Burapha Journal of Medicine

Central retinal artery occlusion due to giant cell arteritis: A case report

Kanyarat Thammakumpee — 2025-06-26

Introduction: Reports of giant cell arteritis cases in Thailand remain limited, despite its clinical significance.

Objective: To describe the symptoms, clinical manifestations, ophthalmologic assessments, laboratory investigations, and histopathological characteristics of patient with Central retinal artery occlusion due to giant cell arteritis

Case presentation: This case report presents an elderly Thai male patient who experienced a sudden onset of bilateral vision loss accompanied by a persistent headache. Three weeks later, the patient developed progressively worsening headache, generalized fatigue, and jaw claudication for three days before seeking medical attention. A comprehensive clinical evaluation was performed, including visual acuity assessment and detailed fundoscopic examination. Laboratory investigations revealed significantly elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. A temporal artery biopsy was subsequently conducted to confirm the diagnosis of giant cell arteritis (GCA). GCA is a systemic inflammatory disease affecting medium- to large-sized arteries, which can result in severe and irreversible vision loss. It is considered an ophthalmologic emergency that requires prompt recognition and urgent management. Early diagnosis and immediate initiation of corticosteroid therapy are critical in preventing permanent visual impairment and other complications.

Conclusion: The effective management of GCA necessitates a multidisciplinary approach, particularly involving collaboration between ophthalmologists and other medical specialists.

Exercise for student to prevent hyperkyphosis

Pimonpan Taweekarn — 2025-06-26

Context: Tablets are frequently used by students for study – up to an average of 3-3.5 hours per day. Research reports link tablets to health problems such as headaches, neck and shoulder pain.

Objective: To review exercise routines for both the prevention and treatment of hyperkyphotic symptoms.

Materials and Methods: Literature was reviewed from research articles from the Thai Journal Online (ThaiJO), ScienceDirect and Pubmed. The keywords were “kyphosis,” “respiratory function” and “Ruesi Dutton,” for articles published between 2007-2023.

Results: 2 hours of tablet use with poor posture can trigger muscle discomfort. Changing posture may decrease discomfort in the upper extremity and neck. The posture during tablet use consists of trunk flexion, round shoulder and shoulder elevation, which leads to musculoskeletal pain. However, when the tablet is placed flat on the desk, while there is an increase in shoulder flexion and elevation, respiratory function is decreased. Exercises such as Ruesi Dutton may be useful to promote trunk mobility.

Conclusion: Sitting for a long time with poor posture (slump sitting) can lead to thoracic hyperkyphotic. Ruesi Dutton has proven, with much research, to help decrease, and even prevent, thoracic hyperkyphotic.

Editor's Note

Somjit Prueksaritanond — 2025-06-26

บูรพาเวชสาร ปีที่ 12 ฉบับที่ 1 เดือนมกราคม - มิถุนายน 2568 (BURAPHA JOURNAL OF MEDICINE: Bu J Med Vol.12 No.1 January – June 2025) ผู้นิพนธ์นาเสนอบทความวิจัยและบทความวิชาการที่คณะกรรมการผู้ทรงคุณวุฒิ (Peer Review) ได้พิจารณากลั่นกรองบทความเพื่อความสมบูรณ์ และคุณภาพ สุงสุดก่อนการเผยแพร่สู่สาธารณะ บทความที่อยู่ในวารสารจึงมีความรู้ใหม่ นวัตกรรม ที่เกิดจากงานวิจัย ด้วยการดำเนินงานวิจัย วิเคราะห์ และสังเคราะห์ข้อมูล เพื่อตอบวัตถุประสงค์ที่กำหนดไว้และมีแนวทางการนำไปประยุกต์ใช้ให้เกิดประโยชน์ต่อบุคคล ครอบครัว ชุมชน สังคม และประเทศชาติ ฉบับนี้ประกอบด้วยบทความวิจัย 6 บท และบทความวิชาการ 1 บท

Prevalence of non-communicable diseases and factors related to occupational physical activity among workers in the Amata Nakorn Industrial Estate

Anothai Juttuporn — 2025-06-26

Context: The prevalence of non- communicable diseases (NCDs) is rising among the working-age population, and work conditions may pose a significant risk for NCDs.

Objective: This study aimed to examine the prevalence of NCDs in a workforce, and to correlate those NCDs with the levels of occupational physical activity exerted by those workers in their daily responsibilities.

Methodology: This study employed a retrospective approach by collecting data from the medical statistics system of the Vipharam Amata Nakorn Hospital, which serves workers from the Amata Nakorn Industrial Estate. In 2019, data was collected from the medical statistics of the hospital after the Estate workers underwent an annual health check. The total sample consisted of 1,618 individuals. Descriptive statistics were used to present prevalence rates of NCDs. From this group, 1,212 workers with complete job characteristic data (i.e., physicality of work) were selected and divided into two categories: 1,034 workers engaged in light-level physical activity and 178 workers in moderate-level physical activity. Multivariate logistic regression analysis was used to examine the impact of occupational physical activity on disease, adjusting for gender and age effects.

Results: The prevalence of NCDs was as follows: obesity (28.67%), hypertension (13.91%), suspected diabetes mellitus (3.50%), abnormal triglycerides (27.69%), abnormal total cholesterol (53.74%), low HDL (10.38%), high LDL (72.32%), abnormal electrocardiogram (11.50%), abnormal
kidney function (8.05%), abnormal liver function (1.58%), positive hepatitis B virus infection (3.45%), abnormal audiogram (48.62%), abnormal spirometry (17.59%), abnormal occupational vision test (occupational) (72.92%). Regarding occupational physical activity, after adjusting for age and sex, workers with light-level physical activity were found to have a 1.5 times higher risk of obesity compared to those with moderate-level activity (AOR: 1.50, 95% CI: 1.07–2.10). Likewise, a significantly higher risk of abnormal electrocardiograms were found—15 times compared to the moderate-level group (AOR: 15.22, 95% CI: 6.71–34.51).

Conclusion: Common NCDs among workers in the Amata Nakorn Industrial Estate include obesity, dyslipidemia, hypertension, and diabetes mellitus-all of which are risk factors for cardiovascular complications. Workers with light-level occupational physical activity are particularly prone to NCDs. Therefore, lifestyle modifications are essential for preventing NCDs among Thai workers.

The effects of implementing teaching programs to develop knowledge and responsibilities of caregivers attending to children with Thalassemia Sakaeo at the Crown Prince Hospital in Thailand

Kannika Sirito — 2025-06-26

Introduction: Thalassemia is a genetic disease caused by a blood disorder that is commonly found in Thailand and is a major public health problem of the country. Children with thalassemia need to be treated with blood transfusions, often causing patients to have an overload of iron.
Therefore, the caregivers’ treatment is important when supervising children.

Objectives: To plan a teaching program for caregivers tending to children with thalassemia, and compare their knowledge and behavior before and after attending the courses.

Method: A quasi-experimental research plan with a pre- and post-test group was conducted on a sample of 14 caregivers of children with thalassemia who were receiving regular blood transfusions. The 14 cases were from the Somdech Phra Yuppharat Hospital in Sa Kaeo, Thailand. The results from launching this teaching program were analyzed using descriptive statistics and Wilcoxon signed - rank test with a statistical significance at p ≤ 0.05.

Results: After receiving the teaching program, the caregivers had significantly higher scores on the appropriate knowledge and behavior of children with thalassemia (p = 0.001 and p = 0.020, respectively).

Conclusions: The teaching program on knowledge of thalassemia and advice before discharging patients can provide caregivers with better knowledge and behavior to care for their patients. Therefore, a systematic program of knowledge and advice on nursing about thalassemia should be implemented.

Prevalence and factors related to motorcycle accidents among students receiving treatment at Burapha University Hospital in 2019

Thanate Thanasarnwimon — 2025-06-26

Context: Student motorcycle accidents are common near universities.

Objective: To study the prevalence and factors related to motorcycle accidents among students receiving treatment at Burapha University Hospital.

Methodology: A retrospective cross-sectional analytic study was conducted using medical records of students who experienced motorcycle accidents between January 1 and December 31, 2019, with a total of 581 cases. A sample of 467 cases was used for analysis of associated factors. Data were analyzed using descriptive statistics and logistic regression analysis.

Results: A total of 581 students were found to have been involved in motorcycle accidents, representing a high prevalence among trauma patients. From the 467 sampled cases, alcohol consumption was significantly associated with head and neck injuries (OR 4.798, p < 0.001). The average treatment cost was 3,951.15 baht.

Conclusion: Not wearing a helmet and alcohol consumption were significant risk factors associated with severe injuries among university students. Therefore, safety promotion measures such as encouraging helmet use and discouraging alcohol consumption should be implemented to reduce the severity of motorcycle accidents.

Risk factors associated with mortality in patients with Streptococcus suis infections: A retrospective cohort study conducted at the Somdejphrajaotaksinmaharaj Hospital in Tak Province, Thailand

Kanyamas naosang — 2025-06-26

Context: Streptococcus suis is a bacterium that lives in the upper respiratory tracts and digestive tracts of pigs. It is a disease that can be transmitted from animals to humans through direct contact, but also through wounds and other factors, including patient medical history, and can lead to mortality.

Objective: To study the risk factors resulting in death, as well as the general characteristics of the disease, from the medical data of patients diagnosed with a Streptococcus suis infection. The patient group was selected from the Somdejphrajaotaksinmaharaj Hospital in the Tak province in North-West Thailand.

Material and methods: This study was a retrospective cohort study. Data were collected between January 1, 2013 - June 30, 2024 from the medical records at the Somdejprachaotaksinmaharaj Hospital. The medical records included a full investigation report as stored in the hospital’s
HOSxP program. A total of 51 cases were analyzed using descriptive statistics and inferential statistics (Mann-Whitney U test, with significance at 0.05).

Result: The 51 patients, most of whom were male (80.39%), and were living in the Tak province (68.62%), had an average age of 33.30±57.12 years. Many of the patients worked as general laborers (52.94%). The patients had a history of smoking and drinking (78.43% and 41.18%), and had consumed raw pork or pork products, but had no other contact with pork or raw pork (45.10% and 86.27%). The laboratory test results of many of the patients showed a high white blood cell count and a low platelet count (81.60% and 18.40%). The patients were hospitalized for less than or up 15 days, most with symptoms improving (92.16%). However there was a 7.84% mortality rate. Most of the deceased patients were monks (50.00%). Factors to consider were the patient’s occupation and medical history, of either alcoholic liver disease or endocarditis, These three factors were statistically significant regarding patient mortality rates
from Streptococcus suis infections (p = 0.014, 0.010 and 0.025, respectively).

Conclusion: Statistically significant risk factors for mortality in patients with a Streptococcus suis infection were occupation, alcoholic liver disease and endocarditis.

Studies of prescribing errors from pharmaceutical services for in-patients of a general hospital

Khanitta Potjanabunpot — 2025-06-26

Introduction: Prescribing errors are events that may lead to the inappropriate or harmful use of medication by patients. Additionally, such errors are one of many quality indicators for hospitals. Analyzing these incidents reveals not only the frequency of errors made, but can also signal causes in prescribing errors that need correction.

Objective: To study the rate of occurrence and analyze the causes of prescribing errors.

Methods: This descriptive study extracted data from physician’s orders as recorded in the hospital computer system during office hours from 1 September 2023 - 29 February 2024. The data were collected in medication error report forms for statistical analysis.

Results: A total of 549 prescribing errors were recorded. The five most common errors were supra-therapeutic dosages (186 times, 33.88%), sub-therapeutic dosages (118 times, 21.49%), cases of the wrong drug (114 times, 20.77%), the need for additional drug therapy (45 times, 8.20%), and duplicate drug treatments (22 times, 4.01%).

Conclusion: According to the study, the most common prescribing errors were high dosages. Therefore, provision of strategies should be established to develop a system that prevents prescribing errors, along with a program to continuously collect data, monitoring the system’s effectiveness as more improvements are made.