Journal of Medicine and Health Sciences

Characteristics of latex medical glove usage among health personnel and association with latex allergy

Chawapon Luengtongkam — 2025-08-31

Latex medical gloves have been shown to induce Type I hypersensitivity latex allergy (latex allergy symptoms), with significant contributing factors including personal factors and glove usage characteristics. However, studies from Thailand and Southeast Asia are relatively limited. This study aimed to investigate the characteristics of glove usage among health personnel associated with the development of latex allergy symptoms. This study was a cross-sectional analytical epidemiological study utilizing secondary data, including 45 health personnel with and 343 without probable symptoms of latex allergy. Data were collected from databases of self-administered questionnaires, which included variables on glove usage characteristics and latex allergy symptoms. The analysis was conducted using descriptive statistics and multiple logistic regression. The results indicated that the group with probable symptoms of latex allergy had a significantly higher proportion of health personnel with a history of hand dermatitis (p < 0.001), atopic diseases (p = 0.004), and usage of gloves with high extractable protein weight (p = 0.002) compared to those without probable symptoms of latex allergy. Personal factors and glove usage characteristics associated with probable symptoms of latex allergy included: atopic diseases (Adjusted OR = 2.34, 95% CI:1.03, 5.35), history of hand dermatitis (Adjusted OR = 2.66, 95% CI:1.27, 5.57), use of powdered latex gloves (Adjusted OR = 2.31, 95% CI:1.61, 8.71), and use of gloves with high extractable protein weight (Adjusted OR = 2.21, 95% CI: 1.08, 4.58). The analysis of factors contributing to definite symptoms of latex allergy revealed that gloves with high extractable protein weight were statistically significantly associated with definite symptoms of latex allergy (Adjusted OR = 2.36, 95% CI: 1.98, 6.20). When the analysis was conducted only on the subgroup without a history of dermatitis, gloves with high extractable protein weight remained statistically significantly associated with definite symptoms of latex allergy (Adjusted OR = 5.67, 95% CI: 1.59, 37.0). In conclusion, the main factor contributing to the development of latex hypersensitivity symptoms among tertiary-level health personnel in hospitals was the utilization of high extractable protein weight medical latex gloves.

Nata de coco patches supplemented with herbal extracts for the inhibition of acne-inducing bacteria

Boonsri Jongsareejit — 2025-08-31

This study examines herbal extracts as an alternative acne treatment to reduce antibiotic use, which may contribute to drug resistance, by evaluating their efficacy in inhibiting acne-related bacteria, including Staphylococcus aureus, Staphylococcus epidermidis, and Cutibacterium spp. To determine the most effective extracts and develop them into acne patches that are composed of Nata de coco combined with herbal extracts and compare the efficacy of the most effective extracts in inhibiting acne-causing microbes with commercial acne patches by disc diffusion and dilution methods. The result demonstrated that the mangosteen pericarp extract in ethanol solvent exhibited the greatest effectiveness in suppressing the growth of all three bacterial strains, with inhibition zone diameters measuring 21.33±1.15, 18.00±3.46, and 14.67±1.15 millimeters, respectively. Lower inhibition levels were seen in the mangosteen pericarp extract in DMSO and the lakoocha extract in both ethanol and DMSO. On the other hand, the extracts of turmeric and tanaka showed minimal inhibition, while the extracts using distilled water as a solvent showed no inhibition. The minimum inhibitory concentration (MIC) of the mangosteen pericarp extract in distilled water was determined to be 3.6×10^-7, 3.6×10^-7, and 3.6×10^-9milligrams per milliliter (mg/ml), respectively, for bacterial inhibition. The inhibitory concentrations in the ethanol solvent were 3.6x10^-9, 3.6x10^-8, and 3.6x10^-8mg/ml, respectively. The lakoocha extract exhibited comparable benefits but necessitated greater doses. Furthermore, the turmeric and tanaka extracts combined with distilled water failed to demonstrate the minimum inhibitory concentration (MIC). The experimental results demonstrated that the anti-acne patches developed from Nata de coco incorporated with mangosteen pericarp and lakoocha extracts exhibited superior antibacterial activity against all three tested bacterial strains compared to the commercial anti-acne patches, which showed no inhibitory effect. These findings suggest that the anti-acne patches made with Nata de coco and herbal extracts from mangosteen pericarp and lakoocha could be developed further as a strong acne treatment.

Comparison of analgesic techniques: iPACK+PAI vs ACB+PAI in total knee arthroplasty: A single-center non-inferiority randomized controlled trial

Thippatai Kerdchan — 2025-08-31

Knee osteoarthritis stands as the predominant indication necessitating total knee arthroplasty (TKA), a procedure often accompanied by moderate to severe postoperative pain. Multimodal analgesia strategies for TKA encompass diverse pharmacological regimens and specific nerve blockades and aims to achieve optimal analgesia, facilitating early mobilization, and minimizing opioid consumption. The objective of the study is to compare cumulative morphine consumption in patients undergoing TKA between adjunct adductor canal block (ACB) and interspace between the popliteal artery and capsule of the knee (IPACK) block within the first 12 postoperative hours. In a non-inferiority, randomized controlled trial, this study assessed the efficacy of IPACK block or ACB combined with periarticular infiltration (PAI) in patients undergoing TKA under spinal block, focusing on postoperative morphine consumption. The patients were enrolled, and randomly assigned to either the ACB group or the IPACK group to attain a final 1:1 ratio with 14 patients in each group. The primary endpoint was the cumulative morphine consumption at 12 hours postoperatively. The mean morphine consumption in the IPACK group was 7.71±4.18 mg compared to 7.14±5.2 mg in the ACB group, yielding a mean difference = 0.57 mg (95% confidence interval = -3.23, 4.37). Cumulative morphine consumption at 60 minutes, 6 hours, and 24 hours did not exhibit statistical disparities between the groups. Similarly, pain scores and side effects at these time points did not demonstrate statistically significant differences. Nevertheless, the trial could not establish non-inferiority, possibly due to the small sample size. In conclusion, in the context of PAI accompanying TKA, the cumulative morphine consumption in IPACK block combined with PAI did not differ from that of ACB combined with PAI at the 12-hour mark postoperatively. There were also no differences observed in the pain score and associated side effects.

Effects of slow-deep breathing training program on physical performance in older adults with a history of covid-19 infection

Kit khunkitti — 2025-08-31

COVID-19 affects respiratory function and physical fitness, particularly in older adults who recover slowly and are at risk of complications. Deep and slow breathing training can help to improve lung function and overall fitness, but research in this population remains limited. This study aimed to compare the effects of a deep and slow breathing training program on pulmonary function and physical performance in older adults with a history of COVID-19 infection. The study included 46 older adults (aged 60 and above) from Mueang District, Uttaradit Province, Thailand. A total of 46 participants were selected using purposive sampling and divided into two groups of 23 participants each. Participants were randomly assigned to either a control group or an exercise group. The control group maintained their usual lifestyle, while the exercise group participated in the slow-deep breathing exercise program for 8 weeks. Data collection was conducted at three time points: baseline, after week 4 of exercise, and after week 8 of exercise. The data included general demographic information, and physical fitness. Data were analyzed using frequency, percentage, mean, standard deviation, repeated measures ANOVA, and t-tests for independent samples. The results showed that after 8 weeks of exercise, the exercise group demonstrated significant improvements in physical performance (p<0.05 for one parameter and p<0.001 for four parameters). Compared to the control group, three physical performance parameters showed significant improvement in the 30-second chair stand test (p=0.044), 6-minute walk distance (p=0.007), and maximum oxygen consumption (p=0.047). The exercise group had significantly improved pulmonary function compared to their baseline (p<0.001) and showed significantly higher values than the control group in three parameters: %predicted peak expiratory flow rate (p=0.012), vital capacity (p=0.022), and %predicted vital capacity (p=0.002). Additionally, the 8-week deep and slow breathing exercise program effectively enhanced physical performance and pulmonary function in older adults with a history of COVID-19 infection.

Comparative analysis of preparation errors and contamination in robotic and manual chemotherapy compounding: A systematic review and meta-analysis

Piranee Kaewbut — 2025-08-31

The number of cancer patients in Thailand has been steadily increasing, leading to a significant rise in the demand for chemotherapy compounding by manual pharmacists. Currently, robotic systems are widely employed in several countries and have begun to be introduced in Thailand. This systematic review and meta-analysis aim to evaluate the preparation errors and contamination rates associated with intravenous chemotherapy compounding, comparing robotic systems with manual preparation by clinical oncology pharmacists. A total of 2,197 studies were initially identified from various databases, including PubMed, ScienceDirect, Cochrane reviews, and others, covering publications from database inception through April 16, 2025. Of these, 11 studies were selected for inclusion. The quality of the included studies was assessed using the ROBINS-I tool, revealing that 7 studies had a moderate risk of bias, while 4 studies had a serious risk of bias. The meta-analysis demonstrated that robotic chemotherapy compounding was not significantly associated with lower rates of absolute dose errors (MD=-0.04, 95%CI -0.40, 0.33, I²=99.7% model with random effect model), external contamination (OR=0.49, 95%Cl 0.10, 2.40, I²=71.4% model with random effect model) and with a reduction in failure rates or rejected dose (OR=0.45, 95%Cl 0.09, 2.17, I²=84.1% model with random effect model). Additionally, environmental contamination (OR=1.61, 95%Cl 0.72, 3.63, I²=54.3% model with random effect model) was more frequently observed in the robotic compounding group, although this difference was not statistically significant. In conclusion, robotic chemotherapy compounding represents an effective alternative to manual preparation by pharmacists. However, its high cost should be considered, and implementation must align with each hospital's specific needs and financial capabilities.

Association of age, sex, and other risk factors with survival in patients with renal cell carcinoma

Phonsuda Jitkasikorn — 2025-08-31

Renal cell carcinoma is a complex cancer, with its incidence rising among elderly patients. It affects both males and females, but males are twice as likely to develop kidney cancer than females. This study aims to provide the relationship of gender and age factors to treatment outcomes in patients with RCC. We conducted a retrospective cohort study included RCC patients aged 18 years and above who diagnosed and treated from Jan 2012 to December 2021 and completed the follow-up until December 2024. Descriptive statistics were used to summarized demographic and clinical demographic characteristics. Survival outcome at 5 years were analyzed using the Kaplan–Meier method and log-rank test. A Cox proportional hazards model and p-values were reported based on likelihood ratio test were used to determine factors associated with overall survival. A total of 689 RCC patients were identified, the majority were male (72.13%) The mean and Median age were 57.39 years (SD 13.71) and 59.02 years (IQR 18.49), respectively. Over the past 10 years, 310 patients (44.99%) had died. The 5-years and 10-year overall survival rates were 61.16% (95%CI: 57.33-64.76) and 48.98% (95%CI: 44.31-53.49), respectively. The 5-year survival rates were significantly higher in females (68.30%) than in males (58.43%) (p=0.008). Patients aged over 60 had a 1.71 times higher risk of death compared to those under 60 (95%CI: 0.91-3.23, p-value =0.098). Significantly by sex, with 5-years survival of 58.43% in male and 68.30 % in female (p-value =0.008). Patient with Clear cell tumor was significantly associated with higher survival compared to non-clear cell (p-value =0.048). Patients covered under the Universal coverage Scheme and Social Security Scheme had increased mortality risk of 1.50 (95%CI: 0.78-2.87) and 3.37 (95%CI: 0.67-19.93), respectively. Tumor staging and smoking were identified as risk of mortality. Patient who smoked had a 65% higher risk of death than non-smoker. In conclusions, sex, older patient, histology subtype, tumor grade and staging were identified as significant prognostic factor for survival in kidney cancer patients. The study of treatment accessibility, healthcare system factors, including in the advocacy for inclusion in the National List of Medicines can help improve the survival and quality of life of the patients.

Technique and efficacy of pain control after major breast surgery in Srinagarind Hospital

Naruemon Vattanasiriporn — 2025-08-31

The incidence of breast cancer has increased over the years, and breast surgery remains the mainstay treatment. Effective acute postoperative pain management has a significant impact on the quality of life. This study aims to evaluate efficacy of pain control management after major breast surgery in Srinagarind hospital. This retrospective descriptive study was approved by the institutional ethics committee; we extracted data from patients who underwent major breast surgery between January 1, 2020, and December 31, 2022. Patients aged over 18 years and ASA physical status of I-III were included. Patients who underwent bilateral breast surgery, breast reconstruction, and incomplete anesthetic records were excluded. Patient demographic data, type of surgeries, anesthetic techniques, postoperative pain scores, cumulative opioid requirements, and opioid-related complications were collected in the study. From this study, 302 out of the 523 patients met the inclusion criteria. All the patients were female, with 53.6% undergoing modified radical mastectomy and 85.4% receiving general anesthesia (GA) alone for surgery. None to mild pain at the Post-Anesthesia Care Unit (PACU) was reported by 51.9% of patients. Combining GA with any regional anesthesia (RA) technique significantly reduces the incidence of severe pain in the PACU. More than 46% of patients who had GA alone reported severe pain, but only 31.8% who had both GA and RA together (p-value=0.036). From this study, over half of the patients undergoing major breast surgery in our hospital experience adequate pain control. The combination of RA with the GA technique improves the acute postoperative pain relief.

Efficacy of lidocaine spray, either alone or in combination with anti-inflammatory throat spray, in alleviating discomfort during unsedated esophagogastroduodenoscopy: A double-blind randomized controlled trial

Arunluk Buranathawornsom — 2025-08-31

Controlling patients’ pain during Esophagogastroduodenoscopy (EGD) is a fundamental factor in increasing patient satisfaction, reducing discomfort, and improving patient cooperation. Although lidocaine spray is a common and safe anesthetic option for unsedated EGD, endoscopists continue to seek ways to improve the preparation process before the EGD procedure. This study aimed to compare patient satisfaction, pain, and discomfort between the use of lidocaine spray alone and in combination with anti-inflammatory throat spray. This prospective, randomized clinical trial was conducted at Yala Hospital, Yala, Thailand between January 2024 and May 2024. Patients were randomly assigned to one of two groups: one received only a lidocaine spray (Group A), while the other received a combination of lidocaine spray and an anti-inflammatory throat spray (Group B, using Benzydamine Hydrochloride). After the procedure, patients rated their satisfaction, pain, and discomfort on a numerical scale from 0 to 10. A total of 100 subjects were randomized to receive either Lidocaine Spray alone (n=50) or a combination of Lidocaine Spray and an Anti-inflammatory Throat spray (n=50). The patient satisfaction score (Group A: median (IQR) 10 (9,10); Group B: median (IQR) 9 (9,10); p=0.248), pain score (Group A: median (IQR) 3 (1,5); Group B: median (IQR) 2.5 (0,5); p=0.624) and discomfort score (Group A: median (IQR) 3 (1,5); Group B: median (IQR) 3 (2,5); p=0.203) were not significantly different between the groups. Adverse events, including sore throat, bitter taste, nausea, and vomiting, were lower in group B, though the differences were not statistically significant. This study concludes that both methods have similar effects on patient satisfaction, pain and discomfort. Therefore, preparation for EGD using lidocaine spray alone remains a safe and effective approach to local anesthesia. Adding an anti-inflammatory throat spray may be an option to help reduce certain adverse events.

Association between possible sarcopenia, peripheral neuropathy, and the risk of falls in patients with type 2 diabetes mellitus

Surapa Hangsaphruek — 2025-08-31

Type 2 diabetes is a health problem that affects various systems of the body, especially the muscular and nervous systems. Sarcopenia is common in diabetic patients and may increase the risk of peripheral neuropathy and falls, which affect quality of life and can lead to serious complications. This retrospective study aimed to study the relationship between possible sarcopenia peripheral neuropathy and the risk of falls in patients with type 2 diabetes. The sample consisted of 455 patients diagnosed with type 2 diabetes for 5 years or more and were aged 50 years or older and received treatment between October 1, 2023 and September 30, 2024. The study used medical record review and statistical data analysis using ready-made programs, including frequency, percentage, mean, standard deviation, and analysis of the relationship using Pearson Chi-square, Fisher's exact test, and Multiple logistic regression. The results showed that 31.6% of the patients had sarcopenia, 17.8% had neuropathy, and 47.5% were at risk of falls. Sarcopenia was associated with neurological deficits (p = 0.014) and falls risk (p < 0.001). Multiple logistic regression analysis showed that those with sarcopenia were approximately 2.11 times more likely to fall than those without sarcopenia (OR = 2.11; 95% CI: 1.26, 3.55; p =0.005). Therefore, surveillance and development of preventive measures, such as exercise and nutritional care, are important to reduce the risk and improve the quality of life of patients. These findings support the integration of sarcopenia screening into routine diabetes care to reduce fall risk.

Comparative study of lower-dose 10% intravenous dextrose (15 g and 20 g) versus standard 50% dextrose (25 g) in achieving euglycemia during hypoglycemia treatment

Kanjanee Wachirarangsiman — 2025-08-31

Hypoglycemic patients treated with a rapid intravenous bolus of 50% dextrose often have higher post-treatment blood glucose levels compared to those receiving 10% dextrose, potentially causing adverse effects such as rebound hypoglycemia and increased glycemic variability. This prospective, non-blinded, non-randomized cohort study with sequential group allocation compared the proportion of post-treatment euglycemia and volume overload within 24 hours among adult patients (≥18 years) treated for hypoglycemia in the emergency department (ED) or by the emergency medical service (EMS). Patients were divided into three groups: Group 1. 10% dextrose, 15 g; Group 2. 10% dextrose, 20 g; Group 3. 50% dextrose, 25 g. The proportions of patients achieving euglycemia (defined as capillary blood glucose [CBG] 80–180 mg/dL) at 15 and 60 minutes were analyzed using difference in proportions analysis. Multilevel multivariable regression was used to assess CBG, volume overload, and post-bolus hyperglycemia (CBG >180 mg/dL) and hypoglycemia (CBG <80 mg/dL), adjusting for confounders and intrapersonal correlations. Each group included 55 patients. At 15 minutes, the differences in the proportions of patients achieving euglycemia were 60.0% (95% CI = 45.2–74.8; p<0.001) for the 15 g group and 30.9% (95% CI = 13.2–48.6; p=0.001) for the 20 g group. The mean CBG levels were euglycemic for the 15 g and 20 g groups but hyperglycemic for the 25 g group (p<0.001). Hyperglycemia risk was reduced by -65.8% for the 15 g group and -40.4% for the 20 g group. Volume overload was similar for the 15 g, while the 20 g groups had statistically significant lower than the 25 g group (-4.9%; p=0.007). These findings suggest that using 10% dextrose (15 g and 20 g) was more effective than 50% dextrose (25 g) at achieving euglycemia and reducing hyperglycemia, without increasing volume overload.

Occupational therapy rehabilitation for a patient with systemic sclerosis patient: A case report

Metida Khumjorhor — 2025-08-31

Systemic sclerosis is an autoimmune disease that causes skin hardening and restricts joint on patients with systemic sclerosis movement. This study aimed to investigate the effects of occupational therapy on systemic sclerosis patients in Thailand, where research in this area is limited. The case report involved a 28-year-old Thai female with a 4-year history of symptoms including hardened skin on the face and arms, lip retraction, and deformed wrists with flexion contractures. The rehabilitation treatment lasted 6 months and divided into 2 phases: occupational therapy activities to increase range of motion, hand function training, and activities of daily living (ADL) training. The Hand Mobility in Scleroderma (HAMIS) assessment, and the Barthel ADL Index were used to evaluate treatment effectiveness. After treatment, the patient showed increased skin flexibility, improved range of motion in wrists and elbows, and enhanced hand grip and wrist extension. These improvements led to better self-care, which resulted in enhanced abilities for daily activities and community living skills, such as driving a car and being able to work to support the family business. This study highlights the improvement role of occupational therapy in the rehabilitation of individuals with systemic sclerosis. It is essential to consider the different stages of the disease and when it gets worse so that treatment plans are tailored to each person. The findings can be developed into guidelines for caring for systemic sclerosis patients in Thailand.

Cerebrovascular disease and e-cigarettes use in adolescents and young adults: A critical concern for health professionals

Pornpimon Wong-intha — 2025-08-31

Cerebrovascular disease is a leading cause of mortality and vascular complications in the brain, significantly impacting public health systems worldwide, with a high number of patients and deaths per year. Smoking is a major risk factor in the development of the disease. Currently, electronic cigarettes (e-cigarettes) are gaining popularity among young people worldwide because of the misunderstanding that e-cigarettes are harmless. The liquid in e-cigarettes contains nicotine and many other harmful chemicals, such as aldehyde produced from vaporizing the liquid, which damages blood vessel walls, promotes atherosclerosis, affects the cardiovascular and neurological systems, and increases the risk of Cerebrovascular disease. This article reviews the effects of e-cigarettes on Cerebrovascular disease incidence in adolescents and young adults. This age groups exhibits the highest rate of e-cigarettes smoking and belief that they are safer than conventional cigarettes, alongside the insufficient regulations of e-cigarettes. Therefore, it is a challenge for health professionals to prevent stroke caused by e-cigarettes and reduce the use of e-cigarettes in adolescents and young adults by using evidence-based knowledge to provide health education to the public, particularly among adolescents and young adults. This includes developing guidelines for campaigns to prevent, reduce, and quit e-cigarettes use, monitoring social and public health impacts, and developing future research.