The Effectiveness of Ramadan Focused Education on Awareness and Glycemic Control of Diabetic Muslims (Type 2 Diabetes) During Ramadan Fasting

The majority of Muslim diabetic patients are unaware of complications during fasting, therefore diabetic patients who want to fast need a pre–Ramadan assessment and education to increase their awareness of the risks of fasting. This study examined the effectiveness of Ramadan focused education aimed at increasingself-awareness and glycemic control in Muslims with type 2 diabetes who fast during Ramadan. A pre and post experiment with a randomized controlled trail was being conducted among 212 patients at Primary Care Units of Songkhla. To be eligible, patient participants must be fasting diabetic patients during Ramadan.The study is a two-centre randomized wait-list controlled trial. Subjects were 108 patients who were allocated to the intervention group (educated about meal planning, physical activity, medications, recognizing and managing complications before Ramadan) and 104 patients were in the control group or wait list control (The control group received conventional group counseling).The data were analyzed using descriptive statistics, ANCOVA, and t- test. After Ramadan, we observed no difference in FBS and HbA1c between intervention and control patients. On comparing the self-awareness score of realization of the diabetic patients between the intervention and the control groups after adjusting for baseline [adjusted difference1.10, 95% confidence interval (CI). 29, 1.71; P=0.005], the difference statistically significant (p< 0.005). The intervention significantly increased self-awareness. The role of structured education for patients is well established in the management of diabetes. This should be extended to Ramadan-focused diabetes education and drug modification program on awareness of self-care and glycemic control in Muslims with type 2 diabetes who fast during Ramadan in Thailand.

Costs and Effectiveness of Ciprofloxacin and Ceftriaxone in Treatment of Typhoid Fever in Children in Thailand

The burden of typhoid fever remains high in impoverished settings, and increasing antibiotic resistance is making treatment costly. The purposes of this study were: to compare the costs and the effectiveness of typhoid programs between oral and injection treatments in pediatric patients at Songkhla Hospital. This study was an incidence-based cost-of-illness analysis from providers’ perspective. Micro-costing approach was employed for calculating patient-specific data. The study was conducted in Songkhla Hospital in the southern part of Thailand from 2009 to 2010. The total number of the cases was 78. Patients taking antibiotics for 48 hours, and those suspected of having complicated typhoid fever like peritonitis, ileus, toxic encephalopathy were excluded. We collected and reviewed medical records. In all provisionally selected children, blood was drawn for complete blood count, widal test and blood culture. The statistics used in data analysis were descriptive statistics and the cost-effectiveness of typhoid treatment with the two methods was compared using independent t-test. The results of the study revealed that the average cost of typhoid treatment with oral Ciprofloxacin calculated with DRG was 3,301.88 baht which was lower than that of injection Ceftriaxone treatment calculated with DRG (3,615.05 baht). When the operation costs were considered, the results of the study remained the same, i.e. the treatment cost of typhoid with oral Ciprofloxacin was two times lower than that with injection Ceftriaxone. The average cost of the oral treatment was 2,844.45 baht, and that of the injection treatment was 5,303.19 baht. Regarding the effectiveness of typhoid treatment with Ciprofloxacin measured from the time the fever was reduced, it was found that the body temperature of the two methods of treatment were used was not significantly different (p<.05). The patients on oral medications had a fever for an average of 3.36 days while those on injection treatment had a fever for an average of 3.76 days. However, the lengths of stay (LOS) of the two groups of patients were significantly different. The results of this study showed that the cost-effectiveness of oral treatment was better than injection. Bedside, the patient and caregiver spent less time when oral treatment was administered than when injection treatment was used. Therefore, the direct cost for treatment was reduced and the indirect cost as a result from LOS was also reduced. Above all, the patient did not get pain from injection while the effectiveness of fever reduction was not different.

Outcomes of the Prince of Songkla University Model to Building Nursing Research Capacity for Thai Nurses to the Asian Region : Participatory Action Research

Building research capacity in nursing services has been recognized internationally as important in order to produce a sound evidence for decision–making in policy. Prince of Songkla University has adopted the direction of development which is consistent with its vision of being a leading university in the Asian region with the obligations of producing research. The aim of this study is to evaluate the outcomes (the number of research reports and nurses' satisfaction) of building nursing research capacity with the Prince of Songkla University Model. This participatory action research was a part of study on the outcomes of building nursing research capacity with the Prince of Songkla University Model. One hundred participants (n = 100) were recruited on a voluntary basis during the years 2004–2009. Six participatory development steps were carried out. Data were collected through recording research report presentations, a questionnaire, and satisfaction interviews. Quantitative data were analyzed with descriptive statistics. It was found that 61% (n = 61) of the Thai nurses were able to present their research reports at international conferences in three countries, namely the Republic of Korea (three times, or 50.82%), Japan (44.26%) and Indonesia (4.92%). The majority of the presentations (72.13%) were in the form of poster presentations; most of the research designs (45.90%) were descriptive studies, followed by quasi-experimental research (27.87%); and most of the research topics (22.95%) were on adult nursing, followed by nursing administration and management (18.03%), and nursing education (16.38%). The participants' satisfaction was: 85% at a high level, and 15% at a moderate level. As academic and service partners move forward to design and implement changes to prepare the next generation of building nursing research capacity for the realities of a changing health care delivery, both process from PSU Model and outcomes evaluations must be incorporated in planning. The key point is that measurement is essential to determine the short –and long-term effectiveness and the efficiency of this model.