการนอนพักรักษาตัวในโรงพยาบาล ก่อนการทดลองย้อนหลัง 3 ปี ค่าเฉลี่ย 3.45,4.22 และ 3.80 วัน หลังการทดลอง ค่าเฉลี่ย 2.20 วัน และหลังจำหน่ายออกจากโรงพยาบาล 28 วัน ของผู้ป่วยโรคเบาหวานที่ได้รับการใช้แนวปฏิบัติในการวางแผนการจำหน่ายผู้ป่วยโรคเบาหวาน โดยใช้รูปแบบ D-METHOD พบว่าไม่มีอุบัติการณ์การกลับมารักษาซ้ำในโรงพยาบาล(Re-Admit)

การดูแลทารกที่คลอดจากมารดาที่ติดเชื้อไวรัสตับอักเสบบี

Suppamas Punchuey — Fri, 17 Jan 2025 00:00:00 +0700

Physical Therapy treatment on Ischemic stroke : 2 Case study

Chirayoot Tantapakul — Fri, 17 Jan 2025 00:00:00 +0700

This study is based on the fact that stroke patients will suffer from various limitations, especially in performing daily activities after being discharged from the hospital. Physical therapy is therefore very necessary to enable these patients to perform daily activities for a better quality of life.

Physical Therapy treatment on Ischemic study studies of effective on physical therapy treatment in ischemic stroke patients after being discharged from the hospital and receiving physical therapy for 3 months, and to study the outcomes of physical therapy in ischemic stroke patients.

The first patient was a stroke patient with Hypertension, Hyperlipidemia and Heart disease. The second patient was a stroke patient with Hypertension, Diabetes and Hyperlipidemia .As obtained from medical records. Assessment tools included activities of daily living assessment, in-depth interviews, physical therapy assessment, and movement assessment. Treatment was based on physical therapy principles. The study period was from July to September 2024. Data analysis was descriptive

The results of this study show that both case study patients received physical therapy. The first patient was able to walk by single cane and the second patient was able to walk by independent that both cases perform daily activities independently. After receiving physical therapy, stroke patients with comorbidities and with the involvement of physical therapists, interdisciplinary teams, village volunteers, and family members were able to perform daily activities and improve their quality of life.

Mass Accident Investigation: The Case of the Student Van Lost control across lanes and into a ditch on the opposite side of the road. On rural highway number 5036 (rural highway intersection K.B. 6022 - Tha Tha Phae Lang Sot), Koh Lanta District. Krabi Pr

Wirayut Sontimuang — Fri, 17 Jan 2025 00:00:00 +0700

Road accidents cause injuries, disabilities, and loss of life. On January 11, 2024, the Nopparat Center in Krabi Province received reports of an accident involving a school van that lost control and overturned into a ditch across the opposite lane on Rural Highway No. 5036 (Rural Highway Junction KB.6022 - Lang Sord Pier). The investigation team from Koh Lanta Hospital, along with a multidisciplinary team from related agencies in the province, went to the site to investigate the accident in order to determine the causes and factors related to the injuries and fatalities resulting from the incident. This descriptive study involved interviewing relevant parties, surveying the accident site, collecting data from patient medical records, and analyzing factors contributing to injuries and fatalities using Haddon’s Matrix. The investigation found that the van had a total of 9 passengers: 6 males and 3 females. There were no fatalities; however, 6 individuals sustained serious injuries and were transported to Krabi Hospital, while 3 others suffered minor injuries, received first aid, and were sent home. The factors leading to the injuries were attributed to the driver's behavior of excessive speed, which caused the vehicle to lose control and cross into the right traffic lane, resulting in the vehicle ending up in the roadside ditch.

Nursing Care for Patients with Postoperative External Fixation of Fractured Leg Bones Transported by Fixed-Wing Aircraft: A Case Study

Nakarin Chuenit, Sittiporn Ratburom — Fri, 17 Jan 2025 00:00:00 +0700

Patients with post-surgical fractures with external fixation devices, who are transported using fixed-wing aircraft, must inevitably confront various symptoms, treatment effects, and risks associated with air transport. Therefore, the approach to care aims to prevent postoperative complications, mitigate the effects of air transport, and ensure the safe transfer of patients to their destination. This article presents the role of nurses in managing patients with fractured bones with external fixation and are being transported by fixed-wing aircraft. The nursing process, encompassing five stages starting from assessment, nursing diagnosis, planning, implementation, and evaluation is integrated with Gordon's eleven health patterns framework. The study identified three key nursing issues encountered during air transport: 1) the presence of pain in the left leg following the Left Popliteal Artery Repair with Medial Fasciotomy and External Fixation from Femur to Tibia, 2) the risk of displacement of the external fixation device due to frequent patient movement and 3) the potential for complications arising from air transport. The findings revealed that, following appropriate nursing interventions tailored to each identified issue, the pain in the left leg was reduced from a pain score of 6 to 2. Importantly, there were no indications or symptoms of dislodgment of the external fixation device, nor were there complications resulting from the air transport. This study underscores the significance of providing close and appropriate care for patients during air transport to facilitate their effective and safe recovery.