Chonburi Hospital Journal-วารสารโรงพยาบาลชลบุรี

No More Smoke, No More Stress: Tameํ Your Nicotine Brain with Vernonia cinerea.

2026-08-24T16:14:00+07:00

Tobacco is the number one risk factor in global public health, directly contributing to chronic diseases such as coronary heart disease, lung cancer, and emphysema, and leading to premature death among Thais. Cigarette smoke contains over 7,000 chemicals, including at least 70 known carcinogens, such as tar, formaldehyde, and hydrogen cyanide. These substances induce oxidative stress, damaging and obstructing the walls of small blood vessels, which increases the risk of cardiovascular disease by 2 to 4 times and raises the risk of lung cancer by up to 25 times. Therefore Quitting smoking not only reduces illness and death rates for the smokers themselves, but it also reduces the risk of secondhand smoke for people around them.

Masthead

2026-08-21T13:41:54+07:00

Editor

Sittichai Tantipasawasin, D.D.S. Chonburi Hospital, Thailand

Segmental Editor

Sittichai Tantipasawasin, D.D.S. Chonburi Hospital, Thailand

Woranart Ratanakorn, MD. Chonburi Hospital, Thailand

Advisory

Numphol Danpipat, MD. Chonburi Hospital

Assistant Professor Paisan Kangvonkit, D.D.S. Mae Fah Luang University

Jirasak Kanchanapongkul, MD. Private Hospital

Somprasong Tongmesee, MD. Chonburi Hospital

Editor Board

Emeritus Professor Pirom Kamolratanakul Chulalongkorn University

Professor Aurasa Waikakul Mahidol University

Associated Professor Somchai Satesirisombat Chulalongkorn University

Associated Professor Kampanart Huanbutta Eastern Asia University

Associated Professor Wichit Tharanon Thailand Center of Excellence for Life Sciences

Associated Professor Saowanee Thongnopakun Burapha University

Associated Professor Tanakan Sangnim Burapha University

Associated Professor Kitti Krungkraipetch Burapha University

Sawitree Visanuyothin Maharat Nakhon Ratchasima Hospital

Suchada Anotayanon Chonburi Hospital

Tusanee Choumthong Chonburi Hospital

Porntipa Suparasri Ratchapat University, Chonburi

Chuenrutai Yeekian Queen Savang Vadhana Memorial Hospital

Dechwit Worasayan Chonburi Hospital

Pornpoj Sriuthaisiriwong Chonburi Hospital

Pinit Noorit Chonburi Hospital

Sarawut Thamthanawit Chonburi Hospital

Sombat Apithamsunthorn Aikchol Hospital

Komwuth Konchalard Queen Savang Vadhana Memorial Hospital

Prapap Yuthavisuthi Phrapokklao Chanthaburi Hospital

Kritawit Kritayamaneerat Phrapokklao Chanthaburi Hospital

Pakdee Sannikorn Rajavithi Hospital

Katesiree Kornsithikul Chonburi Hospital

Wasana Hongkan Chonburi Hospital

Sawarat Chaijindaratana Chonburi Hospital

Hatsaya Tantipong Chonburi Hospital

Katkanit Thammakumpee Burapha University

Jindarat Laohathaimongkol Queen Savang Vadhana Memorial Hospital

Jidapa Phuwakonkunlawut Ederly Health Care Center, Thai Red Cross Society

Pattira Tantipasawasin Burapha University

Napaporn Chalermpornpong Phrapokklao Chanthaburi Hospital

Manager

Nichapat Tanmee Chonburi Hospital

Thanagridta Ruangtongma Chonburi Hospital

Rusty Pipe Syndrome: Case Report

2024-06-10T12:28:05+07:00

Introduction: Rusty pipe syndrome is a condition in which blood mixes with breast milk shortly after childbirth, without the mother experiencing any pain or having any nipple wounds. It typically affects both breasts and is considered rare, occurring in approximately 0.1% of breastfeeding women. If the condition persists for more than 7 days, further investigation may be necessary to determine the cause. Most healthcare providers are unfamiliar with this condition, which can lead to concern and anxiety about breastfeeding, and may result in discontinuation of breastfeeding.

Objective: To report the clinical presentation of cases with rusty pipe syndrome.

Methods: A retrospective study of two breastfeeding women. Demographic data, clinical presentation, and clinical course were obtained.

Results: Two mothers presented with unilateral painless bloody nipple discharge on the first day of lactation. Both cases resolved spontaneously without any investigation or specific management. Rusty pipe syndrome was diagnosed. Exclusive breastfeeding could be continued.

Conclusion: Rusty pipe syndrome is a benign cause of bloody nipple discharge during the lactation period. It can resolve spontaneously, allowing mothers to continue breastfeeding safely. Health care providers should recognize this condition.

Hantavirus Disease

2026-08-30T17:23:20+07:00

Hantavirus Disease is a zoonosis. This infectious disease is not a new outbreak. It was first reported after the Korean War. In the 1950s. It is common among soldiers stationed near the Hantan river. The first hantavirus was isolated in 1978 in South Korea. There are rodents as the main source of nesting diseases. Hantaviruses were first classified as a specific genus called "Orthohantavirus".

It is classified as a viral RNA in the family Hantaviridae. The Andes virus (ANDV) strain, which is found mostly in South America, is the only strain of the Hanta virus that can spread from person to person. Once the Hanta virus enters the body, there is an incubation period of about 1–8 weeks. The initial symptoms are usually non-specific, similar to the flu or other respiratory diseases including acute high fever, headache, muscle pain, fatigue. However, it is observed that if you have Hanta disease, the patient will deteriorate very quickly when symptoms begin to appear. Later, there may be severe respiratory symptoms or kidney and bleeding symptoms, depending on the strain of the virus. Currently there is no specific treatment and no vaccine, therefore, the patients must receive supportive care

Hantavirus in Thailand

2026-08-27T11:47:06+07:00

Instruction

2026-08-21T13:46:14+07:00

Factors Influencing Antibiotic Dispensing Behaviors of Community Pharmacists in Eastern Thailand An Analysis Using the COM-B Model

2026-08-28T14:42:41+07:00

Community pharmacists play a crucial role in promoting the appropriate use of antimicrobials in Thailand. However, empirical evidence regarding behavioral factors associated with antibiotic dispensing remains limited. In particular, the Capability, Opportunity, Motivation–Behavior (COM-B) model has not yet been applied to examine antibiotic dispensing behavior within the cultural, economic, and environmental context of eastern Thailand. This cross-sectional descriptive study aimed to examine factors associated with antibiotic dispensing behavior among community pharmacists in this region. Data were collected from 185 community pharmacists working in community pharmacies using a self-administered postal questionnaire. The questionnaire assessed capability, opportunity, motivation, and self-reported antibiotic dispensing behavior using five-point Likert scales. The internal consistency coefficients of the four measures were 0.78, 0.71, 0.74, and 0.84, respectively.

The study found that most respondents were female (73.5%), aged 39 years or younger (84.3%), and had graduated from a five-year Bachelor of Pharmacy program (57.8%). The largest proportion had specialized in pharmaceutical care (43.8%). Most pharmacists worked in independent pharmacies (77.3%), while approximately half of the pharmacies had passed the Good Pharmacy Practice (GPP) inspection criteria established in 2018 (B.E. 2561) (53.5%). The respondents demonstrated a high level of capability, whereas opportunity and motivation were moderately high, and self-reported rational antibiotic dispensing behavior was at a high level. Capability, opportunity, and motivation were positively and significantly associated with antibiotic dispensing behavior, with Pearson’s correlation coefficients of 0.63, 0.35, and 0.65, respectively. Stepwise multiple regression analysis identified motivation and capability as variables associated with antibiotic dispensing behavior in the final model. The final model explained 53.8% of the variance in self-reported antibiotic dispensing behavior (adjusted R² = 0.538).

These findings indicate that community pharmacists generally demonstrated a high level of professional capability and that motivation was positively associated with self-reported antibiotic dispensing behavior. However, because this was a cross-sectional study, the findings do not establish causal relationships. Further studies using validated measures and objective or observational assessments of dispensing practice are warranted.

Effects of Pre-anesthetic Education Using Video and Leaflet on Parental Anxiety in Pediatric Surgical Patients: A Randomized Controlled Trialtil

2026-08-28T13:36:04+07:00

Background: Anxiety before anesthesia is common in pediatric patients and parents. It may affect the physical, mental and behavioral readiness of children. Providing appropriate information and knowledge to the parents of child patients before anesthesia is therefore important. And should be developed as a systematic guideline.

Objective: To evaluate the effects of pre-anesthetic education delivered through an educational video and printed information leaflet in reducing pre-anesthetic anxiety among parents of pediatric patients.

Methods: This randomized controlled trial was conducted among parents of pediatric patients aged ≤12 years who were scheduled to undergo elective surgery under anesthesia at Queen Savang Vadhana Memorial Hospital in Sriracha from April 2025 to January 2026. Each group of 32 patients. The experimental group received a multimodal education intervention consisting of standard routine instruction combined with a video demonstration and educational documents illustrating preoperative preparation steps, potential complications, and intra-operative anesthetic procedures, along with an informational brochure for home review. The control group received standard routine verbal instruction alone. The data collection tool is divided into two parts :1. Basic information of parents, including gender, age, education, career, History of parents receiving anesthesia, History of bringing children to anesthesia. 2. Conditional State-Trait Anxiety Inventory (STAI FORM Y-1) In which both groups of parents will complete an anxiety assessment in 3 stages. After receiving the advice and after the surgery is completed. Analyzed baseline data with Frequency, percentage, mean and standard deviation, compared data between group with the Chi-square test, Fisher’s exact test, Mann-Whitney U test, and compared anxiety over 3 periods within the group and between non-parametric group.

Results: A total of 64 parents were enrolled, with 32 participants in each group. Baseline demographic and clinical characteristics were comparable between the two groups. There was no significant difference in anxiety scores before the pre-anesthetic consultation (p = 0.170). However, after receiving the educational intervention, parents in the intervention group demonstrated significantly lower anxiety levels than those in the control group (p < 0.001). This significant difference remained after surgery (p < 0.001). Participant satisfaction with the educational intervention was rated as very high, and no surgical postponements occurred in either group.

Conclusions: Pre-anesthetic education delivered through an educational video combined with a printed information leaflet significantly reduced anxiety among parents of pediatric patients compared with standard pre-anesthetic consultation alone. Incorporating multimedia educational materials into routine pre-anesthetic practice may improve parental preparedness and reduce preoperative anxiety.

Rehabilitation Components for the Development of a Neck Pain School Program for Patients with Chronic Nonspecific Neck Pain: An Integrative Review

2026-08-28T13:15:16+07:00

Introduction: Nonspecific chronic neck pain is a health problem that affects pain, disability, and daily living. Rehabilitation for patients with this condition comprises multiple components, including exercise, education, and behavioral and self-management strategies. However, evidence regarding these rehabilitation components remains heterogeneous and lacks a clear organization of knowledge that can serve as a basis for developing a Neck Pain School Program.

Objective: To review and synthesize rehabilitation components investigated in patients with nonspecific chronic neck pain and to organize these components as a knowledge base for the development of a Neck Pain School Program in subsequent research.

Design/Methods: This study employed an integrative review design. Studies were searched in PubMed, Scopus, CINAHL, Web of Science, the Cochrane Library, and ThaiJo, covering studies published from 2015 to June 15, 2026, according to predefined eligibility criteria. Two reviewers independently screened the studies. Data on study characteristics and rehabilitation components were extracted, followed by an integrative synthesis in which components were categorized according to shared characteristics. The risk of bias of the included studies was also assessed.

Results: A total of 14 studies met the eligibility criteria. The synthesis identified four major groups of rehabilitation components: (1) exercise-based components, including deep cervical flexor training, cervical stabilization exercises, and scapular strengthening exercises; (2) pain education components; (3) behavioral and self-management components; and (4) multimodal rehabilitation combining more than one component. Exercise-based components were identified in 13 studies (92.9%), education-based components in 7 studies (50.0%), behavioral and self-management components in 7 studies (50.0%), and multimodal rehabilitation in 9 studies (64.3%).

Conclusion and Recommendations: This review identified four major groups of rehabilitation components for patients with nonspecific chronic neck pain. Exercise-based components were the most frequently reported, followed by multimodal rehabilitation, while education and behavioral and self-management components were also incorporated into rehabilitation interventions. The synthesis and organization of these components can provide a knowledge base for defining the content and structure of a Neck Pain School Program for development in subsequent research.

Congenital Craniofacial Abnormalities

2025-07-30T14:55:19+07:00

Congenital craniofacial abnormalities affect growth of the skull and face result in craniofacial deformities, limited brain development, increase intracranial pressure and disturb blood brain circulation and also cerebrospinal fluid in the brain. Most of these disorders are caused by craniosynostosis. The severity of the craniofacial deformities and brain development depend on the age of onset, the number and location of the associated cranial sutures involvement. The incidence rate was found between 1 to 2,100 and 1 to 2,500 of live birth around the world. They are classified into 2 types: non-syndromic craniosynostosis and syndromic craniosynostosis. The most common non-syndromic craniosynostosis are sagittal craniosynostosis (60%), unicoronal craniosynostosis (15-20%), bicoronal craniosynostosis (5-10%), metopic craniosynostosis (15%) and lambdoid craniosynostosis (2%) The most common types of syndromic craniosynostosis are Muenke syndrome, Crouzon syndrome, Saethre-Chotzen syndrome, Pfeiffer syndrome and Apert syndrome. Although craniosynostosis is a rare craniofacial deformity in Thailand. it leads to the disability and impairment of the nervous system, intelligence, and learning ability. Early diagnosis and appropriate treatment are important to reduce disability and improve the quality of life.

Vol. 51 No. 2 (2026)

2026-09-01T18:02:58+07:00

Thai Girl, 14 Years Old, Domiciled in Rayong Province Came with Swelling, Gained 5 kg in 2 Weeks before Coming to the Hospital.

2026-08-28T13:07:31+07:00

Thai girl, 14 years old, domiciled in Rayong Province

came with swelling, gained 5 kg in 2 weeks before coming to the hospital.

Physical examination:

T 36.4 C, PR 76/min, RR 20/min, BP 127/82 mmHg

Puffy eyelid, Pitting edema both legs 3+

Heart and lung: normal

Labaratory investigation

UA: Protein 4+, RBC>100/HPF with dysmorphic RBC

Urine Protein to creatinine ratio (UPCR) 8 mg/mg

Cr 0.73 mg/dL, C3 169 mg/dL (normal)

The patient underwent a renal biopsy with the results as shown in the picture.