Maharaj Nakhon Si Thammarat Medical Journal

Analysis of The Development Results of The Drug Dispensing Service System for Inpatients in The Internal Medicine Department of Maharaj Nakhon Si Thammarat Hospital

2025-06-30T15:21:21+07:00

Background: Inpatient medication dispensing is essential for successful drug system development. It demands multidisciplinary collaboration to reduce medication errors and protect patients.

Objective: To analyze the results of developing an inpatient medication dispensing service system in the internal medicine department and utilize the obtained data for further improvement of the inpatient medication dispensing service system.

Materials and Methods: A retrospective descriptive study was conducted on patients from medical wards 3-6, special medical wards 4-5, and MICU 1-2. The study was divided into two periods: pre-intervention from June 2019 to September 2019 and post-intervention from June 2023 to September 2023. Frequency distribution, medication error rates, and percentages were used for statistical analysis.

Results: The number of sub-activities was reduced by 8, resulting in a more concise workflow of 14 sub-activities. The lead time for medication dispensing prior to delivery was significantly reduced from 24 hours to 5.5 hours. Overproduction waste decreased by 54.28%. The error rate for pre-dispensing errors decreased by 66.06%. The error rate for dispensing errors decreased by 56.87%.

Conclusions: This retrospective study indicates that reducing workload and streamlining the medication dispensing system are factors that may contribute to a decrease in both pre-dispensing errors and dispensing errors. Consequently, these improvements are likely to enhance patient safety related to medication use.

The Effect of Health Education Program on Knowledge and Practice in Postpartum Primiparous Women

2025-06-30T15:26:21+07:00

Background: Postpartum is a transitional period in life. Changes in both physical and mental aspects may cause anxiety. Especially mothers after giving birth to their first pregnancy. Lack of knowledge, confidence, and experience in taking care of yourself And that's right baby It can cause fear and anxiety, as well as complications for one's own health.

Objectives: To compare the mean scores on knowledge levels of mothers on how to behave after giving birth in their first pregnancy between groups that received a knowledge program on how to behave after giving birth. and the group receiving standard nursing care.

Materials and Methods: This research is a quasi-experimental research. The sample group consisted of 60 first-time postpartum women who received services at Phatthalung Hospital. Purposeful selection was performed. Divided into experimental groups and the control group, 30 patients per group. The control group received standard nursing care. The experimental group received an educational program on how to behave after giving birth. Data were analyzed using frequency, percentage, mean, standard deviation, and t- test statistics.

Results: Mothers after giving birth in their first pregnancy receive a program to provide knowledge on how to behave after giving birth. The knowledge level of self-care was significantly higher than the group receiving normal nursing care (p < 0.05).

Conclusion: Educational program on how to behave after giving birth Helps mothers after their first pregnancy have a higher average score of knowledge in taking care of themselves.

Factor related to outcomes of Out-of-Hospital Cardiac Arrest at Emergency Department, Thungsong Hospital, Nakhon Si Thammarat

2025-06-30T15:31:22+07:00

Background: Out-of-hospital Cardiac Arrest (OHCA) is an emergency condition that requires
cardiopulmonary resuscitation (CPR). The OHCA has a low survival rate. Studying factor related to outcomes of OHCA is therefore important to improve the development of emergency medical service.

Objective: The study aims to define the survival factors of OHCA and analyze the relevant factors to outcome of OHCA at Emergency Department, Thungsong Hospital, Nakhon Si Thammarat.

Materials and Methods: Retrospective study was performed on OHCA patients. Data was
collected from medical records of OHCA patients who attended the hospital between May 1, 2021 to April 30, 2023.

Results: There were 162 OHCA patients enrolled and the sustained return of spontaneous circulation (ROSC) rate was 27.78%. The influence factors related to sustained ROSC were bystander CPR (OR 6.321, 95%CI 2.463-16.222) and transportation mode by EMS (OR 4.245, 95%CI 1.712-10.526).

Conclusions: This study found that major factors associated with successful resuscitation of OHCA patients were bystander CPR and transportation mode by EMS.

Shock Index as a Predictor of Hyperlactatemia for Early Detection of Septic Shock in Patients Presenting to Emergency Department

2025-06-30T15:36:19+07:00

Background: Sepsis is a critical medical emergency with high mortality rates of 62-73.9%, especially in severe sepsis and septic shock patients. Serum lactate testing aids in diagnosis and treatment, though it may not be readily available in community hospitals. As a result, shock index (SI) has been used to predict hyperlactatemia.

Objective: To investigate the sensitivity and specificity of shock index (SI) values in predicting hyperlactatemia in sepsis patients.

Materials and Methods: This retrospective descriptive study analyzed sepsis patients who visited the emergency department at Thungsong Hospital from February 1, 2024, to July 31, 2024. Vital signs were recorded and converted into shock index to study its relationship with lactate levels, vasopressor use, ICU admission, and 28-day mortality.

Results: Among 200 patients, the optimal SI cut-off for predicting lactate ≥ 4 was ≥ 1 (sensitivity 82.86%, specificity 68.46%). Furthermore, SI ≥ 1 was associated with vasopressor use, ICU admission, and 28-day mortality.

Conclusions: Shock index is an effective predictor of hyperlactatemia for early detection of septic shock. An SI ≥ 1 is optimal for predicting lactate levels ≥ 4 and is associated with vasopressor use, ICU admission, and 28-day mortality.

Maternal Health Knowledge and Health Behavior During Pregnancy of Mothers Aged 18 Years and Over in at Nakhon Si Thammarat Province

2025-06-30T15:41:35+07:00

Background: Pregnancy induces physical, emotional, and social changes in women, affecting their health behaviors and pregnancy outcomes. Maternal health knowledge is essential for promoting healthy behaviors during pregnancy.

Objective: To examine the relationship between maternal health knowledge and health behaviors during pregnancy.

Materials and Methods: This descriptive correlational study involved 85 pregnant women attending Maharaj Nakhon Si Thammarat Hospital. Data were collected using structured questionnaires measuring maternal health knowledge and health behaviors. Descriptive statistics and Spearman’s correlation coefficient were used for analysis.

Results: Participants had a mean maternal health knowledge score of 63.55 (SD = 9.25) and a mean health behavior score of 164.95 (SD = 18.54). Maternal health knowledge showed a low positive correlation with health behaviors (r = 0.483, p < 0.01).

Conclusion: Enhancing maternal health knowledge can improve health behaviors among pregnant women, reducing pregnancy risks and promoting better health outcomes for both mothers and infants.

Result of Magnetic Resonance Imaging(MRI) Fusion Transperineal Prostate Biopsy in Patient with Persistent Elevated Prostate Specific Antigen Levels and Prior Negative Random Transrectal Ultrasound (TRUS) Guided Biopsy in Maharaj Nakhon Si Thammarat Hospit

2025-06-30T15:47:48+07:00

Background: Conventional biopsy fails to detect the presence of some prostate cancers(PCas). Repeatedly negative prostate biopsies in individuals with elevated prostate specific antigen (PSA) levels can be frustrating for both the patient and the urologist. Magnetic resonance imaging targeted, transrectal ultrasound guided transperineal fusion biopsy has shown encouraging results for detecting clinically significant prostate cancer.

Objectives: This study was performed to determine the result of magnetic resonance imaging (MRI) fusion transperineal prostate biopsy and complication in patients with persistently elevated prostate specific antigen levels and prior negative random transrectal ultrasound (TRUS) guided biopsy at Maharaj Nakhon Si Thammarat Hospital,Thailand.

Materials and Methods: A retrospective study was conducted by reviewing medical records patients were underwent Magnetic resonance imaging(MRI) targeted, transrectal ultrasound guided transperineal fusion biopsy with persistently elevated prostate-specific antigen(PSA) levels and prior negative random transrectal ultrasound (TRUS) guided biopsy during June 1st, 2022 to July 31th, 2024 in Maharaj Nakhon Si Thammarat Hospital.

Results: Magnetic resonance imaging (MRI) fusion transperineal prostate biopsy can detected prostate cancer 9 in 27 patient(33%) with prior negative random transrectal ultrasound (TRUS) guided biopsy.

Conclusion: Magnetic resonance imaging(MRI) fusion transperineal prostate biopsy can detect significant prostate cancer and small lesion with lower complication.

The Promoting Program Development of Cervical Cancer Screening by Self-testing for the HPV Virus among Women at Risk in Surat Thani Metropolitan Municipality

2025-06-30T15:52:20+07:00

Background: The cervical cancer screening by self-testing for the HPV virus is a convenient method, accurate and easy access to exam.

Objectives: To develop and study the promoting program development of cervical cancer screening by self-testing for the HPV virus of women at risk, including, comparing satisfaction with the program between proactive and defensive programs

Material and Method: This research was action research. The sample group consisted of 80 people. They were divided into 2 groups; experimental group of 40 samples which was a group that used the developed program, consisted of 1) Public relations and appointments for HPV testing 2) Training and demonstration of screening to village health volunteers 3) Village health volunteers provide knowledge and demonstrate screening procedures 4) Women at risk collect the specimens 5) Sending items for examination and reporting the examination results and 5) Referral for treatment), and comparative group, which was a group that used the defensive program, 40 samples. Data collection was used questionnaires and data analysis was performed by descriptive statistics, Chi-square test / Fisher’s exact test, independent t-test and paired sample t-test.

Results: Found that perceived risk of cervical cancer, perceived severity of cervical cancer, perceived benefits of prevention and treatment of cervical cancer and attitudes towards cervical cancer screening had increased and more than the defensive program. In addition, there was statistically significant higher satisfaction to the promoting program development of cervical cancer screening than the defensive program, scored 35.5 in the proactive program and 32.1 in the defensive program (p-value < 0.01).

Conclusion: Proactive program, the promoting program of cervical cancer screening by self-testing for the HPV virus, it increased the scores of cervical cancer awareness in the study population and increase satisfaction in the post-program of cervical cancer screening. It should be used the promoting program development for further screening.

The Model Development in Hepatitis B and C Virus Screening by Cooperation between Staffs and Village Health Volunteers, Surat Thani Metropolitan Municipality

2025-06-30T15:57:32+07:00

Background: Chronic hepatitis is caused hepatitis B and C viruses which can cause to liver cancer. Therefore, it is necessary to develop a screening model for hepatitis B and C viruses for reduce the incidence of liver cancer.

Objectives: To develop a screening model for hepatitis B and C viruses. Study knowledge about hepatitis B and C, screening procedures and problems of public health volunteers (PHVs) and the results of the hepatitis B and C screening model.

Material and Method: This research was action research. The sample group consisted of 1) 17 medical personnel and related officials 2) 16 PHVs 3) 8 public health service center staff 4) 120 Thai people at risk of hepatitis B and C which had develop a screening model, training PHVs about hepatitis B and C and conduct screening. The study instruments were hepatitis B and C screening model, questionnaire and screening result record form. Data were analyzed using descriptive statistics and Paired sample t-test.

Results: The model development of screening consists of 1) Public relations 2) Preparation of screening equipment 3) Screening service provision. The study results found that most PHVs had good knowledge about hepatitis B and C, at 62.5% and 87.5% respectively. Screening was carried out at a high level, 93.8%. There were problems in screening, such as blood sampling expertise, screening cooperation, and restricted service locations, at 50.0%, 43.7%, and 25.0%, respectively. The screening results showed that the screened people had significantly increased knowledge about hepatitis B and C infections. (p-value < 0.001). There was a high level of satisfaction with the service, 80.8% and found positive results for hepatitis B and C viruses at 2.5 and 0.0%, respectively.

Conclusion: From the study results, should be used the model development in hepatitis B and C virus screening, next.

Factors Associated with Burnout in Clinical Medical Students at Maharaj Nakhon Si Thammarat Hospital

2025-06-30T16:02:58+07:00

Background: Medical students experiencing burnout from clinical practice may face mental health challenges, which can negatively impact their learning efficiency and ability to provide patient care. In the long term, this condition could lead to psychiatric disorders. Understanding the factors influencing burnout in medical students is beneficial for developing strategies to support their wellbeing and promote better mental health among clinical medical students.

Objectives: To study the level of burnout and the factors associated with work-related fatigue among clinical medical students.

Materials and Methods: This cross-sectional analytical study includes 80 clinical medical students from Maharaj Nakhon Si Thammarat Hospital in the 2024 academic year. The research tools comprised five parts: personal data, work factors, educational factors, burnout test (Maslach Burnout Inventory; MBI). Data was collected from July 1 to July 30, 2024, and analyzed using descriptive statistics such as percentage, mean and standard deviation, and inferential statistics such as Chi-Square Test and Fisher's Exact Test.

Results: The study found that the majority of medical students experienced burnout in terms of emotional exhaustion and depersonalization. Personal accomplishment was found to be at a high level, with 96.3% of students achieving high personal accomplishment. Regarding the relationship with various factors, low satisfaction with sleep and insufficient personal time were associated with high levels of emotional exhaustion and depersonalization. (p<0.05) High satisfaction with psychological support from the medical center and support from medical instructors was associated with lower levels of emotional exhaustion and depersonalization (p<0.05) Factors such as thoughts of quitting, motivation to study medicine from parents and relationship problems with ward colleagues contributed to high levels of emotional exhaustion. Students working in major wards and those exercising less than three days a week experienced higher levels of depersonalization (p<0.05)

Conclusion: This study suggests that clinical medical students at Maharaj Nakorn Si Thammarat Hospital experience moderate to high levels of burnout in various dimensions. Therefore, there should be an appropriate and consistent support system from the medical center addressing factors related to burnout, including sufficient rest and personal time, easily accessible and comprehensive psychological counseling, and monitoringburnout, especially for those working in major wards.

The Effect of Self-management Support Program for Exercise with Elastic Bands on Health-Related Physical Fitness of Elderly Muslims

2025-06-30T16:07:53+07:00

Background : Promoting physical fitness is essential in helping older adults maintain an effective daily life.

Objectives : To compare physical fitness scores before and after participating in a self-management program for exercise with elastic bands on physical fitness in Muslim older adults.

Material and Method : This research employed a quasi-experimental design. The sample consisted of 32 elderly individuals aged 60 years and above. Data were collected using a physical fitness assessment record and a self-administered elastic band exercise record at home. Data analysis was performed using descriptive statistics and paired t-tests.

Results : The study found that after receiving the program, the sample group had a statistically significant decrease in body mass index (BMI) at the .05 level. Upper body flexibility, arm muscle strength, leg muscle strength, movement and balance ability, and cardiovascular endurance all significantly increased at the .05 level. Lower body flexibility increased, but not to a statistically significant degree at the .05 level.

Conclusion : A self-management support program for elastic band exercise has a positive effect on the physical fitness development of elderly Muslims.

Database Analysis for Proper Referral System to Phatthalung Hospital by Case Mixed Index and Adjusted Relative Weight

2025-07-01T09:03:31+07:00

Background: The referral system in Phatthalung Province currently lacks standardized criteria and clear metrics for determining the appropriateness of patient referrals.

Objectives: The Case Mix Index and Adjusted Relative Weight values, which indicate case complexity and resource utilization, were used to evaluate the effectiveness of the referral system.

Materials and Methods: This retrospective study, involved reviewing medical records and data from the Thai Referral Program collected between October 2021 and October 2023. The QlikView program was used to analyze the data. The ratio of Adjusted Relative Weight values that are less than the Case Mix Index values was analyzed and used to identify the most frequently referred diseases. The data was analyzed to present the top 20 most referred diseases in Phatthalung hospital. Including analyzing the appropriateness of using resources.

Results: The rate of patients transferred to Phatthalung Hospital with the Adjusted Relative Weight value lower than the Case mixed index value in the years 2021 to 2023 was 31.6%, 32.7%, and 27.9%, respectively. The appropriate Adjusted Relative Weight value for transfers to F1 hospital is less than 0.55, while the appropriate Adjusted Relative Weight value for transfers to M1 hospital is less than 0.8. The underlying cause of these referrals is a lack of human resources and medical equipment. Therefore, a suitability analysis will help develop the hospital service system appropriately. This leads to the further development of an effectivea reference system.

Conclusion: Adjusted Relative Weight and Case Mix Index can be utilized to develop the referral system and enhance the capacity of community hospitals.

The Prevalence and Risk Predictors of Cesarean Scar Defect at Six Weeks Postpartum

2025-07-01T09:19:45+07:00

Background: Cesarean scar defect following cesarean section is an emerging condition that can have long-term implications for maternal health, particularly abnormal vaginal bleeding, cesarean scar pregnancy, and other complications that may arise during future pregnancies.

Objectives: To determine the prevalence of uterine niche following cesarean section at 6 weeks postpartum and to analyze factors potentially associated with the development of uterine niche.

Materials and Methods: This descriptive prospective cohort study was conducted at Vachira Phuket Hospital from April 15, 2024, to November 15, 2024. The study population included healthy, singleton pregnant women aged 18 years or older who underwent cesarean delivery. Participants were assessed for uterine niche using ultrasound at 6 weeks postpartum.

Results: Among 101 participants, the prevalence of uterine niche was 74.3% (75/101), with 38.7% (29/75) of these cases classified as large niches. The study found that anteverted uterus was significantly associated with the development of uterine niche, increasing the risk by 18-fold (adjusted OR = 18.00, 95% CI = 4.17 – 77.77, p < 0.001). Additionally, women under 35 years of age had a 6.19-fold increased risk of developing large uterine niches (adjusted OR = 6.19, 95% CI = 1.59 – 24.09, p = 0.009).

Conclusions: The prevalence of uterine niche in postpartum patients at Vachira Phuket Hospital was 74.3%, highlighting the importance of monitoring this condition, particularly in cases of anteverted uterus. Additional ultrasound evaluation is recommended to confirm the presence of uterine niche, monitor symptoms, assess potential complications, and evaluate healing progress over a 6-month period.

Echo-Guided Pericardiocentesis Using a Central Venous Catheter: Classical Intermittent Versus Continuous Pericardial Drainage

2025-07-01T09:26:11+07:00

Background: Cardiac tamponade is a life-threatening condition that requires timely diagnosis and management.

Objective: To identify the difference in mortality for classic intermittent pericardial drainage and continuous drainage using a Jackson-Pratt drainage system of echo-guided pericardiocentesis using a central venous catheter (CVC).

Materials and Methods: An analytic cohort study included all patients who were hospitalized due to a principal diagnosis of cardiac tamponade and underwent echo-guided pericardiocentesis using the CVC from October 1 to September 30, 2023. The differences in mortality between groups were tested using a log-rank test and prognostic predictors for mortality were analyzed using Cox proportional hazards regression.

Results: Of the 32 patients (71.9% male, median age 66 years) were enrolled. The in-hospital mortality in the intermittent group compared to the continuous group was 46.7% and 11.8% (HR = 4.785, 95%C l= 0.992-23.075, p = 0.051), and the median event-free survival was 16.8 and 19.9 days (log-rank p = 0.028). The 1-year recurrence in the intermittent group compared to the continuous group was 62.5% and 13.3% (HR = 4.783, 95%Cl = 0.919-24.890, p = 0.063), and the median recurrence-free survival was 102.7 and 228.0 days (log-rank p = 0.041).

Conclusions: The continuous group tends to benefit in a single center study.

Effect of Hemostatic Agent Contamination on Bond Strength of Composite Resin Restorations to Dentin: A Systematic Review and Meta-analysis

2025-07-01T09:30:41+07:00

Background: Resin composite materials are highly sensitive to moisture. If contaminated by blood or fluids, the bond strength between the resin composite and tooth structure may decrease. Therefore, hemostatic agents are used to control bleeding in the gingival area and reduce fluids in the gingival sulcus, creating an optimal environment for the adhesion of restorative materials.

Objective: To synthesize research findings and a meta-analysis on the effects of hemostatic agent contamination on the bond strength of resin composite to dentin.

Material and Methods: Systematic searching for relevant research on PubMed and Google Scholar, as well as conducting manual searches, was done. The literature search was conducted until 2024. Only articles in English or Thai were taken. The meta-analysis of the effects of hemostatic agent contamination on the bond strength of resin composite to dentin was performed from 18 accepted publications.

Results: The shear bond strength, micro-shear bond strength, and micro-tensile bond strength of resin composite to dentin in the non-contaminated group were higher than in the hemostatic agent-contaminated group. However, a definitive conclusion cannot yet be drawn due to the high heterogeneity of the data.

Conclusions: Hemostatic agent contamination has a negative effect on the bond strength of resin composite to dentin. However, due to the current limitations and the limited number of available studies, further high-quality research is needed.

Treatment Outcomes of Oropharyngeal Cancer Patients Treated with Radiotherapy in Maharaj Nakhon Si Thammarat Hospital

2025-07-01T09:37:27+07:00

Background: Oropharyngeal cancer (OPC) is the type of head and neck cancer (HNCs) consisting of cancer of the base of the tongue, the tonsils, soft palate, and posterior and lateral pharyngeal walls. The incidence of OPC is increasing globally, and radiotherapy remains as treatment cornerstone. Nevertheless, there is limited data regarding the efficacy of OPC treatment in Thailand.

Objective: To evaluate survival outcomes for patients with oropharyngeal carcinoma who were treated with radiation in Maharaj Nakhon Si Thammarat Hospital.

Material and Methods: The retrospective study was conducted, including patients with newly diagnosed oropharyngeal cancer treated with radiotherapy. The primary endpoint was the 2-year overall survival rate. Secondary endpoints were overall survival (OS) and median progression free survival (PFS), estimated by the Cox’s proportional hazard model.

Results: From January 2020 to December 2022, 67 patients with oropharyngeal cancer received radiotherapy. Sixty-five patients (97%) had squamous cell carcinoma; 95 % were male with a median age of 61. Stage IV disease were accounted for 58%, with 52 patients (78%) were treated with concurrent chemoradiation (CCRT). The 2-year OS was 48 %. The median OS and PFS were 23.8 and 19.8 months. After treatment completion, 68% of patients had no tumor recurrence.

Conclusion: The survival outcome of patients with oropharyngeal cancer in Maharaj Nakhon Si Thammarat was comparable to other studies. Longer follow-up periods are needed to assess delayed benefit to radiotherapy.

The Relationship Between Gestational Hypertension and The Results of The Quadruple Test at Thungsong Hospital, Nakhon Si Thammarat Province

2025-07-01T09:42:34+07:00

Background: Currently, pregnant women in Thailand are screened for Down syndrome using the quadruple biochemical test to identify high-risk cases (HRQT). Other Studies have suggested a possible association between HRQT and the development of hypertension in pregnancy. This study aims to investigate the relationship between HRQT and hypertensive disorders during pregnancy.

Objective: To evaluate the association between hypertension in pregnancy and the results of Down syndrome screening via the quadruple test at Thungsong Hospital, Nakhon Si Thammarat Province.

Materials and Methods: A retrospective cohort study based on medical records with positive quadruple test results from October 1, 2020 to September 30, 2023 using descriptive statistics to determine the correlation in data analysis.

Results: The study population consisted of 2,530 pregnant women. 167 women (6.6%) were classified as high-risk (HRQT) based on the Quadruple Test results. From confirmatory amniocentesis in the HRQT group, 3 fetuses were diagnosed with Down syndrome, and all 3 pregnancies were terminated. This left 164 HRQT cases who continued their pregnancies. Among them, gestational hypertension (GHT) was detected in 8.54% of the HRQT group (P < 0.05), compared to 0.85% in the LRQT group. Pre-eclampsia was found in 4.62% of the HRQT group (P < 0.05), compared to 0.68% in the LRQT group.

Conclusion: Pregnant women with high-risk results from the quadruple test for Down syndrome showed a statistically significant higher incidence of gestational hypertension and pre-eclampsia.

Comparison Efficacy of Premedication Regimens Used to Prevent Paclitaxel Hypersensitivity

2025-07-01T09:47:47+07:00

Background: Paclitaxel is a widely used chemotherapy drug. Hypersensitivity reactions are among the most common adverse reactions to paclitaxel. During the years 2021-2023, the reported incidence of hypersensitivity was 4.75%, Which was the highest compared to the other chemotherapy drugs.

Objective: This study aimed to investigate the relationship between different premedication regimens and hypersensitivity, and to determine the factors associated with the occurrence of hypersensitivity in patients receiving Paclitaxel.

Materials and Methods: Data were collected from the hospital database of Maharaj Nakhon Si Thammarat Hospital. This study included cancer patients treated with Paclitaxel between October 1, 2022 and February 29, 2024.

Results: The results showed that a total of 217 patients had hypersensitivity 21 patients (9.67%) experienced hypersensitivity. The highest incidence of hypersensitivity occurred in patients who received premedication regimen A (Dexamethasone 20 mg IV, Chlorpheniramine 10 mg IV, Famotidine 20 mg oral), followed by regimen B (Dexamethasone 20 mg IV, Diphenhydramine 25 mg oral, Dexamethasone 4 mg oral 12,6 hr. before Paclitaxel) and C (Dexamethasone 20 mg IV, Diphenhydramine 25 mg oral, Famotidine 20 mg oral), respectively. Compared to patients who received premedication regimen C, Patients who received premedication regimens A and B had 1.1 times (95% CI; 0.301-4.153) and 0.8 times (95% CI; 0.253-3.076) the likelihood of developing hypersensitivity, respectively.

Conclusion: Although no statistically significant association was found, it was revealed that regimen C was observed to have the lowest incidence of hypersensitivity. The study's findings may provide a basis for consideration to select a premedication regimen to prevent hypersensitivity from Paclitaxel.

Prevalence and Factors Associated with Malnutrition of Pediatric Patients in Hospitalized at Tertiary Care Hospitals

2025-07-01T09:54:35+07:00

Background: Malnutrition is a common condition among children, influenced by many factors and differences in diagnostic criteria. It significantly affects growth, immunity, and increasing infection during hospitalization.

Objective: To determine the prevalence of malnutrition and associated factors in hospitalized children at Maharaj Nakhon Si Thammarat Hospital.

Materials and Methods: This is a retrospective descriptive study. Medical records of pediatric inpatients admitted to Maharaj Nakhon Si Thammarat Hospital between June 1, 2023, and June 30, 2024, were corrected.

Results: A total of 284 participants were included. Based on the World Health Organization (WHO) growth criteria, the prevalence of wasting (WFH z-score < -2) and stunting (HFA z-score < -2) was 13% each. The prevalence of being overweight (WFH z-score > 2/BMI z-score > 1) was 13%, while obesity (WFH z-score > 3/BMI z-score > 2) was 14%. No significant associated factors or complications from malnutrition were identified.

Conclusion: The prevalence of both undernutrition and overnutrition was relatively high, at 26% and 27%, respectively. Nutritional management in children remains important, although this study did not identify significant associated factors or complications. Further research is warranted.

Predictors of 30-Day Mortality of Cardiogenic Shock Complicating ST-Elevation Myocardial Infarction at Trang Hospital

2025-07-01T09:58:12+07:00

Background: ST-elevation myocardial infarction is a major health problem in all countries. The presence of cardiogenic shock increases mortality in this patient population.

Objective: To study the mortality rate and predictors of 30-day mortality of patients with acute ST segment elevation myocardial infarction with cardiogenic shock at Trang Hospital.

Materials and Methods: This is a retrospective study of patients with acute ST segment elevation myocardial infarction with cardiogenic shock who were admitted to Trang Hospital from January 2021 to December 2023.

Results: A total of 83 patients were included in this study. The results showed that 30-day mortality rate was 37.4% (31 patients). Factors that significantly affected the mortality rate were eGFR (AOR = 0.94, 95% CI = 0.90-0.97, P = <0.001), Ventricular arrhythmia (VT/VF) (AOR = 4.69, 95% CI = 1.26-17.51, P = 0.021), and the number of inotropic drugs. (AOR = 2.88, 95% CI = 1.13-7.38, P = 0.027)

Conclusions: Patients with acute ST-segment elevation myocardial infarction with cardiogenic shock admitted to Trang Hospital had a mortality rate of 37.4%. eGFR, Ventricular arrhythmia (VT/VF) and the number of inotropic drugs were associated with increased mortality.

Laparoscopic Percutaneous Extraperitoneal Closure in Pediatric Indirect Inguinal Hernia and Hydrocele : Approaching and Outcomes in Regional Hospital Perspective

2025-07-01T10:03:12+07:00

Background: The etiology of indirect inguinal hernia and hydrocele in children is patent processus vaginalis. Traditional gold standard procedure is open repair. Conventional open herniotomy and hydrocelectomy has been reported the recurrent and metachronous rates. Now a day, Laparoscopic extraperitoneal closure has been reported the reduced these incidences.

Objective: This report introduce the result of laparoscopic extraperitoneal closure technique in Maharaj Nakhon Si Thammarat hospital

Materials and Methods: The Retrospective study about Laparoscopic Percutaneous Extraperitoneal Closure in Pediatric Indirect Inguinal hernia and hydrocele in Maharaj Nakhon Sri Thammarat , Age 0-15 years old. Collect data from 2017-2022.

Results: A series of 60 children were all of inguinal hernia and hydrocele treat by laparoscopic percutaneous extraperitoneal closure in Maharaj Nakhon Si Thammarat hospital. The patient were male 48(80%) and female 12(20%). The number of patent processus vaginalis are unilateral lesion 46(76%) and metachronous lesion 14(24%). The operative time in male populations in unilateral lesion was 23.75 mins and bilateral lesion was 30.4 mins and in female populations in unilateral lesion was 23 mins and bilateral lesion was 30 mins. Recurrence in 1 patient(1.6%). No postoperative testicular atrophy.

Conclusion: Laparoscopic Percutaneous Extraperitoneal Closure of processus vaginalis in Pediatric Indirect Inguinal Hernia and Hydrocele has a safe , good and satisfy result of procedure

Torectomy and Alveoloplasty Before Wearing Removable Partial Denture: A Case Report

2025-07-01T10:06:53+07:00

Torus and exostosis can affect patients’ quality of life such as difficulties in eating, frequent sores or irritation from hard foods, or problems with dentures insertion and retention. These are indications for torus and exostosis removal. This article presents a 61-year-old male patient requiring a removable partial denture due to eating problem. From oral examination, upper right and left buccal exostosis and right and left torus mandibularis were found, which obstructing dentures placement. The treatment was performed by torectomy and alveoloplasty to create more favorable oral cavity for dentures. After a 2-month follow-up, the oral cavity was ready, so a removable partial denture was done. Outcome shows successful placement of removable partial dentures. The patient reported improved chewing ability, no gum pain, and overall satisfaction the dentures.

Orthodontic Treatment in Bimaxillary Protrusion with Upper Incisor Extraction: A Case Report

2025-07-01T10:10:12+07:00

Orthodontic treatment plan of bimaxillary protrusion is four first bicuspid extraction. This case report presents 22-year-old Thai male patient with protrusive upper and lower anterior teeth. The patient was diagnosed with skeletal Class I relationship and dental Class I malocclusion, convex facial profile and protrusive upper and lower lips. The upper right central incisor had previously treated and asymptomatic apical periodontitis with iatrogenic root perforation, resulting in a poor prognosis. The treatment involved fixed orthodontic appliances with the extraction of three first premolars and the upper right central incisor. The upper right lateral incisor was substituted for the extracted central incisor. Treatment outcomes demonstrated a stable occlusion, improved facial esthetics, This case report highlights the successful use of lateral incisor substitution as an alternative treatment approach for patients requiring upper central incisor extraction.

Tooth Autotransplantation: Alternative Method of Restoring Missing Tooth

2025-07-01T10:13:38+07:00

Tooth autotransplantation is an effective alternative treatment for replacing missing teeth, particularly in cases where conventional prosthetic options such as fixed and removable dentures or dental implants are not viable due to financial constraints or developmental concerns in younger patients.

This case report describes the successful transplantation of a mandibular third molar to replace a severely decayed second molar in a 20-year-old female patient. Following a six-month evaluation, the patient exhibited normal occlusion, functional chewing ability, and no symptoms. Radiographic analysis confirmed favorable periradicular conditions, continued root development is a sign of successful pulp regeneration and indicates the tooth’s vitality.

Management of Internal Root Resorption in The Maxillary Lateral Incisor Using MTA

2025-07-01T10:18:55+07:00

Internal root resorption may occur in cases of chronic inflammation of the dental pulp. The etiologies of internal root resorption are caries, previous dental treatment, or trauma from orthodontic treatment. Most internal root resorption occurs in the anterior teeth.

This article presents a case of a 21-year-old Thai female patient who was undergoing orthodontic treatment. The orthodontist found internal root resorption on an X-ray during treatment. An emergency root canal was performed and the patient was referred for further treatment.

The patient underwent examination and found that the oral mucosa was normal with no sinus opening. Tooth 22 had a good restoration and no leakage. Palpation and percussion test were normal. Periapical film showed 4 x 6 mm² internal root resorption and a 1 x 1 mm² periapical lesion. Cone beam computed tomography (CBCT) showed the internal root resorption toward the labial side with 0.58 mm of root dentine remaining. The prognosis of this tooth was good because the root had not yet been perforated. Treatment plan was root canal treatment, repair internal root resorption with MTA, restore with a post and a core. After the orthodontic treatment was completed, this tooth will be restored with crown, in that order to receive continuous orthodontic treatment. After 3 months follow up, the results were found to be satisfactory. The patient had no any symptom and persist periapical lesion.

The Results of Using Innovative Urine and Feces Containers for Microscopy Analysis to Reduce the Spread and Exposure to Dangerous Germs Such As Tuberculosis, COVID, and Microorganisms

2025-07-01T10:25:03+07:00

Background: The delivery of samples is an important process in laboratory testing. The sample must be maintained and biosafety must be taken into account. It must meet the standards according to the criteria.

Objective: To study the results of using innovative urine and feces containers for microscopy analysis to reduce the spread and exposure to dangerous germs such as tuberculosis, COVID, and microorganisms.

Materials and Methods: Selected samples were purposively randomized to 300 samples per group. The control group was packed with urine and feces containers as usual. The experimental group used innovative urine and feces containers. 1. Foam holes for placing containers 2. Foam containers with tight-fitting lids. The tools used for data collection were data recording forms. Data were analyzed using descriptive statistics and independent t-test. Study period: February 2025 to March 2025

Results: The results of the study from all 300 samples in each group found that after the experiment, the experimental group had an average score of 0 samples (0 percent) of incident microscopic analysis that did not meet standards. All samples were not contaminated outside the plastic bag (100 percent), and there was no tilting, spilling, or falling (100 percent). There was a small amount of 3 samples (1 percent) that could be put to practical use and beneficial to the agency.

Conclusion: the researcher recommends using innovative equipment for packing urine and feces for microscopic analysis to reduce the spread and exposure to dangerous germs such as tuberculosis and COVID-19. Microorganisms can be used as a guideline to reduce the risk of spreading and exposure to dangerous germs.