Journal of Health Science and Medical Research

Using Infant and Child Feeding Index and Its Components to Assess Infant Feeding Practices and Risk of Anemia among 6–12-Month-Old Thai Infants

Praenapa Chaithaweesup — 2025-03-20

Objective: To examine the feeding practices among the mothers of 6-12-month-old infants using Infant and Child Feeding Index (ICFI) scores and to determine which components in the ICFI were associated with anemic infants.
Material and Methods: One hundred nineteen healthy term infants aged 6-12 months were recruited from November 2020 to December 2021. Infant feeding practices of the mothers were assessed using a 24-hour food record to collect which foods the infants consumed before the scheduled visit, and food group frequencies during the previous week. The food intakes of the infant were categorized into seven food groups and ICFI scores were calculated. Each infant had their weight and length measured, and a complete blood count was performed to assess anemia.
Results: The number of food groups was significantly higher in the 9-12-month-old infants than in the 6-9-month-old infants (5 vs 4, respectively, p-value<0.01) and also the ICFI scores (6 vs. 5, respectively, p-value<0.01). Anemia was found in 35 infants (29.4%) and was significantly higher in infants who were mainly breastfed, who were given complementary meals with dietary diversity <4 food groups, and who had an ICFI score <5. However, multivariate logistic regression found that the only significant factors associated with anemia were mainly breastfed (adjusted odds ratio 3.15, p-value<0.001) and dietary diversity <4 food groups (adjusted odds ratio 3.94, p-value=0.01).
Conclusion: Infants older than 6 months should be mainly breastfed with 3-4 complementary meals with at least 4 food groups daily to prevent anemia from iron deficiency.

Performance of the Machine Learning Algorithm in Stature Estimation Using Scapula Measurements from Post-Mortem Computed Tomography in a Thai Male Population

Thutchai Opaburanakul — 2025-03-20

Objective: This study attempted to investigate the performance of stature prediction models from scapular dimensions based on post-mortem computed tomography (PMCT) using machine learning algorithms within the male population of Southern Thailand.
Material and Methods: Linear Regression (LR), K-Nearest Neighbors (KNN), Random Forest tree (RF), and Support vector machine (SVM) algorithms were used to create the stature estimation model. Then its performance was compared by coefficient of determination (R²), mean absolute error (MAE), mean squared error (MSE), and root mean squared error (RMSE).
Results: Machine learning is a valuable tool for estimating stature within this demographic. LR algorithm provided the best performance matrices, with the highest R² being 0.316, and the lowest values for MAE, MSE, and RMSE being 4.379 cm, 29.530 cm, and 5.382 cm, respectively.
Conclusion: The machine learning algorithm demonstrated valuable tools for estimation stature. However, it is essential to note that complex machine learning models do not always produce better performance measures than non-complex models.

Exploring Prevalence and Predictors of Clinically Suspected Dialysis Disequilibrium Syndrome in End-Stage Kidney Disease Patients Initiating Hemodialysis

Budsarawadee Nookaew — 2025-03-20

Objective: This study aimed to examine the prevalence and predictors of clinically suspected dialysis disequilibrium syndrome (DDS) in end-stage kidney disease (ESKD) patients starting their first hemodialysis session.
Material and Methods: Data was retrospectively collected from a university hospital; from december 2020 to july 2023. It included adult patients receiving their first session of hemodialysis. Patient demographics, comorbidities, medications, and laboratory results were analyzed. The primary objective was to identify clinically suspected DDS using predefined criteria. Multivariate logistic regression was used to identify independent risk factors for clinically suspected DDS.
Results: A total of 106 patients were enrolled. Among these, 18.8% had clinically suspected DDS, with nausea being the most prevalent symptom. The onset of symptoms varied, with a median of 240 minutes. Multivariate analysis revealed higher pre-hemodialysis serum creatinine as a risk factor for DDS (adjusted OR: 1.13; 95% CI: 1.02–1.25), while lower pre-hemodialysis serum sodium (adjusted OR: 0.90; 95% CI: 0.84–0.98) and capillary blood glucose levels (adjusted OR: 0.99; 95% CI: 0.97–1.0) were associated with increased risk. Notably, elevated blood glucose levels were protective against DDS.
Conclusion: Higher pre-dialysis serum creatinine, coupled with lower sodium and glucose levels significantly predicts DDS. These findings emphasize the necessity of tailored hemodialysis prescriptions and vigilant monitoring of patients likely to develop DDS.

Does Harmonic Scalpel Tonsillectomy Have Better Postoperative Outcomes Than Cold Dissection Technique in Adults? Results of A Randomized Double-Masked Study

Vinay Kumar — 2025-03-20

Objective: To compare postoperative pain, intraoperative blood loss, operating time, time needed to return to a normal diet, and activity between harmonic scalpel and cold dissection tonsillectomies.
Material and Methods: In this prospective, double-blind study, eligible patients aged 18 and above (n=88) were randomized to receive either harmonic scalpel tonsillectomy (n=44) or cold steel tonsillectomy (n=44). Pain was assessed using the visual analogue scale (VAS) on days 1, 4 and 7, respectively. Intraoperative bleeding was measured by intra-suction blood and the weight of tonsil swabs.
Results: On postoperative day one, the mean pain score in the harmonic scalpel group was 4.6±1.4 (range, 2-7), and in the cold steel group, it was 7.2±1.7(range, 4-10): (p-value<0.001). The mean pain score on the 7th postoperative day in the harmonic scalpel group was 2.3±1 (range, 1-4), and in the cold steel group, it was (2.6±1.3, range 1-6) (p-value=0.145). The mean intraoperative bleeding in Group 1 was 8±1.9 (range, 5-12 cubic centimeter (cc)), and in Group 2 was 66.3±8.1 (range, 58-90 cc): (p-value<0.001). The mean duration of surgery in Group 1 was 14.5±3.5 (range, 11-28 minutes) and in Group 2 was 27.4±4.4 (range, 22-38 minutes) (p-value<0.001). The mean time taken to return to resume daily activities in the case of harmonic scalpel was 7.6± 0.8 days, whereas in cases of the cold steel method it was 8.8±0.9 days (independent t-test, p-value=0.050).
Conclusion: Harmonic scalpel tonsillectomy has less postoperative pain compared to the cold dissection technique. Additionally, there is less intraoperative blood loss and a reduced incidence of delayed haemorrhage.

Effectiveness of Community Based Group Therapy for Chronic Low Back Pain in Older Women in Bangladesh: A Randomised Controlled Trial

Tanzila Akhter — 2025-03-20

Objective: Group therapy involves multiple people being treated by one or more health professionals. It can cure physical and psychological conditions; such as attention-deficit/hyperactivity disorder (ADHD), emotional trauma, anxiety, despair, and post-traumatic stress disorder (PTSD). This study investigates whether community-based group therapy helps older women with chronic low back pain.
Material and Methods: The study was a randomized controlled trial, with 40 patients divided into control and intervention groups. The control group received conventional treatment in an institute-based rehabilitation (IBR) facility, while the intervention group received the same exercise program in a community-based rehabilitation (CBR) setting. Both groups received supervised 30-minute sessions five days a week for eight weeks. The numeric pain rating scale (NPRS) was used to measure the severity of pain and the Roland-Morris Disability Questionnaire (RMDQ) measured physical disability due to low back pain in older women.
Results: The average age of the participants was 56 (53 to 58.50). The BMI findings were 7.5% (n=3) of participants being underweight and 45% (n=18) of participants being overweight. In terms of pain and physical disability due to low back pain, the CBR group showed significant improvement (p-value<0.05) in cases of both inter- and intra-group comparison using the IBR treatment facility.
Conclusion: Group therapy treatment reduces low back pain and prevents the severity of back pain in older women, thereby improving their quality of life. This study shows that group-based physical therapy helps relieve chronic low back pain. Strengthening, stretching, and flexion exercises in groups improve quality of life and minimise discomfort.

Optimal Timing for Postanesthesia Care Unit Discharge Using Physiological-Based Criteria in In-Patients Undergoing Low-Risk Surgery with General Anesthesia: A Prospective Observational Study

Worranut Taesiri — 2025-03-20

Objective: All postanesthesia patients must be monitored in the postanesthesia care unit (PACU) until they meet PACU discharge protocols. These included both physiological-based discharge (PBD) criteria and time-based discharge (TBD) criteria. The efficacy of using only PBD criteria to determine PACU discharge remains unclear. Therefore, this study aimed to determine the optimal timing for PACU discharge using PBD criteria alone for in-hospital patients undergoing low-risk surgeries.
Material and Methods: This was a prospective observational study, involving 532 patients who had undergone elective low-risk surgery under general anesthesia (GA). At the PACU, the following data points were recorded: patient demographics, anesthesia and surgical data, the time required to meet PBD criteria, the actual PACU discharge time, complications during PACU admission, and causes of delayed PACU discharge. This study analyzed the comparison between the average time to meet PBD criteria and the ‘actual’ PACU discharge time.
Results: A total of 532 patients admitted to the PACU were enrolled in this study. The mean PBD time was 12.6± 8.4 minutes, and the mean actual PACU time was 65.1±15.5 minutes: a difference that was statically significant [mean difference 52.5 (51.1, 54.0) minutes, p-value<0.001]. No severe complications were observed. Severe pain was the most recorded complication during PACU admission. The highest cause of delayed PACU discharge was the unavailability of hospital patient transporters.
Conclusion: The PACU discharge time for in-hospital patients undergoing low-risk surgery under GA, based on PBD criteria, was significantly shorter than that based on TBD criteria; additionally, no severe complications were reported.

Exploring Alternative Sweeteners: Consumer Perspectives and Product Development for Healthier and Affordable Choices

Chernporn Navanukraw — 2025-03-20

Objective: This study aimed to evaluate the consumption, consumer experiences, and expectations of alternative sweeteners (AS) among adults. It also developed and assessed a prototype alternative sweetener product (ASP) in terms of acceptability and willingness-to-pay compared to sugar.
Material and Methods: Two studies were conducted. In Study I, a cross-sectional survey assessed consumer experiences and expectations of AS. In Study II, a prototype ASP was developed using erythritol, stevia and sucralose via a geometric dilution method. The ASP was then compared to sugar in snacks and beverages through a single-blinded experiment.
Results: The survey revealed that 63.6% disliked the taste of AS, expecting a sugar-like taste and affordable price. The single-blinded experiment showed no significant differences in overall liking between the ASP and sugar. The cost of the ASP prototype was 88% cheaper than the average marketed AS available in physical markets.
Conclusion: These findings indicate consumer readiness to accept AS, although current market products do not fully meet consumer expectations. The ASP prototype, being more affordable and acceptable, has the potential to reduce barriers related to the affordability and acceptability of AS. The simplicity of the technique used to prepare the ASP prototype also facilitates the transfer of this technology to consumers for home use.

Health Threats among Thai Pilgrims during Pilgrimage to Holy Buddhist Places in India: A Cross-Sectional Descriptive Study

Phannathat Tanthanapanyakorn — 2025-03-20

Objective: The pilgrimage to make merit by visiting and paying respect to four sacred Buddhist places in India is a popular tradition among Thai pilgrims. However, health threats are common occurrences during such pilgrimages. This study aimed to investigate health threats and associated factors among Thai pilgrims during the pilgrimage to sacred Buddhist places in India.
Material and Methods: This cross-sectional descriptive study surveyed 404 Thai pilgrims who visited sacred Buddhist places from December 2023 to February 2024, using cluster sampling. The data was collected in India during their pilgrimage to sacred Buddhist places through a questionnaire. Data were analyzed by using descriptive statistics and multiple logistic regression.
Results: The majority of pilgrims in India experienced health threats (61.4%) during pilgrimage to sacred Buddhist places; including fever (45.8%), cough/sore throat (20.3%), headache/migraine (11.1%), constipation (10.4%), muscle pain/back pain (6.7%), phlegm (6.7%), knee/leg pain (6.4%) and diarrhea/food poisoning (5.4%). After adjusting for the effects of all other variables, factors significantly associated with health threats during the pilgrimage at the Holy Buddhist places were: age (adjusted odds ratio (AOR)=1.26, 95% confidence Interval (CI)=1.17-2.22, p-value=0.014), duration of pilgrimage (AOR=1.63, 95% CI=1.01-2.82, p-value=0.042), expenses for pilgrimage (AOR=1.94, 95% CI=1.16-3.16, p-value=0.011), health conditions (AOR=3.29, 95% CI=2.03-5.38, p-value<0.001) and health preparation (AOR=1.63, 95% CI=1.01-2.63, p-value=0.044).
Conclusion: The findings demonstrated that factors related to health threats need to be addressed. Health preparation is a crucial factor for developing guidelines and planning to provide healthcare services for pilgrims.

Influence of Parental Dental Anxiety on Children’s Oral Health Status - a Cross Sectional Survey

Aseema Samal — 2025-03-20

Objective: Parental dental fear and anxiety (DFA) significantly influence adolescents’ access to the dental care and their ability to maintain oral health. The study aimed to evaluate how dental anxiety of parents affects the oral health status of their children using the Index of Dental Anxiety and Fear “(IDAF)-4C+” scale.
Material and Methods: A cross-sectional survey was conducted among 111 parent-child pairs in the out patient department (OPD) of the Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, Bhubaneswar, Odisha (India). Children aged 6 -14 years and one of their parents were selected using convenient sampling for the study. An investigation was done to assess the impact of the dental anxiety of the parents on the oral health status of their children. A pre-tested questionnaire, “IDAF-4C+” was used to measure the dental anxiety and fear of the parents. Clinical examinations of the children were done using the World Health Organization (WHO) dentition status (2013). The STATA-14 was used for statistical analysis.
Results: 44% of the parents reported no or little, or low dental fear. Of the rest, 8% reported moderate dental fear and 4% reported high dental fear. Positive correlations were found between the dental fear, phobia symptom, and dental experience of the parents and the oral health status of their children (r1=0.1254, r2=0.1120, r3=0.1829) for each of the 3 modules of the IDAF-4C+ (IDAF-4C, IDAF- P, IDAF-S) i.e. core, phobia and stimulus model respectively.
Conclusion: The dental anxiety of a parent affects the oral health of their children. The IDAF-4C+ scale provides a comprehensive insight into the origins of dental anxiety and its impact on emotions, cognitive processes, and behaviour.

Non-Typhoidal Salmonella Gastroenteritis Outcomes in Immunocompetent Children

Suppasiri Samphantharat — 2025-03-20

Objective: To compare the clinical outcomes in children older than 3 months with non-typhoidal Salmonella (NTS) gastroenteritis treated with or without empirical antibiotics.
Material and Methods: Medical records of all patients aged 3 months to 15 years having experienced their first episode of NTS and treated at Songklanagarind Hospital from January 2007 until December 2021 were reviewed.
Results: NTS infections occurred in 18 (8.0%) of 224 patients, with NTS gastroenteritis. Antibiotics were empirically prescribed to 159 (70.9%) patients. The antibiotics group included a significantly higher proportion of patients with a general sick appearance (20.1% vs. 6.3%), bloody diarrhea (56.6% vs. 33.3%), and abdominal pain (12.9% vs. 1.9%) than that in the no-antibiotics group. The antibiotics group seemed to have a shorter median (interquartile range [IQR]) duration of bloody diarrhea (3.0 [1.3–4.8] vs. 4.5 (3.0–6.5) days, p-value=0.051), but similar duration for fever (3.0 [1.0–4.0] vs. 3.0 [1.3–5.0] days, p-value=0.566) compared to that for the no-antibiotics group. In multivariate analysis, children with underlying diseases (extravascular hemolytic anemia and/or abnormal kidney and urinary bladder system), fever duration >5 days by the first visit, and white blood cell (WBC) count >15,000 cells/mm3 were at risk of iNTS infections, with an odds ratios (95% confidence intervals) of 7.96 (1.70, 37.30), 7.75 (1.74, 34.46), and 8.69 (2.39, 31.55), respectively.
Conclusion: Patients aged 3-36 months with NTS gastroenteritis having an underlying disease, fever duration >5 days, and/or WBC count >15,000 cells/mm3 should be treated with empirical antibiotics while waiting for hemoculture.

An Accuracy Study of Contact and Non-Contact Clinical Thermometers at Songklanagarind Hospital, Thailand

Mahdee Samae — 2025-03-20

Objective: This study aimed to assess and validate the accuracy of contact clinical thermometers (CCTs), clinical digital thermometers (CDTs), temperature probes, and non-contact clinical infrared thermometers (NCCITs), which are commonly used at Songklanagarind Hospital.
Material and Methods: The Medical Equipment and Maintenance Centre (MEMC) at Songklanagarind Hospital collected a total of 187 clinical thermometers, from various departments. This collection comprised of 45 temperature probes, 112 CDTs, and 30 infrared thermometers. All these thermometers underwent calibration at three distinct temperature points, via comparison with the secondary reference temperature standard (Pt100, SIKA). To assess the accuracy of the collected thermometers, an evaluation of the associated error and uncertainty was conducted. The maximum permissible errors (MPEs) were precisely defined as: ±0.2 °C and ±0.3 °C for CCT and ±0.5 °C for NCCIT.
Results: The results revealed that all temperature probes, which represent 100% of the sample, demonstrated an average acceptable accuracy; determined by the average of the percentage of acceptable accuracy across three temperature calibration points, within the Maximum Permissible Error (MPE) range of ±0.2 °C. However, only 14% of the CDTs showed an average acceptable accuracy within the MPE of ±0.2 °C. Meanwhile, 51% of the CDTs met the MPE of ±0.3 °C. Additionally, 90% of the NCCIT demonstrated superior acceptable accuracy compared to the MPE of ±0.5 °C.
Conclusion: This research emphasizes the significance of assessing the reliability and accuracy of clinical thermometers through calibration techniques; especially during the ongoing COVID-19 pandemic, which demands large-scale illness screening.

Magnetic Resonance Imaging in Evaluation of Bone Tumor Matrix: Diagnostic Value and Matrix Characteristics

Wisitsak Pakdee — 2025-03-20

Objective: Plain radiographs are vital for initial evaluations of bone tumors. However, multiplanar imaging; like magnetic resonance imaging (MRI), is often necessary for inconclusive cases. Hence, we aimed to determine the diagnostic value of MRI in evaluating bone tumor matrix and analyzing MRI characteristics of the matrix.
Material and Methods: This study reviewed 245 MRI and plain radiographs of pathologically confirmed bone tumors; including 123 mineralized and 122 non-mineralized bone tumors. A radiologist having 16 years of experience assessed tumor matrix characteristics, including border, signal intensity on T1-weighted (T1W), T2-weighted (T2W), and gradient-echo images, along with enhancement patterns. Sensitivity, specificity, and a 95% confidence interval were used to present diagnostic values.
Results: MRI demonstrated a sensitivity and specificity of 78.1% and 87.7% in differentiating mineralized from non-mineralized matrices, compared to 75.6% and 92.6% for plain radiographs. Both modalities showed high sensitivity and specificity in evaluating osteoid and chondroid matrices (MRI: 80.3%/84.0%, 94.5%/96.8%; radiographs: 80.3%/72.0%, 95.1%/96.4% specificity). High specificity was noted in evaluating fibrous matrices (97.4%/99.6%) but with low sensitivity (23.5%/11.8%). MRI outperformed radiographs in subcategorizing fat, soft tissue, and cystic tumors. The chondroid matrix exhibited distinct characteristics on MRI (well-defined lobulated border with high/intermediate T2W and lobulated/peripheral enhancement), while osteoid and fibrous matrices showed similar features, except in T1W signal intensity. Non-mineralized tumors displayed varied characteristics.
Conclusion: While plain radiographs are essential for initial bone tumor assessment, especially for mineralization, MRI is superior in evaluating tumor matrices and non-mineralized tissues in providing detailed characterization for staging and treatment planning.

Anthropometric and Physical Fitness Component Profiles in Malaysian Adolescence Recreational Karateka

Mohamad Azwan Aziz — 2025-03-20

Objective: Measuring the physical fitness components of athletes provides crucial information in designing an individual training program to enhance performance. However, a huge gap is identified, in the lack of baseline physical fitness profiles among Malaysian adolescence Karateka. Our objective is to describe the physiological profiles of Malaysian adolescence Karateka.
Material and Methods: This cross-sectional study was conducted in the Klang Valley; at eight Karate training facilities in participants aged 13-19 years old. Demographic data, anthropometric and short physical performance batteries, 3-minute YMCA step test, Jamar handgrip dynamometer test 3-minutes and 1-minute sit-up test were collected and analysed using statistical package for social sciences version 26.
Results: The mean age was 15.8±1.8 years. The mean body mass index was 21.5±4.5 kg.m², the mean VO2 peak was 59.0±12.4 ml.kg.min, and the mean hand grip strength was 30.7±9.3 kg. Karateka in higher age groups (18-19 years) had a significantly higher weight (median=64.4, p-value=0.003), higher skeletal muscle mass (median=27.6, p-value=0.006), higher hand grip strength (median=37, p-value=0.000), and higher 1 min sit up test (median=32, p-value=0.071). Male Karateka had a higher skeletal muscle mass (median=25.9 kg, p-value=0.000), higher hand grip strength (median 33.1 kg, p-value=0.000), higher 1 minute sit-up test (median=32, p-value=0.001) and higher VO2 peak (median 67.2 ml.kg.min, p-value=0.000).
Conclusion: This serves as baseline anthropometric and physical fitness profiles among Malaysian adolescence Karateka.

Effects of a Futsal Sports-Specific Program on Cognitive Intelligence in Youth Male Futsal Players

Thanyawat Homsombat — 2025-03-20

Objective: The purpose of this pre-experimental research was to compare the effects of novel futsal sports-specific training on cognitive intelligence before and after 4 and 8 weeks of training in youth male futsal athletes.
Material and Methods: Participants included 26 youth male futsal athletes via a systematic random sampling method. The experiment instrument was novel futsal sports-specific training that combined specific futsal training and plyometrics three days a week, for eight weeks. The instruments used to collect data were the standard simple reaction time task to assess processing speed, and the standard cognitive flexibility test consisted of a trail-making test part A and trail-making test part B. Descriptive statistics including percentages, means, standard deviations, and inferential statistics; including one-way analysis of variance with repeated measures and the Bonferroni test. Statistical significance was set at the 0.05 level.
Results: The results found that when conducting a one-way ANOVA with repeated measures, both processing speed and cognitive flexibility were significantly different before, during the 4th week and after the 8th week of training. Comparing the mean pair, it was found that both processing speed and cognitive flexibility decreased significantly before and after the 4th week, before and after the 8th week, and after the 4th week and after the 8th week.
Conclusion: Futsal players’ performance is influenced by a sophisticated program called: ‘Novel futsal sports-specific training’, which focuses on cognitive intelligence traits; including cognitive flexibility and processing speed.

Oral Health-Related Quality of Life in Orthodontics: A Cross Sectional Study on Adolescents and Adults in Orthodontic Treatment in Kuantan, Pahang

Cheong Joo Ming — 2025-03-20

Objective: This study aimed to assess the impact of the OHIP subscale on OHRQoL and compare the OHRQoL of adolescents and adults.
Material and Methods: A total of 160 subjects (60 adolescents and 100 adults) undergoing orthodontic treatment completed the Malaysian Oral Health Impact Profile (S-OHIP(M)) to assess OHRQoL. The instrument consisted of 14 items, grouped into 7 subscales, which were: (i) functional limitation, (ii) physical pain, (iii) psychological discomfort, (iv) physical disability, (v) psychological disability, (vi) social disability, and (vii) handicap. Mann-Whitney U and Kruskal Wallis tests were applied to compare the OHRQoL between both age groups and demographic characteristics.
Results: There was a statistically significant difference in median score for quality of life between adolescents 12(9) and adults 16(8). Physical pain had the highest impact on OHRQoL in both groups; whereas, social disability had the least impact for both groups.
Conclusion: This study showed that adult groups reported a higher score of impact on OHRQoL compared to adolescent groups. In addition, adolescents and adults reported physical pain as having the highest impact on OHRQoL during orthodontic treatment, with social disability being the least affected factor in OHRQoL.

Personalized Adjunctive Hemoperfusion Therapy for Refractory Septic Shock Caused by Vibrio Cholerae in Thalassemia Patient

Natthaka Sathaporn — 2025-03-20

This case report describes a patient with Beta-thalassemia/hemoglobin E that developed Vibrio cholerae septicemia, leading to refractory septic shock with a maximum norepinephrine equivalent dose of 1.84 µg/kg/min and multi-organ failure. As the patient remained in refractory shock despite receiving proper antibiotics and organ support for 48 hours, adjunctive therapy including, HA330 hemoperfusion, was initiated. Shock reversal and significant reduction of inflammatory cytokines were achieved after two intervention sessions. The patient was discharged home, despite an initial predicted mortality rate of 85% based on Acute Physiology and Chronic Health Evaluation II (APACHE II).

Painless Multiple Cranial Neuropathies due to Symptomatic Bone Marrow Metastasis in First Diagnosis of Advanced Stage Breast Cancer: A Case Report

Siriporn Lin — 2025-03-20

Metastatic breast cancer commonly involves the bone, liver, and lungs. While bone marrow metastasis (BMM) is rare, it has a significant association with distant recurrence and diminished survival rates. Typically, BMM manifests with hematological abnormalities and none of the previous reports revealed BMM as a first presentation in breast cancer patients. Herein is a reported case of painless, multiple cranial neuropathies as an unusual initial manifestation of symptomatic BMM, marking the first presentation of metastatic breast cancer.

The Evolution of Lupus Nephritis Treatment; from Conventional to Targeted and Biologics Therapy

Warot Piriyasanguanpong — 2025-03-20

Lupus nephritis (LN) is a common and severe organ manifestation in patients with systemic lupus erythematosus (SLE). LN can present alone or with accompanying extra-renal symptoms. The prevalence and severity vary depending on ethnicity, genetics, and environmental exposure. However, the presence of LN in SLE is a surrogate indicator of disease severity, frequent relapse, increased chronic kidney disease (CKD), and mortality risks. The current conventional standard treatments for LN include corticosteroids, immunosuppressive drugs, and antimalarial drugs. Despite an optimal standard treatment regimen, the outcomes of renal remission, decreased CKD risk, and quality of life are unsatisfactory. In addition, corticosteroid and immunosuppressive drug toxicity are of primary concern. Thus, two dozen promising biological and targeted drugs are being studied in the LN treatment pipeline to improve renal outcomes and mitigate the side effects of conventional therapy. This article aims to review the pathogenesis of LN, summarise the current conventional strategy, and highlight the candidate novel drugs in LN included in Phase II and III clinical trials. These biologics, or targeted therapies, are hoped to facilitate the advancement of the LN treatment paradigm in the era of precision medicine.

Recent Advancements in Intracanal Medicaments used in Paediatric Dentistry: A Comprehensive Review

Sheenam Ayub — 2025-03-20

This review aimed to examine the recent literature concerning conventional intracanal medicaments, and summarize important recent developments. Literature research was performed focusing on articles on safe and effective intracanal medicaments in Google Scholar using the MeSH terms “herbal drugs as intracanal medicaments”, “intracanal medicaments for pediatric patients” and “safe intracanal medicaments”. A total of 63 studies were included in this review, following inclusion and exclusion criteria. Our literature search revealed that drugs derived from natural sources have become promising alternatives for intracanal medicaments due to their safety profile and potential therapeutic advantages. Furthermore, herbal remedies are frequently well-tolerated by paediatric patients, reducing the likelihood of adverse events. The advantages of herbal drugs in paediatric dentistry extend beyond their antimicrobial efficacy. They offer a holistic approach by harnessing the healing properties of nature, potentially minimizing the need for synthetic chemicals and antibiotics. Recent advancements in intracanal medicaments for paediatric dentistry encompass a spectrum of options, ranging from conventional to herbal-based formulations. While conventional medicaments continue to play a vital role, herbal drugs offer promising alternatives with potential benefits in efficacy, safety, and patient acceptance.

The Evolving E-Cigarette: A Comparison Narrative of Cigarette Smoke and E-Cigarette Vapour on Sleep

Swetha Kannan — 2025-03-20

Recent development of ‘e-cigarettes’ has increased the utilization by the common population, under the assumption of it being a safer alternative compared to conventional cigarettes. However, the harmful biological effects of e-cigarettes, or most commonly called vaping, are still not clear. This review aims to highlight the effect of conventional cigarettes on one’s sleeping patterns and quality. The studies reported in this review were collected from the databases that included PubMed, ScienceDirect, Hindawi, ResearchGate, and AHA journals from 1994-2022. Studies that focussed on the effects of smoking on other aspects of one’s health. Separate literature searches were conducted to analyse sleep quality among people that smoked cigarettes and people who used a vape. Literature reviews showed cigarette smoking caused a reduction in sleep quality and also an increased risk of sleep-related disorders. A review of articles concerning the association between vape and sleep also showed similar results, with vape users reporting shortened and poorer sleep quality compared to non-users. Data from this article can prove useful in shedding light on the deleterious impact of vape on sleep and overall general health, as the common notion of e-cigarettes being an acceptable and safe substitute is widely practiced among the younger population.