PSU Medical Journal

The Advancement of Medical Devices in the Future and Ethical Considerations in Healthcare

Osaree Akaraborworn — 2025-08-20

Near Hanging Induced Negative Pressure Pulmonary Edema

Pornchanan Wuttisakdanon — 2025-08-22

Negative pressure pulmonary edema (NPPE) is a rare condition with a high mortality rate. This condition causes acute respiratory failure occurring when sudden, forceful inspiration is against an obstructed airway. Near-hanging is referred to patients having survived a hanging injury. During hanging, the entire neck structure is compressed. This causes sudden airway obstruction, and may develop into acute respiratory failure from suddenly increase intrathoracic pressure. To our knowledge there have not often been reported incidences of negative pressure pulmonary edema after a near hanging condition. Herein, we report a case of negative pressure pulmonary edema after hanging condition.

Cervical Cancer a Rare Cell Type

Nungrutai Saeaib — 2025-08-22

Cervical cancer (CC) is the most common cancer of the female genital tract. Although, the incidence of CC has been continuously decreasing, the mortality rate remains high. The cytologic classification of cervical cancer is categorized by the human papillomavirus (HPV) infection, with most CC being associated with HPV infection; such as squamous cell carcinoma and adenocarcinoma that currently have a good prognosis. There are cell types of CC whose pathogenesis is not usually associated with HPV infection; such as gastric-type mucinous carcinoma, clear cell carcinoma, mesonephric type, endometrioid type, carcinosarcoma, adenosquamous and adenosarcoma. Additionally, the cell type in other organ systems can be found in the cervical uteri; including neuroendocrine tumors, lymphoma and malignant melanoma. Staging and standard treatments are usually not different from that of squamous cell carcinoma and adenocarcinoma; however, the prognosis is relatively worse.

Advancements in Early Gastric Cancer Management: A Focus on Minimally Invasive Techniques

Supakool Jerania — 2025-08-22

Early gastric cancer (EGC) is a significant, global health concern. However,screening programs have improved early detection and outcomes; particularly in East Asia. The management of EGC has evolved from radical gastrectomy with lymph node dissection to minimally invasive approaches that preserve gastric function, while ensuring oncological safety. Endoscopic techniques; such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), offer effective treatment for select patients, with low risk of lymph node metastasis. These approaches provide comparable survival rates to surgery, while reducing postoperative complications, hospitalization and recovery time. Lymph node metastasis remains a key prognostic factor in EGC management. While radical surgery is necessary for cases with lymphatic spread, function-preserving surgeries; including pylorus-preserving gastrectomy (PPG) and proximal gastrectomy (PG), aim to maintain gastric function and improve quality of life. The sentinel lymph node concept has further refined surgical strategies by minimizing unnecessary lymphadenectomy. Risk stratification tools; such as the eCura scoring system, assist in predicting lymph node involvement and guiding individualized treatment decisions. Patients classified as low-risk may benefit from endoscopic resection alone, while those at higher risk may require additional surgical intervention. The growing role of laparoscopic approaches has further advanced minimally invasive treatment, demonstrating comparable oncologic outcomes to open surgery. As treatment paradigms continue to shift, a multidisciplinary approach integrating endoscopic, surgical, and risk-based strategies is essential for optimizing patient outcomes. Future research will further refine treatment guidelines, ensuring a balance between oncological safety and functional preservation in EGC management.

Anesthesia and Preoperative Nutritional Assessment

Panalee Kittisopaporn — 2025-08-22

Preoperative nutritional status plays a crucial role in determining surgical outcomes. Additionally, nutritional status influences recovery, complication rates and overall hospital stay. Malnutrition is often underrecognized, significantly increases the risk of infections, delayed wound healing, prolonged hospitalization and even mortality. Given these risks, a structured approach to nutritional assessment is essential in perioperative care. Various screening tools help identify patients at risk of malnutrition. Once identified, appropriate nutritional interventions can be implemented. Strategies such as oral nutritional supplementation (ONS), enteral nutrition (EN), and parenteral nutrition (PN) have been shown to enhance recovery and reduce postoperative complications.
The role of an anesthesiologist in managing preoperative and postoperative nutrition is being increasingly recognized. Prolonged fasting before surgery, once a standard practice, is now being reconsidered. The Enhanced Recovery After Surgery (ERAS) protocol emphasizes carbohydrate loading before surgery as well as reducing fasting periods to minimize catabolism and improve postoperative recovery. Incorporating nutritional screening and optimization into perioperative planning is vital, particularly for high-risk groups; such as elderly patients and those undergoing major surgeries. Anesthesiologists play a key role in ensuring that patients are metabolically prepared for surgery, ultimately leading to better surgical outcomes and faster recovery.

Expression of NY-ESO1 Protein in Multiple Myeloma

Kanet Kanjanapradit — 2025-08-22

Objective: To evaluate the proportion of New York esophageal squamous cell carcinoma 1 (NY-ESO1) protein expression, via immunohistochemistry staining in bone marrow of multiple myeloma patients. Additionally, to correlate the expression with clinical data and survival outcomes.
Material and Methods: The study population were multiple myeloma patients, diagnosed by bone marrow biopsy in Songklanagarind hospital; from 2012 and 2015. The clinical data and survival outcomes were collected. All cases were stained with NY-ESO1 (E978) antibody and interpreted by one pathologist and a resident.
Results: There were 61 patients that reached the criteria for this study. NY-ESO1 expression was detected in 4 of 61 cases (6.6%). The expression of NY-ESO1 was associated with serum albumin levels (p-value<0.01). However, no association between NY-ESO1 expression nor survival outcome was identified by survival analysis.
Conclusion: NY-ESO1 immunostaining showed low percentages of expression in multiple myeloma neoplastic cells, and was not associated with survival outcome.

The Untoward Effects of COVID-19 Vaccines and Determinant Factors among Vaccinated Healthcare Workers at Public Health Facilities in Addis Ababa, Ethiopia

Tesfaye Desalegn — 2025-08-22

Objective: The overall objective of this study was to investigate the adverse effects of coronavirus disease 2019 (COVID-19) vaccines, and their associated factors among vaccinated health care workers working (HCWs) at public health facilities in Addis Ababa, Ethiopia: 2021/22.
Material and Methods: This study was implemented on 542 study participants found in Addis-Ababa city administration public health facilities, Addis Ababa, Ethiopia. A quantitative approach and facility-based cross-sectional study design, using proportionate allocation of the samples among each health facility, was adopted. The study used a questionnaire as a tool to collect data.
Results: Out of 542 samples, 526 study subjects participated (61.5% females): response rate was 97.05%. The proportion of HCWs having had post-COVID-19 vaccine adverse effects outcome among the study participants was 319 (60.6%, 95% confidence interval: 56.7%-64.6%). Logistic regression analysis results revealed that the odds of having history of allergic reaction to any vaccine were found 11.108 times higher (p-value<0.05), and the odds of having co-morbidity were found to have 2.299 times higher (p-value<0.05) determinant effects to develop and significantly associate with the post-COVID-19 vaccine adverse effects.
Conclusion: Experiences of post-COVID-19 vaccine adverse effects is higher and more common. Following side effects, a significant number of study participants have also undertaken treatment options to reduce post-vaccine discomforts/ pains. Additionally, individuals that have history of allergic reactions to any vaccine and co-morbidities are positively associated with post-vaccine side effects. Therefore, even though post-COVID-19 vaccine side effects are very common, the advantages of taking the vaccine outweigh its disadvantages, and vaccinated individuals can seek treatment options when they experience severe post-vaccine side effects.