Journal of Health Science and Alternative Medicine

The Development of Digital Elderly Health Book (DEHB) Program for Elderly Using, Thailand

Atthaphon Kaewsamrit — 2023-12-31

Introduction: Thailand is currently experiencing a steady increase in its elderly population, coupled with the societal shift towards digitalization in the modern era. Consequently, the utilization of digital technology to facilitate access to health services among the elderly has become crucial. This study aimed to develop a program for promoting the use of a digital elderly health book (DEHB) and evaluate its effectiveness.

Methods: A research and development approach was employed, consisting of three main steps. Firstly, basic information surveys were conducted, and a program to promote the use of DEHB was developed. The informants included stakeholders from four regions of Thailand, with a sample size of 10 people per region. Secondly, a quasi-experimental research design was implemented to assess the effectiveness of the developed program. The participants were divided into four experimental areas (158 subjects) and four control areas (157 subjects). Thirdly, the program was optimized based on the results of the effectiveness evaluation by qualified experts.

Results: The program for promoting the use of DEHB comprised three essential components: (i) enhancing the capabilities of elderly health workers; (ii) fostering demand and developing skills for utilizing health information among the elderly and their caregivers; and (iii) promoting social influence and participation. The experimental exhibited significantly higher levels of access to and utilization of DEHB compared to the control. There was a substantial level of satisfaction with DEHB.

Conclusion: The successful promotion of digital health adoption among the elderly necessitates proficiency, comprehension, and awareness of its advantages among both practitioners (i.e., public health officials) and users (i.e., elderly individuals and caregivers). It also involves creating social influence to gain more acceptance and support for digital health initiatives.

Complementary and Alternative Medicine Combined with Symptomatic Treatment Improves Symptoms in COVID-19 Patients

Chirasuda Lawsiri — 2023-12-31

Introduction: The global population has been severely affected by the COVID-19 pandemic. The exploration of Complementary and Alternative Medicine (CAM) as a potential complement to standard management for COVID-19 is essential, but it requires conclusive evidence. This observational study aimed to investigate the association between CAM and improvements in COVID-19 symptoms, the incidence of such improvements, the utilization of complementary methods, and the stages of the disease.

Methods: This research involved a secondary data analysis that compared baseline characteristics, treatment modalities, symptoms, and vital signs before and after treatment in a randomized sample of 881 COVID-19 patients. Medical records from April to May 2021 were collected, and 273 participants were included in the study.

Results: Among the respondents, 131 (47.9%) received andrographis capsules alongside symptomatic treatment, 87 (31.9%) received Homeopathic medicine with symptomatic treatment, 33 (12.1%) received symptomatic treatment only, and 22 (8.1%) received Lianhua Qingwen alongside symptomatic treatment. When comparing the proportion of improvements after treatment, it was found that 28 (32.2%) of the 87 participants who received homeopathic medicine alongside symptomatic treatment exhibited the highest improvement in chest x-ray results. The highest proportion of patients receiving Lianhua Qingwen alongside symptomatic treatment showed favorable changes in vital signs, with 9 (41.0%) of the 22 participants demonstrating improvement. Strong evidence of improvement in symptoms was observed with andrographis capsules alongside symptomatic treatment, with 109 (83.2%) of the 131 participants experiencing improvement. Comorbidities among participants and the stage of the disease were found to significantly influence the effectiveness of these four treatment methods (p-value < 0.010).

Conclusion: This study suggests an association between CAM and improving COVID-19 symptoms. Homeopathic medicine showed considerable improvement in chest x-ray results, while andrographis capsules in the symptomatic treatment group demonstrated notable improvement in symptoms. The most remarkable improvement in vital signs was correlated with using Lianhua Qingwen.

Factors Associated with COVID-19 Preventive and Control Behaviors among People in High Incidence Border Community, Thailand - Myanmar

Jiraporn Sangsuwan — 2023-12-31

Introduction: The COVID-19 pandemic has posed a significant threat to global public health for over a year, affecting communities worldwide, including those residing in border areas between Thailand and Myanmar. Mae Sai District, located in the northernmost part of Chiang Rai Province in northern Thailand, serves as a prominent border crossing between the two countries, characterized by high population mobility and a substantial presence of foreign workers, thereby rendering its inhabitants susceptible to COVID-19 transmission. This study aimed to determine factors associated with the prevention and control of COVID-19 behaviors among people in Mae-Sai District, Chiang Rai Province.

Methods: An analytical cross-sectional study was conducted to collect data in Thai-Myanmar borders in Mae Sai District, Chiang Rai Province, Thailand. A validated questionnaire was used to collect the characteristics, predisposing factors, reinforcing factors, and enabling factors related to COVID-19 prevention and control behaviors. The questionnaire was assessed by three experts, and the content validity index (CVI) before use. The Kuder-Richardson coefficient (KR-20) was calculated and yielded a value of 0.73, indicating good reliability. The questionnaires were completed via face-to-face interviews. The data were summarized and analyzed by descriptive statistics and Spearman rank correlation.

Results: A total of 346 participants were recruited for the study, with a majority (59.8%) being females, and 28.3% belonging to the age group of 50 to 59 years. Most participants (53.2%) were married, and a significant proportion (76.6%) had previously experienced COVID-19 infection, with 39.0% opting for home isolation. Encouragingly, a vast majority (96.8%) had received the COVID-19 vaccine, and 52.3% had received at least two doses of vaccination. Predisposing factors, namely attitude (r =0.25; p-value <0.001) demonstrated notable associations with COVID-19 prevention and control behavior. Additionally, reinforcing factors such as social support (r = 0.39; p-value <0.001) and participation (r = 0.45; p-value <0.001), along with enabling factors like service (r = 0.35; p-value <0.001), also positive correlations with COVID-19 prevention and control behavior.

Conclusion: The study's findings underscore the importance of targeted training programs to enhance the population's knowledge, understanding, and awareness of preventing communicable and emerging diseases, including COVID-19. As COVID-19 continues to be a major human threat, particularly in border areas with high population mobility and foreign workers, empowering the community with relevant knowledge and strategies for prevention is crucial to effectively combat the spread of the virus.

Associations between Knowledge, Attitudes, and Practices Regarding Hepatitis B Virus Infection and HBV Infection among Blood Donors in Mogadishu, Somalia: A Hospital-based Cross-sectional Study

Abdirahman Khalif Mohamud — 2023-12-31

Introduction: Globally, more than 81 million blood units are donated annually, and blood transfusion stands as a crucial medical procedure with no viable substitute. Unsafe blood transfusion contributes to 8 to 16 million new hepatitis B virus (HBV) infections, particularly in sub-Saharan Africa. Somalia faces a high demand for blood transfusions with a prevalent HBV infection rate, driven by various factors, yet no similar previous study exists. The objective of this study was to determine the associations between the knowledge, attitudes, and practices of blood donors concerning HBV infection and their infection status in Mogadishu, Somalia.

Methods: A cross-sectional study was conducted in data collection between February and April 2023, using a 5ml blood sample and a well-structured questionnaire. A rapid test was utilized to indicate HBV positivity. Univariable and multivariable logistic regressions were employed to determine the associations, considering at α= 0.050 as statistically significant.

Results: Out of the 420 blood donors who participated in this study, 34 (8.1%) tested positive for HBV infection. The majority of the participants (94.2%) were males with an average age of 30.4 (SD±7.2). In multivariable logistic regression, the study revealed that blood donors with poor knowledge (AOR=5.80, 95% CI=1.69-19.89), those with moderate knowledge (AOR=4.41, 95% CI=1.09-17.90), and those with poor practices (AOR=3.52, 95% CI=1.09-11.34) toward HBV infection were more likely to become infected compared to their counterparts.

Conclusion: Blood donors in Mogadishu, Somalia, face a high burden of HBV infection. To effectively address this issue and ensure a safer blood supply, prioritizing initiatives aimed at enhancing the knowledge of blood donors regarding HBV infection is crucial. This involves educating donors about the various modes of transmission, emphasizing preventive measures, and stressing the importance of regular screenings. Additionally, encouraging better practices related to HBV infection among blood donors is essential in this endeavor.

Physical and Psychological Factors Associated with Non-specific Low Back Pain among Female Cleaners in Academic Settings

Kristsada Chaichan — 2023-12-31

Introduction: Low back pain (LBP) is the most common musculoskeletal disorder (MSD). Cleaning professions are strenuous and physically demanding jobs that often require cleaners to perform awkward movements during cleaning tasks. Although several studies have reported a high prevalence of LBP in cleaners, few studies have identified the physical and psychological factors associated with non-specific LBP (NSLBP) in this population. The study aimed to determine the associations between physical and psychological variables and the presence of NSLBP in female cleaners working in an academic setting.

Methods: One hundred and ninety-nine female cleaners aged 18 to 60 years old with and without LBP were asked to complete a set of self-reported questionnaires to determine individual and work-related variables and quality of life and a Nordic body map to identify NSLBP. Binomial logistic regression analyses were used to determine associations between physical and psychological factors and the presence or absence of NSLBP.

Results: The overall prevalence of MSDs among cleaners was 66.92% in the last 3 months and 43.23% time at present. NSLBP accounted for the majority of MSDs, with a prevalence of 30.24% in the last 3 months and 18.08% time at present. There was a significant association between NSLBP and the WHOQOL physical health domain (AOR= 0.78; 95% CI= 0.69–0.88), the frequency of bending forward during work (AOR= 0.33; 95% CI= 0.13–0.81), the frequency of squatting or kneeling during work (AOR=3.29; 95% CI= 1.06–10.19), feeling exhausted after work (AOR= 4.51; 95% CI= 1.03–19.69), and job dissatisfaction (AOR=0.64; 95%CI= 0.01–0.22).

Conclusion: NSLBP was the most commonly reported work-related MSD among cleaners in an academic setting. Physical factors, including good or bad working postures, and psychological factors, including mental exhaustion, were significantly associated with the existence of NSLBP in cleaners.

Cross-cultural Adaptation of the Roland-Morris Disability Questionnaire for Individuals with Low Back Pain in Myanmar: Psychometric Validation Study

Phyu Sin Oo — 2023-12-31

Introduction: Self-reported subjective measures are important for the assessment and treatment of low back pain (LBP) individuals. The Roland-Morris Disability Questionnaire is a widely used and validated questionnaire for measuring disability due to LBP. This study aimed to develop a cross-culturally adapted Myanmar version of the Roland-Morris Disability Questionnaire (M-RMDQ) and examine its reliability and validity in individuals with LBP.

Methods: The M-RMDQ was developed based on the established guidelines and underwent prefinal testing on 20 individuals with LBP resulting in minor adaptations. The adapted M-RMDQ was conducted on 99 individuals with LBP for internal consistency, test-retest reliability, ceiling and floor effects, and concurrent and construct validity. Reliability was evaluated with Cronbach's alpha and intraclass correlation coefficient (ICC), while concurrent and construct validity were determined through correlations with the Myanmar version of the Oswestry Disability Questionnaire (M-ODQ), visual analog scale (VAS), back performance scale (BPS), and the Stark Quality of Life (QoL) questionnaire.

Results: The M-RMDQ had good internal consistency (Cronbach’s alpha = 0.70, n=99) and test-retest reliability (ICC2, 1 = 0.868; n=83). The M-RMDQ was moderately positive correlated with the M-ODQ (rho = 0.525; n=99) and showed a fair positive correlation with VAS (rho = 0.252; n=99) and BPS (rho = 0.265; n=99), and fair negative correlation with the physical component of the Stark QoL questionnaire (rho = - 0.323; n=99). No correlation was demonstrated with the mental component of the Stark QoL questionnaire (rho = - 0.179; n=99).

Conclusion: The M-RMDQ exhibited favorable psychometric properties, establishing it as a reliable and valid measure for assessing LBP-related disability in the Myanmar population. It is recommended for use in both clinical settings and research studies among Myanmar individuals with LBP.

Stability of Hybridoma Cell Line Clone 4C91F9 Secreting Anti-E Monoclonal Antibody

Siriporn Ponsen — 2023-12-31

Introduction: Since 2018, the Antiserum and Standard Cell Preparation Section, National Blood Center, Thai Red Cross Society (NBC) have succeeded in producing a hybridoma cell line secreted anti-E with a good antibody titer and suitable for blood grouping reagent anti-E production. At first, we established 4 different human monoclonal hybridoma IgM cell lines stably expressing anti-E, namely 4C91A2, 4C91B9, 4C91F9, and 4C91G5, respectively. After that, 4 different cell lines were selected only the perfect one with good growth rate and high titer antibody character. Finally, a clone namely 4C91F9 was selected for culture on a large scale and its supernatant was collected for blood grouping reagent anti-E production. So, we must ensure the 4C91F9 cell line has good antibody titer production stability in the long run. The study aimed to detect the stability of hybridoma cell line clone 4C91F9 secreting anti-E monoclonal antibody from 1st to 3rd generation.

Methods: The cell line clone 4C91F9 secreting 1st generation anti-E was thawed from liquid nitrogen and selected to be the best single cell line with a good growth rate and high titer antibody secretion tested by limiting dilution method. Afterward, the selected cell line will be frozen in liquid nitrogen for 7 days. In addition, the 1st generation cell line that separated from freezing was cultured to harvest supernatant subjected to further serologic testing. The 2nd generation cell line was thawed after being frozen for 7 days for the limit dilution method again until 3rd generation. Serological testing for supernatant from all generation cell lines consisted of antibody identification with panel cells and antibody titration (potency) with R1R2, R1Rz, and r”r red blood cell group O. Also, a specificity test with antigen E positive and antigen E negative red blood cells was performed.

Results: Anti-E antibodies from all three generations of clone 4C91F9 showed perfect stability with high titer. Titers of 512, 1024, and 1024 were obtained at room temperature, and 512, 512, and 512 were obtained at the indirect antiglobulin test (IAT), respectively.

Conclusion: The characteristics of all generations of anti-E production are comparable to the American Association of Blood Banks (AABB) standard. This result confirms the quality of the anti-E monoclonal antibody suitable for being a blood typing reagent produced by Nation Blood Center, Thai Red Cross Society to ensure the safety of the blood donation and transfer process.

Evaluative Discourse on Noseclip Utilization in Spirometric Assessments: An Extensive Review

Simaporn Promsarn — 2023-12-31

This review critically examines the use of noseclips in spirometry, a key diagnostic tool in respiratory medicine. While noseclips are commonly employed to prevent nasal breathing and theoretically enhance the accuracy of spirometric measurements such as Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1), their actual efficacy is debated. Analyzing a range of studies, the review reveals that the impact of noseclips varies across populations, with no significant changes observed in spirometric values in many cases, while others note an improvement in detecting conditions like exercise-induced bronchoconstriction, particularly in children. The review also highlights patient comfort concerns. Discomfort from noseclips can potentially influence patient cooperation and test accuracy. Technical considerations further complicate the picture; improper fitting of noseclips may alter natural breathing patterns, affecting results. In summary, this article presents a divided consensus on the effectiveness of noseclips. While some studies advocate their use, especially in specific clinical or research settings, others question their necessity, citing the negligible impact on spirometric outcomes and potential patient discomfort. The evidence suggests the need for further nuanced research, including exploring non-invasive spirometric techniques, to establish a more standardized approach to spirometry. Understanding the specific scenarios where noseclips are beneficial is crucial for improving respiratory diagnostics and patient care.

The Impacts of Body Position on Respiratory Function and Lung Measurements: A Comprehensive Review

Simaporn Promsarn — 2023-12-31

Pulmonary function is a critical determinant of respiratory health, governing the exchange of oxygen and carbon dioxide in the human body. This review explores the intricate relationship between body position and pulmonary function, drawing insights from various studies. Alterations in body position can have a profound impact on pulmonary parameters. Transitioning from sitting to supine positions leads to decreased forced expiratory volume in 1 second (FEV1) and reduced vital capacity (VC). Similarly, the prone position shifts tidal ventilation towards specific lung regions, highlighting the influence of body position on ventilation distribution. In healthy individuals, sitting positions generally result in better pulmonary function, with higher FVC, FEV1, PEF, VC, PImax, and PEmax values. However, this effect varies in individuals with specific medical conditions. For example, patients with chronic heart failure experience worsened lung function in lateral decubitus positions. Understanding these position-related changes in pulmonary function is essential for optimizing patient care, particularly in clinical settings. These findings underscore the need for further research to elucidate the nuanced interactions between body position and lung mechanics, ultimately enhancing diagnostic and therapeutic strategies for respiratory disorders.

Assessing the Accuracy of the Figure-of-Eight Walk Test in Distinguishing Between Household and Community Ambulation in Post-Stroke Individuals

Pantila Pramuan — 2023-12-31

Introduction: Traditional post-stroke walking assessments often prioritize linear trajectories, failing to capture the complexity of everyday ambulation. Navigating the intricacies of everyday life requires adaptability that extends beyond the confines of linear paths. It involves addressing dynamic challenges, such as turns, varied terrains, and unexpected obstacles, which are often not adequately captured by traditional post-stroke walking assessments. The Figure-of-Eight Walk Test (F8WT) compensates for this limitation by assessing walking ability in varied scenarios. However, investigations into its accuracy for differentiating walking capabilities post-stroke are notably lacking. This study aimed to investigate the precision of the F8WT in distinguishing between household and community walkers among individuals post-stroke.

Methods: Sixty-two stroke participants, capable of walking independently or with minimal assistance (one assistant at most), were categorized into household and community walkers based on gait speed measurements. The F8WT was then administered, with its discriminative accuracy assessed using the area under the receiver operating characteristic (ROC) curve. Additionally, an optimal cutoff value distinguishing the two categories was calculated.

Results: The F8WT demonstrated robust discriminative potential, achieving the area under the curve (AUC) of 0.96 (95% CI = 0.91–1.00) on the ROC curve analysis. It registered a sensitivity of 97.60% and a specificity of 84.20%. A critical cutoff point was established at >11.20 seconds for effective categorization.

Conclusions: The F8WT is a potent assessment tool, successfully differentiating between household and community walking abilities among stroke survivors. This precise demarcation underscores its applicability in individualized post-stroke rehabilitative planning.

Comparative Effects of Vojta Therapy and Standard Physical Therapy on Pain Level and Functional Ability in Working-Age Patients with Non-Specific Low Back Pain

Dadanee Thaothong — 2023-12-31

Introduction: The standard physical therapy plays a role in reducing low back pain and increasing functional ability. Vojta therapy helps strengthen the deep muscles of the trunk, beneficial effect on patients with back pain. However, there is a lack of studies on vojta therapy in working-age back pain patients. The study aimed to compare the effects of vojta therapy combined with standard physical therapy and standard physical therapy alone on pain and the functional ability in working-age patients with non-specific low back pain.

Methods: The participants were 50 working-age patients with low back pain and were divided into 2 groups: the experimental group received vojta therapy combined with standard physical therapy (n=25), and the standard physical therapy alone group (n=25). The vojta therapy is 30 minutes and standard physical therapy treatment is 45 minutes, 2-3 times per week, for 4 weeks. Assessment of pain levels and functional ability before and after 4 weeks of treatment or 10 complete treatments. Descriptive statistics include mean, percentage, and standard deviation to describe characteristics, and inferential statistics was an independent t-test to compare pain level and functional ability between the experimental group and the control group. The statistical significance level was set at the 0.05 level.

Results: Within both the experimental and control groups, a significant reduction in pain scores (mean=1.00±0.00) and an improvement in functional ability (mean=1.92±1.45) were observed between pre-test and post-test assessments. When comparing the groups, the experiment exhibited significantly reduced pain scores (mean=1.00±0.00; 95% CI= -1.52 - 0.32) and improved functional ability (mean=4.72±3.62; 95% CI=-8.1-1.74) compared to the control.

Conclusion: Both groups are effective in managing pain and improving the functional ability of low back pain patients. However, vojta therapy combined with standard physical therapy has had better results than the standard physical therapy alone group.

Health Impacts from Air Pollution in Border Community of Thailand-Myanmar

Possathorn Hangtrakul — 2023-12-31

Introduction: Health impacts from air pollution are a major health challenge for people living in border areas in northern Thailand particularly those who live in Mae Sai District, Chiang Rai. The study aimed to assess the health impacts of air pollution among people living in the border community of Thailand–Myanmar.

Methods: The mixed-method study was applied to collect data from selected people living in Wiang Phang Kham sub-district, Mae Sai District, Chiang Rai Province. Data were collected by a validated questionnaire, in-depth interview, and group discussion between August 2022 to March 2023.

Results: A total of 404 participants were randomly selected for the study in the quantitative phase. At the individual level, difficulty in breathing, chest tightness, and conjunctivitis, especially in the elderly were reported. Stress and anxiety from lack of income were detected. Moreover, being unable to work was the majority of issues reported among the working-age. A large number of people who had health problems related to poor air pollution were reported. Finally, non-effective policies implemented indirectly affect people’s health. Avoiding outdoor activities, trade, and agriculture were immediately effective measures.

Conclusion: Poor air pollution impacts directly on those people suffering from health, especially among patients related to respiratory diseases including children and the elderly. It urgently needs national and international collaboration to improve poor air quality in northern Thailand.

In vitro Effect of Lipophilic and Hydrophilic Rice Strain Extracts in Sa Kaeo Province on the Prevention of Calcium Oxalate Crystal Formation and Aggregation

Witoon Khawsuk — 2023-12-31

Introduction: Kidney stone is a worldwide urological problem affecting human health, with a recurrence rate of up to 50%. It contains a multi-process involving crystal nucleation, growth, and aggregation. Using substances to interfere with these processes may be useful in reducing recurrent stone formation. The study aimed to investigate the inhibition effect of local colored rice strain extracts from Sa Kaeo Province on the formation and aggregation of calcium oxalate (CaOx) crystals in vitro

Methods: Black rice, black glutinous rice, and red rice strains were extracted using hexane and ethanol, called lipophilic and hydrophilic rice extracts, respectively. Rice extracts at different concentrations (10–400 µg/ml) were incubated with the CaOx crystal solution overnight. The number of CaOx crystals was counted and the percentage inhibition of CaOx crystal formation and aggregation was calculated. Statistical analysis with a significant difference was considered at a=0.05.

Results: All three rice extracts significantly decreased the number of CaOx crystal formation and aggregation. Using hexane extract, the red rice showed the highest inhibition of CaOx crystal formation, whereas the black glutinous rice showed the highest inhibition of CaOx crystal formation among the three rice strains' ethanol extracts. In addition, black glutinous rice had the strongest inhibition of the crystal aggregation among the three rice strains' hexane extracts, whereas black rice showed the highest inhibition among the three rice strains' ethanol extracts. Conclusion: Black glutinous rice containing lipophilic and hydrophilic molecules was most effective in inhibiting the formation and aggregation of CaOx crystals. This study can be applied to the development of a supplemental product to prevent kidney stone formation.

Thalassemia and Hemoglobinopathies in Thailand: A Systematic Review

Prapapun Leckngam — 2023-12-31

Thalassemia and hemoglobinopathies are inherited autosomal recessive blood diseases, that have been the major health problem in Thailand. The study on the prevalence of thalassemia and hemoglobinopathies is important for the prevention and control of thalassemia diseases. The object of this article is to provide the current prevalence of thalassemia mutations in Thailand, focusing on common α- and β-thalassemia mutations. The prevalence of α-thalassemia mutations and the data reveal that the frequency of α0-thalassemia (SEA type) is the most common throughout the country. Meanwhile, α+-thalassemia (3.7 kb deletion) is also high, followed by 4.2 kb deletion. While codon 41/42 (-TCTT) and codon 17 (A>T) make up the majority of β-thalassemia mutations, the frequency of these two types is high, accounting for more than 50% in the North, Northeast, and Central Thailand. While it is lower in southern Thailand, averaging about 22-32% because codon 19 (A>G) is widely distributed after codon 41/42. However, Hb E is the major β-hemoglobinopathy owing to its high prevalence in all regions.