Prapokklao Hospital

Diabetic retinopathy is preventable with glycemic control through appropriate health behaviors that are influenced by health beliefs. A multidisciplinary team led by nurses can address health beliefs, but the impact of preventing diabetic retinopathy is unexplored. This two-group quasi-experimental, pretest-posttest study investigated the effects of a Multidisciplinary Team Approach on health beliefs, diabetic retinopathy prevention behavior, and hemoglobin A1C. The participants comprised 62 adults with type 2 diabetes who had hemoglobin A1C over 7% selected from a general hospital in Thailand’s western province using simple random sampling. They were assigned to the experimental group (n = 31), who engaged in the 12-week Multidisciplinary Team Approach along with usual care, and the control group (n = 31), who obtained only usual care. Data were collected between May 2023 and February 2024 using the Health Belief Questionnaire, the Diabetic Retinopathy Prevention Behavior Questionnaire, and the Hemoglobin A1C test. Data were analyzed using descriptive statistics, paired t-test, and independent t-test. Following the program, the experimental group had significantly higher mean scores of health beliefs and diabetic retinopathy prevention behavior, and lower hemoglobin A1C compared to the control group and before the program. Nurses should be trained to implement this program to raise health beliefs of diabetic retinopathy and motivate behavior change for glycemic control. However, a further multisite randomized controlled study is needed before it can be implemented in practice.

Type 2 diabetes mellitus is a chronic non-communicable disease with a substantial impact on global public health. Individuals with diabetes are considered immunocompromised and face elevated risks of complications from viral infections, particularly COVID-19. To improve outcomes, effective plasma glucose control and robust self-management strategies are essential. This quasi-experimental study investigated the effectiveness of a self-management support program on self-care behaviors, fasting blood glucose, and hemoglobin A1c levels among adults with uncontrolled diabetes attending diabetic clinics in two hospitals in central Thailand. Thirty-two participants from each setting were purposively recruited by matched of their gender, age, body mass index, and similar HbA1c levels. The experimental group received a Self-management Support Program for 12 weeks; the control group received only usual care. Outcomes measures were the Self-Care Behaviors Questionnaire, fasting blood glucose, and HbA1c levels. Analysis involved descriptive statistics, paired t-test, independent t-test, and repeated measures ANOVA. Findings demonstrate the effectiveness of the program in glycemic control and behavior change. Nurses can use this program in practice to empower adults with uncontrolled diabetes to manage themselves. However, further study with long-term follow-up to determine the sustainability of self-care behaviors and glycemic control using randomized controlled trials is needed.

Background/Objectives: Wannachawee recipe (WCR) has been listed in the Hospital Traditional Medicine Formulary and has been used as a Thai medicine to treat psoriasis in the Thai Traditional Medicine Clinic of Prapokklao Hospital since 2006. Previous reports have found that WCR demonstrates good results for the treatment of patients with psoriasis. Among 136 Thai psoriasis patients who received WCR, 92.80% responded well. Although WCR is effective, there is still a lack of scientific data, especially relating to the bioactive compound in WCR. Therefore, this study aims to evaluate the phytochemicals in WCR via bioassay-guided isolation. Methods: In this study, the WCR was extracted via decoction with water, in a process based on traditional Thai medicine. The water extract was concentrated and dried using a spray dryer. The crude water extract was isolated using the partition technique with organic solvents, namely petroleum ether and ethyl acetate. These fractions were then separated and tested for anti-inflammatory activity using the bioassay-guided fractionation method. Results: Two particular types of pro-inflammatory cytokines are involved in inflammation and are among the factors that cause psoriasis—TNF-α and IL-6. Thus, we evaluated the isolated samples in terms of anti-inflammatory activity. The isolation resulted in two pure compounds—p-coumaryl aldehyde and trans-p-coumaryl alcohol. In the efficacy test of the isolated compounds, compared to the standard indomethacin at the same concentration of 12.5 ug/mL, trans-p-coumaryl alcohol was found to have the best efficacy, inhibiting TNF-α by 29.28% and IL-6 by 36.75%, with the standard compound showing inhibitions rates of 15.80% for TNF-α and 27.44% for IL-6. Conclusions: This study is the first report to identify the bioactive compound of WCR as trans-p-coumaryl alcohol or 4-hydroxycinnamyl alcohol.

Sparganosis is a rare parasitic infection caused by the larvae ofSpirometraspecies, with spinal involvement being exceedingly uncommon. We present the case of a 46-year-old woman with progressive lower limb weakness, sensory deficits, and bowel and bladder dysfunction over a 3-month period. Initial magnetic resonance imaging revealed an abnormal intradural lesion from L2 to S2, along with thoracic spinal cord edema, raising suspicion for a spinal dural arteriovenous fistula (DAVF). After referral to our institution, further imaging ruled out DAVF, and findings suggested arachnoiditis and radiculitis of the lumbosacral nerve roots. The patient underwent a laminectomy, revealing inflamed arachnoid membranes and diffuse yellowish-whitish granulation tissue adherent to the cauda equina, which histopathological analysis confirmed as sparganosis. Postoperatively, the patient showed improved motor strength, although bowel and bladder dysfunction persisted. This case highlights the diagnostic challenges of spinal sparganosis, the need for early surgical intervention, and the importance of considering parasitic infections in endemic regions.

Infertility, a global concern affecting both sexes, is influenced by modifiable and non-modifiable risk factors. While the literature predominantly underscores the clinical- and cost-effectiveness of lifestyle interventions in the realm of infertility treatment, a holistic compilation analysing the economic dimensions of such interventions is lacking. This systematic review aimed to fill this gap by evaluating the economic facets of lifestyle interventions in the management of infertility. An exhaustive search was conducted within the PubMed, Embase, and Scopus databases from their inception to February 2024. The aim was to find articles related to the economic aspects of lifestyle interventions in infertility management. These included clinical studies covering economic outcomes and economic evaluations. The Drummond Checklist was used to assess the quality of the included studies. From an initial yield of 7555 articles, five studies were deemed eligible for inclusion, comprising three cost-effectiveness analyses, one prospective cohort study and a randomized controlled trial, all of which were undertaken in high-income countries (the Netherlands, Australia and Japan). These studies included patients receiving infertility treatments for conditions such as unexplained infertility, polycystic ovary syndrome, ovulation disorders, or mild male infertility, inclusive of individuals with and without obesity. The women who participated in these studies were up to 45 years of age. The findings suggested that integrating lifestyle intervention programmes tends to enhance pregnancy and live birth outcomes. These programmes encompass coaching, psychological or behavioural guidance, nutritional adjustments, exercise regimes, weight management, smoking cessation and mindfulness techniques. Moreover, these interventions are likely to be more cost-effective than standard infertility care. For couples embarking on infertility treatments, the integration of lifestyle interventions into their management strategy not only fosters clinical benefits but also represents a cost-effective alternative to conventional care, particularly within high-income settings.

Background/Objective: Lichen sclerosus is a chronic inflammatory skin disease that affects people of all ages and sexes. Evidence of cardiovascular risk factors in lichen sclerosus has been continuously reported; however, the definitive association remains inconclusive. This meta-analysis aimed to summarize the association between cardiovascular risk factors and lichen sclerosus. Methods: Electronic databases, including MEDLINE and EMBASE, were systematically searched from inception to May 2024 to identify the literature reporting the association between cardiovascular risk factors and lichen sclerosus. A random-effects model was used for the meta-analysis. Results: We included 16 eligible studies: nine case-control studies, six retrospective cohort studies, and one cross-sectional study. A total of 432,457 participants were included. Lichen sclerosus was significantly associated with type 2 diabetes mellitus with an odds ratio of 2.07 (95% CI: 1.21-3.52). Although not statistically significant, a trend of increasing risk in hypertension, dyslipidemia, obesity, and metabolic syndrome was observed among lichen sclerosus patients, with odds ratios of 1.56 (95% CI: 0.90-2.70), 1.44 (95% CI: 0.94-2.23), 5.84 (95% CI: 0.37-92.27), and 1.36 (95% CI: 0.52-3.54), respectively. Conclusions: Lichen sclerosus was associated with diabetes mellitus and potentially correlated with hypertension, dyslipidemia, obesity, and metabolic syndrome. Population-based prospective observational studies are required to further elucidate these findings and assess the impact of these associations.

This study developed a causal relationship model of herb use from observational data and analyzed the direct and indirect effects of herb use on health according to the model. A cross-sectional study was conducted with 400 participants aged 26-59 years, selected through multistage random sampling. The instruments used for data collection included demographic information, herb use, health literacy (HL), perceived social support, societal values, and attitudes toward herb use. The conceptual model, hypothesized based on prior evidence, was tested using confirmatory factor analysis through structural equation modeling. Path coefficients were estimated using the maximum likelihood method. The final model utilized empirical data, which showed that perceived social support had the most significant impact on herb use. This was followed by HL, positive attitudes toward herbal remedies, and societal values, with coefficients of 0.31, 0.18, and 0.16, respectively. When analyzing variables that indirectly affected herb use, it was clear that positive attitudes, perceived social support, and societal values significantly influenced herb use through HL, with influence coefficients of 0.08, 0.16, and 0.04, respectively. Together, these variables accounted for 68% of the variance in herb use. The findings from this study can be utilized to develop and implement strategies that guide the use of herbal products, ultimately aiming to improve human health.

The situation of older Thai family members has changed, resulting in less interaction that could impact family bonds. A sequential explanatory mixed methods design explored communication and relationships within older adults’ families. Using communication patterns and family relationships questionnaires, a survey was administered to 180 older adults in Phetchaburi province. Then, 40 participants were engaged in semi-structured interviews. The quantitative data were analyzed using simple linear regression, and the qualitative data were analyzed using content analysis. The quantitative results revealed that most family communication patterns with high family relationships were pluralistic. Consensual (B =7.13; SE = 3.26; p < .05) and protective communication patterns (B = 1.72; SE = 0.82; p < .05) were associated with family relationships. The qualitative analysis highlighted the contributors to low family communication and relationships, which included a lack of effective communication skills, unresolved conflicts, technology distraction, and poor time management. The management strategies were active listening, being a role model, and having a heart-to-heart conversation. The initiation of relationships among older adults’ families has originated from communication within the family. Thus, healthcare providers, especially community nurses, should create a family interaction program to promote open and positive communication between older adults and their families.