PSU Medical Journal <p><strong>PSU Medical Journal (PSUMJ)</strong> is a comprehensive multidisciplinary, peer-review journal published triannually (three times a year) by the Faculty of Medicine, Prince of Songkla University. The journal aims to serve as a high-visibility portal for quality researches in medicine and related fundamental science, especially contemporary health issue and innovative medical technology. Although priority is given to clinical medicine, basic scientific articles including biomedical science, biomedical engineering and public health are also welcome. The editorial team of PSUMJ consists of experts from various fields in Prince of Songkla University and its affiliated institutes. Besides, renown consultants from all medical fields are also connected through our network. From the beginning dates, PSUMJ will engage itself into high publication standard and aims toward entering acceptable indexing databases in the near future.</p> Faculty of Medicine, Prince of Songkla University en-US PSU Medical Journal 2773-871X Update in Postoperative Cognitive Dysfunction after Cardiac Surgery: A Literature Review <p style="font-weight: 400;">Cardiac surgery is a common surgery in the elderly including of coronary artery bypass surgery and valvular heart surgery. The major complication after cardiac surgery is neurological complication. Postoperative cognitive dysfunction (POCD) is one of the major neurological complications. Patients who have neurological complications are reported to have a lower ability to form and organize their thoughts and understanding after the completion of surgery. POCD has the consequences in all health aspects. For instance, a longer period of hospital stay, poor quality of life and the increased rate of other complications.</p> <p style="font-weight: 400;">However, there is no precise definition of cognitive impairment. In order to diagnose, preoperative neuropsychological tests are normally compared with postoperative neuropsychological tests. However, other similar neurological diseases after the surgery should be ruled out.</p> <p style="font-weight: 400;">The risk factors for POCD were categorized into 3 major factors. Firstly, surgical factors which are systematic inflammation, cerebral microemboli, global hypoperfusion, induced hypothermia, and extreme hemodilution. Secondly, anesthetic factor which is total intravenous anesthesia. Thirdly, patient factors which are age, underlying disease, genetic, and smoking habit. If these mentioned conditions can be addressed before surgery, the incidence of cognitive impairment is very likely to be lower.</p> Natparin Sangprateep Jutarat Tanasansuttiporn Sumidtra Prathep Sutthasinee Petsakul Wilasinee Jitpakdee Wirat Wasinwong Copyright (c) 2022 Author and Journal 2022-05-19 2022-05-19 2 2 59 69 10.31584/psumj.2022254213 Anesthesia in Post Coronavirus 2019 (COVID-19) Syndrome <p style="font-weight: 400;">The pandemic era of Coronavirus 2019 (COVID-19) continues to threaten the major global health system in all aspects. Additionally, the number of patients requiring surgery is gradually increase. Patients always suffer from complications of the Coronavirus disease in both the short term and long term. To reduce morbidity and mortality, delaying elective surgeries for 7 weeks in COVID-19 recovered patients is the latest recommendation. As there is scarce of evidence in “post-COVID syndrome”, healthcare providers should carefully conduct preoperative evaluations and risk assessments for individual patients. In this paper, we review the recent evidence of long-term sequelae of COVID-19 infections, isolation times, time to elective surgery, and key considerations for anesthetic management of previouslyinfected patients.</p> Thadakorn Tantisarasart Chanya Deekiatphaiboon Copyright (c) 2022 Author and Journal 2022-05-19 2022-05-19 2 2 71 83 10.31584/psumj.2022252196 Evolution and Bioinformatic Analysis of the Whole Genome Sequences of SARS-CoV-2 <p style="font-weight: 400;">Coronavirus Disease 2019 (COVID-19) disease, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus, has been spreading as a pandemic and health catastrophe. The increase in the rate of infection influenced the mutation rate to increase greatly. Mutations found in the spike protein site of SARS-CoV-2 may result in changes in the binding of the angiotensin-converting enzyme 2 (ACE2) receptor in the human respiratory mucosa, which is a significant step in infection, severity, and speed of the epidemic. Scientists are now recognizing and focusing on variant of concern (VOC) that are currently spreading and affecting: Alpha, Beta, Gamma, Delta, and Omicron. Therefore, to monitor and mitigate the spread of coronavirus-19, it is imperative to understand the structure, functions, and mutation of the virus. Bioinformatics is one tool used to determine strains in the genetic code data obtained by molecular biomolecular processes such as real-time polymerase chain reaction (RT-PCR), next generation sequencing (NGS), Mass Array and others. As the COVID-19 pandemic seems not to end soon, viruses continue to evolve, and this has given them a greater potential for infection and evasion of immunity, monitoring of viral genome is crucial.</p> Thanit Sila Wison Laochareonsuk Komwit Surachart Samonrapat Surasombatpattana Wanut Saelim Surasak Sangkhathat Copyright (c) 2022 Author and Journal 2022-05-19 2022-05-19 2 2 85 98 10.31584/psumj.2022254705 Has the Game Come to an End? Puttisak Puttawibul Copyright (c) 2022 Author and Journal 2022-05-19 2022-05-19 2 2 43 43 10.31584/psumj.2022256439 Neurological Outcome and Associated Injuries In Near-Hanging Patients: A 10-Year Songklanagarind Hospital Experience <p style="font-weight: 400;"><strong>Objective: </strong>Death and injury from attempted hanging is common in Thailand. To date, few studies that have collected and analyzed treatment outcomes following near-hanging in this country. This study was conducted to examine factors associated with treatment outcomes in near-hanging injury patients. </p> <p style="font-weight: 400;"><strong>Material and Methods: </strong>The records of all near-hanging injury patients who visited Songklanagarind Hospital between 2009 and 2018 were reviewed. Data collected and analyzed included patient characteristics, imaging, and neurological outcomes from their arrival at the emergency department to their last follow-up or death. The treatment outcomes were classified into favorable and unfavorable outcomes. </p> <p style="font-weight: 400;"><strong>Results: </strong>Twenty-one cases were included in the study and the median age was 36 years. Of the 21 cases, 13 cases were categorized as incomplete hanging, seven were complete hanging and one had no recorded type of hanging. Six of the patients died, four at the emergency department and two after being hospitalized. Fourteen patients had favorable outcomes, the patients in this group had higher systolic blood pressure, oxygen saturation, and Glasgow Coma Scale Score on admission. </p> <p style="font-weight: 400;"><strong>Conclusion: </strong>Near-hanging injury patients had a high mortality rate. The factors associated with unfavorable outcomes were history of cardiac arrest before hospitalization, initial Glasgow Coma Scale Score, systolic blood pressure, and oxygen saturation on admission.</p> Wasin Panchawirat Osaree Akaraborworn Burapat Sangthong Komet Thangkhao Copyright (c) 2022 Author and Journal 2022-05-19 2022-05-19 2 2 45 49 10.31584/psumj.2022247338 A Case Report of the Herniation of the Appendix Through the Abdominal Wall Defect Presenting with Appendico-Cutaneous Fistula <p style="font-weight: 400;"><strong>Objective:</strong> To report a case of the herniation of appendix through the abdominal wall defect presented with appendico-cutaneous fistula.</p> <p style="font-weight: 400;"><strong>Material and Methods: </strong>This study was designed as a retrospective chart review using patient’s clinical data, imaging, endoscopic report, and treatment review.</p> <p style="font-weight: 400;"><strong>Results: </strong>A 70-year-old male patient with a surgical history of small bowel resection due to small bowel intussusception 60 years ago presented with purulent discharge oozing from his surgical scar for two months. The diagnosis of appendico-cutaneous fistula was made by abdominal computer tomography scan and colonoscopy. The laparoscopic assisted open approach for appendectomy and abdominal wall repair was performed successfully.</p> <p style="font-weight: 400;"><strong>Conclusion:</strong> The herniation of the appendix through the abdominal wall defect is uncommon. Very few cases have been reported. We presented a successful treatment of a patient who presented with appendico-cutaneous fistula from appendiceal herniation via incisional hernia.</p> Pawan Chansaenroj Arisara Wongtanawat Kittiya Amornwitthawat Tawiwat Surojnametakul Poon Wongvisavavit Copyright (c) 2022 Author and Journal 2022-05-19 2022-05-19 2 2 51 54 10.31584/psumj.2022252606 6-Year Hidradenitis Suppurativa with Nocardia Otitidiscaviarum <p style="font-weight: 400;">Hidradenitis suppurativa is a chronic recurrence disorder of the folliculopilosebaceous units; the most common locations are the axillary, inguinal, inframammary, genital, or perineal areas. They are commonly characterized by recurrence inflammation and the development of sinus tract formations. Most causative pathogens are bacterial (Coagulase-negative staphylococci) or fungal. Early diagnosis and treatment can reduce morbidity with good cosmetic results.</p> Atthawit Mongkornwong Orawan Chansanti Surasak Sangkhathat Copyright (c) 2022 Author and Journal 2022-05-19 2022-05-19 2 2 55 58 10.31584/psumj.2022253100