Quality of life and hemoglobin levels of hemodialysis patient at Siriraj Hospital.

Objective: To evaluate the relationship of the quality of life (QOL), and hemoglobin (Hb) level of hemodialysis (HD) patients. Methods: This study was a cross-sectional study. Face-to-face interviews using a Kidney Disease Quality of Life - Short Form (KDQOL-SF™1.3) questionnaire (which consisted of SF-36 and kidney disease questionnaires) were conducted during November-December 2009 with 152 patients receiving hemodialysis at Siriraj hospital, Bangkok, Thailand. QOL measures were compared in stepwise Hb levels of 9, >9 to 10, >10 to 11, >11 to 12, and >12 g/dl. Scores of QOL and Hb level were examined for the relationship and statistical significance using ANOVA. Results: The increasing Hb levels are statistically significant increases in kidney disease domain scores on the kidney disease component of the questionnaire (p=0.042). About the SF36 component, the difference between 5 groups of Hb levels were significant in the general health (p=0.023), role emotion (p=0.015), social functioning (p=0.008), and mental component summary scores (p=0.039). Conclusion: The difference of the Hb levels were statistically significant differences in the effects of kidney disease, general health, role emotion, and social function scores, and mental component summary scores of the KDQOL-SF questionnaire. However, a long-term assessment should be considered. These findings have implications for the care of hemodialysis patients in terms of the initiation of the Hb target of erythropoietin (EPO) therapy.

Outcomes and cost minimization between siriraj cold hot pack and the innovator product.

Objective: To evaluate the quality of product and compare outcomes and costs between Siriraj Cold Hot Pack and an innovator product from the patient and hospital perspective. Methods: Siriraj Cold Hot Packs were prepared and tested for outcome and cost with the innovator product. The criteria for comparison such as heat and cold retention, compression resistance and skin irritation between the Siriraj Cold Hot Pack and the innovator product were determined and then analyzed for the economic effect by cost minimization analysis. Results: Siriraj Cold Hot Pack exhibited standard characteristics (p > 0.05). After being soaked in 95-100°C for 5 minutes or in 70-80°C for 7 minutes, it could retain heat at a temperature higher than 43°C for at least 10 minutes. It also retained cold at temperature below 10°C for longer than 10 minutes after being stored in a freezer for 2 hours, in a refrigerator (2-4°C) for 4 hours or on ice for 20 minutes. The comparison of heat and cold retaining and compression resistance between the Siriraj Cold Hot Pack and the innovator product revealed no difference. However, when they were soaked with water and heated with a microwave at 600 watts for 2 minutes, the Siriraj Cold Hot Pack was able to significantly retain heat longer than the innovator product (p < 0.05). For economic analysis, Siriraj Cold Hot Pack is the best choice. The sensitivity analysis from the patient perspective was conducted by increasing the price of the Siriraj Cold Hot Pack until greater than 25%, both products will be equivalent the best choice. From the hospital perspective, increasing the cost of production until greater than 102%, both products will be equivalent the best choice. Conclusion: The results show that Siriraj Cold Hot Pack yielded the similar capability to the innovator product, including hot and cold retention, compression resistance and the irritation results. Siriraj Cold Hot Pack is the best choice for both the patient and hospital perspective.

Confidence in the daily use of antiseptic alcohol.

Objective: To evaluate the active ingredient of 70 % Alcohol in two most common daily usage patterns after container opening i.e. the long opening period without container lid closure and the short period opening with the lid opening twice a day. Methods: 70 percent Alcohol was prepared in two common usages package sizes of 60 ml, and 250 ml, of our institution. We evaluated the quantity of ethyl alcohol that is the active ingredient in 70% alcohol in two aforementioned conditions to determine the time duration that the alcohol concentration remained greater than 60 percent in 60 ml, and 250 ml, package size. The alcohol concentration was quantified by a gas chromatography method for 3 batches and 5 samples per batch. Results: The ethyl alcohol concentrations of 60 ml, and 250 ml, packages of 70 percent alcohol declined to lower than 60 percent in 18 and 32 days respectively in the long opening period condition, whereas the short period opening condition resulted in running out of volume in 24 and 49 days for 60 and 250 ml, package before the decline of the ethyl alcohol concentration to lower than 60 percent. Conclusion: We can be confident that the 70 percent alcohol in our institution package sizes of 60 ml, and 250 ml, preserve their antiseptic properties for 18 and 32 days respectively when the lid is left open, whereas they maintain their antiseptic properties until the package is finished in the twice daily usage condition. These finding should be introduced into the practice guideline of the medical personnel and the patients.