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Buppha P.,Srinakharinwirot UniversityNakhon Nayok | Kusumaphanyo C.,Srinakharinwirot UniversityNakhon Nayok | Chittawatanarat K.,Chiang Mai University
Journal of the Medical Association of Thailand | Year: 2016

Objective: To identify risk factors associated with extubation failure (EF) in patients admitted to surgical ICUs (SICUs). Material and Method: Data were gathered during April 2011-January 2013 by collecting demographic, admission details, daily summary, nutritional profile, APACHE II scores, and discharge summary from patients admitted to SICUs among nine university hospitals. Exclusion criteria include pediatric patients, non-consent patients, multiple trauma, cardiovascular and thoracic, and neurosurgical patients. Data were collected to the endpoint of 28 days of admission. Morbidity and mortality were determined. Complications or adverse events that occurred during admission were detailed in separate record forms. Result: Of 4,652 patients, 2,890 were intubated. Among them, 2,749 were successfully extubated leaving 141 with extubation failure. Overall incidence of EF was 4.88% (with range from 1.41-7.33). Patient characteristics in EF groups were compared to successful groups. Advanced age, presence of congestive heart failure, vascular disease, COPD, emergency surgery, poor APACHE II and SOFA scores, and concurrent use of vasopressors, inotropes and sedatives were significant differences. The most common causes of EF were respiratory failure, inability to cough and laryngeal edema. Outcomes of EF included prolonged length of ICU stay [2 (IQR 1-5) vs. 11 (IQR 6-15) days] and hospital stay [16 (IQR 10-27) vs. 23 (IQR 15-33) days]. Patients with EF were at risk of 6-fold longer ICU stay than successful extubation. Adjusted odds ratio of age, congestive heart failure, emergency surgery, and SOFA score were identified with statistical significance to be risk factors of EF. Conclusion: EF can affect outcomes of ICU admission. Identifying the risk factors associated with EF will help reduce its incidence and improve ICU outcomes. © 2016, Medical Association of Thailand. All rights reserved.

Khomkaew S.,Srinakharinwirot UniversityNakhon Nayok | Bunyawanihakul P.,Srinakharinwirot UniversityNakhon Nayok | Chaorakam I.,Kasetsart UniversityNakhon Pathom
Journal of the International Society for Southeast Asian Agricultural Sciences | Year: 2016

This paper attempts to demonstratethe performance of a sugarcane planter at the Agricultural Machinery Center, Kasetsart University Research from April 2014 to March 2015 with minimum tillage resulting from a slippery sliding rate (slip %), drawbar pull, drawbar power and PTO power as varied by the different densities of residues at 0, 2, 4, and 6 ton/ha and 2 depth levels of soil at 10 cm and 20 cm. The test was done over one and two rounds in the crop field, after the final sugarcane harvesting, with a moisture content of 22.115% (bulk density) and 19.202 % (bulk density). It was discovered that the fuel consumption rate of the sugarcane planter was at125 m/l at a tractor velocity of 3.2616 km/hr, the slippery sliding rate at 4.44 %, the draft (pulling) of lower link and top link at 8.30 kW, PTO power at 16.56 kW. The performance and total power of the sugarcane planter with minimum tillage resulted from the depth level of the soil opener and the different densities of the sugar cane leaf residues at 0 2 4 and 6 ton/ha and depth level of the soil to affect performance of the sugarcane planter. Therefore, the angle of subsoil opener should be reduced to less than 31 degrees to reduce the effect of soil resistance. © 2016, International Society for Southeast Asian Agricultural Sciences. All Rights Reserved.

Supakumnerd K.,Srinakharinwirot UniversityNakhon Nayok | Chungchoo C.,Kasetsart University
Kasetsart Journal - Natural Science | Year: 2015

Currently, many mechanical parts are produced from computer numerical control (CNC) machines including CNC machining centers and CNC turning centers. In order to keep production costs as low as possible, workpieces have to be rejected at the minimum rate. This can be done, but it depends on many parameters. One important parameter is adequate machine performance to produce the workpiece. In this research, a new technique was introduced to evaluate the performance of both CNC machining and turning centers. The first benefit of this technique is that manufacturers can evaluate a machine’s performance themselves (no expert is required). The second benefit is that the approximate workpiece dimensions can be predicted in advance. In addition, using the standard test piece, experimental results confirmed that this new technique can be used in industry. © 2015, Kasetsart University. All rights reserved.

Namwong L.,King Mongkut's University of Technology Thonburi | Authayanun S.,Srinakharinwirot UniversityNakhon Nayok | Saebea D.,Burapha UniversityChonburi | Patcharavorachot Y.,King Mongkut's University of Technology Thonburi | Arpornwichanop A.,Chulalongkorn University
Journal of Power Sources | Year: 2016

Proton-conducting solid oxide electrolysis cells (SOEC-H+) are a promising technology that can utilize carbon dioxide to produce syngas. In this work, a detailed electrochemical model was developed to predict the behavior of SOEC-H+ and to prove the assumption that the syngas is produced through a reversible water gas-shift (RWGS) reaction. The simulation results obtained from the model, which took into account all of the cell voltage losses (i.e., ohmic, activation, and concentration losses), were validated using experimental data to evaluate the unknown parameters. The developed model was employed to examine the structural and operational parameters. It is found that the cathode-supported SOEC-H+ is the best configuration because it requires the lowest cell potential. SOEC-H+ operated favorably at high temperatures and low pressures. Furthermore, the simulation results revealed that the optimal S/C molar ratio for syngas production, which can be used for methanol synthesis, is approximately 3.9 (at a constant temperature and pressure). The SOEC-H+ was optimized using a response surface methodology, which was used to determine the optimal operating conditions to minimize the cell potential and maximize the carbon dioxide flow rate. © 2016 Elsevier B.V.

Tantisiriwat W.,Srinakharinwirot UniversityNakhon Nayok | Santiwattanakul S.,Srinakharinwirot University
Journal of the Medical Association of Thailand | Year: 2015

Objective: To identify the epidemiology of candida isolations in HRH Princess Maha Chakri Sirindhorn Medical Center and the sensitivity of all candida species to fluconazole. Material and Method: Two hundred of Candida albicans and other Candida species from clinical specimens were collected from microbiological department between January 2010 and April 2012. All Candida were identified by standard methods and the sensitivity of fluconazole was tested by using fluconazole E test test. Results: There were 8 species of Candida in this study including: C. albicans (n = 94), C. tropicalis (n = 66), C. glabrata (n = 11), C. guilliermondii (n = 10), C. parapsilosis (n = 9), C. zeylanoides (n = 4), C. keyfr (C. pseudotropicalis) (n = 2), C. lusitaniae (n = 1), Candida species (n = 3). The percentage of non-albicans Candida spp. was slightly higher than C. albicans (53% vs. 47%). C. tropicalis was identified as the highest percentage of all non-albicans Candida spp. Fluconazole resistant strains were detected among C. albicans (35.71%), C. tropicalis (13.85%), C. guilliermondii (20.0%), and C. zeylanoides (50.0%). The common spp. with highest percentage of resistant strain was C. albicans. Conclusion: Fluconazole could be used as the first-line antifungal for candidiasis at HRH Princess Maha Chakri Sirindhorn Medical Center. Empirical treatment with amphotericin B and stepping down to fluconazole when sensitivity suggested might be the recommendation for severe cases in our setting. © 2015, Medical Association of Thailand. All rights reserved.

Upapan P.,Srinakharinwirot UniversityNakhon Nayok
Journal of the Medical Association of Thailand | Year: 2015

Erysipelothrix rhusiopathiae infection in humans may not be as rare as previously thought. In most cases, the disease is acquired from animals through work-related exposure. Human infection has been reported since the early 1900’s up to the present. Unsolved issues associated with this organism include inadequate disease control in animals, difficulty in identification and isolation of the bacteria, diagnostic delay due to unawareness of this uncommon disease or unfamiliarity with the increasingly diverse clinical manifestations, and inappropriate antibiotic use due to misdiagnosis, as well as drug resistance. In this review, we attempt to address the unsolved issues related to human Erysipelothrix infection and suggest possible solutions. © 2015, Medical Association of Thailand. All rights reserved.

Songtish D.,Srinakharinwirot UniversityNakhon Nayok | Akranurakkul P.,Srinakharinwirot UniversityNakhon Nayok
Journal of the Medical Association of Thailand | Year: 2015

Objective: This study aimed to identify the clinical presentation, natural history, severity and associated factors in Thai women presented with mastalgia. Material and Method: One hundred and five Thai women with breast pain who visited HRH Princess Maha Chakri Sirindhorn Medical Center were interviewed with breast pain. The data about socio-economic status, sign and symptoms of breast pain, associated factors, mental status and quality of life at first presentation and 6-12 months afterward were collected. Results: In 105 Thai women who present with mastalgia, the pain was associated with menstrual cycle, around 70 percents. Both cyclic and non-cyclic mastalgia patients had similar characteristics as type, intensity and location. There were no differences in caffeine and high-fat food intake between mild and severe mastalgia. In twenty-seven percent of patients who had severe breast pain, the pain affected their work, sleeping and daily entertainment. Though the pain did not influence mental status, it affected some part of quality of life such as a part of bodily pain, social function and mental health. At second follow-up, 80 patients had decreased severity and intensity of pain. The mental status and quality of life evaluations were statistically significant. Conclusion: The results showed that most mastalgia was associated with menstruation. Diet showed no definitive association with breast pain severity and severe mastalgia influenced patients’ daily activity and quality of life. © 2015, Medical Association of Thailand. All rights reserved.

Hunchaisri N.,Srinakharinwirot UniversityNakhon Nayok | Chantapant S.,Srinakharinwirot UniversityNakhon Nayok | Sirirattanapan J.,Srinakharinwirot UniversityNakhon Nayok
Journal of the Medical Association of Thailand | Year: 2015

Objective: Investigate the benefit of zinc supplement combined with standard treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) patients. Material and Method: A prospective, randomized study was designed to evaluate the hearing outcomes in ISSNHL patients treated with zinc supplement. The patients were randomized into two groups, the study and the control group. The study group received oral chelated zinc with standard treatment (oral prednisolone), while the control group received standard treatment alone. Hearing improvement was assessed from pure-tone average (PTA) and speech discrimination scores (SDS). Results: After treatment, significant hearing improvement was noted in both groups regarding PTA value (p = 0.016, 0.025). SDS was also improved in both groups but with no statistical significance (p>0.05). Post-treatment PTA and SDS values between the zinc and control groups were not statistically different (p>0.05). Hearing improvement was documented in eight of 16 patients in the study group and seven of 14 patients in the control group. This was no significant difference (p = 1.000). Conclusion: Zinc supplementation does not have benefit when combined with standard treatment. Nevertheless, more subjects and well-designed studies are needed to verify the effect of zinc. © 2015, Journal of the Medical Association of Thailand. All right reserved.

Rerksuppaphol L.,Srinakharinwirot UniversityNakhon Nayok | Rerksuppaphol S.,Srinakharinwirot UniversityNakhon Nayok
Journal of the Medical Association of Thailand | Year: 2015

Background: Cigarette smoking is a common tobacco use which is the leading preventable cause of death in Thailand. Prevalence and risk factors of cigarette smoking are varied amongst communities. Objective: The present study aimed to determine the prevalence and associated risk factors of cigarette smoking amongst middle-school students studying in the Ongkharak district, central Thailand. Material and Method: A cross-sectional survey was conducted with students of the public schools in Ongkharak district, central Thailand, in 2013. Of 677 middle-school students (grade 7-9) who currently enrolled in the classes, 130 were randomly selected. Data on smoking as well as demographic characteristics were collected using an anonymous selfadministered questionnaire which was modified from the 2013 Middle School Youth Risk Behavior Survey (YRBS) and translated into Thai. Results: The prevalence of children who smoked or had smoked before was 24.6% (38.9% amongst males and 6.9% amongst females, p-value <0.001), of this proportion 50% were current smokers. Logistic regression analysis showed that the risk factors for having ever smoked were being male (OR = 7.63, 95% CI 2.26-26.90), of an older age (OR = 2.30, 95% CI 1.40-3.76), high coffee or tea consumption (OR = 2.95, 95% CI 1.08-8.05) and sharing a household with a smoker (OR = 2.96, 95% CI 1.09-8.06). Those who have smoked reported higher prevalence of asthma compared to those who have never smoked (25.0% vs. 9.2%, p-value = 0.033). Conclusion: About a quarter of middle-school students in Ongkharak district smoked cigarettes. Anti-smoking and prevention policies should be encouraged to tackle this rising major public health problem. © 2015, Medical Association of Thailand. All rights reserved.

Kongsakorn N.,Srinakharinwirot UniversityNakhon Nayok | Maroongroge P.,Srinakharinwirot UniversityNakhon Nayok
Journal of the Medical Association of Thailand | Year: 2015

Chorea is a type of hyperkinetic movement, referring to involuntary, irregular, aimless, nonrhythmic, abrupt, rapid, unsustained movements. The term hemichorea refers to chorea of one side of the body. A 39-year-old woman presented with a three-week history of abrupt, involuntary movements of her right hand and right foot, which was compatible with hemichorea of the right side. MRI brain showed a 1.7x1.5x1.3 cm lesion in the posterior limb of the left internal capsule and the lateral part of the left thalamoganglionic region, which was seen as mixed iso-and hyperintense in T1W images, and heterogeneous and hyperintense in T2W/ FLAIR images. T2 gradient sequences showed a peripheral rim of decreased signal intensity, which is the hemosiderin ring, and no significant brain edema. Partial contrast enhancement of the lesion after contrast media injection suggested cavernous angioma. After medical treatment with haloperidol 2.5 milligrams per day, her symptom gradually improved within 2 months. © 2015, Medical Association of Thailand. All rights reserved.

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