Physical fitness of the applied Thai traditional medical students at faculty of medicine Siriraj Hospital, Mahidol University.

Objective: This study was conducted to evaluate the fitness of applied Thai traditional medical (ATTM) students thereby obtaining data to promote a greater physical fitness in ATTM students. Methods: Cardio-respiratory fitness, muscular strength, flexibility and body composition were measured in 208 ATTM students from years 1 to 4 in the academic year 2010. To determine their lifestyles, questionnaires were also answered by ATTM students. Results: Firstly, although cardio-respiratory fitness of female ATTM students was within normal limit of Thai, cardio-respiratory fitness of male ATTM students was lower than that of Thai. Secondly, muscular strength of both male and female ATTM students was lower than those of Thai. Thirdly, flexibility of ATTM students was comparable to that of Thai. Fourthly, although BMI of ATTM students was comparable to that of Thai, the average waist to hip circumference ratio of female ATTM students was higher than that of female Thai. Finally, eighty four percent of ATTM students exercised less than three times a week and fifty percent of ATTM students ate less than three meals per day, respectively. Conclusion: ATTM students need not only the training programs for cardio-respiratory fitness, and muscular strength but also need a breakfast campaign. Persuading them to pay more attention to their physical exercises and appropriate diets will eventually create the healthy ATTM practitioners in the future.

Body composition, muscular strength and cardiovascular strength of the second-year medical students at faculty of medicine Siriraj Hospital, Mahidol University.

Objective: This study was conducted to evaluate Siriraj medical students’ fitness thereby obtaining data for promoting greater physical fitness in Siriraj medical students. Methods: Physical fitness among second year medical students academic year 2008 was measured by methods including body mass index (BMI) and waist to hip circumference ratio in determining body composition, hand grip dynamometer in determining muscular strength, heart rate as well as blood pressure before and after performing a YMCA step test in determining cardiovascular strength and a questionnaire in determining the lifestyle of medical students. Results: Average BMI and cardiovascular strength of both male and female medical students were within normal range compared to those of Thai. However, muscular strength of both male and female medical students was relatively low compared to those of average Thai as sixty-six per cent of them had exercise less than twice a week. Conclusion: Siriraj medical students need more physical exercises to improve their physical fitness. It is important to persuade medical students to pay more attention to their health, which will eventually make them to be healthy doctors in the future.

Clinical experience of the use of tolterodine in patients with overactive bladder at Siriraj Hospital.

Objective : To determine the efficacy of Tolterodine in patients with overactive bladder. Design : Open study. Setting : Gynaecological Outpatient Clinic, Department of Obstetrics & Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. Subjects : From August 2000 to June 2001, thirty patients who met the symptomatic definition of overactive bladder without local or metabolic causes were enrolled in this study. Intervention : Tolterodine 2 mg bid were given to the patients for 12 weeks. Main outcoem measurement : Patients' global opinion on results of treatment , change in voiding frequency, urgency episodes, urge incontinence episodes, and adverse events from medication. Results : Patients' global opinion showed a marked improvement in the condition in 6 cases (4 cases showed improvement in 2 weeks while the other 2 cases within 4 weeks of treatment), some improvement in 20 cases and failure of treatment in 4 cases (1 case discontinued at 2 weeks due to severe headache, 2 cases at 4 and 8 weeks due to lack of improvement and 1 case at 4 weeks due to economic problems). The mean number of voids per 24 hours showed a trend to decrease since the start of treatment from 12 times per 24 hours to 6 times per 24 hours after 12 weeks of treatment. The mean number of days with urgency per week showed a decreasing trend since the start of treatment from 2.8 days per week to less than 1 day per week after 12 weeks of treatment. The mean number of days with incontinence per week decreased from 3.5 days per week at the start of treatment to less than 1 day per week after 12 weeks of treatment. The adverse events from medication included a dry mouth in 15 cases (12 cases with mild degree and 3 cases with moderate degree ), 5 cases had flatulence, 5 cases had a slow urinary stream and 5 cases had a headache ( including 1 case who discontinued the treatment after 2 weeks). Conclusion : Tolterodine is effective in improving patient's view of their bladder condition, decreasing urinary frequency, urgency episodes and urge incontinence episodes. It is also well-tolerated by the patients.

Bladder cancer in Siriraj Hospital from 1991 to 1995.

A retrospective study was under taken of 284 patients with blander cancer seen at Siriraj Hospital from 1991 to 1995. Of the total 284 patients, new patients comprised 158 cases, while recurrent cases numbered 126. The average ages were 60-70 years. The male to female patients ratio was 235 to 59 (4:1), with the most common symptom being haematuria. Most of the patients (both new and recurrent cases) were in stage A, and the common histology was transitional cell carcinoma. A total of 39 patients in stages O and A were treated by TUR and adjuvant intravesical BCG therapy, while 62 patients with invasive bladder cancer underwent cystectomy.

Study of hand injury registry in siriraj hospital during 1993-1995.

Introduction: Trauma is one of the major causes of death among Thai people. In that respect, hand injuries have become an interesting issue during the past three years. Method: Patients with hand injuries (code S60-S69 in ICD 10) were selected from the Siriraj Truama Registry during 1993-1995 and than analyzed with regard to age, occupation, causes of accident and other data. Result: During the part three years, (1993-1995) 13,027 hand-injury patients were serviced by the unit. These included: 9,716 males and 3,311 females, with a ratio of male of 2.9:1. The greatest number of injuries was seen in patients aged 11 to 40 years, two of whom died from causes other than hand injury. Workers, laborers and students were the most common occupations. The sites of the accidents were homes, followed by public places and roads. Most patients arrived at the hospital within 30 minutes of the accident. Lacerated wounds were found to account for 54.4 percent (7,167 patients) of the total cases. Sharp objects and machinery were found to be the main causes of injury (3,397 patients), followed by traffic accidents (2,994 patients). In the traffic accident groups, injuries related to motorcycle accidents were found in 2,472 patients (82.6 percent). Injuries in this group were unintentional. Conclusion: From the incidence of hand injuries, it can be seen that this is the most common type of injury to occur in various types of accidents. Therefore the results of this study can be modified to formulate a prevention program, e.g., training for machine workers before they begin employment. In addition, first aid for hand injuries should be taught, including how to stop bleeding.

CPR in Siriraj Hospital: A preliminary report.

The determine the incidence and outcome of cardiopulmonary resuscitation (CPR), the availability of CPR equipments and personnel competence, we did a retrospective study by asking the head nurses of 117 wards in Siriraj Hospital. These were 53 adult wards, 24 pediatric wards and 40 combined wards. The total amount of patients in 3-month period was 183,874 patients which included 34,116 in-patients and 149,758 out-patients. Cardiac arrest occurred in 694 in-patients (2.03% of total patients) and 54 out-patients (0.04% of total patients). Among the 748 cardiac arrest patients, 685 received CPR (91.58% of cardiac arrest patients). Among these patients, 292 responded to CPR (42.67% of patients received CPR) and 393 died in spited of CPR (57.37% of patients received CPR). Patients in the Department of Internal Medicine had the highest incidence of CPR (47% of patients received CPR) whereas those in the Department of Radiology, Ophthalmology, Otorhinolaryngology had the lowest incidence (1%). The survival rates following CPR in the aforementioned departments were 32%, 0% and 20% respectively. Defibrillators were available in 24% of the wards. The completeness of airway equipments ranged from 60% to 90% of the wards. Electrocardiography, pulse oximeter and capnometry were available in 50%, 18% and 7% of the wards respectively. Subjective evaluation of nurses competence in performing CPR were as following: 86% of nurses from ICU were able to perform basic life support compare to 55% of nurses from emergency room and 31% of nurses from general wards. Fifty-five to sixty-two percent of ICU nurses could interpret ECG monitoring and 61% of nurses from 8 ICUs could used defibrillators. Delay time in doctor’s arrival for CPR more than 10 minutes was found in 54% of the wards. In order to improve the efficiency of CPR, we suggest that teaching and training of CPR should be mandatory and continuous, the guideline of CPR equipments should be recommended by the hospital’s experts and the hospital should provide more defibrillators to wards. The administration and communication system s should be reorganized to reduce the delay time in CPR.

Articles published by staffs of faculty of medicine Siriraj Hospital during 1992-1995.

Articles published by faculty staffs during 1992-1995 in various journals were collected and analysed. Total number of the articles published during the 4-year period was 1,387 articles. Four hundred and twenty-five, 446, 295, and 221 articles were published in 1992, 1993, 1994 and 1995 respectively or 0.66, 0.69, 0.46 and 0.34 article per person per year. On average, clinical departments published more articles than preclinical departments. Her Majesty’s Cardiac Centre, Department of Pediatrics, Department of Medicine, Department of Dermatology, department of Blood Transfusion and Medicine and Department of Microbiology published more than one article per person per year. The most common journal that published articles of the faculty staffs was Siriraj Hospital Gazette. The top three peer-reviewed journals that published articles from the faculty staff, were Journal of the Medical Association of Thailand, Southeast Asian Journal of Tropical Medicine and Public Health and Asian Pacific Journal of Allergy and Immunology. Department of Medicine, Department of Pediatrics and Department of Orthopaedics and Rehabilitation contributed for 20.5, 10.6 and 9.1 percents of the publications in these journals respectively.