PSU Medical Journal

Reviewer Acknowledgement, 2025

Puttisak Puttawibul — 2025-12-04

Preventive Health Care Will No Longer Be Cheap

Surasak Sangkhathat — 2025-12-04

The Effect of Service Quality on Customers’ Satisfaction: A Study on Public Healthcare Centers at Yeka Sub-City in Addis Ababa, Ethiopia

Tesfaye Desalegn — 2025-12-04

Objective: The general objective of this research is to identify the effect of healthcare service quality on the customers’ satisfaction at the public health centers of the Yeka sub-city in Addis Ababa, Ethiopia.
Material and Methods: This cross-sectional study was conducted in 2020, across public health centers at Yeka sub-city, Addis Ababa; Ethiopia. Using proportional allocation, 567 participants were selected through a systematic exit interview approach at every 7th interval. Data analysis included the frequency distribution of socio-demographic characteristics and satisfaction levels, presented in tables and figures. Logistic regression analysis at a 95% confidence interval was used to identify the predictors of customer satisfaction; at a p-value<0.005.
Results: A total of 567 (69.66% female) study subjects were included.The response rate was recorded to be 98.61%, overall customer satisfaction accounted for 400 (70.55%) [95% Confidence Interval: 66.80%-74.30%]. Logistic regression analysis revealed that responsiveness (odds ratio [OR]=5.21, p-value<0.000), reliability (OR=7.47, p-value<0.000), and empathy (OR=2.44, p-value<0.005), along with other service quality sub-components, had a significant positive impact on customer satisfaction.
Conclusion: The level of customers’ overall satisfaction in this study is significantly higher compared to most other studies conducted in Ethiopia. Factors; such as reliability, responsiveness, and empathy were positively linked to customers’ satisfaction. To further enhance satisfaction and encourage the use of healthcare services, health centers should focus on improving the quality of their healthcare services.

Gaps in MPO and PR3 ELISA Performance in ANCA-Associated Vasculitis: A Thai Cohort Analysis

Katelada Pengket — 2025-12-04

Objective: Early and accurate diagnosis of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is critical to initiating appropriate treatment and for improving patient outcomes. Delayed diagnosis may result in irreversible organ damage, prolonged disease activity and increased mortality. Although, myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA detection by enzyme-linked immunosorbent assay (ELISA) is widely implemented, diagnostic performance may vary across different AAV subtypes and ethnic populations. This study aimed to assess the diagnostic accuracy of MPO-ANCA and PR3-ANCA ELISA in a hospital-based cohort of Thai patients.
Material and Methods: A retrospective analysis was conducted on clinical and serological data from a hospital-based Thai cohort of patients tested for ANCA, using MPO and PR3 ELISA; from January 2019 until August 2024. Sensitivity and specificity were calculated using confirmed AAV diagnoses as the reference standard.
Results: Among the 55 confirmed AAV cases, ELISA detected MPO-ANCA or PR3-ANCA in 39 cases (70.9% sensitivity), and showed 95.0% specificity among non-AAV controls. Subtype analysis revealed the highest sensitivity for microscopic polyangiitis (MPA, 76.7%) and granulomatosis with polyangiitis (GPA, 66.7%), but low sensitivity for eosinophilic granulomatosis with polyangiitis (EGPA, <30.0%). MPA was the most common subtype (48.4%), with a median age of 67 years. ELISA failed to detect ANCA in 29.1% of the confirmed AAV cases, most of which were EGPA.
Conclusion: MPO-ANCA and PR3-ANCA ELISA are highly specific; however, they have limited sensitivity, particularly for EGPA. Given the regional variations in AAV subtype prevalence, reliance on ELISA alone may cause underdiagnosis. Complementary testing strategies may improve detection of ELISA-negative samples.

Progress Test Preclinical Medical Students’ Perspectives and Suggestions on the Progress Test at the Faculty of Medicine, Prince of Songkla University

Pornpimol Piluntanaporn — 2025-12-04

Objective: To explore the perspectives and suggestions of preclinical medical students at the Faculty of Medicine, Prince of Songkla University, in regards to the progress test system. It focuses on perceived benefits, satisfaction, and the appropriateness of test scheduling. Additionally, to synthesize student feedback for improving test design and feedback in alignment with Outcome-Based Education (OBE).
Material and Methods: A mixed-methods study, using secondary data from questionnaires attached to the progress test reporting system during the academic years of 2022–2024. The sample included 477 medical students, from Years 1 to 3. Quantitative data were analyzed using descriptive statistics; qualitative data from open-ended responses were analyzed using content analysis.
Results: Students reported high satisfaction and recognized the benefits of the Progress Test; especially the e-testing format (mean scores: 4.33, 4.39, 4.28) and individualized feedback (4.24, 4.16, 4.19) across years 1 to 3. Over 75% in all years found the test schedule appropriate. Open-ended responses suggested improvements in four areas: (1) providing answer keys with explanations, (2) topic-based performance analysis, (3) aligning test schedules with learning workload, and (4) clarifying test objectives.
Conclusion: These findings reflect an overall positive perception of the progress test among preclinical medical students; particularly in terms of satisfaction, perceived benefits, and the application of test results for self-development. Students in years 2 and 3 showed stronger engagement with the feedback system and used test results for informed learning planning. In contrast, year 1 students expressed a need for clearer communication regarding the test’s purpose and structure. These patterns align with the principles of OBE and self-directed learning, which emphasizes continuous assessment for learner development. The study recommends improving individualized feedback, aligning test schedules with learning demands, and utilizing test results to support case-by-case academic advising; ultimately promoting effective and sustainable long-term learning behaviors.

Factors Influencing External Research Grant Applications Among Academic Staff at the Faculty of Medicine, Prince of Songkla University

Nuttha Siriruk — 2025-12-04

Objective: 1) To study factors influencing external research grant applications among academic staff at the Faculty of Medicine, Prince of Songkla University 2) To compare factors influencing external research grant applications among academic staff at the Faculty of Medicine, Prince of Songkla University, classified by: personnel type, years of service, educational level, academic position, academic publication and external research grant applications and 3) To study the needs for external research grant applications among academic staff at the Faculty of Medicine, Prince of Songkla University.
Material and Methods: This study employed a quantitative research methodology, using a cross-sectional study design. Data were collected using a checklist questionnaire. Content validity was verified with an item objective congruence index of 0.93, and reliability was assessed using Cronbach’s Alpha Coefficient of 0.89. Sample selection utilized stratified random sampling, with sample size determined according to Krejcie and Morgan’s concept.
Results: The study included 100 participants. The investigation of factors influencing external research grant applications among academic staff at the Faculty of Medicine, Prince of Songkla University revealed that personal factors, particularly grant application skills, significantly and positively influenced multiple variables: external research grant applications (Beta=0.656, p-value<0.05), academic publication dissemination (Beta=0.529, p-value<0.05), and academic position (Beta=0.367, p-value<0.05), respectively. For academic position, external factors related to research environment were significant positive predictors (Beta=0.342, p-value=0.005). Regarding work experience duration, personal factors related to research attitudes showed significant negative influence (Beta=-0.311, p-value=0.034). For external research grant applications, external factors related to policy and management demonstrated significant negative influence (Beta=-0.394, p-value=0.014). Personnel type and education level could not be significantly predicted by either personal or external factors. When comparing differences by personnel type, years of service, educational level, academic position, academic publication and external research grant applications, no statistically significant differences were found at the 0.05 level and the overall need for external research grant applications among academic staff at the Faculty of Medicine, Prince of Songkla University was at a high level (x̄=3.75, standard deviation=0.89).
Conclusion: The factors influencing external research grant applications among academic staff at the Faculty of Medicine, Prince of Songkla University, specifically grant application skills and research-conducive environmental factors, emerged as significant positive influencing factors. These factors are crucial for promoting external research grant applications among academic faculty members. When categorized by personnel type, years of service, education level, academic position, academic publication record, and previous external research grant applications, no statistically significant differences were found at the 0.05 level. The overall demand for external research grants was at a high level.

Nalbuphine: Core Facts and Practical Uses

Teerapatra Ophawatanasin — 2025-12-04

Nalbuphine is a synthetic opioid with a unique mechanism of action, acting as an agonist at kappa-opioid receptors and an antagonist at mu-opioid receptors. This dual activity underpins its ability to provide effective pain relief, while reducing the likelihood of side effects typically associated with mu-opioid receptor stimulation. This review outlines the pharmacological properties, therapeutic uses, effectiveness, safety profile and potential benefits of nalbuphine in various clinical scenarios. Compared to morphine, nalbuphine offers similar levels of analgesia, but with a reduced risk of respiratory depression, itching, nausea and vomiting. It has demonstrated utility in managing perioperative pain, preventing and treating opioid-induced pruritus, and serving as an adjunct in both regional and neuraxial anesthesia. Nevertheless, its application in pediatric, and obstetric settings is debated due to a lack of comprehensive safety data. Additionally, in individuals with opioid dependence, nalbuphine should be used with care, as it may trigger withdrawal symptoms.

Neoadjuvant Chemotherapy for Breast Cancer: Who Should Get It?

Nattapong Wisedsook — 2025-12-04

Neoadjuvant chemotherapy plays a critical role for patients eligible for preoperative therapy; especially for those with HER2-positive or triple-negative breast cancer. Advances in systemic therapy have led to increased rates of pathological complete response (pCR), a key indicator of long-term outcomes and a guide for subsequent adjuvant treatments. pCR also serves as a surrogate marker for the approval of new drugs in breast cancer. Neoadjuvant chemotherapy enhances the feasibility of breast-conserving surgery and sentinel lymph node biopsy for patients showing a clinical response. Effective management requires collaboration with a multidisciplinary team—including medical oncologists, surgical oncologists and radiation oncologists—prior to starting treatment. This is to consider therapy sequencing, its results in various treatment options, and appropriate management of breast and axillary nodes for potential de-escalation. Future advancements in personalized therapy involve identifying patients with exceptional responses to neoadjuvant chemotherapy whom may be able to avoid surgery entirely, and developing strategies to tailor neoadjuvant regimens using predictive biomarkers.