Biomedical Sciences and Clinical Medicine

OBJECTIVE This study aims to cross-culturally translate the Tinnitus Functional Index (TFI) questionnaire into Thai, and to determine the psychometric properties of Thai version (TFI-Th). METHODS TFI was translated into a Thai version (TFI-Th) using a forward - backward translation procedure. All participants completed the following questionnaires in random order: TFI-Th, Visual analog scales, Tinnitus Handicap Inventory Thai Version (THI-T), and Thai Hospital Anxiety and Depression Scales (Thai HADS). RESULTS The content validity index (CVI) of the TFI-Th was high. The TFI-Th showed adequate convergent and divergent validity. The correlation between TFI-Th and other measurements were calculated and showed a high correlation with THI-T (r = 0.82), a moderate-to-high correlations with each items of VAS (r = 0.66-0.86), and a moderate correlation with depression (r = 0.58) and anxiety (r = 0.62) of Thai HADS. The internal consistency reliability of TFI-Th was excellent (μ = 0.97). CONCLUSIONS The results of the present study revealed that the cross-cultural TFI-Th had similar reliability and validity to the original TFI and suitable for the evaluation of Thai tinnitus patients. KEYWORDS tinnitus, Thai Tinnitus Functional Index, psychometric properties, reliability

Vorapun Premkraisorn

Krisna Lertsukprasert

Pawin Numthavaj

Rattinun Tiravanitkul

Chanchai Jariengprasert

Cross-Cultural Adaptation and Psychometric Properties of Tinnitus Functional Index for Thai Patients

泰国耳鸣功能指数的跨文化适应与心理测量特性

OBJECTIVE To evaluate serum markers in liver function tests (LFT) at various intervals after traumatic liver injury to identify serum markers associated with unfavorable outcomes. METHODS A retrospective cohort analysis was conducted of trauma center patients older than 18 years with traumatic liver injury. Liver function test (LFT) results of patients with favorable and unfavorable outcomes were compared at different post-injury time points. Statistical significance was established as p-value less than 0.05. RESULTS Of the 206 patients with severe liver injuries in the unfavorable outcome group, 119 (57.8%) needed intervention. Aspartate amino-transferase (AST) and alanine transaminase (ALT) were seen to increase in correlation with injury severity at initial admission. On days 1-5 and 6-10 after admission, the unfavorable outcome group had a slower decline in AST. In the unfavorable group, total bilirubin (TB) and direct bilirubin (DB) levels rose significantly 5 days after the injury and were higher than normal with a higher odds ratio (OR) of unfavorable outcome 11-15 days after injury in multivariable analysis [OR (95% confidence intervals): 2.7 (1.02-7.37) and 6.9 (1.08-44.14), respectively]. CONCLUSIONS Liver function tests can help identify individuals at risk for traumatic liver injury complications. Elevated levels of TB and DB are statistically significantly associated with adverse outcomes, particularly after day 5 following the injury. Early repeating LFT in first five days after injury may be less beneficial in determining patient risk. Blood test results may be affected by the amount of fluid resuscitation, particularly on the first day of admission in cases of high- grade injuries. KEYWORDS aspartate aminotransferase, liver injury, liver function test, unfavorable outcome, alanine transaminase, bilirubin

Ginthasuphang Wangsapthawi

Narain Chotirosniramit

Kaweesak Chittawatanarat

Association of Liver Function Serum Markers and Unfavorable Outcomes in Traumatic Liver Injury Patients

创伤性肝损伤患者肝功能血清标志物与不良结局的关联

Borderline personality disorder (BPD) is one of three clusters of personality disorders characterized by a pattern of difficulty regulating emotion, impulse control, interpersonal relationships, and self-image. Emotional dysregulation, impulsive aggression, repetitive self-injury, and chronic suicidal tendencies make these individuals frequent users of mental health services. BPD has a variety of causes and involves several factors which interact in various ways with each other. Emotional dysregulation and impulsivity can be caused by genetic factors and traumatic childhood experiences and lead to dysfunctional behaviors, psychosocial conflicts, and deficits that may exacerbate emotional dysregulation and impulsivity. BPD has been linked to anatomical alterations in brain areas in the prefrontal cortex, cingulate cortex, hippocampus, amygdala, hypothalamus, corpus callosum, and frontolimbic network. These brain changes can lead to the manifestation of the inability to control behavior, feelings, and interpersonal relationships, which often leads to violence. These symptoms may begin at a young age or in early adulthood and tend to continue as the individual ages. The goal of this article is to review how structural changes in the brain can cause BPD. KEYWORDS Borderline personality disorder, MRI in BPD, BPD patients, personality disorders, structural imaging BPD, neurobiology BPD

Patcharin Ryden

Chanokporn Choochat

Structural Brain Alterations in Borderline Personality Disorder

边缘型人格障碍的脑结构改变

OBJECTIVE This study aimed to investigate the prevalence of and factors associated with depression in residents in training at the Faculty of Medicine, Chiang Mai University. METHODS This cross-sectional study was conducted with Faculty of Medicine residents in training from March to July 2020. We used the nine-item Patient Health Questionnaire (PHQ-9) to determine the level of depression. Binary logistic regression was used to evaluate associated factors: loneliness, burnout, sleep quality, emotional quotients (EQ), and perceived social support (PSS). RESULTS About one-fifth of the residents in training exhibited depression (47 of 201), and 6.97% had indications of suicidality. Factors showing a positive correlation with depression included loneliness (aOR: 1.27; 95% CI: 1.15-1.40); burnout scales of depersonalization (aOR: 1.18; 95% CI: 1.10-1.25), and reduced personal accomplishment (aOR: 1.10; 95% CI: 1.05-1.14). Factors showed a negative correlation with depression: perceived social support from significant others (aOR: 0.91; 95% CI: 0.85-0.98). Three subscales of EQ included motivation (aOR: 0.82; 95% CI: 0.68-0.99); life satisfaction (aOR: 0.83; 95% CI: 0.70-0.97); level of peace (aOR: 0.76; 95% CI: 0.66-0.87). CONCLUSIONS The prevalence of depression in residents was 23.40%. Loneliness, low social support, and burnout (depersonalization, reduced personal accomplishment) were all associated with depression. Three EQ factors (motivation, life satisfaction, and peace) appeared to have potential for reducing depression. KEYWORDS depression, resident training, loneliness, emotional intelligence, burnout

Kamolchanok Chimnuan

Nuntaporn Karawekpanyawong

Saranat Orrapin

Suttipong Kawilapat

Punjaree Wiriyacosol

The Prevalence and Associated Factors of Depression among Residents in Training in a Northern Thailand University: A Cross-sectional Study

泰国北部某大学培训居民中抑郁症的流行率及相关因素：一项横断面研究

OBJECTIVE To explore the proportion of non-severe ischemic stroke patients returning to work (RTW) and to examine the association of demographic, clinical, and evaluative information with RTW outcomes. METHODS This observational study included non-severe ischemic stroke patients at the stroke ward, Srinagarind Hospital, Khon Kaen, Thailand between September 2021 and November 2022. Patients included were over 18-year-old, had NIHSS scores not exceeding 14, were currently employed and wanted to RTW. Patients were assessed at the discharged time, 2-week-follow-up, and 3-month-follow-up. Bivariate analysis was conducted using either Chi-square or Fisher’s exact test. RESULTS Sixty-four patients were recruited of whom 4 dropped out, leaving a total of 60. The cumulative proportions of successful RTW patients at the discharged time, 2-week-follow-up, 1-month-follow-up, and 3-month-follow-up were 26.7%, 51.7%, 70%, and 76.7% (95%CI 16.8-38.8, 39.2-64.0, 57.7-80.5, 64.9-86.0), respectively. Most patients could RTW in the first month, then the number plateaued at 3 months. More successful RTW patients included those in cognitive demand occupations, evaluated as normal to minor neurological severity, motor power graded 4-5 at discharge, passed MoCA or MMSE test, and who were rated as independent by either the mRS or the BI. Bivariate analysis revealed statistically significant association between RTW proportion and occupation type, neurological severity, motor power, and ADL disability. CONCLUSIONS Most non-severe ischemic stroke patients could RTW within 3 months after discharge. Occupational type, neurological severi-ty, motor power, and ADL associated with the proportion of RTW (3-month-follow-up). RTW evaluation of non-severe stroke patients should be assessed at short intervals for 3 months after discharge. KEYWORDS return to work, ischemic stroke, occupation, cognition, activities of daily living

Krittin Wipahut

Naesinee Chaiear

Sirintip Boonjaraspinyo

Kannikar Kongbunkiat

Somsak Tiamkao

Warisa Soonthornvinit

Proportion of Non-severe Ischemic Stroke Patients Returning to Work

非重度缺血性卒中患者重返工作比例

OBJECTIVE The aim of this study was to investigate occupational risk factors, particularly focusing on working hours, in the patients with cerebrovascular diseases and cardiovascular diseases to help reduce the incidence of those diseases in the future. METHODS This descriptive study was conducted retrospectively. Patients age 18 to 65 with a first diagnosis of acute stroke and acute myocardial infarction in the years 2019 to 2022 were included. Demographic data were obtained from in-patient records. Occupational data, including working hours and other missing data, were obtained through telephone interviews with the patients. RESULTS After excluding individuals who were unemployed at the time of the disease incident, deceased, unwilling or unreachable to participate, a total of 146 patients were included in this study. Of those, 115 participants (78.8%) were first diagnosed with acute stroke and 31 participants (21.2%) were first diagnosed with acute myocardial infarction during the study period. The median and interquartile range of weekly working hours of all participants, participants with acute stroke, and participants with acute myocardial infarction were 56 (25), 56 (35), and 59 (27) hours per week, respectively. The range of working hours per week was from 4 to 112 hours. The majority of participants reported not engaging in dangerous work as defined by Thailand’s Ministry of Labour, reported no significant occupational hazards, stated they had minimal stress and that they had control over their own job. CONCLUSIONS The results indicate that the majority of stroke and myocardial infarction patients from this center worked ≥ 55 hours per week. Although the majority reported having no significant occupational factors, recognizing and incorporating a history of occupational factors could be beneficial in disease diagnosis, disease prevention, prevention of recurrence, and aiding the return-to-work process of the patients. KEYWORDS overwork, cerebrovascular disease, cardiovascular disease, myocardial infarction, stroke, occupational disease, long working hours

Pakanaporn Chongchitpaisan

Premyot Piemnithikul

Wanna Chongchitpaisan

Occupational Characteristics and Working Hours of Stroke and Myocardial Infarction Patients at a Hospital in Bangkok: A Descriptive Study

曼谷某医院中风和心肌梗死患者的职业特征及工作时间：一项描述性研究

OBJECTIVE The primary objective was to determine the 5-year overall survival rate and 5-year disease-free survival rate of patients with CACx 1A1 treated at Chiang Mai University Hospital and the secondary objective was to describe treatment modalities as well as their associated complications. METHODS Patients with stage IA1 cervical cancer diagnosed from January 2001 to June 2018 at Chiang Mai University Hospital were retrospectively reviewed. Inclusion criteria included previously untreated patients diagnosed with stage IA1 cervical cancer (2018 FIGO staging system). Exclusion criteria were patients with recurrent cervical cancer, other gynecologic malignancies, and those in a pregnant state. The analysis included treatment patterns, surgical types, and clinicopathologic variables, i.e., nodal metastasis, parametrial involvement, positive surgical margins, deep stromal invasion (DSI), lymph-vascular space invasion (LVSI), adjuvant treatment, 5-year disease-free survival, and 5-year overall survival. All pathologic slides were reviewed by gynecologic pathologists. The Kruskal-Wallis test, Fisher’s exact test, the Kaplan-Meier method and log-rank test were used for statistical analysis. RESULTS Of the 184 patients included in this study, simple hysterectomy was the most common treatment (57.3%), followed by modified radical hysterectomy (MRH) and radical hysterectomy (RH) (27.6% and 9.7% respectively). Conization and radiation were chosen in a few cases. At the median follow up time of 40.8 months, the 5-year disease free survival rate was 99.1% and the 5-year overall survival rate was 95.0%. Pelvic lymph node dissection was done in 62 cases (33.7%), but only one case (0.54%) had pelvic lymph node metastasis. CONCLUSIONS The surgical and survival outcomes for women with stage IA1 cervical cancer are excellent. They can be effectively treated with less radical interventions such as simple hysterectomy and conization. Lymph node metastasis is rare at this stage (0.54%); therefore, lympha-denectomy may possibly be omitted. KEYWORDS cervical cancer, IA1, treatment outcome

Sethawat Sethasathien

Charuwan Tantipalakorn

Unyavee Apichottiwat

Kittipat Charoenkwan

Prapaporn Suprasert

Jatupol Srisomboon

Treatment Patterns and Surgical Outcomes of Stage IA1 Cervical Carcinoma

IA1期宫颈癌的治疗模式和手术结果

OBJECTIVE This study aims to analyze factors related to a good quality of work life (QoWL) for employees in the poultry processing industry in northeastern Thailand. METHODS This study was a cross-sectional analytical study. The sample size was 229 poultry processing workers with good and 458 with not-good QoWL. The Work-related Quality of Life Scale-2 Online Website (THQWL) questionnaire was used. A test of the reliability of the questionnaire found a Cronbach’s alpha of 0.899. The principal analyses used the Chi-squared test, the Fisher exact test, and binary logistic regression. Confidence intervals were set at 95% (95% CI), and a p-value of less than 0.05 (p &lt; 0.05) was considered statistically significant. RESULTS Factors significantly related to employees with a good QoWL were working in departments other than slaughtering departments (AOR = 15.58, 95% CI: 7.62, 31.83, p &lt; 0.001), having less than a bachelor’s degree education level (AOR = 6.65, 95% CI: 3.05, 14.49, p &lt; 0.001), being a unit leader or in an upper level position (AOR = 7.26, 95% CI: 3.30, 15.98, p &lt; 0.001) and working 40 or more hours per week (AOR= 1.92, 95% CI: 1.17, 3.16, p = 0.010). CONCLUSIONS Not working in the slaughtering department showed the strongest association with good QoWL. Other factors significantly linked to good QoWL included an education level lower than a bachelor’s degree, holding positions as unit leaders or in upper management, and working 40 hours or more per week. The study’s findings can be applied to enhance and promote the QoWL of workers in the poultry processing and related industries as well as to help improve and reinforce the knowledge, skills, and other attributes important to the efficient performance of employees in the poultry processing industry. KEYWORDS quality of work life, poultry processing industry, work- related quality of life scale, slaughtering

Janthimard Mornmee

Factors Related to a Good Quality of Work Life for Employees in the Poultry Processing Industry in Northeastern Thailand

泰国东北部家禽加工业员工良好工作生活质量的相关因素

OBJECTIVE This study aims to identify environmental risk factors associated with behavioral problems in children and adolescents with attention deficit hyperactivity disorder (ADHD). METHODS A case-control study was conducted in children aged 4-15 years comprising 92 children diagnosed with ADHD and 92 controls without ADHD. Stratified sampling was used to select 184 participants residing in Chiang Mai and Lamphun provinces, Thailand. Data were collected from the mothers of the participants using a self-report questionnaire between May and August 2022. The questionnaire consisted of three parts: child characteristics (gender, age, underlying diseases, past illness history), mother’s characteristics (age, income, occupational status, history of cigarette smoking and alcohol drinking), and maternal perceptions about caring for the child and the child’s behavioral problems (exposure to chemicals/toxicants, frequent punishment, excessive use of digital media and games). Data were analyzed using descriptive statistics, chi-squared test, odds ratio (OR) and logistic regression using SPSS version 21. RESULTS Most of participants were males (86.96%) while 13.04% were females. The results showed that the ADHD cases were significantly more likely than the controls to have underlying diseases such as G6PD, allergy, and asthma (p = 0.006). There was also a statistically significant correlation with smoking history in the mothers of ADHD cases (OR = 2.64; 95% CI: 1.36-5.13 p = 0.004). In terms of maternal perceptions, the mothers of ADHD children were significantly more likely than the controls to have frequently punished the child (OR = 6.26; 95% CI: 3.24-12.07; p &lt; 0.001), to have children who were exposed to chemicals (pesticides and fertilizer) or toxicants (passive smoking) (OR = 4.14; 95%CI: 1.76-9.73; p = 0.001), and to have allowed their child to use digital media and play video games excessively (OR = 2.82; 95% CI: 1.55-5.16; p = 0.001). After adjustment for other environmental risk factors, frequent child punishment (ORadj = 4.32; 95% CI: 2.13-8.78; p &lt; 0.001) and exposure of the child to chemicals/toxicants (ORadj = 2.66; 95% CI: 1.00-7.02; p = 0.049) were found to be significantly related with ADHD. CONCLUSIONS Frequent child punishment was the most significant environmental risk factor related to behavioral problems among children with ADHD. This indicates the importance of healthcare providers developing strategies and/or interventions to enhance knowledge and awareness in mothers of ADHD which can improve treatment outcomes. KEYWORDS ADHD, risk factors, behavioral problems, maternal percep- tions

Chutinart Sakarinkhul

Soontaree Srikosai

Environmental Risk Factors Associated with Behavioral Problems among Children with Attention Deficit Hyperactivity Disorder: Maternal Perceptions

注意力缺陷多动障碍儿童行为问题的环境风险因素：母亲感知

OBJECTIVE Hemoglobin (Hb) variants resulting from mutations in globin genes and leading to qualitative abnormalities of globin proteins can result in a spectrum of clinical presentations. Herein we describe a case of a 10-year-old boy with an Hb variant, Hb Lansing-Ramathibodi (HBA1:c.264C&gt;G, codon 87 His&gt;Gln), who was incidentally found to have low pulse oximetry oxygen saturation readings (low SpO2). Laboratory investigations revealed mild microcytic anemia. Arterial blood gas showed normal partial pressure of oxygen (PaO2) and arterial oxygen saturation (SpO2) values, indicating an oxygen saturation gap. Subsequent Hb analysis identified an abnormal peak, prompting further molecular studies which confirmed the coinheritance of Hb Lansing-Ramathibodi, Southeast Asian deletional α0-thalassemia and the Hb E trait. The patient’s mother, carrying the Hb Lansing-Ramathibodi and Hb E traits without Southeast Asian deletional α 0-thalassemia, was asymptomatic. This case underscores the importance of identifying and characterizing rare Hb variants presenting with an oxygen saturation gap for informed clinical management and genetic counseling. KEYWORDS alpha-thalassemia, coinheritance, hemoglobin Lansing- Ramathibodi, low SpO2, oxygen saturation

Kornkamol Chouymankong

Nattawan Arkarattanakul

Kanittha Mankhemthong

Nisarat Sirinam

Arunee Phusua

Kanda Fanhchaksai

Pimlak Charoenkwan

Coinherited Hemoglobin Lansing-Ramathibodi/Southeast Asian Deletional α0-thalassemia and Hemoglobin E Causing Falsely Low Oxygen Saturation on Pulse Oximetry

共遗传的血红蛋白兰辛-拉玛蒂比迪/东南亚缺失型α0-地中海贫血和血红蛋白E导致脉搏血氧仪上氧饱和度假性降低

Publication Information	Publisher: Chiang Mai University Faculty of Medicine，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2022，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:

Biomedical Sciences and Clinical Medicine

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