plueme/wizJson huggingface dataset:
Combination antiretroviral therapy has proved to effect lower morbidity and mortality
rates among HIV/AIDS patients. However, the effectiveness of continuing patient care is also important. Therefore, evaluation of treatment to improve the management
system is needed. This study was aimed at evaluating the effectiveness of triple therapy
with antiretroviral drugs by comparing CD4 cell counts, opportunistic infection rates during
treatment, side effect and adherence to treatment.
The patients’ data were retrospectively obtained from patient records. The patients
were those who came for treatment at Somdetpraboromrachineenart Hospital, Nathawee
district, Songkhla Province from January 2003 and April 2008. None of the patients received
treatment previously. CD4 cell count, body weight before and after treatment
were compared and analyzed by Wilcoxon signed-rank test.
There were 46 patients who met the criteria for treatment, but complete data were
available from 42 patients, 23 were male and 19 were female, 17 had AIDS, and there were
16 symptomatic and 9 asymptomatic HIV-infected patients. The results of treatment revealed
that CD4 counts after six months in all groups were significantly increased compared
with those before treatment. Side effects occurred in 10 patients, 8 with rash, 1 with
lipoatrophy and 1 with increased SGPT level. None of the patients developed opportunistic
infection after six months of treatment until now. Almost all (39 patients) showed
good adherence to treatment.
The study concluded that triple therapy with GPO-VIR in a middle-sized community
hospital gave good results. An effective management system that helps patients to
adhere to treatment and continuing evaluation is an important factor.
The aims of this research were to examine the situation and epidemiology of tuberculosis
in four district hospitals in Nakhon Ratchasima Province in fiscal years 2005-2007.
All tuberculosis patients registered between October 2004 and September 2007 were selected
for the study.
The research instruments consisted of OPD card, treatment card, tuberculosis record,
and sputum examination record. The data were analyzed by using descriptive statistics.
The results showed that prevalence rates were 74.3, 112.1, 81.1 per 100,000 population
respectively in 2005-2007. Incidence rates were 64.9, 100.7, 69.0 per 100,000 and mortality
rates were 8.1, 14.0,3.5 per 100,000 respectively during that period. The success rate
was 73.5 percent and cure rate was 53.5 percent. The percentages of HIV infection in
tuberculosis cases were 4.7, 5.8 and 11.0, increasing by year, with a high mortality rate of
44.2 percent.
A high success rate was found in the occupation of civil servants (100%), students
(100%) and prisoners (91.9%). Tuberculosis cases with diabetes mellitus were also found
to have a high success rate (100%). Directly observed therapy (DOT) by health personnel
produced a relative risk of 1.33 significance compared with no direct observation. However,
DOT, with observation by cousins, showed no significant difference compared with
that produced by no direct observation.
Workers in small industries in rural areas work under unhealthy and poor environmental
conditions because of the limitation of local health services. In addition, unsafe
equipment and chemicals are commonly used in the manufacturing process. This study
explored the working processes in wooden furniture factories in Loei Province after the
workers had received information about the health and safety of workers, and about the health and environmental risks in surrounding communities affected by these small industries.
This study employed both qualitative methods, including participation observation,
in-depth interviews, group discussions and questionnaire interviews, as well as
quantitative methods, such as secondary data analysis from existing documents. The
results of the study showed that the manufacturing processes of these kinds of factories
might be directly harmful to the health and safety of the workers. Poor working conditions,
for example, dust, smoke and noise pollution, might not only affect the health and
safety of these workers but also afftect the health of their family members and communities.
Community hospitals and tambon administrations should be major stakeholders in
managing theses occupational health problems by launching a “healthy public” policy
and providing all sectors with guidance, including that on the manufacturers, workers,
and health centers or primary care units. Moreover, management at the national policy
level should be implemented by providing a simplified version of the diagnosing process
of diseases related to occupational health, strengthening occupational health surveillance
in local settings and initiating prospective cohort studies to identify specific determinants
of local occupational diseases.
The purposes of this study were to determine the results of the screening of Papanicolaou
smears (Pap smears) for cervical cancer in HIV-infected women in Prachantakam
district, Prachinburi Province. The subjects enrolled in this study were 34 HIV-infected
women who were among the people living with HIV/AIDS.
PAP smears were done in 34 HIV-infected women; one (2.94%) of them was found
to be abnormal, and one (2.94%) revealed cervical cancer. Compared with the results of
PAP smear that had been done on 7,756 women in Prachinburi Province, 0.31 percent
were found to be abnormal, and 0.04 percent had cervical cancer.
Therefore, standard routine screening for cervical cancer using PAP smears for HIVinfected
women should be necessary under the health insurance policy.
The purpose of this research was to study the level of self-care participation of diabetes
patients according to the opinions of those patients in Sophisai District, Nongkhai Province,
and to study the factors of the correlation and self-care participation. The sample included
400 diabetes patients who had been registered by Sophisai Hospital and cured. A
survey questionnaire was administered to the participants. The study utilized the SPSS program,
with statistics on percentage, mean and standard deviation, including the chi-square
for correlation with normal scale and interval scale factors and utilized the Cramer ’s V coefficient
for ratio scale. The results of the study showed that the self-care participation of diabetes
patients according to their opinion was at the medium level. The analysis of sectors
found that the most common self-care participation of diabetes patients was diet; the next
were exercise and self-care participation in daily life. The least common form of participation
was foot care.
The correlation between the factors related to personal characteristics, economics and
social aspects and self-care participation found that: there was no correlation for sex in the
self-care participation of diabetes patients as a whole nor was there any correlation with
participation in every side when considering sectors.
There was no correlation in age for the self-care participation of diabetes patients, nor
was there any correlation with the participation when considering sectors.
There was correlation in education for self-care participation as a whole; when considering
sectors, but there was correlation with participation, namely diet, exercise and selfcare
in daily life.
There was no correlation in income for self-care participation of diabetes patients as a
whole, nor was there any correlation with participation in considering sectors.
There was correlation in occupation for the self-care participation of diabetes patients,
when considering the sectors; the correlation with was in diet.
There was correlation in the factors of receiving information about self-care participation
as a whole, and there was correlation with participation in every aspect when considering
sectors.
The study would be applied in planning for good-quality services, supporting the
diabetes patients for self-care participation, emphasizing communication. Providing knowledge,
giving health information through the targets, building leaders who acknowledge
and are able to be the primary person in self-care participation and able to transfer information
to the members or the diabetes patient group.
Banphaeo hospital is going to be the first autonomous hospital in Thailand: non-profit and government subsidiary hospital. This paper aims to show the background, methodology and philosophy of the hospital subsidiary budgeting for the year 2000 ehich their rational is based on the Banphaeo hospital's mission. It's mission is to provide universal coverage of basic health service package in Banohaeo district. The basic health service package consists of health promotion, prevention, primary health care, rehabilitation, and curative service for the health cardholder.
Thus, the Banphaeo hospital subsidiary budgeting is based on capitation. It will pay to the tertiary care hospital for referred patients and to subcontractors for gatekeeper services too. The new budgeting method will change the service concept by aiming at holistic care not the quantity of curative care.
However, this budget should be only for the operating cost, not including with capital cost, which should be proposed by each item project.
The subsidiary budgeting use the data from morbidity rate and admission rate from Health and Welfare survey of National Statistics Office and average operating cost from several costing studies. Per capita budget is consisted of curative expenses and health promotion expenses. For the curative expense, this study uses outpatient department care (OP) cost (morbidity rate X OP cost per visit) plus Inpatient department care (IP) cost (admission rate X IP cost per case). For the health promotion expenses, this study estimate 20% of per-capita subsidiary budget.
From the calculation above, Banphaeo which is located in the rural of central Thailand will receive per-capita subsidiary health budget about 562 baht per year and per capita subsidiary health promotion about 149 baht per year, all together 712 baht per year. Yet, changing from a public hospital to an autonomous hospital will increase salary up to 150% thus the curative cost will rise to 633 baht. Ultimately, summing up with 149 baht of health promotion, the per capita budget will be 782 baht per year.
The researchers analyze the financial feasibility and found the operating expense is about 100.4 millions. Banphaeo population is 91,000, less Civil Servants Medical Benefit Scheme and health insurance 10% the hospital will receive 64 millions per year (91,000*0.9*782) from government and 39 millions from other revenue. Finally, the researchers do believe that it is possible for Banphaeo hospital to provide the universal health care coverage to the Banphaeo population. Moreover, this study can apply this method of budgeting to the whole kingdom.
The objectives of this descriptive study of a food-borne botulism outbreak caused
by the consumption of minced barking-deer meat in Phusang district, Phayao Province
were: (1) to confirm the diagnosis of botulism and the outbreak of the disease; (2) to
study the characteristics of the disease’s epidemiology, the outbreak and the distribution
of the disease; (3) to find the cause of the outbreak, source and vector of transmission of
the disease, and (4) to measure the disease control interventions. Descriptive and analytical
epidemiological studies used retrospective cohort studies to prove the hypo- thesis
of relative risk (RR) factors.
The result of this study found that 69 persons (26.53%) of the 260 persons who ate
the barking-deer were hospitalized in Chiangkham Hospital (between 24 June and 5 July
2006). The majority were males (62.31%), aged 30 - 60 years (34.62%). The main symptoms
of infection were abdominal distension, stomach ache, nausea, diarrhea, dry mouth,
difficulty breathing, and vomiting, respectively. An analytical epidemiological study
found that the food that caused the illness was raw minced barking-deer meat (RR = 2.04,
95% CI = [1.11 - 3.75] and showed that the persons who ate the raw meat were two times more to get the disease. As for other barking-deer body parts, it was found that the bile
(RR = 1.66,95 % CI = [1.13 - 2.43]) and entrails (RR = 1.66, 95% CI = [1.10-2.05] were the
main risk factors. The laboratory results confirmed that seven of the patients who got
botulism survived.
It was suggested to the public health institute and the officials related to the Bureau
of Epidemiology that they should take care of the people by emphasizing the importance
of hygiene and not eating raw meat, especially entrails, and that they should change their
consumption behaviors.
It was also suggested that the next research (1) study the consumption behaviors
related to eating raw meat and find methods for reducing illness, and (2) study ways to
communicate information on safe consumption behavior.
The economic crisis, that occurred nearly two year ago, has affected on campaigning all sectors to cut back their spendings and buying local made products in order to reduce national currency reserve. Drugs or pharma ceutical products are considered as manufactured goods that are relied on imported raw materials that represented 35-50%of the local manufactured pharmaceutical product cost. For import finished products, it represents 80-100% of the cost. With this import dependency, there is no doubt that the impact of economic crisis on pharmaceutical business would be unavoidable.
This study was aimed at describing and analyzing the situation and problems of drug management system and utilization in the Ministry of Public Health hospitals, recommending measures for drug management reform.
Thailand’s 1996 National Essential Drug List (NEDL) was based on the World Health Organization (WHO) minimal drug list concept. However, after Cabinet Resolution in February 1998, copayment for drugs outside the NEDL was enforced to Civil Servant Medical Benefit Scheme (CSMBS) beneficiaries. Pressures from CSMBS copayment triggered the 1996 NEDL revision resulted in a new version of “maximum drug list” 1999 NEDL. Promulgated on January 29, 1999, the current 1999 NEDL consisted of 933 items classified as sub-list A., B., C., D. and E whereby DUE must be introduced for the use of sub-list D.
The objectives of this study were 1) to compare the hospital drug list and cost of drug consumption in fiscal year 1999 broken down by sub-lists of 1996 NEDL compared to 1999 NEDL, 2) to analyze the pharmaceutical and therapeutic committee (PTC) decisions on their hospital drug list revision in 1993, 3) to assess the impact of 1999 NEDL on different types of patients, namely CSMBS, Low income patients, Voluntary Health Card Holders and Social Security Scheme (SSS) beneficiaries. The researchers used two approaches: document research and structured telephone interview.
Thirty-four hospitals (39% of proposed samples) agreed to provide electronic database of the fiscal year 1999 drug list and consumption value. Ninety five from 108 hospitals agreed to provide telephone interviews. Despite the fact of maximum list of 1999 NEDL, Department of Medical Service hospitals (DMS) and non-Ministry of Public Health (non-MOPH) public hospitals dispensed quite high proportion of  non-ED drugs. Reclassification of previously 1996 non-ED into sub-lists A., B., C., D. and E. of 1999 NEDL account for 9.9%, 24.2%, 32.4%, 42.5% and 42.2% of total drug consumption in district, provincial, regional, DMS and non-MOPH public hospitals respectively. Cost of drug consumption due to reclassification of 1996 non-ED to 1999 DEDL account for 881.67 million Baht in 34 hospitals, this implies that if there were no 1999 NEDL, there will be savings of 881.67 million Baht to insurance schemes assuming that all ED are reimbursable. Sub-list D. drug consumption in 34 hospitals was 602 million Baht in the fiscal year 1999, 24.2% of total drug consumption in these hospitals. Telephone interview reveals to the reasons for adding some more non-EDs into 1999 NEDL by PTC in 15 hospitals are patients have to take and cheap cost. All these drugs were drugs that used to be considered by 1999 NEDL developing subcommittee. There are some extent discriminating dispensing policy, biased towards CSMBS and against Low Income Scheme beneficiaries, Social Insurance and Voluntary Health Card lied in-between, during the 1999 hospital drug list revisions.
Art therapy has long been practiced in many countries, especially in the West, as an alternative
means for treating mentally traumatized persons. It is not yet implemented routinely in Thailand. The
present investigators took the opportunity of a catastrophic event that occurred in Uttaradit Province in
May 2006, which caused vast destruction of most of the citizens’ houses and farmland and caused great
mental trauma among the residents. Study samples comprised eight school children aged 7-14 years (five
boys and three girls) whose property and relatives’ lives were lost. For the present study, the psychiatrist
member of the author team selected those patients with symptoms that were not so severe that they
would require conventional psychiatric therapy. There were followed up weekly for 12 weeks to observe
the progress of their illness.
The artists also attended the weekly sessions and provided the children with the supplies necessary
for doing art work and urged them to draw anything they wanted to on the paper provided every week.
Their weekly products were photographed for subsequent interpretation of their mental progress. At the
end of the research session, their mental progress was judged by comparing the results of the psychiatrist’s
opinion about the interpretation of the drawings. It was concluded that the art therapy practice in
this group of children yielded considerable success as evidenced in seven of the eight subjects (87.5%).
The investigators suggest that art therapy is effective for managing chidren suffering from mental trauma
caused by disasters.
The diabetes risk score is a simple tool for predicting the probability that individuals will develop
diabetes mellitus in the future. This paper introduces the Thai diabetes risk score calculated from data
obtained from a previous study of cardiovascular disease in a cohort of employees of the Electricity
Generating Authority of Thailand. The scores were derived from coefficients in the logistic regression
model. Variables which significantly predicted the diabetes incidence included age, sex, body mass index,
waist circumference, blood pressure and family history. The predictive performance of the tool was
75 percent. This simple tool could be used to identify those who are at high risk of diabetes and encourage
them to follow healthy lifestyles.
This study was aimed at assessing the governance and management of purchasing universal health
care services of Thailand’s National Health Security Office (NHSO). The research methodology used was
the quality method; it involved reviewing the literature and related documents, a briefing from the staff of
the NHSO and in-depth interviewing of the representatives of providers and purchasers in each selected
province in four regions of Thailand. The data obtained were analyzed by using content analysis technique
and the result was presented descriptively. The results of the study showed that governance existed
at both the central and provincial levels. At the central level, governance was provided by four important
organizations including the NHSO Board, the NHSO, the Service Standard and Quality Control Board
(SQCB), and the Ministry of Public Health. At the provincial level, governance passed through three
important organizations comprising the Provincial Public Health Office (PPHO), the provincial branch of
the NHSO, and the public and private health-care providers. The regional branch of NHSO and local
government had little to do with governance. Governance was informal in the provinces. The problems
of governance were due to the confusion between the purchasing and providing functions of the PPHO.
The purchasing power of the NHSO provided a great effect on the governance of the provincial health
insurance. There are four important summarizing recommendations for improving service purchasing
governance, including separating the SQCB into an autonomous body, making the division the cutting
between the purchasing and providing roles, delegating more authority to branch offices of the NHSO,
and opening more opportunities to civil society and local organizations for participating in governing the
purchasing functions under the Universal Coverage Scheme.
Diabetes mellitus and its associated complications are major health and economic burdens worldwide,
in Asia and the Pacific and in Thailand. This burden is expected to continue to rise. The aim of this
study was to determine the prevalence of diabetes and impaired fasting glucose (IFG), their association
with cardiovascular risk factors, and evaluate the management of blood glucose, blood pressure and cholesterol
in diabetes by geographical region of Thailand. We used a database of the National Health Examination
Survey 2004, a stratified multistage sampling design representing 37,138 individuals aged ≥ 15
years; the data were collected using questionnaires, physical examination and laboratory examination
The prevalence of diabetes mellitus and IFG weighted to the national 2004 population was 6.6 percent
(5.9% in men and 7.2% in women) and 12.6 percent (14.8% in men and 10.5% in women), respectively.
Diabetes was more prevalent in urban areas. In two-thirds of those diabetics who had not been previously
diagnosed, the prevalence of associated risk factors was high among diabetics as well as those with IFG.
Two-thirds of the diabetics with concomitant high blood pressure were not aware that they had high
blood pressure. Eighty percent of the diabetics with concomitant high cholesterol were not aware that
they had high cholesterol. The risk factors for diabetes and IFG were male sex, high blood pressure, high
cholesterol, central obesity and overweight. Most risk factors could be modified by lifestyle interventions.
Improvements in prevention, diagnosis and treatment of diabetes and associated risk factors are
required in order to decrease the expected burden.
Basic bio-medical research is an essential component in public health for dealing with increased and
complex threats from emerging, re-emerging and existing prevalent diseases in the modern world. The
existence of a critical mass of scientists, personnel, facilities and technology, working concurrently with
efficient public health and clinical facilities, capable of producing high-quality scientific information
related to diseases or problems, is a critical component for any nation, in particular for developing countries facing health threats. The article gives a close-up view of the experiences of a network of bio-medical
research within academic institutions collaborating with clinical facilities within the Ministry of Public
Health. The purpose of collaboration was the production of essential scientific information that could
translate into useful clinical and epidemiological applications. The article reveals the tacit potentials, in
personnel and facility, embedded within the Ministry that, if properly managed and supported, could be
utilized in order to enhance this essential collaborative activity
This retrospective descriptive study was conducted on 370 patients to assess the
efficiency of extracorporeal shock wave lithotripsy (ESWL) in removing their renal or
ureteral calculi in Thabo Crown Prince Hospital in the period from March 2006 to March
2007. There were no severe complications and, at the three-month follow-up, KUB radiography
revealed stone-free pictures in an average of 66.21 percent patients who underwent
the procedure. Thus, it is concluded that ESWL is a good alternative intervention
for the removal of renal and ureteral calculi, especially those smaller than 20 mm.