Singburi Hospital Journal

Prevalence and Risk Factors for Knee Osteoarthritis among Pre-elderly and Young-old People, U Thong District, Suphan Buri Province

Thanate Tatirat — Wed, 16 Jul 2025 00:00:00 +0700

Osteoarthritis of the knee is a significant health issue commonly found among middle-aged and older adults, with an increasing trend in prevalence. This study aimed to investigate the prevalence and risk determinants associated with knee osteoarthritis. A descriptive research design was employed. The sample consisted of 265 individuals aged 50–69 years, residing in U Thong District, Suphan Buri Province, categorized as pre-elderly and early elderly population.

The findings revealed that 38.5% of the participants were at risk of knee osteoarthritis. On average, symptom severity was at a mild level. There was a statistically significant correlation between risk level and symptom severity (r = .610, p < .001). Identified risk factors included being a government officer, having a body mass index (BMI) above the standard (overweight or obese), and having a history of knee injury. Conversely, good stress management and low-risk smoking behavior were associated with risk reductions of 36.8% and 18.5%, respectively. The predictive model used in the study was deemed appropriate, with a predictive power of 77.0%.

The findings suggest that screening for knee osteoarthritis should be extended to pre-elderly populations, with emphasis on individuals who are overweight, have a history of knee injury, have experienced high stress, smoke, or are employed in government positions. Moreover, an integrated care system should be developed to address varying levels of symptom severity through health promotion, prevention, treatment, and rehabilitation tailored to each risk group.

Intussusception in Children in Phra Nakhon Si Ayutthaya Province

Chanakan Tanjararak — Sun, 20 Jul 2025 00:00:00 +0700

Intussusception is the most common cause of abdominal emergencies in children under 2 years of age. Accurate and prompt diagnosis is crucial to reduce complications and mortality. The objective of this study was to study pediatric intussusception in Phra Nakhon Si Ayutthaya Province. A retrospective descriptive study was conducted by reviewing medical records of pediatric patients aged 0–15 years diagnosed with intussusception at Sena Hospital and Phra Nakhon Si Ayutthaya Hospital between 2020 and 2024.

There were 45 pediatric patients diagnosed with intussusception. The male to female ratio was 1.6:1, aged from 3 months to 9 years and 1 month. The most common presenting symptom was abdominal pain (81.6%), followed by vomiting and bloody mucoid stools. Classic triad symptoms were observed in only 11 patients (22.4%). On physical examination, abdominal pain was noted in 19 cases (38.8%), abdominal distension in 17 cases (34.7%), and palpable abdominal mass in 8 cases (16.3%). The most common initial diagnosis was "rule out intussusception" (30.6%). Treatment methods included pneumatic reduction in 32 cases (71.1%), surgical intervention in 21 cases (46.7%), and spontaneous resolution in 2 cases (4.4%). Complications occurred in 12 cases (26.7%), and no mortality was reported.

Pediatric intussusception is an abdominal emergency. Early recognition by the first-contact physician is essential for timely and appropriate management, which can reduce the need for surgery and the risk of serious complications.

Maternal Factors Associated with Low Birth Weight in Term Newborns at Singburi Hospital

witchulada chaonoum — Tue, 26 Aug 2025 00:00:00 +0700

Low birth weight (LBW) represents a major public health problem worldwide. It is a long term indicator of maternal malnutrition and marker of poor antenatal care. LBW infants are at high risk of perinatal mortality and morbidity. This retrospective case-control study was conducted to discover maternal factors associated with low birth weight in term newborns at Singburi Hospital. Data were collected from October 1, 2022 to September 30, 2024.Data were analyzed using Chi-square test and Fisher’s exact test to evaluate significant factors related with LBW (p<0.05)

The results revealed that, among a total of 1,773 mothers, 70 term newborns weighting <2,500 g. were found. Significant factors associated with LBW were education level ( =19.598, p<0.001), monthly income ( =11.321, p=0.023), 1^st ANC ( =6.190, p=0.045), total weight gain ( =9.766, p=0.045), medical complication (fisher’s exact test=5.818, p=0.017), and total weight gain in relation to BMI ( =8.116, p=0.017).

In conclusion, maternal factors including low educational attainment (below vocational certificate/high school), monthly income <10,000 baht, total gestational weight gain <11.5 kg, the presence of medical complications, and inadequate weight gain relative to BMI were found to be associated with low birth weight (LBW) newborns.

Effectiveness of Rapid Guideline-directed Medical Therapies initiation Strategy at Heart failure Clinic, King narai hospital.

Sakolrat Hauythan, Waranya kedchai — Tue, 26 Aug 2025 00:00:00 +0700

This study employed a quasi-experimental, one-group pretest–posttest design to evaluate the effectiveness of a rapid and intensive titration protocol for the treatment of heart failure with reduced ejection fraction (HFrEF) at the Heart Failure Clinic, Phra Narai Maharaj Hospital. The sample comprised 34 patients with heart failure, selected through simple random sampling. The intervention consisted of a rapid and intensive titration guideline implemented in the clinic. Data collection instruments included a personal information questionnaire, physical examination and laboratory record forms, medication titration records based on guideline-directed medical therapy (GDMT), time to achieve target GDMT, records of adverse drug events, and hospital readmission data. Data were analyzed using descriptive statistics and paired t-test.

Results showed that, following the application of the rapid and intensive titration protocol, most participants achieved full implementation of GDMT. The majority reached the maximum tolerated dose (% target dose) within 6–10 weeks across the three main drug groups. No severe adverse drug events were observed during the treatment period. Left ventricular ejection fraction (LVEF) significantly improved from a baseline mean of 23.67 ± 6.81% to 35.20 ± 9.57% after 16 weeks of treatment (p < .005).

The rapid and intensive titration protocol in the heart failure clinic enabled most patients to safely achieve target medication doses, with a low incidence of adverse effects. These findings support the feasibility and effectiveness of adopting this approach in routine clinical practice.

Effects of a Self-Management Knee Pain Relief Program on Elderly Patients with Osteoarthritis in the Service Area of Bang Krabue 2 Subdistrict Health Promoting Hospital, Mueang District, Sing Buri Province

Runghirun Injek — Tue, 26 Aug 2025 00:00:00 +0700

Osteoarthritis significantly impacts the quality of life of the elderly globally, particularly in rural areas with limited access to healthcare. Self-managing knee pain is a suitable approach for this demographic in many resource-constrained settings. This quasi-experimental research aimed to compare knee pain in older adults with osteoarthritis after participating in a 4-week self-management knee pain relief program. The study involved a single group of 40 participants from village no. 4 and 7, Bang Krabue Sub-district, Mueang District, Sing Buri Province, in February 2025. Data were collected using a questionnaire witha pain rating scale (1-10 points), and the Ministry of Public Health’s clinical knee osteoarthritis screening form. Data analysis employed descriptive statistics and repeated measures ANOVA.

The results showed that the majority of the samples were female (92.5%), and their initial knee pain level was moderate (mean= 6.6, SD = 1.90). After they participated in the program, their knee pain tended to decrease to a mean of 2.8 (SD = 1.19) at the end of the 4^th week, and the difference in the experimental results (before-after) at each time point across the weeks was statistically significant (F-test = 4.18, p = 0.007). However, a slight increase in knee pain was observed at the beginning of each subsequent week. For example, after the first week of intervention, the pain level was 4.7, and at the start of the second week, the pain level was 5.2. This pattern was observed in every cycle of the experiment.

The self-management knee pain relief program has been shown to be effective in the short term. To enhance long-term outcomes, improvements could include the extension of the program’s continuity and duration, controlling factors and incorporating additional outcome measures.

Outcomes of Nerve Transfer Procedures for Shoulder Abduction in Traumatic Brachial Plexus Injuries: A Retrospective Study at Saraburi Hospital

Piyachanok Jindaluang — Tue, 26 Aug 2025 00:00:00 +0700

Traumatic brachial plexus injuries cause severe functional loss, particularly in shoulder abduction, which is crucial for daily living. Nerve transfer is an established microsurgical technique that restores muscle function.

This retrospective study compared outcomes of two surgical techniques for irrecoverable upper trunk injuries (C5–C6): spinal accessory nerve to suprascapular nerve, and spinal accessory nerve to suprascapular nerve combined with nerve to the long head of the triceps muscle to anterior axillary nerve. Fifty-seven patients underwent surgery between October 2013 and October 2023, with 56 completing follow-up. Most injuries were traffic-related (87.7%). Assessment using the Medical Research Council (MRC) grading scale showed that the dual-transfer group achieved faster recovery (mean 10.08 vs. 13.14 months, p<0.05), though no statistically significant difference was found in the proportion achieving MRC grade ≥3 (p>0.05).

These findings indicate that both techniques effectively improve shoulder abduction, arm function, and quality of life, with dual transfer providing a faster recovery advantage. The results highlight the capacity of provincial hospitals to deliver high-level microsurgical care and contribute valuable evidence to comparative research on nerve transfer procedures within the Thai healthcare system.

A Comparative Study of 0.15 mg and 0.2 mg Intrathecal Morphine for Post-Cesarean Analgesia: A Quasi-Experimental Study with Historical Control versus New Intervention

methinee thamnoranart — Tue, 26 Aug 2025 00:00:00 +0700

The intrathecal administration of morphine in combination with local anesthetics is the standard analgesic technique for cesarean section. However, intrathecal morphine can cause side effects, including pruritus, nausea, vomiting, and respiratory depression. The incidence of these side effects is dose dependent. This was a quasi-experimental study employing a historical control versus new intervention design. The study involved 80 pregnant women who underwent cesarean section at Pathumthani Hospital. All participants received an intrathecal injection of 0.5% hyperbaric bupivacaine. They were then divided into two groups: the study group received 0.15 mg intrathecal morphine, while the control group received 0.2 mg intrathecal morphine. This study aimed to compare the effectiveness of a lower dose of intrathecal morphine 0.15 mg with that of a 0.2 mg. The objective was to determine whether the lower dose provided equivalent pain relief while reducing the incidence of side effects within the first 24 hours.

The results revealed no significant difference between the two groups in pain intensity at 6, 12, 18, and 24 hours post-surgery, the number of patients requesting tramadol, the total amount of tramadol administered in the first 24 hours, and the time to the first dose of tramadol, and the incidence of nausea and vomiting. Pruritus, however, was significantly lower in the 0.15 mg morphine group compared to the 0.2 mg group at 12 hours post-surgery (p-value = 0.021). All patients in both groups regained consciousness without experiencing opioid-induced respiratory depression.

The administration of 0.15 mg of intrathecal morphine during cesarean section provided similar pain control efficacy comparable to 0.2 mg withing the first 24 hours post-surgery, while resulting in a lower incidence of pruritus.