Samutprakan Hospital Journal (SMPK HOS J)

Case Study: Two Comparative Rare Cases of Parameatal Urethral Cysts in Children: Is Surgical Excision Necessary?

2024-10-04T17:21:19+07:00

Parameatal urethral cysts are relatively common in children and often asymptomatic. However, approximately 20% of cases present with urinary disturbances or other complications. Due to their rarity, no standardized treatment guidelines currently exist. This case study aims to explore the natural history of parameatal urethral cysts in children and to propose treatment recommendations. Data were collected from the medical records of two pediatric patients diagnosed with parameatal urethral cysts who received treatment at Samutprakan Hospital between October 1, 2016, and May 31, 2024. A comparative analysis was conducted using international case reports as references.

International case studies indicate that in asymptomatic patients with cysts smaller than 5 millimeters, 6 - 25% resolve spontaneously within an average of 5.5 to 24 months, suggesting that a follow-up period of at least 24 months is advisable. If the cyst does not resolve during this period, cyst excision is recommended. For symptomatic patients with cysts 5 millimeters or larger, cyst excision is generally indicated. In this study, the first patient, who presented with urinary flow disturbances and a 1-centimeter cyst, experienced spontaneous resolution after 18 months of follow-up, contrary to international trends. The second patient, asymptomatic with a 1-centimeter cyst, did not experience spontaneous resolution after a 5-year follow-up, necessitating cyst excision. Post-surgical follow-up at two months showed no recurrence or urethral stricture.

These findings suggest that in asymptomatic or mildly symptomatic patients, even with cysts larger than 5 millimeters, observation may be a reasonable initial approach. Surgical excision should be considered if the cyst does not resolve after 24 months.

Nutritional Assessment of Chronic Kidney Disease Patients Undergoing Hemodialysis Using the Nutrition Alert Form (NAF) Compared with the Malnutrition Inflammation Score (MIS) at Samutprakarn Hospital

2024-08-14T21:26:29+07:00

This quasi-experimental research aims to compare the results of using the Nutrition Alert Form (NAF) and the Malnutrition Inflammation Score (MIS) for assessing malnutrition, as well as to examine the energy and protein intake of patients from food consumed. Data were collected between February and April 2024 from 65 chronic kidney disease patients undergoing hemodialysis at Hemodialysis Centers 1 and 2, Samutprakan Hospital. Data collection methods included general health records, the NAF, MIS, 24-hour food diaries, and the Easy Dietary Assessment (EDA) for chronic kidney disease patients. Data were analyzed using descriptive statistics, ROC curve, and kappa analysis, along with Pearson and Spearman’s correlation coefficients at a 95% confidence level (p < 0.05).

The results showed that the majority of the sample were female (61.54%), and 26.15% had been on dialysis for more than 45 months. Nutritional assessments using NAF and MIS identified moderate malnutrition in 64.62% and 53.84% of patients, respectively, and severe malnutrition in 15.38% and 33.85% of patients, respectively. When using MIS as the standard, the optimal NAF cutoff score for diagnosing malnutrition was 8, with a sensitivity of 77.27% and specificity of 72.0%. The consistency of the cutoff score, as measured by Kappa and ROC curve analysis, showed an AUC ROC value of 0.747 with moderate consistency (kappa = 0.458, p < 0.001). Patients over 60 years of age had an average energy intake of 940.72 kcal per day, while those under 60 had an average of 1151.11 kcal per day. The average daily protein intake was 44.57 grams, which is 64.81% of the recommended daily intake.

Therefore, NAF can diagnose malnutrition in patients with chronic kidney disease undergoing dialysis by using a severe malnutrition cutoff score of 8 or higher.

The Association Between the Health Belief Model and Stroke Prevention Behaviors Among Hypertensive Patients at Tai Ban Subdistrict Health Promoting Hospital, Mueang Samut Prakan District, Samut Prakan Province

2024-08-07T20:47:41+07:00

This correlational study aims to examine the relationship between the Health Belief Model and stroke prevention behaviors among hypertensive patients attending Tai Ban Subdistrict Health Promoting Hospital, Mueang Samut Prakan district, Samut Prakan province, from October 2023 to April 2024. A systematic random sampling method was used to recruit 300 hypertensive patients. The research instrument included a questionnaire comprising: 1) demographic information, 2) a test on stroke warning signs knowledge, 3) health beliefs related to stroke prevention, and 4) stroke prevention behaviors. Data were analyzed using descriptive statistics, and Pearson correlation coefficient was employed to assess the relationships.

The results revealed that knowledge of stroke warning signs had a significantly moderate positive correlation with stroke prevention behaviors (r = 0.561, p < 0.001). Additionally, the Health Belief Model was found to have a significantly moderate positive correlation with stroke prevention behaviors (r = 0.528, p < 0.001) among hypertensive patients.

Factors Related to Health Promotion Behaviors of Elderly People with Chronic Diseases Receiving Services at Phraeksa Subdistrict Health Promoting Hospital, Mueang Samut Prakan District, Samut Prakan Province

2024-09-11T15:29:09+07:00

This study is cross-sectional descriptive research to examine the level of health-promoting behaviors among elderly individuals with chronic diseases and to explore the relationships between predisposing, enabling, and reinforcing factors and these health-promoting behaviors. The study was guided by the PRECEDE model and Pender's health promotion model (Pender, 2011). The sample comprised 350 elderly individuals aged 60 years and above with chronic diseases, selected through purposive sampling. Data were collected using a questionnaire validated by three experts, yielding a content validity index of 0.91, with reliability coefficients ranging from 0.71 to 0.91. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient.

The findings revealed that the overall level of health-promoting behaviors among the elderly with chronic diseases was high (M = 4.00, SD = 0.43). Predisposing factors, including knowledge level, attitudes towards health promotion, and health perception, were also at high levels (M = 8.53, SD = 0.91; M = 4.00, SD = 0.66; M = 4.14, SD = 0.54, respectively). Enabling factors were at a high level (M = 3.98, SD = 0.68), as were reinforcing factors (M = 3.91, SD = 0.45).

Positive correlations were found between predisposing factors (knowledge and health perception) and health-promoting behaviors, with high and moderate levels of correlation (r = 0.678, r = 0.483, respectively). Enabling factors showed a moderate positive correlation (r = 0.476). Reinforcing factors, including advice on health responsibility, interpersonal relationships, and stress management, exhibited positive correlations at high and moderate levels (r = 0.676, r = 0.438, and r = 0.448, respectively). All these factors were significantly positively correlated with the level of health-promoting behaviors among elderly individuals with chronic diseases (p < 0.05, p < 0.001).

Perception and Self-care Behavior to Prevent Falls in the Elderly at Rom Pho Subdistrict Health Promoting Hospital, Mueang Samut Prakan District, Samut Prakan Province

2024-10-02T22:03:09+07:00

This descriptive correlational research aims to study the level of perception, self-care behaviors for fall prevention, and the relationship between perception levels and self-care behaviors for fall prevention among elderly individuals at Rom Pho Subdistrict Health Promoting Hospital, Mueang Samut Prakan District, Samut Prakan Province. The sample consisted of 350 elderly individuals aged 60 years and older residing within the service area of the Rom Pho Subdistrict Health Promoting Hospital, Theparak subdistrict, Mueang Samut Prakan district, Samut Prakan province. Data were collected using questionnaires and analyzed using percentage, mean, standard deviation, and Pearson's product moment correlation coefficient to test the hypothesis at a significance level of 0.05.

The results showed that: 1) the overall levels of perception and self-care behaviors for fall prevention were rated as high and 2) perception of fall prevention was significantly correlated with self-care behaviors for fall prevention among elderly individuals at a statistical significance level of 0.05.

Distribution of Vancomycin Resistance Genes in Enterococci Isolated from Patient Specimens at Samutprakan Hospital

2024-07-17T20:02:11+07:00

Antimicrobial resistance poses a global crisis, affecting humans, animals, food, and the environment. In Thailand, Enterococci are recognized as important pathogens in nosocomial infections. Vancomycin-resistant Enterococci (VRE) are classified as high-priority drug-resistant bacteria due to their significant impact on human health, animals, food, and the environment. Therefore, monitoring drug resistance trends is crucial for effective treatment, prevention, and developing guidelines for infection control in hospitals.

This study surveyed the distribution of vancomycin-resistant genes in Enterococci isolated from patient specimens at Samutprakan Hospital. The highest proportion of isolates was identified as Enterococcus faecalis (61.5%), followed by Enterococcus faecium (33.9%) and other Enterococci (4.6%). However, the highest rates of VRE were found in Enterococcus faecium (5.3%), followed by Enterococcus faecalis (0.1%). Of the 48 VRE strains collected between January 2022 and June 2023, all (100%) were identified as Enterococcus faecium. Moreover, all strains harbored the vanA gene, with a vancomycin Minimal Inhibitory Concentration (MIC) value of > 256 µg/ml.

Interestingly, 62% of the strains were sensitive to Teicoplanin. Additionally, VRE strains exhibited sensitivity to Linezolid (100%), Daptomycin (94%), and Tetracycline (82%).

Comparison of Cervical Cytology and Colposcopic Biopsy Results in HPV non 16/18 Oncogenic Type Positive Patients at General Hospital in Singburi

2024-10-21T22:20:09+07:00

This retrospective study aims to compare cervical cytology results with colposcopic biopsy findings in patients positive for HPV non-16/18 type. The sample included 110 women aged 30 – 65 years who tested positive for HPV non-16/18 type and underwent cervical cytology and colposcopy at Inburi Hospital between October 1, 2020, and November 30, 2023. Data collected included general characteristics, cervical cytology results, and colposcopic biopsy findings. Descriptive statistics such as frequency, percentage, mean, and standard deviation were used, and the McNemar test was applied to assess the consistency between the two diagnostic methods.

The study found that in cases with normal or abnormal cervical cytology, colposcopic biopsy often revealed higher levels of abnormality, indicating a discrepancy between the two diagnostic methods. The McNemar test demonstrated a statistically significant difference between cervical cytology and colposcopic biopsy results (p < 0.001).