Saraburi Hospital Medical Journal

Effects of multidisciplinary care in the heart failure clinic of Pranangklao Hospital

2023-08-21T16:21:56+07:00

Its primary objective was to assess the data and outcomes of multidisciplinary treatment within the heart failure clinic at Pranangklao Hospital. The research encompassed a total of 85 patients, with a notable predominance of males at 69.41%. A majority of these patients fell within the age between 30 and 60 years. Moreover, 56.47% of the subjects presented comorbidities, including hypertension (58.82%), diabetes mellitus (37.65%), atrial fibrillation (18.82%), and chronic kidney disease (stage 3-5, 15.29%), with a substantial proportion being smokers (50.59%) and alcohol consumers (51.76%). More than 80% of patients received ACEI (angiotensin-converting enzyme inhibitors), ARBs (angiotensin receptor blockers), and ARNI (Angiotensin Receptor Blocker/Neprilysin Inhibitor). A comparative analysis of pre- and post-treatment data revealed that a higher number of patients achieved treatment goals in alignment with heart failure treatment guidelines. Notable improvements were observed in the utilization of MRA (Mineralocorticoid receptor antagonist), beta-blockers, and SGLT-2 (sodium-glucose co-transporter-2) inhibitors, all of which demonstrated statistical significance (p < 0.001). NYHA (New York Heart Association) functional class evaluations indicated a substantial shift from Class III and IV to Class I and II for nearly all patients, with significant improvements in cardiac performance status noted three months after treatment initiation. Heart failure hospitalization within the subsequent three months was limited to just 3.5% of the participants, and no fatalities occurred within the one-year follow-up. In conclusion, the implementation of multidisciplinary care resulted in more patients receiving the recommended medication dosages, improved disease control, symptom management, and a reduction in disease-related complications. Mortality and hospitalization rates decreased, while clinic performance met the desired benchmarks, enhancing patients' quality of life. The study underscores the importance of healthcare professionals and multidisciplinary teams staying abreast of evolving treatment modalities.

Evaluation of the Efficiency of Plasma Separation Centrifugation for Blood Clotting Testing between a Speed of 4,000 rotations per minute for 5 minutes and the Standard Method

2023-10-18T08:54:42+07:00

Stroke is a severe neurological disorder that can have significant impacts on patients, their families, the economy, and society. The treatment of patients with such conditions requires timely intervention with anticoagulant medications, relying on rapid laboratory tests to guide medication usage. The key tests for consideration include assessing blood clotting factors such as PT (Prothrombin Time), INR (International Normalized Ratio), and aPTT (Activated Partial Thromboplastin Time). At present, the hematology and clinical laboratory of Saraburi Hospital has established guidelines and procedures for plasma separation in blood clotting tests. The standard method involves centrifuging plasma at a speed of 3,500 revolutions per minute (rpm) for 15 minutes, a relatively lengthy process that may impact patient care. To enhance diagnostic efficiency and treatment, a comparative study was conducted to evaluate the effectiveness of plasma separation using two different speeds: 4,000 rpm for 5 minutes and the standard 3,500 rpm for 15 minutes. The study involved two groups: 30 healthy blood donors and 30 patients receiving warfarin, an anticoagulant. Key parameters, including PT, INR, aPTT, Platelet count (Plt.), Potassium (K), and Lactate Dehydrogenase (LDH), were compared between plasma separation at 3,500 rpm for 15 minutes and 4,000 rpm for 5 minutes. Statistical analysis of the results from 60 blood samples revealed no significant differences (p>0.05) in PT, INR, aPTT, Plt. count, and K between the two separation methods. However, LDH levels showed a statistically significant difference (p = 0.01), suggesting that red blood cells may rupture but remain within detectable quantities by the analyzing instrument. The comparable results of PT and aPTT between the two separation methods indicate that the faster centrifugation method can be a valid and time-saving alternative to the standard procedure. This has the potential to achieve accurate results and speedy test outcomes, reducing waiting times and facilitating prompt assessment and treatment decisions for emergency patients more efficiently.

The results agreement between the CoviQuick v2.0 RTqPCR Kit and AllplexTM 2019-nCoV assay for the detection of SARS-CoV-2 infection

2023-10-03T17:25:50+07:00

The detection of SARS CoV-2 utilizing the Allplex^TM 2019-nCoV assay includes RNA extraction steps. A standard RNA extraction is used in the Allplex^TM 2019-nCoV assay. The results of the Allplex^TM 2019-nCoV assay and the CoviQuick v2.0 RT-qPCR Kit, which use direct specimens in nasopharyngeal and throat swabs, were compared in this study. Seventy-three patient samples were collected, including 28 positive and 45 negative samples. The concordance rate between both tests was 90.4% (66/73) and the inconsistency rate was 9.6% (7/73). The positive correlation was 75.0%, while the negative correlation was 100%. Furthermore, the CoviQuick v2.0 RT-qPCR Kit's correlation in positive samples with cycle threshold (Ct) > 25 was reduced to 68.4%. The CoviQuick v2.0 RT-qPCR Kit showed significantly higher Ct values for the N gene than the Allplex^TM 2019-nCoV assay (p = 0.012). These findings imply that the CoviQuick v2.0 RT-qPCR Kit could be used to replace the prior reagent kit in the case of positive samples with Ct < 25 since it is more convenient and reduces turnaround time. If the CoviQuick v2.0 RT-qPCR Kit shows negative results, the procedure must be redone.

Keywords: SARS-CoV-2, COVID-19, real-time RT-PCR, Allplex^TM 2019-nCoV assay, CoviQuick v2.0 RT-qPCR Kit