Royal Highness Princess Maha Chakri Research Articles

Predicting factor for mortality rate in surgical intensive care units

Background: The body of evidence on surgical intensive care unit (SICU) mortality and its predictors is still being determined. This study analyzed the significant predicting factors for mortality in SICU patients. Materials and Methods: The medical records of patients in SICUs at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, from June 2020 to July 2021, were retrospectively reviewed. Patients were excluded if transferred from other hospitals and not undergoing orthopedics, otolaryngology, obstetrics, and gynecology surgeries. Results: A total of 276 patients admitted to SICUs were included in this analysis, and 60.5% were men. The mean age was 60.07 ± 17.19 years. The average length of SICU stay was 8.1 ± 10.79 days, and the mortality rate was 23.6%. By univariate analysis, significant predictive factors for mortality rate in SICU patients were acute physiology and chronic health evaluation II (APACHE II) (p < 0.001), Glasgow coma scale (GCS) ≤ 8 (p < 0.001), sequential organ failure assessment (SOFA) score (p < 0.001), serum albumin < 2.5 (p = 0.013), and sepsis or septic shock (p < 0.001). From receiver operating characteristics (ROC) curve analysis to predict mortality, the best cut-off point of APACHE II and SOFA scores were 15.5 and 5.5, respectively. The multivariate logistic regression analysis significantly identified APACHE II > 15, GCS ≤ 8 and SOFA score > 5 as significant predictive factors associated with the mortality rate in SICU patients. Conclusions: APACHE II > 15, GCS ≤ 8, and SOFA score > 5 are predictive mortality factors in SICU patients. Patients with these factors should be given priority for admission to the SICU when there is a discrepancy between the demand and the supply for SICU beds.

Correlation between Carbapenem Consumption and Carbapenems Susceptibility Profiles of Acinetobacter baumannii and Pseudomonas aeruginosa in an Academic Medical Center in Thailand.

The emergent issue of carbapenem-resistant Acinetobacter baumannii (A. baumannii) and Pseudomonas aeruginosa (P. aeruginosa) is a major problem in Thailand. The wide use of carbapenems can increase selective pressure of bacterial resistance. The objective of this study was to determine the relationship between carbapenem consumption and the susceptibility rates of A. baumannii and P. aeruginosa, including multi-drug resistance (MDR) strains. This was a retrospective study. Carbapenem consumption and susceptibility profiles were collected from 2007 to 2013 at the Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Thailand. We found that the susceptibility rate of A. baumannii to imipenem and meropenem from the sputum and the bronchoalveolar lavage (BAL) specimens was significantly decreased during the study period, but no significant change was found in the P. aeruginosa data. The relationship between carbapenem consumption and the susceptibility rate of A. baumannii had a clear association with the use of ertapenem. We found a statistically significant negative correlation between ertapenem consumption and the susceptibility rate of A. baumannii to imipenem (r = −0.91; p = 0.004) and meropenem (r = −0.97; p = 0.000) in the data from the non-ICU wards. In addition, imipenem use had a moderate negative correlation with the MDR P. aeruginosa data but no statistical significance (r = −0.714; p > 0.05). In conclusion, our study suggested there is an association between carbapenem use and the susceptibility of A. baumannii and P. aeruginosa. Notwithstanding this, information on ecological factors should be considered for further study. These findings showed the need to optimize the carbapenem prescription policy. Avoiding carbapenem overuse and rethinking the appropriate initial therapy might decrease the rate of resistant organisms.

Influence of Plant Origins and Seasonal Variations on Nutritive Values, Phenolics and Antioxidant Activities of Adenia viridiflora Craib., an Endangered Species from Thailand.

Adenia viridiflora Craib. is an indigenous plant found in Thailand, Cambodia and Vietnam that has become threatened owing to lack of knowledge about its agricultural management. This plant is now rare in the wild and was registered in the Plant Genetic Conservation Project under the initiation of Her Royal Highness Princess Maha Chakri Sirindhorn (RSPG) to promote sustainable conservation and optimally beneficial utilization. A. viridiflora has a long history of utilization as a nutrient-rich source with medicinal properties but scientific evidence of the veracity of these claims is limited. Here, the nutritional compositions, phenolic contents and antioxidant activities of different plant parts (young shoots and old leaves) of A. viridiflora were investigated using plants collected from four areas of Thailand as Kamphaeng Phet (KP), Muang Nakhon Ratchasima (MN), Pakchong Nakhon Ratchasima (PN) and Uthai Thani (UT) at different harvesting periods (March-April, May–June and July–August). Results indicated that young shoots provided higher energy, protein, fat, dietary fiber, phosphorus, sodium, and zinc than old leaves. By contrast, nutrients such as total sugar, vitamin C, carotenoids, potassium, calcium, magnesium, and iron contents were higher in old leaves that also exhibited higher phenolic contents and most antioxidant activities than young shoots. Generally, most nutrients, phenolic contents, and antioxidant activities exhibited no clear trend among different plant origins. The harvesting period of July–August provided a suitable climate for biosynthesis of most nutrients, while high phenolics were mainly found in samples harvested in March–April. No clear trend was observed in the prevalence of antioxidant activities that varied according to assay techniques.

The influence of stone size on spontaneous passage of common bile duct stones in patients with acute cholangitis: A retrospective cohort study

BackgroundThe common bile duct (CBD) stones passage in patients with cholangitis was unclear.This study aimed to evaluate the effect on CBD stone sizes and predicting factors on spontaneous passage in patients with cholangitis. MethodThe medical records of cholangitis at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University from January 2014 to December 2019 were retrospectively reviewed. Patients with acute cholangitis from CBD stones underwent ERCP in the same admission were enrolled. ResultOf the 96 patients, The rate of spontaneous passage of CBD stones was 19.8%. By univariate analysis, factors significantly associated with a predictor of spontaneous CBD stone passage in patient with cholangitis were single CBD stone (p = 0.001), CBD stone diameter < 5 mm (p < 0.001), and clinical symptom improved before ERCP procedure (p = 0.004). Multivariate logistic regression analyses also revealed that these three factors were significantly associated with spontaneous passage. From ROC curve analysis, stone size of less than 4.85 mm was more likely to pass spontaneously with acceptable sensitivity (81.8%) and specificity (78.9%). ConclusionsCBD stone diameter < 5 mm, single CBD stone and improved clinical symptom before ERCP procedure are key predictors of spontaneous CBD stone passage in cholangitis.

Effectiveness of transcatheter arterial embolization for patients with shock from abdominopelvic trauma: A retrospective cohort study

BackgroundTranscatheter arterial embolization (TAE) is a useful endovascular technique for controlling hemorrhage in blunt abdominopelvic trauma without shock. However, several studies have reported that TAE is safe and effective for controlling hemorrhage in hypovolemic shock. ObjectiveTo evaluate the effectiveness of TAE for patients with shock from abdominopelvic trauma. MethodThe medical records of patients with abdominopelvic trauma at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University from January 2014 to January 2019 were retrospectively reviewed. We enrolled patients with shock caused by injury to solid organs or pelvic fractures who underwent TAE. ResultOf the 320 patients, 14 patients with shock underwent TAE. A total of 78.6% were male. The mean age was 37.5 years. The average injury severity score was 31.3. The most common mechanism of injury was traffic accidents (85.7%). Embolization was performed for 8 liver injuries, 5 pelvic fractures and 1 splenic injury. The treatment time for TAE was approximately 47.9 ± 33.2 min. The mean length of hospital stay was 21.3 ± 15.9 days. Two patients died (14.3%). There were no embolization-related complications. A significant improvement in systolic blood pressure (p = 0.028) and a decrease in heart rate (p = 0.001), lactate concentration (p = 0.011), and crystalloid fluid (p = 0.001) and blood transfusion requirements (p = 0.002) were observed after TAE. ConclusionsTAE is a safe and effective method for treating shock patients with a rapid or transient response to resuscitation. For patients who are nonresponsive to resuscitation, TAE is an additional useful option for arterial hemorrhage control in abdominopelvic trauma.

Development of Dried Chili Paste with Added Indigenous Herbs from Conserved Area of Plant Genetic Conservation at Kanchanaburi Province

The objectives of this research were to serve Plant Genetic Conservation Project under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn (RSPG) and to promote the use of indigenous plants growing in Kanchanaburi province to be used in the production of healthy food. The main research activity of this study was to develop dried chili paste made with grilled fish by adding local herbs which are Wan-Prao-Hom (Kaempferia roscoeana Wall.), Kra-Chai-Pran (Zingiber citriodorum J. Mood &amp; T. Theleide), Ka-Pa (Alpinia malaccensis (Burm.f.) Roscoe.) and Plai (Zingiber cassumunar Roxb.). These plants were all identified as indigenous plants. The sensory evaluations were conducted with a 5-point hedonic scale and within the recommended guidelines. The total phenolic compounds were determined and the antioxidant activities of the product were also analyzed via DPPH and ORAC assays. The sensory evaluation score showed that dried chili paste containing 3.7 % chili obtained higher overall liking score than product containing 5.4 % chili. The water activity of product was 0.34 which was in line with the standard protocol of the Thai community. For nutritional values, it presented that one serving size (12 g) of product provided 23 kcal of energy, 4.95 g of protein, 0.48 g of fat, 1.35 g of fiber and 403 mg of sodium. Moreover, the dried chili paste with added indigenous herbs from RSPG at Kanchanaburi had higher total phenolic compounds and antioxidant activities than the herbals chili powder with grinded spices product. According to consumer acceptability test, the acceptability level was 92 %, while 88 % said that they would like to buy the product. Therefore, this research can serve as a prototype to develop other local foods having suitable tastes and health-enhancing benefits. Finally, the research may help to create job opportunities and generate the income for people living in the community.

Prevalence of Colonic and Liver disease in Patients with group D Streptococcus Infection in Tertiary Hospital in Thailand

Background: Group D Streptococcus (GDS) infection was most often associated with infective endocarditis and bacteremia. GDS formerly named as Streptococcus bovis. In addition to an association of GDS with colonic disease, evidence of a correlation with liver disease has been presented. This study aimed to evaluate the prevalence of colonic and liver disease in patients with GDS and to identify factors that increase risk of colonic and liver diseases in patients with GDS infection. Methods: A prospective study of all adult patients with GDS infection at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center between March 2016 and December 2017 and retrospective chart review between January 2012 and February 2016 were performed. Results: Sixty-two episodes of GDS infection in 45 patients were included in the study. Thirty-two patients (51.6%) were male and mean age was 64 ± 10.7 years. Two patients (3.2%) was diagnosed colorectal cancer and 49 patients (79%) had liver cirrhosis before GDS infection. Most of patients had bacteremia (93.5%). Subspecies were identified in 48.4% of patients, 25 patients (40.3%) were S. gallolyticus and 5 patients (8.1%) were S. pasteurianus. Forty-seven percent of patients had colonic evaluation and 19 patients (30.7%) had colonic disease. Prevalence of colonic disease and liver disease in GDS infection was 33.8% and 79%, respectively. Six patients with GDS infection had both colonic and liver disease. Overall median to mortality was 1.28 years (95%CI 0.68-1.86). Mortality rate was 48 person/100 person-year. Conclusion: Prevalence of colonic disease and liver disease was 33.8% and 79%, respectively. Patients with GDS infection should be evaluated for colonic and liver disease. Colonic and liver disease may simultaneous occurs in the patients with GDS infection.

Conservation of genetic resources of durian in Nonthaburi province affected by flooding

Nonthaburi, the oldest durian-planting area in Thailand, was damaged by flooding in 2011. Approximately 464 ha were destroyed. The Ministry of Agricultural and Cooperative established a project to support a project initiated by Her Royal Highness Princess Maha Chakri Sirindhorn to help farmers, and assigned the Department of Agriculture (DOA) to execute the project. Two activities were conducted during 2011-2014: 1) to conserve and release old cultivars of durian to farmers and identify simple characteristics of durian cultivars, and 2) to demonstrate good cultural practices using the integration of DOA technology and farmers' knowledge. The Chanthaburi Horticultural Research Center (CHRC) and the Horticultural Research Institute (HRI) were able to conserve 15 cultivars from flooded areas and propagate them at CHRC. CHRC has propagated 25,000 plants from 73 cultivars that originated from Nonthaburi province and planted them at the Plant Genetic Conservation Project under the Royal Initiation of Her Royal Highness Princess Maha Chakri Sirindhorn (RSPG) at CHRC. These plants were released to Nonthaburi durian farmers between September 2012 and April 2013 in order for them to re-establish their durian orchards. A total of 160 ha of durian were grown. To identify cultivars, three classes of fruit characteristics were used: 1) external criteria including shape, size, spine shape, ridge between locules, apex and peduncle length, 2) internal criteria including flesh colour, firmness, odour and taste, and 3) maturity criteria including early, medium and late harvesting. New technologies for growing durian were applied on four farms in Nonthaburi province, three of which farmers were from Amphoe Mueang Nonthaburi and one was from Amphoe Pak Kret. Chemical fertilizers recommended by soil analysis, phosphate-solubilizing microbes as biofertilizer, plant-protection technologies and knowledge of cultural practices of farmers were used. During the early stages of durian growth, intercrops such as vegetables and banana were grown. Two years after transplanting, the durian trees were taller than 2 m. Farmers had income from intercrops of 133-166 USD month-1. They will get income from durian plants in 3-4 years.

Success in Organ Donation Program in Thailand

Introduction The Thai Red Cross Organ Donation Centre has been involved effectively and consistently in several parts of organ donation process for more than 23 years. Although there are many stakeholders in organ donation process, we described success factors for increase total numbers of deceased donors. Material and methods A retrospective study of data from The Thai Red Cross Organ Donation Center from 1st January 2006 - 31st December 2016. We collected the data of deceased donors in Thailand over the last decade, and also various related activities and programs involving in organ donation. Results There was an increased in deceased donors from 1.03 to 3.33 per million population. The total number of donors was 1,433, number of donors increased 244 %, annual rate increased 14 % on average. The donors were 1,153 males (80.5%) and 280 females (19.5%). Over 9,398 organs and tissue had been transplanted including 2,477 kidneys; 601 livers; and 112 hearts. During the same period, there were 245 training activities. The majority of activities were visiting provincial hospitals (61.6%). The rest of them were transplant coordination training courses (14.7%), Transplant Procurement Management International training courses (1.2%), Walk Rally for nurse and medical students (15.9%), courses for retrieval team training with Soft Cadaver (0.8%) and other courses (5.7%). There were other activities to provide knowledge to the public in order to promote organ donation such as music video, songs, video clip in YouTube, organ donation roadshows, organ donation project celebrating the 84 th birthday anniversary of Her Majestry Queen Sirikit, the 60th anniversary of His Majesty the King's accession to the throne and 60th birthday anniversary of Her Royal Highness Princess Maha Chakri Sirindhorn. Moreover, the Ministry of Public Health (MOPH) strategies and policy during 2013–2016 has played the important roles. MOPH has set the organ donation process as Key Performance Indicators for the government hospitals. Conclusion Although all factors have favored the increase in organ donation, a great impact was in the last 4 year since MOPH has launched strategies and policy. The Thai Red Cross Organ Donation Centre helped donor and transplant hospitals to set their own local network of organ donation, not only by materials support but also useful comprehensive guidance. However, continuing public awareness campaign for a better understanding is still necessary.

DEVELOPMENT OF LEARNING MANAGEMENT PROCESSES BASED ON THE CONTEMPLATIVE EDUCATION AND THE OPTIMUM EXPERIENCE APPROACHES FOR LEADING OF OPTIMUM LEARNING QUALITY TOWARD TEACHER-EARLY CHILDHOOD INTERACTIONAL RELATIONSHIPS

To develop learning management process based on the Contemplative Education Approach (CEA) and the Optimum Experience Approach (OEA) to enhance the ability relationships between teachers and students were built up, students’ responses of their effects to their learning management process based on the CEA and OEA towards teacher and Early childhoods were respected, such as, being lovely, affectively children, and creating conduction to their classroom learning environments. To administer which as 165 early childhood students in 11 classes and 11 teachers from the Early Childhood School at Bang Sai Royal Folk Arts and Crafts Center under the Royal Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn were participated with the qualitative data, collectively. Research procedures were designed in 2 steps; first, teachers plans to manage the instructional design for including early childhoods who ought to practice their experiences and self-learning processes on self-awareness with practicing mindfulness through their self-observing activities, to improve the meditational activities and real life with themselves were observed by teachers, second, early childhoods respective learning of their opportunity on modern experience, self-literacy, self-mindfulness observation, observing a case study on their activities, and self-practicing daily life. Most of teachers were able to invent and change the increasing relationships between teachers and early childhoods’ abilities evidence from 1 to 2 scales. Relationships between teachers and students were invented the instructional processes with the role models’ teaching management to support and create children’ learning activities, children’ learning outcomes of their understanding, self-awareness, learning abilities, and were responded by teachers’ interaction behaviours with the CEA and OEA instructional methods to their classroom environments. Based on the findings, suggestions for enhancing teachers’ and children’ abilities of their associations between the CEA and OEA classroom environments are needs. The developing learning management processes are explored, respected, accepted, and loved ties for children, relatively. Article visualizations:

Educational Cooperation between Thailand and Cambodia: Outcomes on Human Development, International Understanding and Future Prospect

Thailand and Cambodia set up educational cooperation since 1996, before signed a Memorandum of Understanding on Cooperation in the Promotion of Education in 2003. This research aimed to investigate outcomes of educational cooperation projects on Cambodia human development and international understanding, process of participatory learning and action on educational cooperation among Cambodian coordinators and beneficiaries, driving force and future prospect on educational cooperation, and propose policy recommendation for educational cooperation in the middle future (2020). This research performed 3 phases: documentary research, survey research, and futures research. The samples were 2 groups of participants: 1) 10 Thai and 7 Cambodian coordinators; and 2) 311 Cambodian beneficiaries. The research results revealed Thailand and Cambodia had 4 main educational cooperation projects which consisted of 7 sub-projects. About 14,923 Cambodian beneficiaries were developed by educational cooperation projects. Most of them participated in the project initiated by Her Royal Highness Princess Maha Chakri Sirindhorn. After participating with the projects, international understanding among Cambodian coordinators was increased by 2.47 to 3.47 (40 percent); while among Cambodian beneficiaries was increased by 2.81 to 3.59 (28 percent). Analyzing the driving forces affected by the interaction between human development and international understanding indicated educational cooperation between Thailand and Cambodia in the middle future should be focused on higher education and vocational education scholarship.

The Study of Soil Physical and Chemical Properties in Plant Genetic Protection Area of RSPG, Nampung Dam EGAT, Thailand

This work aims to study soil physical and chemical properties in two forest types including dry dipterocarp forest (DDF) and mixed deciduous forest (MDF) located in Plant Genetic Protection Area under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn, Nampung dam EGAT, Sakon Nakhon province, Thailand. The samples were collected 3 times in December 2011, February and May 2012. The results showed that the average values of soil properties in MDF including, soil moisture, electical conductivity, organic matter, total nitrogen, avialable phosphorus and exchangeable potassium were higher than those in DDF. Only soil pH in MDF was less than that in DDF. It can be concluded that MDF have more fertility status of soil than DDF.

A Brief History of Development of the Cyclotron and PET Center at Wattanosoth Cancer Hospital

Located on&nbsp;the basement floor of the Wattanosoth Building, you will find many&nbsp;highly&nbsp;specialized&nbsp;technical medical equipment.&nbsp;For this&nbsp;is&nbsp;where&nbsp;the&nbsp;Department&nbsp;of Oncology Imaging and Nuclear Medicine, and the Department of RadiatioTherapy are located. Both of these departments are part of Wattanosoth Cancer&nbsp;Hospital.&nbsp;Her&nbsp;Royal Highness Princess Maha Chakri Sirindhorn bestowed&nbsp;the&nbsp;name&nbsp;of&nbsp;“Wattanosoth”&nbsp;to the hospital in 2006. The meaning of Wattanosoth is&nbsp;“hospital for advanced medicine”.

Candida konsanensis sp. nov., a new yeast species isolated from Jasminum adenophyllum in Thailand with potentially carboxymethyl cellulase-producing capability

A new yeast species (KKU-FW10) belonging to the Candida genus was isolated from Jasminum adenophyllum in the Plant Genetic Conservation Project under The Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn area, Chulabhorn Dam, Konsan district within Chaiyaphum province in Thailand. The strain was identified via analysis of nucleotide sequences from the D1/D2 domain of 26S ribosomal DNA and based on its morphological, physiological and biochemical characteristics. The sequence obtained from yeast isolate KKU-FW10 was 97 percent identical to that of Candida chanthaburiensis (GenBank accession number AB500861.1), with 506/517 (nucleotides identity/total nucleotides) matching nucleotides, nine substitutions and two gaps being detected. This species belonged to the Candida clade. Regarding morphological characteristics, isolate KKU-FW10 presents cream-colored butyrous colonies, vegetative reproduction through budding and, round cells without filaments or ascospores. The major ubiquinone detected was Q-9. The above results suggest that isolate KKU-FW10 is a new member of the genus Candida, and the name Candida konsanensis is proposed for this yeast. The type strain of the new species is KKU-FW10(T) (= BCC 52588(T), = NBRC 109082(T), = CBS 12666(T)). In addition, this KKU-FW10 could potentially produce 58.24 Units/ml of carboxymethyl cellulase when it was cultured in YP broth containing 1.0 % carboxymethyl cellulose for 24 h.

Online Learning Activities Kit on Plants in Thai Literature in Compliance with the School Botanical Garden of Plant Genetic Conservation Project under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn

Online Learning Activities Kit on Plants in Thai Literature in Compliance with the School Botanical Garden of Plant Genetic Conservation Project under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn

New record of a freshwater crab Phricotelphusa callianira (De Man, 1887) (Decapoda: Brachyura: Gecarcinucidae) from Thailand

An expedition by scientists participating in a Plant Genetic Conservation Project under the Royal Initiative of Her Royal Highness Princess Maha Chakri Sirindhorn to Tachai Island, off the coast of Changwat Phangnga, Andaman Sea, southern Thailand in April 1999, revealed a new record of the freshwater crab Phricotelphusa callianira (De Man 1887). The new distribution data is considered indicative of a lack of freshwater biota surveys in the area studied, and emphasizes the need for further biogeographical studies.

H5N1 Influenza A Virus and Infected Human Plasma

H5N1 Influenza A Virus and Infected Human Plasma

Her Royal Highness Princess Maha Chakri Sirindhorn

Her Royal Highness Princess Maha Chakri Sirindhorn