Effect of Covid-19 pandemic on gender associated with risk factors: a retrospective data analysis, Thailand.

Background: The COVID-19 pandemic is having a serious impact around the world. Many countries have experienced a two or three wave pattern in reported cases. The virus's spread in Thailand was a cluster event distributed over multiple locations, multi-spender, and multiple waves of outbreaks. Objective: This study aims to study gender associated with age, risk factors, and nationality during coronavirus pandemic in Thailand. Material and methods: A retrospective cohort study was conducted from January 2020 to May 2021 (17 months) to determine the number of confirmed cases and identify gender associated with, age, various risk factors and nationality were analyzed by chi square test and binary logistic regression analyses. Results: The results show that the number of cases increased by over 100,000 over the course of three waves of outbreaks. The logistic regression analysis revealed that genders were significantly related with age, various risk factors, and nationality across different waves (p < 0.01). Across the primary risk factors were community risk, community cluster and close contact with a previously confirmed patient on confirmed cases during COVID-19 pandemic. Conclusion: Significant differences between genders were significantly associated with age, various risk factors, and nationality may be due to weak social distancing policies and the lack of public health interventions. A COVID-19 vaccination plan is needed for people who are at risk of suffering severe symptoms as well as the general population in outbreak areas to increase immunity.

Burnout prevalence and contributing factors among healthcare workers during the COVID-19 pandemic: A cross-sectional survey study in an urban community in Thailand.

BACKGROUND: Burnout is associated with an increased risk for severe COVID-19. Few studies have examined burnout prevalence related to healthcare workers during the pandemic. This study investigated the burnout prevalence and contributing factors among HCWs, including medical staff and support staff, during the COVID-19 pandemic in an urban community in Thailand. METHODS: A cross-sectional online survey was distributed among HCWs in Bangkok, Thailand, from July-August 2021. The independent t-test and one-way analysis of variance (ANOVA) were used to compare the contributing factors and burnout items. Variable factors associated with burnout among HCWs were used in multiple linear regression models. RESULTS: A total of 517 HCWs' survey responses were received. Most participants were medical staff (55.3%), female (83.4%), and over the age of 35 (59.4%); most participants (65.6%) did not have any diseases but had family members that did (63.6%). The prevalence of overall burnout presented among medical staff (25.9%). The results of the multiple linear regression models found that female (vs. male, ß 0.088; 95% CI 0.033, 6.614) was higher associated with overall burnout score. In addition, hours of sleep as > 6 hr./day (vs. ≤ 6 hr./day, ß -0.120; 95% CI -6.012, -0.969) was lower associated with overall burnout score. CONCLUSION: This study highlights the importance of addressing burnout among HCWs, in which female medical staff who slept less than six hours per day were associated with burnout. Our study further suggested that both intervention and identification are needed of frontline HCWs to prevent and reduce the risk of burnout, as the proportion of females compared to males is high. Thus, the government should provide support in these areas to prevent a humanitarian crisis.

Prevalence of perceived stress and coping strategies among healthcare workers during the COVID-19 outbreak at Bangkok metropolitan, Thailand.

BACKGROUND: Healthcare workers (HCW), who are crucial workforce, have experienced stress during the COVID-19 pandemic. They have been learning to fight against and support patients as much as possible. Thus, this study aims to account for the psychological impact of the COVID-19 outbreaks on the healthcare workers of medical school hospitals in terms of their perceived stress and coping styles. METHOD: This cross-sectional study was conducted from June to August, 2021. 517 HCWs self-administered the online survey. Perceived Stress Scale (PSS-10) in Thai-version was used to examine the perceived stress symptoms. Brief-COPE score was used to determine the coping strategies. Independent sample t-test, one-way analysis of variance (ANOVA), and multivariable regression analysis were utilized. The level of significance was set at p-value < 0.05. RESULT: The prevalence of perceived stress among the HCWs was 41.97%. Coping strategies were used to deal with stress during the outbreak for problem-solving (Mean ± SD = 0.25 ± 0.60) and positive attitude (Mean ± SD = 2.85 ± 0.62). Significant difference was observed in the use of coping strategies among those who differ in marital status (F2, 514 = 7.234, p-value = 0.001), having children (t515 = -4.175, p-value < 0.001), and days off (t515 = -1.992, p-value = 0.047). Multivariable regression analysis reported who those perceived stress symptoms using social support more than those normal stress (AOR 1.54, 95% CI 1.070-2.236, p-value = 0.02). The perceived stress symptoms group used the avoidance strategy 2.03 times more than the other group (AOR 2.03, 95% CI 1.406-2.934, p-value < 0.001). Interestingly, the participants who perceived stress symptoms applied a positive attitude strategy lesser than those who experienced normal stress (57.5%) (AOR 0.42, 95% CI 0.307-0.590, p-value < 0.001). CONCLUSION: The impact of the COVID-19 pandemic on mental distress remains. The findings of this study suggest further study to assess the HCWs' stress after the pandemic. HCWs should consider merging each of the coping strategies to balance work and lifestyle in pandemic situations.

Knowledge, attitudes, and practices related to the COVID-19 pandemic among pregnant women in Bangkok, Thailand.

BACKGROUND: Pregnancy is associated with increased risk for severe COVID-19. Few studies have examined knowledge, attitudes, and practices (KAP) related to pregnancy during the pandemic. This study investigated the association between socio-demographic characteristics and KAP related to COVID-19 among pregnant women in an urban community in Thailand. METHODS: A cross-sectional online survey was distributed among pregnant women in Bangkok, Thailand from July-August 2021. Binary logistic regression was conducted to test the association between socio-demographic characteristics and KAP related to COVID-19, and a Spearman's analysis tested correlations between KAP scores. RESULTS: A total of 150 pregnancy survey responses were received. Most participants were third trimester (27-40 weeks gestation; 68.0%). Pregnancy had never been risked contracting COVID-19 (84.7%). Most expressed concerns about being infected with COVID-19 during pregnancy and following birth (94.0 and 70.0%, respectively). The results of binary logistic regression analysis found associations between knowledge and marital status (OR = 4.983, 95%CI 1.894-13.107). In addition, having a bachelor's degree or higher was associated with higher attitude scores (OR = 2.733, 95%CI 1.045-7.149), as was being aged 26-30 (OR = 2.413 95%CI 0.882-6.602) and 31-35 years of age (OR = 2.518-2.664, 95%CI 0.841-8.442). Higher practice scores were associated with having a bachelor's degree or higher (OR = 2.285 95%CI 1.110-6.146), and income ≥15,001 bath (OR = 4.747 95%CI 1.588-14.192). Correlation analysis found a weak positive correlation between knowledge and practice scores (r = 0.210, p-value = 0.01). CONCLUSION: Participants overall had high KAP scores. This study can guide public health strategies regarding pregnant women and COVID-19. We recommend that interventions to improve and attitude and practice scores. Knowledge on pregnancy and COVID-19 should focus on reducing fear and improving attitudes toward the care of patients as well as the promotion of preventive practices.

Covid-19 knowledge, attitudes, and practices among healthcare workers in urban community Bangkok, Thailand.

Objective: This study examined associations between socio-demographic characteristics and knowledge, attitudes, and practices (KAP) related to COVID-19 among healthcare workers in Bangkok, Thailand. Materials and methods: A cross-sectional online survey was distributed among healthcare workers in Bangkok, Thailand from July - August 2021. Results: A total of 637 responses were received. Most participants were clinical workers (68.4%), and nearly half (47.3%) had been at risk of infection with COVID-19 (ever screening test). Binary logistic regression analysis found associations between high knowledge scores and the 26-35-year age group (OR=1.776-1.562, 95%CI 1.021-2.853), having a bachelor's degree or higher (OR=1.672, 95%CI 1.058-2.644), and clinical workers (OR=1.784, 95CI% 1.188-2.678). The 36 year and above age group was associated with higher attitude scores (OR=2.406, 95%CI 1.567-3.695). Higher practice scores were associated with females (OR=1.913, 95%CI 1.057-3.464), and clinical workers (OR=1.903, 95CI% 1.170-3.095). Correlation analysis found a positive correlation between practice scores and knowledge (r=0.322, p <0.001) and attitudes (r=0.263, p <0.001). Conclusion: Although healthcare workers demonstrated overall high knowledge, attitude, and practice scores, this study identified several factors that influence KAP. This study can guide public health strategies regarding healthcare workers during the third wave of the COVID-19 pandemic in Thailand.

Seasonal variation in the prevalence of preeclampsia.

OBJECTIVE: To determine whether there is a seasonal impact on the prevalence of preeclampsia in the tropical climate of Bangkok. MATERIAL AND METHOD: Medical records of all singleton pregnant women who delivered in the authors' institution between 2008 and 2009 were reviewed. The meteorological variables during the study period were obtained from database of the Thai Meteorological Department. The period of study was then divided into two main seasons: monsoon and dry seasons. The rates of preeclampsia occurring in the two seasons, based on the date of conception and date of delivery, were compared. RESULTS: Data of 7,013 gravidas were included for analysis. Of these, 327 (4.7%) developed preeclampsia. The monsoon season had lower mean maximum temperature (37.0 degrees C vs. 38.1 degrees C, p = 0.114), was more humid (77.0% vs. 68.7%, p < 0.001) and had higher daily rainfall (196.5 mm vs. 37.0 mm, p < 0.001) than dry season. Women who conceived in the dry season were at greater risk to develop preeclampsia than those who conceived in the monsoon season (5.3% vs. 3.7%, adjusted OR 1.51; 95% CI 1.18-1.93). The preeclampsia rates of women who delivered in both seasons were not significantly different: 5.0% in the dry season vs. 4.3% in the monsoon, p = 0.178. CONCLUSION: There is a seasonal impact on the prevalence of preeclampsia based on the time of conception, but not the time of delivery. The rate of preeclampsia is significantly higher when conception occurs in the dry season.

Prevalence of exclusive breastfeeding at 3, 4 and 6 months in Bangkok Metropolitan Administration Medical College and Vajira Hospital.

OBJECTIVE: To determine the prevalence of exclusive breastfeeding at 3, 4, and 6 months postpartum in women who delivered at Bangkok Metropolitan Administration Medical College and Vajira Hospital, and to evaluate the potential factors for continuation of exclusive breastfeeding. MATERIAL AND METHOD: A prospective descriptive study was performed in 210 mothers who delivered in the authors' institution between December 1, 2006 and February 28, 2007. All eligible subjects were interviewed before discharge from the hospital. The successive postpartum interviews were then conducted via telephone at 3, 4, and 6 months after delivery. RESULTS: Average maternal age was 27 years and over half (54.3%) were primipara. Rates of exclusive breastfeeding at 3, 4, and 6 months were 48%, 26%, and 11% respectively. Significant factors for exclusive breastfeeding were duration allowed for work absence and intended time to breastfeed. CONCLUSION: Approximately half of the mothers in the present study provided exclusive breastfeeding to their babies in the first 3-month postpartum. The prevalence of exclusive breastfeeding at 6 months was lower than the 30% goal of the 9th National Economic and Social Development Plan. The need to return to work and intended time to breastfeed were the significant factors affecting duration of exclusive breastfeeding.

Results of laparoscopic pelvic and/or para-aortic lymphadenectomy in gynecologic oncology patients in Bangkok Metropolitan Administration Medical College and Vajira Hospital.

OBJECTIVE: To determine the results of laparoscopic lymphadenectomy in gynecologic oncology patients. MATERIAL AND METHOD: Medical records of 31 gynecologic oncology patients who underwent laparoscopic lymphadenectomy between November 1, 2004 and February 28, 2007 were retrospectively reviewed. RESULTS: The median age of the study population was 47 years (range 24-77 years). Sixteen patients (51.6%) had endometrial cancer while 15 (48.4%) had ovarian malignancy, with median numbers of resected pelvic and paraaortic nodes of 12 (range 3-30 nodes) and 1 (range 1-3 nodes). The groups of lymphadenectomy only, lymphadenectomy with total laparoscopic hysterectomy, and lymphadenectomy with laparoscopic assisted vaginal hysterectomy had median blood losses of 100 ml (range 30-220 ml), 350 ml (range 100-800 ml), and 200 ml (range 150-400 ml) respectively. Accidental injuries of common iliac artery and large bowel occurred in two patients, all of whom were converted to a laparotomy for correcting the damaged sites. Overall, the median duration for postoperative recovery was three days (range 2-8 days). CONCLUSION: The results suggest that surgical staging for gynecologic malignancies can be adequately performed through laparoscopic surgery, with benefit in terms of early postoperative recovery.

First 4-hour urinary protein - creatinine ratio for diagnosis of significant proteinuria in preeclampsia.

OBJECTIVE: To evaluate the diagnostic accuracy of the first 4-hour urinary protein - creatinine ratio for prediction of the significant proteinuria in preeclampsia. STUDY DESIGN: Diagnostic test SUBJECTS: One hundred and sixty-four pregnant women who were initially diagnosed with hypertensive disorder and hospitalized in the obstetric ward and labor room at Bangkok Metropolitan Administration Medical Collage and Vajira Hospital between July 2005 and April 2006. MATERIAL AND METHOD: Urine samples were collected within 24 hours in two consecutive periods: the first 4 hours and the next 20 hours. The urine volume, urine protein and creatinine concentration were separately measured and the first 4-hour urinary protein - creatinine ratio were calculated. With the use of a protein level > or = 300 mg in 24 hours urine collection as the gold standard, the sensitivity and specificity of the first 4-hour urinary protein-creatinine ratio for diagnosis of significant proteinuria were determined with cutoffs range. RESULTS: One hundred and sixty four patients were recruited for this study including 112 patients (68.3%) who had preeclampsia. The first 4-hour urinary protein-creatinine ratio was most accurate for diagnosis of preeclampsia is 0.30 with 81% sensitivity, 88% specificity, PPV of 93%, and NPV of 71%. CONCLUSION: The first 4-hour urinary protein-creatinine ratio at 0.3 is the most accurate value for diagnosis of significant proteinuria in preeclampsia