Effect of Temperature on the Killing of Opisthorchis viverrini Eggs In Vitro

Contaminated liver fluke egg in the environment has led to the high prevalence of human opisthorchiasis associated with cholangiocarcinoma in Southeast Asia. To find the effective lessening methods of Opisthorchis viverrini eggs in the contaminated environment, we investigated the temperature conditions for killing of these trematode eggs in vitro. Numerous O. viverrini eggs were obtained in the proximal part of uteri of adult worms from experimental hamsters. Mature eggs with miracidium were allocated by experimental groups (2 control: positive and negative and 4 treatment: 50, 60, 70, and 80°C) with 0.85% saline, and treated by the experimental plan. Eggs in each experimental groups were observed under the confocal microscope after stain with Propidium Iodide (PI) to evaluate the effect of temperatures. Eggs in 70 and 80°C groups were all killed after over 10 min heated. Majority of eggs in 60°C (10, 15, and 30 min heated), 70 and 80°C (5 min heated) groups were inactivated. However in 50°C group, below half of eggs were to be killed in all time lapse (10, 15 and 30 min). In order to prevent O. viverrini infection and cholangiocarcinoma, direct treatment of sewage by heating at 70 or 80°C at least 10 min is essential. Therefore, treatment of O. viverrini eggs at a high temperature is a potential method for controlling egg contamination in sewage.

A Development of Pain Assessment and Pain Documentation as a Fifth Vital Sign in a University Hospital

Background: Pain assessment and documentation can be used as vital sign for the improvement of postoperative pain management; however, these systems have never been adopted for use at Srinagarind Hospital.Objectives:1.     To develop a systematic postoperative pain assessment and documentation as the fifth vital sign; and,2.     To implement a revised graphic sheet for pain documentation at Srinagarind Hospital.Design:  Descriptive studySetting:  Srinagarind Hospital, Faculty of Medicine, Khon Kaen UniversityMethods:  Researchers explored the ward nurses’ attitudes and practices vis-à-vis the pain assessment and documentation in a pilot ward.  Subsequently, systematic pain assessment and documentation using the old graphic sheet, originally developed for recording four other vital signs, were re-designed to include the new sign, tested and revised for its practicality.  The revised graphic sheet was re-tested in two other wards and finally the system was implemented throughout the hospital.Measurement:  Pain assessment tools, frequency of pain documentation and the number of patients assessed before and after the study were recorded.  The ward nurses were asked to give their comments on the practicality of the new system for pain assessment and documentation.Results:  In the pilot ward, misunderstanding regarding the pain assessment tools was found among some ward nurses. The frequency of pain assessment and documentation significantly increased after using the revised graphic sheet (43.2% vs. 57.3%, p=0.039).  The prevalence of no pain assessment also decreased significantly (12.1 vs. 2.2%, p=0.008).  Most of the nurses (87.5%) could complete the pain record form within one minute.  The new system, as reported by 62.5% of the ward nurses, nominally increased their workload.  Re-testing this system in the other two wards increased the number of pain assessments and documentations on the first post-operative day from 67% to 98 %.  The revised graphic sheet was then accepted by the policy makers for use throughout the hospital.Conclusion:  The system of post-operative pain assessment as the fifth vital sign was developed.  A revised graphic sheet was used for pain documentation and accepted for routine use.  The new system increased the number of pain assessments and documentations of post-operative patients.