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ABSTRACT: This study was conducted to assess the prevalence of overweight/obesity and the related demographic data and health behaviors of Thai medical students. A cross-sectional study of 5441 medical students from all the 13 medical schools in Thailand was conducted in 2006 by means of a self-administered questionnaire. Demographic data, health behaviors, and self-reported body weight and height were recorded. The results revealed that Thai medical students have a lower prevalence of overweight/obesity than the general population of the same age group. The multiple logistic regression analysis showed that higher academic year was associated with being overweight or obesity in males, having improper dietary habits were associated with being overweight or obesity in both genders, whereas alcohol consumption was associated with being overweight in male only. Therefore, medical curricula should place an emphasis not only on knowledge but also on attitudes and behaviors for healthy lifestyles.
Asia-Pacific Journal of Public Health 12/2011; · 1.06 Impact Factor
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ABSTRACT: The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, named statins, are well-established cholesterol-lowering drugs able to reduce cardiovascular risk in hypercholesterolemic patients. The possible effect of statin on bone tissue, so-called pleiotropic effects has received particular attention. Studies reported a positive effect of statin on bone tissue in both of animal and human study by enhancing the expression of the bone morphogenetic proteins (BMPs), in particular of BMP2, which in turn leads to osteoblast differentiation and bone formation including interfering with osteoclastic activity. In a systematic review, the lipophilic statin as simvastatin had positive effect to bone mineral density (BMD) better than the more hydrophilic statin such as atorvastatin and fluvastatin. This study was aimed to compare efficacy of medical therapy between HMG-CoA reductase inhibitor and non-HMG-CoA reductase inhibitor group to changing of bone mineral density and bone markers in the patients with hyperlipidemia.
A prospective randomized control trial study enrolled the 212 hyperlipidemia with osteopenia patients to study in year 2006-2008. All subjects were randomized to 2 groups between statin and non-statin group; the patients were screened by inclusion criteria and measured in bone mineral density (BMD), bone marker and blood chemistry. All data were analyzed by difference of changing in bone marker and BMD between statin and non-statin groups using paired t test.
The present study showed 212 hyperlipidemia with osteopenia patients of which 106 patients in statin group had mean age (63.17+/-9.51 years) and the same number of patients in non-statin group had mean age (60.96+/-8.9 years). All subjects were 63 patients in male and 149 patients in female. Difference of bone formation marker and BMD between after and before was significantly higher than in statin group and the difference of bone resorption marker was also significantly lower than in statin group.
The lipophilic statin as moderate to high dose of simvastatin had beneficial positive effect to increasing BMD and could be additive use for prevention of bone loss in hyperlipidemia patients.
Bone 04/2010; 46(4):1011-5. · 4.02 Impact Factor
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ABSTRACT: Although biliary bypass technique which used jejunum as a conduit is a common procedure in open technique of hepatobiliary tract surgery, its complicated technique made it is not feasible for laparoscopic surgery. Before 1960, stomach was used vastly for biliary drainage but late stricture which resulted from too much tension along suture line made it not much acceptable. The authors report surgical technique of laparoscopic gastric tube flap for biliary bypass in order to made it practicable for laparoscopic surgery.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 02/2010; 93 Suppl 2:S39-42.
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Somkiat Wattanasirichaigoon
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ABSTRACT: This study examined the effect of temperature and ischemia on permeation of fluorescently-labeled dextran (M.W. = 4 kDa; FD4) across rat intestinal mucosa. Permeability was evaluated ex vivo using an everted gut sac technique in both the mucosal-to-serosal (M-->S) and serosal-to-mucosal (S-->M) directions. At baseline (B), 30-min of ischemia (I-30) and 60-min of ischemia (I-60), intestinal segments were prepared and incubated at 37 degrees C, 15 degrees C and 4 degrees C for 30 min. Clearance (nl/min/cm2) was calculated based on the accumulated amount of FD4 at 30 min. Both M-->S and S-->M fluxes increased with increasing temperature at B, I-30 and I-60. Ischemic gut (I-30 and I-60) had about a three-fold higher (M-->S)/(S-->M) flux ratio than that of normal gut (p < 0.001). At 4 degrees C, neither M-->S nor S-->M flux was different between B and I-30, but both M-->S and S-->M fluxes significantly increased at I-60, suggesting an increase in permeation via a passive mechanism. Increased bidirectional fluxes at 37 degrees C were obtained in the I-30 and I-60 gut sacs when compared to B. We conclude that FD4 is actively transported across the intestinal mucosa in the S-->M direction and that ischemic injury increases passive diffusion of the probe across the gut wall.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 06/2009; 92 Suppl 3:S15-23.
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ABSTRACT: The wound dressing synthesized from carboxymethylchitosan hydrogel (CM) and chitin-(polyacrylic acid) hydrogel (PAA) were examined for their dermal irritation potential response using the Draize test.
Eighteen male Sprague-Dawley rats were divided into three groups (6 rats/each). Rats in group 1 were designed as control, group 2 were treated with CM, and group 3 were treated with PAA. The test materials diameter 1 x 1 cm were topically applied on the skin in group 2 and 3. Two skin sites (1 x 1 cm in size) were located at the back. One site was intact and the other was abraded in such a way the stratum corneum had no bleeding.
After 24 and 72 hours of wrappings, the materials were removed and the test sites were evaluated in terms of erythema and edema using adopted Draize scoring system. At the end of the experiment, all rats were anesthesized with intravenous thiopental sodium. Blood samples from descending aorta were collected for liver and kidney function test and all organs were weighed. The results of this experiment showed 1) no irritation of both materials in this animal model; 2) no material-related induced liver and kidney dysfunction and 3) organ weights had no significant difference between the groups.
Both CM and PAA should be considered safe to use in the purpose of wound dressing in further clinical trials.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 05/2007; 90(4):724-9.
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ABSTRACT: This is Phase 2 of the authors study on long-lived Thai physicians. After obtaining quantitative data from Phase 1, the authors approached 11 male and 5 female physicians whose ages were older than general population's life expectancy. The authors conducted an in-depth interview using semi-structured questions asking about their life, work, lifestyle, and relevant factors. Then the authors synthesized the factors influencing longevity. The authors found that they are genetic, financial stability/security, trying to be disease-free by increasing positive lifestyle (such as exercise) and decrease negative lifestyle (such as drug addict, alcohol consumption), mind-set to be non-attachment (either doing nothing or busy doing everything), and being mentally ready to die. The authors also proposed policy implications for Thai physicians and people accordingly.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2005; 88(9):1257-60.
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ABSTRACT: This survey was aimed at obtaining a screening survey on mental health status of Thai physicians. We systematically sampled to obtain 440 Thai physicians from the directory of Thai Center for Continuing Medical Education (CCME). Then, we obtained their mental health status by mailing a questionnaire containing Thai GHQ-28 and asking them to reply, later we obtained through telephone interview. The response rate was 86.3 percent, and 60.3 percent of them were male. The result revealed that 15 male and 13 female physicians had abnormal mental health status. The overall prevalence rate of abnormal mental health status was 7.4 percent. We also found a significant negative association between mental health status and career satisfaction and the use of sedatives in the past 6 months. This study pointed out that mental health of some Thai physicians was to be concerned. These problems, along with their physical health problems, should be tackled systematically and preventatively in order to have the majority of Thai physicians in good health and able to serve the population more effectively.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S9-13.
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ABSTRACT: The objectives of this study were to explore characteristics of the long-lived Thai physicians. We sent 983 posted questionnaires to 840 male and 143 female physicians. We obtained 327 of them back after 2 rounds of mailing, yielding a response rate of 33.3 percents. The response rate of male physicians was 32.4 percents and that of female physicians was 38.5 percents. Their ages were between 68-93 years (75.1 +/- 4.86 years on average). The majority were married, implying that their spouses were also long-lived. Around half of them still did some clinical work, one-fourth did some charity work, one-fourth did various voluntary works, one-fifth did some business, one-fifth did some academic work, and some did more than one type of work. Most long-lived physicians were not obese, with BMI of 16.53-34.16 (average 23.97 +/- 2.80). Only 8 had BMI higher than 30. BMIs were not different between male and female physicians. However, four-fifths of them had diseases that required treatment, and some of them had more than one disease. The five most frequent diseases were hypertension, diabetes, ischemic heart disease, dyslipidemia, and benign prostate hypertrophy, respectively. Most long-lived physicians did exercise (87.8%), and some did more than one method. The most frequent one was walking (52.3%). Most did not drink alcohol or drank occasionally, only 9.0% drank regularly. Most of them slept 3-9 hours per night (average 6.75 +/- 1.06). Most (78.3%) took some medication regularly; of most were medicine for their diseases. Most did not eat macrobiotic food, vegetarian food, or fast food regularly. Most long-lived physicians practiced some religious activities by praying, paying respect to Buddha, giving food to monks, practicing meditation, and listening to monks' teaching. They also used Buddhist practice and guidelines for their daily living and work, and also recommended these to their younger colleagues. Their recreational activities were playing musical instruments (15%), singing (27%), doing hobbies (64.0%), and others (51.8%). Most did not reply on question whether they achieved their self-actualization target of their lives, this might result from the fact that this was rather an abstract question. Our first part study revealed some characteristics of long-lived Thai physicians that seem to be in agreement with other studies indicating that physicians compared favorably with the general population in mortality from physical illness. This may result from several factors: the medical student selective process leading to "healthy worker effect", knowledge in medicine, access to care, and their healthy behaviors (such as nutrition, exercise, religious activities which help improve their spiritual well-being).
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S23-32.
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ABSTRACT: Physicians often conduct research on other occupations' health or general populations' health, but their health has hardly been studied systematically. The authors conducted a cross-sectional descriptive survey on 440 physicians systematically selected from their medical license numbers. The response rate was 86.4% (380 out of 440). Two-hundred and twenty-nine were male, and 151 were female. Their average age was 40.8 years (range: 22-74). Most of them were Buddhists (93.9%), specialists (64.2%), married only once and still lived with their spouses (59.5%), and concurrently practiced medicine (95.5%). Their overall satisfaction as physicians was 60.2% high, and 37.2% moderate. Their average sleep time was 6-8 hours per night for 58.9%. Most had eye problems (74.9%) and most were refractive errors such as myopia. Most (63.8%) of them did not have any prevalent diseases. Whereas those who had diseases had (in order) allergy, hypertension, asthma, diabetes, and cancer. Their current illnesses included respiratory tract infection. Most physicians did not smoke (94.2%) nor drink alcohol (70.5%). Most of them were not vegetarians (60.4%), did not eat fast food (99.2%). Interestingly, 41.4% of them were accounted for spending less than twice per week for exercise. As expected, 23.7% of them were exposed to blood, 14.5% to respiratory tract secretion, and 13.7% to pus/secretion from wounds. This study serves as a basis for health promotion approach to medical community and does create awareness of health among Thai physicians.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S1-4.
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ABSTRACT: To investigate the risk factors for suicide in Thai physicians.
The study focused on 18 doctors who had committed suicide before January 2002, identified by death certificates and the reported data from Thai Medical Council. Consensus case reports were assembled by using the psychological autopsy method. Study methods included semi-structured and in-depth interviews of next of kin and interviews of classmates, colleagues and medical or mental health services workers who had treated the suicide victims.
The sample consisted of 18 subjects (17 males, one female). The age range was 30-49 years old. Most victims were specialists (11 out of 18; 3 gynecologists, 2 psychiatrists, 2 pediatricians, 2 surgeons and 1 internist, 1 radiologist). The methods of suicide were 6 hanging, 5 gun shots, 5 intravenous injections, 1 jumping and 1 drug over-dose. Psychiatric disorders were found in 11 out of 18 cases, and depressive disorder was the most common disorder. Interpersonal conflict and/or loss were the most common factors leading to suicide (6 out of 18), the second factor was psychiatric illness and the third factor was work problems.
In assessing suicidal risk, a history of interpersonal conflicts and loss and the presence of co-morbid psychiatric disorders are particularly important. The important strategies for suicide prevention in Thai physicians are early detection and proper management of psychiatric illness especially depressive disorder and recognition the significance of family support.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S14-8.
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ABSTRACT: The purposes of this cross-sectional study were to collect data regarding satisfaction and influencing factors related to satisfaction of Thai Physicians. The survey was conducted during October 2002 to March 2003. Study subjects were 440 physicians obtained by systematic random sampling. They were asked to reply posted questionnaire and telephone interviewed later if they did not reply the mailed questionnaire. The authors could obtain data from 380 out of 440 cases (86.3%), 60.3% were male and 39.7% were female. Their average age was 43.9 and 37.7 years, respectively, with an overall average of 40.9 years. The level of career satisfaction of Thai Physicians was high (60.2%), moderate (37.2%) and low (2.6%). Conclusively the factors which influenced or predicted satisfaction of Thai physicians were age, exercise and accident. The author make some recommendations for improving Thai physicians' satisfaction.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S5-8.
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ABSTRACT: Previous report suggested early age at death of Thai physicians; the estimate however was not a comparable measurement with general Thai population. This information created a concern on the health status of Thai population. This study was therefore aimed to calculate life expectancy of Thai physicians and to compare with Thai population. Information on year of birth of all registered physicians and year of death of physicians who died during 1998-2002 was retrieved from the database of the Thai Medical Council and the Centre for Continuing Medical Education of Thailand. Age-specific mortality rates were computed for ages of 23-24, 25-29, and then 5-year intervals until 70 years or more. These age-specific mortality rates were used for calculation of life expectancy by using the method of abridged life table. During the year 1998-2002, there were 655 deaths among 25,501 Thai physicians. According to life table calculation, life expectancy at age 23 for Thai physicians was 63.5 years or they could live until age of 86.5 years when they started their career and those figures for Thai general population were 53.2 and 76.2 respectively. The differences between these two populations were declined in older age groups. Increased life expectancy among physicians compared to general population was also reported in other countries. A longer life span of physicians might be a result of higher socioeconomic status and low prevalence of health risk behavior.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S19-22.
