Sense of identity as a family physician. Applying the four principles of family medicine in a remote Thai village.
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Biomedical subjects
Publications and source records attributed to S Hathirat.
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In Thailand, Buddhist monks and temples are scattered throughout the country even in the rural poor. There are approximately one temple and four monks for every two villages of about 1000 people. If Buddhist monks are able to expand their roles to health care and education, Buddhist temples will automatically become community health posts and 'Health for All by The Year 2000' will be achieved within 5-10 years in Thailand. Therefore, a volunteer monk-training program has been carried out and about 2000 graduates have returned to their community to disseminate primary health care. However, a systematic and 'industrialized' approach is necessary to get some visible impact on the health of the rural Thai population.
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The effect of physical training on hemodynamic performance was evaluated in a group of patients who had had a myocardial infarction and a group of healthy, age-matched controls. Before training, the patients' mean ventilatory equivalent was significantly less than that of the controls at the lowest workload (300 kpm/min), the mean stroke volume was significantly increased at the highest workload then achieved (600 kpm/min), and the mean arteriovenous oxygen content difference was significantly smaller at the highest workload. The patients had a relative bradycardia before training and there was no significant reduction in mean resting or submaximal heart rate after training. Their mean oxygen uptake was significantly reduced at the lowest exercise workload after training and this response was significantly different from that of the controls after 8 weeks of training. Mean cardiac output during exercise was significantly reduced in the patients after training, but only at the 600-kpm/min workload, the response being blunted at 900 kpm/min; mean stroke volume was also significantly reduced at this workload after training; both these responses were significantly different from those of the controls Mean arteriovenous oxygen content difference at 6oo kpm/min was significantly increased in the patients after training, though the response was not significantly different from that of the controls. Mean ventilatory equivalent was also significantly increased in patients after training, becoming similar to that of the controls.
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