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Pongthep Rajsirisongsri,1 Direk Patikulsila,1 Phichayut Phinyo,2– 4 Paradee Kunavisarut,1 Voraporn Chaikitmongkol,1 Onnisa Nanegrungsunk,1 Atitaya Apivatthakakul,1 Sutheerada Seetasut,1 Yaowaret Tantivit,1 Napatsorn Krisanuruks,1 Apisara Sangkaew,1 Nawat Watanachai,5 Janejit Choovuthayakorn1 1Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Department of Biomedical Informatics and Clinical Epidemiology (Bioce), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 4Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand; 5Department of Ophthalmology, Faculty of Medicine, Mahidol University, Bangkok, ThailandCorrespondence: Janejit Choovuthayakorn, Email janejit.c@cmu.ac.thPurpose: To evaluate the anatomical and visual outcomes of patients with rhegmatogenous retinal detachment (RRD) who received primary repair by combined pars plana vitrectomy with scleral buckling (PPV/SB) or pars plana vitrectomy (PPV) alone by using a propensity analysis.Patients and Methods: This study was a single center retrospective observational study. Medical records of patients who underwent surgical interventions between January 2013 and December 2019 were retrospectively reviewed. The single surgery anatomic success (SSAS) and final anatomic success were the primary outcomes, whereas the final visual acuity changes was the secondary outcome.Results: This study included a total of 683 patients (683 eyes), with a median (interquartile range, IQR) follow-up duration of 13 (5.5 to 28.8) months. Of them, 211 patients (30.9%) underwent PPV/SB, while 472 patients (69.1%) underwent PPV as their primary procedure. The two treatment groups did not significantly differ in the risk of achieving SSAS (weighted risk difference: 0.012, 95% confidence interval (CI): − 0.067 to 0.092, p value = 0.776) or achieving final retinal anatomic attachment (weighted risk difference: − 0.038, 95% CI: − 0.106 to 0.030, p value = 0.272). The occurrence of proliferative vitreoretinopathy was identical between the two treatment groups (56 patients (26.5%) for the PPV/SB group and 104 patients (22.0%) for the PPV group), p = 0.199. Nonetheless, the patients who received PPV alone showed a significantly greater mean improvement in VA (weighted mean difference; 0.295, 95% CI; 0.150, 0.440, p < 0.001).Conclusion: This work supports the findings that adding SB to PPV had little impact on anatomical results (either a single surgical success rate or the overall final success rate) for RRD repair. Although PPV alone is shown to improve vision, confirmation of these associations requires further prospective studies using standardized surgical techniques.Keywords: rhegmatogenous retinal detachment, pars plana vitrectomy, combined pars plana vitrectomy and scleral buckling, visual outcomes, anatomical outcomes, propensity score analysis

Pongthep Rajsirisongsri,1 Direk Patikulsila,1 Phichayut Phinyo,2–4 Paradee Kunavisarut,1 Voraporn Chaikitmongkol,1 Onnisa Nanegrungsunk,1 Atitaya Apivatthakakul,1 Sutheerada Seetasut,1 Yaowaret Tantivit,1 Napatsorn Krisanuruks,1 Apisara Sangkaew,1 Nawat Watanachai,5 Janejit Choovuthayakorn1 1Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Department of Biomedical Informatics and Clinical Epidemiology (Bioce), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 4Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand; 5Department of Ophthalmology, Faculty of Medicine, Mahidol University, Bangkok, ThailandCorrespondence: Janejit Choovuthayakorn, Email janejit.c@cmu.ac.th

Phichayut Phinyo,1– 4,&ast; Nutcha Jarupanich,2 Lalita Lumkul,2,4 Areerak Phanphaisarn,3,5 Thanate Poosiripinyo,6 Sermsak Sukpanichyingyong,6 Pichaya Thanindratarn,7 Yodsawee Pornmeechai,8 Taweechok Wisanuyotin,9 Rapin Phimolsarnti,10 Ekarat Rattarittamrong,11 Dumnoensun Pruksakorn3– 5,&ast; 1Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand; 4Center of Multidisciplinary Technology for Advanced Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 5Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 6Department of Orthopaedics, Khon Kaen Hospital, Khon Kaen, Thailand; 7Chulabhorn Hospital, Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand; 8Department of Orthopedics, Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand; 9Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 10Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 11Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand&ast;These authors contributed equally to this workCorrespondence: Phichayut Phinyo, Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Si Phum, Muang, Chiang Mai, 50200, Thailand, Tel +66-5393-6150, Fax +66-5393-6150, Email phichayutphinyo@gmail.com; phichayut.phinyo@cmu.ac.th Dumnoensun Pruksakorn, Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Si Phum, Muang, Chiang Mai, 50200, Thailand, Tel +66-5393-6150, Fax +66-5393-6150, Email dumnoensun@hotmail.com; dumnoensun.p@cmu.ac.thPurpose: A diagnostic model to differentiate multiple myeloma (MM) from bone metastasis (BM) in patients with destructive bone lesions (MM-BM DDx) was developed to promote timely and appropriate referral of patients with MM to hematologists. External validation has never been conducted. This study aims to externally validate the performance of the MM-BM DDx model.Patients and Methods: This multi-center external validation study was conducted using retrospective data of patients over 45 years old diagnosed with MM or BM at six university-affiliated hospitals in Thailand from 2016 to 2022. The MM-BM DDx development dataset, including patients from 2012 to 2015, was utilized during external validation. Diagnostic indicators for MM included in the MM-BM DDx model are serum creatinine, serum globulin, and serum alkaline phosphatase (ALP). MM and BM diagnosis was based on the documented International Classification of Diseases 10th Revision codes. Model performance was evaluated in terms of discrimination, calibration, and accuracy.Results: A total of 3018 patients were included in the validation dataset (586 with MM and 2432 with BM). Clinical characteristics were similar between the validation and development datasets. The MM-BM DDx model’s predictions showed an AUC of 0.89 (95% CI, 0.87, 0.90). The predicted probabilities of MM from the model increased concordantly with the observed proportion of MM within the validation dataset. The estimated sensitivity, specificity, and LR for each odds class in the validation dataset were similar to those of the development dataset.Conclusion: The discriminative ability and calibration of the MM-BM DDx model were found to be preserved during external validation. These findings provide support for the practical use of the MM-BM DDx model to assist clinicians in identifying patients with destructive bone lesions who are likely to have MM and enable them to arrange timely referrals for further evaluation by hematologists.Keywords: diagnosis, primary care, clinical prediction model, referral, bone metastases, multiple myeloma

Tuangprot Porapaktham,1 Janejit Choovuthayakorn,1 Onnisa Nanegrungsunk,1 Phichayut Phinyo,2– 4 Krittai Tanasombatkul,2,3 Nawat Watanachai,1 Paradee Kunavisarut,1 Voraporn Chaikitmongkol,1 Direk Patikulsila1 1Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 4Musculoskeletal Science and Translational Research (MSTR), Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCorrespondence: Janejit Choovuthayakorn, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand, Tel +66 53 935512, Fax +66 53 936121, Email janejit.c@cmu.ac.thPurpose: To determine characteristics and factors associated with no vision survival (included no light perception, enucleation, and evisceration) following open globe injury (OGI) and to correlate the proportion of final vision to predictive values of ocular trauma score (OTS).Patients and Methods: The medical records of consecutive patients diagnosed as OGI between January 2015 and December 2020 were retrospectively reviewed. Data collected included demographics, mechanisms and modes of injuries, ophthalmic presentations, managements, and visual outcomes at the final visit.Results: Three hundred and seventy-one patients with a mean (standard deviation, SD) age of 44.0 (17.4) years were included. Male with workplace injury was the most frequent scenario. High-velocity metallic objects were the predominant causative materials. Following treatments, fifty-six eyes (14.9%) obtained no vision survival. Factors associated with no vision survival following OGI were low presenting vision, globe perforation, larger wound, presence of relative afferent pupillary defect, retinal detachment, and vitreous hemorrhage. Compared to OTS predictive values, eyes in OTS categories 1 and 2 had a lower proportion of no vision survival.Conclusion: This study identified the importance of workplace injuries. Overall, there were comparable final visions between OTS and this study. However, a reduced proportion of no vision survival among severely injured eyes signifies the challenges of OGI management.Keywords: open globe injury, visual outcomes, characteristics, no vision survival

Worapaka Manosroi,1 Pichitchai Atthakomol,2,3 Natthanaphop Isaradech,4 Phichayut Phinyo,3,5 Tanawat Vaseenon2 1Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 4Biomedical Informatics Center, Department of Family Medicine, Chiang Mai University, Chiang Mai, Thailand; 5Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCorrespondence: Pichitchai Atthakomol, Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Muang Chiang Mai, Thailand, Tel +66 53 936453 Email p.atthakomol@gmail.comPurpose: Osteoporotic hip fracture surgery is associated with a risk of morbidity and mortality. Admission hemoglobin levels < 10 g/dL have been documented as a strong predictor of mortality risk. This study aimed to investigate the mortality outcome between osteoporotic hip fracture patients who had preoperative hemoglobin levels raised to ≥ 10 g/dL and those with hemoglobin levels were < 10 g/dL.Patients and Methods: This 5-year retrospective observational study included 226 participants with osteoporotic hip fractures that required surgery and who had admission hemoglobin levels < 10 g/dL. Patients were categorized into two groups: those with corrected preoperative hemoglobin ≥ 10 g/dL and those with either corrected or uncorrected preoperative hemoglobin < 10 g/dL. Outcomes were analyzed using Cox proportional hazard regression adjusted for confounders. Results are presented as hazard ratio (HR) and 95% confidence interval (95% CI).Results: Among 226 the patients, the overall mortality rate was 17.25% (n=39/226) of the 226 patients, 93 (41.15%) had their hemoglobin levels raised to ≥ 10 g/dL by red blood cell transfusion. Multivariable analysis after adjustment for confounders showed a 50% lower incidence of mortality among patients with preoperative hemoglobin levels ≥ 10 g/dL than among those with hemoglobin levels < 10 g/dL (HR 0.50, 95% CI (0.25– 0.99), p=0.048).Conclusion: In osteoporotic hip fracture patients with admission hemoglobin < 10g/dL, raising preoperative hemoglobin levels to ≥ 10 g/dL can significantly reduce the risk of mortality. Testing for and correction of low preoperative hemoglobin levels is of value in hip surgery patients.Keywords: osteoporosis, hip fracture, anemia, mortality

Prapasri Kulalert,1 Phichayut Phinyo,2,3 Jayanton Patumanond,3 Chutima Smathakanee,4 Wantida Chuenjit,4 Sira Nanthapisal5 1Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand; 2Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 4Department of Pediatrics, Hat Yai Hospital, Songkhla, Thailand; 5Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, ThailandCorrespondence: Phichayut PhinyoDepartment of Family Medicine, Faculty of Medicine, Chiang Mai University, 110/510 Intawaroros Road, Suthep, Mueang Chiang Mai District, Chiang Mai, Chiang Mai Province 50200, ThailandTel +66 89 850 1987Email phichayutphinyo@gmail.comPurpose: Intermittent nebulization of short-acting beta-agonists (SABA) is the initial treatment of choice for children with asthma exacerbation. However, children with severe asthma exacerbation (SAE) may not show an adequate response and need aggressive stepwise therapy. We aimed to explore factors associated with a poor response to intermittent nebulized SABA in children with SAE.Methods: A retrospective cohort study of children with SAE diagnosed according to the definition of the British Guidelines on the Management of Asthma, who were admitted at Hat Yai Hospital from January 1, 2015, to December 31, 2017. All children were treated with intermittent SABA nebulization. Treatment failure was defined as children needing escalated therapy. Logistic regression with confounding score adjustment was used to explore the predictors of treatment failure.Results: One hundred thirty-three children were included in the analysis, 59 were in the failure group and 74 were in the success group. After adjusting for potential confounders, they were significantly associated with a previous history of intubation (adjusted OR 6.46, 95% CI 1.13 to 36.79, p=0.036), receiving < 3 doses of nebulized salbutamol in the emergency room (ER, aOR 3.21, 95% CI 1.15 to 9.02, p=0.027), ER measured oxygen saturation (SpO2) < 92% (adjusted OR 3.02, 95% CI 1.18 to 7.75, p=0.022), and exacerbation triggered by pneumonia (adjusted OR 2.67, 95% CI 1.19 to 6.00, p=0.017).Conclusion: We identified four prognostic factors of treatment failure in children with SAE: a previous history of intubation; receiving < 3 doses of nebulized salbutamol in the ER, SpO2 at ER < 92%; and exacerbation triggered by pneumonia. Further prospective studies are required to confirm our findings before clinical implementation.Keywords: status asthmaticus, hospitalization, nebulization, treatment failure, prognosis

Executive function (EF) is essential for academic achievement, successful work, and physical and mental health. Although evidence shows that several factors have been linked to EF, these results are mixed. This study aims to identify both biological and environmental variables associated with impaired EF in preschoolers. This study was a population-based cross-sectional study of healthy children aged 2-5 years from public and private schools in Chiang Mai, Thailand. EF was assessed using a parent report of the Behaviour Rating Inventory of Executive Function-Preschool (BRIEF-P). Multivariable logistic regression analysis was used to explore the biological and environmental factors relevant to impaired executive functioning. In a total of 1540 included children, 213 children (13.83%) were defined as impaired EF. We found that biological factors--male (odds ratio [OR], 1.41, 95% confidence interval [CI] [1.04-1.91]), overweight/obesity (OR, 1.59, 95% CI [1.10-2.31]), less physical activity (OR, 1.77, 95% CI [1.10-2.84]), and environmental factors--low maternal education (OR, 1.61, 95% CI [1.13-2.31]), permissive parenting style (OR, 2.75, 95% CI [1.24-6.13]), and excessive screen exposure (OR, 1.66, 95% CI [1.15-2.41])--are associated with an increased risk of impaired EF. Adjusting modifiable factors, such as healthy weight status, positive parenting, appropriate screen time, and adequate physical activities, may be necessary for children to promote EF.

This article is to study corporate social responsibility through packaging and communicated CSR to evaluate consumer buying decisions using the packaging from coconut fibrin. Packaging was obtained from local materials in the community of Samut Sakorn Province, Thailand. Using local waste material (coconut fibrin) for green packaging, it is beneficial to the environmental issue, and can create jobs in the community by making paper and packaging from coconut fibrin. Coconut pulp paper has performed under alkaline conditions coupling a mixture of natural additives consisting of carboxymethyl cellulose and corn starch. The obtained pulp paper was tested according to The National Standard of Kraft paper. It was characteristic of the liner board. The individual packaging was fabricated and used as an instrument for the consumer perception study (258 informants). We found the consumer view of business doing CSR is an ethical organization (4.44) that deems to present responsibility to society and the environment. The decisions were agreed upon, and consumers were delighted to buy the packaging. The CSR activity through the packaging could induce community development in job creation and reduces waste in the community by adding value to green packaging. The CSR activity of business influences the positive perception of consumers. [ABSTRACT FROM AUTHOR]