Hua Hin Medical Journal

Comprehensive Dental Care for A Complex Case: A Case Report

2026-04-18T11:46:22+07:00

Background: Caring for patients with complex needs requires the principles of comprehensive dental care. This holistic approach focuses on the patient’s overall health, considering the unique factors and individual differences of each person. This concept further encompasses prevention, health promotion, and the long-term maintenance of oral health.

Case Report: This report presents the case of an 11-year-old female patient who presented with multiple dental caries. Although the patient had a history of dental treatment three years prior, she lacked continuous care due to a negative attitude toward dental procedures. Clinical and radiographic examinations revealed mixed dentition with extensive decay in both primary and permanent teeth. Additionally, the patient presented with two supernumerary teeth (mesiodens): one erupted and one impacted between the maxillary central incisors.

Treatment Plan: The treatment plan involved extracting non-restorable permanent teeth and primary teeth, removing the supernumerary teeth, and performing restorations on carious teeth. Root canal treatment was performed on three maxillary anterior teeth with pulpal involvement, followed by the placement of dental posts. The impacted mesiodens was surgically removed. Throughout the treatment period, the patient received oral hygiene instruction and dietary counselling during every visit.

Results: Following treatment, the patient was free from dental pain and regained normal masticatory function. The restoration of her smile significantly boosts her confidence and fostered a positive attitude toward future oral self-care. Follow-up appointments showed improved plaque control and no new carious lesions.

Conclusion: This case report highlights the importance of comprehensive dental care through a structured yet flexible, patient-centered treatment plan. Especially in pediatric patients with dental anxiety and complex clinical needs, effective planning leads to better cooperation from both the patient and guardians. This ultimately ensures successful clinical outcomes and instills a lasting positive attitude toward oral health.

Nursing Care of Acute Ischemic Stroke with Intravenous Thrombolysis and Mechanical Thrombectomy: A Case Study

2026-02-04T13:03:04+07:00

Background: A stroke is a neurological disease in which the brain loses blood to nourish from narrowed or ruptured cerebral arteries. As a result, brain cells die, which can cause disability or death. Currently accepted treatment guidelines include intravenous thrombolytic drugs in ischemic strokes. Mechanical thrombectomy to remove blood clots within 6 hours and craniotomy to reduce intracranial pressure in patients with cerebral edema within 48 hours can reduce mortality and disability. This article presents a case study with the aim of studying the nursing of patients with acute stroke receiving intravenous thrombolysis and mechanical thrombectomy

Methods: This study was a patient admitted to an intensive care unit with a stroke. Institute of Neurology, 1 case for a period of 5 days from the collection of patient information from medical records in the form of nursing records. Doctor's treatment, interviews with patients and relatives. Observe, analyze comparative data, and plan the nursing process in the form of Focus Charting and monitor changes including distribution planning

Results: It was found that this patient had a history of diabetes and high blood pressure, which are the main causes of stroke. The patient was treated with intravenous thrombolysis and mechanical thrombectomy procedure to remove the blood clots. After treatment, the patient improved. The patient improved in order, 18 points on the NIHSS, 5 points on the modified Rankin scale (mRS), and 2 points on the Barthel index. Use of critical nursing practices in the acute phase that are still pending for referral. Distribution Planning As follows: 1) Intracranial pressure control, 2) Oxygen therapy, 3) Blood sugar level management, 4) Activities of Daily Living support. Institute of Neurology, 5 days in total

Conclusion: This patient was treated with intravenous thrombolysis and mechanical thrombectomy procedure to remove the blood clot. After treatment, the patient began to improve without complications. Enter a physical therapist's rehabilitation program. Therefore, the medical team coordinated to send the patient back for further treatment according to the original rights and made an appointment to monitor the symptoms 4 weeks before discharge. It can be seen that if the patient is cared for in a critical stage by a multidisciplinary team. In particular, registered nurses who are competent to care for patients in critical stages according to nursing standards, including holistic patient nursing, have resulted in good clinical results to reduce the mortality rate and reduce the disability of patients.

Comparison of Visual Acuity and Intraocular Pressure and Number of Glaucoma Medication before and after Cataract Surgery in Patients with Angle Closure Glaucoma

2026-03-10T14:18:44+07:00

Background: Primary angle-closure glaucoma (PACG) can be managed using various treatment modalities, including medications and laser therapy. However, in patients whose intraocular pressure remains uncontrolled, lens extraction with intraocular lens implantation has recently been recognized as an effective surgical treatment for PACG.

Objective: To evaluate the effectiveness of intraocular lens implantation surgery in patients with primary angle-closure glaucoma (PACG) who had previously been treated with antiglaucoma medications and/or laser therapy, focusing on improvements in visual acuity, reduction of intraocular pressure (IOP), and decreased use of antiglaucoma medications.

Methods: This preliminary experimental study employed a one-group pretest–posttest design. The study population consisted of patients with PACG who attended the ophthalmology clinic at Prachuap Khiri Khan Hospital and were treated with antiglaucoma medications and/or laser therapy, followed by cataract extraction with intraocular lens implantation. Data were collected from October 20, 2024, to January 20, 2025. A total of 31 eyes were included in the study. Descriptive statistics, including percentages, means, and standard deviations, were used for data analysis. Inferential statistics included the Friedman test and Wilcoxon Signed Ranks Test.

Results: The median visual acuity significantly improved after intraocular lens implantation surgery. When compared across follow-up periods at 1 week, 1 month, and 3 months postoperatively, visual acuity showed statistically significant improvement over time. The median intraocular pressure and the number of antiglaucoma medications used were significantly reduced at 1 week after surgery. However, no statistically significant differences in median intraocular pressure or medication use were observed between the 1 month and 3 month follow-up periods.

Conclusion: Cataract extraction with intraocular lens implantation in patients with primary angle closure glaucoma is an effective treatment modality. The procedure effectively reduces intraocular pressure, decreases dependence on antiglaucoma medications, and improves visual acuity, leading to better disease control and enhanced quality of life for patients.

The Outcomes of Endodontic Treatment in Dental Department, Somdet Phraphutletlha Hospital, Samutsongkhram Province

2026-04-01T13:36:37+07:00

Background: Studying the success rates and factors associated with endodontic treatment is crucial for prognosis and for assisting dentists and patients in making informed decisions about selecting the most appropriate treatment plan for each individual patient, especially when there are more than one treatment option for that tooth.

Objectives: The purpose of this study was to evaluate the outcomes and influence factors of endodontic treatment in Dental department, Somdet Phraphutletlha Hospital, Samutsongkhram province.

Methods: The retrospective study recalled 137 treated teeth from 1 Jan 2022 to 31 Dec 2025, follow up period is 7-43 months. The criteria used for evaluation of the outcomes were clinical and radiographic examination by applying Gutmann’s criteria. Factors influencing the endodontic treatment outcome were analyzed using Chi-square test or Fisher’s exact test at significant level of 0.05.

Results: From the 137 samples, the majority were female (65%), aged 18-77 years. Based on clinical symptoms and radiographic assessments, the success rate of endodontic treatment was 73%, while the failure rate was 27%. Factors significantly associated with endodontic treatment success (p-value<0.05) included tooth type (p=0.010), status of the pulp (p<0.001), and pre-operative periapical lesion (p<0.001).

Conclusion: The success rate of endodontic treatment was 73% for 100 and the failure rate was 27%. Tooth type, status of the pulp and pre-operative periapical lesion were significantly associated with the success of endodontic treatment.

Relationship between Hand Grip Strength and Physical Mobility in Patients with Obesity: a Retrospective Study

2026-03-23T13:54:18+07:00

Background: The Timed Up and Go Test (TUGT) is widely used; however, its administration requires adequate space and time. Hand grip strength (HGS) is a simple and rapid measure of overall muscle strength that may offer a practical alternative in constrained settings.

Objectives: To examine the relationship between HGS and TUGT performance in patients with obesity and to evaluate whether HGS can serve as a proxy indicator of mobility impairment.

Methods: This retrospective study included patients with obesity referred for physical therapy assessment at the Physical Therapy Unit, Srinagarind Hospital, Khon Kaen University. A total of 91 participants were included. HGS was measured using a handgrip dynamometer, and functional mobility was assessed using the TUGT. The association between HGS and TUGT was analyzed using Spearman’s rank correlation coefficient. Receiver operating characteristic (ROC) analysis was performed to determine the ability of HGS to identify reduced mobility (TUGT≥12 seconds).

Results: The majority of participants were female (67%) and the median age of 30 years. The median grip strength was 27 kg and the median TUGT time was 8.2 seconds. Grip strength was negatively correlated with TUGT (ρ=-0.38, p<0.001). Significant correlation was observed in women (ρ=-0.54, p<0.001), but not in men (ρ=-0.25, p=0.170). ROC analysis showed that grip strength had good discriminative ability for reduced mobility (AUC=0.86; 95% CI 0.70-1.00) in female with an optimal cut-off value of <17.5 kg.

Conclusions: Hand grip strength is associated with functional mobility in patients with obesity, particularly among women, and may serve as a practical screening tool in clinical settings.

Handgrip Strength as a Predictor of Exercise Capacity in Women with Obesity: A Retrospective Study

2026-03-23T13:51:42+07:00

Background: Obesity is a critical global public health issue, particularly among women, affecting both physical and mental health. The 6-Minute Walk Test (6MWT) is the most commonly used assessments of exercise capacity. However, such testing may be difficult to perform in patients with obesity due to limitations related to safety concerns, as well as constraints in space and time. In contrast, handgrip strength (HGS) is a simple, rapid assessment using handgrip dynamometry that reflects overall muscle strength and endurance for long‑distance walking such as the 6MWT. This study aimed to investigate the relationship between handgrip strength and the 6MWT in women with obesity.

Methods: This retrospective study included 57 women with obesity referred to the Physical Therapy Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. Handgrip strength was measured using a handgrip dynamometer, and exercise capacity was measured using the 6MWT. The correlation was analyzed using Spearman’s rank correlation. Receiver operating characteristic (ROC) analysis was performed to determine the ability of grip strength to identify reduced exercise capacity.

Results: Participants had a median age of 31 years (IQR = 18) and a median BMI of 38.3 kg/m² (IQR = 9.4). Mean handgrip strength was 24.1 kg (SD = 6.2), and the median 6MWT distance was 363 m (IQR = 59). Handgrip strength showed a significant positive correlation with the 6MWT (r_s = 0.59, p < 0.001). Receiver operating characteristic (ROC) analysis demonstrated that handgrip strength had good accuracy in identifying reduced exercise capacity (AUC [95% CI] = 0.75 (0.55 -0.96). The optimal cut-off value was 27 kg, yielding a sensitivity of 80% and a specificity of 69.2%.

Conclusions: Handgrip strength is significantly correlated with exercise capacity in women with obesity. It may serve as a viable clinical screening tool for identifying reduced exercise capacity in this population.

The Ergonomics Innovation Management for Elderly Safety in Hua Hin District, Prachuap Khiri Khan Province

2026-04-01T14:47:33+07:00

Background: Older adults experience declines in physical, mental, social, and spiritual health, and environments often fail to meet their changing needs. This can cause difficulty with daily activities, safety issues, and a higher risk of accidents, falls, and serious injuries that could be fatal, with cascading impacts on family and social economics. Applying ergonomic principles when designing environments to accommodate the physical abilities and needs of seniors is essential. It helps maintain free movement, reduces reliance on others, and improves quality of life.

Objectives: 1) To study the safety management situation for the elderly in Hua Hin District; 2) To identify safety management problems; and 3) To present ergonomics management innovations for the safety of the elderly in Hua Hin District, Prachuap Khiri Khan Province.

Methods: This study is qualitative research conducted in Hua Hin District, Prachuap Khiri Khan Province. It involved both participatory and non-participatory observations. In-depth interviews were conducted with key informants using semi-structured interview guides (CVI = 0.96) until data saturation was reached. The participants were divided into three groups: policymakers, practitioners, and elderly individuals, along with their caregivers. Participants were selected using purposive and snowball sampling methods. Data collection took place from January 2026 to March 2026.

Results: Key informants included 23 individuals. Data analysis reveals three core insights: 1) A Multi-Level Policy Framework with a clear Policy-Practice Gap; 2) Five safety management problems including physical environmental risk factors, physical capacity limitations, monitoring system gaps, the need for family/community participation, and demand for context-appropriate innovations; and 3) The proposed innovation "E-Safe Hua Hin" or HEESM (Hua Hin Ergonomics for Elderly Safety Model) comprises five main components: (H) Hazard Assessment, (E) Environment Design based on Universal Design principles, (E) Exercise & Capacity Enhancement, (S) Smart Surveillance using IoT/AI, and (M) Multi-stakeholder Network. The innovation accommodates both local elderly residents and long-stay tourists, aligning with Hua Hin's strategy as a global wellness tourism destination.

Conclusion: The HEESM innovation and Single Data Platform represent integrated management innovations combining interdisciplinary knowledge in humanities, environment, technology, and society. They effectively reduce fall risk and improve safety for the elderly by shifting the paradigm toward proactive, elderly-centered care. The Single Data Platform ensures continuous and sustainable surveillance and can serve as a model for other coastal tourism cities. This approach benefits not only elderly residents but also reduces the burden on caregivers and local public health budgets, contributing to the development of local and national health policies.