Hua Hin Medical Journal

Prevalence and Risk Factors Associated with Readmission within 28 Days of COPD Patients at Hua-Hin Hospital

Supawiwatch Rodjanasingha — 2023-01-09

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is the majority public health problem in Thailand for ages. COPD was also one of the most common disorders affecting inpatients at the Internal Medicine Department of HUA HIN Hospital. However COPD patients had still exacerbated although ones were recent admitted in Hospital.

Objectives: The study's purpose was to determine the prevalence of readmission and the factors associated with readmission in COPD patients admitted to HUA HIN Hospital within 28 days.

Method: The Retrospective study was conducted in HUA HIN Hospital. COPD patients diagnosed between October 1, 2020, and September 30, 2021 were included. Patients with incomplete data were excluded. The demographic data, clinical data were extracted and analyzed by Chi-square test and multiple logistic regression.

Result: In this study, the Prevalence of readmission within 28 days among 1,225 COPD patients in HUA HIN Hospital is 13.18 %. From baseline variables, the factors associated with in-hospital Readmission included Using steroid (OR=1.39 p-value=0.044) Comorbidity (OR=6.71 p-value<0.001) Influenza Vaccination within 1 year (OR=8.05 p-value<0.001) Intensive Care Unit (ICU) setting/Intubation/Ventilators (OR=4.28 p-value=0.025)

Conclusion: Overall 1,225 COPD patients readmission rate is 13.18% that associated significantly with history of using steroids, History of influenza vaccination within 1 year, Severity of Patients who were admitted in ICU, received intubation, ventilator using.

Keywords: Chronic Obstructive Pulmonary Disease, Readmission, Factors associated

Factors associated with Postpartum Weight Retention in Thai Singleton Pregnant Women at 6 Weeks Postpartum in Hua Hin Hospital

Jiratchaya Kleebsuwan — 2023-01-09

Abstract

Background: Obesity is currently a major problem with increasing epidemiological trends worldwide, including in Thailand. Obesity creates impacts on human beings, both at the individual and state level, as it affects human health, society and economic status. Generally, when women become pregnant, their weight will increase quickly and many cases of acquired weight have remained after childbirth. If women do not take care of themselves correctly, the remaining weight will ultimately grow into overweight and obese.

Objective: The objective of this analytical research was to examine factors affecting postpartum weight retention at 6 weeks postpartum.

Methods: The sample was a medical record of 908 Thai women who were attended antenatal care, maternity visits and postpartum follow-up at Hua Hin Hospital between October 1, 2018 and September 30, 2021. Data were analyzed using Percentage, Mean, and Standard deviation, t-test, one-way ANOVA, Correlation and Stepwise multiple regression analysis.

Results: The results showed that the postpartum weight retention at 6 weeks of Thai women who received antenatal care, maternity care and postpartum follow-up at Hua Hin Hospital had an average weight of 2.31 kg (S.D.= 4.54). According to the pre-pregnancy characteristics, during pregnancy and mode of delivery found that the parity, pre-pregnancy body mass index and pregnancy weight gain had an effect on the residual weight at 6 weeks postpartum (P<0.05). Obtained result from the multiple regression analysis according to the order of the variables entering the equation was statistically at the significant level of 0.01. The pregnancy weight gain was predicted by 44.2% at 6 weeks of postpartum weight.

Conclusion: From the results of this research, the author suggested that the factors affecting the postpartum weight retention, especially pregnancy weight gain should be monitored. Attention to the primigravida women and women with a normal pre-pregnancy body mass index should be the priority.

Keywords: Postpartum weight retention, Pregnancy weight gain, Postpartum follow-up, Pregnant woman

Mental Health of Dementia Patient’s Caregivers in Hua Hin Hospital

Dussanee Trakulchang — 2023-01-09

Abstract

Background: At present, Thailand has entered an aging society. Dementia is one of the major problems for the elderly that affects not only the physical, mental, social, and economic but also the patients includes caregivers, family and society.

Objective: To study mental health and factors associated with mental health of Dementia patients’ caregivers in Hua Hin Hospital.

Material and Method: Cross-sectional descriptive study was done. The sample size consisted 72 caregivers of patients diagnosed with dementia under ICD 10 who attended a psychiatric clinic at Hua Hin Hospital and were recruited by simple random sampling. The tool was used as a questionnaire for dementia patients’ caregivers. The statistics used to analyze data were frequency, percentage, mean, standard deviation, Chi-square test and Fisher’s exact test.

Results: 65.4% of Dementia patients’ caregivers had no risk for mental health problems. Statistically significant factors associated with mental health of dementia patients’ caregivers were activities of daily living and some neuropsychiatric symptoms such as hallucination, disinhibition and sleep problems (p<0.05) but other factors were not associated.

Conclusion: From this study, additional assistance should be provided to caregivers of dementia with partially dependent patients including patients with hallucination, disinhibition and sleep problems.

Keywords: mental health, caregiver, dementia, activities of daily living, neuropsychiatric symptoms

Child and Adolescent Psychiatric Consultation to Pediatric Inpatients at Hua Hin Hospital between 2011-2021

Pacharaporn Maleevach — 2023-01-09

Abstract

Background: Consultation-Liaison psychiatry is the consultation service provided for a patient with a physical illness and possibly with a psychiatric problem(s) as well. This is because child and adolescent patients bear higher risks of psychiatric problem(s) than normal child and adolescent do. However, there are few studies on child and adolescent consultation-liaison psychiatry in Thailand, most of them are conducted in major medical schools.

Objective: The aim of this study is to collect the socio-demographic data as well as the prevalence of psychiatric diagnosis among the hospitalized child and adolescent patients at the Psychiatric and Addiction Department, Hua Hin Hospital between June 2011 and December 2021. The data collection also includes the patients’ symptoms; reasons for referral to psychiatric consultation; the compatibility of diagnosis between the referring doctors and psychiatrists; as well as the patterns of treatments; and follow-up treatment after hospital discharge. The results of the study will be used to improve the psychiatric service at Hua Hin Hospital.

Method: The retrospective study has been conducted among hospitalized patients consulted at the Child and Adolescent Psychiatric Unit, the Psychiatric and Addiction Department between June 2011 and December 2021. The data analysis is made by using percentage and average.

Results: One hundred and eighteen patients were totally referred to the Child and Adolescent Unit between June 2011 and December 2021. There were 39 male, and 79 female patients. Their average age was 11.8 years old. The majority age group was 14 years old. Referrals made by the Pediatric Department were of the highest percentage (66.1%). The main reason for referrals was to assure proper treatment (72.9%). In most cases (72.9%), the patients’ symptoms were described without any specific psychiatric diagnosis. The most common psychiatric diagnosis was “adjustment disorder” (37 patients, 31.4%). Most of the patients (94.1%) received psychiatric diagnosis. Whereas, 5.9% (7 patients) did not receive a psychiatric diagnosis. The study has revealed that all the patients received non-pharmacological treatments. While, 45.8% (54 patients) received pharmacological treatments. After being discharged, 62.5% of patients came back for follow-up consultation.

Conclusion: Child and adolescent psychiatric consultation is an important part of the treatment plan among hospitalized child and adolescent patients. It will not only help decrease the severity of patients’ distress but also increase quality of their lives as well as preventing further psychiatric problems. The most common problem among the patients were adjustment disorder that needs the holistic treatment approach including pharmacological and psycho-social treatments together with follow-up care after hospital discharge.

Keywords: Child and adolescent psychiatric consultation-liaison, prevalent of psychiatric disorder, chief complaint, psychiatric treatment

Adverse events following immunization (AEFIs) of COVID-19 vaccine in Samutsakhon Hospital

Chanchira Choppradit — 2023-01-09

Abstract

Objectives: To analyze the prevalence and characteristics of patients who experienced adverse events following immunization (AEFIs) from COVID-19 vaccines reported to the Adverse Drug Reaction Center in Samutsakhon Hospital classified by seriousness, types of vaccines and dosing schedules.

Methods: This retrospective observational study collected data on all patients received COVID-19 vaccines either who experienced AEFIs during the 30-minute observation period or who were discharged and revisited the emergency room, the general practice unit or admitted to the inpatient department in Samutsakhon Hospital due to AEFIs. Patients with AEFIs were assessed by physicians and pharmacists. The data in this study were collected from AEFI form-sheets reported to Adverse Drug Reaction center of Samutsakhon hospital and network between February 28, 2021 and June 30, 2022. The data were analyzed by descriptive statistics using frequency and percentage (Each patient may have more than one event).

Results: We found 622 AEFI reports from 620 patients. Most of the patients were female (72.58%). The AEFIs were most frequently found in the age group of 18 to 40 years (49.03%), in who received Sinovac vaccine (41.96%), after the first dose of COVID-19 vaccination (58.52%), and during the period between 30 minutes to 24 hours. The most frequently found AEFI was pruritic rash. The prevalence of total and serious AEFIs were 6.27 and 0.85 events per 10,000 doses, respectively. The most common AEFI from CoronaVac^® (Sinovac), Vaxzevria^® (AstraZeneca), Comirnaty^® (Pfizer) and Covilo^® (Sinopharm) was pruritic rash (3.95, 1.09, 0.64 and 0.34 events per 10,000 doses, respectively) and from Spikevax^® (Moderna) was fever (6.05 events per 10,000 doses). There were 78 reports of serious AEFIs, without causality assessment, from 76 patients who received Vaxzevria^®, CoronaVac^®, Comirnaty^®, Covilo^® and Spikevax^® (28, 24, 19, 4 and 3, respectively), most of which were female (46), in the age group of 41 to 60 years (32) and after the first dose (36). Stroke was the most commonly found serious AEFI (29), followed by anaphylaxis (13), death (13), admission longer than 3 days (7), myocarditis/pericarditis (6), Bell’s palsy (5), coagulation disorder (2), Guillain-Barre syndrome (2) and disability of permanent blindness in one eye (1).

Conclusions: The prevalence of AEFIs from COVID-19 vaccines was 6.27 events per 10,000 doses, which was rare. Most of AEFIs were non-serious. The prevalence of serious AEFIs was 0.85 events per 10,000 doses (without causality assessment), which was very rare. The serious AEFI symptoms were found involving various organ systems and including disability and death. Therefore, close monitoring after COVID-19 vaccination is needed.

Keywords: adverse events following immunization (AEFI), prevalence of AEFI, COVID-19 vaccines