Journal of Health Science and Medical Research

Paraneoplastic Cerebellar Degeneration with Anti-Yo Antibody in a Patient with Fallopian Tube Adenocarcinoma: A Case Report and Literature Review

Jirayu Sae-Chan, Supakorn Yamuthai, Thanyalak Amornpojnimman, Prut Koonalinthip — Thu, 19 Jun 2025 00:00:00 +0700

Paraneoplastic cerebellar degeneration (PCD) typically presents via acute to subacute cerebellar ataxia, dysarthria, and ocular dysmetria, resulting from tumor-induced autoimmunity against the cerebellum. In most cases, symptoms of PCD show months before a diagnosis of cancer. Therefore, it is important for clinicians to investigate the primary tumor in PCD cases in order to treat both conditions concurrently. Herein, we report a case of PCD associated with an anti-Yo antibody, leading to a diagnosis of left fallopian tube adenocarcinoma.

A Case Report of Lithium-Induced Tardive Dyskinesia

Chutimon Boonrod, Keerati Pattanaseri, Juthawadee Lortrakul — Thu, 19 Jun 2025 00:00:00 +0700

Our case involves an elderly patient with bipolar disorder with a history of long-term low-dose lithium monotherapy (600 mg/day) who subsequently developed tardive dyskinesia as an adverse drug reaction. Generally, tardive dyskinesia is an iatrogenic movement disorder resulting from the long-term use of dopamine-blocking agents. However, lithium, a mood stabilizer with a mechanism of action that is not completely understood, has also been identified in some studies for its potential impact on dopamine synthesis and transmission. While common adverse effects of lithium include nausea, vomiting, and fine tremors, it rarely causes movement disorders. Limited reports exist regarding tardive dyskinesia associated with lithium usage. Following normal laboratory investigations, lithium was discontinued and diazepam was prescribed instead. Subsequent follow-up visits showed an improvement in symptoms.

Concurrent Emphysematous Gastritis and Small Bowel Ischemia Induced by Methamphetamine Abuse

Thu, 19 Jun 2025 00:00:00 +0700

Methamphetamine abuse poses significant health risks, including cardiovascular and cerebrovascular events. Herein is presented a young woman with chronic amphetamine abuse having developed severe abdominal pain and vomiting. Investigations revealed emphysematous gastritis and small bowel ischemia, leading to rapid deterioration and death despite aggressive intervention. This unique case underscores the need for early recognition and intervention to prevent the life-threatening consequences of methamphetamine abuse. The concurrent occurrence of emphysematous gastritis and small bowel ischemia has not been, to our knowledge, previously documented in methamphetamine users, highlighting the importance of clinician vigilance as abuse rates rise.

Success Rate of Drilling and Knuckle Wire Crossing Technique in Chronic total Occlusion of the Femoro-Popliteal Artery and Predicting Factors Related to it in Real-World Data

Thu, 19 Jun 2025 00:00:00 +0700

Objective: Crossing chronic total occlusion (CTO) in femoro-popliteal (FP) arteries is challenging. Hence, this study aimed to describe real-world data on the technical success rate of crossing FP CTO lesions, and analyze predicting factors for crossing failure.
Material and Methods: This retrospective study, conducted at a single center, involved patients with peripheral arterial disease (PAD) and FP CTOs, categorized as Rutherford categories 3-6, having undergone endovascular recanalization from 2017 to 2022. Baseline characteristics and crossing success rates were described using frequencies, percentages, means, medians, standard deviations, and interquartile ranges. Factors associated with crossing failure were analyzed through logistic regression analysis, with statistical significance set at a p-value<0.05.
Results: Among the 181 patients analyzed, the majority exhibited minor tissue loss (63%) and severe disease (TASC II category D, GLASS grade 4). The predominant CTO crossing approach was based on plaque cap morphology (CTOP) classification type B (66.9%), with severe CTO calcification (PACSS type 4) in 23.8%. Median occlusion length was 16.1 cm; 85.6% successfully crossed the CTO and antegrade success was 57.5%. Factors associated with crossing failure included: CTOP types C or D, CTO at the P3-popliteal artery, severe CTO calcification, and dyslipidemia. Retrograde recanalization showed higher success rates in CTOP type D and longer occlusions.
Conclusion: This study highlights the safety and effectiveness of the catheter-wire crossing technique for FP CTOs. CTOP classification, CTO location, severe calcification, and dyslipidemia predicted crossing failure. The retrograde approach works well in CTOP type D and longer CTOs, providing insights for improving success in clinical practice.

External Validation of the PeRSonal Gestational Diabetes Model for Predicting Adverse Pregnancy Outcomes in Women with Gestational Diabetes: A Retrospective Cohort Study in a Tertiary Hospital in Thailand

Sunittha Sanguanchua, Sorawat Sangkaew, Khodeeyoh Kasoh — Thu, 19 Jun 2025 00:00:00 +0700

Objective: This study aimed to validate the PeRSonal Gestational Diabetes (GDM) model with two-step glucose tolerance diagnostic criteria.
Material and Methods: A retrospective cohort study was conducted on participants having delivered with GDM diagnosis in a tertiary hospital; from October 1, 2020, until September 30, 2022. The main outcome was a composite of maternal and perinatal adverse pregnancy complications. Model validation evaluated the predictors and calculated risk by using a two-step glucose tolerance test in the PeRSonal model formula. Model performance was analyzed for discrimination, calibration, and overall performance.
Results: This study analyzed 685 from the initial 764 participants with GDM, with 218 (31.8%) developing adverse pregnancy outcomes. The most frequent adverse outcomes were hypertensive disorders in pregnancy 132 (19.3%) and neonatal hypoglycemia 91 (13.3%). This validation achieved an area under the curve (AUC) of 0.70 (95% confidence interval (CI) 0.65 to 0.74), calibration-in-the-large of 0.17, a calibration slope of 1.34, and a Brier score of 0.20, respectively. The cut-off clinical risk probability of 27.5% can predict adverse outcomes with a sensitivity of 67.3%, specificity of 63.8%, a positive predictive value (PPV) of 46.7%, and a negative predictive value (NPV) of 80.5%.
Conclusion: The PeRSonal model maintains its predictive effectiveness in two-step glucose tolerance diagnostic criteria.

Development of a New Tool for Monitoring the Eating, Exercise, and Medication Use among Diabetes Persons with Hypertension

Patcharee Numsang, Sureeporn Thanasilp, Ratsiri Thato — Thu, 19 Jun 2025 00:00:00 +0700

Objective: To develop and test a novel health behavior monitoring instrument designed for diabetes persons with hypertension.
Material and Methods: This study was designed to develop and test an instrument in four phases: item generation, content validity assessment, pilot testing, and full study. The Eating, Exercise, and Medication Use Questionnaire (EEMQ) was generated based on evidence available in literature reviews. The content validity of the indices of item objective congruence (IOC) was assessed by five experts face validity was piloted in a convenience sample of 10 individuals, and reliability was assessed by the full study in 30 participants with diabetes and hypertension.
Results: The content validity assessment by five experts yielded a high content validity index (IOC=0.97), indicating that the items were relevant. Following the compilation of questionnaire items, content experts provided feedback on the content and appearance of the preliminary tool. The questionnaire demonstrated feasibility for monitoring health behavior, showing good exploratory values of validity. The self-efficacy scale of EEMQ exhibited a Cronbach’s alpha coefficient of 0.923, indicating satisfactory to excellent reliability in evaluating the internal consistency of the instruments.
Conclusion: The Eating, Exercise, and Medication Use Questionnaire (EEMQ) has emerged as a suitable and comprehensive tool. It has been validated for content, face validity, and acceptable reliability. It is ready for use in monitoring health behavior related to diet, exercise, and medication use, particularly within behavior modification programs based on the Information-Motivation-Behavioral Skills (IMB) model for diabetes patients with hypertension.

Influence of Text Neck Syndrome on Postural Sway and Cervical Proprioception in Adults with and Without Neck Pain

Thu, 19 Jun 2025 00:00:00 +0700

Objective: The objective of the study was to explore the influence of text neck syndrome on postural sway and cervical proprioception in adults with and without neck pain. The study also evaluated the connection between cervical proprioception and postural sway in individuals with and without neck pain under both eyes-open and eyes-closed conditions.
Material and Methods: This cross-sectional observational study included 16 participants with neck pain and 16 without neck pain. Subjects’ postural sway was assessed with eyes open and closed for 30 seconds on a solid surface using a Wii board and physio-sensing software. Cervical proprioception was assessed with a laser pointer. Pearson correlation and the independent t-test were used to analyze the data.
Results: There were significant differences (p-value<0.05) in ellipse area and mean velocity in both eyes-closed and eyes-open conditions, as well as in cervical proprioception between subjects with and without neck pain. A significantly positive correlation (p-value<0.001) was observed between cervical proprioception error (extension, right and left rotation, and right and left lateral flexion) and postural sway in both eyes-closed and eyes-open conditions in adults with and without neck pain.
Conclusion: The findings indicate that there are significant differences in cervical joint position inaccuracy and postural sway between individuals with and without neck pain. Assessing cervical joint position sensation and postural sway in patients with neck pain is important, and clinicians should consider this need. To address these issues, we recommend implementing targeted neck rehabilitation intervention programs to enhance patient outcomes.

Human Leukocyte Antigen (HLA) Frequencies and 4-loci HLA Haplotype Frequencies in Southern Thailand

Thu, 19 Jun 2025 00:00:00 +0700

Objective: To determine the antigen and haplotype frequencies of human leukocyte antigen-A (HLA-A), -B, -DRB1, and -DQB1 in southern Thailand.
Material and Methods: We retrospectively analyzed HLA typing data from patients treated at Songklanagarind Hospital between September 2004 and May 2023. In total, 629 patients with HLA-A and -B typing results were included, and HLA-DRB1 and -DQB1 data were available for 529 patients. Haplotype frequencies were determined in 55 patients with complete four-locus HLA typing data from at least two family members.
Results: A total of 66 unique HLA antigens were identified across four loci (16 HLA-A, 30 HLA-B, 13 HLA-DR, and 7 HLA-DQ). The most common HLA-A antigens were A24 (25.4%), A11 (24.3%), and A2 (18.8%). The most common HLA-B antigens were B75 (11.6%), B35 (8.4%), and B58 (8.4%). For HLA class II, the highest frequencies of HLA-DR antigens were found in DR15 (23.6%), DR12 (18.4%), and DR7 (10.9%). HLA-DQ5 (33.9%), DQ7 (21.6%), and DQ6 (14.3%) were the most frequently detected HLA-DQ antigens. The most prevalent four-loci haplotype was A33-B44- DR7-DQ2 (4.6%).
Conclusion: This study provides valuable insights into the HLA antigens and haplotype frequencies in southern Thailand. These findings serve as a foundational basis for future studies on disease associations, support transplantation services, and contribute to personalized medicine.

National Survey of Recently Graduated Thai Medical Interns’ Characteristics and Perspectives Regarding Resignation Intention: A Retrospective Cross-Sectional Observational Study

Thu, 19 Jun 2025 00:00:00 +0700

Objective: The Thai medical internship program is a one-year post-graduation program that requires newly graduated doctors to rotate in major specialties in a government hospital. These newly graduated doctors carry a significant workload in the hospital and Thai healthcare system. However, there is a lack of data on the characteristics and attitudes of this new generation of doctors, which limits the ability to create appropriate interventions to address the issue of resignations within this group. This study aimed to collect data in order to understand the Thai medical internship program and identify the possible reasons for resignations among the new generation of doctors.
Material and Methods: This retrospective cross-sectional descriptive study was compiled from the recently graduated medical interns' national general information survey, 2021. We used descriptive statistics and Spearman's correlation using Statistical Package for the Social Sciences version 28.0.0.0.
Results: We included 2,431 participants, of which 1,139 (46.9%) were male and 1,292 were female (53.1%). The most common expected salary range during the internship was 40,000–60,000 Thai Baht per month (46.2%). Up to 3.5%, or 84 participants, planned to resign from their internship. The reasons for the resignations from the program included a poor working environment (61.4%), too much workload (51.7%), and low income (42.9%). Those interested in the cosmetic field (5.8%) and willing to work in other fields (7.6%) were much less common.
Conclusion: The main reason for the possible resignations of the newly graduated Thai doctors was the miserable work environment, due to a multitude of factors that require further research and intervention.

Validity and Reliability of the Thai Version of the Knowledge and Attitudes Survey Regarding Pain (Thai KASRP)

Thu, 19 Jun 2025 00:00:00 +0700

Objective: The knowledge that healthcare providers have about pain management influences the treatment that patients receive. Given the rapid advances in pain knowledge and the uniqueness of pain management in different cultures and contexts, it is necessary to assess pain knowledge in different countries. This study aimed to (1) translate and culturally adapt the original English version of the knowledge and attitudes survey regarding pain (KASRP) instrument into Thai, and (2) conduct a preliminary evaluation of the validity and reliability of the translated questionnaire.
Material and Methods: The KASRP instructions and items were translated into Thai using the World Health Organization guideline for the translation of instruments. Content validation of the Thai KASRP was evaluated by an expert panel. Test-retest reliability was evaluated using data from 30 healthcare providers. Face validity was evaluated by 7 healthcare providers for the questionnaire’s clarity, format, and acceptability. All information was used to revise the Thai KASRP into a final version.
Results: Some items of the original KASRP were updated to maximize clarity, comprehensibility, and consistency with the current standards of pain management in Thailand. Moreover, some items were removed because their contexts were not compatible with pain practice in Thailand. An expert panel rated 99% of the translated items as relevant and clear, supporting the measure's content validity. Test-retest reliability was good to excellent.
Conclusion: The Thai KASRP demonstrated good validity and reliability. It could be used to assess the knowledge and attitudes of health professionals regarding pain management in Thailand.

Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders in Central Sterile Supply Technicians, Nakhon Si Thammarat Province, Thailand

Thu, 19 Jun 2025 00:00:00 +0700

Objective: The study aimed to examine the prevalence of work-related musculoskeletal disorders among central sterile supply technicians (CSSTs) in Nakhon Si Thammarat Province, Thailand, and investigate the risk factors associated with these disorders.
Material and Methods: A cross-sectional study was conducted among CSSTs regarding work-related musculoskeletal disorders (WMSDs). Technicians were asked about the presence and severity of disorders throughout the whole body during the sterilization procedure. The survey was distributed to the CSSTs at the central sterilization supply departments (CSSDs) of 32 hospitals in Nakhon Si Thammarat province, Thailand.
Results: The prevalence rate of WMSDs in various bodily regions was assessed among technicians at the time of questioning (88.3%), after one week (65.4%), and after one year (59.2%). Various body parts were reported to have developed Musculoskeletal problems, with the lower back being the most frequently reported (88.8%), followed by the upper back (84.9%), and the ankles/feet (38.5%). These MSDs were influenced by age over 30 years (odds ratio [OR] 3.32, 95% confidence interval [CI] 1.59-6.93), work schedule (OR 2.58, 95% CI 1.02-4.96) and the handling of heavy-load equipment (OR 2.56, 95% CI 1.47-10.37) or carts, which significantly increased the risk of developing such illnesses.
Conclusion: Many CSSTs from the CSSDs reported WMSDs in various locations on their bodies. Lower back pain was the most common complaint.

Effect of Global Postural Re-education on Pain, Disability, and Posture in Desk Job Workers with Nonspecific Neck Pain: Randomized Control Trial

Reema Joshi, Nikita Chandan Muthiyan — Thu, 19 Jun 2025 00:00:00 +0700

Objective: To study the effect of Global postural re-education (GPR) on pain, disability, and posture in patients with chronic nonspecific neck pain.
Material and Methods: A single-blinded randomized control trial was conducted. A total of 45 individuals, with nonspecific neck pain aged between 20-40 years, with Craniovertebral Angle (CVA) of less than 49 degrees, were randomly assigned to either the GPR or control group, according to inclusion and exclusion criteria. The intervention was twice a week, spanning four weeks. Outcome measures included: the Numerical Pain Rating Scale (NPRS) for pain intensity, the Neck Disability Index (NDI) for disability assessment and the CVA for posture evaluation.
Results: To establish the difference between the groups, the Mann-Whitney U test was performed, and within-group analysis was performed by the Wilcoxon sign rank test. NPRS showed significant improvement (p-value=0.02). NDI did not show significant improvement (p-value=0.83); CVA showed significant improvement (p-value=0.0009).
Conclusion: This study concludes that GPR was more effective in reducing pain, increasing function, and improving posture than the control group and can be used in regular practice with proper setup.

The Train-of-Four Ratio in Patients Fulfilling Clinical Criteria for Extubation

Thu, 19 Jun 2025 00:00:00 +0700

Objective: Neuromuscular blocking agents are commonly used in patients undergoing general anesthesia with an endotracheal tube. This can result in residual neuromuscular blockade and respiratory complications. The decision to extubate is usually based on clinical criteria assessment. This study aimed to investigate the train-of-four (TOF) ratio in patients having fulfilled the clinical criteria before extubation.
Material and Methods: This prospective observational study recruited 294 elective adult patients, with American Society of Anesthesiologists classification I-III, having undergone general anesthesia using muscle relaxants. The baseline TOF ratio was measured before surgery. Once the surgery was finished, the endotracheal tube would be removed if the patient fulfilled the clinical criteria for extubation. The TOF was immediately measured before extubation, and upon postanesthesia care unit (PACU) arrival. The TOF ratio was normalized by dividing it with the baseline TOF ratio.
Results: The overall median interquartile range (IQR) for the normalized TOF (nTOF) outcomes before extubation was 0.87 (0.74, 0.98). Of the 294 patients, 162 (55%) and 132 (45%) had a nTOF ratio of <0.9 and ≥0.9, respectively. On PACU arrival, the overall median IQR TOF ratio was 0.9 (0.8, 0.98), with 51% and 49% of them having had an nTOF ratio of <0.9 or ≥0.9, respectively.
Conclusion: In patients fulfilling the clinical criteria for extubation, approximately half of them demonstrated residual neuromuscular blockade (nTOF <0.9) immediately before extubation and upon PACU arrival. Close observation and monitoring of patients receiving muscle relaxants should be warranted.

Evaluating E-Cigarette Addiction in Thailand: Validation of Dependence Assessment Tools for Policy and Clinical Use

Thu, 19 Jun 2025 00:00:00 +0700

Objective: To adapt and validate the Penn State Electronic Cigarette Dependence Index (PS-ECDI) and the e-cigarette version of the Fagerström Test for Cigarette Dependence (e-FTCD) for use in Thailand and to assess the current status of e-cigarette addiction among Thai users.
Material and Methods: A systematic process of translation, cultural adaptation, and pilot testing of the PS-ECDI and e-FTCD was followed. Expert panel reviews, back-translation, and cognitive interviews were conducted to ensure cultural relevance and clarity. The instruments were administered to 193 Thai e-cigarette users. Internal consistency was assessed using Cronbach’s alpha and validity was evaluated through correlation with the Substance Use Disorder Screening Test (SUDST). The current status of e-cigarette addiction was analyzed.
Results: The culturally adapted PS-ECDI demonstrated strong internal consistency, with a Cronbach’s alpha of 0.87 and a robust correlation with SUDST. The e-FTCD had a Cronbach’s alpha of 0.57. E-cigarette addiction was highly prevalent in the sample, with 65% of users exhibiting signs of dependence. Younger age, male sex, and concurrent use of other substances were significantly associated with higher levels of e-cigarette addiction.
Conclusion: Culturally adapted and validated tools are essential to measure e-cigarette dependence in Thailand. The validated PS-ECDI is a reliable instrument for health professionals and policymakers to assess e-cigarette dependence, facilitating the development of culturally informed public health interventions and regulatory frameworks. Further refinement of the e-FTCD is necessary to enhance its reliability. The high prevalence of e-cigarette addiction among Thai users underscores the need for targeted public health interventions.

Prevalence and Factors Associated with Abnormal Ultrasonographic Findings of Hemiplegic and Non-Hemiplegic Shoulders in Patients after Stroke

Nipa Kridrum, Jittima Saengsuwan, Patpiya Sirasaporn — Thu, 19 Jun 2025 00:00:00 +0700

Objective: This study aimed to explore ultrasound (US) imaging in hemiplegic and non-hemiplegic shoulders in patients after stroke and to study factors associated with hemiplegic shoulder pain (HSP) and abnormal US findings on the hemiplegic side.
Material and Methods: A cross-sectional study was conducted to explore shoulder US imaging in hemiplegic and nonhemiplegic shoulders in a total of 60 patients after stroke and to study factors associated with HSP and abnormal US findings in the hemiplegic side of stroke patients who attended an outpatient rehabilitation clinic.
Results: Sixty patients after stroke were enrolled in the study (40 men and 20 women). Their mean age was 58.7 years. The prevalence of shoulder pain was 63.3% (38/60). Among those with shoulder pain, 81.6% (31/38) reported pain on the hemiplegic side. Fifty-five patients (91.7%) had shoulder US abnormalities on the hemiplegic side whereas 45 patients (75.0%) had shoulder US abnormalities on the non-hemiplegic side. The three most common shoulder US abnormalities on the hemiplegic side were biceps peritendon effusion (66.7%), supraspinatus tendinosis (45.0 %), and positive dynamic supraspinatus impingement (26.7%). The three most common shoulder US abnormalities on the non-hemiplegic were supraspinatus tendinosis (36.7%), biceps peritendon effusion (33.3%), and subdeltoid-subacromial bursitis (18.3%).
Conclusion: Shoulder pain and US abnormalities were prevalent in patients with hemiplegic stroke. Biceps peritendon effusion was the most common abnormality in shoulder US imaging on the hemiplegic side.

Cost-Effectiveness of Sorafenib, Lenvatinib, and FOLFOX4 for Advanced Hepatocellular Carcinoma in China

Jian Yang, Min Zhao, Xiaolei Zhou, Mu Yan, Xuejuan Zhao, Fan Li — Thu, 19 Jun 2025 00:00:00 +0700

Objective: Liver cancer is the third leading cause of cancer mortality in China. This study assesses the cost-effectiveness of sorafenib, lenvatinib, and FOLFOX4 in the treatment of advanced hepatocellular carcinoma (HCC) to inform clinical decision-making.
Material and Methods: We used a Markov model to simulate the progression of HCC and calculate Quality-Adjusted Life Years (QALYs) and Incremental Cost-Effectiveness Ratios (ICERs) under two scenarios. Costs were obtained from the Yaozhi Network, while transition probabilities and utilities were derived from the REFLECT, EACH, and CELESTIAL clinical trials. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to evaluate model robustness and parameter uncertainty.
Results: In Scenario A, using market-listed prices, sorafenib, and lenvatinib were found to be more cost-effective than FOLFOX4, with ICERs of $11,635.28 and $1,499.93 per QALY, respectively, both below the cost-effectiveness threshold. In Scenario B, with centralized procurement prices, sorafenib had a negative ICER of -$7,351.26 per QALY, indicating cost savings with improved outcomes, while lenvatinib had an ICER of $2,685.99 per QALY. Sensitivity analysis revealed that drug costs, utilities of disease progression, and discount rates were key determinants of ICER values.
Conclusion: Sorafenib and lenvatinib are significantly more cost-effective compared to FOLFOX4, particularly under centralized procurement pricing. These results support the inclusion of these treatments in public health policy to enhance healthcare outcomes and optimize resource allocation, thereby improving the economic and quality-of-life metrics for patients with HCC.

Effectiveness of The ME Online Program to Reduce Medication Errors among Primary Health Care Units in The City Areas of The Thai-Cambodian Border Provinces, Thailand

Thu, 19 Jun 2025 00:00:00 +0700

Objective: Medication errors are considered significant issues in public health operations. They are frequently encountered and continuously increasing, particularly in the border provinces of Thailand and Cambodia. This study was a quasi-experimental study conducted in order to examine the effectiveness of the ME online program for reducing medication errors in primary care units (PHCs) in the city areas of the Thai-Cambodian border.
Material and Methods: This study was conducted using a one-group pretest and posttest design by recruiting 36 participants responsible for drug administration through stratified sampling. They received the ME online program for 4 months. This program was designed to address knowledge, attitudes, and practices related to medication errors. The ME online platform was developed using Google Forms and Line official accounts to report and summarize medication errors. Data analysis involved descriptive statistics and paired t-tests.
Results: The findings indicate statistically significant increases in the mean scores of knowledge, attitudes, and practices related to medication errors compared to baseline and 4 months (p-value<0.001). Additionally, the rate of medication errors decreased from 7.4% to 4.5% compared to the baseline and 4 months after implementing the program. The Category B medication error rate was reduced from 7.2% to 4.5%, and Category A from 0.2% to 0.0%. There was a statistically significant reduction in the medication error rates compared to baseline and at 4 months (p-value=0.038).
Conclusion: This ME online program effectively reduced medication errors and could also be integrated for collecting and reporting such events. Furthermore, it could be extended for an implementation in other areas of the Thai-Cambodian border provinces.

Influence of Sodium Reduction Using KCl and MSG on the Nutritional Profile and Consumer Acceptability of Bhutanese Cheese Curries

Thu, 19 Jun 2025 00:00:00 +0700

Objective: The rise in non-communicable diseases (NCDs); such as cardiovascular diseases, hypertension, diabetes, and cancers, in Bhutan is linked to unhealthy diets that are high in salt and saturated fats. This study aimed to reformulate popular high-sodium Bhutanese cheese curries—Shakam Datshi and Kewa Datshi—by reducing their sodium content using potassium chloride (KCl) and monosodium glutamate (MSG), while preserving traditional flavors and improving their nutritional profiles.
Material and Methods: Shakam Datshi and Kewa Datshi were identified as the highest sodium content dishes among commonly consumed Bhutanese meals. Sodium was partially replaced with KCl and MSG, and additional ingredient adjustments to align with WHO dietary guidelines. Sensory and Satiety evaluations with 50 Bhutanese panelists compared the modified recipes to the original and assessed the acceptance and fullness provided by the reformulated dishes in four healthy set menus.
Results: The reformulation achieved a 20% reduction in sodium for Shakam Datshi and over 40% for Kewa Datshi. Potassium levels significantly increased to 377.47 mg in Shakam Datshi and 651.51 mg in Kewa Datshi. Both dishes also showed reductions in total and saturated fats. Sensory evaluations indicated that the modified recipes retained high overall liking scores, similar to the originals (7.96 vs. 8.28 for Shakam Datshi and 7.48 vs. 7.90 for Kewa Datshi). Satiety assessments revealed sustained feelings of fullness.
Conclusion: This study demonstrated that significant sodium reduction in traditional Bhutanese cheese curries can be achieved without compromising taste or cultural authenticity. These findings provide a viable strategy to reduce hypertension in the Bhutan population through healthier dietary options.

Molecular Analysis of Chloroquine and Sulfadoxine/Pyrimethamine Resistant Markers in Plasmodium Falciparum Isolated from Three Provinces in Southern Thailand

Thu, 19 Jun 2025 00:00:00 +0700

Objective: This study investigated mutations in various genes associated with chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) resistance in P. falciparum; including the P. falciparum chloroquine resistance transporter (pfcrt), P. falciparum multidrug resistance 1 (pfmdr1), P. falciparum dihydrofolate reductase (pfdhfr), and P. falciparum dihydropteroate synthase (pfdhps).
Material and Methods: A total of 104 P. falciparum samples were obtained from patients across three (Ranong, Surat Thani and Yala) provinces of southern Thailand; between 2012 and 2019. To assess the genetic polymorphisms, pfcrt K76T and pfmdr1 N86Y were identified using PCR-RFLP assay, and pfdhfr C59R and pfdhps K540E was identified using Semi-nested PCR and nucleotide sequencing.
Results: Genetic analysis revealed that 61 (58.65%) isolates were positive for pfcrt and 55 (52.88%) for pfmdr1. Notably, the Ranong province isolates showed high prevalence of pfdhfr 51I, 59R, 108N, and 164L mutations (IRN-L) along with pfdhps 540E mutation. The Surat Thani province isolates exhibited the highest frequency of quadruple mutations in both pfdhfr and pfdhps genes.
Conclusion: The surveillance guidelines and policy formulation of appropriate Malaria treatment strategies must be implemented in these locations.

The Health Challenges and Health-Seeking Behaviors of Female Burmese Labor Migrants in Khon Kaen, Thailand: A Focus on Self- Medication and Reproductive Health Needs

Chaw Yadanar Aung@ Kyel Sin Moe Htet, Tipaporn Kanjanarach — Thu, 19 Jun 2025 00:00:00 +0700

Objective: To identify the expressed health problems, health-seeking behaviors, conditions and products for self-medication, reproductive health needs and other expressed health needs of female Burmese labor migrants in Khon Kaen, Thailand.
Material and Methods: One hundred and twenty female Burmese labor migrants in Khon Kaen were recruited using the snowball technique. Data were collected through face-to-face interviews conducted in Burmese, using a self-developed semi-structured questionnaire. Content analysis was used for data interpretation.
Results: The most commonly reported health problems were muscle pain from work, fatigue, stress, and difficulty sleeping. Sleep issues were often linked to worries about their families in Myanmar. Despite having health insurance, participants preferred self-medication due to perceptions that their symptoms did not require medical treatment and concerns about wage deductions for hospital visits. Products used for self-treatment included analgesic balms and Yachud (a pre-packed combination of medicines) for muscle pain, inhalers, and herbal instant coffee for fatigue and stress, and meditation for sleep issues. Medicines were typically purchased from local market stands. While 96 participants used birth control pills, they were uncomfortable discussing reproductive health with strangers or in public. They found accessing healthcare and self-care medicine in Thailand easy and expressed no other health needs.
Conclusion: The use of culturally familiar medicines from Myanmar among migrant workers poses legal and health challenges. Interventions to ensure access to safe, culturally sensitive healthcare options that comply with Thai health regulations should be sought.