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Item Open Access อุบัติการณ์ของการจัดการความปวดที่ไม่เพียงพอในผู้ป่วยหนักทางศัลยกรรมที่ใช้เครื่องช่วยหายใจ(2564) ณภัทร ธิคม; กรุณา วงษ์ตั้งมั่น; รวงข้าว ทองศรี; ปิยวรรณ วงศ์เจริญกิจ; พัณณิตา เครือมิ่งมงคล; ์Napat Thikpm; Karuna Wongtangman; Piyawan Wongcharoenkit; มหาวิทยาลัยมหิดล. คณะแพทยศาสตร์ศิริราชพยาบาลที่มา: ความปวดทำให้เกิดความไม่สุขสบายนำไปสู่ภาวะแทรกซ้อน เช่น ภาวะสับสนเฉียบพลัน, ผู้ป่วยไม ่ให้ความร่วมมือในการรักษา, เพิ่ม ระยะเวลาการนอนใน ICU., เป็นต้น การดำเนินการ: ผู้ร่วมวิจัยจะได้รับการ ประเมินความเจ็บปวด , ประเมินระดับความรู้สึกตัว, ข้อมูลการได้รับยาแก้ ปวดและยาระงับประสาท จากนั้นจะติดตามภาวะแทรกซ้อนจนกว่าออกจาก หอผู้ป่วยวิกฤติ หรือ 30 วันหลังจากเข้ารับการรักษาในหอผู้ป่วยวิกฤติทาง ศัลยกรรม ผลการวิจัย: อุบัติการณ์ของการจัดการความปวดที่ไม่เพียงพอขณะ พัก 28.8%, อุบัติการณ์ของการจัดการปวดที่ไม่เพียงพอขณะทำกิจกรรม 33.9%, ขณะพักผู้ป่วยที่ได้รับการประเมินความปวดด้วยเครื่องมือ CPOT มี อุบัติการณ์ของการจัดการความปวดที่ไม่เพียงพอสูงกว่าผู้ป่วยที่ได้รับการ ประเมินความปวดด้วยเครื่องมือ NRS สรุป: ผู้ป่วยในหอผู้ป่วยวิกฤติทางศัลยกรรมโรงพยาบาลศิริราช ยังคงมีการจัดการความปวดที่ไม่เพียงพอสูงจึงควรที่จะสร้างแบบแผน มาตรฐานในการประเมินจัดการความปวด เพื่อลดอุบัติการณ์ของการรักษา อาการปวดPublication Metadata only Incidence of Inadequate Pain Treatment among Ventilated, Critically Ill Surgical Patients in a Thai Population(2021-06-01) Napat Thikom; Ruangkhaw Thongsri; Piyawan Wongcharoenkit; Phannita Khruamingmongkhon; Karuna Wongtangman; Siriraj Hospital(every 4 hours) and during bed-bathing using the Critical Care Pain Observation Tool (CPOT; Thai version) or the 0–10 numeric rating scale (NRS). CPOT scores > 2 or NRS scores > 3 signified inadequate pain control, while a RASS score ≤ -3 was defined... surgical intensive care unit (SICU) patients has never been reported. Aims: To determine the inadequate pain control incidence among ventilated, critically ill, surgical patients. Design: Prospective, observational study. Setting: SICU of a university-basedItem Metadata only Analgesic effectiveness of methoxyflurane inhaler during genicular nerve block in knee osteoarthritis: a randomized controlled trial(2024-01-01) Sawang S.; Kimpee P.; Itthichaikulthol W.; Tontisirin N.; Limpoon S.; Seangrung R.; Pasutharnchat K.; Cohen S.P.; Sawang S.; Mahidol Universitythe procedure. Secondary outcomes included changes in VNRS and behavioral pain scale (critical care pain observational tool) during the procedure, hemodynamic changes, anxiety level, sedation score, and adverse events. Results 42 patients with a mean age of 66..., and adverse effects between the two groups. Conclusion A methoxyflurane inhaler combined with local anesthesia provided better procedural pain control than local anesthesia alone with no observable differences in adverse effects. Future studies evaluatingPublication Open Access เครื่องมือประเมินความปวดและระบบการจัดการความปวดใรงพยาบาลรามาธิบดี(2550) จันทร์ทิพย์ วงศ์วิวัฒน์; สุปาณี เสนาดิสัย; สุธีรา จักรกุล เหลืองสุขเจริญ; พจนี รอดจินดา; ภัทรา นิโครธา; นันทนา สุขสมนิรันดร; โศศิษฐา คงคุ่ย; Jantip Vongsvivut; Supanee Senadisai; Suteera Chukkul Luengsukcharoen; Podjanee Rodjinda; Pattra Nicrotha; Nuntana Suksomnirundorn; Sositta Kongkuy; มหาวิทยาลัยมหิดล. คณะแพทยศาสตร์โรงพยาบาลรามาธิบดี. ภาควิชาพยาบาลศาสตร์Publication Open Access Quality of intrapartum care by skilled birth attendants in a refugee clinic on the Thai-Myanmar border: a survey using WHO Safe Motherhood Needs Assessment(2015) Gabie Hoogenboom; Thwin, May Myo; Kris Velink; Marijke Baaijens; Prakaykaew Charrunwatthana; François Nosten; Rose McGready; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unitof intrapartum care provided by SBAs in Mae La camp, a low resource, protracted refugee context on the Thai-Myanmar border. Methods: In the obstetric department of Shoklo Malaria Research Unit (SMRU) the standardized WHO Safe Motherhood Needs Assessment tool... neonatal care. Observed incorrect practice included: improper controlled cord traction; inadequate hand washing; an episiotomy rate in nulliparous women 49% (34/70) and low rates 30% (6/20) of newborn monitoring in the first hours following birth. OverallPublication Open Access Diagnostic accuracy of peripheral venous lactate and the 2009 WHO warning signs for identifying severe dengue in Thai adults: a prospective observational study(2016) Vipa Thanachartwet; Anan Wattanathum; Oer-areemitr, Nittha; Akanitt Jittmittraphap; Duangjai Sahassananda; Chalida Monpassorn; Manoon Surabotsophon; Varunee Desakorn; Mahidol University. Faculty of Tropical Medicine. Department of Clinical Tropical MedicineBackground: Dengue is the most common mosquito-borne viral disease in humans. However, the sensitivities of warning signs (WSs) for identifying severe dengue in adults are low, and the utility of lactate levels for identifying severe dengue in adults has not been verified. Therefore, we aimed to evaluate the diagnostic accuracy of using peripheral venous lactate levels (PVL), as well as WSs established by the World Health Organization, for identifying severe dengue. Methods: We prospectively evaluated individuals hospitalized for dengue who were admitted to the Hospital for Tropical Diseases in Thailand between May 2013 and January 2015. Blood samples to evaluate PVL levels were collected at admission and every 24 h until the patient exhibited a body temperature of <37.8 °C for at least 24 h. Data were recorded on a pre-defined case report form, including baseline characteristics, clinical parameters, and laboratory findings. Results: Among 125 patients with confirmed dengue, 105 (84.0 %) patients had non-severe dengue, and 20 (16.0 %) patients had severe dengue. The presence of clinical fluid accumulation as a WS provided high sensitivity (75.0 %, 95 % confidence interval [CI]: 50.9–91.3 %) and specificity (90.5 %, 95 % CI: 83.2–95.3 %). The PVL level at admission was used to evaluate its diagnostic value, and receiver operating characteristic curve analysis revealed an area under the curve of 0.84 for identifying severe dengue. At the optimal cutoff value (PVL: 2.5 mmol/L), the sensitivity and specificity were 65.0 % (95 % CI: 40.8–84.6 %) and 96.2 % (95 % CI: 90.5–99.0 %), respectively. A combined biomarker comprising clinical fluid accumulation and/or PVL of ≥2.5 mmol/L provided the maximum diagnostic accuracy for identifying severe dengue, with a sensitivity of 90.0 % (95 % CI: 68.3–98.8 %) and a specificity of 87.6 % (95 % CI: 79.8–93.2 %). Conclusions: Clinical fluid accumulation and/or PVL may be used as a diagnostic biomarker of severe dengue among adults. This biomarker may facilitate early recognition and timely treatment of patients with severe dengue, which may reduce dengue-related mortality and hospital burden.Publication Open Access Long-term morbidities in stroke survivors: a prospective multicenter study of Thai stroke rehabilitation registry(2013) Vilai Kuptniratsaikul; Apichana Kovindha; Sumalee Suethanapornkul; Nuttaset Manimmanakorn; Yingsumal Archongka; Mahidol University. Faculty of Medicine Siriraj Hospital. Rehabilitation Medicine Departmentfactors of stroke-related complications during the first year after discharge from rehabilitation ward. Methods: A prospective observational study was conducted in nine tertiary-care rehabilitation centers. We evaluated the incidence of morbidities...Background: Stroke-related complications are barriers to patients’ recovery leading to increasing morbidity, mortality, and health care costs, decreasing patient’s quality of life. The purpose of this study was to quantify incidence and riskPublication Open Access Validity and reliability of quality of recovery-35 Thai version: a prospective questionnaire-based study(2016) Siriporn Pitimana-aree; Suthipol Udompanthurak; Saowaphak Lapmahapaisan; Matula Tareerath; Aungsumat Wangdee; Mahidol University. Faculty of Medicine Siriraj Hospital. Department of Anesthesiologyand renamed the Quality of Recovery-35 Thai version (Thai QoR-35). Overall, 43 outpatients and 53 inpatients rated their health and recovery status using three patient evaluation tools: 100-mm Visual Analogue Scale–Recovery (VAS-R), six-item Activities... demonstrated good reliability with high internal consistency at three time points (Cronbach’s alpha = 0.88, 0.89, 0.91, respectively; P < 0.01) and a split-half reliability coefficient of 0.65 (P < 0.001). Conclusion: Thai QoR-35 is a valid, reliable toolPublication Open Access Chronic kidney disease impairs bone defect healing in rats.(2016-03-09) Dutmanee Seriwatanachai; ดุษมณี เสรีวัฒนาชัย; Liu, Weiqing; Kang, Ning; Dong, Yuliang; Zhou, Liyan; Lin, Yunfeng; Ye, Ling; Liang, Xing; Yuan, Quan; Mahidol University. Faculty of Dentistry. Department of Oral BiologyChronic kidney disease (CKD) has been regarded as a risk for bone health. The aim of this study was to evaluate the effect of CKD on bone defect repair in rats. Uremia was induced by subtotal renal ablation, and serum levels of BUN and PTH were significantly elevated four weeks after the second renal surgery. Calvarial defects of 5-mm diameter were created and implanted with or without deproteinized bovine bone mineral (DBBM). Micro-CT and histological analyses consistently revealed a decreased newly regenerated bone volume for CKD rats after 4 and 8 weeks. In addition, 1.4-mm-diameter cortical bone defects were established in the distal end of femora and filled with gelatin sponge. CKD rats exhibited significantly lower values of regenerated bone and bone mineral density (BMD) within the cortical gap after 2 and 4 weeks. Moreover, histomorphometric analysis showed an increase in both osteoblast number (N.Ob/B.Pm) and osteoclast number (N.Oc/B.Pm) in CKD groups due to hyperparathyroidism. Notably, collagen maturation was delayed in CKD rats as verified by Masson’s Trichrome staining. These data indicate that declined renal function negatively affects bone regeneration in both calvarial and femoral defects.Publication Open Access Estrogen Deficiency Leads to Further Bone Loss in the Mandible of CKD Mice.(2016-02-17) Dutmanee Seriwatanachai; ดุษมณี เสรีวัฒนาชัย; Guo, Yuchen; Sun, Ningyuan; Duan, Xiaobo; Xu, Xin; Zheng, Liwei; Wang, Yongyue; Yuan, Quan; Mahidol University. Faculty of Dentistry. Department of Oral BiologyBACKGROUND: Chronic kidney disease (CKD) has been regarded as a grave public health problem. Estrogen is a critical factor for both renal protection and bone remodeling. Our previous study demonstrated that CKD impairs the healing of titanium