Rungnirand Praditsuwan - Academia.edu (original) (raw)

Papers by Rungnirand Praditsuwan

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2010

To identify the burdens of Thai dementia caregivers and to determine the services that could supp... more To identify the burdens of Thai dementia caregivers and to determine the services that could support them in this function. The authors surveyed 88 dementia caregivers attending "Caregiver Day". The questionnaire contained Caregiver Burden Inventory. The answers range from "not at all descriptive" (zero) to "very descriptive" (4). The authors also explored baseline characteristics of caregivers and care recipients as well as caregiver's needs of a supporting system. There was an 82% response rate. Responses in time-dependence burden distributed almost equally in the five possible scales. In developmental and physical burden, caregivers rate scores mainly from 0-2. The scores in social and emotional burden ranged mainly between 0-1. Dependency in basic activities of daily living correlated with higher caregiver burden (odd ratio 7.48, 95% confidence interval 1.42-39.53, p = 0.02), while sex and kinship did not. The top three caregiver's needs wer...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2012

Delirium, an acute decline in attention and cognition, is found to be a common life-threatening c... more Delirium, an acute decline in attention and cognition, is found to be a common life-threatening clinical syndrome among hospitalized older patients. However, there has been no study to date regarding prevalence and incidence of delirium in Thai older patients. The authors aimed to determine prevalence and incidence of delirium in older patients admitted to general medical wards in a university hospital in Thailand. A prospective observational study was conducted in Siriraj Hospital. All patients aged 70 years or older admitted to general medical wards during study period were included. Delirium assessments were undertaken initially within the first 24 hours of admission and serially every 48 hours until patients developed delirium or were discharged. Delirium was diagnosed by experienced geriatricians based on the DSM-IV criteria. Prevalence was based on delirium identified at the first assessment, whereas incidence was defined based on cases developed during hospitalization. Two hu...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

Delirium in older patients is common and leads to poor clinical outcomes. It is, however, prevent... more Delirium in older patients is common and leads to poor clinical outcomes. It is, however, preventable if its risk factors are identified and modified accordingly. To determine risk factors associated with delirium in hospitalized older patients admitted to general medical wards at Siriraj Hospital. A prospective observational study was conducted at general medical wards, Siriraj Hospital. All consecutive patients aged 70 years or older admitted during study period were assessed and followed until discharge. A diagnosis of delirium was made if patients developed symptoms which fulfilled DSM IV criteria. Information regarding demographic data, co-morbid illnesses, preexisting cognitive status and functional status was collected at admission. Factorf associated with delirium were analyzed using logistic regression models. Risk factors associated with developing delirium identified from univariate analysis were female gender, age more than 80 years-old, having 4 or more co-morbidities, ...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2005

To determine the efficacy and cost-effectiveness of influenza vaccination in the Thai elderly liv... more To determine the efficacy and cost-effectiveness of influenza vaccination in the Thai elderly living in an urban community. The study design was a stratified, randomized, double blind, placebo-controlled trial. A total of 635 participants aged 60 years and older living in an urban community was randomized to receive an influenza vaccine or tetanus toxoid as a placebo injection. All participants were followed up 4-6 weeks in the community for influenza-like illness and treatment received, hospitalization and death for one year. A hemagglutination inhibition (HI) test for influenza virus antibody of all participants was done on the day of vaccination as well as 1 month, 5 months, and 12 months after the vaccination. Main outcome measures were immune response rate and protective titer, influenza-like illness, serological influenza, treatment received for influenza-like illness and their expenses, hospitalization and death during the study period. The immune response rate of vaccination...

Palliative Care: Research and Treatment, 2013

Viral Immunology, 2012

Influenza vaccination, which has been targeted to the elderly and those at serious risk of compli... more Influenza vaccination, which has been targeted to the elderly and those at serious risk of complications, is recommended. The purpose of this study was to determine antibody responses after influenza vaccination among Thai elderly persons living in the community. A total of 591 subjects consisting of 308 vaccinees and 283 non-vaccinees were enrolled in the study. Antibodies to H1N1, H3N2, and B viruses were detected by hemagglutination inhibition (HI) testing. The numbers of subjects who had protective antibody titers ≥40 and geometric mean titers (GMTs) of antibodies against A(H1N1), A(H3N2), and B viruses prior to vaccination were similar for the vaccine and placebo groups. The seroprotection rates and GMTs for influenza virus A(H1N1), A(H3N2), and B strains after influenza vaccination at 1, 5, and 12 mo in the vaccine group were significantly higher than those in the placebo group. The seroprotection rates for the A(H1N1) and A(H3N2) strains, but not the B strain, met Committee for Proprietary Medicinal Products (CPMP) criteria (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;60%). GMTs and seroprotection rates against influenza B strain in the vaccinees at all time points were &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;40% and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;60%, respectively, and significant differences between the vaccinees and the placebo controls were observed. The GMTs and seroprotection rates for influenza strains in those with pre-existing antibody titers ≥40 were significantly higher than those in the group with pre-existing antibody titers &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;40. These findings demonstrated that the elderly living in the community developed adequate antibody responses with sustainable titers throughout the 12-month study period after influenza vaccine immunization. Moreover, the presence of pre-existing antibody at a titer ≥40 prior to vaccination strongly affected the antibody response to influenza vaccination.

Medical Education, 2005

BACKGROUND Medical students' final clinical grades in internal medicine are based on the results ... more BACKGROUND Medical students' final clinical grades in internal medicine are based on the results of multiple assessments that reflect not only the students' knowledge, but also their skills and attitudes.

Journal of Clinical Neuroscience, 2013

The platelet amyloid precursor protein (APP) ratio has recently been shown to be a promising diag... more The platelet amyloid precursor protein (APP) ratio has recently been shown to be a promising diagnostic marker for Alzheimer's disease (AD). To evaluate its usefulness in Thai patients, platelet APP was analyzed by immunoblotting. The APP ratio was calculated as the ratio of the combined band density of the 120-kD and 130-kD isoforms compared to that of the 110-kD isoform. The mean ages (and ranges) of 27 normal and 13 AD-affected subjects were 68.3 (60-84) and 79.3 (70-97) years, respectively. The Thai Mental State Examination (TMSE) scores demonstrated that the AD patients had significantly poorer cognitive functions than the normal subjects, with mean TMSE scores of 20.3 and 27.6 (maximum score of 30 points), respectively (p < 0.05). The platelet APP ratios of the AD patients were significantly lower than those of normal subjects: values (mean ± standard deviation) were 7.32 ± 1.29 and 9.13 ± 3.00, respectively (p < 0.05) for AD patients and normal subjects. However, the ranges of the APP ratios from both groups markedly overlapped, which precluded the establishment of a cutoff level to differentiate between the AD and normal subjects. In addition, no significant correlations were observed between the platelet APP ratio and the TMSE score or between the APP ratio and the serum cholesterol in this study, in contrast to previous reports.

Geriatrics & Gerontology International, 2013

Delirium, a common disorder in hospitalized older patients, frequently results in unfavorable con... more Delirium, a common disorder in hospitalized older patients, frequently results in unfavorable consequences. Previous studies in different settings have provided conflicting results regarding clinical outcomes and mortality. We aimed to study three clinical outcomes--length of stay (LOS), in-hospital mortality and 3-month mortality--among delirious Thai older patients. A prospective observational study was carried out in a university hospital in Thailand. All patients aged older than 70 years admitted to general medical wards were included. Delirium assessments were undertaken within the first 24 h of admission and serially until discharge. Subsequent assessments were carried out at 3 months after discharge. Delirium was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria. Factors associated with mortality were determined by using logistic regression models. LOS was significantly longer in the delirium group (10 and 8 days, P = 0.001). Furthermore, the delirium group had higher in-hospital and 3-month mortality (P &amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Factors significantly associated with in-hospital mortality in multivariate analysis were age more than 80 years (AOR 2.74, 95% CI 1.05-7.15), malignancy (AOR 3.11, 95% CI 1.16-8.33), severe illness (AOR 3.75, 95% CI 1.38-10.20) and delirium (AOR 7.34, 95% CI 1.51-35.69). Delirium remained a strong predictor for 3-month mortality in multivariate analysis with AOR of 3.33 (95% CI 1.45-7.62) CONCLUSIONS: Delirium was associated with prolonged hospital-stay and was the strongest predictor for mortality among older hospitalized patients. It requires serious attention from physicians, healthcare administrators and policy makers to implement an appropriate management plan for this high-burden issue.

Advances in Health Sciences Education, 2005

Utilization of objective structured clinical examinations (OSCEs) for final assessment of medical... more Utilization of objective structured clinical examinations (OSCEs) for final assessment of medical students in Internal Medicine requires a representative sample of OSCE stations. The reliability and generalizability of OSCE scores provides validity evidence for OSCE scores and supports its contribution to the final clinical grade of medical students. The objective of this study was to perform item analysis using OSCE stations as the unit of analysis and evaluate the extent to which OSCE score reliability can be improved using item analysis data. OSCE scores from eight cohorts of fourth-year medical students (n = 435) in a 6-year undergraduate program were analyzed. Generalizability (G) coefficients of OSCE scores were computed for each cohort. Item analysis was performed by considering each OSCE station as an item and computing the corrected item-total correlation. OSCE stations which negatively impacted the reliability were deleted and the G-coefficient was recalculated. The G-coefficients of OSCE scores from the eight cohorts ranged from 0.48 to 0.80 (median 0.62). The median number of OSCE stations that negatively impacted the G-coefficient was 3.5 (out of a median of 25 total stations). When the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;problem stations&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; were deleted, the median G-coefficient across eight cohorts increased to 0.62--0.72. In conclusion, item analysis of OSCE stations is useful and should be performed to improve the reliability of total OSCE scores. Problem stations can then be identified and improved.

Clinical Interventions in Aging, 2011

To study the effectiveness of simply-performed balancing exercises in fall prevention. Design: Pr... more To study the effectiveness of simply-performed balancing exercises in fall prevention. Design: Pre-and post-trial. Participants: Elderly with falls in the previous year. Intervention: Simple balancing exercise was performed at home every day and was recorded in the booklet. Measurements: New falling events and a battery of balancing abilities including the Timed Up and Go Test (TUGT), chair stand, functional reach, and Berg balance scale-short form were evaluated at baseline, 3-, 6-, 9-, and 12-month periods. Fear of falling and quality of life scores were assessed at baseline and 12-month periods. Results: 146 subjects were recruited, 116 female (79.5%) with a mean age of 67.1 years. At the end of the study, 49% of participants had not fallen. All of the balancing abilities were compared between frequent and infrequent fallers and were significantly improved (P , 0.001) except for functional reach in the frequent fall group. Most subjects (72%-79%) complied well with the exercise program. However, compliance had no effect on balancing abilities. About 36.4% of participants had adverse events from exercise, of which knee pain was the top ranked. The quality of life and the fall efficacy scores increased significantly at the end of the study. Factors affecting falling were compliance with exercise (adjusted odds ratio [OR]: 2.55, 95% confidence intervals [CI]: 1.04, 6.30) and a history of falling $3 times in the previous year (adjusted OR: 3.76, 95% CI: 1.18, 11.98). Conclusion: Performing simply-designed balancing exercises, at least 3 days per week, can increase balancing abilities, and decrease fall rates in the elderly with a history of previous falls. However, strategies to encourage elderly compliance may prevent falling.