Department of Military and Community Medicine, Phramongkutklao College of Medicine
Prevalence and associated factors of macrovascular complications in patients with hypertension; in Patthana Nikhom hospital, Lopburi province
Noncommunicable diseases are a significant public health problem in Thailand and worldwide. In Thailand, Hypertension is found among people as much as 24.7% of, predominantly in people older than 80; 64.9% are found to have hypertension. Hypertension is also associated with Macrovascular complications. We determined the prevalence and risk factors of Macrovascular complications, which consisted of Coronary heart disease and cerebrovascular disease among hypertensive patients in Patthana Nikhom hospital, Lopburi province, Thailand. A Cross-sectional study was performed on Adults with hypertension who visited Patthana Nikhom hospital between 2017-2019. The secondary data were retrieved from the electronic medical records of Patthana Nikhom hospital. Coronary heart disease was defined by ICD-10, including I20-I21, and Cerebrovascular disease was defined by ICD-10, including I60-I63. Descriptive statistics were used to analyze demographic data and incidence. Logistic regression analysis was performed to determine the odds ratio for macrovascular complication. A total of 9,025 patients with hypertension were enrolled in the study. We analyzed only myocardial infarction and cerebrovascular disease due to the low prevalence of peripheral arterial disease recorded in Patthana Nikhom hospital. In myocardial infarction, after adjusting for the potential confounding factor, we found that the risk of myocardial infarction was higher in age group (95%CI 1.038-1.055, p-value = <0.001), male vs. female (95%CI 1.107-1.659, p-value =0.003), dyslipidemia (95%CI 1.013-1.794, p-value =0.041) and gouty arthritis (95%CI 1.088-2.456, p-value =0.018). Contrary to the results shown above, after adjusting for the potential confounding factor, we found that the protective factor of myocardial infraction was alcohol drinking (95%CI 0.285-0.865, p-value =0.013). In cerebrovascular disease, after adjusting for the potential confounding factor, we found that the risk of cerebrovascular disease was higher in age group (95%CI 1.021-1.034, p-value =<0.001), male vs. female (95%CI 1.778-2.52, p-value =<0.001), T2DM (95%CI 1.054-1.483, p-value =0.01) and higher diastolic blood pressure (95%CI 1.001-1.008, p-value =0.014).
# วัตถุประสงค์ 1. เพื่อหาอัตราอุบัติการณ์และปัจจัยเสี่ยงของการติดเชื้อไวรัสชิคุนกุนยาในกาลังพลทหารที่ปฏิบัติหน้าที่รักษาความสงบในจังหวัดชายแดนใต้ 2. เพื่อหาผลลัพธ์ทางคลินิกของการติดเชื้อไวรัสชิคุนกุนยาในกาลังพลทหารที่ปฏิบัติหน้าที่รักษาความสงบในจังหวัดชายแดนใต้ # การวิเคราะห์ 1. อธิบายเชิงพรรณนาลักษณะทั่วไปของประชากร, สถานะภาพทางสุขภาพ และผลการตรวจตัวอย่างเลือดทางห้องปฏิบัติการ โดยการใช้สถิติ จานวน ร้อยละ ค่าเฉลี่ย และมัธยฐาน ผลการศึกษาจะแสดงอัตราอุบัติการณ์แบบ Incidence rate จาแนกตามตัวแปรทางด้านบุคคล เวลา และพื้นที่ทางภูมิศาสตร์ ผลการศึกษาจะรวมถึงการระบุสัดส่วนของผู้ป้วยที่ติดเชื้อลาม่แสดงอาการ และสัดส่วนของผู้ที่แสดงอาการจาแนกตามระดับความรุนแรงของอาการที่เกี่ยวกับการอักเสบเรื้อรังของข้อ จากระดับคะแนนของแบบเก็บข้อมูลสุขภาพแบบทั่วไป EQ-5D และ SF-36 และแบบเฉพาะ AUSCAN® หรือ WOMAC® 2. การหาความสัมพันธ์ระหว่างปัจจัยเสี่ยงต่อการติดเชื้อไวรัสชิคุนกุนยากับผลการตรวจพบระดับแอนติบอดีต่อเชื้อไวรัสชิคุนกุนยา จะใช้การคานวณหา incidence rate ratio และใช้ Poisson Regression Model ในการระบุ ถึง independent effect # ระยะเวลา การวิจัยนี้เป็นการศึกษา Retospective Cohort Study เพื่อหาอัตราอุบัติการณ์ของโรคชิคุนกุนยาและเป็นการติดตามสถานการณ์การติดเชื้อไวรัสชิคุนกุนยาของกาลังพลทหารที่ปฏิบัติหน้าที่รักษาความสงบในจังหวัดชายแดนใต้โดยเก็บข้อมูลลักษณะของประชากร ปัจจัยเสี่ยง ลักษณะอาการและอาการแสดง และเจาะเลือดตรวจทางซีโรโลยีด้วยวิธี ELISA และ Hemagglutinin Inhibition (HI) ร่วมกับตรวจวิเคราะห์หาสารพันธุกรรมของเชื้อไวรัสชิคุนกุนยาด้วยวิธี Polymerase Chain Reaction (PCR) ซึ่งมีพื้นที่การดาเนินโครงการวิจัยคือ พื้นที่จังหวัดชายแดนใต้ที่มีกาลังพลทหารปฏิบัติหน้าที่รักษาความสงบ มีระยะเวลาดาเนินโครงการนาน 1 ปี 6 เดือน #การขอเข้าถึงแบบสอบถาม #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [แบบสอบถาม](http://bigdata.pcm.ac.th/organization/009crf)
โครงการอัตราอุบัติการณ์และปัจจัยเสี่ยงของการติดเชื้อชิคุนกุนยาในกำลังพลทหารที่ปฏิบัติ หน้าที่รักษาความสงบในจังหวัดชายแดนใต้ของประเทศไทย
Over the last several decades, the global incidence and prevalence of type 2 diabetes mellitus (T2DM) have increased significantly, including in Thailand. Macrovascular complication is the first ranked among the most common causes of death in type 2 diabetes (T2D) patients with complications. The information on the prevalence of macrovascular complications among patients with T2D in Thailand is lacking, especially in a community hospitals. We aim to determine the prevalence and associated factors of macrovascular complications among patients with T2D in Thawung hospital, Thawung district, Lopburi province, Thailand. A Cross-sectional study was conducted in Thawung hospital, Lopburi province. The data of T2D patients between 2016 and 2020 were retrieved from the electronic medical records after permitting the hospital. Macrovascular complications, including coronary heart disease and cerebrovascular disease, were defined by ICD-10. Descriptive statistics were used to analyze demographic data and prevalence. Multivariate logistic regression analysis was performed to determine the factors associated with macrovascular complications. There were 3,148 patients with T2D who participated in the study. The prevalence of macrovascular complications among T2D was 11.1%. After adjusting for confounders, the factors associated with macrovascular complications were higher age (Adjusted odds ratio=1.03; p-value < 0.001), HbA1C(Adjusted odds ratio=1.38; p-value=0.007), and low-density lipoprotein levels (LDL) (Adjusted odds ratio=1.45; p-value=0.026).
Prevalence and associated factors of macrovascular complications in patients with type 2 diabetes at Thawung hospital, Lopburi province
Incidence of hypoglycemia in Diabetic Mellitus patients in Pattananikom Hospital
Hypoglycemia is a medical emergency requiring prompt recognition and treatment to prevent organ and brain damage. This study aims to find out the incidence of hypoglycemia and association factors for providing guidance to healthcare providers to safely and effectively assist diabetic patients. A retrospective cohort study was collected from secondary data from the Pattananikom hospital database. A total of 1155 Thai diabetes participants aged 35 years or older in 2019 were included in the study. Descriptive statistics were used to analyze demographic data. Logistic regression was performed to determine the associated factors of hypoglycemia. Factors with p-value less than 0.05 were considered statistically significant. The incidence of hypoglycemia (DTX < 70 mg/dl) was 4 %. In addition, hypoglycemia was associated with chronic kidney disease (OR: 0.04, p-value < 0.01), history of peripheral artery disease (39.22, < 0.01), regular insulin usage (0.03, < 0.01), and LDL equal to 100 mg/dl and above (0.15, 0.02). However, further studies could provide informative insights into the causal relationship of factors related to hypoglycemia.
Prevalence and associated factors of uncontrolled blood pressure among hypertensive patients in the rural communities in the central areas in Thailand: A cross-sectional study
#PROJECT SUMMARY Nowadays, hypertension is a common and primary risk factor for cardiovascular diseases. It is one of the major global public health issues with the prevalence of 30.8%. The high prevalence of hypertension is reported in Thailand. According to the Thai National Health Examination Survey V (NHES V) conducted in 2015, one in four Thais had hypertension. Hypertension may worsen disease progression and lead to further complications, such as the risk of heart failure, cerebral ischemia, cerebral hemorrhage and chronic kidney diseases. Regarding recent available data concerning controlled blood pressure worldwide, the prevalence of controlled blood pressure was 68.9% and 37.5%, in the US and PR China, respectively. Nevertheless, in Thailand, most information related to hypertension is collected in hospitals or hospital-based organizations rather than at the community level. A half of areas in Thailand are still rural (47%) where the healthcare infrastructure and healthcare provider characteristics differ from those of urban vicinities especially in remote rural areas. Furthermore, the last research related to uncontrolled hypertension was conducted in a rural community in 2012. The report showed that two-thirds patients with hypertension could not achieve the target blood pressure control. Furthermore, the other study in Thailand showed the absolute numbers of individuals with cardiovascular risk factors were greater in rural rather than urban regions. However, only the limited information is available on factors potentially responsible for uncontrolled blood pressure among patients with hypertension in remote rural communities. The required information is essential to focus on preventing the problems. Improving blood pressure control will help to reduce disability from any complications including cardiovascular accident and chronic kidney disease, reduce medical costs and improve quality of life. The present study was conducted directly in a rural population and in primary health care (PHC) units. The objectives of the study were to determine uncontrolled blood pressure and identify risk factors associated with uncontrolled blood pressure among patients with hypertension in the remote rural communities of the central area in Thailand. #ชื่อเจ้าของฐานข้อมูล และการติดต่อ ร.อ. ผศ.บุญทรัพย์ ศักดิ์บุญญารัตน์ ภาควิชาเวชศาสตร์ทหารและชุมชน วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า Capt. Asst.Prof.Boonsub Sakboonyarat, MD, MPH Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand E-mail Boonsub1991@pcm.ac.th #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/uncontrolled_bp_data)
ร.อ. ผศ.บุญทรัพย์ ศักดิ์บุญญารัตน์
#วัตถุประสงค์ของการวิจัย 1. เพื่อประมวลผลของการสำรวจการเข้าถึงบริการทางด้านการดูแลสุขภาพหญิงมีครรภ์ ในประชากรหญิงหลังคลอดที่ใช้สิทธิประกันสังคม 2. เพื่อศึกษาปัจจัยที่ส่งผลต่อการเข้าถึงบริการทางด้านการดูแลสุขภาพหญิงมีครรภ์ ในประชากรหญิงหลังคลอดที่ใช้สิทธิประกันสังคม #วิธีการดำเนินการ 1. ทบทวนวรรณกรรมที่เกี่ยวข้องกับการบริการทางด้านการดูแลสุขภาพหญิงมีครรภ์ ในประชากรหญิงหลังคลอดที่ใช้สิทธิประกันสังคม โดยเฉพาะอย่างยิ่งที่เกี่ยวข้องกับตัวชี้วัดหลักที่จะใช้ในการประเมินการเข้าถึงบริการ 2. นำแบบประเมินที่ทางสำนักงานประกันสังคมและสำนักงานหลักประกันสุขภาพแห่งชาติ ได้ทำการสำรวจประจำปีบประมาณ 2558 มาทำการบันทึกข้อมูล บริหารจัดการข้อมูล และทำการวิเคราะห์ทางสถิติ 2.1 จำนวนขนาดตัวอย่างเป็นไปตามที่ สำนักงานประกันสังคมและสำนักงานหลักประกันสุขภาพแห่งชาติ ได้กำหนดไว้ให้สามารถเป็นตัวแทนในระดับประเทศโดยมีขนาดตัวอย่างที่ต้องการอย่างน้อย 3,385 ราย 2.2 ตัวชี้วัดหลักจะรวมถึง ร้อยละของมารดาที่มีการฝากครรภ์ครั้งแรกที่อายุครรภ์น้อยกว่า 12 สัปดาห์ และ ร้อยละของมารดาที่คลอดบุตรมีชีวิตที่มีน้ำหนักมากกว่า 2,500 กรัม 3. ทำการวิเคราะห์ความสัมพันธ์ของปัจจัยพื้นฐานประชากร ลักษณะการทำงาน พื้นที่ กับการไม่ถึงเป้าหมายของบริการได้แก่ การฝากครรภ์ครั้งแรกที่อายุครรภ์มากกว่า 12 สัปดาห์ หรือคลอดบุตรที่มีน้ำหนักแรกเกิดน้อยกว่า 2,500 กรัมเป็นต้น 4. ทำการสังเคราะห์สภาวะของสถานการณ์การบริการทางด้านการดูแลสุขภาพหญิงมีครรภ์ ในประชากรหญิงหลังคลอดที่ใช้สิทธิประกันสังคม เพื่อให้ได้ข้อแนะทำที่เป็นรูปธรรมในการปรับปรุงระบบบริการต่อไป #การขอเข้าถึงแบบสอบถาม #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [antenatal-care](http://bigdata.pcm.ac.th/organization/antenatal-care)
การสำรวจการเข้าถึงบริการทางด้านการดูแลสุขภาพหญิงมีครรภ์ ในประชากรหญิงหลังคลอดที่ใช้สิทธิประกันสังคม
สิทธิประกันสังคม
ระบบฐานข้อมูลสุขภาพระยะยาว Big Data เพื่อประโยชน์ทางด้านการเรียนการสอนเวชศาสตร์ชุมชน
Cerebrovascular disease is one of the leading health problems of the Thai population today. Unfortunately, despite the development of the Thai public health system, there is still an increase in the death rate from stroke. This study aimed to study cerebrovascular disease's prevalence and risk factors in patients with type 2 diabetes mellitus at Phatthana Nikhom Hospital, Pattananikom District, Lopburi Province. The researcher and research collaborator went to collect data at Phatthana Nikhom Hospital. Phatthana Nikhom District Lopburi Province By collecting data on stroke patients with diabetes (N =2,648 samples), Diabetes Mellitus means a 12-hour Fasting Plasma Glucose (FPG) blood test with a blood glucose level ≥ 126 mg / dL or a previously diagnosed diabetic. Alternatively, they were treated with oral medication or injections to lower blood sugar. We analyzed the risk factors for acute ischemic stroke in people with diabetes from a questionnaire using logistic regression analysis by preliminary analysis by univariate logistic regression analysis. The magnitude of the correlation of risk factors for acute ischemic stroke in patients with diabetes mellitus from a single factor was the crude odds ratio (OR), along with a 95% confidence interval. In-depth analysis was performed to adjust the correlation from the effects of other factors (adjusted for other potential confounders) by multivariate logistic regression analysis, showing the adjusted odds ratio (OR) and the 95% confidence interval. The magnitude of the relationship was statistically significant. (statistically significant) at p-value <0.05. Ischemic stroke is still a health problem in many populations. Our study showed the prevalence of ischemic stroke among patients with diabetes was 6.6% and found that only being male, aspirin used and the first HbA1c level significantly associated with ischemic stroke among patients with diabetes. We suggest that diabetic patients pay attention to glycemic control and keep HbA1c to glycemic goal, especially in male diabetic patients, to decrease the risk of ischemic stroke.
Prevalence and risk factors of stroke in type 2 diabetic patients at Phatthana Nikhom hospital, Phatthana Nikhom District, Lopburi province
Prevalence and Risk Factors of advanced chronic kidney disease among patients visiting in CKD clinic, Sanam Chai Khet Hospital, Sanam Chai Khet, Chachoengsao province, Thailand
At present, chronic kidney disease is one of the significant problems in Thailand and worldwide. According to the research, the prevalence of chronic kidney disease in 2017 was 697.5 million people across the globe or around 9.1 percent of the world population. The prevalence increased by 29.3 percent from 1990 to 2017. In addition, the study of chronic kidney disease prevalence in Thailand in 10 provinces covering all regions in Thailand found that the prevalence of chronic kidney disease was 17.5 percent, and from the studies with people who have the criteria for chronic kidney disease in every stage, all studies indicate that hyperglycemia and blood pressure affects the development of chronic kidney disease. In a study by the American Association of Diabetes Educators in 2017, diabetes causes chronic kidney disease in 44 percent of all patients with chronic kidney disease. The study of the relationship between overweight and diabetes under the topic of the Mechanism linking diabetes mellitus and obesity 2014 found that increased BMI levels were associated with the development of insulin-resistant diabetes. Of people with type 2 diabetes, 86 percent of these people were associated with being overweight or obese, and, in addition, being overweight and obesity are global health problems. The prevalence of obesity increased dramatically in 2016; there were 1.9 billion adults (people older than 18 years old) worldwide with overweight, of which more than 650 million are obese. The research team sees the importance of chronic kidney disease, which is why the research team decide to study the prevalence and risk factors of chronic kidney disease. In addition, the relationship between overweight and the prevalence of chronic kidney disease patients in Sanam Chai Khet hospital has yet to be studied. For this reason, the research team is interested in studying the relationship between being overweight and the prevalence of chronic kidney disease in Sanam Chai Khet hospital. Therefore, a cross-sectional study investigates chronic kidney disease's prevalence and risk factors in Sanam Chai Khet hospital chronic kidney patients during 2016-2020. The data were retrieved from electronic medical records of the hospital information system. A total of 1263 chronic kidney patients participated in the study; 937 patients were diagnosed with chronic kidney stage 3 or above, a prevalence of 74.19 percent. The risk factors of chronic kidney disease stage 3 or above are patients over 70 years old, with a body mass index greater than 23 kg/m2, diabetes patients, hypertension, and hypertensive crisis.
Hypertension has a long course of action and has high mortality and rate of morbidity from associated hypertension complications such as cardiovascular disease, stroke, and renal failure. In 2015, the Ministry of Public Health in Thailand reported 18,922 deaths from cardiovascular events and 27,884 deaths from stroke, indicating the danger of hypertension. It was also found that hypertension in the young causes a poor prognosis if not treated early. On the contrary, if treated from the beginning to control appropriate blood pressure, it will make the future good health and reduce the rate of hospitalization. A cross-sectional study was conducted from the health registry of hypertension in young patients in Bangkhla hospital and Sanam Chai Khet hospital, Chachoengsao province, during 2015-2021 to investigate the prevalence and associated factors of hypertension in the young. Adjusted odds ratio and 95% confidential intervals were calculated to determine associated factors. In 39,366 diabetic patients who participated in this study, the prevalence of hypertension in the young was 2.22%. The factors associated with hypertension in the young were male sex (are: 2.69, 95% CI: 1.673-4.290), Age more than 30 years old(aOR = 2.248 95% CI = 1.220-4.414), BMI ≥23 kg/m2 (aOR = 6.874 95% CI = 1.233- 38.335), history of smoking (are: 4.46, 95% CI: 1.710-11.648), diabetes (aOR = 6.056 95% CI = 2.728-13.445) and cardiovascular disease (aOR = 10.445 95% CI = 1.22-89.447). The prevalence of hypertension in the young patients in Bangkhla hospital and Sanam Chai Khet hospital was lower than the prevalence in Thai patients. The associated factors were male sex, overweight, smoking history, alcohol drinking, diabetes mellitus, myocardial infarction, heart failure and stroke, and abnormal laboratory results, including FBS( Fasting Blood Sugar) and Cr ( Serum Creatinine). Our findings may help raise awareness of hypertension in young patients in healthcare providers and awareness in patient self. The proper management and reasonable plan for the chronic disease may help reduce the prevalence of hypertension in the young and following complications. Regular follow-up, proper advice, and encouraging patients to be behavioral changing, especially modifiable factors, which are smoking and weight controlling, would give better disease control and reduce the risk of vascular complications.
Prevalence and risk factors of hypertension in the young patients at Bangkhla hospital, Bangkhla district, Chachoengsao province and Sanam Chai Khet hospital, Sanam Chai Khet district, Chachoengsao province
Noncommunicable diseases (NCDs) are significant health problems worldwide and in Thailand. Dyslipidemia is an important modifiable risk factor of atherosclerotic disease, which increases the risk of vascular complications in T2DM patients. It is defined by abnormal lipid profiles, which are elevated cholesterol or triglyceride levels or reduced high-density lipoprotein levels. The results can be applied for proper management of T2DM patients and determine the associated factors to prevent complications, especially in primary health care units, which tend to have a higher prevalence of dyslipidemia. A cross-sectional study was conducted from the health registry of type 2 diabetic patients in Bangkhla hospital, Chachoengsao province, during 2016-2020 to investigate the prevalence and associated factors of dyslipidemia among T2DM patients. Adjusted odds ratio and 95% confidential intervals were calculated to determine associated factors. In a total of 3,017 diabetic patients who participated in this study, the prevalence of dyslipidemia was 78.06%. The factors associated with dyslipidemia were female sex (aOR: 2.69, 95% CI: 1.673-4.290), BMI ≥23 kg/m2 (aOR: 2.80, 95% CI: 1.497-5.236), HbA1C ≥7% (aOR: 1.66, 95% CI: 1.083-2.538), history of smoking (aOR: 4.46, 95% CI: 1.710-11.648), hypertension (aOR: 2.28, 95% CI: 1.481-3.501) and diabetic nephropathy (aOR: 7.13, 95% CI: 1.719-29.538). The prevalence of dyslipidemia among T2DM patients in Bangkhla hospital differed from the prevalence in Thai patients but was lower than in most primary care units. The associated factors were female sex, overweight, HbA1C ≥7%, smoking history, hypertension, and diabetic nephropathy. Our findings may help raise awareness of dyslipidemia in diabetic patients in healthcare providers and awareness in the patient self. The proper management and good plan for the chronic disease may help reduce the prevalence of dyslipidemia and following complications. Regular follow-up, proper advice, and encouraging patients to behavioral changes, especially modifiable smoking and weight control, would improve disease control and reduce the risk of vascular complications.
Prevalence and associated factors of Dyslipidemia among type 2 diabetic patients at Bangkhla Hospital BangKhla District Chachoengsao province
อุบัติการณ์และปัจจัยเสี่ยงของการประสบอุบัติเหตุจราจรในกำลังพลทหาร สังกัดกองทัพบก ปี 2553
อุบัติเหตุจราจร
#สถานที่ทำการวิจัย 1. พื้นที่ที่วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า 2. หน่วยทหารที่ถูกเลือก ที่สังกัดมณฑลทหารบก (มทบ.) หรือหน่วยขึ้นตรงของจังหวัดทหารบก (นขต.จทบ) และหน่วยกองพลทหารราบ #วัตถุประสงค์ของการวิจัย 1.เพื่อศึกษาอุบัติการณ์และปัจจัยเสี่ยงของการประสบอุบัติเหตุจราจร การบาดเจ็บและเสียชีวิตจากอุบัติเหตุจราจร ในทหารประจำการกองทัพบก #ประโยชน์ที่จะได้จากการวิจัย 1. ได้เห็นภาพที่ชัดมากขึ้นของอุบัติเหตุจราจรในข้าราชการทหารประจำการ : อัตราป่วย อัตรา ตาย สามารถบอกขนาดของปัญหาได้ชัดเจนมากขึ้น 2. ทราบถึงปัจจัยเสี่ยงที่มีผลต่อการเกิดอุบัติเหตุขนส่ง เพื่อนำไปสู่การแก้ไข หรือ หาแนวทางในการป้องกัน ซึ่งนำไปสู่อัตราการเกิดอุบัติเหตุขนส่งที่ลดลง #การขอเข้าถึงแบบสอบถาม #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [แบบสอบถาม](http://bigdata.pcm.ac.th/organization/motor-vehicle-injury-crf)
Prevalence and Associated Factors of Stroke in Thawung Hospital, Thawung District, Lopburi Province
We aim to determine stroke prevalence and associated risk factors in Thawung hospital, Thawung district, Lopburi province. We collected demographic data, history taking, physical examination, laboratory results, and diagnosis of NCDs (hypertension, dyslipidemia, diabetes mellitus, heart diseases, chronic kidney disease ) patients from recorded computer data during the last five years (2016-2020), including age, gender, healthcare coverage, smoking, alcohol drinking, BMI, blood pressure, FBS, HbA1c, triglyceride, LDL, a provisional diagnosis of stroke (2016-2020), underlying hypertension, dyslipidemia, diabetes mellitus, heart diseases, chronic kidney disease in 3,777 patients. Descriptive statistics were used to analyze demographic data. In addition, logistic regression was used to determine the associated factors of stroke. The five-year prevalence of stroke among NCD patients in Thawung hospital was 9.3 %. The associated risk factors from the multivariable analysis were gender, age, BMI, hypertensive crisis (SBP ≥180 or DBP ≥110 mmHg), smoking, and alcohol drinking. Reasonable control of BMI and blood pressure could prevent stroke, while cessation of smoking and alcohol drinking are also significant risks. So, Public health interventions aimed at preventing and reducing stroke should be designed and provided.
Pulmonary Tuberculosis Mortality and Its Risk Factors Among Patients With Type 2 Diabetes And Pulmonary Tuberculosis In Four Community Hospitals, Central Thailand
Tuberculosis (TB), a communicable disease, is currently a significant health problem in Thailand. Type 2 diabetes (T2D) is an indicator of poor TB outcomes; however, data according to specific antihyperglycemic use and tuberculosis outcomes in community hospital settings in Thailand remain limited. We aimed to determine TB mortality as well as explore the demographic and clinical risk factors among patients with pulmonary TB and underlying T2D. A retrospective cohort study was conducted between January 1, 2013, and December 31, 2020, to determine tuberculosis mortality and its risk factors among patients with T2D and pulmonary TB visiting three community hospitals, in central Thailand. T2D and pulmonary TB were determined according to the International Classification of Diseases, Tenth Revision codes presented in medical records. TB mortality data were reviewed and retrieved from the tuberculosis treatment cards. Patients were classified as “dead” when they died before completing treatment regardless of the causes. Multivariable cox proportional regression analysis was performed to obtain the adjusted hazard ratios (AHR) and 95% confidence interval (CI) of factors related to TB mortality. A total of 133 patients with T2D and pulmonary TB were enrolled in the present study; 74 (55.6%) participants were males. At baseline, the average age of participants was 57.29+12.51 years. During the study period, the TB mortality rate was 15.74 (95% CI 8.13-27.50) deaths per 100 person-years. The independent risk factors for TB mortality included age ≥70 years (AHR 5.45, 95% CI; 1.36-21.84), use of insulin (AHR 4.62, 95% CI; 1.11-19.21), and positive sputum test result at 1st follow-up (AHR 16.10, 95% CI; 2.10-123.40). TB mortality among patients with T2D should be emphasized. Insulin use may be a proxy indicator for poor glycemic control associated with mortality. Additionally, elderly patients should be closely observed for successful treatment as well as monitoring for any adverse events.
Nowadays, Thailand and other countries are encountering with COVID-19 outbreak. A state of emergency and curfew were declared During the pandemic. The public health system during the outbreak adapted the way of healthcare work, for example, postponing the follow-up, limiting the patient at OPD, and sending medicine to the patient’s address. On the other hand, the preventive measure of the outbreak promotes unhealthy lifestyles such as inappropriate eating behavior and diminished exercise. We aimed to determine the cumulative incidence and risk factors of uncontrolled hypertension among hypertensive patients and the association between the outcome and admission in Phatthananikhom hospital during the COVID-19 pandemic. Researchers collected demographic data, personal history, and diagnosis from the online medical record of Phatthananikhom hospital. Hypertensive patients with controlled hypertension three months before the outbreak were selected for the study. The criteria for uncontrolled hypertension are defined when most SBP measurements are≥140 and/or DBP ≥90. A retrospective cohort study was conducted until the end of the study period (3 April 2020 – 22 March 2021) to determine uncontrolled hypertension incidence and risk factors during the COVID-19 pandemic. The cumulative incidence of uncontrolled hypertension among hypertensive patients is 34.3%. The final model was adjusted for age, sex, DM comorbidity, smoking status, and BMI. After adjusting, the factors associated with uncontrolled hypertension during covid-19 were a BMI of more than 35 kg/m2, current smoker, and DM comorbidity. We found that uncontrolled hypertension was associated with admission during the study period. In conclusion, during the Covid-19 pandemic, All the public health measurements and hospital restrictions might affect the natural course of hypertension—especially in hypertensive patients with DM comorbidity, current smoker, and obesity. Therefore, planning of management of blood pressure control has to be established to reduce the incidence of uncontrolled hypertension and prevent further complications of hypertension.
Incidence and risk factors of uncontrolled hypertension in hypertensive patients during COVID-19 pandemic in Phatthananikhom hospital
Prevalence and risk factors of microvascular and macrovascular complication in type 2 diabetes at Thaluang hospital, Thaluang, Lopburi, Thailand
Nowadays, type 2 diabetes patient in Thailand is much more prevalent than before. According to the 2017 statistics, there are 4.4 million diabetes patients in the 54 million population. Type 2 diabetes can lead to multiple complications in the patient, including microvascular and macrovascular complications. These complications can be the causes of worse quality of life, disability, hospitality, and death. In 2020, statistics from Lopburi healthcare data, 9.1 percent of Thaluang hospital’s patients had Type 2 diabetes, the most significant number among the other diseases in Thaluang hospital. We conducted this research to study the prevalence and associated factors of type 2 diabetes vascular complications, which can be used to promote the prevention of this complication in the future. We conducted this cross-sectional analytic research using the secondary data from Thaluang hospital’s medical record to assess the prevalence and the associated factors of vascular complications in type 2 diabetes patients in Thaluang hospital. From Multivariate analysis, we found the statistically associated factors of each vascular complication. Ischemic heart disease is associated with age (Odds ratio 1.09 (1.03-1.16) p-value 0.01), and HbA1C more than 8.5 g/dl (Odds ratio 6.38 (1.45-28.13) p-value 0.01). Stroke is age (Odds ratio 1.02 (1.01-1.04) p-value 0.03), hypertension (Odds ratio 3.26 (1.02-5.16) p-value 0.04), and Calcium channel blocker use (Odds ratio 1.76 (1.12-2.79) p-value 0.02). Peripheral artery disease is associated with age (Odds ratio 1.03 (1.01-1.05) p-value <0.01), female gender (Odds ratio 1.52(1.06-2.48) p-value 0.03), duration since diagnosis more than five years (Odds ratio 2.11(1.40-3.20) p-value <0.01), Insulin use (Odds ratio 2.17(1.36-3.46) p-value <0.01). Diabetic retinopathy is associated with duration since diagnosed more than five years (Odds ratio 2.49(1.58-3.93) p-value 0.04), and HbA1C more than 7.5 g/dl (Odds ratio 3.634(1.47-8.99) p-value 0.01). Peripheral neuropathy is associated with age (Odds ratio 1.06 (1.01-1.11) p-value 0.01), duration since diagnosis (Odds ratio 1.16(1.01-1.33) p-value 0.03), and HbA1C (Odds ratio 1.40(1.12-1.75) p-value <0.01). Chronic kidney disease is associated with age (Odds ratio 1.02 (1.01-1.04) p-value 0.02), ACEI/ARB use (Odds ratio 2.53(1.65-3.88) p-value <0.01), and HbA1C greater than9.0 (Odds ratio 1.69 (1.08-2.67) p-value 0.02).
##วัตถุประสงค์การวิจัย เพื่อประเมินผลการดูแลรักษาผู้ป่วย กำลังพลที่ป่วยด้วยโรคเบาหวานชนิดที่ 2 และกำลังพลที่ป่วยด้วยโรคความดันโลหิตสูงจากเวชระเบียนผู้ป่วยตามเกณฑ์มาตรฐานของโรงพยาบาลสังกัดกองทัพบก และหาความชุกของผลลัพธ์ทางคลินิกของผู้ป่วยโรคเบาหวานชนิดที่ 2 และโรคความดันโลหิตสูงที่เข้ารับการรักษาในโรงพยาบาลสังกัดกองทัพบก งานวิจัยนี้เป็นการศึกษาแบบ Cross-Sectional Study (ตั้งแต่ตุลาคม 2558 ถึง กันยายน 2559) คัดเลือกโดยการสุ่มตัวอย่างแบบ Purposive Sampling จากข้อมูลโรงพยาบาลในสังกัดกองทัพบกทั้ง 4 ภาคทั่วประเทศ โดยประชากรที่ทำการศึกษา ได้แก่ ผู้ป่วยโรคเบาหวานชนิดที่ 2 และผู้ป่วยโรคความดันโลหิตสูงที่มารับบริการที่โรงพยาบาลนำร่องสังกัดกองทัพบกทั้ง 4 โรงพยาบาล ทั่วประเทศ รวมถึงผู้ที่มารับบริการที่หน่วยบริการในโรงพยาบาลนำร่องสังกัดกองทัพบก มากกว่า 12 เดือนขึ้นไปอีกด้วย #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/dmht-study)
Clinical outcomes of patients diagnosed with Type 2 DM and Hypertension visiting the Royal Thai Army Hospitals
หน่วยวิจัยเวชศาสตร์ทหาร วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า
Model development to improve primary care services using an innovative network of homecare providers (WinCare) to promote blood pressure control among elderly patients with noncommunicable diseases in Thailand: a prospective cohort study
Asst.Prof. Capt. Boonsub Sakboonyarat, MD
#PROJECT SUMMARY Thailand has been rapidly approaching an aged society in conjunction with an increase in non-communicable diseases (NCD) especially hypertension and type 2 diabetes. Demographics and epidemiological transitions create some challenge to the health system in Thailand in the case of a long term care policies, in particular modality to support home care. Therefore, the model development to facilitate primary care home services for elderly patients with NCD using an innovative network of homecare providers (WinCare) was established. The study aims to evaluate the effectiveness of WinCare to improve blood pressure (BP) control as well as health-related quality of life (HRQoL) among elderly patients with NCD. A prospective cohort study will be conducted between July 2019 and January 2020 in a suburban area, Chiang Mai Province, Thailand. The intervention included WinCare and WinCare application. WinCare will provide check-in visits to measure their blood pressure and body weight (once weekly), play the roles of other home care for the patients, and record measurements and activities in WinCare app for 6 months. The primary outcomes of the study are differences in systolic BP, diastolic BP, and controlled BP (systolic BP<140 mmHg and diastolic BP<90 mmHg) at 6-month follow-up between the intervention and control groups, adjusting for potential confounders. In addition, the model development of primary care services for elderly patients using an innovative network of homecare providers (WinCare) will be established to provide additional human resources to provide nonmedical care which filled the gaps among health care providers, primary care units and patients residing in a community. This innovation model will contribute rewarding jobs with additional remuneration for human resources in communities. This study was reviewed and approved by the Royal Thai Army Medical Department Institutional Review Board. Written informed consent was obtained from the participants following the WMA Declaration of Helsinki Ethics principles for medical research involving human subjects (approval number: S073q/61_Exp). #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/wincare-pub)
The study from the National Statistical Office showed that there were more than 10 million active smokers in Thailand from 2000 to 2015, and the cost to society from tobacco use continued to mount, including direct medical costs and indirect costs from losing productivity due to early morbidity and mortality. Many people widely know about smoking's adverse effects. These effects are cardiovascular diseases such as Myocardial infarction and stroke, respiratory diseases such as chronic obstructive pulmonary disease, gastrointestinal diseases, cancer, infertility, congenital anomalies, and socioeconomic problems. If someone can quit or reduce smoking, they can prevent all these health and economic problems. Past studies showed that many smokers try to quit smoking but do not succeed due to many factors. So, smoking reduction may be a more achievable goal for them. Once smoking reduction is encouraged, it can lead to further efforts to achieve cessation. So, the objective of this study is to find the associated factors of smoking reduction that will be used to develop further interventions to encourage people to reduce smoking and may lead to complete smoking cessation in the future. We aimed to investigate the prevalence and associated factors of smoking reduction among patients of the smoking cessation clinic, Thawung hospital, Lopburi, Thailand. A quantitative, cross-sectional study was conducted to investigate the prevalence and associated factors of smoking reduction among patients at the smoking cessation clinic at Thawung hospital. The data were collected from case record forms and the hospital database of the smoking cessation clinic of Thawung hospital, Lopburi, Thailand. There were 96 patients participated in this study. The prevalence of smoking reduction among patients at the smoking cessation clinic was 72.9% of all participants. Most of the participants were male patients. The significant factors correlated with smoking reduction were the number of visits to the smoking cessation clinic and being in the preparation stage from the stage of change model. A smoker who cannot suddenly stop smoking would benefit from the smoking reduction, which can lead to further success in smoking cessation. This study showed that the frequency of visit to the clinic affect the success of smoking reduction, so an intervention program should be developed aiming to increase the participants and follow-up rate of patient attending this clinic. Stage of change is also a basic method to evaluate the patient's mind and motivation to choose the proper interventions or treatment for each patient.
Prevalence and associated factors of successful smoking reduction among patients at smoking cessation clinic of Thawung hospital, Lopburi, Thailand (2017-2010)
Noncommunicable diseases (NCDs) such as heart disease and stroke, cancer, diabetes, and chronic lung diseases are important health problems that Thailand confronts. Accounting for more than 70% of all deaths for all ages in Thailand are due to NCDs, including diabetes.1 Presently, there have been several studies about diabetic nephropathy4. Pivotal risk factors for the progression of diabetic nephropathy include uncontrolled blood sugar level, longer duration of diabetes, high blood pressure, obesity, and dyslipidemia. Blood glucose control and strict blood pressure control, especially with medication, use of lipid-lowering agents, and lifestyle modification, reduce diabetes-related mortality and delay the progression of diabetic nephropathy. Chronic kidney disease patients require higher medical expenditures and more health resources than those without diabetes. This study is about the prevalence and risk factors of diabetic nephropathy in a community hospital in Chachoengsao province (Category F2 – 30 hospital beds). The results can be applied to management for type 2 diabetic patients to determine the risk factors and prevent further complications. A cross-sectional study investigates the prevalence and risk factors of diabetic nephropathy in type 2 diabetic patients at Bangkhla hospital, Chachoengsao province, during 2015-2020. The data were retrieved from electronic medical records of the hospital information system. IRB RTA approved this study: R148h/63_Exp.Three thousand two hundred thirteen diabetic patients participated in the study, and 807 were diagnosed with diabetic nephropathy, 25.12% of prevalence. Risk factors of diabetic nephropathy are being older than 60 years old, having a BMI > 23 kg/m2, and having systolic blood pressure ≥ 140 mmHg, while a normal HDL level is a protective factor.
Prevalence and Risk Factors of Diabetic Nephropathy in Type 2 Diabetic Patients at Bangkhla hospital, Chachoengsao province
Prevalence and associated factors of electrocardiographic left ventricular hypertrophy in a rural community, central Thailand
#PROJECT SUMMARY Left ventricular hypertrophy (LVH) is considered a cardiac condition secondary to both structural and functional adaptation of the heart leading to many life-threatening complications like myocardial ischemia, left ventricular (LV) dysfunction, heart failure and even sudden cardiac death.1–4 Several studies reported that the potential risk factors of LVH included being male5,6, high blood pressure 7,8, insulin resistance9 and obesity10. Detecting and monitoring LVH, a strong predictor of cardiovascular diseases and death11, is crucial. Regression of LVH could reduce the risk of adverse outcomes.12 Approximately one half of the Thai population resides in rural areas where the characteristics of healthcare infrastructure and providers differ from those of urban settings especially in remote rural areas. In Thailand, a related study among adults in an urban setting in 2000 reported a prevalence of LVH at approximately 13%.13 However, only limited information is available on the prevalence of and factors potentially responsible for LVH among adults in remote rural communities. The required information is essential to focus on preventing problems. Even though echocardiography is a gold standard to detect LVH, the technology is unavailable to use in those remote areas and also requires more specialists to complete the process. However, ECG criteria for LVH have been illustrated as strong independent predictors of cardiovascular morbidity and mortality in the general population3,14. Thus, this study aimed to determine the prevalence and associated factors of electrocardiographic-LVH (ECG-LVH) among adults in a remote rural community in central Thailand #ชื่อเจ้าของฐานข้อมูล และการติดต่อ *ร.อ. ผศ.บุญทรัพย์ ศักดิ์บุญญารัตน์ *ภาควิชาเวชศาสตร์ทหารและชุมชน วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า *Capt. Asst.Prof.Boonsub Sakboonyarat, MD, MPH *Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand *E-mail Boonsub1991@pcm.ac.th #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/lvh_data)
Dynamic Risk Factors associated with HIV-1 infections among the Royal Thai Army conscripts : Integrated HIV related behavioral surveillance existing sero-surveillance
##PROJECT SUMMARY The prevalence of HIV among young Thai men stabilized at 0.5% from 2005 to 2011. A cross-sectional study was conducted among the male army conscripts in 2018 at 36 military training units nationwide. All new conscripts in each selected unit were invited to participate in the study. Questionnaires were used to determine risk factors to HIV infection that had been developed from related risk factors studies among young Thai men. Among 4629 participants, 44 (1.0%) HIV positive individuals were identifed. The proportion subject reporting a history of sex with another man was 10.1%. The prevalence of HIV infection among men who have sex with men (MSM) was 4.0%. The proportion of consistent condom use with a male partner was 39.7%. The risk factors of HIV infection included having sex with another man, history of sexually transmitted infection and history of sex in exchange for gifts/money. Only 1.4% of MSM used pre-exposure prophylaxis (PrEP). HIV prevention programs including PrEP in Thailand should be emphasized among MSM in both rural and urban settings. ##ชื่อเจ้าของฐานข้อมูล และการติดต่อ หน่วยวิจัยเวชศาสตร์ทหาร วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า Research Unit for Military Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand ##Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/hiv-study)
Alcohol Consumption and Its Associated Factors among Adolescents in a Rural Community in Central Thailand: A Mixed-Methods Study
Early onset of alcohol use was associated with alcohol dependence and other health problems. Although national data include information about alcohol consumption in Thailand,(1) sufficient information about the socio-ecological context associated with alcohol consumption among adolescents in a particular community is still limited. A few studies investigating alcohol consumption among adolescents were conducted in urban and suburban areas, presenting an estimated prevalence of current alcohol consumption ranging from 10.4% to 18.6%. Nowadays, one-half of the Thai population still resides in rural areas where healthcare provider characteristics, health literacy, and socioeconomic contexts may differ from those in urban areas. Recently, a related quantitative study about the substance abuse situation in a remote rural community, Chachoengsao Province, detected that 36.8% of adolescents reported being a current alcohol drinker and indicated that alcohol drinking was associated with substance abuse in the rural community, which was considered a major health issue in the Thai rural community. Unfortunately, information regarding risk factors for alcohol consumption among adolescents in this remote rural area was not uncovered. The present study aimed to identify the prevalence and factors associated with alcohol consumption among adolescents in a remote rural area using quantitative methods. Moreover, a qualitative study will explore the socio-ecological factors affecting alcohol consumption, including family members and friends, store and accessibility, and social and environmental factors. If factors associated with alcohol consumption among adolescents are explored, appropriate strategies and practical interventions may be implemented in this population to resolve this issue in the future. The study enrolled a total of 413 adolescents. On average, young adolescents initiated alcohol consumption at age 13. The lifetime drinking prevalence among adolescents was 60.5%, while the one-year drinking prevalence was 53.0%. The prevalence of hazardous drinking among current drinkers was 42.0%. Alcohol consumption was associated with females (adjusted prevalence ratio (APR): 1.19; 95% CI: 1.01–1.41), age ≥16 years (APR: 1.28; 95% CI: 1.09–1.50), having close friends consuming alcohol (APR: 1.75; 95% CI: 1.43–2.14), night out (APR: 1.93; 95% CI: 1.53–2.45), being a current smoker (APR: 1.39; 95% CI: 1.15–1.69), and having relationship (with boyfriend/girlfriend) problems (APR: 1.18; 95% CI: 1.01–1.38). Qualitative data demonstrated that individual and environmental factors, including friends, family, social media use, and alcohol accessibility, affect alcohol use in this population. Therefore, effective strategies should be implemented across multiple levels of the socio-ecological model simultaneously to alleviate alcohol consumption and attenuate its complications. #ชื่อเจ้าของฐานข้อมูล และการติดต่อ ร.อ. ผศ.บุญทรัพย์ ศักดิ์บุญญารัตน์ ภาควิชาเวชศาสตร์ทหารและชุมชน วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า Capt. Asst.Prof.Boonsub Sakboonyarat, MD, MPH Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand E-mail Boonsub1991@pcm.ac.th #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/alcohol-rural-study)
Dengue is a viral infection transmitted by Aedes mosquitoes. It constitutes a significant public health issue in Thailand. Thus, this study aims to determine trends in the morbidity rate of dengue infection and the prevalence and associated factors of thrombocytopenia among dengue patients. Data on dengue cases were retrieved from Tha Wung Hospital electronic medical records based on ICD-10 diagnoses: A90 and A91. Between 2012 and 2020, there were 1260 dengue cases presented to Tha Wung Hospital. Descriptive analysis included characteristics of dengue patients and spatiotemporal patterns of disease. Chi-square for trend was used to determine trends in the morbidity rate of dengue infection. Logistic regression was used to identify associated factors of thrombocytopenia in dengue patients. A total of 1260 dengue patients were included in the study. Trends in the morbidity rate of dengue infection increased significantly from 2012 to 2020. There were 402 patients with thrombocytopenia (31.9%) and 858 patients without thrombocytopenia (68.1%). The risk factors of thrombocytopenia in dengue patients are age greater than or equal to 13 years old in the age group under 20 years and increasing yearly among patients aged 20 years and over. Thus, effective preventive measures and appropriate management protocols according to age should be implemented.
Trends in the morbidity rate of dengue infection among population in Tha Wung District, Lopburi Province, Thailand, 2012-2020
#PROJECT SUMMARY COPD is a principle condition leading to several serious complications, ie, cor pulmonale, recurrent pneumonia, pneumothorax and respiratory failure. Although the pathogenic mechanisms of COPD remain unclear, various risk factors such as genetic constitution, bronchial hyper-responsiveness, perinatal factors, childhood asthma, air pollution and cigarette smoking were identified to cause the disease. In addition, COPD is considered a common occupational disease in particular populations including tunnel workers, coal miners and agricultural workers. Related studies have reported the prevalence of COPD among agricultural workers including cattle, swine and poultry breeders was relatively high compared with that among nonfarming workers. Agricultural workers can be exposed to biochemical, organic and inorganic substances which may contribute to COPD, for instance, dust, biomass smoke, ammonia, silica and endotoxins. Approximately one half of the Thai population live in rural areas where the characteristics of healthcare infrastructure and providers differ from those of urban settings especially in remote rural areas. According to Thai national health policies, some noncommunicable diseases including type 2 diabetes and hypertension, but not COPD have been actively surveyed at the community level. Thus, the current situation of COPD in rural communities remains limited. Most of the Thai population in rural communities works as agriculturists. However, the information of factors potentially responsible for COPD among agriculturists remains limited, which is essential to focus on preventing the disease. Attenuating the risk factors of COPD will also help to slow disease progression and reduce associated complications. The present study aimed to determine the prevalence and risk factors of COPD among agriculturists in a remote rural community in Chachoengsao Province, central Thailand #ชื่อเจ้าของฐานข้อมูล และการติดต่อ ร.อ. ผศ.บุญทรัพย์ ศักดิ์บุญญารัตน์ ภาควิชาเวชศาสตร์ทหารและชุมชน วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า Capt. Asst.Prof.Boonsub Sakboonyarat, MD, MPH Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand E-mail Boonsub1991@pcm.ac.th #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/copd_rural)
Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand
Recently, the Hyperglycemic crisis is the most severe acute complication of diabetes and is associated with significant morbidity and mortality in diabetes patients. A cross-sectional study is used in the quantitative method. The population in this study are selected under the condition that they must be diabetes type 2 patient, age 18-year-old above, and visit the disease at Sanam Chai Khet Hospital, Sanam Chai Khet District, Chachoengsao Province, Thailand, July 1st,2015 – July 1st,2020 In This study, five years-data collected from 2,834 patients who were diagnosed with Diabetes mellitus at Sanamchaikhet hospital in 5 years 2,761 patients (97.4%) had no hyperglycemic crisis, 59 patients (2.1%) developed HHS, and 14 patients (2.1%) developed DKA. No mixed DKA/HHS has been diagnosed. Diabetic ketoacidosis patients show that they were referred to other hospitals 9(64.3%), admitted to hospital 3(21.4%), and not admitted to hospital 2(14.3%). The patients admitted to the hospital have time to admit about 5.33 days which is precipitated by infection 11(78.6%), the first diagnosis of diabetes mellitus 1(7.1%), Unknown cause 2(7.1%), and diabetic ketoacidosis patient who has complication to need orotracheal tube was 1(7.1%). In a hyperosmolar hyperglycemic state, patients show that they were not admitted to hospital 46(78%), referred to other hospitals 1(1.7%), and admitted to hospital 12(20.3%). The patients admitted to the hospital have time to admit about 7.17 days which is precipitated by infection 5(8.5%), Inadequate insulin 4(6.8%), High sugar intake 3(5.1%), psychological disorder 1(1.7%), and Unknown cause 46(78%). The study shows factors associated with diabetic ketoacidosis in diabetes patients; For Type of Diabetes Mellitus, patients who were unspecified diabetes mellitus are 49.54 times more likely to develop DKA than patients who are type 2 diabetes mellitus (Adjusted OR 49.54, 95%CI = 6.16 – 398.50, p-value <0.001) Smoking, patients who were current smokers are 4.76 times more likely to develop DKA than patients who quit or never smoking (Adjusted OR 4.76, 95%CI = 1.03 – 21.95, p-value 0.04) Alcohol drinking, patients who were current alcohol drinking are 5.85 times more likely to develop DKA than patients who quit (Adjusted OR 5.85, 95%CI = 1.27 – 27.00, p-value 0.02) and Comorbidity, patients who have 1-2 comorbidities drinking are 0.11 times less likely to develop DKA than patients who have no comorbidity (Adjusted OR 0.11, 95%CI = 0.13 – 0.89, p-value 0.04) The study shows factors associated with the hyperosmolar hyperglycemic state in diabetes patients, Patients with chronic kidney disease are 2.42 times more likely to develop HHS than patients who had no chronic kidney disease (Adjusted OR 2.42, 95%CI = 1.10 – 5.92, p-value 0.027)
Prevalence and risk factors of hyperglycemic crisis in diabetic patients at Sanam Chai Khet Hospital,Sanam Chai Khet District, Chachoengsao Province, Thailand
Prevalence and associated factors of obesity among adults in a rural community in Thailand: serial cross-sectional surveys 2018
#PROJECT SUMMARY Obesity is one principle risk factor leading to noncommunicable diseases including diabetes and hypertension. Additionally, obesity was confirmed to precipitate cardiovascular diseases, especially atherosclerotic cardiovascular diseases (ASCVD). One recent report showed a low association between obesity and myocardial infarction, a moderate association with stroke and a high association with high blood pressure. Thus, when the process of obesity is interrupted, these complications will be terminated. In addition, some dietary behaviors associated with obesity include salt intake and coffee consumption. Related studies have reported an association between urine sodium levels as a proxy for salt intake, increasing BMI and metabolic syndrome. However, only limited information is available on factors potentially responsible for obesity among adults in a remote rural community, and the required information is essential to focus on preventing problems. Decreasing BMI will help to reduce cardiovascular risks and any complications. The present study was conducted directly in a rural population and reported the prevalence of obesity among adults residing in a Thai rural community 2018. In addition, we investigated the associations of obesity and behavioral factors including urine sodium level. #ชื่อเจ้าของฐานข้อมูล และการติดต่อ ร.อ. ผศ.บุญทรัพย์ ศักดิ์บุญญารัตน์ ภาควิชาเวชศาสตร์ทหารและชุมชน วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า Capt. Asst.Prof.Boonsub Sakboonyarat, MD, MPH Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand E-mail Boonsub1991@pcm.ac.th #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request. #การขอเข้าถึง Protocol และ ข้อมูล #กดที่ ปุ่ม ร้องขอข้อมูล ที่ หน้า [Protocol และ ข้อมูล](http://bigdata.pcm.ac.th/organization/obesity_data)
#PROJECT SUMMARY Nowadays, hypertension is a common and primary risk factor for cardiovascular diseases. It is one of the major global public health issues with the prevalence of 30.8%. The high prevalence of hypertension is reported in Thailand. According to the Thai National Health Examination Survey V (NHES V) conducted in 2015, one in four Thais had hypertension. Hypertension may worsen disease progression and lead to further complications, such as the risk of heart failure, cerebral ischemia, cerebral hemorrhage and chronic kidney diseases. Regarding recent available data concerning controlled blood pressure worldwide, the prevalence of controlled blood pressure was 68.9% and 37.5%, in the US and PR China, respectively. Nevertheless, in Thailand, most information related to hypertension is collected in hospitals or hospital-based organizations rather than at the community level. A half of areas in Thailand are still rural (47%) where the healthcare infrastructure and healthcare provider characteristics differ from those of urban vicinities especially in remote rural areas. Furthermore, the last research related to uncontrolled hypertension was conducted in a rural community in 2012. The report showed that two-thirds patients with hypertension could not achieve the target blood pressure control. Furthermore, the other study in Thailand showed the absolute numbers of individuals with cardiovascular risk factors were greater in rural rather than urban regions. However, only the limited information is available on factors potentially responsible for uncontrolled blood pressure among patients with hypertension in remote rural communities. The required information is essential to focus on preventing the problems. Improving blood pressure control will help to reduce disability from any complications including cardiovascular accident and chronic kidney disease, reduce medical costs and improve quality of life. The present study was conducted directly in a rural population and in primary health care (PHC) units. The objectives of the study were to determine uncontrolled blood pressure and identify risk factors associated with uncontrolled blood pressure among patients with hypertension in the remote rural communities of the central area in Thailand. #ชื่อเจ้าของฐานข้อมูล และการติดต่อ ร.อ. ผศ.บุญทรัพย์ ศักดิ์บุญญารัตน์ ภาควิชาเวชศาสตร์ทหารและชุมชน วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า Capt. Asst.Prof.Boonsub Sakboonyarat, MD, MPH Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand E-mail Boonsub1991@pcm.ac.th #Availability of data and materials The datasets generated or analyzed during the current study are not publicly available because the data sets contain confidential information. Thus, due to ethics restrictions concerning the data sets, they are available from the corresponding author upon reasonable request.
การประมวลผลข้อมูลและรายงานผล การสำรวจการให้บริการทางด้านการดูแลสุขภาพหญิงมีครรภ์ ในประชากรหญิงหลังคลอดที่ใช้สิทธิสิทธิประกันสังคม
Data Dictinoary โครงการ การประมวลผลข้อมูลและรายงานผล การสำรวจการให้บริการทางด้านการดูแลสุขภาพหญิงมีครรภ์ ในประชากรหญิงหลังคลอดที่ใช้สิทธิสิทธิประกันสังคม
Data dictionary โครงการ อุบัติการณ์และปัจจัยเสี่ยงของการประสบอุบัติเหตุจราจรในกำลังพลทหาร สังกัดกองทัพบก ปี 2553
Publication Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand
Alcohol consumption and its associated factors among adolescents in a rural community in central Thailand: a mixed-methods study
#PROJECT SUMMARY Left ventricular hypertrophy (LVH) is considered a cardiac condition secondary to both structural and functional adaptation of the heart leading to many life-threatening complications like myocardial ischemia, left ventricular (LV) dysfunction, heart failure and even sudden cardiac death.1–4 Several studies reported that the potential risk factors of LVH included being male5,6, high blood pressure 7,8, insulin resistance9 and obesity10. Detecting and monitoring LVH, a strong predictor of cardiovascular diseases and death11, is crucial. Regression of LVH could reduce the risk of adverse outcomes.12 Approximately one half of the Thai population resides in rural areas where the characteristics of healthcare infrastructure and providers differ from those of urban settings especially in remote rural areas. In Thailand, a related study among adults in an urban setting in 2000 reported a prevalence of LVH at approximately 13%.13 However, only limited information is available on the prevalence of and factors potentially responsible for LVH among adults in remote rural communities. The required information is essential to focus on preventing problems. Even though echocardiography is a gold standard to detect LVH, the technology is unavailable to use in those remote areas and also requires more specialists to complete the process. However, ECG criteria for LVH have been illustrated as strong independent predictors of cardiovascular morbidity and mortality in the general population3,14. Thus, this study aimed to determine the prevalence and associated factors of electrocardiographic-LVH (ECG-LVH) among adults in a remote rural community in central Thailand.
Pubication of Prevalence and associated factors of electrocardiographic left ventricular hypertrophy in a rural community, central Thailand
วิทยาลัยแพทยศาสตร์พระมงกุฎเกล้า