plueme/wizJson huggingface dataset:
This study was aimed at identifying the general characteristics and different factors
related to the commission of suicide, and the factors affecting the accomplishment of
suicide between residents of Khanuworalaksaburi and Khlongkhlung districts in 2007.
Secondary information on the patients was obtained from the report 506 DS in 2007. The
data were analyzed by descriptive statistics, t-test and logistic regression.
The study included 110 patients, 12 were successful in committing suicide, equal to
10.6 percent of the total. The death rate of Khlongkhlung’s victims was four-fold greater
than Khanuworalasaburi’s. Nearly all of the suidcides committed were Thai agriculturists,
in the working-age group and married. The prevalence in females was four times
higher than in males. For most of the subjects, it was their first attempt; of those who
survived, they were reluctant to repeat the suicide attempt. Most of the victims had two
or more precipitating factors: the most common was depression, physically chronic
diseases and having sufferred abuse; these were enabling factors but not significant.
Most of the victims received service provision two or more times. The comparative study
indicated that there was significance in the different modes of committing suicide, especially
with regard to the use of insecticide, and physically chronic illness, particularly
rheumatic diseases, as well as tobacco addiction. The types of services provision included
making suggestions to their relatives, handout distribution, medication for depressive
disorder, other supportive services such as referral for repeated suicide attempts. The
risk factors and service provision were both significant factors in decreasing the success
rate of those intending to commit suicide. Having suffered abuse was an important factor
in raising the success rate. The authors suggest that the provision of good-quality and
appropriate services would effectively decrease the success of attempts to commit suicide,
while the screening for the precipitating factors and a change in abusive behavior
would reduce the number of attempts.
This descriptive research was carried out to study psychosocial adjustment during
the perimenopausal period of women. The subjects were 89 married women in the
perimenopausal period who visited the outpatient department of Phoprathapchang Hospital,
Phichit Province, in 2007. The study used a questionnaire consisting of two parts:
personal data record and psychosocial adjustment in the perimenopausal period.
The results showed that 53.93 percent of perimenopausal women reported overall
psychosocial adjustment at a good level and 46.07 percent at a poor level. In considering
each aspect, the aspects of the vocational environment, domestic environment, social environment
and psychological distress were at good levels, i.e., 59.55, 51.69, 62.92 and 55.06
percent, respectively, while the aspects of health-care orientation, sexual relationship and
extended family relationship were at a poor level of 51.69 percent.
The results of this study could be utilized as basic information in planning care,
counseling and for enhancing psychosocial adjustment for the well-being of the perimenopausal
women.
This is a report of the results of a prospective series of manual sutureless extracapsular
cataract extraction on 161 eyes, performed at Taphanhin Crown Prince Hospital,
Phichit Province, in the period May 2006 - November 2007. The patients, aged 42 to 82
years (mean 68.9 years), had a preoperative visual acuity of less than 3/60 in 47.8 percent
of the cases (76 eyes). Of the 159 patients who returned for follow up, the visual acuity at
one month postoperatively was improved in 153 eyes (96.2 %), i.e., VA 6/18 or better in
42.1 percent, and 6/24 - 6/60 in 57.2 percent. When measured by pinhole, visual acuity
was 6/18 or better in 78.6 percent of the eyes. There was no major sight-threatening
complication; only minor surgical complications were encountered in 10 eyes (6.3%). In
conclusion, this intervention is cost-effective, appropriate and provides accessibility for
underserved cataract-blind patients in community hospitals. It also empowers health
personnel and should be implemented in other community hospitals or eye camps in
order to eliminate the backlog of such patients and improve the quality of life of the Thai
elderly in rural areas.
The objective of this retrospective study was to determine the incidence of teenage
pregnancy and to compare pregnancy outcomes between teenagers and adults who delivered
in Chaibadan Hospital, Lop Buri Province. The study group included singleton
primigravida women aged 13-19 years who gave birth between October 1, 2003 and September
30, 2006. The comparison group consisted of singleton primigravidae, aged 20-29
years, who gave birth at the same hospital in that period. The study revealed that the
incidence of teenage pregnancy was 20.77 percent; teenagers had a higher proportion of
inadequate antenatal care (i.e., no ANC or ANC<4 times) compared with adult pregnant
women. Preterm delivery was higher in the study group than in the control group. There
was no statistically significant difference in obstetric complications, birth weight, stillbirth
and Apgar score between the two groups.
This survey-based research was aimed at determining the factors associated with
low back pain, satisfaction levels, needs and suggestions regarding the service of the Bang
Pla Ma Hospital, Suphanburi Province. The sample comprised 347 patients undergoing
low back pain treatment more than once during the period October 1 to November 30,
2007. Data were collected by a structured questionnaire, analyzed and reported as frequency,
percentage and mean. Of the total number of patients, 64.3 percent were female (average 48 years and
married); 37.2 percent were graduated from primary school; 35.2 percent had a bachelor’s
degree. A good number of them were government officers (41.5%) and had moderate
salary (63.9%); those earning more than 20,000 Baht/month comprised 29.1 percent of the
total. Most the patients (56.8%) held the right of reimboursement and 34 percent had
rights under the health assurance scheme. Most of the low back pain occurred not only
when the patients lifted heavy objects using two hands while bending (49.9%), but also
when they had improper postures. They were mostly non-consumers of alcohol (81.8%)
and non-smokers (87.3%), and regularly exercised (65.1%). Patients had received health
education relating to low back pain, in particular using local heat massage (80.7%); however,
most had moderate knowledge about keeping healthy (61.4%). Patients were mostly
satisfied with Thai massage; the next highest level of satisfaction was among those taking
a prescription pill. Having treatments 1-3 times alleviated the symptoms of most patients.
Alternative medical therapies should be advised for patients with low back pain.
anphotpisai Hospital, Nakhon Sawan Province
The effects of health promotion development among diabetics, using self-efficacy
and social support, on fasting blood sugar and HbA1c in type-2 diabetes patients were
studied in four primary care units (PCUs) in Banphotpisai district, Nakhon Sawan Province, in the period from April to July 2006. The study sample comprised 126 patients who
attended the medical outpatient department and diabetic clinic of four PCUs; they had
fasting blood sugar levels higher than 180 mg/dl. The data were collected by means of
demographic questionnaires and diabetic care questionnaires, including measurement of
FBS and HbA1c. The data were analyzed using percentage, standard deviation, and paired
sample t-test. The average score for self-efficacy of pre-test was 101.28 and of post-test
113.70. The average score for social support of pre-test was 85.94 and of post-test 94.33.
The average FBS of pre-test was 142.42 mg/dl and of post-test 126.43 mg/dl. The average
HbA1c of pre-test was 5.34 mg/dl and of post-test 5 mg/dl.
The increasing incidence of diabetes mellitus (DM) every year has resulted in multiple
complications of DM. Diabetic neuropathy is one of the most important complications;
it causes diabetic foot and leads to amputation of the legs. In a rural hospital, the
relationship between neuropathy and foot ulcer provides important information for the
development of a preventive foot-care program in a DM clinic. A retrospective study
was performed from medical records and diabetic foot evaluations from October 2005 to
September 2006; a total of 1,029 diabetic patients from Wichianburi Hospital, 247 from the Putaey primary care unit and 308 from the Kokeprong primary care unit, were studied.
Of the total, 31.51 percent were males and 68.49 percent females; 404 patients (24.72%)
had neuropathy, 60 patients (14.85%) in this group had foot ulcer, and 47 of them (3.82%)
had foot ulcer without neuropathy. The risk of foot ulcer in neuropathic patients was
almost eight-fold (7.92 times) greater than that of non-neuropathic patients. Seventynine
patients with foot ulcer had hyperglycemia; the mean blood glucose levels ranged
between 125 and 179 mg/dl, and blood glucose levels of more than 125 mg/dl were 4.39-
fold greater than the normal glucose level. Foot ulcer in diabetic patients was related to
neuropathy and blood glucose levels; thus well-controlled blood glucose and good foot
care in diabetic neuropathic patients is important in preventing foot ulcer.
To develop a stroke-care model for the outpatient department, Thoen Hospital in
Lampang Province, 32 patients were studied in the period February -July 2007 (six months)
by a multidisciplinary team. The method of study was a three-dimensional framework.
The first dimension was to strengthen the health-care team, focusing on control of comorbid
conditions and risk factors. It was found that, in the DM-patient group of 13
cases, the results of risk control as the compliance levels of blood pressure, plasma fasting
glucose, TG and LDL were about 23.08, 30.77, 69.23 and 23.08 percent, respectively. In
the group of 14 cases without DM but having other risk factors, we found that the levels
of blood pressure, TG and LDL were under control at 64.29, 57.14 and 14.29 percent, respectively.
By monitoring for new risk factors, we could detect such factors in 24 cases
(75%), for whom we controlled both their previous and new risk factors purposely in
order to reduce stroke recurrence. The second dimension was to encourage self-care
behavior in the patients and their caregivers; we could empower 30 cases (93.75%) to
achieve successful rehabilitation. For evaluating the quality of life, we used the Barthel
Index of Activity of Daily Living; we found that the score had statistically significantly
increased (p = 0.005). The stroke patients could pass their post-test in the topics of nutrition,
domestic vegetables and traditional Thai medicine; the increase was significant (p =
0.005). The last dimension was for providing competency for the partnership of the community
health-network. The local government and a volunteer-group participated in
home health-care activities for stroke patients in the villages. For improving the quality
of life for the stroke patients, many community plans have been implemented, such as
the screening activities among the population at risk for stroke prevention and fostering
health promotion in the Thai style. In conclusion, there is a limitation on stroke care in
the outpatient department of the community hospital, but with such a model, using the
concept of a multidisciplinary team, the effectiveness of integrated health care for stroke
patients could definitely be improved.
Neonatal jaundice is a common and, in most cases, benign problem in neonates. The
treatment of neonatal jaundice is indicated in pathologic jaundice and the goal of therapy
is to prevent the concentration of unconjugated bilirubin in the blood from reaching levels
at which neurotoxicity may occur. For more than three decades, phototherapy has been the standard of care for the initial treatment of neonatal jaundice. A retrospective
study about the result of treatment for neonatal jaundice compared between phototherapy
with and without blue light lamps was done in Thabo Crown Prince Hospital from October
1, 2004 to September 30, 2007. The purpose of this study was to identify which type of
lamp used in phototherapy was more effective in decreasing the blood bilirubin level.
This study showed that the highest blood bilirubin level during treatment with phototherapy
without blue light lamps was significantly higher and also the length of stays for
treatment was significantly longer than in the group that used phototherapy with blue
light lamps. Although many factors affect the efficacy of phototherapy in decreasing the
blood bilirubin level, one of the important factors is the type of lamps used. This study
suggests that, for the treatment of neonatal jaundice to be effective, phototherapy with
blue light lamps is recommended.
A clinic for HIV-infected patients was set up at the Sawangdandin Crown Prince
Hospital, Sakon Nakhon Province in October 2002. This study was conducted during the
period from October 2002 through September 2007 to collect clinical as well as administrative data from the outpatient and inpatient medical records of all HIV patients who
attended the Clinic during the period October 2002 to September 2007. Descriptive data,
i.e., frequency, percentage, means and standard deviation, median, minimum and maximum
values, derived from the use of the Mann-Whitney U test and Kruskal Wallis test
were obtained.
The results showed that the HIV-infected patients were 54.4 percent male and 45.6
percent female, their average age 35.5 years, education status 72.3 percent primary school,
agriculture 73 percent, and heterosexual infection risk 93 percent. There were significant
differences in the median amounts of CD4 when they started taking anti-HIV drugs (p
value= 0.035). There was no statistically significant difference in the median duration
from contracting HIV infection to the treatment period (p = 0.113). The most common
drug regimen used was Nevirapine, Lamivudine and Stavudine during the periods 2002-
2004 and 2005-2007 (75.8%), and the response rate was 81.7 percent. There was no statistically
significant difference in median duration of response to anti-HIV drugs depending
on the amount of CD4 (p= 0.088). Side effects of anti-HIV drugs included skin rashes,
neuritis and cheek lipoatrophy. The most common of the opportunistic infections was
pulmonary tuberculosis. The initial time to receive drugs was quite delayed when a CD4
level of lower than 100 cells/ml was used as an indicator. When acute symptoms subsided,
the majority of patients moved to new working areas and received drugs via relatives.
The result was inconsistent taking of drugs and drug resistance usually developed
thereafter. In such a context, the author has suggested that HIV patients should be given
information about opportunistic infection and CD4 levels. Regular care and medications
for the patients would be effective if high-quality networks are set up. Finally, it is
importanct to pursue the cooperation of organizations offering work and proper income
for the patients after their condition has been improved by treatment with anti-HIV drugs.
This was a retrospective study on intentional self-harm among patients at
Khoksamrong Hospital in the years 2004-2006. The patients were those who intentionally
attempted suicide but survived, and who were brought to Khoksamrong Hospital
for treatment. Data were collected using a standard form for depression and a self-harm
surveillance system (report 506.DS) and a form to collect data from death certificates
( M.B.1.). Women comprised the majority of the cases (64.17%), married persons (58.33%)
and laborers (49.17%). Most of them (96.67%) had attempted suicide for the first time.
Common precipitating causes (48.33%) were “personal conflicts with a close person and
love affair problems.” A common self-harm method was “ingesting a sedative” (21.67%).
Of eight cases who died among the 120 suicidal patients hospitalized, the youngest was
25 years old and the oldest 70 years old. The most common stimulating event among the
cases of mortality were “personal conflicts with a close person and love affair problems.”
The most common method of committing suicide was “drinking chemical agents.” Of the
29 cases dead on arrival at the hospital, 17 were males and 12 were females, and 31.03
percent were aged 30-39 years. The most common methods were hanging (58.62%), following
by drinking chemical agents (31.03%). It is apparent that men used more aggressive
methods than women.
Hand, foot and mouth disease is a communicable disease caused by a virus that
infects mostly preschool children. In 2006, there were 3,961 cases and seven deaths in
Thailand; Nakhon Ratchasima Province had 85 cases and 3 deaths. Enterovirus 71 was
the causative pathogen. This descriptive study conducted at Chumphuang District,
Nakhon Ratchasima Province during the period from 2002 to September 30, 2007, used
individual disease investigation forms, outpatient and inpatient records and the midyear
population data of the Ministry of Interior. There were 47 cases, no deaths, 31 males
and 16 females among them; the sex ratio was 1.9:1. Most of them were found during
June to October. Forty were treated as outpatients and only seven were admitted to the
hospital. Fever, and palm and sole rash were the common symptoms; most patients were
from Chumphuang Tambon, and no case was detected at Nontoom Tambon; only one
patient was found in each village. Stool and paired serum samples were derived from
93.62 percent of the patients and Enterovirus 71 was isolated from two stool specimens in
2006 and 2007. According to the disease surveillance system, primary health-care staff
should be trained to screen and refer the suspects to hospitals, viral isolation should be
supported and promoted among the health-care services. The disease-control measures
should emphasize community health education and the isolation of patients from other
children either in school or in child-care centers.
Thailand and Myanmar are both among the 22 countries with a high burden of
tubercuosis (TB) cases identified globally. Population migration in Mae Hong Son Province
may have a great impact on the national TB-control program. Mae Hong Son’s Muang
district is close to Myanmar. Citizens of both countries travel back and forth across the
border for business or for temporary or permanent settlement. This phenomenon causes
problems in controlling tuberculosis in Thailand.
In the period 2001-2007, a total of 829 tuberculosis patients were registered at the TB
clinic of Srisangwan Hospital. They were taken for study and 795 newly registered cases
(Thai 49.6%, non-Thais 51.4%) were reviewed, reflecting a very high incidence of new
tuberculosis cases in this region. Detailed data were reported in the text.
Cardiovascular diseases are among the three most important causes of death worldwide, including in Thailand and in Chai Nat Province. This one-group prepost test design of quasi-experimental research was conducted in order to study the effectiveness of the cardiovascular risk reduction model of Nongkhoon Primary Care Unit, Amphur Watsing, Chai Nat Province. The study sample included 129 residents aged 35 to 60 years, living in the vicinity under the responsibility of the Nongkhoon Primary Care Unit; they were selected by simple random sampling. Data were collected using questionnaires, i.e., the pre-test data were collected in the month of March 2006 and post-data in September 2006. The statistical analyses were descriptive, such as percentage, arithmetic mean and standard deviation, and analytic statistics by paired t-test and multiple regression. The results revealed that pre- and post-data disclosed that all samples had normal blood pressure and body mass index. Men had a low health risk, while women had a high health risk. Pre-test data denoted a low level of self-care practice for prevention of cardiovascular risks and post-test data had a medium level. All parameters, i.e., blood pressure, body mass index, health risks and the practice of self-care for reducing cardiovascular risks both pre- and post-data, yielded significant correlations at a p-value of
Chronic obstructive pulmonary disease (COPD) is one of the top five diseases treated
at Sungmen Hospital. This cross-sectional descriptive study was carried out to review
the management practice of COPD patients in Sungmen Hospital. The subjects studied
were 167 patients who attended the COPD Clinic from August to October 2007. The
majority of patients (77.8%) were male, with the mean age being 68.2 years. Ninety-four
percent of them had a history of smoking and 26.7 percent were still active smokers.
Diagnosis of COPD was made in 84.7 percent of the cases by history-taking, combined
with physical examination and pulmonary function test. The mean values of FVC, FEV1
and %FEV1 were 68.6, 55.5 and 58.4 percent, respectively. The patients were categorized
based on the severity of the disease; 71.2 percent of the patients suffered moderate to
severe disease. The study disclosed that COPD patients with mild to moderately severe
morbidity had received excessive medications, according to the COPD clinical practice
guidelines. Sustained-release theophylline was prescribed at a high rate in every stage of
severity of the patients. More needed long-acting beta-2 agonist inhalers and long-term
oxygen therapy, but these therapies were not available due to the patients’ economic constraints.
The therapeutic management of COPD patients, by establishing a COPD clinic
in a community hospital, using existing hospital resources, would offer better efficiency
in the diagnosis and treatment of COPD patients.
This retrospective descriptive study was designed to determine the clinical outcomes
of mini-laparotomy exploration (MLE), with simple closure of a perforated ulcer in patients
treated at Chaibadan Hospital. Of the 70 ulcer patients, 62 (M:F 8:1; aged 51.2 ± 15.6
years and 12.8% over 60) underwent the MLE procedure in the period between October 1,
2001 and September 30, 2007. The ulcer types were type I (prepyloric part of stomach and
first part of duodenum) 78.4 percent, and type I (antrum) 14.5 percent. The average operative
time was 32.8 ± 12.7 minutes. Operative complications were encountered in 30
percent of the patients, i.e., 12 patients with an infected wound, and four patients had
postoperative fever; however, there was no death. Postoperative medication included
anti-H. pylori and proton pump in all patients. The benefits of the surgical procedure
studied were small abdominal wound and scar with less pain, decreased severe complications
with early ambulation and no mortality.