Journal of Medical Bioscience

Contributory influence of supplemental intake and environmental pollutants on baseline serum and human milk levels of lead, cadmium, chromium, and zinc in lactating women in Lagos, Nigeria

Oluwakemi Oyelowo — 2024-06-18

Background:Routine heavy metal assessment is important in lactating women.

Objectives:This study aimed to investigate the concentration of lead, cadmium, and chromium and the protective role of zinc in the peripheral blood and breastmilk of lactating women within four weeks of delivery at the Lagos University Teaching Hospital (LUTH). It also sought to explore the link between heavy metals and supplemental intake, or environmental pollutants linked to heavy metals.

Methods:A total of 40 subjects were recruited for the study. The sociodemographic characteristics,supplemental intake use, and possible exposure to some sources of heavy metals were assessed using standard methods.

Results:The results revealed that 67.0% of the subjects had lived in Lagos for more than 120 months(120). About 60% reported using eye kohl and some used hair dye. The serum level of lead was observed to be higher in those with a higher intake of Vitamins D and B. The serum level of cadmium was also observed to be lower in those who took calcium as a supplement. Zinc levels were lower in the participants who reported taking folic acid as a supplement.

Conclusion:Supplementations with vitamins, calcium and folic acid as well as exposure to hair dye,paints and radiation have the potential to alter the serum and breastmilk levels of important microelements like cadmium, lead and zinc in lactating women.

Depression, defense styles, and related factors of the elderly at Public Health Center 7 in Bangkok

Chonanee Petanelaphalin — 2024-06-18

Background: Depression is a common mental health problem among the elderly. The elderly are often faced with degeneration from the aging process and life crises. If they have limited capacities for adaptation or use inappropriate defensive styles that would lead to depression in the elderly.

Objectives: The study aimed to explore the prevalence of depression, defense styles, and related factors among the elderly in the senior club at Public Health Center 7 in Bangkok, Thailand.

Methods: Data were consecutively collected from 129 elderlies in the senior club at Public Health Center 7 in Bangkok. They were asked to complete the set of questionnaires, including; The defense styles questionnaire-60 (DSQ-60), the Thai geriatric depression scale (TGDS-30), the social activities participation of the elder, and the 1-year life event questionnaire, and Chula activities of daily living index (Chula ADL Index).

Results: Depression was found in 9.3% of the subjects. The most frequently utilized defensive styles were adaptive defense mechanisms, especially, altruism. These adaptive defense mechanisms also had a negative correlation with depression. Male gender, history of psychiatric disease, moderate dependency level of the instrumental activity of daily living (IADL), moderate to a high level of stress in the economy, high-stress level on the social facet, frequent use of passive-aggression or reaction formation defensive styles, and rarely using of sublimation could statistically be associated with depression for these samples.

Conclusion: The one-tenth proportion of the elderly in this study had depression, which is comparable to the previous reports. Almost all of them used adaptive defense styles which also decreased the risk of depression. Recent results from the related factors and promoting adaptive defensive styles would be helpful for the prevention of depression in caring for the elderly at the senior club.

The components of workplace innovation management leadership of first-line nurse managers in University Hospitals

Siriwan Thongthip — 2024-06-18

Background: Nursing organization management in University Hospitals (UH) requires workplace innovation management, which is the role of managers. However, there is a lack of new knowledge on workplace innovation management in the context of UH. Based on a review of 14 research articles, the researchers became aware of the need to expand knowledge by studying the components of workplace innovation management leadership of first-line nurse managers (FLNMs) in UH.

Objective: To study the components of workplace innovation management leadership of first-line nurse managers in university hospitals.

Methods: A mixed-method research design comprises qualitative (phase 1) and quantitative (phase 2) research. The first group was the samples of qualitative research (10 subjects) that were selected by using snowball technique while the second group was the samples of quantitative research (427 subjects) that were selected by using multi-stage technique. In the first phase of the study, data were collected using indepth interview. The questionnaire was validated using content validity that was 0.97 with of 0.95 reliability. The qualitative research included data triangulation, content analysis, and analysis for quantitative research using descriptive statistics and reference statistics for testing structural fit using exploratory factor analysis (EFA), confirmatory factor analysis (CFA) for both first and second-order models.

Results: In phase I (a qualitative approach), when analyzing the content and grouping it, five issues were identified. However, when extracting components using EFA, six components were found. The components were analyzed to confirm the CFA both first and second-order models, both of which had 6 components each as follows: 1) creative vision;2) inspirational motivation; 3) human resources in enabling and driving innovation; 4) innovation capacity building; 5) team building and participation; and 6) creating innovator. This measurement model was statistically significant and consistent with empirical data.

Conclusion: The components of workplace innovation management leadership of FLNMs in UH consist of six components, and the workplace innovation management leadership model is consistent with empirical data.

Cross-cultural adaptation and reliability of the water orientation test Alyn into Thai version: Preliminary study

Mattana Bhumipraphat — 2024-06-18

Background: Hydrotherapy benefits children with developmental disorders who find land-based physical activity challenging. Water Orientation Test Alyn (WOTA1 and WOTA2) offers reliable and cost-effective means to any group with or without disabilities and at all ages, starting at 4 - 5 years.

Objectives: This study aimed to translate and adapt the WOTA into Thai and evaluate their internal consistency and interrater reliability in Thai children and youths.

Methods: WOTA1 and WOTA2 were translated through a forward-backward translation process and reviewed by experts. Cronbach’s alpha, percent agreement, and intraclass correlation coefficients (ICCs; 95% CI) were used to calculate internal consistency, inter-rater agreement, and inter-rater reliability, respectively. Weighted kappa coefficients (Kw) were applied in item-level analyses to measure the degree of agreement between raters on a 4-ordinal scale. Assessors evaluated children’s performance in a swimming pool setting (30 minutes/child).

Results: The cross-cultural translation process achieved consensus and equivalence, ensuring understandable terminology and command language. Phase II assessed Thai-WOTA1 and Thai-WOTA2 separately. Percent agreement between raters indicated excellent agreement (90.9% for Thai-WOTA1; 100.0% for Thai-WOTA2). Cronbach’s alpha was > 0.9 in both instruments, suggesting excellent internal consistency of the Thai-WOTA. ICC of 0.92 (95% C = 0.87 - 0.96) for Thai-WOTA1 and of 0.96 (95% CI = 0.91 - 0.99) for Thai-WOTA2, suggesting excellent interrater reliability. Weighted kappa of test items in both Thai-WOTA1 and Thai-WOTA2 indicated excellent agreement (K = 0.7 to 1.00).

Conclusion: The preliminary study conducted in Thailand demonstrates excellent reliability in the Thai-WOTA1 and Thai-WOTA2 assessments among the Thai children’s population, indicating potential for future research.

Obsessive-compulsive symptoms, social support and quality of life of Psychiatric Out-patients at King Chulalongkorn Memorial Hospital

Naruporn Wutthijariyakul — 2024-06-18

Background: Obsessive-compulsive symptoms can be found in people who suffer from mental illnesses, which are not necessarily obsessive-compulsive disorder. Yet, these symptoms can affect the sufferer’s quality of life (QOL).

Objective: The study aimed to determine obsessive compulsive disorder (OCD) symptoms, social support and quality of life of Psychiatric Out-patients at King Chulalongkorn Memorial Hospital.

Methods: One hundred and eight Psychiatric Out-patients of 18 years old or over were enrolled to complete four self-assessed questionnaires including the personal information questionnaires, the Florida Obsessive-Compulsive Inventory Thai Version, the social support questionnaires and the World Health Organization Quality of Life Brief version-Thai version (WHOQOL-BREF-THAI) Questionnaires.

Results: There were 74 (68.5%) female patients, 32 (29.6%) male patients. The mean age was 33.5 ± 15.3 years old. The mean OCD symptom severity scores were 5.6, with 64.0% having a chance of developing OCD (scoring 5 or higher). Approximately 65.0% of the patients had medium social support while 17.6% had low social support. Most patients (73.1%) had medium QOL while 15.7% had poor QOL. Patients aging between 18 - 35 years tended to have poorer QOL as well as patients with depression, and those who had lower income. Patients who had a chance of developing OCD (scoring 5 or higher on the OCD symptom severity scales) and patients with low social support were more likely to have poorer QOL.

Conclusion: Age, income, social support, presence of depression, number of OC symptoms, scores on OCD symptom severity scales were found to be significantly related to the patients’ quality of life.

A retrospective of occupational post-exposure prophylaxis against HIV infection in healthcare workers at King Chulalongkorn Memorial Hospital

Suwitcha Sawekkulchol — 2024-06-18

Background: Healthcare workers are at risk for exposure to diseases through direct contact with patients. A large number of newly registered antiretroviral drugs currently available, both in monotherapy and in combination formulations, has led to adjustments in clinical practice for human immunodeficiency virus (HIV) prophylaxis. Therefore, analysis of antiretroviral drug regimens used, to determine whether they meet clinical guidelines or not, is important to ensure safety for healthcare workers.

Objective: This study aimed to investigate the antiretroviral drug regimens received by healthcare workers.

Methods: Retrospective data were collected, from patients diagnosed by ICD-10 criteria from January 1, 2019 to December 31, 2022, by the researcher. The data from an electronic database, which was created specifically for research purpose, were screened and confidential.

Results: During the period between January 1, 2019 and December 31, 2022, at the emergency room, there were 121 visits from 106 healthcare workers, who had occupational accidents and requested antiretroviral therapy to prevent post-exposure HIV infection. In 116 of those visits, which represented 95.9%, physicians prescribed antiretroviral drugs no later than 72 hours after exposure, which was in line with clinical guidelines. Most of those who received antiretroviral drugs in 2019, 2020, and 2021 were prescribed rilpivirine + tenofovir disoproxil fumarate /emtricitabine. This regimen accounted for 77.2%, 82.2%, and 78.1% in each year, respectively. While for those who received antiretroviral drugs in 2022, the majority of them were prescribed dolutegravir + tenofovir disoproxil fumarate /emtricitabine, which represented 85.7%. Common adverse effects found from antiretroviral drugs were nausea, vomiting, jaundice, and facial numbness.

Conclusion: At King Chulalongkorn Memorial Hospital, occupational post-exposure prophylaxis prescriptions in healthcare workers were consistent with Thailand National Guidelines on HIV/AIDS diagnosis, treatment, and prevention.

Prevalence and associated factors of premenstrual syndrome and premenstrual dysphoric disorder among physical therapy internship students in Bangkok and surrounding areas

Thunchanok Ratchatasitthigul — 2024-06-18

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common disorders affecting the health and daily life of reproductive-age women. Nevertheless, the study on PMS and PMDD among Thai physical therapy students is still lacking.

Objectives: To investigate the prevalence and associated factors for moderate to severe PMS and PMDD among undergraduate physical therapy internship students in Bangkok metropolis and the surrounding areas.

Methods: A cross-sectional descriptive study was conducted in 256 physical therapy students in three randomly selected universities from August to December 2022. The subjected were asked to complete self-administered questionnaires included: 1) Personal and educational information; 2) medical and menstrual-related information; 3) Lifestyles information; 4) Premenstrual Symptoms screening tool (PSST) - Thai version; 5) Patient health questionnaire (PHQ-9) - Thai version; 6) Suanprung Stress Test- 20 (SPST-20); and 7) World Health Organization Quality of Life Brief–Thai (WHOQOL-BREF-THAI). The collected data were analyzed using descriptive and inferential statistics.

Results: The prevalence of moderate to severe PMS and PMDD was 31.3% and 6.6%, respectively. According to logistic regression analysis, moderate to severe PMS was significantly associated with the presence of medical illnesses (P = 0.006), premenstrual bloating (P = 0.036), diarrhea during menstruation (P = 0.022), dizziness during menstruation (P = 0.012), having high to severe level of stress from SPST - 20 (P = 0.035), and having depression (P < 0.001), whereas no factors were significantly associated with PMDD when using logistic regression analysis.

Conclusion: According to the study, 37.9% of physical therapy students had moderate to severe PMS and PMDD. As a result, these students must be concerned about physical, emotional, and behavioral premenstrual symptoms for the sake of their health, internship performance, and overall quality of life.

Work-related stress and mental health among bus drivers in Bangkok mass transit authority

Chayuth Tangwiwat — 2024-06-18

Background: The work-related stress and mental health problems are increasing every year due to the changing environmental and social conditions. Bus drivers are particularly vulnerable to these problems because of their jobs and the unsafe work environment that can cause work-related stress and mental health problems.

Objective: This study aimed to investigate the prevalence and factors associated with work-related stress and mental health problems among bus drivers in the Bangkok mass transit authority.

Methods: A cross-sectional study was conducted among 329 bus drivers during February and April 2023. The instrument used in this research was a questionnaire that included personal factors, workrelated factors, and work environment. Work-related stress was assessed by using the Thai JCQ-45, while mental health status was evaluated using the Thai GHQ-12. Data were analyzed using descriptive statistics, bivariate, and multiple logistic regression analyses.

Results: The response rate was 86.6%. The prevalence of high work-related stress was 30.4% and the prevalence of individuals at risk of mental problems was 19.5%. Factors associated with work-related stress included female gender (aOR 2.1, 95% CI: 1.1 - 4.3), physical exercise at least 5 days per week (aOR 0.32, 95% CI: 0.1 - 0.9), high physical job demands (aOR 7.5, 95%CI: 4.0 - 14.0), high social support (aOR 0.1, 95% CI: 0.0 - 0.4). Factors associated with the risk of mental health problems were working more than 48 hours per week (aOR 2.1, 95% CI: 1.1 - 4.0) and high hazard at work (aOR 3.8, 95% CI: 31.9 - 7.5). Moreover, employees with high work-related stress had a 1.8 times higher risk of mental health problems (95% CI: 1.0 - 3.1) compared to those with low work-related stress.

Conclusion: Bus drivers are at risk of work-related stress and mental health problems. Therefore, organizations should promote policies regarding work-related stress and mental health problems to ensure that employees can work happily and maintain good mental health.

Characterization of murine monoclonal anti-M and anti-N blood group reagents produced by national Blood Centre, Thai Red Cross Society

Kallaya Kerdkaewngam — 2024-06-18

Background: This study is serologic testing of anti-M and anti-N murine monoclonal antibodies which secreted from five murine monoclonal hybridoma clones composed of NBC-M2(7H32B7), NBCN1(139G3G2), NBC-N2 (9A3D9), NBC-N3(9A5B7), and NBC-N4(9D3D5). All the clones were produced by the Antiserum and Standard Cells Production Section, National Blood Centre, Thai Red Cross Society.

Objective: To study serologic characteristics of anti-M and anti-N murine monoclonal antibodies products.

Methods: The serologic characteristics were performed for potency and specificity of antibodies. . Effect of proteolytic enzymes including Papain, Trypsin, Chymotrypsin, and Neuraminidase to monoclonal antibodies were done. Testing temperature and pH effected antigen-antibody binding reaction. Our anti-M and anti-N were compared to commercial products. Type of known and unknown M and N antigen red blood cells were determined and also the unknown was compared to polyclonal anti-M and anti-N. Antibodies stability testing by preserving at 4°C, 22°C - 24°C, and room temperature for every four months until two years. Isotype were tested by using commercial kits.

Results: Our anti-M and anti-N had the best potency and specificity to both normal red blood cells and enzyme treated red blood cells. Antigen-antibody binding reaction was better in low temperature as 4°C and at room temperature than at 37°C. Effect of pH showed antigen-antibody binding was better at pH 5.5 and 7.0 than at pH 8.5. Our anti-M and anti-N potency were stronger than the commercial products and rabbit polyclonal antibodies. Known M and N antigen red blood cells typing results showed correctly in every sample. Unknown M and N antigen red blood cells typing results showed both rabbit polyclonal and monoclonal antibodies corresponding in every sample. Stability testing showed anti-M and anti-N were stable more than one year when preserved at 4°C. As for the isotype testing, it showed anti-M and anti-N are IgG1.

Conclusion: Anti-M and anti-N murine monoclonal antibodies were appropriate for producing blood group phenotyping reagents to replace the polyclonal rabbit immunized serum.

Current state and need for scientists on genomic variants in Thailand

Rungnapa Ittiwut — 2024-06-18

Shortly after the beginning of genomics Thailand action plan in 2020 for research in genomics medicine and standardized genetic testing in Thailand, the need for scientists on genomic variants has been significantly increased to analyze, filter, prioritize, and categorize genetic variations. Well-trained scientists on genomic variants were assigned to look for disease-causing variants that predict the prognostic impact of variants, as well as assess the risk of disease and disease prevention. Thus, various short-term training courses in genomic variant analysis initiated by medical professional societies and institutes have been developed to urgently train scientists on genomic variants. These courses were recommended for individuals interested in pursuing a career as scientists on genomic variants. However, the courses left behind some specific questions regarding the exact responsibilities and duties a scientist on genomic variants. This review article provides both the details and characteristics of the scientist jobs on genomic variants in Thailand as well as the qualifications of the trainees including their prerequisite basic knowledge in medical sciences, molecular biology and genetics, genomic medicine, data science, and the use of human genome databases. The article also provides the trainees an overview of both onsite and online training courses in Thailand with an aim to enhance their understanding and skills in collaborating effectively with other healthcare professionals in the field of genomic medicine in the near future.

The learning using psychiatric standardized patients in simulation: Lesson learned of teaching and learning in anger aggression and violence nursing management

Amporn Nueangjaknak — 2024-06-18

Psychiatric standardized patients refer to individuals or actors who have been trained, rehearsed, expressed emotions, and feelings. Behavioral expression in the role of psychiatric patients with virtual reality by experienced psychiatrist coaching to provide knowledge and understanding about the progression of various psychiatric diseases to the actors. The learning management of psychiatric and mental health nursing which sciences and arts are specialization. The therapeutic communication techniques are used by nurses whom therapeutic use of self with psychiatric patients. Simulation is a teaching form to provide experience training for nursing students to use simulated psychiatric standardized patients for learning management in a virtual environment. Self-assessment and selfawareness, preparing for caring for psychiatric patients in real-life situations.