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> en-US (Kamolthip Suwanthavee) (Pattama Malakul) Thu, 29 Sep 2022 16:19:00 +0700 OJS 60 Author Index, Keyword Index Puttisak Puttawibul Copyright (c) 2022 Thu, 29 Sep 2022 00:00:00 +0700 Reviewer Acknowledgement, 2022 Puttisak Puttawibul Copyright (c) 2022 Thu, 29 Sep 2022 00:00:00 +0700 Anesthetic Implications of Robotic-Assisted Radical Prostatectomy in a Patient with Immune Thrombocytopenia: a Case Report <p style="font-weight: 400;">We report the first case of a robotic-assisted radical prostatectomy (RARP) operation at Songklanagarind Hospital. The patient was diagnosed with prostatic adenocarcinoma. He also had underlying immune thrombocytopenia (ITP) and suspected previous pulmonary tuberculosis. General anesthesia with an endotracheal tube was the choice of anesthesia. This article discusses specific considerations regarding robotic surgery and the patient’s condition. The operation was successful; it took about 160 minutes longer, incurred 200 ml more of blood loss, but it led to an equal length of hospital stay compared to the data from another tertiary hospital in Thailand. A minor complication was a pressure sore on the patient’s shoulder, conceivably due to the shoulder braces.</p> Pannawit Benjhawaleemas, Tanan Bejrananda, Chanatthee Kirsiripant, Chutida Sungworawongpana, Ratikorn Boonchai, Sarayuth Boonchai Copyright (c) 2022 Author and Journal Wed, 28 Sep 2022 00:00:00 +0700 Revitalising South Thai Tourism through Medical and Wellness Tourism Panupong Puttarak Copyright (c) 2022 Author and Journal Wed, 28 Sep 2022 00:00:00 +0700 Neurobiology of Attention Deficit Hyperactivity Disorder <p style="font-weight: 400;">Factor of neurobiology ADHD consisted of several factors; such as, mutation of genes, disequilibrium of dopamine levels, and both structural and functional abnormalities of the brain. Even the smallest change in gene mutation can cause more complex problems; thus, the factor of neurobiology ADHD is one important cause that impacts ADHD children; such as, psychosocial and environmental factors. Presently, technologies have become more helpful in research. The limitations of this study included that only free access papers were included, and that the, diagnosis in DSM V were used as search terms instead of ICD system, because of up-to-date popularity. Hence, there might have been some data missed via this searching strategy. Therefore, further studies should include these in the future.</p> Pinnaree Wonganan, Janyaporn Jiamjaroenkul, Buranat Runglaksameesri Copyright (c) 2022 Author and Journal Wed, 28 Sep 2022 00:00:00 +0700 Basic Lung Ultrasonography in Critically Ill Patients: a Literature Review <p>Nowadays, lung ultrasonography is a popular choice to diagnose critically ill patients with conditions such as pneumonia, atelectasis and pneumothorax because the ultrasonography has higher sensitivity and specificity than chest x-rays. The ultrasonography can be easily performed at the bedside and does not require patient transfers that may increase the opportunity of endotracheal tube and ventilator circuit dislodgement. Moreover, there is no radiation exposure associated with ultrasound. Lung ultrasonography is operator-dependent. therefore, knowledge, skill and experience are needed to improve the accuracy of the test. This review consists of the basic use of an ultrasound machine and lung ultrasonography for the diagnosis of common diseases in critically ill patients.<span class="Apple-converted-space"> </span></p> Natchapol Nonsee, Suttasinee Petsakul, Jutarat Tanasansuttiporn, Sumidtra Prathep, Wilasinee Jitpakdee Copyright (c) 2022 Author and Journal Wed, 28 Sep 2022 00:00:00 +0700 Research Instrument Management System: RIMS, an Application for Lab Instrument Reservation Utilization <p style="font-weight: 400;"><strong>Objective: </strong>Instrument administration including accessibility control, schedule time for reservation, and periodical machine utilization are essential tasks for high-end molecular laboratory. Such repetitive work can be automated using information technology.<br /><strong>Material and Methods: </strong>As a part of Laboratory Information Management System (LIMS), the Research Instrument Management System (RIMS) is an online application using a user-friendly platform constructed for efficiency of access, end-user communication, instrument reservation.<br /><strong>Results: </strong>RIMS utilizes instrument information including the date of set up, machine identification, last preventive maintenance and financial record. Data logging and periodic reports are displayed as a graphical dashboard which is simple and flexible monitoring administration. The researchers are categorized into subgroups according to their experience in operating each instrument and facilitated reservation by the subgroups, i.e., unskilled researchers can make a reservation only after the have attended a training session.<br /><strong>Conclusion: </strong>The system has now been launched with a continually improving process for fundamental equipment of translational medical research.</p> Wanut Saelim, Wison Laochareonsuk, Pasarat Khongkow, Thanyaporn Waiyapoka, Surasak Sangkhathat Copyright (c) 2022 Author and Journal Wed, 28 Sep 2022 00:00:00 +0700 Different Doses of Intrathecal Morphine on Postoperative Analgesia and Pruritus after Cesarean Section: a Prospective Randomized Triple-Blinded Trial <p><strong>Objective: </strong>Intrathecal morphine (ITM) is an effective postoperative analgesia provided after Cesarean section. However, pruritus is an undesirable side effect that disrupts maternal breast feeding. This study aimed to evaluate the effects of three different doses of ITM added to spinal bupivacaine on postoperative analgesia and opioid-related side effects in Cesarean section.<span class="Apple-converted-space"> <br /></span><strong>Material and Methods: </strong>This prospective randomized, triple-blinded trial was conducted in 321 patients undergoing Cesarean section. They were allocated to receive either; one intervention group; intrathecal morphine 50 mcg (IT50 group, N=98), 100 mcg (IT100 group, N=100), or 200 mcg (IT200 group, N=101), added to spinal bupivacaine for Cesarean section. The primary outcome was the incidence of pruritus in the recovery room, and then every 4 hours for 24 hours. The secondary outcomes were the pain scores at rest and during activities, time to the first analgesia, 24 hours of morphine consumption and the incidence of postoperative nausea and vomiting (PONV).<span class="Apple-converted-space"> <br /></span><strong>Results: </strong>Patient characteristics between the three groups were comparable. Both of the IT50 and IT100 groups had a lower incidence of pruritus, when compared with the IT200 group at all-time points, with the exception of at 24 hours; wherein, there were no differences between the three groups. Pain scores during activities were not different between the three groups. However, at rest the IT50 group had a higher pain score than those in the IT100 and IT200 groups; at 4, 8, and 16 hours. Time to the first analgesic requirement was shorter in the IT50 group (2 hours) than in the IT100 (2.4 hours) and IT200 (2.6 hours) groups (p-value=0.03). Moreover, the median [IQR] of morphine consumption in 24 hours was higher in the IT50 group [17 mg (9, 29.8)] than those in the IT100 [13 mg (5, 23.2)] and IT200 [12 mg (4, 17)] groups (p-value&lt;0.001). However, the incidence of PONV was lower in the IT50 group compared to other groups.<span class="Apple-converted-space"> <br /></span><strong>Conclusion: </strong>This study demonstrates that reducing the dose of ITM to 100 mcg added to spinal bupivacaine is effective to maintain postoperative analgesic effects. Additionally, it reduces the incidence of postoperative pruritus compared to ITM at 200 mcg.<span class="Apple-converted-space"> </span></p> Orarat Karnjanawanichkul, Jatuporn Pakpirom, Thitiporn Pueaksuwan, Sasikaan Nimmaanrat, Niranuch Siripunt, Sukanya Keawsridam Copyright (c) 2022 Author and Journal Wed, 28 Sep 2022 00:00:00 +0700 Studying Higher Education within Armed Conflict Areas of Thailand: a Study of Post-Traumatic Stress Disorder <p><strong>Objectives: </strong>To compare the prevalence of post-traumatic stress disorder (PTSD) symptoms and examine the associated factors between students who studied at campuses located within the areas affected by Southern Thailand’s insurgency, and those in a nearby province.<span class="Apple-converted-space"><br /></span><strong>Material and Methods: </strong>This study was of a cross-sectional designed, conducted by self-administered questionnaires; using the Thai version of the PTSD checklist. The subject groups were Prince of Songkla University students who studied at the Pattani Campuses, which are located within the restive areas of Southern Thailand’s insurgency, and Hat Yai Campus, which is in a nearby province.<span class="Apple-converted-space"> <br /></span><strong>Results: </strong>Of all 897 university students, 454 university students studied in Pattani. The prevalence of PTSD symptoms was 30.8%; which is statistically significant, compared with 17.6% of those who studied in Hat Yai (p-value&lt;0.001). The associated factors, in both groups, were perception of stress from the violence due to the insurgency. Moreover, domicile and intention to resign were significantly associated with PTSD symptoms in the Pattani Campus group. However, gender, religion and satisfaction of university teaching were associated factors among university students at the Hat Yai Campus.<span class="Apple-converted-space"> <br /></span><strong>Conclusion: </strong>Difference of PTSD symptoms among university students, who studied at the campus located in restive areas and a nearby province, was statistically significant. Both groups reported that perception of stress from the violence due to the insurgency was associated with their PTSD symptoms.<span class="Apple-converted-space"> </span></p> Chonnakarn Jatchavala, Arnont Vittayanont Copyright (c) 2022 Author and Journal Wed, 28 Sep 2022 00:00:00 +0700