Journal of Health Science and Medical Research

The Role of Genetic Variants in Rheumatoid Arthritis Pathophysiology and their Impact on Disease Mechanisms

Jethendra Kumar Muruganantham — 2024-12-19

Rheumatoid arthritis (RA) is a chronic inflammatory condition caused by genetic and environmental factors. By identifying genomic regions associated with an increased risk of RA, Genome-wide association study (GWAS) has provided insight into the genetic component of the condition. A better understanding of these characteristics is necessary to improve RA therapy. The objective is to identify gene variants associated with RA susceptibility, severity, and progression. A search of PubMed, Embase, Scopus, Science Direct, and MEDLINE databases revealed articles concerning rheumatoid arthritis, genetics, genetic aspects, and autoimmune disorders. The research studies considered were reviews, meta-analyses, randomized controlled trials, and systematic reviews. The data was sought from May 2016 and May 2023. Genetic factors are thought to play a significant role in the production of cytokines, the activity of immune cells, and abnormal immune responses in RA. By combining molecular genetics with clinical characteristics, it is possible to enhance RA medications and provide tailored care to each individual. Recent studies have identified several susceptibility loci and key genes associated with the development of RA, providing insight into the mechanism underlying the disease. These genetic associations can be used to develop targeted medicines and personalized care strategies for people whom have rheumatoid arthritis. The purpose of this review is to enhance the quality of life by finding the gene mechanism of patients suffering from RAl; however, more research is still required to understand genetic and environmental influences fully.

Monkeypox (MPOX): Unmasking the Lesser-known Viral Threat

Saksham Shah — 2024-12-19

Monkeypox (Mpox) is caused by a viral infection and has been endemic in several African states after the last outbreak throughout the world in 2003. This disease resurfaced in the year 2022 and has since spread worldwide, even in countries where no cases had been reported in the earlier outbreak. While the world was still recovering from the menace of corona virus disease 2019 this virus; having similar features, started to spread across the world affecting thousands of people. The virus can be transmitted from human to human, and to humans from bites and scratches of infected animals. Common signs and symptoms include rashes and lymphadenopathy, accompanied with fever. Preventive measures for the Mpox virus include: using masks and alcohol-based hand sanitizers, practicing social distancing in crowded areas and practicing safe sexual activities. ACAM2000 and LC16m8 are a few vaccines available for its treatment. Early diagnosis and timely treatment of the disease have helped to curb the incidence and mortality of Mpox. Through this article, we discuss the history of infection, mode of transmission, the genomic data of the virus along with its signs and symptoms and its prevention and treatment using available vaccines. World governments and healthcare providers need to act appropriately in order to combat another such outbreak, as this disease has not been eradicated yet.

Inflammation and Cancer: The Most Recent Findings

Olumakinde Omiyale — 2024-12-19

An in-depth investigation into the complicated relationship between inflammation and cancer provided new findings. We explored new developments that shone a light on the involvement of inflammation in the emergence of many cancers in this study. What we know of this complex interaction has been shaped over time by historical observations that have transformed into molecular mechanistic findings. Understanding the importance of the invasion of immune cells in tumor micro-surroundings, gaining knowledge of the signaling mechanisms that control inflammation-induced carcinogenesis, and identifying inflammatory agents as possible biomarkers for diagnosis and the outlook may lead to novel therapeutic strategies and improved patient outcomes. The combination of immunotherapies and other treatment techniques offers a promising way to enhance therapeutic effects. The development of novel therapies like adoptive T-cell therapy and oncolytic viral therapy further emphasizes how far we have come. The need to manage immune evasion mechanisms and improve these therapeutic approaches further are still problems. We describe the intriguing possibility of using inflammation as a tool for targeted treatment for cancer in this investigation, with possibilities for better patient outcomes and alternative treatment methods.

Cannabis Use Behaviors and Related Harms among Adults in Thailand by Sex Assigned at Birth and Age Groups

Jirawan Jayuphan — 2024-12-19

Objective: The objectives of this study were to describe: 1) cannabis use behaviors; 2) self-reported cannabis-related harms and harmful behaviors among adults in Thailand, stratified by sex (assigned at birth) and age groups.
Material and Methods: A nationally-representative survey among adults in Thailand in May 2023 was conducted. Data using descriptive statistics with sampling weight adjustment was analyzed.
Results: Among the study participants (n=2,191 participants), approximately 15% of the participants were current cannabis users (estimated number: 7.5 million people aged 20 or over nationwide). Former and current users reported recreation or other non-medical purposes as the primary purposes of use (93% combined). Ingestion was the most common method of cannabis use. Male participants were more likely than female participants in all age groups to report using smoked cannabis. The most common harmful was riding a motorcycle after having used cannabis, although virtually no participants reported road accidents after same-day cannabis use.
Conclusion: This study's data provided basic information for relevant stakeholders. However, the lack of detailed information, the potential influence of social desirability, and the limited temporal generalizability should be considered in the interpretation of this study’s findings.

Efficacy of Blood Utilization in Elective Surgery for Non-COVID Patients during COVID-19 Outbreaks

Perinpit Jitmun — 2024-12-19

Objective: This study aimed to evaluate the pattern of blood transfusion requests and utilization in non-coronavirus disease (COVID) patients having undergone elective surgeries during the COVID-19 pandemic.
Material and Methods: The pattern of blood transfusion requests and utilization for elective surgical procedures in six departments of a University Hospital; between January 2020 and December 2021, were retrospectively evaluated. The cross-match-to transfusion (C/T) ratio, transfusion probability (%T), transfusion index (Ti), and maximum surgical blood order schedule (MSBOS) were calculated.
Results: A total of 15,030 patients underwent elective surgery. Among the 14,426 units of blood requested, 12,776 (89%) units were cross-matched preoperatively for 5,799 (39%) patients, and an additional 1,650 (11%) units were requested for 394 (2.6%) patients intraoperatively. Among these, 4,588 (32%) units were transfused to 1,710 (11.4%) patients. The overall C/T ratio, %T, and Ti were 2.78, 29.5%, and 0.79, respectively. Blood utilization indices for each department varied substantially according to the type of surgery, with blood utilization indices being unfavorable for 68 (80%) of the 85 procedures. The MSBOS was 0 for 32 procedures.
Conclusion: Over-ordering of blood units for elective surgical procedures remained common during the COVID-19 pandemic. The blood utilization indices showed substantial variations according to the type of surgical procedures. The MSBOS has been formulated to assist in future decision-making.

Prevalence and Associated Factors of Depression Symptoms Among Aquaculture Workers in Hai Phong, Vietnam: A Cross-Sectional Study

Tam Nguyen Van — 2024-12-19

Objective: This study aimed to determine the prevalence and factors associated with depression symptoms among aquaculture workers in Hai Phong, Vietnam.
Material and Methods: The study involved 1,220 aquaculture workers in coastal and offshore areas of Hai Phong, Vietnam; from March 2022 to September 2022. It was a cross-sectional descriptive epidemiological study, utilizing direct interviews with aquaculture workers to identify depression symptoms and associated factors. The Depression-Anxiety- Stress Scale (DASS 21) was used to assess depression symptoms.
Results: The prevalence of depression symptoms among aquaculture workers was 28.7%, with 20.9% experiencing mild depression, 6.3% moderate depression and 1.5% severe depression. Several factors were associated with depression symptoms; including gender (OR=2.03; 95% CI 1.56-2.63), being single or divorced (OR=1.44; 95% CI 1.04-1.99), age ≥60 (OR=1.63; 95% CI 1.05-2.55) compared to those under 40, chronic illnesses (OR=3.16; 95% CI 2.43-4.11), poor sleep quality (OR=2.84; 95% CI 2.13-3.79), alcohol abuse (OR=1.36; 95% CI 1.06-1.75), and irregular physical exercise (OR=2.09; 95% CI 1.62-2.70).
Conclusion: Depression disorder is a mental health concern among aquaculture workers. To alleviate depression symptoms, workers should consider lifestyle adjustments, incorporate regular physical exercise, and undergo routine health check-ups for timely counseling and treatment.

Physical Violence During Pregnancy and Associated Factors of Mental Distress Among Women in Yangon Region, Myanmar: A Secondary Analysis of a Cross-Sectional Study

Win Thuzar Aye — 2024-12-19

Objective: Violence against women during pregnancy is a critical human rights issue and a significant global public health concern. The study aimed to assess the prevalence of physical violence during any pregnancies and mental distress by ever-pregnant women, investigate the association between physical violence and mental distress, and explore additional factors linked to mental distress.
Material and Methods: This secondary analysis of household-based cross-sectional study included 1,045 ever-pregnant women aged 18-49 years from Yangon Region, Myanmar, interviewed between October and November 2016. Physical violence and mental distress were assessed utilizing the standardized Demography and Health Survey questionnaire and the Hopkins Symptom Checklist-10, respectively. Multiple logistic regression analysis was used for association between physical violence and mental distress.
Results: We found that 6.4% (95% CI 5.1% to 8.1%) of the women had experienced physical violence during pregnancy and 34.1% (95% CI 31.3% to 37.0%) had suffered mental distress. We identified no significant association between physical violence during pregnancy and mental distress. Women residing in an urban area, having more than three children, experiencing family debt, having poor health status, having a partner with controlling behavior, and having a partner who consumed alcohol were significantly associated with mental distress.
Conclusion: One in 16 women in Yangon, Myanmar, had experienced physical violence during a pregnancy, while approximately one-third of the women had suffered from mental distress. It is a problem of serious concern in many countries to screen pregnant women for risk factors associated with mental distress during their antenatal care and prepare the appropriate mental health services for them.

Links to Cyberbullying of Risky Online Behavior and Social Media Addiction among Students in Grades 7-9 in Bangkok

Wanlop Atsariyasing — 2024-12-19

Objective: This present study examined the connections regarding cyberbullying, risky online behavior and social media addiction, among 7th–9th grade students in Bangkok; Thailand.
Material and Methods: A cross-sectional survey was conducted, using a self-report questionnaire consisting of: demographic data, cyberbullying, risky online behavior and the Social Media Addiction Screening Scale (S-MASS), involving 3,667 students.
Results: Cyberbullying involvement was significantly associated with almost all risky online behaviors. The three riskiest behaviors, according to the odds ratios, were disclosing personal information (odds ratio (OR)=3.7, 95% confidence interval (CI) [2.7, 5.1]), making appointments to meet with online strangers (OR=3.0, 95% CI [2.1, 4.2]), and having conversations with online strangers (OR=2.6, 95% CI [2.3, 3.0]). Additionally, cyberbullying involvement exhibited a strong association with the high-risk category of social media addiction (OR=4.4, 95% CI [3.3, 5.8]). Furthermore, all subgroups of cyberbullying, including cyber-victims, cyberbullies, bystanders and the combined subgroups, demonstrated associations with almost all risky online behaviors. Moreover, the high risk category of social media addiction, with the combined subgroup, exhibited the highest odds ratio.
Conclusion: Cyberbullying involvement was found to be associated with risky online behavior and social media addiction among middle school students in Bangkok.

Association of Online Learning Tools and Students’ Health: A Case Study During the COVID-19 Pandemic

Thanakrit Neamhom — 2024-12-19

Objective: This study aimed to determine the health effects on undergraduate students from online learning and connectivity devices, characterizing the association between significant confounding factors and the prevalence of health symptoms among undergraduates.
Material and Methods: This cross-sectional study was conducted from July to August 2021 and involved 219 undergraduates selected by simple random sampling from an academic institute within Thailand. Data were analyzed using Chi-square and Kendall’s tau-c tests. All data were collected through a self-administered questionnaire.
Results: Among participants, (1) tablets and smartphones were the major devices used (97.7% and 77.2%, respectively), (2) the prevalence of nervous-related and mental symptoms was over 80% for headache, dizziness, fatigue, difficulty concentrating, stress, tiredness and anxiety, (3) the Chi-square test results for laptop devices revealed an association with anxiety and burnout effects (p-value<0.05 for all), while anxiety presented as a positive correlation coefficient of Kendall rank (0.003), with desktop PC devices, and (4) learning media including video, PowerPoint and academic articles, played a major role in affecting health; especially academic articles, which exhibited a positive relationship in all related effects.
Conclusion: The use of learning media during the Coronavirus Disease-19 (COVID-19) pandemic has had an impact on students’ mental health. Decisions regarding implementing mitigation measures and monitoring programs should be reconsidered to reduce risks to students’ health.

Effectiveness of a Patient-Family-Shared Care Program on Delaying the Progression of Chronic Kidney Disease in Uncontrolled Type 2 Diabetic Patients: A Quasi-Experimental Study

Kanlayanee No-in — 2024-12-19

Objective: This study aimed to examine the effectiveness of a patient-family-shared care program in delaying the progression of chronic kidney disease (PFS-DCKD-P) in uncontrolled type 2 diabetic patients within Phrae province, Thailand.
Material and Methods: In this quasi-experimental research, twenty-three patient-family member dyads in the intervention group completed the 16-week PFS-DCKD-P; while twenty-two patient-family member dyads of the control group received a regular program. Outcomes included: patients’ shared care, family members’ shared care and the clinical outcomes, which were chronic kidney disease clinical indexes (CKDC-Indexes). Differences were compared within the groups before and after participating in the program as well as differences between groups after participating in the program. Descriptive statistics, paired t-test, and independent t-test statistics were used for data analysis.
Results: The patients’ shared care of a decision-making component and a reciprocity component, systolic blood pressure (SBP), and blood sugar (BS) after program participation were higher than before in the intervention group (p-value<0.05). When compared between groups, the SBP of the intervention group was lower than the control group (p-value<0.05). There were no statistical differences of patients’ and family members’ shared care mean scores between the two groups. However, family members’ shared care of the communication component was increased in the intervention group (p-value<0.05).
Conclusion: The PFS-DCKD-P showed no explicit effectiveness on improving shared care for both patients and family members, nor for CKDC-Indexes. Further studies should optimize each program activity and encourage more consistent participation from family members.

Hospital Food Waste Trends: A Bibliometric Analysis

Hafidlotul Mu’awanah — 2024-12-19

Objective: Food waste in hospitals has a significant impact on environmental sustainability. The effect of food waste includes the potential for pollution, eutrophication, and global warming, all of which are highly destructive to the Earth’s ecology. This study aims to determine the trends of hospital food service based on hospital waste to achieve a sustainable hospital.
Material and Methods: This study examined 137 articles from the Scopus database using the descriptive-analytic method. The records issued between 2018 to 2022 that were gathered based on the keywords “hospital,” and “food,” and “waste” were used in this exploration investigation.
Results: The result indicated that the three-year (93 papers) analysis trend of hospital food waste has been toward developing sustainable hospitals. The top three keywords are waste (3.3%), food (3.09%), and hospital (2.06%). The hospital food waste was positively associated with the food, food service, and hospital assessment, with correlation values ranging from 0.76 to 0.85 (p-value≥0.70). The cluster’s themes on hospital food were waste food contamination (36.13%), environmental sustainability (34.45%), and hospital food services (29.4%).
Conclusion: Addressing hospital food waste is crucial for achieving sustainable hospital development. Managing food waste is essential to achieve sustainability in hospitals as it produces the highest amount compared to other sectors.

Covid-19 Patients with First-Diagnosed Substance Use Disorders in Southern Thailand: A Study from a Field Hospital

Jarurin Pitanupong — 2024-12-19

Objective: This retrospective study investigated usage patterns, withdrawal symptoms, and treatments provided to COVID-19 patients with first-diagnosed substance use disorders at a field hospital in southern Thailand in 2021.
Material and Methods: The medical records of all COVID-19 patients were reviewed, and descriptive statistics were calculated and reported. The process of analyzing data was carried out by utilizing Program R.
Results: Of the 2116 patients, 12.9% had a history of substance and/or alcohol use without any prior diagnosis. Most patients were male (94.9%), and the mean age was 31.7 years old. Tobacco and kratom were the substances most frequently used by COVID-19 patients. Withdrawal symptoms were observed in approximately half of all patients with substance use disorders, particularly those who used kratom and opioids. The most commonly reported withdrawal symptoms were insomnia and muscle aches, and chlorpromazine and amitriptyline were the most prescribed psychotropic medications. The majority of patients with substance use disorders (93.8%) did not report any complications related to their COVID-19 infection.
Conclusion: This study found that 12.9% of COVID-19 patients admitted to a field hospital in southern Thailand in 2021 had a newly diagnosed substance use disorder. The substances most commonly used by these patients were tobacco and kratom. Approximately half of the patients with substance use disorders experienced withdrawal symptoms, and kratom and opioids were the substances most frequently associated with these withdrawal symptoms.

Clinical Outcomes of Langerhans Cell Histiocytosis: A Single-Center Experience

Nassawee Vathana — 2024-12-19

Objective: To evaluate the clinical outcome of Langerhans cell histiocytosis (LCH) in countries with limited resources.
Material and Methods: A retrospective chart review of patients <15 years old, diagnosed with LCH and treated at Siriraj Hospital; from January 1, 2002 until December 31, 2016, was performed. The patients’ demographic data, treatment protocol, and efficacy of treatment were collected and analyzed.
Results: LCH was diagnosed in 38 patients, with a median age of 1.9 years old; of whom, 24 had multisystem disease (MS) and 14 had single system disease (SS). In the MS group, 16 patients had risk of organ (RO) involvement, with hepatic involvement being most common. The prevalence of central diabetes insipidus was 21.0%. Reactivation was observed in 11 patients (28.9%). RO involvement of the hematopoietic system (p-value=0.016), spleen (p-value=0.031), and MS (p-value=0.001) were significantly associated with a poor response to induction therapy. RO involvement of the hematopoietic system (p-value=0.016), liver (p-value=0.0), and spleen (p-value=0.005), as well as MS (p-value=0.013) were significantly associated with reactivation risk. The 5-year event-free survival rate of patients with and without RO involvement were 9.2% and 88.3%, respectively. The 5-year overall survival rate of patients with and without RO involvement were 82.5% and 96.4%, respectively.
Conclusion: The prevalence of MS and RO involvement seemed high in this cohort; however, the outcomes were comparable to other Asian studies. Novel treatment for RO involvement may improve clinical outcomes.

Risk Factors for Anastomotic Leakage after Rectal Surgery in Locally Advanced Rectal Cancer

Chusaeng Teerawiwatchai — 2024-12-19

Objective: To identify the risk factors for anastomosis leakage (AL) after rectal resection for locally advanced rectal cancers (LARCs) treated with neoadjuvant chemoradiation (nCRT).
Material and Methods: A retrospective risk factor study was conducted in LARC patients who received nCRT in Hatyai Hospital from September 2014 to September 2023. The patients were classified into two groups, AL and no anastomotic leak (No-AL) groups. The variables analyzed included age, gender, body mass index (BMI), American Society of Anesthesiologists classification score (ASA), history of significant weight loss, tumor level, time interval between nCRT and surgery, the number of staples, surgical approach, estimated blood loss (EBL), packed red cell (PRC) transfusions, operative time, diverting ostomy, and type of surgery. These predictive factors were analyzed by univariable and multivariable logistic regression.
Results: One hundred and seventeen patients were included in the study. The AL rate was 8.5% and the 30-day mortality rate was zero. The study found that BMI, time interval, EBL, and PRC transfusions were associated with a significantly increased AL risk under univariable analysis. In the multivariable analysis, four factors were identified as independent risk factors for AL: BMI less than 18 kg/m², time interval more than 11 weeks, needing packed red cells blood transfusion, and operative time more than 400 minutes.
Conclusion: Diverting stoma can reduce AL consequences but does not reduce its incidence. Diverting stoma should be considered in locally advanced rectal cancer treated with neoadjuvant chemoradiation patients with the risk factors noted above-BMI less than 18 kg/m², time interval longer than 11 weeks, needing PRC transfusion, or operative time more than 400 minutes.

Factors Related to The Active Aging Concept and Functional Capacity in The Thai Elderly

Pakin Chaichuay — 2024-12-19

Objective: This study aimed to examine factors related to the active aging concept and functional capacity in elderly Thais.
Material and Methods: The study population was 253 elderly people aged 60 years and over. The tools used for data collection were a standardized active aging concept questionnaire, which had an index of item objective congruence (IOC) of 0.938. The descriptive statistics used percentages, means, and standard deviation, and inferential statistics were calculated through stepwise multivariate linear regression to investigate the factors that impacted the functional abilities associated with active aging.
Results: The results showed that functional capacity had a low to moderately positive correlated significance with mean a correlation with the willingness of the elderly people to follow or practice the active aging concept, the health service system and environmental and lifestyle factors had a moderately positive effect; and behavior had a low positive correlated significance with practice the active aging. The regression coefficients of the health service system factors and environmental and lifestyle factors had a positive relationship to the practice of active aging.
Conclusion: In summary, the health service system and environmental and lifestyle factors had a positive relationship with the practice of active aging. Relevant agencies can use this as basic information for planning and promoting the development of increased functional capacity for the elderly.

Acute Effects of Exercise Breaks on Attention and Working Memory During a University Lecture: A Group-Randomized Controlled Trial

Wilawan Chaiut — 2024-12-19

Objective: This study investigated the acute effects of exercise breaks on attention and working memory during lectures among third-year physical therapy students.
Material and Methods: In total 65 participants were randomly assigned to exercise breaks (N=22), game breaks (N=21), and no breaks (N=22). The lecture was divided into two parts. Participants watched each part of a 50-minute computer-based video lecture. The present study examined the heart rate, perception, attention, and working memory impact of 5-minute breaks. The exercise breaks group performed a series of callisthenic exercises, the game breaks group played a computer game, and the no breaks group watched the entire lecture continuously without breaks. The differences in means for variables among each group were compared using a 3x2 repeated measure Multivariate Analysis of Covariance (MANCOVA).
Results: Exercise breaks during lectures facilitated a positive impact on the modulation of shifting working memory in comparison to game breaks and non-exercise breaks (p-value<0.05). Significant pre-test to post-test in shifting working memory improvements were found in the exercise breaks group (F(2,62)=4.266, p-value=0.018). The variation in mean shifting working memory was 12.1 percent of the effect (n_p²=0.121). This improvement aligned with better learning results, especially when assessed for immediate outcomes.
Conclusion: Exercise breaks during academic lectures demonstrated a statistically significant impact on shifting working memory. Consequently, further investigations are required to explore the enduring impacts of exercise breaks on cognitive functions in the long term. Additionally, determining the optimal duration of exercise breaks and lecture lengths is essential for guiding university teaching practices.

The Myanmar Version of the Oswestry Disability Questionnaire: A Cross-Cultural Adaptation, Reliability and Validity Study in the Low Back Pain Population

Phyu Sin Oo — 2024-12-19

Objective: To translate and cross-culturally adapt the Myanmar version of the Oswestry Disability Questionnaire (M-ODQ), and examine its reliability and validity in the low back pain (LBP) population.
Material and Methods: The M-ODQ was cross-culturally adapted in accordance with the ISPOR guidelines for translation. Prefinal testing was done on 20 individuals with LBP, with minor changes. The test-retest reliability, internal consistency, concurrent and construct validity, plus ceiling and floor effects of the M-ODQ were conducted on 101 individuals with LBP, via calculating the intraclass correlation coefficient ICC_(2,1), Cronbach’s alpha, and Spearman’s rank correlation coefficient by correlating with the Myanmar version of the Roland-Morris Disability Questionnaire (M-RMDQ), visual analogue scale (VAS), back performance scale (BPS), and the Stark quality of life (QoL) questionnaire. The level of significance was set at p-value<0.05 for all statistical analyzes.
Results: The test-retest reliability and internal consistency of the M-ODQ showed an ICC_(2,1)of 0.91 and a Cronbach’s alpha of 0.703, thus indicating that the M-ODQ had an acceptable level of reliability. A moderate correlation between the M-ODQ and M-RMDQ (rho=0.56); and fair correlation with the VAS (rho=0.253), BPS (rho=0.336), and the physical component of the Stark QoL questionnaire (rho= -0.274) were found. Weak or no correlation was demonstrated with the mental component of the Stark QoL questionnaire (rho= -0.204). No ceiling or floor effects of the M-ODQ occurred in this study.
Conclusion: The M-ODQ is a reliable and valid outcome measure for assessing disability among LBP patients in the Myanmar population.

Idiopathic Granulomatous Mastitis: A Retrospective Cohort Study of Treatment Modalities in 83 Patients From Southern Thailand

Puttiporn Puttawibul — 2024-12-19

Objective: Idiopathic granulomatous mastitis (IGM) is a rare condition that mimics breast cancer. Current treatment strategies include both surgical and medical therapy. This study aimed to report and describe the clinical signs, radiological findings, management, clinical course, and outcomes after treatment of IGM, from a major tertiary care institute in southern Thailand.
Material and Methods: The medical records of 83 patients with IGM treated at our institute between January 2001 and April 2022 were retrospectively studied. Patient characteristics, clinical presentations, radiological findings, microbiological workups, tissue pathologies, treatment modalities, outcomes and follow-up data were reviewed and analyzed. The success rate, recurrence rate, and time to heal were compared between the different treatment modalities.
Results: Overall, 83 patients were diagnosed with IGM. Due to insufficient follow-up periods, data from only 50 patients were used for the analysis. Initially, 34,3,8, and 5 were treated surgically, with steroids, anti-tuberculosis (TB) drugs, or other treatments, respectively; 32 (64%) achieved disease resolution. The median time to heal was 472 days, while the median time to heal after surgery, steroid therapy, anti-TB therapy, and others was 614.5, 333, 208.5, and 406 days, respectively. Surgery resulted in the longest time to heal; however, the difference was not statistically significant (p-value=0.23). Eighteen (36%) patients experienced recurrence.
Conclusion: There was no significant difference among the treatment modalities in terms of time to heal and recurrence. Surgery resulted in the longest healing time, the highest incidence of complications, and a recurrence rate of approximately 50%. Surgical treatment should be reserved for aggressive diseases.

The Effect of a Single Session of Preoperative Exercise Training on The Rate of Functional Improvement in Patients Who Underwent Total Knee Arthroplasty at a Tertiary Hospital in Southern Thailand: A Retrospective Cohort Study

Pongphon Chuchuen — 2024-12-19

Objective: To evaluate the effect of a preoperative exercise training program before total knee arthroplasty (TKA) and the factors associated with functional outcomes after TKA.
Material and Methods: A retrospective cohort study was conducted. Patients were selected to receive a preoperative exercise training program before TKA. The changes in the Knee Society Score (KSS) were evaluated before and after surgery at 6, 12, and 24 weeks between the preoperative exercise and the standard care groups.
Results: The mean objective scores (KS-OS) and functional scores (KS-FS) were significantly improved at 6 (T1), 12 (T2), and 24 (T3) weeks following surgery. The effect of a single session of preoperative exercise training had no significant difference in both scores (KS-OS T1 p-value=0.53, KS-OS T2 p-value=0.59, KS-OS T3 p-value=0.63; KS-FS T1 p-value=0.16, KS-FS T2 p-value=0.94, KS-FS T3 p-value=0.99). There was no significant difference in the knee range of motion at 6 (p-value=0.68), 12 (p-value=0.12), and 24 (p-value=0.05) weeks after surgery. Ages of 65 years and older and length of stay in hospital, equal to or greater than 5 days, were associated with lower functional outcomes.
Conclusion: The preoperative exercise training program did not affect functional outcomes. Advanced age and longer length of stay in the hospital were associated with poor functional outcomes.

Establishing Local Diagnostic Reference Levels for CT Angiography Examinations

Abhimanyu Pradhan — 2024-12-19

Objective: Computed tomography angiography (CTA) examinations are performed to diagnose blood vessel anomalies. However, this examination results in a significant radiation dose being received by the patient. Local diagnostic reference levels (DRLs) are necessary for determining the extent of radiation dose during examinations. Therefore, the main objective of this study is to establish local DRL values for CTA examinations.
Material and Methods: In this study, a total of 213 participants underwent CTA examination; wherein: 67 underwent computed tomography (CT) cerebral angiography (CTCA), 80 underwent CT pulmonary angiography (CTPA), 40 underwent CT lower limb angiography with aortogram (CTLLA), and 26 underwent CT upper limb angiography (CTULA). Body mass index along with the circumference of the body were calculated. A number of dose descriptors; such as computed tomography dose index volume (CTDIvol) and dose length product (DLP), were collected, and DLP was used to calculate the effective dose, using the conversion factor.
Results: For the angiography phase, CTCA, CTPA, CTLLA, and CTULA had median CTDIvol values of: 31.62, 6.38, 12.16, and 10.12 mGy, respectively. Median DLP and effective dose for CTCA were: 1388.64 mGy*cm & 4.30 mSv, CTPA were 243 mGy*cm & 3.41 mSv, CTLLA were 1855.86 mGy*cm & 12.06 mSv, and CTULA were 945.98 mGy*cm & 2.93 mSv, respectively.
Conclusion: The estimated local DRLs were lower than the international standard for the angiographic phase; however, the dose exceeded the international standard when the entire examination was considered. This study revealed the need for dose optimization in CTA examinations.