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Jin Sothornwit,1 Gulapar Srisawasdi,2 Atchara Suwannakin,2 Apiradee Sriwijitkamol1 1Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand; 2Foot Clinic, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Bangkok, Thailand Purpose: The aim of this study was to investigate health-related quality of life (HRQoL) in patients with diabetic foot problems and compare the HRQoL between diabetic patients with: 1) diabetic foot problems (DF), including diabetic foot ulcer (DFU) or amputation (AMPU); 2) other diabetic complications (COM), such as diabetic retinopathy (DR), end-stage renal disease (ESRD), or coronary artery disease (CAD); and 3) no diabetic complication (CON).Patients and methods: A total of 254 diabetic patients were studied in a cross-sectional setting. HRQoL was evaluated using Thai version of the Euro Quality of Life Questionnaire (EuroQoL), with five dimensions and five-level scale (EQ-5D-5L). Utility scores were calculated using time trade-off methods.Results: A total of 141 patients in the DF group (98 DFU and 43 AMPU groups), 82 in the COM group (27 DR, 28 ESRD, and 27 CAD groups), and 31 in the CON group were interviewed. The mean age was 63.2±12.1 years, body mass index was 24.9±4.7 kg/m2, mean hemoglobin A1c was 7.7±2.1%, duration of diabetes was 13.1±9.9 years, and the mean utility scores were 0.799±0.25. After having DF, 21% of patients had lost their jobs. The COM group had lower utility scores than the CON group. Among the diabetic complications, the DF group had the lowest mean utility scores as compared to the COM and CON groups (0.703±0.28 in the DF group, 0.903±0.15 in the COM group, and 0.961±0.06 in the CON group, P

Objective: The aim of this study was to find a technique to make a disposable monofilament which is accurate and affordable for Thailand context. A prototype of local made monofilament was developed and tested with the calibrated universal machine test to evaluate its performance compared with the commercial monofilament. Effect of the uncontrolled humidity condition on the performance of the commercial monofilament was also studied. Methods: Review of literatures showed no published specifications of the monofilament. The investigators set the concepts that materials must be locally available and affordable. Also, the unit cost must be affordable for primary care units in Thailand. Monofilament’s fabrication technique was developed and the accuracy test of monofilament force was performed and compared with the commercially available monofilament. Results: The specification of locally made disposable 10-gram Semmes-Weinstein monofilament was identified. The force of the monofilaments developed was in an acceptable range for a standard clinical practice and comparable to the commercially available monofilament. From the study, the effect of Thailand’s humidity conditions can deteriorate the performance of the monofilament. The investigators decided to use a disposable monofilament one to ensure its hygiene and accuracy. Conclusion: The local made disposable 10-gram Semmes-Weinstein monofilament was developed. The material is available and affordable for Thailand context. The accuracy of the monofilament’s force was measured by a calibrated testing apparatus. Availability, durability, and cost are important issues to be concerned for medical tools that have been recommended to use worldwide. The result from this study could be applied to other countries that have similar conditions as Thailand.

Purpose: The aim of this study was to investigate health-related quality of life (HRQoL) in patients with diabetic foot problems and compare the HRQoL between diabetic patients with: 1) diabetic foot problems (DF), including diabetic foot ulcer (DFU) or amputation (AMPU); 2) other diabetic complications (COM), such as diabetic retinopathy (DR), end-stage renal disease (ESRD), or coronary artery disease (CAD); and 3) no diabetic complication (CON). Patients and methods: A total of 254 diabetic patients were studied in a cross-sectional setting. HRQoL was evaluated using Thai version of the Euro Quality of Life Questionnaire (EuroQoL), with five dimensions and five-level scale (EQ-5D-5L). Utility scores were calculated using time trade-off methods. Results: A total of 141 patients in the DF group (98 DFU and 43 AMPU groups), 82 in the COM group (27 DR, 28 ESRD, and 27 CAD groups), and 31 in the CON group were interviewed. The mean age was 63.2±12.1 years, body mass index was 24.9±4.7 kg/m², mean hemoglobin A1c was 7.7±2.1%, duration of diabetes was 13.1±9.9 years, and the mean utility scores were 0.799±0.25. After having DF, 21% of patients had lost their jobs. The COM group had lower utility scores than the CON group. Among the diabetic complications, the DF group had the lowest mean utility scores as compared to the COM and CON groups (0.703±0.28 in the DF group, 0.903±0.15 in the COM group, and 0.961±0.06 in the CON group, P<0.01). There was no difference in the mean utility scores between DFU and AMPU groups. Patients in the DF group reported moderate-to-severe problem in all dimensions more than the other groups. Conclusion: DF have the greatest negative impact on HRQoL. Therefore, diabetic foot care should be emphasized in clinical practice to prevent foot complications. [ABSTRACT FROM AUTHOR]

Objective: Therapeutic hypothermia is a recommended treatment by standard guidelines for patients after cardiac arrest but it is not distinguished in Thailand. The present report aimed to demonstrate feasibility of its use in Thailand., Case Report: Two cases of patients after cardiac arrest treated with therapeutic hypothermia are reported. Surface cooling method with Arctic Sun system was applied in both cases. Core temperature curve and serial laboratory parameters are also reported., Conclusion: This initial experience of therapeutic hypothermia after cardiac arrest with surface cooling method implicates feasibility of its use in Thailand.

Primary Objective: To study the effect of calf stretching box usage in increasing the compliance of performing calf stretching exercise as compared to the conventional exercise method., Secondary Objective: To study the effect of calf stretching box usage in decreasing the calf muscle tightness and complications as compared to the conventional exercise method., Material and Method: Eighty patients older than 45 years old with calf muscles tightness were enrolled in a prospective, randomized single-blinded controlled trial at the out-patient Rehabilitation medicine clinic, Siriraj Hospital, Bangkok Thailand between April and August 2009. Patients were randomized into two groups, the study group (stretching by using calf stretching box) and the control group (stretching by the conventional exercise method). Patients in both groups were asked to hold the stretch for at least 1 minute and to perform the stretching program at least two times per day, every day for two weeks. Furthermore, they were asked to record the real frequency and duration of their exercise and complications in a logbook every day., Results: Thirty-eight patients in each group completed the study. The baseline characteristics of the patients in both groups were similar. The study group had higher frequency and longer duration of performing calf stretching exercise than the control group. They also reported more decrease of calf muscle tightness with less pain complication (shoulder pain, knee pain, low back pain, and calf muscle pain) than the control group (p < 0.05). However, there were no significant differences in the (between before and after) numbers of taut bands, trigger points, and tender points of calf muscle and degree of ankle range of motion between the two groups., Conclusion: Stretching calf muscle with calf stretching box can increase compliance, decrease calf muscle tightness and decrease complications when compared with the conventional exercise method.