Journal of Associated Medical Sciences

A Review Article : Designing Grid Displays in AAC Systems to Enhance Accuracy and Reduce Latency in Symbol Searching

Wansiya Kamonsitichai — 2024-10-21

Augmentative and Alternative Communication (AAC) systems support individuals
with complex communication needs. This review article examines factors influencing
the design of grid displays in AAC systems to enhance symbol searching accuracy
and reduce latency. Four key areas are identified: the organization of symbols, color
cues, visual crowding, and symbol location. Effective symbol organization, such as
semantic-syntactic and schematic displays, can facilitate efficient communication,
while color cues may improve visual attention and memory recall. Managing visual
crowding and strategically placing symbols based on visual field biases and motor
control abilities are also crucial. By optimizing these elements, speech-language
pathologists can develop AAC displays that improve user communication outcomes.
The findings provide guidelines for designing user-centered AAC systems tailored
to individual cognitive, motor, and sensory needs.

Review article: Local medicinal plants in Nigeria for the management of diabetes; an evaluating of glucose metabolism, insulin sensitivity, and physiological parameters

olusoji Oyesola — 2024-11-23

Background: Nigeria, like many regions worldwide, faces a growing burden of diabetes, prompting increased interest in traditional medicinal practices.

Objective: This review examines the efficacy of local medicinal plants in Nigeria for managing diabetes mellitus, focusing on their effects on glucose metabolism, insulin sensitivity, and physiological parameters.

Materials and methods: Four commonly used plants, Aloe vera, bitter leaf (Vernonia amygdalina), bitter lemon (Citrus aurantium), and ginger (Zingiber officinale), were scrutinized for their potential therapeutic effects.

Results: The literature review revealed numerous studies exploring the antidiabetic properties of these plants, including their ability to lower blood glucose levels, improve insulin sensitivity, and modulate various physiological parameters associated with diabetes.

Conclusion: The findings suggest promising avenues for utilizing local medicinal plants in diabetes management, although further research, including clinical trials, is warranted to validate their efficacy and safety.

Analysing the effectiveness of cognitive behavioural therapy in university students with ADHD: A systematic review

Gabriella Maraschin — 2024-10-10

Background: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and often persists into adult life. University students with ADHD frequently experience great difficulty with global academic functioning, resulting in higher drop-out rates and, consequently, higher unemployment rates.

Objective: This literature review aims to analyse the effectiveness of cognitive behavioural therapy (CBT) interventions to reduce ADHD-related symptoms in university students with ADHD.

Materials and methods: A literature search was conducted via EBSCO database in October 2023 using key terms: ADHD OR attention deficit hyperactivity disorder AND cogniti* intervention OR cogniti* therapy AND college student* OR university student*. The inclusion criteria were studies using cognitive behavioural therapy as their primary intervention for individuals with ADHD who are enrolled in university or college and are 18 years or above in age.

Results: Seven out of 115 papers were deemed eligible and were included in this review. This review’s studies included four randomized control trials and three before and after open trials. Three key themes were identified through data extraction: intervention design, outcome measures used, and effectiveness of interventions on ADHD-related symptoms. All the studies tailored their CBT intervention toward university students. There was a statistically significant improvement in core domains of ADHD-related impairment, in particular, inattention (N=7), overall executive functions (n=5), and hyperactivity-impulsivity (N=1).

Conclusion: While the current findings suggest positive results of CBT for reducing ADHD-related symptoms in university students with ADHD, further research should explore the sustainability of these gains over the long term. Due to the lack of explicit published study on this topic in the United Kingdom, further research should be conducted in the UK to assess the applicability and effectiveness of tailored CBT interventions within the British university environment.

Sensory processing and social participation in children with autism spectrum disorder: A systematic review

Deepak Vignesh Raj S S — 2024-10-25

Background: Children with autism spectrum disorder experience various challenges, in which difficulties in social participation represent a significant area of concern. Research studies indicate that autistic children who experience more challenges in sensory processing tend to demonstrate lower social competence. Therefore, a comprehensive synthesis of the evidence exploring the link between sensory processing and social participation is needed to develop targeted interventions and support strategies to enhance social functioning in children with autism spectrum disorder.

Objective: This systematic review aimed to investigate the impact of sensory processing on social participation in children with ASD aged 3-18 years.

Materials and methods: The review involved a comprehensive search across electronic databases such as Scopus, PubMed, and OTseeker. The McMaster Critical Review Form for Quantitative Studies was used to evaluate the methodological quality of the included articles.

Results: A total of 4,158 records were identified through database searches and manual searches. Following the title and abstract review, 10 studies were selected for the full-text review, which led to the inclusion of 8 studies in the systematic review that met the predefined criteria. Among the 8 studies, 7 studies reported a significant correlation between sensory processing and social participation in children with ASD. Specifically, sensory over-responsivity, under-responsivity, and seeking behaviors were found to influence the child’s ability to comprehend, interpret, and respond to social cues effectively, thereby increasing the social challenges commonly associated with ASD.

Conclusion: This systematic review underscores the evident impact of sensory processing difficulties on social participation among children with ASD. It highlights the critical role of sensory processing in facilitating successful social functioning across diverse contexts and emphasizes its importance in enhancing overall social well-being in children with ASD.

Exploring the role of the vestibular system in visuospatial memory in developmental dyslexia: Narrative review

Ramesh Natrayan — 2024-11-14

Individuals with dyslexia face significant challenges when it comes to writing and reading, even though they can receive an education. Various theories suggest that difficulties in processing auditory and visual cues, crucial for reading, are the underlying cause of developmental dyslexia. The vestibular system intricately processes the visuospatial memory, essential to reading comprehension. This review aims to provide a detailed explanation of the crucial role of the vestibular system in visuospatial memory, cognition, and motor planning.

Understanding visual perception skills in autism spectrum disorder: A systematic review

Redkar Simran Sandeep Sandeep — 2024-12-13

Background: Visual perception in individuals with autism spectrum disorder (ASD) can vary, often showcasing both strengths and challenges. Many individuals with ASD excel in detail-oriented processing, allowing them to focus on fine details rather than the overall picture, which can be advantageous in tasks requiring attention to small details, such as visual search and pattern recognition. Understanding these unique aspects of visual perception in ASD is crucial for developing tailored interventions and support strategies to enhance visual processing abilities and overall social functioning.

Objective: To understand the visual perception skills in autism spectrum disorder.

Materials and methods: The systematic review was registered in PROSPERO and followed the guidelines of PRISMA. A comprehensive search was conducted through the databases (Scopus, PubMed, ProQuest, EBSCOhost, and OTseeker) and printed journals. Studies were included if they focused on visual perception skills in children with autism aged 3-12 years, were peer-reviewed, published between January 2014 and February 2024, and were available in full-text in English. The AXIS Tool for Cross Sectional Studies was used to conduct the critical appraisal.

Results: 19141 studies were derived for database search and 932 from printed journals. A total of sixteen (N=16) studies were identified within the scope of our study. AXIS Tool for Cross-sectional studies was used to evaluate the quality of the sixteen studies. Visual perception skills in ASD have yielded diverse findings, such as perceptual bias, enhanced visual processing, enhanced visual search, and differences in visual processing speed. The review suggested that visual perception impairments are commonly seen in ASD, impacting their functional independence. The review also highlights the importance of understanding the basis of visual perception impairments in this population.

Conclusion: The systematic review concludes that visual perception deficits are one of the primary deficits in autism spectrum disorder. Furthermore, the review reflects on the complex and diverse nature of visual perception skills exhibited by individuals with autism spectrum disorder. These deficits impact overall performance in everyday functioning, especially self-care, academics, and socialization.

The validity and reliability of modified cough transport outcome using slower airflow for assessing mucus viscoelasticity

Aung Aung Nwe — 2024-09-04

Background: The cough transportability technique reflects changes in mucus rheology. However, the necessity of high airflow rates, such as 8 L/s, to carry out this technique limits its utility, as specialized setups or equipment are required.

Objective: This study aims to identify practical alternatives to higher airflow rates and utilize easily accessible equipment, such as mechanical air pumps (2 L/s).

Materials and methods: Mucus simulant gel (MSG) of 4 viscoelasticity and sputum from patients with bronchiectasis were collected and prepared. All samples underwent standard airflow cough transport (sCT) and modified cough transport (mCT). Additionally, three rounds of each MSG and two rounds of sputum underwent mCT.

Results: A Pearson correlation analysis between mCT and sCT revealed very high (r=0.986, p=0.014) and high (r=0.771, p<0.001) in the MSG and the sputum of bronchiectasis patients, respectively. The test-retest reliability of mCT revealed ICCs of 0.997 and 0.926 in the MSG and sputum of patients with bronchiectasis, respectively.>

Conclusion: mCT could be an alternative to sCT, offering a more accessible option for conducting cough transportability

Momordica charantia L. with Oxy Combination of Momordica charantia L. with oxytetracycline enhanced antibacterial and antibiofilm activities against some multidrug-resistant bacteria

Wisatre Kongcharoensuntorn — 2024-09-05

Background: Momordica charantia L., the common name for bitter gourd, frequently used as a vegetable and in traditional medicine to treat wounds, peptic ulcers, parasites, and worms. Regarding of finding alternative ways to cure nosocomial infection caused by multidrug-resistant bacteria, bitter gourd in combination with some antibiotics may be a practical choice to reduce the cost of therapy and be devoid of side effects from antibiotics.

Objective: This study aimed to determine the antimicrobial, antibiofilm, and synergy effects of ethanol extract from bitter gourd in combination with conventional antibiotics, ampicillin, and oxytetracycline against some drug-resistant bacteria.

Materials and methods: The antimicrobial activity was tested by broth microdilution, and the lowest concentration that inhibits the visible growth of each microorganism was recorded as MIC. A checkerboard microdilution assay was designed to test the synergistic effect of bitter gourd extract. A crystal violet staining assay was carried out to test antibiofilm activity

Results: The bitter gourd extracted by ethanol revealed antibacterial activity with a MIC range of 1.25-80 mg/mL. Synergistic effects of bitter gourd extract with ampicillin and oxytetracycline were effective against P. mirabilis and drug-resistant P. aeruginosa growth by FICI at 0.141 and 0.63, respectively. The results found that bitter gourd exhibited antibiofilm activities against E. coli ATCC 25922, drugresistant P. aeruginosa, and Methicillin-Resistant Staphylococcus aureus (MRSA) at 2-4 hours after starting inoculum and the inhibitory efficacy values were 37.62%, 71.14%, and 69.87%, respectively.

Conclusion: The ethanol extract from bitter gourd had antibacterial effect, synergy effect when mixed with ampicillin and oxytetracycline.

Preliminary study: Exploring the influence of healthcare services and antibiotic discontinuation among pulmonary tuberculosis patients with self-administration in Western Thailand: A case-control study

Saikaew Chuachan — 2024-09-05

Background: Outpatients generally use self-administration, which might result in defaulting from treatment.

Objective: This study evaluated the association between patient treatment discontinuation and health service.

Materials and methods: This retrospective case-control study was conducted in a TB clinic at Makarak Hospital, Kanchanaburi Province, Thailand. Participants who completed and discontinued treatment from 2017 to 2021 were surveyed using questionnaires.

Results: A total of 198 patients with TB who discontinued (N=49) and completed treatment (N=149) were analyzed. Associated factors of discontinued treatment in those who were male were (OR=8.41, 95%CI: 1.55-45.61), not receiving support from a family member (OR=33.75, 95%CI: 3.22-353.76), and waiting time of more than 3 hours for health services (OR=9.39, 95%CI: 1.98-44.64).

Conclusion: Prolong treatment delivery services that exceed more than 3 hours and living without family support were associated with drug discontinuation in patients with TB who were self-administration treatment. These factors should be considered to enhance TB treatment success and infection control.

Motivational factors influencing research completion: A literature review for occupational therapy and health professions

Paolo Miguel P Bulan — 2024-09-05

Background: Graduate education, particularly at the master’s and doctoral levels, is crucial in developing advanced professional skills and fostering a researchoriented mindset. However, many students struggle to complete their research due to various motivational and institutional challenges. This literature review examines the factors influencing research completion in graduate school to provide insights into occupational therapy and related health professions, emphasizing the importance of intrinsic and extrinsic motivational factors.

Objective: The primary goals of this review are to (1) identify the intrinsic and extrinsic motivational factors that influence research completion, (2) explore the barriers to research completion at the graduate level, and (3) propose motivational strategies that graduate programs can adopt to support research completion among occupational therapy and other health professions.

Materials and methods: A literature search was conducted across multiple databases, including the ASEAN Citation Index, EBSCO, Google Scholar, and Scopus. The review focused on studies published between 2010 and 2024 investigating motivational strategies, barriers, and research completion in graduate school. A total of 17 peer-reviewed articles met the inclusion criteria and were subjected to frequency and thematic analyses to identify key themes and patterns.

Results: The thematic analysis revealed four key themes: (1) intrinsic motivation and personal growth, (2) external support and institutional resources, (3) barriers to research completion, and (4) improving support systems. The findings highlight that intrinsic factors such as personal satisfaction and ambition are crucial for research completion, while external factors like mentorship, institutional resources, and cultural context play significant roles. Identified barriers include imposter syndrome, inadequate supervision, and time management challenges. Enhancing mentorship, strengthening institutional support, and developing student skills are recommended to improve research completion rates.

Conclusion: This review underscores the importance of addressing intrinsic and extrinsic motivational factors to support research completion among graduate students in occupational therapy and related health professions. By implementing targeted strategies that enhance mentorship, provide robust institutional support, and develop essential research skills, graduate programs can significantly improve research outcomes and advance evidence-based practice in health professions.

The roadblocks to business ownership: Analyzing the challenges Thai physical therapists face despite entrepreneurial education

Jirakrit Leelarungrayub — 2024-09-07

Background: The field of entrepreneurship poses significant challenges for undergraduate students and physical therapists in Thailand. Entrepreneurial intention, entrepreneurial courses in the physical therapy curriculum, and personality qualities are likely the prominent influencers. The social-environmental factors, access to resources, and perceptions of opportunity are also suggested to play a role of the secondary influencers on entrepreneurship. Regrettably, there is a lack of empirical evidence about the impact of these effects on entrepreneurial concepts within physical therapy.

Objective: This study aimed to ascertain the mutual correlation and assess the primary and secondary influencers for entrepreneurship among undergraduate students and physical therapists.

Materials and methods: A cross-sectional study was conducted on 120 physical therapy students and general physical therapists. An online, structured questionnaire with a five-point Likert scale for primary and secondary influencing factors was designed. All questions’ content validity and reliability were determined before being applied to all respondents, and a significant relationship was identified with Barlette’s test. The Kaiser-Meyer-Olkin Measure (KMO) and the measure of sample adequacy (MSA) were used to assess the overall feasibility of factorial analysis. Finally, the IBM SPSS AMOS program analyzed the influence on entrepreneurship with structural equation modeling (SEM).

Results: The results from 120 responses (74 females and 46 males), 64 undergraduate students, and 56 general physical therapists were 25.81±6.62 years (21-51 years old). All questions showed good reliability. All influencing factors showed a significant relationship and feasibility through factor analysis (FA). Furthermore, the primary factors showed that personality traits strongly influenced entrepreneurship compared to entrepreneurial intention. However, the curriculum had a meager impact. In addition, secondary influencing factors, such as opportunity perception, access to resources, and social-environment factors, highly influence entrepreneurship.

Conclusion: Personality traits and entrepreneurial intention are the most influencing factors, but the course in the curriculum is less influential for entrepreneurship. On the other hand, opportunity perception, access to resources, and social/environmental factors are also the secondary strong influencing factors among physical therapy students and general physical therapists.

A web-based decision support system to support occupational therapy services in promoting active ageing

Supawadee Putthinoi — 2024-09-07

Background: Dealing with the consequences of Thailand’s ageing population is a significant challenge. The growing usage of Information and Communication Technology (ICT) has the potential to support healthy and active ageing.

Objective: This study aimed to develop a web-based Decision Support System (DSS) and evaluate its usability.

Materials and methods: Research and Development (R&D) was a study design. It was divided into two phases: the development of the web-based DSS and its usability.

Results: The web-based DSS was designed under the requirements of the users and comprised seven components: 1) the login page; 2) the main page; 3) the register page; 4) active ageing measurement; 5) decision-making for older people; 6) the Occupational Therapy (OT) recommendations system; and 7) exporting information. A System Usability Score (SUS) of 80.41 in the usability test showed that the web-based DSS was very user-friendly and had excellent efficacy, efficiency, and satisfaction.

Conclusion: The web-based DSS effectively enhanced ageing for older people.

Psychometric properties of the self-report questionnaire on occupational balance in university students with game addiction

Naphatsorn Phuprasoet — 2024-09-10

Background: The prevalence of adolescents and young adults playing games on the internet is increasing worldwide. However, excessive game playing can cause game addiction among adolescents. Studies have demonstrated that game addiction increases the risks of physical and mental health problems, leading to occupational performance issues. Nevertheless, what level of game addiction impacts occupational health issues is controversial. Therefore, this study focused on occupational balance, an individual’s perception of a proper amount and diversity of activities. The study demonstrated that occupational imbalance could lead to a decrease in an individual’s occupational performance. However, an appropriate instrument for screening occupational balance in young adults with game addiction has never been studied yet, especially in a Thai version.

Objective: This study aimed to develop a self-report questionnaire on occupational balance for Thai university students with game addiction.

Materials and methods: The questionnaire consisted of 21 items divided into four dimensions, including the individual’s perceptions of participating in meaningful activities, having the proper proportion of time to perform occupations, having the appropriate variety of professions, and being satisfied with their health and well-being. In addition, the psychometric properties of a questionnaire were investigated.

Results: The questionnaire had sufficient validity and good internal consistency for screening occupational balance in Thai university students with game addiction. The questionnaire was divided into four dimensions, each with good construct validity and internal consistency.

Conclusion: The questionnaire was valid and reliable for evaluating occupational balance for Thai university students with game addiction. This information can provide a new occupational therapy instrument for identifying occupational balance in the population with game addiction.

Analyzing dprE1 gene variations in drug-resistant Mycobacterium tuberculosis isolates from Northern Thailand

Zayar Phyo — 2024-09-23

Background: DprE1 has been discovered as a highly promising candidate for eradicating multidrug-resistant tuberculosis (MDR-TB) due to its localization and crucial role in cell wall synthesis. Several DprE1 inhibitors in clinical trials target different binding sites on the DprE1 protein. However, mutations in these binding sites can result in resistance to these inhibitors. Nonetheless, only a few reports exist on the sequence analysis of the dprE1 gene in drug-resistant clinical isolates, especially in Thailand, a country with a high TB burden.

Objective: To investigate the genetic variations in the dprE1 gene among drugresistant clinical Mycobacterium tuberculosis (Mtb) isolates from Northern Thailand and to examine mutations known to confer resistance to specific inhibitors.

Materials and methods: Drug resistance profiles of 19 clinical Mtb isolates from Northern Thailand—11 multidrug-resistant Mtb, 2 isoniazid-resistant Mtb, and 6 rifampicin-resistant Mtb-were assessed using the agar proportion method and Sanger sequencing. New PCR and sequencing primers were designed to cover the entire length of the dprE1 gene. Mutation profiles were detected by performing DNA alignment against the reference strain, M. tuberculosis H37Rv, using BioEdit Sequence Alignment version 7.2.5. The distribution of these mutations was assessed through the Basic Local Alignment Search Tool (BLAST) server. Visual representation of amino acid mutation regions in DprE1 was generated using the PyMOL 3.0.

Results: The mutation at codon 387 associated with benzothiazinone (BTZ) compounds was not observed in the dprE1 gene of any clinical isolates. The most common mutation profile, C→T at codon 459, was found in 73.68% of clinical isolates. However, this is a silent mutation and probably indicates genetic polymorphism. Non-synonymous substitutions in the dprE1 gene were detected: A356T in one INH-R isolate and V400I in two RIF-R isolates. BLAST analysis revealed that the A356T mutation in the INH-R isolates had a 100% match with sixteen Mtb strains from other regions. Interestingly, the V400I mutation in the RIF-R isolates had not been reported, making this the first documentation of such a finding.

Conclusion: Although no mutations directly linked to resistance against current DprE1 inhibitors were found, mutations in the DprE1 binding sites could affect the efficacy of these inhibitors. This study highlights the significance of mono-drugresistant strains that acquire dprE1 mutations, potentially complicating future TB treatment targeting DprE1.

Assessment of dose uniformity and optimal CT number for virtual bolus in breast VMAT planning

Rusdchai Chaisuttee — 2024-10-03

Background: ICRU Report No. 83 proposes using the Flash Region in the strategic design of breast cancer treatment. However, concerns persist regarding the delivery of the designated radiation dose to breast cancer patients undergoing Volumetric Modulated Arc Therapy (VMAT) with virtual bolus in the irradiation plan.

Objective: This study aimed to assess dose uniformity in breast VMAT treatment with a virtual bolus, validate the planning dose by comparing it with nanoDotTM measurements on a Rando phantom, and determine the optimal CT number for the virtual bolus in breast VMAT planning. Materials and

Materials and methods: To assess dose uniformity in the breast VMAT plan, nine nanoDot™ dosimeters were placed on the breast of Rando phantom, followed by CT simulation and VMAT treatment planning. The clinical target volume (CTV) and organs at risk were contoured, and the planning target volume (PTV) boundaries were expanded by 5 mm and 10 mm for virtual bolus thicknesses of 10 mm and 15 mm, respectively. The CT number of the virtual bolus varied from 0 to -700 HU. The planning doses at 9 points were determined, and the coefficient of variation (%CV) was calculated. Additionally, measurements at these 9 points were performed using nanoDot™ dosimeters. The calculated and measured doses were then compared. Finally, VMAT treatment plans with a virtual bolus were implemented in 10 breast cancer patients, using the virtual bolus with varying CT numbers as in the phantom study to evaluate the optimal CT number of the bolus.

Results: The doses among the 9 points for each plan were uniform, with a %CV of less than 4. For calculated dose validation, the percentage differences between the measured and calculated dose for all treatment plans, with variations in the CT number and the bolus thickness, were within ±5%. To determine the optimal CT number for the virtual bolus, the breast cancer treatment plan that met the dose criteria for tumors and organs at risk was the plan with a CT number of 0 HU for both virtual bolus thicknesses of 10 and 15 mm.

Conclusion: Virtual bolus provides uniform dose distribution for breast VMAT planning, which measurements from nanoDotTM can validate. The appropriate CT number for the virtual bolus is 0 HU for both bolus thicknesses. In future studies, measurements should be conducted on actual patients.

Validity and reliability of the Thai Shortened Token Test

Natha Trisakdipol — 2024-10-11

Background: The Token Test (TT) helps evaluate language comprehension in individuals with aphasia. This test can detect comprehension difficulties, even in mild aphasia cases. In Thailand, the other language tests for aphasia focused primarily on multiple aspects of language, which took a long time to evaluate. The Shortened TT, which has fewer commands, has been chosen to be translated for this study. Previously, the Shortened TT was translated into Thai using only forward translation and had not yet been evaluated for its psychometric properties. Thus, this study focuses on translating the Shortened TT into Thai using a forward and backward translation process and determining its validity and reliability.

Objective: To translate, validate, and determine the reliability of the Thai Shortened TT.

Materials and methods: The Shortened TT was translated using forward and backward translation. Following the completion of the translation process, five expert speech-language pathologists (SLPs) evaluated its content validity using the Content Validity Index (CVI), the Content Validity Index for Items (I-CVI), and the Content Validity Index for Scales (S-CVI). Then, it was administered to 12 normal participants and 12 aphasia participants to determine the test-retest, intra-, and inter-rater reliability using the Intraclass Correlation Coefficient (ICC).

Results: The Thai Shortened TT’s content validity was satisfied at CVI=0.920, I-CVI=0.800-1, and S-CVI=0.983. The test-retest, intra-, and inter-rater reliability were excellent. In the normal group, they were 0.943, 0.985, and 0.974, respectively; in the aphasia group, they were 0.985, 0.999, and 0.999, respectively.

Conclusion: This study indicated that the Thai Shortened TT can be utilized and is suitable for clinical evaluation regarding its content validity and reliability.

Application for acoustic assessment: A pilot study in Parkinson’s patients

Worapol Boonyaban — 2024-10-24

Background: Patients with Parkinson’s disease (PD) often experience speech impairment that impacts their daily lives. In speech therapy for PD patients, it is important to use instruments to evaluate acoustic characteristics and support rehabilitation programs. However, in Thailand, access to acoustic assessment instruments is limited due to their high price and lack of portability.

Objectives: This study’s aim was to develop an application for acoustic assessment (AAA) and to conduct a pilot study of the application among healthy aging (HA) and aging PD subjects.

Materials and methods: This study was a developmental research design comprising three distinct phases. Phase one focused on the development of the AAA and evaluation of the accuracy and precision of the application. In phase two, a comparative analysis was conducted between AAA and Praat, a speech analysis software package, among twenty HA. Five acoustic parameters: loudness, jitter, shimmer, high frequency (Hf₀), and low frequency (Lf₀), were used to determine concurrent validity. Phase three compared both AAA and Praat with twenty aging PD subjects, examining the concurrent validity and reliability, and comparing the acoustic parameters of HA users with those of the aging PD cohort.

Results: In phase one, the AAA shows strong accuracy ranging from 96.86% to 99.59% and high precision, with a Coefficient of Variation (%CV) of 1.65%-3.78%. In phase two, the concurrent validity of AAA compared with Praat in HA exhibited significant and very strong correlations (r_s ≥ 0.90, p > 0.05) in all acoustic parameters, except for shimmer, which showed significant and strong correlations (r_s = 0.73, p = 0.00). In phase three, the concurrent validity of AAA compared with Praat in aging PD subjects exhibited significant and very strong correlations (r_s ≥ 0.90, p > 0.05) in loudness, Hf₀, and Lf₀, whereas significant and strong correlations were shown in jitter (r_s = 0.85, p = 0.00) and shimmer (r_s = 0.82, p = 0.00). The Intraclass Correlation Coefficient (ICC) exhibited excellent reliability in all acoustic parameters (r > 0.90). When comparing the HA and aging PD subjects using AAA, significant differences (p < 0.05) were observed in all acoustic parameters, except for Lf₀
(p < 0.55).

Conclusion: The AAA demonstrates high concurrent validity and reliability. It can effectively be utilized for testing in PD groups, serving as an alternative tool for evaluating acoustic characteristics and aiding in treatment planning.

Prevalence and antimicrobial resistance of Salmonella isolated from pork in the Northern part of Thailand

Kanitapon Supadej — 2024-10-30

Background: Salmonella is one of the most common foodborne bacteria frequently isolated from pork. It pose significant public health risks due to its potential to harbor antimicrobial resistance (AMR) genes. The emergence and spread of multidrug-resistant (MDR) Salmonella strains are of particular concern as these can be transferred to humans through food or contaminated environments.

Objective: To determine Salmonella’s prevalence and antimicrobial resistance determinants from pork at retail markets in the Northern part of Thailand.

Materials and methods: Salmonella was isolated and identified from 173 pork samples. The isolates were serotyped using the slide agglutination test with somatic- (O) and flagellar- (H) antigens, and tested for antimicrobial susceptibility using 23 different antimicrobials using the disc diffusion method. By polymerase chain reaction (PCR), the extended-spectrum β-lactamases (ESBL) genes (blaTEM, blaSHV, blaCTX-M-1, blaCTX-M-2, blaCTX-M-8/25 and blaCTX-M-9), quinolone-resistance determining region (QRDR) including gyrA, gyrB, parC and parE, plasmid-mediated quinolone resistance (PMQR) determinants including qnrA, qnrB, qnrD, qnrS, and aac(6’)-Ib-cr were determined.

Results: In this study, 98.8% of the samples were identified as Salmonella. Among these, 72.5% of isolates showed resistance to at least 1 antimicrobial agent and 48.5% were MDR. Ampicillin/tetracycline/trimethoprim-sulfamethoxazole (AMP/ TE/SXT) was the most common phenotypic resistance pattern. The results revealed that 4 ESBL genes (blaTEM, blaCTX-M-1, blaCTX-M-2, and blaCTX-M-9) were detected in 3 isolates- identified as ESBL producers. Moreover, all 9 quinolone-mediated resistance determinants were observed in quinolone resistance isolates.

Conclusion: The results demonstrated that most MDR isolates harbored quinolone resistance determinants. We report the distribution of MDR in Salmonella strains isolated from pork and the correlation between the phenotypic and the genotypic susceptibility. These findings raise great concern about the spread of resistant Salmonella strains in the Northern part of Thailand.

Thumb carpometacarpal joint immobilization orthosis

Kedsrin Ktavutvat — 2024-11-06

Background: A new design of thumb carpometacarpal joint immobilization orthosis for positioning and improving hand function. This orthosis stabilizes the thumb in the desired position when thenar muscles are weakened, first carpometacarpal joint pain, deformities, or other thumb problems. This orthosis frees the dorsum of the hand, covers the palm, curves and conforms to the thenar web space, and holds the thumb in opposition.

Objective: To study compliance and acceptance of patients with the new design thumb carpometacarpal joint immobilization orthosis that is easy to fabricate and reduces cost.

Materials and methods: This pilot study was set at the Occupational Therapy Unit, Department of Rehabilitation Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University. All twelve patients, including seven of first carpometacarpal joint arthritis, two Syringomyelia, two median nerve injuries, and one cerebral palsy, were asked to fill out a questionnaire designed for hand function and activities of daily living. In contrast, the thumb carpometacarpal joint immobilization orthosis was fabricated. After the patient had worn the new design orthosis for two weeks, they were asked to complete two questionnaires. One was hand function and activities of daily living, and the other was five items of patients’ satisfaction with thumb carpometacarpal joint immobilization orthosis that was found out from the factors related to compliance with hand orthosis.

Results: After two weeks, all patients who applied a thumb carpometacarpal joint immobilization orthosis could improve the quality of writing, open doors, and pick up small coins. They all accepted thumb carpometacarpal joint immobilization orthosis to take turns applying with thumb spica because free space at the dorsum of the hand permitted them to move more flexibly with excellent support at the first carpometacarpal joint, letting them tolerate long-term activities.

Conclusion: The new thumb carpometacarpal joint immobilization orthosis focuses on thumb opposition and allows free movement of the wrist and metacarpophalangeal joints, especially in the case of carpometacarpal joint arthritis who do not have a weak thumb. It can be substituted for another thumb opposition orthosis because of easy fabrication and reduced cost.

Concurrent validity and accuracy of wrist-wearable devices to track heart rate during exercise in sedentary individuals

Teerawat Nithiatthawanon — 2024-11-11

Background: Heart rate (HR) is commonly used as an indicator to represent a change in oxygen consumption and energy expenditure during activities. Nowadays, HR is easily measured by low-cost wrist-wearable devices, but a few studies examine the validity and accuracy of these devices in sedentary people.

Objective: The study aimed to explore the concurrent validity and accuracy of low-cost wrist-wearable HR devices (The GT2e: approx. 4000 THB and Red Mi watch 2 lite: approx. 1000 THB) for measuring HR during exercise on a treadmill in people with a sedentary lifestyle.

Materials and methods: Seventy-six sedentary participants (60 female; 78.95%) were instructed to wear a Polar H7 while randomly wearing a watch on each hand. Participants were asked to walk or run on the treadmill for 40 minutes, including free-living activities, exercise, and HR recovery phases. Pearson’s correlation coefficient was utilized to explain the levels of correlation (concurrent validity) of wrist wearable devices with the Polar H7. In contrast, the Bland-Altman method, Concordance correlation coefficient (CCC), and Mean Absolute Percentage Error (MAPE) were then used to determine the accuracy of wrist wearable devices.

Results: The GT2e had an excellent agreement with the Polar H7 in free-living activities, exercise sessions, and the HR recovery phase (CCC=0.88, 0.85 & 0.78, respectively) and strong correlation with the criterion measured; Polar H7 (r=0.79 - 0.88; p<0.001). While Red Mi watch 2 lite also had an excellent agreement and correlation in free-living activities and the HR recovery phase (CCC=0.88 - 0.85; r=0.79), but a moderate agreement was found in the exercise phase (CCC=0.55; r=0.61 [p><0.001]).

Conclusion: Both the GT2e and Red Mi watch 2 lite wrist-wearable devices could be used as alternative HR-measured devices to detect HR in sedentary people’s daily lives. However, the GT2e wrist-wearable device was more valid and accurate in detecting HR than the Red Mi watch 2 lite.

Diadochokinetic rate in Thai adults using between auditory-perceptual and instrumental methods

Awirut Soyrayab — 2024-11-13

Background: Diadochokinetic (DDK) rate refers to the time taken to execute rapid repetitive movements of articulators during speech. DDK rate assessment has been used to screen or as part of an assessment to diagnose and plan treatment for motor speech disorders. It contained alternating motion rate (AMR) and sequential motion rate (SMR) assessments. There were two main methods for DDK assessment: perceptual speech assessment and instrumental speech assessment.

Objective: This study aimed to compare the DDK rate measured by auditoryperceptual and instrumental methods and investigate the effects of age and gender on the DDK rate in normal Thai adults.

Materials and methods: In this cross-sectional study, the participants were Thai adults aged 21-78. Sixty participants were divided equally into three age groups: young adult, middle-aged adult, and older adult group. All participants were asked to repeat four speech tasks as rapidly as possible, namely, AMR as [ph a:], [th a:], [kh a:], and SMR as [ph a:-th a:-kh a:]. DDK rates were measured using two methods, namely, the auditory-perceptual method and the instrumental method, which used the Praat program. The paired sample t-test examined the difference in average DDK rates between the two methods. The one-way ANOVA was utilized to analyze the average rate differences among three age groups, while gender differences were analyzed through an independent sample t-test.

Results: The averages of SMR between the auditory-perceptual method and thePraat program were significantly different (p<0.05), whereas the averages of AMRwere not significantly different. The findings also found that averages of SMR hadsignificant differences (p<0.05) between three age groups and two genders. Theyoung adult group had a higher average of SMR than middle-aged adult and olderadult groups. Males had a higher average of SMR than females.

Conclusion: This result indicates that different assessment methods result in different DDK rates, especially SMR. Therefore, choosing the DDK rate assessment method should be careful and consider its accuracy. Moreover, the SMR task may be more sensitive than the AMR task to age-related change and gender factors.

COVID-19 vaccination doesn’t influence sperm motility, concentration, and morphology

Rehab Sh. Al-Maliki — 2024-11-15

Background: The COVID-19 pandemic, driven by SARS-CoV-2, necessitated the rapid development and global deployment of vaccines. Despite the high efficacy of vaccines like AstraZeneca and Pfizer-BioNTech in preventing severe COVID-19, concerns about potential side effects, particularly on male fertility, have arisen.

Objective: This study aims to evaluate the impact of COVID-19 vaccination on key sperm parameters (motility, concentration, count, and morphology) and serum interleukin-6 (IL-6) levels in men.

Materials and methods: A cross-sectional study was conducted over six months (March to August 2022) at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in Baghdad, Iraq. The study included 63 participants divided into three groups: AstraZeneca vaccine group (N=24), Pfizer vaccine group (N=19), and an unvaccinated control group (N=20). Participants’ sperm parameters were analyzed following the WHO guidelines, and serum IL-6 levels were measured using ELISA.

Results: No statistically significant differences were found in sperm motility, concentration, total sperm count, or morphology between vaccinated and unvaccinated groups. Specifically, sperm motility was 57.3±8.9% in the vaccinated group versus 56.8±9.2% in the control group (p=0.782). Sperm concentration was 62.5±14.7 M/mL in the vaccinated group compared to 61.9±15.1 M/mL in the control group (p=0.845). Total sperm count was 185.6±43.8 M in the vaccinated group versus 183.2±44.5 M in the control group (p=0.802). Morphologically normal sperm were 4.2±1.1% in the vaccinated group versus 4.1±1.0% in the control group (p=0.659). Serum IL-6 levels showed no significant differences between the groups.

Conclusion: COVID-19 vaccination with either AstraZeneca or Pfizer-BioNTech does not adversely affect sperm parameters or induce significant changes in serum IL-6 levels. These findings support the safety of COVID-19 vaccines concerning male reproductive health, alleviating concerns about potential adverse effects on fertility.

Alternative X-ray attenuation material from iodide-starch-gel-based materials

Nutjaree Suriya — 2024-11-16

Background: Iodine is often used as a contrast media because the k-shell binding energy (K-edge) is 33.2 keV, the average energy of a diagnostic X-ray. Thus, iodine can be utilized as a radiation attenuation material for X-rays.

Objective: This study aimed to produce low-energy X-ray attenuation materials used as X-ray shielding. A sodium iodide compound will be synthesized by polymerizing mung bean starch with sodium iodide.

Materials and methods: The iodide-starch-gel-based material (ISG) was made by mixing a mung bean starch solution (10 %w/w) with a sodium iodide (NaI) solution (100, 200, 250, and 300 mg-Iodine/gm). The linear attenuation coefficient (µ) was determined using radiation dose acquired from the DR plate system and CdTe detector. The X-rays were done at 50 - 120 kVp to study the attenuation properties.

Results: The results showed that the linear attenuation coefficient of t ISG was slightly higher than that of sodium iodide solution at the same concentration. The spectrum still shows an X-ray absorption characteristic at about 30.1-40.5 keV K-edge range.

Conclusion: Iodide-starch-gel-based components can attenuate X-ray with a K-edge range from 30-40 kVp. The attenuation coefficient of X-ray radiation varies linearly with energy level. Moreover, the concentration of the NaI solution is directly proportional to the attenuation of X-ray radiation. Thus, based on these properties and the gel-like consistency of the substance, it can be developed into a surface coating material to reduce X-ray radiation exposure.

Effect of attachment-based family therapy to reduce depression among persons diagnosed with schizophrenia

Sivapriya S — 2024-11-21

Background: Schizophrenia is a chronic mental disorder that affects a person’s way of thinking, his behaviors, and his or her feelings. One of the common symptoms of schizophrenia is depression, and depression can be associated with suicidal thoughts. Attachment-based family therapy is an intervention that was used to treat depression in young adults but has never been used in persons diagnosed with schizophrenia

Objective: This study was done to find out the effect of Attachment-based family therapy on reducing depression among persons diagnosed with schizophrenia.

Materials and methods: Thirty male participants aged between 25 and 60 years who were already diagnosed with schizophrenia were selected and participated in this study. The participants were divided into 2 groups, with 15 participants in each as experimental and control groups. Beck’s Depression Inventory was used to find out the level of depression in both groups. The experimental group underwent Attachment-Based Family Therapy, whereas the control group attended conventional occupational therapy for 3 months. The SPSS software version was used for data analysis. The descriptive statistics examined the distribution of records to summarize the data. If the p<0.05, it is statistically significant.> <0.05, it is statistically significant.

Results: The results of this study showed that Attachment-Based Family Therapy was effective in reducing depression among persons diagnosed with Schizophrenia.

Conclusion: The results suggested that Attachment-Based Family Therapy was effective for the experimental group, and the level of depression decreased after the intervention.

Comparison of the effectiveness of blacklight blue lamp and wood lamp in the screening of tinea capitis

Sutsarun Prunglumpoo — 2024-12-08

Background: Tinea capitis is a common fungal infection of the scalp in children. Most cases are caused by Microsporum canis or Trichophyton mentagrophyte. Wood lamps screen for tinea capitis by detecting green-yellow fluorescence produced by tryptophan metabolites. Because wood lamps are expensive and replacement parts are difficult to find during maintenance, we have developed a blacklight blue lamp device with a similar wavelength that is cheaper than wood lamps.

Objective: To evaluate the BLB lamp device for screening tinea capitis by determining the sensitivity, specificity, and accuracy compared to fungus culture (gold standard).

Materials and methods: One hundred seventy-five patients with suspected tinea capitis were tested using KOH examination, fungal culture, a Wood lamp, and a blacklight blue lamp device. The research data obtained will be used to analyze the sensitivity, specificity, and accuracy of the blacklight blue lamp device by comparing it using various methods.

Results: The analysis assessed the sensitivity, specificity, and accuracy of the blacklight blue lamp device, Wood lamp, and KOH preparation when comparing fungal culture as the standard method for diagnosing tinea capitis. The sensitivity was 99.39%, 100%, and 100%, specificity was 100%, 90.91%, and 100%, and accuracy was 99.43%, 99.43%, and 100%, respectively. The p-value for the three methods’ differences was 0.723 for sensitivity, 0.735 for specificity, and 0.676 for accuracy. These results show that the differences between the two methods’ sensitivity, specificity, and accuracy were not statistically significant.

Conclusion: The blacklight blue lamp device effectively screened tinea capitis with a sensitivity, specificity, and accuracy that were not significantly different from the wood lamp. It may be an inexpensive tool used as a substitute in the health service system.

Comparing quality of life difference between diabetics and non-diabetics during the SARS-CoV-2 pandemic and post-pandemic: A web-based cross-sectional study India

Suchismita Rout — 2024-12-11

Background: The COVID-19 pandemic has irreversibly altered the global landscape, with far-reaching consequences for individuals’ quality of life (QOL). In India, the series of lockdowns imposed to combat the pandemic presented unique challenges, exacerbating mental health concerns and amplifying anxiety and discontent among the population. Notably, the pandemic’s impact on QOL has been unevenly distributed, with diabetic individuals potentially facing distinct challenges compared to their non-diabetic counterparts. Existing research in India has primarily focused on the health-related concerns of diabetic individuals, leaving a significant knowledge gap regarding the QOL of non-diabetic individuals during and following the pandemic. A comprehensive understanding of QOL differences between diabetic and non-diabetic populations is crucial for developing targeted interventions and improving overall well-being.

Objective: This study aims to address this gap by exploring and comparing the QOL of diabetic and non-diabetic individuals in India during and after COVID-19, providing valuable insights into the pandemic’s impact on this critical aspect of health.

Materials and methods: A cross-sectional, comparative online-based survey study was conducted among 212 participants (diabetic and non-diabetic) aged 18 years and below 60 years visiting SRM General Hospital, between July and August 2021 during the COVID-19, and their self-reported scores were compared two years post-pandemic. A snowball sampling method was employed due to the pandemic's dynamic nature and online data collection feasibility. The RAND SF-36, a widely used 36-item quality-of-life questionnaire, was administered online via Google Forms and distributed through social media platforms and email invitations. Paired t-tests compared quality of life (QOL) during and after the SARS-CoV-2 pandemic. Multivariate regression analysis identified independent predictors influencing RAND SF-36 subscale scores.

Results: The study involved the collection of responses from a total of 212 participants, with a mean age of 46.61±17.4 years. The RAND SF-36 questionnaire assessed the quality of life (QOL) during and after the SARS-CoV-2 pandemic. The results revealed significant differences in the general (45.8±13.0 vs 64.9±19.7; p=0.001) and mental health (53.5±12.3vs. 62.7±12.8, p<0.001) between the two time periods.Furthermore, the study revealed age (β=-0.369, p=0.004, 95%CI [-0.608, -0.101]) and employment status(β=-2.11, p=0.041, 95%CI [ -0.083, -4.139]) showed significant negative association with physical health-related component. In addition, the duration of comorbidities (β=-5.326, p=0.047,95%CI [-11.408, -0.756] gravely affected the mental health component, respectively.>

Conclusion: Significant differences were noted in quality of life (QOL) between the SARS-CoV-2 pandemic period and after, with lower general health and mental health scores shown in diabetics as compared to non-diabetic individuals. Older age and unemployment were associated with worse physical health QoL, while the longer duration of comorbidities negatively impacted mental health QOL regardless of diabetes status. These findings suggest the pandemic substantially affected various aspects of QoL, underscoring the need for targeted interventions to support vulnerable populations.

Evaluation of stress measurement using a wrist-worn device in volunteer subjects under Thai massage and cardio-exercise treatment

Chatladda Thubthimngam — 2024-12-11

Background: Stress is one of the key factors leading to mood disorders. Screening for stress through questionnaires and heart rate variability (HRV) required delicate consideration and expertise for result interpretation. Nowadays, wrist-worn devices, a non-invasive and real-time monitoring technology for assessing stress levels, are widely used.

Objective: To evaluate wrist-worn devices for stress measurement and assess the stress responsiveness of Thai massage (TM) and cardio-exercise in volunteers.

Materials and methods: Device verification was inferred before distributing the wrist-worn device to volunteers. Fifty volunteers were randomly assigned to 1.5 hours of TM and 4 weeks of cardio-exercise in zones 1-2 as a stress relaxation program. The stress response rate was compared among 3 different stress measurement tools: an HRV device, cortisol level, and a wrist-worn device.

Results: Wrist-worn devices’ step count and heart rate function were verified within an acceptable error of <5% and well correlated with the HRV device before starting the assignment. The significantly decreased value of the stress after TM indicated the responsiveness for stress relaxation within an 85% response rate by HRV (p<0.001) and 75% by wrist-worn devices (p=0.002). ><0.001) and 75% by wrist-worn devices (p=0.002). Higher response outcomes were achieved from the cardio-exercise program, resulting in an 80% response rate by cortisol (p<0.001), 83.3% by HRV device (p=0.001), and 90% by the wrist-worn device (p=0.001). Significant agreement of Kappa values for all paired devices under cardio-exercise reveals an acceptable similar response outcome from wrist-worn devices. The responsive outcome between TM and cardio-exercise programs in similar volunteer groups demonstrates no significant difference measured by HRV devices (p=0.375) and wrist-worn devices (p=0.625) using the McNemar test.

Conclusion: The data herein suggest that a wrist-worn device’s stress monitoring provides satisfaction with real-time monitoring and long-term records comparable with HRV devices and cortisol measurements. Cardio exercise for 4 weeks of light and very light cardio is suggested as a continuous approach for stress relaxation. The TM program is a passive intervention that may help temporary relaxation compared to continuous cardio exercise according to subjective preference.

Improvement in Neisseria gonorrhoeae culture using modified fastidious broth

Wiriya Simmawong — 2024-12-20

Background: Culture of Neisseria gonorrhoeae is essential for antimicrobial susceptibility testing and drug resistance surveillance. However, the success rate for N. gonorrhoeae culture from samples collected at sexually transmitted disease clinics is low. Moreover, culturing this fastidious organism can be challenging.

Objective: This study aimed to develop and evaluate a modified fastidious broth (mFB) for improved preservation and culture of N. gonorrhoeae that would serve as both a transport medium for specimen collection from patients with suspected gonococcal infections and a growth enhancer for N. gonorrhoeae culture.

Materials and methods: The mFB was evaluated using five standard bacteria strains at a concentration of 105 , 103 , and 101 CFU/ml: N. gonorrhoeae, Streptococcus agalactiae, Listeria monocytogenes, Escherichia coli, and Staphylococcus saprophyticus. After that, the mFB was used to collect specimens from 29 patients (77 samples) at the Venereal Disease Clinic at Mae Sot Hospital in Tak Province, Thailand, between October 2023 and February 2024. A total of 77 specimens were divided into 2 groups according to the gram-negative diplococci in Gram stain: 1) positive results (8 specimens) and 2) negative results (69 specimens). Furthermore, the N. gonorrhoeae culture was compared by using mFB on Chocolate agar (CA) and the direct plate specimen culture on Thayer Martin agar (TMA).

Results: The results showed that the mFB could inhibit the growth of E. coli, L. monocytogenes, S. agalactiae, and S. saprophyticus but did not affect the growth of N. gonorrhoeae and significantly enhanced its growth. Using mFB, N. gonorrhoeae recovered 100% (8/8) of the positive Gram stain results from 77 clinical specimens, while direct TMA culture only recovered 75% (6/8). In addition, mFB enabled the detection of N. gonorrhoeae in 2 of the 69 Gram stain-negative specimens that were negative by direct TMA culture.

Conclusion: N. gonorrhoeae culture using mFB, followed by subculture on CA, indicated that the mFB can preserve N. gonorrhoeae in clinical specimens during delivery to the laboratory and promote its growth. This has the potential to improve gonorrhea diagnosis and treatment with appropriate antibiotics, as well as enhance surveillance of antimicrobial-resistant gonorrhea.