Journal of Health Science and Medical Research
Journal of Health Science and Medical Research (JHSMR), abbreviation name: J Health Sci Med Res; formally known as: Songklanagarind Medical Journal. The academic health science journal of Prince of Songkla University, Thailand, goal is to provide open opportunities for publication of the highest quality manuscripts. The journal is dedicated to: research or other academic topics, patient reports, interesting new scientific articles, suggestions, and new concepts that will be beneficial to medical professionals, public health workers and any other readers interested in this field. All articles are double-blindly peer-reviewed by experts in the corresponding field. Our frequency times of publication are: 6 issues per year (Jan-Feb, Mar-Apr, May-Jun, Jul-Aug, Sep-Oct, and Nov-Dec). Aims and scope JHSMR offers an interdisciplinary forum for basic or applied medical and health sciences research, evidence-based and scientifically written articles. Our content focuses on, but is not limited to, these areas of medicine and health science; - Clinical medicine - Biomedical science and biomedical engineering - Public health research - Data science in medicine and health care Publication type Since 2018, JHSMR has published 4 types of paper; including original articles (including systematic reviews), review articles, case reports and selected editorials. Frequency: 6 issues per year January – February March – April May – June July – August September – October November – December Language: English Free Access: online and print ISSN: 2586-9981 (Print) ISSN: 2630-0559 (Online) *ISSN (Print and Online) start date Vol.36 No.2 Apr-Jun 2018
Faculty of Medicine, Prince of Songkla University
Clinical Prediction Model of Long COVID During the Delta and the Omicron Variant Dominant Waves in Thailand
Objective: Long coronavirus disease (long COVID) represents a significant burden on healthcare systems and requires enhanced management strategies. There is a critical need for more comprehensive care and targeted healthcare services for affected populations. This study aimed to develop a clinical prediction scoring system for long COVID in patients recovering from COVID-19. Material and Methods: This prospective cohort study collected data at Thammasat University Hospital and the Thammasat Field Hospital during the Delta- and Omicron-variant-dominant epidemics. Phone interviews regarding long COVID symptoms were conducted with 2516 patients at 3 months post-infection. A stepwise logistic regression model was employed to develop the final predictive model for long COVID. Results: In total, 40.46% of patients exhibited long COVID symptoms 3 months after infection. Our model comprised 5 predictors: dyspnea, healthcare worker status, female gender, severity of acute illness, and variant dominant wave. With a sensitivity of 57.1% and a specificity of 67.3% at 3 months, the risk score exhibited an area under the receiver operating characteristic curve of 0.62 for long COVID prediction. The probability of long COVID for each risk score point was also reported. The Hosmer–Lemeshow test (p-value=0.49) indicated good model calibration, with closely aligned observed and expected frequencies. Conclusion: The predictive risk score demonstrated satisfactory accuracy in identifying COVID-19 patients at high risk of developing long COVID 3 months post-infection.
Copyright (c) 2025 Journal of Health Science and Medical Research http://creativecommons.org/licenses/by-nc-nd/4.0
Detection of Heterogeneous Vancomycin Intermediate Resistance in Methicillin- Resistant Staphylococcus Aureus Clinical Isolates
Objective: To detect methicillin-resistant Staphylococcus aureus (MRSA) using the cefoxitin disk diffusion method. The study also determined the minimum inhibitory concentration (MIC) of vancomycin through the broth microdilution (BMD) method and categorized it into vancomycin sensitive-MRSA (VS-MRSA), vancomycin intermediate-MRSA (VI-MRSA), and vancomycin resistance-MRSA (VR-MRSA). All the VS-MRSA strains were screened for heterogeneous vancomycin intermediate-MRSA (hV-MRSA). Material and Methods: In this cross-sectional study, 210 MRSA strains were isolated from the different types of clinical specimens. Vancomycin susceptibility in MRSA isolates was investigated by determining the MIC using the BMD method. We used brain heart infusion screen agar with 4 µg/ml of vancomycin (BHIV4) to screen VS-MRSA strains for hV-MRSA and performed the modified population analysis profile area under the curve (PAP-AUC) method to confirm hV-MRSA. Results: On the basis of MIC determination of vancomycin, out of the 210 MRSA strains, we found 202 VS-MRSA, 7 VI-MRSA, and 1 VR-MRSA. BHIV4 applied and screened 202 VS-MRSA isolates, and these were confirmed with the PAP-AUC method, which revealed 34 hV-MRSA. Conclusion: All MRSA strains identified from the different clinical samples had a prevalence of hV-MRSA, 16.83%. Most of the hV-MRSA detected from the VS-MRSA strains showing the MIC of vancomycin on the borderline (2 µg/ml) indicate that the hV-MRSA is a prior stage of development of VI-MRSA.
Identification of ALK, ROS1, RET, MET Mutation in EGFR Wild-Type Non-Small Cell Lung Cancer Patients and Their Associations with Clinicopathological Factors
Objective: Genetic alterations in non-small cell lung cancer, including ALK, ROS1, RET, and MET, have been discovered, and they play a vital role in the advancement of targeted therapies for lung cancer. This study was conducted to detect the presence of ALK, ROS1, RET, and MET mutations, and to explore the correlation between these mutations and various clinicopathological factors. Material and Methods: A cross-sectional descriptive study was carried out involving 69 patients diagnosed with non-small cell lung cancer at the Vietnam National Cancer Hospital from June to October 2022. Samples were identified through histopathological assessments using the PCR method. Data were analysed by descriptive statistics and Chi-Square tests with SPSS 25.0 software. Results: The study indicated that ALK mutations had the highest prevalence at 21.7%, followed by ROS1 mutations at 8.7%. RET mutations were observed with a prevalence of 4.3%, while MET mutations were the least common at 1.5%. Notably, an association was found between ROS1 mutations and female patients (p-value=0.005). The observed mutation rates and their associations with some factors differed from the trends reported in numerous international studies (p-value>0.05). Conclusion: The study identified 4 mutations in samples extracted from non-small cell lung Vietnamese-cohort patients. Female patients had more ROS1 mutations than males. Future studies with larger sample sizes, improved selection criteria, and studies on more parameters are needed in order to demonstrate a more accurate picture of the status of these mutations in Vietnam.
Lifestyle Factors and Selected Parameters for Cardiometabolic Health: A Predictive Study among Malaysian University Staff
Objective: This study aimed to determine the prevalence of cardiometabolic risk factors and their associated factors (personal, behavioral, and environmental) among Universiti Malaysia Terengganu (UMT) staff. Material and Methods: A cross-sectional study using quota sampling was adopted, involving 317 respondents. The Working Characteristics, the Occupational Sitting and Physical Activity Questionnaire (OSPAQ), the International Physical Activity Questionnaire (IPAQ), and Dietary Practices in Malay were self-administered, while the health status examination was assessed by medical staff. Descriptive analysis and Multiple Linear Regression were employed. Results: In the predominantly Malay sample (97.5%), the prevalence of overweight or obesity, raised blood glucose, blood pressure, and total cholesterol among UMT staff was 62.4%, 7.3%, 21.1%, and 70% respectively. The hour of computer usage (environmental factor) was a significantly associated factor for diastolic blood pressure (p-value=0.042, β=0.622, 95% confidence interval (CI)=0.023, 1.221). Conclusion: High rates of obesity and cardiometabolic risks were found among UMT staff, and computer usage hours were significantly linked to diastolic blood pressure. These findings highlight the need for targeted interventions addressing personal, behavioral, and environmental factors, since these findings may extend to similar sedentary working populations.
Mapping Global Road Safety Communication: A Bibliometric Analysis of Campaigns and Awareness Strategies (2000–2025)
Objective: Road traffic injuries are a major global health concern, particularly in low- and middle-income countries (LMICs). While public awareness campaigns are essential for promoting safer behaviors, the research landscape remains fragmented and under-integrated. This study aimed to map the global structure of road safety communication research, identify conceptual trends, and investigate authorship, collaboration, and thematic growth patterns. Material and Methods: A bibliometric analysis was performed on 730 Scopus-indexed documents (2000–early 2025) using Biblioshiny and VOSviewer, following bibliometric protocols. The analysis examined annual publication growth, citation impact, keyword co-occurrence, and co-authorship networks. Thematic maps, multiple correspondence analysis (MCA), and co-citation analyses were employed to explore conceptual clusters and structural progression. Results: The findings revealed consistent growth in global publication output, predominantly from high-income countries. Three core thematic clusters emerged: public health and injury prevention, demographic and psychological profiling, and behavior-based intervention options. Collaboration networks were concentrated in Australia, the United States, and Europe, while LMIC participation remained sparse and episodic. Although digital media and emotion-based messaging are gaining attention, they remain insufficiently explored. Key gaps persist in theoretical integration, campaign evaluation rigor, and geographic inclusivity. Conclusion: Road safety communication research is expanding, but it remains thematically fragmented and regionally imbalanced. Future studies should prioritize interdisciplinary frameworks, leverage digital and culturally attuned strategies, and establish equitable research collaborations, especially involving underrepresented regions.
Curcumin Enhances the Reduction of Keloid Fibroblast Viability Induced by Blue Light
Objective: This study aims to determine the effects of blue light or curcumin alone and its combination on keloid fibroblast viability. Material and Methods: Human keloid fibroblasts were divided into different groups: untreated controls, blue light irradiation at 30 J/cm², curcumin treatment (1.25, 2.5, 5, 10, and 20 µg/mL), and curcumin combined with blue light. Results: Cell viability was assessed using an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and curcumin’s half-maximal inhibitory concentration (IC50) was calculated through regression analysis. Blue light at 30 J/cm2 significantly reduced keloid fibroblast viability to 61.99%, while curcumin at 20 µg/mL decreased viability to 72.01%. When combined with blue light, curcumin exhibited a dose-dependent effect: 5 µg/mL of curcumin reduced viability to 36.51%. In contrast, 10 and 20 µg/mL decreased viability to 15.94% and 15.85%, respectively—significantly greater reductions than curcumin alone. Blue light enhanced curcumin’s effects, lowering its IC50 from 30.95 µg/mL to 3.86 µg/mL. Conclusion: The combination of blue light and curcumin demonstrated synergistic effects, achieving greater reductions in keloid fibroblast viability compared to either treatment alone.
Therapeutic Potential of Clerodendrum Paniculatum Against Hyperlipidaemia and Oxidative Damage: Mechanistic Insights from Experimental Models
Objective: Hyperlipidaemia, a metabolic disorder characterized by elevated blood lipid levels due to impaired lipid metabolism, significantly contributes to diabetes, hepatic steatosis, and cardiovascular diseases. This study investigated the antihyperlipidemic and antioxidant effects of Clerodendrum paniculatum leaf ethanolic extract in high-fat diet (HFD)-induced hyperlipidaemic Wistar rats. Material and Methods: Over an 8-week period, hyperlipidaemic rats were orally administered the extract at 200 and 400 mg/kg doses. The research assessed the extract’s potential to modulate lipid profiles and enhance antioxidant defences, providing insights into its therapeutic role in metabolic disorders associated with dyslipidaemia. The study looked at the blood lipid profile, weight gain or loss, relative organ weight, 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibition, liver histology, and antioxidant enzymes in blood and liver tissues. Results: The blood lipid profile in rats given HFD was dose-dependently improved by administering the extract. Histopathological analysis revealed that C. paniculatum extract (400 mg/kg) effectively restored the hepatic architecture in hyperlipidaemic rats. Treatment significantly reduced body weight, relative liver weight (p-value<0.05), serum total cholesterol (p-value<0.05), and triglycerides (p-value<0.05), while elevating HDL-cholesterol (p-value<0.05). The extract demonstrated dose-dependent HMG-CoA reductase inhibition (12.8 and 9.8 U/mg protein at 200 and 400 mg/kg, respectively), indicating potent suppression of cholesterol biosynthesis. These findings suggest the extract’s dual mechanism of action, improving lipid metabolism while protecting against hepatic damage in hyperlipidaemia. Conclusion: The study suggests that C. paniculatum leaf extract may boost antioxidant defences, helping combat oxidative stress-related disorders. Findings indicate its potential to reduce hyperlipidaemia in HFD-fed rats by inhibiting HMG-CoA reductase and improving liver histopathology.
Determinants of Lactate Clearance and Mortality in Adult Patients with Severe Trauma
Objective: To evaluate the association between initial blood lactate levels, blood lactate clearance (BLC) at 6 hours, and in-hospital mortality among patients with severe trauma. Material and Methods: This prospective observational study included 100 adult patients with severe trauma (Revised Trauma Score <6) admitted to a Level-I Trauma Center. Initial and 6-hour venous lactate levels were measured, and BLC was calculated. The endpoint was in-hospital mortality. Logistic regression was used to assess associations with in-hospital mortality and BLC. Results: The in-hospital mortality rate was 27%. Non-survivors had significantly higher initial lactate levels than survivors (14.2±6.4 vs. 5.7±2.2 mmol/L; p-value<0.01). In multivariate analysis, only initial lactate remained independently associated with mortality (adjusted OR 3.98; 95% CI: 1.30–9.71; p-value<0.001). Patients with low BLC (<10%) had significantly higher mortality than those with high BLC (40.0% vs. 7.9%; p-value=0.030), although no clinical variable independently predicted BLC. Conclusion: Initial blood lactate is a strong independent predictor of mortality in severe trauma. While BLC ≥10% is associated with improved survival, its determinants remain multifactorial. Serial lactate monitoring should be considered an integral part of early trauma care, especially in resource-limited settings.
The Perception, Behaviour, and Preferred Features of Mobile Applications Screening Tools for Pediatric Feeding Disorders Among Caregivers and Speech Therapists
Objective: To explore the perception, behaviour, and preferred features of caregivers and speech therapists in the design of a mobile application for the screening of Pediatric Feeding Disorders (PFD). Material and Methods: A cross-sectional study was conducted using a Perception, Behaviour and Preferred Features of Mobile Applications Screening (PBF-MAS) questionnaire. The participants included 30 caregivers and 30 speech therapists recruited from Malaysian public healthcare facilities. Sociodemographic profiles were obtained, and the PBF-MAS questionnaire consisted of domains related to the perception, behaviour, importance of early screening for PFD, and the preferred features of mobile applications. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 29.0. Results: Most caregivers were female (90%), aged between 19 and 49 years, while speech therapists were predominantly female (93.3%), aged between 25 and 44 years. A majority of respondents expressed a high interest in mobile applications, particularly in features such as screening questionnaires (83.3%), educational resources (75%), meal planning (63.3%), and feeding progress tracking (66.7%). Statistically significant differences were observed between caregivers and speech therapists in preferred features such as educational resources (p-value<0.001), progress tracking (p-value=0.028), customizable profiles (p-value<0.001), meal tracking (p-value<0.001), and feeding schedule reminders (p-value<0.001). Despite the interest, actual usage remained low, with only 10% of caregivers and 6.7% of speech therapists having downloaded feeding-related apps, indicating a gap between interest and practical use. Conclusion: Digital health tools can facilitate early intervention and alleviate the burdens on caregivers and speech therapists of PFD. Healthcare providers must offer training to caregivers on using these digital tools effectively. Application developers should focus on creating user-friendly, culturally relevant applications. Future research should examine the long-term impacts of these tools on feeding issues and quality of life.
A Prospective Study on Perforated Peptic Ulcers: Peritoneal Fluid and Its Clinical Relevance to Overall Outcome
Objective: To determine whether the spectrum of microorganisms isolated from the peritoneal fluid in a case of perforated peptic ulcer influences the various post-operative complications and the overall outcome of the patient. Perforated Peptic Ulcers (PPUs) carry the risk of severe complications, and extensive peritoneal contamination is common in India, with a potentially different microbial spectrum compared to Western India. Peritoneal fluid culture may be valuable in predicting patient outcomes. Material and Methods: The study was conducted in the Post Graduate Department of General Surgery, Institute of Medical Sciences & SUM Hospital, Bhubaneswar, Odisha, India, over 3 years and included 525 patients with generalized peritonitis due to PPUs. Peritoneal fluid collected during surgery was analyzed for microorganisms. Postoperative complications and overall outcomes were correlated with the severity of peritonitis and the isolated microorganisms. Results: In this series, the incidence of PPUs in males outnumbered females 11.5:1, and delayed presentation (>48 hours) occurred in 42.0% of patients. Peritoneal fluid cultures were positive in 59.0% of samples, with Escherichia coli (49.0%) being the most common isolate, followed by Klebsiella pneumoniae (K. pneumoniae), Citrobacter freundii (C. fruendii), Enterococcus faecalis (E. faecalis), and Candida albicans (C. albicans). Culture positivity significantly increased the risk of postoperative complications (odds ratio 6.75 times, p-value<0.05) and the need for critical life support (odds ratio 10.2 times, p-value<0.05). Conclusion: Peritoneal fluid culture in PPU patients is a crucial investigation, revealing the spectrum of microorganisms and highlighting their impact on disease progression and postoperative outcomes.
Copyright (c) 2026 Journal of Health Science and Medical Research http://creativecommons.org/licenses/by-nc-nd/4.0
Comparison of Outcomes Between S-TUAEP and M-TUAEP in Benign Prostatic Hyperplasia at Rajavithi Hospital
Objective: This study aimed to measure the outcomes in 100 patients who underwent the transurethral anatomical enucleation of the prostate (TUAEP), comparing the results between the standard TUAEP (S-TUAEP) and modified TUAEP (M-TUAEP) procedures in patients with benign prostatic hyperplasia. Material and Methods: Fifty cases were performed in S-TUAEP, and the other 50 were performed in M-TUAEP. Each group recorded demographic data, PSA, IPSS (International Prostate Symptom Score), QOL (Quality of Life score), Uroflowmetry (UFM), Maximum Flow Rate (Qmax), operative time, blood loss, length of hospital stay, and complications. Results: The mean operative time was 114.50±54.30 minutes in the S-TUAEP and 120.26±42.64 minutes in the M-TUAEP (p-value=0.55). The length of stay was 3.12±1.13 days in the S-TUAEP group and 2.50±0.58 days in the M-TUAEP group (p-value<0.001). The mean Qmax at 24 months showed that S-TUAEP was 21.87±7.03 and M-TUAEP was 22.24±6.97 (p-value<0.001). The median comparison of QOL at 24 months between the S-TAUEP and the M-TUAEP was 1 (0.2) and 0 (0.2), respectively (p-value=0.01). Conclusion: The present study reported no statistically significant differences in perioperative outcomes between the two groups. However, a better functional outcome was observed in the M-TUAEP group. More TUAEP cases are required to observe the long-term consequences.
Ethnobotanical Use of Plants for Relieving Stress Among Hill Tribes in Northern Thailand: A Pilot Study
Objective: To describe the ethnobotanical plants used to alleviate stress among the hill tribe communities in Mae Hong Son Province, Thailand. Material and Methods: Data were collected from 3 hill tribe villages; 246 participants were enrolled based on the inclusion criteria: 1) aged 21 years or older, 2) having parents of Karen ethnicity, and 3) understanding the purpose of the study. The exclusion criterion was a request to withdraw from the research. Plant utilization was recorded and cross-referenced with voucher specimens. Taxonomic identification involved photographing and collecting all plant samples. Results: The results show that 59.30% of participants were female, and the mean age was 49.47 years (S.D.=0.54). Half of them had no formal education (50.80%). The most commonly used plant part for stress relief was the leaf (35.80%). Participants reported using 20 plants (17 species) for stress relief. Herbaceous plants were the most common type reported, particularly Centella asiatica (used by 37.40% of all participants). Participants reported using various parts of Pinus merkusii for stress relief. The most common preparation methods included raw consumption, cooking, and boiling (oral consumption, 50-100 grams). Stress levels decreased after plant use; a Stuart–Maxwell test confirmed this change was significant (χ²=14.14, df=2, p-value=0.001). Conclusion: The study highlights traditional knowledge of plants for stress relief in hill tribe communities, providing insights into culturally relevant therapies. However, limitations such as a small sample size and lack of a control group affect generalizability, emphasizing the need for further research on their therapeutic potential.
Anaemia Prevalence Trends Among Indian Women: A Study Based on National Family Health Survey Data
Objective: To compare the prevalence of anaemia in India’s different states and union territories (UTs) and assess the changing trends in the prevalence and severity of anaemia in women of reproductive age over the past 15 years. The study looked at data from the National Family Health Survey factsheets. The factsheets from the National Family Health Survey 3, 4, and 5 have been cited for the same purpose. Material and Methods: This study is a secondary data analysis that reviewed the pertinent secondary literature and used data from National Family Health Survey (NFHS)-3, 4, and 5. Results: Between the NFHS 4 and 5, the prevalence of anaemia in all women aged 15–49 years increased from 53% to 57%, in pregnant women from 50.4% to 52.2%, and in non-pregnant women from 53.2% to 57.2%. Among women aged 15 to 49, the greatest rates of anaemia are seen in West Bengal, Assam (65.9%), and Tripura (67.2%). Conclusion: The Anaemia Mukt Bharat campaign was initiated in 2019 with the objective of mitigating the anaemia burden. However, over the course of the last 5 years, NFHS 5 shows a noteworthy increase in anaemia in women. This emphasizes the necessity of giving current programs a more effective makeover and implementation.
Rapid Diagnosis of Plasmodium knowlesi Infection Utilizing the Loop-Mediated Isothermal Amplification Technique Coupled with a Lateral Flow Assay
Objective: To develop a highly sensitive and specific molecular diagnostic assay for detecting P. knowlesi by combining LAMP with lateral flow assay (LFA). Material and Methods: Six LAMP primers targeting the P. knowlesi 18S rRNA gene were designed, incorporating FITC and biotin labels into the FIP and LoopF primers. Specificity and sensitivity were evaluated using DNA from various Plasmodium species. Clinical samples were tested, and the results were visualized on LFA. Results: The PkLAMP-LFA assay demonstrated a sensitivity of 95.4% (95% CI: 84.5–99.4%) and a specificity of 100% (95% CI: 15.8–100%) compared to nested PCR. The limit of detection was 10 copies/µL. The assay produced results within 60 minutes and required only minimal equipment. Conclusion: The PkLAMP-LFA assay is a rapid, accurate, and field-deployable diagnostic tool for P. knowlesi, offering a practical solution for improved malaria detection and control in endemic regions.
Optimising Tuberculosis Screening Coverage in a Regional Hospital in Thailand: A Multi-Agent Simulation Approach
Objective: To assess the impact of tuberculosis (TB) screening coverage on infection risks using a multi-agent simulation (MAS) model, based on a case study of a private hospital in northeastern Thailand. Material and Methods: A hospital-based multi-agent simulation to evaluate TB transmission across 6 screening coverage levels (0%–100%) during peak and off-peak hours was developed. The model was informed by 200 outpatient observations and hospital data collected between October and December 2024 at a private hospital in northeastern Thailand. A risk matrix was constructed to assess clinical, financial, and reputational outcomes based on scenario-based analysis and stakeholder interviews. Results: The simulation demonstrated that reduced screening coverage substantially increased the risk of TB transmission, with a more pronounced effect during peak hours. At full coverage, infection rates were 0.61 percent during peak hours and 0.30 percent during off-peak hours. In the absence of screening, these rates increased to 5.50 percent and 0.51 percent, respectively. The higher transmission risk during peak hours reflects the influence of increased patient density and interaction. The risk matrix indicated that limited screening during peak hours led to more severe clinical, reputational, and financial consequences than during off-peak periods. Conclusion: The findings support the use of MAS as a dynamic tool for evaluating TB screening strategies under real-world constraints. The model highlights how adaptive screening policies, especially during peak hours, can reduce transmission risk and support operational decision-making in resource-limited hospital settings.
Anatomical Variations of the Sphenoid Sinus in Acromegalic versus Non-Acromegalic Patients with Pituitary Adenoma: Implications for Surgical Planning
Objective: To compare the anatomical differences of the sphenoid sinus and adjacent critical structures between patients with hormone-producing pituitary tumors, distinguishing between acromegalic and non-acromegalic groups, to optimize surgical planning and anticipate potential complications. Material and Methods: A retrospective analysis was conducted on 150 patients diagnosed with hormone-secreting pituitary adenomas (50 acromegalic and 100 non-acromegalic) treated at the Neurosurgery Outpatient Clinic, Songklanagarind Hospital, between January 1, 2012 and December 31, 2022. Patient demographics and sphenoid sinus anatomical characteristics were assessed using computed tomography (CT) scans in collaboration with radiologists. Statistical analysis was performed using the R program with a significance threshold of p-value<0.05. Results: Acromegalic patients exhibited significantly higher rates of post-sellar sphenoid pneumatization (p-value=0.002), sphenoid septum attachment to the optic nerve (p-value=0.018), and Onodi cells (p-value=0.011). The distance between the sphenoid rostrum and Vidian canal was significantly greater in acromegalic patients (p-value<0.001 right side, p-value=0.008 left side). Additionally, acromegalic patients had higher incidences of Vidian nerve protrusion (p-value=0.013), optic nerve protrusion (p-value<0.001), optic nerve dehiscence (p-value=0.025), and internal carotid artery (ICA) dehiscence (p-value=0.034). The intercarotid distance was significantly narrower in acromegalic patients (mean 16.4 mm, p-value<0.001). Conclusion: Patients with acromegaly and hormone-secreting pituitary adenomas demonstrate distinct anatomical variations in the sphenoid sinus and adjacent structures compared to non-acromegalic patients. These differences underscore the necessity for thorough preoperative evaluation and meticulous surgical planning to minimize risks during transsphenoidal pituitary surgery.
The Usual Story of an Unusual Site: A Case Series of Urinary Bladder Paraganglioma from a Single Institution
Objective: Bladder paragangliomas (PUB) are extremely rare. The incidence is <0.06% of all bladder tumors and <1% of all pheochromocytomas. The importance of accurate diagnosis is crucial for effective patient treatment. Material and Methods: This study encompassed 9 cases of bladder paragangliomas, identified over a duration of 6 years. Analyses of the epidemiological features, symptoms, imaging, laboratory tests, treatments, pathology, immunohistochemistry (IHC), and follow-up outcomes were executed. Results: Among the 9 cases of PUB, 5 were female and 4 male, with ages ranging from 24 to 73 years. The most common presenting symptom was painless gross hematuria (67%), followed by micturition attack (22%), and hypertension (11%). Radiologically, the tumors were well circumscribed, solitary, and broad-based. Most patients underwent transurethral resection of the bladder tumor (TURBT). The characteristic Zell Ballen pattern of tumor cells, separated by a delicate fibrovascular network and supported by small sustentacular cells, was evident on microscopy. All tumors were classified as T2, per the 8th edition American Joint Committee on Cancer Staging System (AJCC) staging system. Based on histmorphology, various differentials were considered. On IHC, tumor cells were immunoreactive for synaptophysin, chromogranin, with S100 highlighting sustentacular cells, thereby confirming the diagnosis of PUB. MIB1 ranged from 1-10%. Two patients were lost to follow-up. Duration of follow-up ranged from 3 months to 78 months (6.5 years). All the patients were disease and symptom-free at the follow-up. Conclusion: PUB is a rare condition. Characteristic clinical presentation, histologic features, and application of immunohistochemistry are all important to differentiate this tumor from other bladder tumors, ensuring patients receive the appropriate treatment.
A Genetic Algorithm for Medicine Inventory Management Under Uncertain Demand
Objective: This study aimed to propose an optimal drug inventory management approach for government hospitals under uncertain demand, particularly during emerging disease scenarios like Coronavirus Disease 2019 (COVID-19). The goal was to minimize inventory management costs, including holding, ordering, and drug costs, by determining the optimal order quantity and reorder point. Material and Methods: Drugs were categorized using the K-Means Clustering method to identify similar demand patterns. A mathematical model and a genetic algorithm (GA) were developed to determine the optimal ordering policy. These methods were evaluated based on total inventory management costs and processing times. Sensitivity analysis was performed to evaluate the effects of cost variations, with increments ranging from 10% to 50%. Results: The mathematical model achieved a total inventory management cost of 80,652,330.9 Thai Baht (THB), a 4.7% reduction (3,800,278.1 THB) compared to the genetic algorithm’s 84,452,609.0 THB. However, the genetic algorithm significantly reduced processing time to 60.2 minutes, compared to 368 minutes for the mathematical model, representing an 83.6% time reduction. Compared to the current policy’s cost of 93,442,791.9 THB, the mathematical model lowered costs by 13.7% (12,790,461.0 THB), while the genetic algorithm achieved a 9.6% reduction (8,990,182.9 THB). Conclusion: The proposed methods effectively reduced inventory management costs and processing times compared to the existing policy. This study introduces an integrated approach that combines K-Means clustering, a mathematical model, and a genetic algorithm to efficiently manage hospital drug inventories under uncertainty, reducing both costs and processing time.
Expression of NF2, TRAF7, PI3KCA, and PGR in Skull Base vs Non- Skull Base Meningiomas: A Quantitative Cross-Sectional Study
Objective: Meningiomas exhibit distinct genetic mutations. The association between NF2, TRAF7, PIK3CA, and progesterone receptor (PGR) mutations with tumor location remains elusive. This study aimed to quantify and compare the immunoexpression of these biomarkers across meningioma subtypes. Material and Methods: A cross-sectional analysis was performed on 70 formalin-fixed paraffin-embedded (FFPE) meningioma tissue samples (35 skull base, 35 non-skull base) from Dr. Arifin Achmad Hospital, Indonesia (2021–2023). Immunohistochemistry assessed NF2, TRAF7, PIK3CA, and PGR expression levels based on predefined cell-positivity thresholds. Tumor location, WHO grade, demographic data, and hormonal contraceptive history were also analyzed. Results: In patients with skull base meningiomas, 85.7% were categorized as benign, compared to 62.9% in those with non-skull base meningiomas (p-value<0.020). The immunohistochemical expression levels of NF2, TRAF7, and PIK3CA between the two study groups showed significant differences (p-value<0.001). Skull base meningiomas exhibited a higher expression of NF2, TRAF7, and PIK3CA. This study also demonstrated a positive relationship between the duration of hormonal contraceptive use and the percentage of PGR expression, where longer use of hormonal contraceptives was associated with increased PGR expression in meningiomas (p-value<0.05). There were no significant differences in sex, age, or contraceptive usage prevalence between the groups (p-value>0.05). Conclusion: Skull base meningiomas demonstrate distinct molecular profiles characterized by NF2 presence and TRAF7/PIK3CA overexpression, suggesting non-NF2 tumorigenesis pathways. Non-skull-base meningiomas frequently lack NF2, correlating with higher malignancy. PGR expression is ubiquitous and linked to hormonal contraceptive duration. These findings support the location-based molecular stratification of meningiomas and the development of targeted therapies for difficult-to-resect tumors.
Association Between Perceptions of Educational Environment and Burnout Syndrome in Clinical Medical Students
Objective: Burnout syndrome is a critical concern among medical students, contributing to fatigue, reduced academic performance, and negative health outcomes. The educational environment is considered a key factor influencing burnout. This study aimed to assess medical students’ perceptions of their educational environment and its association with burnout syndrome. Material and Methods: A cross-sectional study was conducted at Chonburi Hospital, Thailand, from November to December 2023, involving 106 clinical medical students. Burnout syndrome was measured using the Maslach Burnout Inventory (MBI), and perceptions of the educational environment were evaluated using the Dundee Ready Education Environment Measure (DREEM). Data were analyzed using descriptive statistics, Pearson’s correlation, and regression analyses. Results: The mean DREEM score was 125.17±12.80, indicating an overall positive perception of the educational environment. The prevalence of burnout syndrome among participants was 50.94%. DREEM scores were significantly negatively correlated with burnout (r=-0.504, p-value<0.001), emotional exhaustion (r=-0.427, p-value<0.001), and depersonalization (r=-0.395, p-value<0.001). Subscales such as the Students’ Perception of Learning (SPL), Students’ Academic Self-Perception (SAP), Students’ Perception of Atmosphere (SPA), and Students’ Social Self-Perception (SSP) were also significantly negatively associated with burnout (all p-value<0.001). Multivariate analysis identified SPA and SSP as significantly associated factors of burnout. Conclusion: Medical students’ perceptions of the educational atmosphere and social support are significantly associated with burnout syndrome. Targeted efforts to improve these aspects of the educational environment may be effective in reducing burnout among clinical medical students.
Antioxidant, Anti-Inflammatory, and Cytotoxic Activities Against Drug-Sensitive and Drug-Resistant Cancer Cells of the Extracts of Clausena excavata, Millettia pachycarpa, and Uvaria grandiflora
Objective: This study aimed to analyze the chemical profiles of bioactive compounds in extracts from different parts of Clausena excavata (C. excavata), Millettia pachycarpa (M. pachycarpa), and Uvaria grandiflora (U. grandiflora), and to examine their antioxidant, anti-inflammatory, and cytotoxic effects on drug-sensitive and -resistant cancer and normal cells. Material and Methods: Ethyl acetate extracts from C. excavata fruits (FCE), M. pachycarpa roots and leaves (RMP and LMP), and U. grandiflora twigs and leaves (TUG and LUG) were analyzed for total phenolic and flavonoid content and the chemical profiles of bioactive compounds. Antioxidant activities were determined using various methods. Anti-inflammatory properties were investigated in lipopolysaccharide-stimulated RAW264.7 cells, and cytotoxicity was evaluated in doxorubicin-sensitive and -resistant leukemic cells (K562 and K562/adr), breast cancer cells (MCF-7 and MCF-7/adr), and normal cells (peripheral blood mononuclear cells; PBMCs). Results: The extracts contained bioactive compounds, including carbazole alkaloids, xanthones, and coumarins in FCE; isoflavonoids, coumarins, and rotenoids in RMP and LMP; and alkaloids, cyclohexenes, and flavonoids in TUG and LUG. TUG, RMP, and LMP exhibited the highest 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, whereas RMP demonstrated the most potent 2,2-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and superoxide radical scavenging activities. LUG showed strong metal-chelating activity (MCA), and LMP showed superior ferric ion reducing antioxidant power (FRAP). FCE exhibited notable anti-inflammatory activity, whereas RMP showed significant cytotoxicity against MCF-7 and MCF-7/adr cells, with minimal toxicity to PBMCs. TUG also proved effective against drug-resistant leukemia cells. Conclusion: These findings highlight the potential of these plants for use in dietary supplements and cancer treatments, especially for drug-resistant cancers.
Maitland Mobilization for Bruxism in Temporomandibular Disorder: Enhancing Pain Threshold, Function, Sleep, and Mouth Opening
Objective: Although Maitland joint mobilization (MJM) of the cervical spine has been widely studied in the treatment of temporomandibular disorders (TMD), limited research exists on its direct application to the temporomandibular joint (TMJ), particularly in patients with bruxism. This study aimed to explore the effectiveness of TMJ-targeted MJM in improving pain pressure threshold (PPT), functional limitation (FL), sleep quality (SQOL), and maximal mouth opening (MMO) in individuals with myofascial TMD associated with bruxism. Material and Methods: This is a single blind, quasi-experimental study with 40 participants allocated to either the control group (Group A; N=20), receiving only conventional exercises, or the experimental group (Group B; N=20), receiving MJM of TMJ with conventional exercises for 4 weeks; 10-cm metal scale was used to measure MMO, a dolorimeter to assess PPT of the masseter, the Mandibular Function Impairment Questionnaire to evaluate FL, and Pittsburgh Sleep Quality Index to assess SQOL. Results: 35 out of the 40 who completed the 4-week intervention were included in the analysis. Baseline demographics were similar between the groups in gender and age (p-value>0.05). The experimental group showed significantly greater improvements in PPT (p-value<0.05), MMO (p-value=0.000), and FL (p-value<0.05) post-intervention. SQOL did not differ significantly between the groups (p-value>0.05). Strong positive correlations were found between PPT and MMO (r=0.873, p-value<0.05), and between FL and SQOL (r=0.715, p-value<0.05). Conclusion: MJM in Bruxism with myofascial TMD effectively improved MMO, PPT (masseter), and FL, but the groups did not exhibit any significant differences in SQOL.
Asymptomatic Complete Heart Block: How Soon Should a Pacemaker be Implanted?
Objective: This study aimed to determine the onset of adverse events after the diagnosis of asymptomatic complete heart block in order to guide the appropriate timing of pacemaker implantation. Material and Methods: A retrospective analysis of data from the electronic medical records from 2002 to 2020 was conducted at a university hospital in Southern Thailand. The study focused on patients diagnosed with asymptomatic complete heart block using standard 12-lead electrocardiograms. Kaplan-Meier survival analysis was used to examine the time from diagnosis to any adverse events before pacemaker implantation. Results: Among 95 asymptomatic complete heart block patients with incidental detection of bradycardia (mean age 70.4±15.0 years old) during hospital visits, the mean heart rate was 40.5±7.2 beats per minute and the median QRS duration was 110 milliseconds (ms) (interquartile range (IQR) 92, 145.8 ms). All patients eventually underwent pacemaker implantation. The median waiting time for the implant was 61 days (IQR 14, 223 days). During the waiting period, 34 patients (35.8%) experienced adverse events. Syncope was the first major adverse event that occurred 27 days after the diagnosis. According to survival analysis, the 30-day and 90-day event-free survivals were 94.2% and 83.7%, respectively. Conclusion: The waiting period for pacemaker implantation in patients with asymptomatic complete heart block poses certain risks. To mitigate the chance of developing major adverse events, it is better to implant a pacemaker sooner rather than later.
Cross-Cultural Adaptation and Validation of the Diet and Exercise Social Support Questionnaire for Thai University Students
Objective: This study aimed to cross-culturally adapt and validate a social support questionnaire for diet and exercise behaviors for use in Thailand. Material and Methods: This study undertook the cross-cultural adaptation of a social support questionnaire and assessed its reliability and validity for application in Thailand. Forward–backward translation was conducted to translate the questionnaire from English to Thai. Then, the semantic, idiomatic, experiential, and conceptual equivalences were assessed by 2 experts in adolescent behavior and social support. A cross-sectional study was then conducted on 200 young Thai women with an average age of 18.32 years to test the Thai version of the self-reported social support questionnaire. The content validity was determined from the S-CVI score, and Cronbach’s alpha was computed to estimate the internal consistency of the scale. Results: The Thai translated version showed an average equivalence score of 0.92–1 and an S-CVI of 0.93. The respective Cronbach’s α for the diet and exercise modules were 0.91 and 0.81. Conclusion: This is the first Thai language social support questionnaire to assess diet and exercise behaviors and will be advantageous for health promotion or weight management programs in Thailand.
Monoclonal Gammopathy of Undetermined Significance and Associated Clinical Risk Factors in Patients from Southern Thailand
Objective: To assess the percentage among suspected individuals and clinical characteristics of MGUS in a Southern Thai population and examine the correlation between comorbidities and MGUS risk classifications. Material and Methods: This retrospective cross-sectional study analyzed 1,359 patients with suspected MGUS at Songklanagarind Hospital from 2013 to 2024. Patients were stratified into risk categories based on laboratory criteria, and associations between demographic factors, comorbidities, and risk classifications were evaluated. Results: A total of 64 MGUS cases were identified, yielding a percentage of 4.7%. IgG was the most commonly observed type of M protein (64.1%), followed by IgA (28.1%) and IgM (7.8%). MGUS was more common in males, while anemia, chronic kidney disease, and neurological disorders were less frequently observed among MGUS cases. These associations remained significant in multivariate analysis. Conclusion: This study provides insights into the prevalence and clinical characteristics of MGUS in Southern Thailand, highlighting the impact of comorbidities on risk classifications. The findings underscore the importance of considering comorbid conditions in MGUS risk stratification beyond conventional laboratory parameters, warranting further research to refine patient care strategies.
Evaluating the Accessibility, Availability, and Utilization of Services in Adolescent Friendly Health Clinics: Insights from a Rural, Backward Caste-Dominated District in Eastern India
Objective: In India, despite the presence of Adolescent Friendly Health Clinics (Anwesha Clinics), barriers to accessing these services remain prevalent. This study explores the accessibility, availability, and utilization of services at Anwesha Clinics in Bankura Health District, a rural, backward caste-dominated district in eastern India. Material and Methods: This study employed an analytical design with an explanatory sequential mixed-methods approach, combining quantitative and qualitative data. The research was conducted across three randomly selected Anwesha Clinics in Bankura, covering a total sample size of 212 adolescents. Data collection spanned 18 months (April 2021–September 2022) and included a pre-designed semi-structured questionnaire for quantitative data, focus group discussions (FGDs) with adolescents who never visited the clinic, and in-depth interviews with counselors for qualitative insights. Clinic infrastructure and IEC materials were assessed using a UNFPA (United Nations Population Fund) reportbased checklist. Quantitative data were analyzed using SPSS for descriptive statistics, chi-square tests, and logistic regression to identify predictors of service utilization. Qualitative data were thematically analyzed, with coding to identify themes related to service access and barriers. Results: The study found 66.51% service utilization, predominantly for counseling, menstrual issues, and anemia. Barriers included lack of awareness, distance, privacy concerns, and inadequate clinic infrastructure. Logistic regression identified significant predictors of service utilization, with females, adolescents from lower socio-economic classes, and those within 3 km of a clinic being more likely to utilize services. Conclusion: Enhancing clinic infrastructure, increasing awareness, and ensuring privacy are crucial for improving adolescent engagement with Adolescent Friendly Health Clinics.
The Effectiveness of 1.5 Tesla MRI in Predicting Axillary Lymph Node Metastasis in Cancer Patients with Breast-conserving Surgery
Objective: Assessing axillary lymph node metastasis accurately before breast-conserving surgery is essential for guiding surgical decisions and improving diagnostic performance. The study aimed to determine the accuracy of breast magnetic resonance imaging (MRI) in assessing axillary lymph node metastasis in cancer patients undergoing breast-conserving surgery. Material and Methods: A cross-sectional descriptive study was conducted on 76 breast cancer patients with indications for conservative surgery at the Vietnam National Cancer Hospital from June 2020 to May 2021. Patients were assessed for axillary lymph node metastasis using a 1.5 Tesla MRI machine through analysis of parameters of size and morphology on conventional sequences and Diffusion-Weighted Imaging (DWI) sequences. Data were analysed by descriptive statistics and T-test with IBM Statistical Package for the Social Sciences (SPSS) 25.0 software. Results: Short-axis length, short/long axis ratio, cortical thickness, loss of fatty hilum, and eccentric cortical thickening were the parameters with statistically significant differences between the two groups of metastatic and non-metastatic lymph nodes (p-value-value<0.05). The Apparent diffusion coefficient (ADC) index was statistically significant between the two groups, with area under the curve (AUC) values higher than the AUC values of the parameters on conventional magnetic resonance (AUC: 0.874, with the optimal threshold of 1.046x10-3 mm2/s for sensitivity of 78.6%, specificity of 85.5%) (p-value<0.05). Conclusion: Conventional MRI combined with DWI sequences can assess axillary lymph node metastasis in patients undergoing breast-conserving surgery with high sensitivity and specificity. Therefore, to improve treatment quality, it is necessary to assess axillary lymph node metastasis before breast-conserving surgery.
Piperine, Isolated from Nigerian Propolis, Modulates GLUT-4 Gene Expression and NF-κB in a Rat Model of Chronic Fructose and Glucose Intake
Objective: This study investigated the effects of piperine from Nigerian propolis on glucose metabolism and inflammatory pathways in a rat model of chronic fructose and glucose intake. Material and Methods: Twenty male Wistar rats were randomly divided into 4 groups: control group, fructose-glucose (unsupplemented) group, fructose-glucose plus piperine group, and fructose-glucose plus metformin group. The fructoseglucose (unsupplemented) group received continuous oral infusion of a 50% fructose and 50% glucose solution (at a concentration of 10% (w/v) each) without any supplements, while the fructose-glucose plus piperine and fructose-glucose plus metformin groups received daily oral administration of piperine and metformin as supplements, respectively, in addition to fructose-glucose infusion. Insulin sensitivity was evaluated by computing the homeostatic model assessment of insulin resistance index (HOMA-IR). Real-time Polymerase Chain Reaction (PCR) was performed to quantify the mRNA expression of the Glucose Transporter–4 (GLUT-4) gene. The protein expression levels of pro-inflammatory transcription factor Nuclear Factor Kappa B (NF-κB) and p-Akt (phosphorylated protein kinase B) were analysed using western blotting techniques. Results: After 8 weeks, biochemical analyses showed that the piperine from Nigerian propolis increased GLUT-4 expression and decreased NF-NF-κB expression compared to the fructose-glucose (unsupplemented) group, where insulin insensitivity persisted. Piperine also significantly lowered blood glucose levels and significantly improved insulin sensitivity by lowering the HOMA-IR in the supplemented animals compared to the unsupplemented infusion group. Conclusion: The results of the study suggest that piperine, an alkaloid from Nigerian propolis, may have the therapeutic potential to mitigate the detrimental effects of chronic fructose and glucose intake on glucose metabolism and inflammatory pathways.
Effectiveness of the Muscle Energy Technique versus Neurodynamic Sliding on Hamstring Flexibility and Balance among Athletes
Objective: Muscle energy technique (MET) and neurodynamic sliding (NDS) are effective in improving hamstring flexibility. However, there is a dearth of information on the efficacy of these techniques for improving balance and regarding which is superior. Therefore, the purpose of the study was to compare the effects of MET with NDS on improving hamstring flexibility and balance among athletes. Material and Methods: A pre-test and post-test experimental study design with a total of 90 participants (30 cricketers, 30 football players, 30 runners) with unilateral hamstring tightness were randomly assigned to Group MET (n=30), Group NDS (n=30), Group MHP (moist heat pack) (n=30). PSLR (passive straight leg raising), AKE (active knee extension), SST (stork stand test), and mSEBT (modified star excursion balance test) were recorded at baseline and post-intervention. Results: Paired t-test for pre- and post-test comparisons of all the groups showed significant improvement (p-value=0.000) in all the outcomes. One-way ANOVA for between-group comparisons showed significant differences for PSLR (p-value=0.000), AKE (p-value=0.000), SST (p-value=0.018), mSEBT reach distance [anterior (p-value=0.000), postero-medial (p-value=0.001), and postero-lateral (p-value=0.001)], mSEBT normalized scores [anterior (p-value=0.002), postero-medial (p-value=0.002), and postero-lateral direction (p-value=0.002)], and mSEBT composite scores (p-value=0.002). Level of significance was set at 95%. Conclusion: MET showed a significant increase in hamstring flexibility; therefore, it is preferred to NDS for increasing hamstring flexibility among athletes. Additionally, MET and NDS are equally effective at improving static and dynamic balance among athletes, as both resulted in comparable outcomes.
Challenges in HIV Screening Among Pulmonary Tuberculosis Patients as Perceived by Healthcare Workers: Mixed-Methods Study and Qualitative Synthesis of Data in Indonesia
Objective: Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) remain major global health challenges, with only half of TB patients in Indonesia aware of their HIV status. Despite the World Health Organization (WHO)’s recommendations for HIV testing among TB patients, stigma and other barriers hinder implementation. This study, conducted in Sragen, Indonesia, aimed to explore the barriers to HIV screening education and testing among TB patients, drawing from qualitative studies conducted in Indonesia. Material and Methods: The study employed a mixed-methods approach, combining quantitative and qualitative data, along with a systematic literature review. A quantitative study assessed TB-HIV service readiness by surveying healthcare workers, providing insights into facility backgrounds and staff knowledge preparedness. Qualitative interviews explore healthcare providers’ goals, strategies, and challenges in educating TB patients about HIV screening, complemented by a synthesis of Indonesian journals on challenges in HIV case detection among primary pulmonary TB patients. Results: Eight participants were involved in providing TB-HIV services at their respective hospitals. Of these, only five had received TB-HIV training in the past two years, and only three had undergone training on HIV screening education. Six themes emerged from the qualitative study, including the significance of HIV screening, TB-HIV program management during the pandemic, provision of HIV testing to TB patients, challenges in HIV screening, proposed solutions, and aspirations. Data synthesis identified individual, interpersonal, and environmental factors influencing the implementation of HIV screening programs. Conclusion: Healthcare workers face challenges in providing HIV screening education to TB patients in Indonesia, including communication barriers, stigma, and limited medical support.
A Retrospective Study on the Evaluation of Platelet Utilization Practices at a Tertiary Care Facility
Objective: Platelets have a relatively brief shelf life of 5 days and are infrequently available. Periodic audit of blood component utilization is necessary to ensure that corrective measures are taken to increase the proper and rational utilization of each component. Aim: To study the transfusion practices of platelets in a tertiary care center. Material and Methods: A retrospective analysis was conducted from January 2023 to December 2023. Demographics, indications, and appropriateness were assessed. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were utilized. Results: The total platelets utilized were 1206. A total of 368 patients received 1206 platelets, which accounted for 409 episodes of transfusion. The male-female ratio was 3:1. The maximum utilization of platelets was seen by the Department of Medicine, 550 (45.6%), followed by Emergency Medicine and Traumatology, 263 (21.8%), Surgery, 148 (12.2%), and Cardiovascular and Thoracic Surgery (CVTS), 94 (7.8%). The most common indication for platelet transfusion was acute bleeding, 85 (20.7%), acute febrile illness (malaria, dengue cases), 68 (16.6%), followed by DIC and Sepsis (9.0%), and hematological conditions, 35 (8.6%); 11.9% of episodes were pre-procedural, 65.7% were prophylactic, and 15.1% were therapeutic. Conclusion: This retrospective assessment of platelet utilization has provided insight into our existing platelet preparation, utilization, and transfusion policies, helping us to promote evidence-based practices by aligning the established guidelines with transfusion practices.
The Porosity and Surface Characteristics of Modified Glass Ionomer Cement
Objective: This study aimed to evaluate the porosity and surface morphology of experimental bioactive glass ionomer cements (BGIC) modified with tricalcium phosphate (TCP), translationally controlled tumor protein (TCTP), and chlorhexidine (CHX). These modifications were intended to enhance the biological and physical performance of conventional glass ionomer cements (GIC) without compromising their structural integrity. Material and Methods: Six groups of GIC-based materials were prepared (N=8), including unmodified GIC, BGIC, MBIGIC, MBIGIC+3T, MBIGIC+3T, and MBGIC+CHX. Porosity was evaluated using Micro-computed Tomography (Micro-CT) and quantified by calculating pore volume and average pore diameter. Surface morphology was assessed using Scanning Electron Microscopy (SEM) at magnifications of 1,000× and 2,000× to observe the homogeneity, granularity, and presence of voids or cracks. Results: The BGIC and MBGIC groups exhibited slightly higher porosity values compared to the control GIC group; however, these differences were not statistically significant (p-value=0.947). Similarly, the MBGIC+3T group showed porosity levels comparable to GIC. In contrast, both MBGIC+10T and MBGIC+CHX demonstrated significantly greater porosity than GIC and the lower TCP-modified groups (p-value=0.01), with no significant difference observed between MBGIC+10T and MBGIC+CHX. Conclusion: Modifications of BGIC with TCP, TCTP, and CHX resulted in increased porosity without compromising the surface integrity or homogeneity of the material. These findings suggest that such modifications could be beneficial in improving ion release and biological activity while maintaining acceptable physical structure. However, the optimal balance between increased porosity and mechanical stability requires further investigation in long-term in vitro and in vivo studies.
Comparing Academic and Teaching Assessment Outcomes in Online vs. In-Person Dental Education During and After COVID-19
Objective: This study aimed to compare the academic performance and teaching evaluations of second-year dental students at Prince of Songkla University in a foundational course between two teaching formats: online learning during the Coronavirus Disease-19 (COVID-19) pandemic (2020-2021) and classroom-based learning after the pandemic (2022-2024). Material and Methods: This retrospective study analyzed data from 50 students per academic year during online teaching (2020–2021) and in-person teaching (2022–2024). The online period consisted of one cohort (n=40), while the in-person period included three consecutive cohorts (approximately 40 students per cohort, n≈120). Quantitative data on academic scores and teaching evaluations were compared using descriptive statistics and independent t-tests (p-value<0.05, 95% CI). Qualitative data from open-ended feedback were anonymized, categorized, and thematically coded through a collaborative review by the research team. Results: No significant differences were found in academic performance between online (mean±S.D.=78.4±6.2) and in-person teaching (79.1±5.8; t (98)=0.53, p-value=0.60). Teaching evaluations were consistently high across both formats, with nearly identical scores for Oral Biology I (4.88 vs. 4.89), Oral Biology II (4.75 vs. 4.80), and Dental Morphology (4.80 vs. 4.90). Thematic analysis of qualitative feedback revealed similar positive perceptions regarding clarity of instruction and accessibility of resources. Conclusion: Both online and classroom-based teaching methods demonstrated similar effectiveness in delivering foundational dental education. These results underscore the adaptability of higher education systems and support the development of blended learning approaches. Such models can enhance educational resilience and respond effectively to future disruptions while accommodating diverse student needs.
Ten Years of Thailand’s Universal Coverage Experience: Strategies to Prevent Tooth Loss and Denture Service Access among Pre-elderly and Elderly
Objective: This study aimed to compare the need for and access to prosthetic services, and to analyze the trends in delivering preventive interventions among the pre-elderly and elderly in Thailand. Material and Methods: The population in this study was the pre-elderly (aged 40-59 years) and the elderly (aged 60 years and above) in Thailand. Dental service delivery for these populations focused on dentures and prosthetic needs. Primary preventive interventions included oral examination, toothbrushing, and fluoride application. Secondary data analysis was conducted. The time frame was 10 years, from 2014 to 2024. Results: Between 2014 and 2024, partial denture (PD) coverage remained very low among the pre-elderly (<0.3%), despite stable need estimates of 13–14%, whereas complete denture (CD) need was negligible, although services were still provided. Among the elderly, PD need was high (43–45%), but coverage stayed below 0.6%, while CD need (2.7–3.4%) contrasted with service delivery, which peaked at over 60,000 cases in 2023 before declining in 2024. Preventive services showed marked expansion in oral examinations and assisted toothbrushing across both groups, while fluoride application remained persistently limited. Conclusion: The findings highlight substantial unmet prosthetic and preventive dental needs, particularly among the pre-elderly.
Subcutaneous Basidiobolomycosis Presenting as Soft Tissue Sarcoma Mimicker: A Case Report
A 20-year-old Thai woman from Takfa, Nakhonsawan, presented with a painful, progressively enlarging, erythematous mass on the right thigh over 2 months; initially suspected to be soft tissue sarcoma, she was later diagnosed with subcutaneous Basidiobolomycosis based on histopathology and fungal culture. She responded well to oral itraconazole and potassium iodide solution.