plueme/wizJson huggingface dataset:
Objective: The purposes of the study in Panomsarakham District, Chachoengsao
Province, were as follows: 1) to survey the quantity of fluoride in drinking water sources;
2) to determine the prevalence and severity of dental fluorosis in district elementary
schools, and its relationship to the presence of fluoride; and 3) to encourage community
participation in solving the dental fluorosis problem.
Method: 1. Collection of 426 water samples from 87 villages; these were sent for
fluoride detection by ion-specific selection method (electrode); 2. a cross-sectional study
was conducted on 2,281 elementary students in grades 1-6 resident in Panomsarakham
district, for the presence of fluorosis and caries;  and 3. resorting to community participation with local authorities.
Result: Highly fluoridated drinking water was found in 13 of 81 villages, and the
levels were especially high in Bansong, Nongyao, Kaohinsorn and Tatan villages.  The
dental fluorosis prevalence rate was 35.9 percent among students from highly fluoridated
villages, and only 12.7 percent among those from villages where the level of fluoridation
is low.  The severity of dental fluorosis depends on the concentration of fluoride in drinking water, with statistical significance being p=0.000.  The mean DMFT was 1.46 in a
highly fluoridated village while it was 1.42 in a village where fluoridation was low.  It
was noticed that the highly fluoridated area still had higher rates of dental caries compared with the area with a low level of fluoridation, which is contrary to the findings of
other reports; this aspect requires further study in the future.
Conclusions: High levels of fluoridation in drinking water were found and its presence directly related to the prevalence and severity of dental fluorosis.  Therefore, the
problem should be solved by stakeholders [government, communities and politicians],
i.e., the communities concerned should take responsibility for a campaign to change  the
source of drinking water; politicians should provide a budget for intervention and the
government should support surveillance and the provising of data.
This research study was conducted on 204 non-insulin dependent diabetes patients
to assess their behavior and the relationship between supporting factors, by making
practical use of the theory of the PRECEDE Model of Lawrence Green, which involves
studying cross-sectional data collected by survey, using structural interviews.  The study population (n = 204) was obtained by simple random sampling from the non-insulin
dependent diabetes patients attending the diabetes clinic in the period June 1-30, 2006.
Descriptive data were submitted for Pearson’s coefficient and multiple regression analyses.  The results were that the behavior in controlling the blood glucose level among
non-insulin dependent diabetes patients was at a moderate level.  Knowledge of diabetes
(p<0.01), perceived susceptibility to diabetes (p<0.01), perceived severity of diabetes
(p<0.01), benefits and cost of following the advice and suggestions of health officers
(p<0.01), the skill of a diabetic (p<0.01), and promotion by spouse, parents, relatives, siblings, neighbors, co-workers, doctors, nurses and public health officers (p<0.01) are positively and statistically significant related to the behavior of blood glucose level control.
The results of the stepwise multiple regression analysis revealed that the factors affecting
the behavior of blood glucose level control in non-insulin dependent diabetes patients
can be promoted by their spouses, parents, relatives, siblings, neighbors, co-workers,
doctors, nurses and public health officers (p<0.001) and the benefits and cost of following
the advice and suggestions of public health officers (p<0.01).  The two variances were in
line with the prediction at 12.90% (R
2
=0.129).  Information obtained from the present
study suggests that the use of certain health strategies, such as meetings, trainings, movies, slides, videos, and showing actual data, would enable the patients to gain more knowledge about the complication of diabetes which might occur in them.   Such strategies
could also give knowledge to their family members (spouses, siblings, as well as public
heath volunteers of the village, and community leaders), and lead to the establishment of
a diabetes club in their village.  Such steps would encourage the patients to take control of
their blood glucose levels so that thay become normal or near normal.
Dapsone hypersensitivity syndrome (DHS) is a condition rarely reported in Thailand.  Recently, during the period from January 1 to August 8, 2007, a 40-year-old male
patient, among the five cases on multidrug therapy (containing dapsone) for treatment of
leprosy, developed DHS (fever, maculopapular rash, hepatitis, lymphadenopathy and
pneumonitis) eight weeks from the start of the treatment.  Prompt drug withdrawal, administration of corticosteroid and supportive treatment led to his rapid are recovery; he
was discharged on the 11th day of hospitalization.  The patient is likely to have represented the second reported case of its kind in Thailand.  The author is publicizing this
case as a  warning to physicians who chance the use of dapsone; they must be aware that
the severe and potentially fatal side-effects of such a hypersensitivity syndrome is not so
rare
Chiang Saen Hospital has provided antiretroviral therapy (ART) to people infected
with HIV, especially the Burmese and Laotians residing in Thailand or in their own countries.  The guidelines of the country program were applied.  The cohort study design
measured ART adherence, survival rate, clinical outcomes, result of the prevention approach and psychological support as outcome indicators.  Data were collected and analyzed using FUCHIA software.  The Kaplan-Meier method was conducted for survival
analysis.  The results revealed that 73 non-Thai PLHA (people living with HIV/AIDS)
who received ART from July 2004 to June 2007 (19 Laotians, 16 of whom resided in their
own country; 51 Burmese, 20 of whom resided in their own country, and three minority
people residing in Chiang Saen.  Mean ART adherence was more than 98.2 per cent.  Mean
survival time in months was 41 (95% CI 39.0-43.2).  Survival at 36 weeks was 96 percent.
Three cases died after ART, two from AIDS and one from the adverse effects of ART.   No
case had been lost to follow-up or stopped treatment.  Thirty per cent of the patients
needed to change individual drugs due to adverse effects.  The health of those on treatment improved.  Access to ART increased the uptake of service in the prevention approach.  Eleven cases received vocational loans and one case received an education fund.
It is one model of how the disadvantaged can access ART in cross-border areas and how
Thailand can support its neighbors.  However, the effectiveness and the sustainability of
the program still need to be considered
This is an evaluation of public health service innovation, with a focus on subdistrict
hospital creation.  The major aims of this work were strengthening the community with
regard to the building of and participation in sustainable health care.  The method considered three phases. The first phase was to create a participation center for fostering
community trust and belief. Triangular cooperation consists of a government organization, subdistrict administration and a community plebiscite in the pilot innovation intiated in three subdistrict hospitals.  In the second phase that followed, 31 subdistrict hospitals
were distributed in 22 subdistrict areas.  The third phase utilized useful community trust
and belief for the creation of various novel projects.  The overall creation extended five
years and involved underlying community triangular participation.  The subdistrict hospitals had permanent registered nurses, telemedicine consulting and medication storage
development. The consequences of subdistrict hospital creation improved the people’s
health service access. While the number of walk-in clients seeking subdistrict hospital
services expanded year on year, a three-fold reduction was observed among those
seeking medical services in Lomsak Hospital.  Important was the two-fold improvement
in chronic illness screening.  In conclusion, the results of this evaluation suggest that a
key important success indicator of subdistrict hospital creation is the strength of community participation, consequently improving community development and sustainability.
Background & rationale Poor adherence to medication is a common problem in
handling patients with chronic disease.  Induction of patient adherence to a long-term
regimen requires impressive information about the regimen being given and the importance for the patient of following strictly the treatment, together with the full support of
their families.
Objectives To evaluate the adherence to medication and clinical outcomes in hypertensive patients with or without diabetes mellitus.
Methodology A retrospective study of hypertensive patients was conducted by reviewing outpatient medical records from June 2006 to June 2007 at Nangrong Hospital.
Two groups of subjects included men and women aged over 18 years old: the group of
primary hypertensive patients had blood pressure above 140/90mmHg and the group of
hypertensive patients with diabetes mellitus had blood pressure above 130/80 mmHg.
Patients with other causes of hypertension, or blood pressure over 200/120 mmHg, or
who had serious complicating illnesses, such as terminal stage of cancer, chronic renal
failure, chronic liver disease, congestive heart failure, stroke, and uncontrolled angina,
were not included.
Results Among the total of 54 patients, the hypertensive patient group (n=30)
had higher blood pressure than the group with hypertension and diabetes (n=24).  The
average ages of patients in the hypertensive group and the group with hypertension and
diabetes group were 60.56±8.97 years and 57.75±7.87 years, respectively.  The risk factors,
i.e., cigarette smoking and alcohol consumption, showed no difference in the two groups.
The study disclosed that the major factors for poor adherence were the complexity of
treatment (66.66%, 83.33%) and a poor provider-patient relationship (66.66%, 75%); the
major factors for improving adherence were emphasized value of the regimen (93.33%,
95.83%) and family support (93.33%, 96.66%).  Impediments to successful adherence to
medication in individual cases, namely taking drugs at the wrong time (36.66%, 37.50%)
and taking extra doses to make up for missed doses (20.00%, 20.83%), showed no difference in the two groups.
Conclusions Poor adherence to a medication regimen is common, contributing to
substantial worsening of disease, death, and increased health-care costs.  Improving adherence requires emphasizing to the patients the value of the regimen, making the regimen simple, medication-taking behavior and family support.
This research studied the factors related to the sick leave behavior of personnel in
Pranburi Hospital, Prachuap Kiri Khan Province to determine the reasons for sick leave
behavior as it related to disease/symptoms, age, sex, income, position, section/institute,
and type of career.  The study population numbered 174.  Retrospective research was
used to compile data on sick leave based on requests for leave of absence over the period
from October 1, 2004 to September 30, 2006.  Analysis of the data was by statistics, percentages, averages, standard deviation, and Chi-square.  Most of the personnel took sick
leave an averae of 2.54 times over the two-year period; a frequent reason for taking sick
leave was  respiratory system disease (35.4%).   The number of days of sick leave ranged
from 0.5 to 2 days/time (84.1%), but there was no significance according to age, sex,
income, position, section/institute, or type of career.
The objective of this qualitative study was to study the adaptation to illness of tuberculosis patients and develop recommendations for family and social support of the
patients. Purposive sampling was carried out by in-depth interviews of registered AFBpositive pulmonary tuberculosis patients who were treated in Chaingyuen Hospital and
lived in Chaingyuen district.  It also included in-depth interviews of the families, neighbors, and health volunteers, as well as the local governor, and health officer. Focus group
discussion was conducted among three groups of neighbors, families and cousins of tuberculosis patients; there were four cases of non-participatory observers in the patients’
families. The results of this study show that, in the first two months of treatment, the
patients required physical and psychological adaptation because of worring disease progression and drug side effects, which made them reduce their activities.  They also needed
support from others, which lowered their self esteem.  After the first two months the
patients felt better owing to their improving health, and the normal activity which gave
them confidence in the treatment and boosted their self esteem.  Although most of the
patients could adapt to the role-functioning aspects, they still helped themselves and
sought the support of others appropriately.  One-third of the patients sought alternative
treatment, especially with Thai herbs, without addressing financial problems.  For social
support most patients were given good care and love by their families and the community with regard to finance, work, using utensils and providing information on the disease, all of which helped the patients.   The patients were satisfied with the treatment
service received from  the national health insurance system despite the lower number of
homevisits allowed under related guidelines. The health officer therefore followed up by
telephone instead of making homevisits, which showed that local government authorities can play a role in homevisits.  Based on this study, we recommend that the authorities
involved should consider develping community networks and creating a referral system
for patient support, providing knowledge about tuberculosis to the community through
appropriate channels, for example, community radio, and developing a home visit system to meet establihed standards, and make continuous evaluation.
This descriptive study was conducted in a lumber mill in Nakhon Si Thammarat
Province to identify noise hazards and hearing impairment among workers in places where
working condition are noisy.  Noise was found to be greater than 90 decibels (A) over
seven areas (63.64%) in the workplace.  Among the 46 workers who worked in noisy areas
without ear protection, hearing losses of 500, 1,000 and 2,000 Hz at 25 decibels (A) were
found in 26 workers (56.62%), at 26-40 decibels (A) in 19 (41.31%), and at 41-55 decibels
(A) in 1 (2.17%).
The investigator suggests that the Hearing Protection Program be introduced and a
work manual be provided for the factories concerned in order to ensure the workers’
safety
The practice of the Bangmunnak-Dongcharoen Health Network in carrying out the
policy of preventive control of diabetes mellitus had been by screening patients and high
risk groups using capillary blood glucose levels greater than 110 mg/dl.  Such persons would
be sent to the hospital for conventional diagnosis.  However, this process created considerable inconvenience as a result of overcrowding with attendees; satisfaction dropped and
attendees missed the opportunity to obtain important knowledge about nutrition and exercise.  The author thus created a model for the screening of diabetics and persons at risk and
for providing knowledge by a multidisciplinary team at the health center.  The model could
be used for evaluating the satisfaction of the attendees, comparing mean scores on their
knowledge about nutrition and exercise before and after education and demonstration, and
evaluating the satisfaction of the health officials with such a model.
The study was carried out at seven health centers in Bangmunnak district, Phichit
Province.  The target population included persons 40 years old and older who had a fasting
plasma glucose level higher than 110 mg/dl.  The sample group was tested for knowledge
about nutrition and exercise (pre-test).  Then education and a demonstration was given by a
doctor, nutritionist and physiotherapist. Post-testing was done, and the satisfaction of the
sample group and health officials was evaluated. The results of the study showed that 77
persons were included in this study: 29 cases were diagnosed as diabetics, and 48 cases were
in the impaired fasting glucose group. Most of the cases studied were in the age group 41-50
years and 51-60 years.  The ratio of females to males was 3.8:1.  Average body weight was
63.56 kg, average height was 154.98 cm; the average was 28.74 kg/m2
and 37 cases (48.05%)
had a BMI of 25 kg/m2
.  The sample group was satisfied with the education and demonstration.  Overall satisfaction was 100 percent and most of the studied group was satisfied with
every step.  The cost of travel was reduced by 7.5 times compared with travel to the hospital.
The mean score of the pre-test for knowledge about nutrition was 7.74/10.  After education,
the mean score increased to 8.94.  The mean score of the pre-test for knowledge about exercise was 7.34/10.  After education, it increased to 8.44.  A significant difference (tested by
paired t-test) in knowledge about nutrition and exercise of the sample group before and
after the education program (p < 0.05) was observed.  The result regarding the satisfaction of
the health officials showed that all the health officials were satisfied with the model (100%).
The results of the study showed that screening, coupled with education about nutrition and
exercise by a multidisciplinary team, can make the attendees more comfortable, economically safe, satisfied with less crowding and able to achieve significantly higher scores on
knowledge about nutrition and exercise.  The officials concerned were satisfied about the
education and demonstration aspects.
The purpose of this study was to explore the trends of dengue hemorrhagic fever on
the disease’s occurrence and its association with ambient temperature, rainfall and relative humidity. Information was collected retrospectively from secondary data related to the occurrence of dengue hemorrhagic fever and meteorological data, reported from January 1, 1996 to December 31, 2006.  Data were presented in frequency, and an association
was analyzed with cross-sectional time-series regression.  The results revealed that the
rate of dengue hemorrhagic fever varied from 120.62 to 277.6 per 100,000 population between epidemic years.  There was a tendency for the population to be affected by the
disease every two to five years.  Ambient temperature, rainfall and relative humidity
were positively associated with the occurrence of the disease (p<0.001, p<0.001 and
p<0.001, respectively).
Based on the results of this study, the author would like to suggest that the Ministry
of Public Health should continuously increase the people’s awareness of the occurrence
of dengue hemorrhagic fever.  The provincial health office should coordinate with the
provincial meteorological center, requesting meteorological data related to dengue hemorrhagic fever for preparation of early warning systems for the prevention and control
program.
A 41- year-old woman was bitten on the left foot by a Russell’s Pit-viper.   Four vials
of antivenin were administered promptly on the first day; however, the antivenin did not
prevent multiple organ bleeding from developing the following day.  The patient had
hematemesis, bleeding per vagina and oliguria the next day from acute renal failure.
Owing to high levels of blood urea, creatinine and anuria, interventions including blood
transfusion, antimicrobials, diuretic and 15 sessions of hemodialysis were given.  All her
conditions improved gradually; the patient was discharged from the hospital after being
hospitalized for 45 days.  This case is a good example showing that prompt antivenin
administration along with other therapeutic modalities, especially adequate hydration, is
effective in dealing with acute renal failure caused by this type of snakebite
Bronchial asthma is a chronic debilitating illness highly prevalent in Thailand.
Danchang Hospital established an asthma clinic on July 10, 2006; it is operated by a patient care team who provide treatment according to international standard guidelines.
This research study was aimed at evaluating the efficacy of the Danchang Hospital asthma
clinic’s efficacy by comparing the results of caring before and after treatment on 85 selected clinic attendees during the period from July 10 to December 31, 2006.
The results showed that the rate of patients receiving medication by nebulizer in the
emergency room was reduced from 59 percent to 11.7 percent and hospitalization was
reduced from 27.3 percent to 2.35 percent; the severity of disease was reduced by 68.2
percent; the rate of correct use of inhalers was 38 percent; decreased use of short-acting
beta 2-agonists was reduced by 82 per cent, and the rate of patients who were able to
perfrom their daily routine activities was 87.3 per cent, which means that their quality of
life was better, and the necessity of emergency room visits and hospitalization was much
reduced.
The purpose of this study was to identify factors influencing the control of blood
pressure levels encompassing four aspects, i.e. personal, pre-disposing, enabling and reinforcing factors.  A sample of study subjects included 381 hypertensive patients living in
Tha Chang district and seeking health care at Tha Chang Hospital, Thon Samo Subdistrict Health Center, Wihan Khao Subdistrict Health Center, and Phikun Thong Subdistrict
Health Center for Commemoration of Her Majesty the Queen’s 60th Birthday Anniversary.  Data were collected by using a questionnaire and analyzed by using percentage
values and the binary logistic regression method for testing the statistical significance of
the factors influencing blood pressure control. The study revealed that the factors influencing blood pressure control among hypertensive patients in Tha Chang district include, in order of high-to-low levels of significance, enough income (OR=2.345), perception of health worthiness (OR=0.478), co-morbidity with hypertension and other diseases (OR=0.414), and supportive care from relatives or someone else with a close relationship (OR=0.316).  Other factors that were found
to be unassociated with blood pressure control are sex, age, educational attainment, knowledge about the illness, perception about being ill, perception about continuous care, attitude toward hypertension, accessibility to health-care facility, satisfaction with healthcare facility, satisfaction with the effects of medication, assistance from health personnel,
and doctor-patient relationships.