Journal of Medicine and Health Sciences <h3><strong>วารสารการแพท</strong>&nbsp;<strong>ย์และวิทยาศาสตร์สุขภาพ&nbsp;</strong></h3> <p>&nbsp;</p> <ul> <li class="show">เป็นสื่อการในการเผยแพร่ผลงานวิจัย ผลงานวิชาการ และผลงานวิจัยอื่นๆ ที่เกี่ยวข้องกับทางการแพทย์และวิทยาศาสตร์สุขภาพของคณาจารย์ นักวิจัย นักวิชาการ แพทย์ พยาบาล เภสัชกร ทันตแพทย์ นักกายภาพบำบัด นักวิทยาศาสตร์ บุคลากร นิสิต ทั้งภายในภายนอก คณะแพทยศาสตร์ มหาวิทยาลัยศรีนครินทรวิโรฒ</li> </ul> มหาวิทยาลัยศรีนครินทรวิโรฒ en-US Journal of Medicine and Health Sciences 2651-1886 รายชื่อผู้นิพนธ์บทความประจำปี 2565 Journal of Medicine and Health Sciences Copyright (c) 2022 2022-12-29 2022-12-29 29 3 รายชื่อผู้ทรงคุณวุฒิประเมินบทความประจำปี 2565 Journal of Medicine and Health Sciences Copyright (c) 2022 2022-12-29 2022-12-29 29 3 The role of dietary approaches to stop hypertension (DASH Diet) on patients with high blood pressure <p><strong>Abstract </strong></p> <p>At the present, the incidence of hypertension is increasing rapidly and continuously. This can be treated by several processes including the adjustment of dietary intake behavior. The Dietary Approaches to Stop Hypertension (DASH diet) has a potential to prevent and control hypertension by consumption of foods rich in potassium, calcium, and magnesium, such as those that prevent endothelia dysfunction and promote endothelial or smooth muscle relaxation. The DASH diet recommends high consumption of vegetables and fruits, lean meat, low-fat dairy products, whole grains, and nuts. Furthermore, the reduction of sodium intake from seasoning, processed and fermented foods, but should also be concerned with non-salty sodium, which contains food products such as sodium nitrite, sodium benzoate, and sodium bicarbonate. The following DASH diet guidelines and consumption of behavior adaptation could reduce the number of hypertension patients and reduce the risk of complications from hypertension as well.</p> Sunitra Chaipai Panrapee Iamtaweejaroen Phakpoom Kooprasertying Yotsinee Huadong Copyright (c) 2022 2022-12-29 2022-12-29 29 3 155 166 Time to assess the daily living activities of stroke patients <p><strong>Abstract </strong></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Post-stroke patients have different recovery times. Previous studies have shown that the assessment of recovery time in post-stroke patients regarding activities of daily living (ADL) ranged from one week to over one year. However, the most common time was three to six months, respectively. The pattern of daily activity among post-stroke patients indicated that the optimal recovery time is within the first 13 weeks, and then 13 to 20 weeks afterwards, when the speed of ADL recovery decreased and became stable. In addition, the severity of a stroke influenced the recovery time for each patient. According to the current guidelines for assessing the daily activities of post-stroke patients, it suggested that ADL should be assessed within the first 48 hours after the stroke incident and may assess every week within the first month. The ADL also suggested that assessment should be conducted again in the third and sixth month after discharge, respectively. Therefore, the ADL assessment should begin within 48 hours after stroke incident, and it should be performed again at least three times to assess the changes. The severity of strokes should be considered when assessing ADL. Whenever the recovery in the activity of daily living in post-stroke patients is stable, assessing ADL is still important and should be performed at least twice afterwards.</p> Watcharasak Phongprapai Non Sowanna Thanin Chattrapiban Copyright (c) 2022 2022-12-29 2022-12-29 29 3 167 179 Soft tissue sarcomas <p><strong>Abstract</strong></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Soft tissue sarcomas (STS) are a group of rare tumors that arise from mesenchymal tissues. Although the etiology is unknown, there are risk factors that increase the risk of STS, such as chemical substances, pesticides, herbicides, and radiation therapies. STS is classified by the WHO into more than 50 histological subtypes and they typically appear as an asymptomatic mass. They can occur anywhere in the body, particularly the arm, leg, trunk, retroperitoneum, head and neck. Diagnosis is made by biopsy for pathological examination. The recommended method is to perform a core needle biopsy along with radiologic imaging, e.g., CT, MRI, or PET scan to assess the size of the tumor, the stage of the disease, and the ability to determine the exact location of the biopsy. The American Joint Committee on Cancer (AJCC) staging system for soft tissue sarcomas is based on histologic grade, tumor size and depth, and the presence of nodal or distant metastases. The treatment goals are to achieve long-term survival, local disease control, and to preserve the function of and the quality of life. Wide local resections are still the primary treatment. Adjuvant radiation therapy is for prevention of local recurrence, whereas radiation therapy prior to resection is to reduce the tumor size. The purpose of chemotherapy is systemic control; therapeutic, adjuvant, and palliative. However, there is still controversy over survival, therefore, chemotherapy is considered on a case-by-case basis. Currently, studies of the molecular characteristics of these tumors have led to the invention of targeted therapy. Most studies are still in phases one and two, but they are likely to be incorporated into standard treatment strategies in the future.</p> Sumitra Chanpeng Copyright (c) 2022 2022-12-29 2022-12-29 29 3 180 197 Journal of Medicine and Health Sciences Journal of Medicine and Health Sciences Copyright (c) 2022 2022-12-29 2022-12-29 29 3 Comparison of the plantar pressure distribution between imported and local materials used for custom-made foot orthoses in patients with type 2 diabetes <p><strong>Abstract </strong></p> <p> The prevention of foot ulcers in diabetic patients around the world can be achieved by the use of appropriate footwear. The recommendations for diabetic patients who have problems with foot ulcers for the prevention of such ulcers include foot care, regular foot screening, and the use of appropriate footwear. Many previous research studies have shown that high pressure on the plantar surface of the foot can be reduced by the use of custom-made foot orthoses with appropriate shoes. In diabetic foot clinics around the world, the choices of materials used to fabricate custom-made foot orthoses depend on the experience of the therapist and the availability of the materials in that area. There are many studies related to plantar pressure distribution in terms of the different types of material used to fabricate custom-made foot orthoses. However, the cost of imported material is higher when compared to the cost of local materials in Thailand. Consequently, the purpose of this study was to compare the plantar pressure distribution patterns during standing and walking between imported and local materials used to fabricate custom-made foot orthoses in diabetic patients with a moderate to high risk of foot ulcers in four areas of the foot: the hind foot, midfoot, forefoot, and toes. The study was conducted with 20 type 2 diabetic neuropathic participants. The participants received two types of custom-made foot orthoses: Insole P (fabricated from Plastazote®, Poron, and micro-cork) and Insole E (fabricated from ethylene-vinyl acetate foam, Poron, and micro-cork). The maximum plantar pressure and distribution were measured using a foot scan array sensor at the hind foot, midfoot, forefoot, and toes during standing and walking. When wearing Insole P, a lower peak pressure was observed in all areas except the heel area when participants were standing compared to with Insole E. Insole P and Insole E showed no significant differences in all areas when the participants were standing, except in the walking trial at the forefoot area, where Insole P had significantly lower peak plantar pressure compared to Insole E. Insole P and Insole E could both reduce the peak plantar pressure in all areas of the foot and provided good pressure distribution during both standing and walking for participants with type 2 diabetes. </p> Voraya Laisanitsalekul Gulapar Srisawasdi Navaporn Chadchavalpanichaya Sasithon Sukthomya Copyright (c) 2022 2022-12-29 2022-12-29 29 3 1 10 The development of skin scrub cream product from Terminalia Catappa Linn. leaf extract <p><strong>Abstract</strong></p> <p> Natural products offer an alternative to skincare, from impact of various environmental pollutants on skin. The leaves of <em>Terminalia Catappa</em> Linn. are commonly used as folk medicine to treat dermatitis on, healthy skin. Previously, there is little scientific evidence to support these viewpoints. The objective of this study was to evaluate the antioxidant activity from <em>Terminalia Catappa</em> Linn. leaf extract by DPPH assay. The development of cream scrub products from <em>Terminalia Catappa</em> Linn. and examining the effects of the product on a 60-person sample group, by specific selection. The instruments consisted of Skin Color Ratio and satisfaction assessment, and the quantitative data were analyzed by percentage, mean, standard deviation, and a paired t-test. The results found that the leaves of <em>Terminalia Catappa</em> Linn. extract showed promising potential antioxidant activity with IC<sub>50</sub> of 1.114 µg/ml. The developed cream scrub results showed that formula no. 2 was the most suitable. After utilizing the product, the skin tone of the experimental groups was substantially lower than the control group, and at a significantly significant level (p0.05). The satisfaction score showed that the experimental group were very satisfied ( =4.30±0.73) As a result, the <em>Terminalia Catappa</em> Linn. cream scrub is another option for people interested in natural skincare. Furthermore, the research supports the usage of Thai medicinal herbs, as well as serving as a guideline for developing products for future commercialization.</p> Aumpol Bunpean Natta Choedchutirakul Punnaporn Kajawong Copyright (c) 2022 2022-12-29 2022-12-29 29 3 11 22 Recovery of inspiratory muscle strength in lobectomy patients receiving physical therapy <p><strong>Abstract</strong></p> <p>This study examines evidence of a lack of inspiratory muscle strength after a lobectomy. The purposes of this study are to examine the changes in inspiratory muscle strength after a lobectomy and to compare inspiratory muscle strength between video-assisted thoracoscopic surgery (VATS) and thoracotomy groups. This retrospective study included lobectomy patients who received physical therapy treatment between May 2018 and December 2020 at the Central Chest Institute of Thailand. Maximal inspiratory pressure (MIP) determined inspiratory muscle strength and was investigated at different times: preoperative, postoperative on discharge day, and two weeks after follow-up. The data were analyzed using two-way repeated ANOVA. There were 61 eligible participants who underwent lobectomy via VATS (n=45) or Thoracotomy (n=16). MIP was significantly decreased on discharge day when compared to preoperative values (p&lt;0.001) and was returned to the preoperative level for two weeks follow-up. When comparing between VATS and Thoracotomy, there was no difference in MIP at discharge day and two weeks follow-up. In conclusion, patients undergoing a lobectomy via VATS or Thoracotomy and received physical therapy treatment suffered the same reduction in postoperative inspiratory muscle strength and recovered to preoperative levels within two weeks of follow-up.</p> Sukalya Kritsnakriengkrai Napaporn Vaewthong Jirawat Klungthumnium Thanthai Kaweemaythee Pharadorn Sriphol Vachiravit Songtanin Voradorn Horbut Yachuravej Thusombat Copyright (c) 2022 2022-12-29 2022-12-29 29 3 23 32 Association between duration of diagnosis to treatments and mortality among advanced stage non-small cell lung cancer patients in Saraburi Hospital <p><strong>Abstract</strong></p> <p>Lung cancer accounts for a high mortality rate. This study aimed to investigate the association between the duration of the process from diagnosis to treatment, other factors, and mortality. This is a retrospective cohort study among 255 patients diagnosed with advanced stage non-small cell lung cancer (NSCLC) in Saraburi Hospital between 1<sup>st</sup> January 2014 and 31<sup>st</sup> December 2019.&nbsp; The risks of dying from lung cancer were assessed using the Cox scale, with time varying covariates. The patient information was obtained from electronic medical records and the National Cancer Registry of Thailand. The mortality rate of lung cancer in Saraburi province was 1.5 per 100 person-month and one-year, three-year, and five-year mortality rates at was 58.8%, 91.3% and 95%, respectively. In univariate analysis, the mortality of lung cancer was associated with longer waiting period for any services. The mortality rate was almost three times higher if the waiting time between the first visit and the diagnosis was more than four weeks, compared to shorter waiting time [HR 2.81 (95%CI 1.95-4.04)]. The longer waiting period for tissue diagnosis was more than two weeks was also associated with higher mortality [HR 2.79 (95%CI 1.85-4.21)]. Furthermore, the waiting period between the diagnosis and the first treatment for more than four weeks and the waiting period between the first visit and the first treatment for more than six weeks were associated with higher mortality rate [HR 1.50 (95%CI 1.11-2.02) and HR 2.63 (95%CI 1.70-4.08) respectively]. In multivariate analysis, these timing factors did not have statistical significance but patients who did not receive any treatments demonstrated the strongest mortality predictor [adjusted HR 4.10 (95%CI 2.32-7.24)]. Patients with histological subtypes, other than adenocarcinoma or squamous cell carcinoma also showed a high risk of mortality [HR 3.00 (95%CI 1.12-8.02)]. The longer waiting periods to treat lung cancer in any services showed higher trends to impact mortality rate although they did not have statistical significance in multivariate analysis. Patients who did not receive any systemic therapy had a higher mortality rate than those who received systemic therapy.</p> Panpicha Chantasartrassamee Voralak Vichapat Copyright (c) 2022 2022-12-29 2022-12-29 29 3 33 52 The correlation of chest X-ray characteristics and severity scores with clinical outcomes in COVID-19 pneumonia patients <p><strong>Abstract</strong></p> <p>The newly emerging coronavirus disease (COVID-19) causes pneumonia. This retrospective descriptive study aims to evaluate the correlation of chest X-ray (CXR) characteristics and severity scores with clinical outcomes in moderate and severe COVID-19 pneumonia patients who require supplemental oxygen, between January 1st, 2021, and December 31st, 2021. The Spearman's correlation coefficient analysis was performed for statistical analysis. There was a total of 305 patients, 64.26% were discharged, and 24.26% died. The mean age was higher in severe than in moderate groups (58.43 and 52.88 years old; p=0.009). The median length of supplemental oxygen and hospital stay were significantly higher in severe rather than moderate groups (10 and 4, and 16 and 12 days, respectively; p&lt;0.001). Peripheral ground-glass opacity in the lower zones of the lungs was the most common finding. Consolidation, perihilar distribution, and diffuse involvement are associated with increased severity, particularly the highest CXR (p&lt;0.001). The severity scores of the initial and highest CXR were higher in the severe group compared to the moderate group. RALE score of the initial CXR equal to or more than eight (adjusted RR = 1.18, 95% CI 1.07-1.31) and Brixia score equal to or more than seven (adjusted RR = 1.16, 95% CI 1.04-1.29) were associated with a higher risk of mortality. In conclusion, the initial and highest CXR characteristics and severity scores have prognostic utility in predicting severe COVID-19 pneumonia. The scores predicted mortality with optimal cut-off points of RALE score of the initial CXR equal to or more than eight or Brixia score equal to or more than seven.</p> Supawan Sukpairoh Supharat Phuntanasiri Metha Songthamwat Thatsanee Sunthorn Copyright (c) 2022 2022-12-29 2022-12-29 29 3 51 66 Efficacy of tranexamic acid for reducing blood loss after caesarean section on women with previous caesarean sections: A randomized controlled trial <p><strong>Abstract</strong></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Postpartum hemorrhage is the most common obstetric complication, especially in the case of a caesarean section. International studies have shown that tranexamic acid is effective in preventing blood loss during and after caesarean section. This study aims to examine efficacy of tranexamic acid for reducing blood loss following a caesarean section. A double-blind randomized and controlled trial method was employed in this study. The sample consisted of pregnant women who had previously received a caaesarean section. The students were divided into experimental and control groups, with 36 students per group. The experimental group received 1g of tranexamic acid and the control group received 9.0% NSS 20ml. The primary outcomes compared mean blood loss, and hematocrit volume after birth. The secondary outcomes were to examine the incidence of postpartum haemorrhage, and adverse events. The statistics were analyzed using chi square test and an independent t-test and there were no statistical differences in terms of age, number of pregnancies, parity, gestational age, maternal weight and height, hematocrit, birth weight and duration of caesarean section in both groups. The mean blood loss was significantly lower in the experimental group than the control group (740.58 ± 139.57 and 853.53 ± 163.67, p = 0.002). ). The mean haematocrit was significantly higher in the experimental group than the control group (35.50 ± 3.29 and 33.92 ± 3.03, p 0.037). ). The incidence of postpartum haemorrhage was significantly lower in the experimental group than the control group (5.56%, 25.00, p = .046.0). There were no statistical differences in the adverse events of both groups. In conclusion, 1 mg of tranexamic acid was effective for reducing blood loss and the incidence of postpartum hemorrhage in women with a previous caesarean section.&nbsp;&nbsp;</p> Chatdoa Sucharit Copyright (c) 2022 2022-12-29 2022-12-29 29 3 69 80 Incidence of Diabetic Ketoacidosis in the Emergency Room, Hatyai Hospital <p><strong>Abstract</strong></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Diabetic ketoacidosis (DKA) is a metabolic complication of diabetes mellitus, characterized by a biochemical triad of hyperglycemia, ketonemia, and metabolic acidosis. This is potentially fatal, especially for the elderly and comorbid patients. The objective of this study was to assess the incidence of DKA in the emergency room at Hatyai Hospital by a retrospective chart review of patients, who were 18-year-old and diagnosed with hyperglycemia or DKA from ICD 10. The analysis covered incidence, clinical features, laboratory results, and the disposition of the patients. The outcomes were reported as the number, ratio, percentage, and median. The results showed that 269 patients were eligible for inclusion in the study. The mean age was 56.2-years-old and most subjects had type 2 diabetes (88.8%) with a mean blood sugar level of 468.2 mg/dL. The DKA incidence was 20.8%, with all of them treated as inpatients and the patients admitted to the general ward (40.3%) and the ICU (85.7%). There was a significant increase respiratory rate, pulse rate and serum potassium. Human insulin is the most current treatment in DKA group (33.1%). Most of all patients came to the emergency room by themselves (51.7%), but there was a high incidence rate of DKA in patients who came with the emergency medical services (EMS) (33.3%). The most comorbid disease was hypertension (34.41%). All of the DKA patients fulfilled the diagnostic criteria of the 2009 criteria from The American Diabetes Association, including high blood sugar, wide anion gap metabolic acidosis, ketonemia or ketonuria with significant differences in the non-DKA group. In conclusion, the hyperglycaemic patients in the emergency room had a significant incidence of DKA less than simple hyperglycemia, but they would have severe consequences if not treated. Therefore, its still necessary to investigate all patients with hyperglycemia. As there were a variety of factors related to the diagnosis, there still needs to be further studies and to find additional relevant factors to determine hyperglycemic patients that could lead to patient care development and appropriate use of limited resources including the improvement of an emergency medical system to reach more people.</p> Nattaya Promwang Pran Na Rungsee Copyright (c) 2022 2022-12-29 2022-12-29 29 3 81 92 Outcome of a frenotomy in infants with ankyloglossia on maternal LATCH score <p><strong>Abstract</strong></p> <p>Ankyloglossia is a common problem in newborns which results in unsuccessful suckling effort. The benefits of frenotomy in the postpartum period to solve suckling problems are still controversial. Therefore, this study was conducted using the LATCH scoring system comparing before and after surgery. The objective was to compare <em>pre-and post</em>-frenotomy LATCH <em>scores among infants with ankyloglossia.</em> A cross-sectional descriptive study was performed at HRH Princess Maha Chakri Sirindhorn Medical Center between January 1, 2018 and December 31, 2020. The maternal and infant data were diagnosed with ankyloglossia, based on&nbsp;<em>Kotlow's</em><em>&nbsp;</em>assessment, were classified and collected. Infants with moderate and more severe ankyloglossia who underwent a frenotomy were included. Comparison LATCH scores before and after surgery used Wilcoxon matched pairs signed ranks test. A total of 166 newborns diagnosed with ankyloglossia were included in this study. There were 110 males (66.27%) with an average age of 4.06±4.30 days. A comparison of pre-and postoperative LATCH scores showed a postoperative median of seven (the interquartile range 7-8) significantly better than preoperative ones with a median of six (the interquartile range 4-6) (p-value &lt; 0.001). &nbsp;After surgery, 34 mothers with LATCH scores over eight (20.48%) were found. The overall<em>&nbsp;complications&nbsp;</em>in the frenotomy procedure, including any minor&nbsp;<em>bleeding,</em> which was only <em>found in</em> two cases (1.2%).&nbsp; There were 42 cases of mothers who were exclusively breastfeeding over a six-month period (25.30%). It was found that the level of education of mothers at the secondary school level and above affected the success of exclusive breastfeeding over a period of six months. In conclusion, a frenotomy during the early postpartum period in infants with moderate to more severe ankyloglossia with breastfeeding difficulties can improve breastfeeding and be evaluated with a LATCH score.</p> Panuwat Wongwattana Pannipa Wiriyaamornchai Thanatcha Panyasin Apisara Phuawongphat Chaladporn Punpongpipat Panachai Huntrakul Copyright (c) 2022 2022-12-29 2022-12-29 29 3 93 106 Knowledge, perceptions, and attitudes of patients regarding advance directives at the End of Life Care at Maha Chakri Sirindhorn Medical Center <p><strong>Abstract</strong></p> <p>Despite the 2007 National Health Act on the right of terminally ill patients to decide not to receive life-saving treatment, but the general public, including medical personnel, still have incorrect perceptions. Therefore, the study of knowledge, understanding, and attitudes towards forethought at the end of life will provide information, and be able to make plans to decide when the end of life is coming. The purpose of this descriptive study was to determine their level of knowledge, perceptions, and attitudes regarding advanced health care directives or living wills for end-of-life care among patients and their relatives at HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC). The survey and descriptive study was conducted from May to July 2021 by the random sampling of patients and their relatives who visited the outpatient internal medicine department at HRH Princess Maha Chakri Sirindhorn Medical Center at Srinakharinwirot University. The questionnaires were categorized to baseline characteristics, knowledge, and attitudes to advanced directions at end of life care. The data were analyzed as descriptive analyses and reported in terms of percentage, mean, and media. The study sample consisted of 464 patients and their relatives at the outpatient internal medicine department of MSMC and chosen by random sampling. The majority of the participants were female (64.01%) and an average age of 48. Most of the patients were Buddhists (87.26%), 66.59% of the samples had knowledge and understood the definition of the end of life and 76.08% understood palliative care. However, only 45.69% knew about revising advanced health care directives and only 30.60% understood the format. As for the attitudes, most of the samples thought that they did not know much about living wills mean total score is 2.59 ± 1.12, and interested to do the living will with a mean total score of 3.01± 1.17. Most of them were likely to encourage their friends or relatives with incurable diseases to accept palliative care instead of full medication care, by a mean of 3.35 ± 1.21. Furthermore, most of them had high expectations of information and counselling about living wills from health professionals with a mean total score of 3.89 ± 1.0. Based on the results, the research suggests that there should be promotions and campaigns to increase knowledge and perception among the patients and relatives about decision-making and choosing a method in terms of advanced health care directives. In addition, further research should study more factors, such as education, occupation, religion, or beliefs that may affect decisions about advanced health care directives.</p> Kanokporn Puthong Thanchanok Tirakanoksathit Pattarapol Pattarapanuwan Santidharm Pattanasiri Sutakorn Kanoptammakul Supap Makruasi Nisa Makruasi Copyright (c) 2022 2022-12-29 2022-12-29 29 3 107 123 Associated computed tomographic features and quantitative measurement of ruptured hepatocellular carcinoma <p><strong>Abstract</strong></p> <p>Ruptured hepatocellular carcinoma (HCC) is a life-threatening complication. The Computed Tomographic (CT) features of ruptured HCC confirmed the diagnosis of a peripherally located tumor with a contour bulge. The associated CT features and quantitative measurement are poorly understood. The assessment of the associated features of ruptured HCC may improve an accurate diagnosis, prognostic understanding, and treatment procedures. The associated CT features and quantitative measurement of ruptured HCC were retrospectively evaluated to improve accurate diagnosis and prognostic evaluation. The case group of 53 patients with ruptured HCC and the control group of 94 randomly selected HCC patients without ruptured tumors was clinically reviewed. The maximal tumor dimension, area, volume, protrusion length and height were greater in the rupture group, with the protrusion ratio and CT attenuation significantly lower. Tumor protrusion, extrahepatic invasion, metastasis, abnormal vascularity, ascites, necrosis and tumor thrombus were also significantly higher in the rupture group. Among the parameters, the protrusion height showed the highest association. Multivariable analysis determined that maximal tumor dimension and tumor protrusion were independently associated with ruptured HCC. Tumor protrusion showed the best correlation. Maximal tumor dimension at a cut-off value of 6.3 cm gave optimal sensitivity (88.7%) and specificity (73.4%). Maximal tumor dimension and tumor protrusion were independently associated with ruptured HCC. The maximal tumor dimension exceeded 6.3 cm and tumor protrusion height of more than 3 cm were suggestive of imminent HCC rupture.</p> Nattawut Jiraaram Sitthipong Srisajjakul Copyright (c) 2022 2022-12-29 2022-12-29 29 3 124 136 A correlation between pretest and posttest scores for a formative assessment and modified essay question (MEQ) scores for a summative assessment among fifth-year medical students in the gastrointestinal emergency session <p><strong>Abstract</strong></p> <p>Formative testing is used to track and evaluate a (learning) program that is still being implemented. As a result, formative testing can aid intrinsic motivation. Summative assessments are used to examine the competencies of the students, evaluate a previously completed (learning) program, and to qualify them for more advanced educational segments. Multiple-choice questions (MCQs) have a greater ability to test knowledge and factual recall. On the other hand, the modified essay questions (MEQ) aim to assess the problem-solving and the clinical reasoning skills of the students. The present study aims to evaluate the correlation between the pretest and posttest scores for a formative assessment and MEQ score for a summative assessment among fifth-year medical students. This was a retrospective observational study by fifth-year medical students in the gastrointestinal emergency session in the subject of the emergency and trauma in the 2021 academic year.&nbsp; The correlation between the pre-and-posttest scores and the MEQ score was calculated using the correlation coefficient and paired t-test. A total of 100 medical students were enrolled in this study, with 46% males and 54% females. The median of pretest score, posttest score, and mean of MEQ score were six (IQR 5-7), and 10 (IQR 9.8-10), and 70.6 <u>+</u> 9.9 points, respectively.&nbsp;The students were divided into two groups, including students who had a minimum passing level and an MEQ score of greater than or equal to 60 points and had a cumulative grade point average of 3.2 <u>+</u> 0.32, which was higher than those who failed to pass the MPL and with a cumulative grade point average of 2.9 <u>+</u> 0.47.&nbsp;The pretest and posttest scores had a very low correlation with the final MEQ score, with an r value of 0.119 and 0.029, respectively.&nbsp;In conclusion, formative assessment using MCQs had a very low correlation with a final MEQ score for summative assessment.&nbsp;On the other hand, the students who passed the MPL score on the final MEQ had a higher cumulative grade point average than the students who failed to pass the MPL, which was also statistically significant.</p> Ar-aishah Dadeh Paramat Siriyod Jirawat Khongsin Copyright (c) 2022 2022-12-29 2022-12-29 29 3 137 144 Factors significantly associated with the research publication status of ophthalmology residents at the Faculty of Medicine Siriraj Hospital, Mahidol University: A 10-year retrospective study <p><strong>Abstract</strong></p> <p>The Department of Ophthalmology in the Faculty of Medicine at Siriraj Hospital provides a residency program for medical doctors to become a certified ophthalmologists. Ophthalmology residents were required to publish or submit a manuscript before the final board examination. This study aims to evaluate and compare research-related factors among ophthalmology residents at the Department of Ophthalmology in the Faculty of Medicine at Siriraj Hospital, Mahidol University, Bangkok, Thailand, from 2007 to 2016, and to identify the factors significantly associated with successful publications. This retrospective study collected data with Institutional Review Board (IRB) approved research projects of ophthalmology residents from 2007 to 2016. The collected data included gender, starting period, authorship status, study design, type of study site, funding status, ophthalmologic subspecialty, and time of publication after IRB approval. There were 102 IRB-approved research projects from 2007 to 2016. Of those, 41.2% projects were published in national or international journals, and 76.2% were published by female residents. Most residents were co-investigators, had unfunded research, collected single-center data, had a retrospective study design, and published their research one year after IRB approval. The number of published research projects during 2007-2011 was significantly higher than that of during 2012-2016 [29 (69.1%) <em>vs.</em> 13 (31.0%); <em>p</em>&lt;0.001]. The results revealed entry into the ophthalmology residency program from 2007 to 2011 to be significantly associated with successful journal publication. Since the rate of successful journal publication decreased during the second half of the study period, strategies to improve research knowledge and support among ophthalmology residents need to be developed and implemented.</p> Wilawan Sanpan Supattra Sawangkul Copyright (c) 2022 2022-12-29 2022-12-29 29 3 145 154