Journal of Health Science and Alternative Medicine

Gut Microbiota in Diabetic Kidney Disease in Northern Thailand: A Preliminary Study

Kaset Chimplee — 2024-12-31

Introduction: The risk factors that lead to the development of kidney damage in type 2 diabetic patients were known, such as poor glycemic control and poor blood pressure control. Data on clinical studies from Thailand and many countries show alteration in composition of gut microbiota in diabetes compared with non-diabetes. Studies from certain countries showed alteration in variation and composition of gut microbiota in patients with chronic kidney disease and end-stage kidney disease. There is no information in Thailand on the alteration in variation and composition of gut bacteria in patients with diabetic kidney disease. The main purpose of the study was to compare the difference in diversity and compositions of gut microbiota between three groups of patients: group A, type 2 diabetic patients with diabetic kidney disease (DN); group B, type 2 diabetic patients with normal kidney function (DM); and group C, hypertensive patients with normal kidney function who did not have diabetes (HT).

Methods: After screening and selecting by inclusion and exclusion criteria, 15 type 2 diabetes patients with chronic kidney disease were enrolled as the study participants (group A), 15 type 2 diabetic patients with normal kidney function were enrolled as the controls (group B), and 15 hypertensive patients with normal kidney function were enrolled as another control group (group C). Stool samples were sent for DNA extraction and 16S metagenome sequencing. For bioinformatic analysis, the Alpha-diversity metric, beta-diversity metric, and Principal Coordinate Analysis (PCoA) were applied. Taxonomy was developed for ASVs using the classify-sklearn native Bayes taxonomy classifier against the Greengenes 13_8 99% Operating taxonomy unit (OTUs) reference sequences. Statistical tests of alpha and beta diversity were performed using Kruskal-Wallis and PERMANNOVA.

Results: The study could not demonstrate the difference in community diversity of gut microbiota in all three groups. The Principal co-ordinate analysis (PCoA) based on Bray Curtis dissimilarity at the OTU level is the main method for the beta diversity analysis. PCoA showed no difference in gut microbiota composition among the three groups (p-value 0.544). PCoA using Jaccard, unweighted unifrac, and weighted unifrac distance analysis all of these methods also showed no difference in the microbial composition among the three groups.

Conclusion: The study could not find the differences in diversity and variation in compositions of gut microbiota in comparison among three groups of participants: type 2 diabetes mellitus with diabetic kidney disease, type 2 diabetes mellitus with normal kidney function, and hypertensive patients with normal kidney function. However, this study confirmed the features of gut microbiota compositions in type 2 diabetes mellitus with diabetic kidney disease from many previous studies, for example, the lower ratio of Firmicutes over Bacteroides in the diabetes group compared with the non-diabetes group. In addition, certain factors such as dietary profiles, lifestyle, and ethical investigation of the participants need to be considered in further study.

Perspectives of Poultry Slaughterhouse Workers on Musculoskeletal Health and Wellbeing Program for the Poultry Industry: A Qualitative Study

Benjamaporn Hancharoenkul — 2024-12-31

Introduction: Work-related musculoskeletal pain (WMSP) is a common occupational disorder in the poultry slaughterhouse industry. Poultry slaughterhouse workers (PSW) reported a high prevalence of work-related musculoskeletal problems (WMP) with mild to moderate disability at work. Therefore, a musculoskeletal health and wellbeing intervention program (MIP) is needed for PSW in the workplace. The study aimed to explore PSW's perspectives on musculoskeletal health and well-being intervention programs in the poultry industry workplace.

Methods: Descriptive qualitative research was conducted among 26 PSW (10 men and 16 women). Data were collected with one-to-one interviews conducted in a private room by a qualified therapist. The average interview time was 33 minutes for each participant. The data was verbatim transcribed and analyzed using thematic analysis.

Results: The finding demonstrated four key themes emerging from the perspectives of PSW on the MIP at the workplace. The four key themes are as follows: (i) work condition, with two subthemes: characteristics of work and influencing factors to WMP, (ii) impacts of WMP on moods, (iii) self-management of symptoms and prevention of WMP, and (iv) organizational support and welfare.

Conclusion: The themes were largely interrelated and built a picture of the perspectives of PSW on MIP in the poultry industry workplace. The perfectives of PSW also helped identify content for MIP development. The study also proposed several recommendations for the musculoskeletal health and well-being of the poultry industry workforce.

Effects of Group Music Therapy Combined with Dolphin Sounds on Mild Depression in Older Adults

Somkiat Suttharat — 2024-12-31

Introduction: Music therapy can help increase serotonin levels. Dolphin sounds produce ultrasonic frequencies, which stimulate the human brain to release endorphins; as a result, depression can be reduced. This music therapy program effectively reduces depression scores in older adults.

Methods: The sample consisted of 24 older adults with depression, divided into an experimental group and a control group selected by purposive sampling. The experimental intervention involved music therapy program sessions conducted once a day, 30 minutes per session, for a duration of 5 weeks, resulting in an index of item-objective congruence of 0.85. The Thai Geriatric Depression Scale (TGDS) was used to assess depression scores. Descriptive statistics included percentages, means, and standard deviations, while inferential statistics entailed the Wilcoxon signed-rank test and the Mann-Whitney U test, with the determination of significance at a=0.05.

Results: After receiving the music therapy program, the experimental group had a significantly lower mean depression score than before the experiment (p-value < 0.010) and significantly lower than the control group receiving regular care (p-value < 0.010).

Conclusion: The present study indicates that 30 minutes for 5 weeks of music therapy program intervention once a day is effective in reducing depression in older adults.

The Impact of Environmental Factors and Emotional Disorders on Occupational Health Issues

Somboon Chaiprakarn — 2024-12-31

Introduction: This study investigates the relationship between factors such as age, gender (specifically male workers), alcohol and drug addiction, occupational risks, emotional disorders, and occupational health issues in the workplace.

Methods: Data was collected through an online survey using convenience sampling from factory workers in Thailand (n=385). Descriptive analysis and Partial Least Squares Structural Equation Modeling (PLS-SEM) were employed to analyze the relationships among the variables.

Results: The results indicate that emotional disorders significantly mediate the impact of alcohol and drug addiction, increasing age, occupational risks, and gender (male workers) on occupational health issues. Additionally, increasing age, alcohol and drug addiction, and occupational risks have a direct and significant effect on occupational illness or injuries in the workplace. However, the direct effect of gender (male workers) on occupational illness or injuries was not significant.

Conclusions: Addressing emotional disorders, addiction, and occupational risks could help reduce occupational illnesses and injuries. Qualitative research should be implemented to gain deeper insights into these relationships.

Knowledge and Perceived Self-Efficacy Regarding Personal Protective Equipment for Coronavirus Disease 2019 Prevention: A Cross-Sectional Study among Thai Nursing Students at Suan Sunandha Rajabhat University

Chakkrich Pidjadee — 2024-12-31

Introduction: Personal protective equipment plays a crucial role in preventing the transmission of Coronavirus Disease 2019 among healthcare workers as well as nursing students in clinical settings. The study aimed to investigate the level and relationship between knowledge and perceived self-efficacy regarding personal protective equipment for COVID-19 prevention among nursing students at Suan Sunandha Rajabhat University, Thailand.

Methods: An analytical cross-sectional study was conducted involving 144 undergraduate nursing students at a single faculty of nursing in Thailand between August and September 2022. An online questionnaire was administered to collect data on participants’ general characteristics, knowledge, and perceived self-efficacy regarding the use of personal protective equipment. Data were analyzed using descriptive statistics, the Chi-Square test, and Spearman’s rank correlation coefficient.

Results: Among 144 participants, a majority demonstrated high knowledge regarding the use of personal protective equipment (45.8%) while reporting moderate perceived self-efficacy regarding the use of personal protective equipment (45.1%). No statistically significant differences in the proportions of knowledge were found based on the participants’ study year (p-value = 0.499). However, there was a statistically significant difference in the proportions of perceived self-efficacy according to the participants’ study year (p-value = 0.013). Furthermore, knowledge was significantly positively correlated with perceived self-efficacy regarding the use of personal protective equipment (r = 0.24; p-value = 0.002).

Conclusion: The findings suggest a need for developing teaching and learning strategies to enhance nursing students’ proficiency in using personal protective equipment in alignment with current requirements.

Systematic Review of N-Acetylcysteine Supplementation in the Management of Rheumatic Diseases

Jozélio de Carvalho — 2024-12-31

Introduction: N-acetyl cysteine (NAC) has been used to treat several rheumatological conditions. The study aimed to review the use of NAC in rheumatic diseases.

Methods: PubMed/MEDLINE, EMBASE, and Scielo databases were screened for articles on NAC and rheumatic diseases until September 2023.

Results: 23 articles were found with 13,603 patients. The investigated diseases were systemic sclerosis, systemic lupus erythematosus (SLE), rheumatoid arthritis, Sjogren syndrome, bone metabolism, and a national cohort. Age varied from 17 to 64 ± 7 years old, and female gender ranged from 45.0% to 100.0% in the included articles. Disease duration ranged from 2 months to 12.1 ± 8.36 years. The NAC dosage ranged from 600 to 4,800mg/day. Concerning outcomes, the SSc articles showed improvement in digital ulcers, reduction in frequency and severity of Raynaud phenomenon, improvement in modified Rodnan skin score, reduction in pain visual analog scale, and one of them saw improvement in lung capacities. Regarding RA, all but one showed improvements in visual analog scale (VAS), health assessment questionnaire (HAQ), disease activity score- 28 joints (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). In SLE, a reduction in SLE disease activity index (SLEDAI) and British Isles Lupus Assessment Group (BILAG) scores, glucose, CRP, and anti-dsDNA antibody levels were observed. An increase in CH50 was also seen. Unexpectedly increased risk of osteoarthritis in whom was under NAC. The side effects were mild in all studies.

Conclusion: NAC seems to be safe in treating some rheumatic conditions, especially lupus, rheumatoid arthritis, and Sjogren syndrome. Running title: NAC in rheumatic diseases.

Factors Influencing Organizational Commitment among Nurse Managers of Labour and Delivery Departments at the Secondary Level Hospitals Affiliated to the Thai Ministry of Public Health

Punyanut Phimchaisai — 2024-12-31

Introduction: Organizational commitment is an essential component that leads the delivery department to accomplish its goals, promote organizational efficiency and effectiveness, and improve the quality of healthcare services for mothers and children. This study aimed to identify and predict factors associated with organizational commitment among nurse managers of labor and delivery departments at the secondary-level hospitals affiliated with the Thai Ministry of Public Health (MOPH).

Methods: A correlational predictive design was applied to collect data in obstetricians-managed and treated health conditions associated with prenatal, intrapartum, and postpartum care in the secondary-level hospitals based on MOPH’s E-service plan, F1- 77 hospitals (first-level) and M2 -88 hospitals (middle-level). Questionnaires were used to collect personal characteristics and information on organizational commitment. There were 17 items to collect data on three dimensions of organizational commitment: affective, continuance, and normative organizational commitment. Seven experts detected the questionnaire’s content validity using a content validity index (CVI) of 0.94, and Cronbach’s reliability coefficient of the questionnaires was 0.84. Data were collected and analyzed using descriptive statistics. Pearson product-moment correlation and stepwise multiple regression were used for the analyses.

Results: A total of 238 nurse managers from 119 labor and delivery departments at the secondary level hospitals based on MOPH’s E-service plan, F1- 77 hospitals (first-level) and M2 -88 hospitals (middle-level) were recruited into the study. Age and education were significantly correlated at p-value<0.010 (r=0.20, r=0.23) and predicted an 8.6% variance in organizational commitment (R² =0.086, p-value <0.010). They also significantly predicted 13.1% and 10.1% of the variance in affective and normative organizational commitment (R²=0.131, p-value<0.001; R²=0.101, p-value<0.010). The strongest influencing of organizational commitment was education level (β=0.21, p-value<0.010), and it was also the best predictor of organizational commitment (β =0.17, p-value< 0.010).

Conclusion: The midwifery nurse administrative of the delivery unit should be concerned with affective and normative organizational commitment. Enhancing continuing education at higher educational levels or taking a short training course could promote a better practice of maternal and midwifery care.

Postoperative C-Reactive Protein as a Biomarker for Complications Following Gastrectomy in Gastric Cancer Patients

Yen Bi Ter — 2024-12-31

Introduction: Globally, gastric cancer ranks as the fifth most prevalent malignancy and the third leading cause of mortality related to cancer, with surgical resection being merely a curative treatment option. Postoperative complications continue to pose major challenges that impact patient outcomes and require prompt detection and management. C-reactive protein (CRP) had the potential role in predicting postoperative complications, but the knowledge was limited in different healthcare settings. The study aimed to identify the predictive role of CRP levels tested on postoperative day 4 (POD4) on the occurrence of complications in gastric cancer patients following gastrectomy.

Methods: This was a single-center, cross-sectional study conducted in two hospitals in Myanmar. The study included 145 patients scheduled for gastrectomy. Data collection involved patient records, clinical examinations, and laboratory investigations. The association between CRP and post gastrectomy complication was analyzed by independent t-test and multiple logistic regression. The association was described using an Adjusted Odds Ratio (AOR), 95% Confidence Interval (CI), and p-value. The statistically significant level was considered at the p-value of < 0.05.

Results: The mean age of patients was 59.5 years, with a predominance of males (58.6%). Complications were identified in 12.4% of cases (95%CI=7.52-18.91). The mean CRP level for patients without complications was 107.98 mg/L, compared to 178.99 mg/L for those with complications (p-value<0.001). Specifically, patients with anastomotic leaks had a mean CRP level of 254 mg/L. Multiple logistic regression analysis indicated that elevated POD4 CRP levels were a significant predictor of complications, with an AOR of 1.38 (95%CI=1.12-1.71). The cut-off CRP value of 135.8mg/L demonstrated the best predictable level for complications with an Area Under ROC curve of 86.0%, a sensitivity of 72.2%, and a specificity of 99.2%.

Conclusion: This study highlighted CRP as a biomarker for complications in gastric cancer patients undergoing gastrectomy. Elevated CRP levels may assist clinicians in identifying at-risk patients, thereby enabling timely interventions and improved patient outcomes.