Buddhachinaraj Medical Journal

Regenerative Endodontics for Management of Non-vital Immature Permanent Tooth: A Case Report

Kanungnit Tangsangiamvisai — 2025-09-16

Endodontic management of necrotic permanent immature teeth is a challenge for the dentist. An open apex, an unusually wide foramen, a tooth with thin root dentin and large canal lumen make the tooth prone to fracture. This report presents a case of regenerative endodontics treatment of permanent immature tooth with pulpal necrosis and symptomatic apical periodontitis and immature root development in 9-year- old patient. The treatment involved disinfecting the root canal system, followed by application of triple antibiotic paste to create a space for blood clot to form, allowing cells to grow. Finally, the access was sealed with mineral trioxide aggregate (MTA) placed apically to the cementoenamel junction, followed by glass-ionomer and resin boned cement over the MTA. After 24 and 36 months of follow-up, the patient was asymptomatic, with no abnormal mobility, and radiographic examination showed root development, lateral thickening, and apical closure. The outcome of this treatment indicates that regenerative endodontics therapy can be successfully performed in non-vital immature permanent teeth and can provide favorable long-term results

Surgical Removal Impacted Teeth under Local Anesthesia in Autistic Patient

Supicha Tangpiboontam — 2025-09-16

A 21-year-old Thai male patient with autism level 1 visited a dentist due to a partially impacted tooth. The diagnosis was horizontal Impaction Class II position B of the left lower third molar. The patient’s family was not comfortable met treatment under general anesthesia and the long waiting time. The treatment results demonstrated that an autistic patient with level 1 was able to co-operate during surgical removal under local anesthesia. However, the level of co-operation and impacted tooth position must be considered to control the duration of the procedure. This report may serve as an alternative for other autistic patients to improve their quality of life

Transfer of Learning After Training on Succession Planning for the Position of Ward Head

Kittiyakon Soinak — 2025-09-16

Succession planning training consumes a substantial amount of time and budget. Therefore, hospitals expect that head nurse who have completed training programs will be able to transfer the learned knowledge to their duties. This descriptive study aimed to explore the level of learning transfer in a succession planning program and the related factors. The population consisted of 37 head nurses who completed a succession planning program and had between 6 months and 5 years of experience in a head nurse position. The research instruments consisted of a questionnaire on learning transfer in a succession planning program and had a reliability value of 0.80, and an interview guide related to the factors associated with transfer of learning in a succession planning program. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed by content grouping. The results showed that 45.9% of head nurses had a high level of learning transfer, whereas the remaining had learning transfer at levels of quite low. Factors related to learning transfer were training format, successor characteristics and work environment. Based on the findings of this study, nursing managers can design activities that support the transfer of learning into head nurses’ practice.

The Impact on Children from Teenage Pregnancy

Natthathee Thanachaiyapan — 2025-09-16

Teenage pregnancy is a global issue and a significant health concern in Thailand. This case control study investigated the impact on children born to teenage mothers compared to those born to mothers over 20 years old, using data from medical records and a teenage screening form from the Adolescent Clinic at Buddhachinaraj Phitsanulok Hospital. The study included personal and medical data such as maternal age, gestational age, chronic diseases, delivery method, birth weight, hematocrit, length and weight of the child, and developmental milestones. Statistical analysis was used to assess the incidence and outcomes of teenage pregnancy. It was found that between 1 July 2021 and 31 December 2022 (18 months), there were a total of 4,387 children born, of which 1,132 (25.8%) were teenage mothers. Infants born to teenage mothers and mothers over 20 years of age were born prematurely at 17.2 % and 13.6 %, respectively. Teenage mothers and mothers over 20 years of age exclusively breastfed their babies at 56.9% and 63.7%, respectively. Delayed expressive language was observed in 3.7% of children born to teenage mothers compared to those born to older mothers (p = 0.035). The findings indicate that children born to teenage mothers are more likely to have health problems than other mothers.

Masticatory Efficiency After Botulinum Toxin Injection in the Masseter Muscl

Napasorn Sawadsopanont — 2025-09-16

Botulinum toxin (BoNT) injections into the masseter muscle are a popular, minimally invasive approach for lower face contouring. While altered masticatory function and chewing difficulties have been reported. This quasi-experimental clinical study aimed to investigate changes in masticatory function following BoNT type A injection into the masseter muscle. Twenty-four participants received injections of 50 units of botulinum toxin into the masseter muscles bilaterally and had their chewing performance assessed using a food chewing questionnaire completed online before injection and at 4, 8 and 12 week post-injection. Results showed no significant changes in masticatory performance throughout the 12-week study period. Median scores (out of 30) were 27.50 (baseline), 30.00 (4 weeks), 27.00 (8 weeks), and 24.00 (12 weeks), with no differences. This study suggests that BoNT-A injection into the masseter muscle does not significantly impair subjective masticatory function by a self-assessment questionnaire.

A Health Promotion Model (HPM) for Dependent Elderly People (DEP): A Case Study of Phromphiram District, Phitsanulok Province

Manatsak Markboon — 2025-09-16

The health promotion model for dependent elderly people has continued to develop, resulting in better health conditions for the elderly. This quasi-experimental research aims to study the results of using the health promotion model for dependent elderly people, a case study in Phrom Phiram District. Phitsanulok Province. Using the serial research model, one group time-series design studied in 258 dependent elderly people in Phrom Phiram District. Phitsanulok Province. The results of using the health promotion model for dependent elderly people found that the ability to perform daily activities after using the health promotion model for dependent elderly at the 1st, 2nd and 3rd month was significantly different (p < 0.001) in all aspects except for the 5th dimension, p = 0.001. The results of the stakeholder satisfaction assessment found that 471 stakeholders were at a good level of satisfaction (mean = 4.14). Which shows that this form of health promotion model for dependent elderly people can be effectively used further.

The Proportion and Clinical Differences of Hydralazine Associated ANCA Associated Vasculitis Compare to Primary ANCA Associated Vasculitis

Manoch Ouwuttipong — 2025-09-16

Hydralazine, known as drug, induced anti-neutrophilic cytoplasmic antibody (ANCA) associated vasculitis (AAV), is a vasodilator used as an adjunct drug for the treatment of moderate to severe hypertension and heart failure with a reduced ejection fraction. AAV is a rare phenomenon, that causes severe pulmonary and nephritis syndrome. This retrospective study was conducted to compare the proportion and differences of AAV in patients taking hydralazine compared to primary ANCA-associated vasculitis, 75 cases of AAV were found, 38 cases were hydralazine-AAV, accounting for 50.67% of AAV. The presence of red blood cells in the urine, diffuse alveolar hemorrhage, inflammation of the lungs and respiratory failure were no difference between the two groups. Treatment was not difference between both groups, with plasma exchange, intravenous pulse methylprednisolone, cyclophosphamide, dialysis from the beginning, and the need for long-term dialysis, was up to more than 30% in both groups. The mortality rate was very high in both groups. In conclusion, hydralazine causes more than half of all ANCA-associated vasculitis cases. Clinical manifestation, laboratory, serologic studies, treatment, the need for long-term dialysis and mortality are not different in both groups.

Time from Extubation to Death in Terminally Ill Patients Who Chose Home Palliative Care versus Hospital Care

Varitsara Tangtrakul — 2025-09-16

Most families let terminally ill patients die in hospital due to uncertainty about the patients’ prognosis if they go home after extubation. This research aims to compare the time from extubation to death of terminally ill patients who chose home palliative versus hospital care. The study uses data from a prognostic factor in a retrospective observational cohort design, tracking data from 5 years at Buddhachinaraj Hospital, Phitsanulok. The duration from extubation to death is measured. It was found that among 171 terminally ill patients who were extubated, 89 patients who chose to die at home had a median time from extubating to death of 4 hours (Q1, Q3 = 2, 19 hours), while 82 patients who chose to die in the hospital had a median time of 3 hours (Q1, Q3 = 2, 20 hours). After adjusting for differences between the two groups of patients, those terminally ill patients who chose to die at home had a 0.3-hour (approximately 18 minutes) sooner chance of dying (95% CI: sooner than 10.8 hours to later than 10.2 hours) with no statistical significance (p = 0.955). These results help guide families in choosing the most appropriate place of care for terminally ill patients based on individual context

Hospitalization Rate and Causes of Hospitalization Among End Stages Renal Disease Patients Treated with Hemodialysis, Continuous Ambulatory Peritoneal Dialysis and Palliative Care

Supansa Seenoo — 2025-09-16

End-stage renal disease (ESRD) is a significant public health issue affecting patient outcomes and healthcare resources. This study compared hospitalization rates and cause of hospitalization among ESRD patients receiving hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), and palliative care. A retrospective study of 227 ESRD patients at Lomsak Hospital (HD: 68, CAPD: 84, Palliative: 75) from January 2021 to December 2023 were included in the analysis. The palliative care group had the highest mean age (65.97 ± 8.45 years, p < 0.001). Hospitalization frequency was not significantly difference (p = 0.5122), but CAPD patients had the longest hospital stays (18.74 ± 12.69 days/ year), followed by palliative care (18.33 ± 14.61 days/year) and HD (13.44 ± 12.77 days/year) (p = 0.0373). The main reasons for hospitalization were volume overload, anemia, and metabolic imbalances. CAPD patients had the highest peritonitis rate (26.2%), while HD patients had more vascular access infections (16.8%). Palliative care did not significantly reduce hospitalization, emphasizing the need to improve community-based palliative services. These findings support treatment strategies and healthcare policy improvements for ESRD management.

Screening System Development for Anemia Prevention in Children Aged 6 Months to 5 Years

Ubonrut Chanthanapodi — 2025-09-16

Iron deficiency anemia in early childhood is a common public health problem in Thailand. It affects children’s physical development, cognitive function, and long-term quality of life. Although clinical practice guidelines recommend anemia screening and iron supplementation, implementation at the primary care level often faces challenges such as a lack of structured systems, non-standardized equipment, and limited confidence among healthcare personnel. This action research aimed to develop and evaluate the outcomes of an anemia screening system for the prevention of anemia in children aged six months to five years. The study was conducted from December 2022 to May 2023. The study was conducted on 20 maternal and child healthcare personnel and 300 parents of children. The developed system comprised three main components: standardization of equipment, personnel development, and improvement of the service delivery system. The results showed that the screening rate increased by 48.9%, iron supplementation rose from 81% to 92.9%, and the prevalence of anemia decreased from 30% to 25%. Staff satisfaction was at a high level (mean = 4.49, SD = 0.45), as was parents’ satisfaction (mean = 4.60, SD = 0.44). In conclusion, the developed system improved operational efficiency, reduced anemia prevalence, and clearly enhanced satisfaction among stakeholders.

Editor’s Note

NanThiya Tanthachun — 2025-09-16

no abstract

Letter to the Editor

Arpa Srinuttisopak — 2025-09-16

no abstract