Chonburi Hospital Journal-วารสารโรงพยาบาลชลบุรี

Instruction

Sittichai Tantipasawasin — 2026-05-01

Cissus quadrangularis: A Natural Alternative for Effective Hemorrhoid Relief

Natrada Burusliam — 2026-05-01

Hemorrhoids is the condition in which the veins in the anus or the tip of the rectum become swollen and turning into polyps. It is caused by the consumption habit of a “Fast life”, fast food that lacks fiber and drinks too little water, which leads to chronic constipation problems. When it comes to intense exertion, the fragile blood vessels are rupture, the bleeding is followed leading to severe pain, torment, and discomfort in daily life

In Thai Traditional Medicine, Hemorrhoids are caused by daily behavior and lifestyle that eats a diet deficient in fiber and work in the sitting position for a long time. Pressure from the weight of the body additional to the abdomen pressure that accumulates over time which is the key.

Thai Traditional Medical Treatment in the Narai Textbook and the Royal Medical Textbook has identified the properties of Cissus quadrangularis L stimulates the veins to increase tension. (Venotonic) cause reduce inflammation, swelling and pain. This brings the hemorrhoids to collapse.

Table of Content

Sittichai Tantipasawasin — 2026-05-14

A 61-Year-Old Thai Male Patient Came with Confusion 2 Days before Coming to the Hospital

Itsara Benjamin — 2026-05-01

A 61-year-old Thai male patient in Chonburi province came with confusion 2 days before coming to the hospital.

4 days ago, relatives gave a history of weakness on the left side after waking up, lifting a spoon of rice and falling. There is no crooked mouth, still talking about things.

2 days ago, the patient present confused and fever.

V/S BT 38.6 C, spo2 93-94%, BP 152/88 mmHg, PR 96/min

Oriented to time place and person

E4M6V5, pupil 3 mm, RTLBE, no facial palsy, decreased pinprick sensation, right side of the face, tongue deviation to the right, motor power grade V/V all except the right leg IV/III, decrease in pinprick sensation in the right thigh and leg

CT brain: 2.4 x 3.0 x3.1 well-defined heterogeneous extra-axial mass with extensive surrounding vasogenic edema involving left frontal and parietal lobes, corpus callosum, left internal capsule, and external capsule, causing mass effect, rightward midline shift

MRI brain as shown

The Histological section as picture below

Question 1: Give a diagnosis

Question 2: Tell me about course of the disease

Question 3: Describe the syndromes you may experience

Omicron Subvarient BA.3.2 “Cicada”

Sittichai Tantipasawasin — 2026-05-01

COVID-19 Cicada (SAR CoV-2, BA.3.2). This is a sub-strain of COVID that branched out from Omicron (BA.3). It was first detected in South Africa at the end of 2024. The proportion of global cases is low, only 1-2%. After 2 years of latent, mutated into BA.3.2 that spreads easier. Currently, COVID Cicada has been found in at least 23 countries around the world.. It accounts for up to 30 percent of all COVID cases. The World Health Organization has classified the virus as Variant Under Monitoring: VUM since last February.

The COVID Cicada is no evidence of increase severity. The symptoms of the Cicada strain of COVID as a whole are still similar to other strains, such as runny nose, nasal congestion, Headache, very exhausted, Sneezing, Sore throat, coughing, Changes in smell or taste. However, the most common symptoms of lately are: Patients may experience severe sore throat, night sweats, and some have skin rashes.

Current generation vaccines may be less effective in preventing infection due to their high mutations, However, the original vaccine still provides good protection against severe symptoms and hospitalization. The risk group is still the elderly and people with underlying diseases, for example’ Diabetes, Heart disease, Lung diseases, Kidney disease, and people with low immunity.

Prevention can be done with standard hygiene, for example, social distancing 1-2 meters, wearing masks in crowded places and frequent hand washing. Booster shots can still be useful in reducing the severity of the disease.

Meadhead

Sittichai Tantipasawasin — 2026-05-01

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

Subcutaneous Panniculitis-like T-cell Lymphoma Complicated by Autoimmune Hemolytic Anemia: A Case Report

Somchai Yongsiri — 2026-05-14

A 36-year-old Thai female presented with generalized painful purplish skin nodules, fever, and other associated systemic symptoms for eight months. This report describes the clinical features, comprehensive laboratory findings, and the diagnosis of Subcutaneous Panniculitis-like T-cell Lymphoma (SPTCL), a rare type of T-cell lymphoma.

The diagnosis was confirmed by skin biopsy with immunohistochemical staining, showing a T-cell phenotype. Critically, the patient's laboratory profile revealed signs of severe complications: Autoimmune Hemolytic Anemia (AIHA) (confirmed by DAT Positive 3+).

Conclusion: The patient was subsequently treated with immunosuppressive therapy tailored to address the underlying lymphoma and AIHA, showing clinical improvement. This report highlights the importance of considering SPTCL in patients presenting with chronic panniculitis and systemic manifestations, and emphasizes the necessity of promptly recognizing life-threatening complications like autoimmune hemolytic anemia.

Fibrinolytic Agents for Patients with Acute Coronary Syndrome

Watcharapong Pricsi — 2026-05-14

Acute coronary syndrome (ACS) cause by plaque rupture or plaque erosion in the coronary arteries. This stimulates the formation of blood clots in the area of rupture or tearing.causing a blockage of the coronary arteries. This can eventually lead to myocardial ischemia and myocardial infarction. Currently, coronary artery opening is performed by using a primary percutaneous coronary intervention (PCI) to dilate the blood vessel with a balloon and inserting a stent immediately to open the way for blood to flow as quickly as possible. It is classified as an effective treatment and should be the first line of treatment in patients with acute coronary artery disease ST-segment elevation myocardial infarction (STEMI) within 2 hours. The use of fibrinolytic agents to dissolve blood clots in the area of the blockage is considered an important therapeutic breakthrough, especially true in medical facilities where it is not possible to refer patients for cardiac catheterization within 2 hours. to reduce the risk of death. However, due to the fibrinolytic agents may cause serious side effects such as bleeding.hypotension and allergic response, the contraindications and precautions should be evaluated before each use of the drug. After receiving thrombolytic drugs, the patient should be referred for cardiac catheterization and definited treatment.

Oral Health Literacy and Factors Associated with Oral Healthcare Behaviors of Village Health Volunteers in Region 6 Health Provider

Parichart Yamsri — 2026-05-01

Oral health literacy is related to oral health care behaviors. The objective was to study oral health literacy and factors related to oral healthcare behavior. This study is a cross-sectional survey research of 410 village health volunteers in Region 6 health providers the research uses multi-stage cluster sampling. Data were collected from a self-administered questionnaire and oral status survey. Data were analyzed using descriptive statistics and chi-square and Spearman Rank tests.

The research results found that the sample group had Oral health literacy at a moderate level (47.1%), Oral healthcare behavior was sufficient (28.4%), and good Oral status was 59.0%. Factors significantly associated with oral healthcare behavior include education level, Predisposing, Enabling, Reinforcing factors, and Oral health literacy (p<0.001). Factors significantly associated with Oral status include age, education level, and the duration of work as a village health volunteer.

The research results suggest that Government and dental public health agencies’ Policies should be added and the environment provided. A system that facilitates access to information sources and oral healthcare services for the public and village health volunteers should provide training to enhance awareness of oral health problems and recognize the benefits of oral healthcare. Oral health literacy in village health volunteers continuously.

A Retrospective Study of the PRK Implant System: Clinical and Radiographic Outcomes After Three Years of Functional Loading

Chailerk Juthakitti — 2026-05-01

Objective: To evaluate clinical and radiographic outcomes of the PRK implant system, a newly developed Thai-made dental implant, after three years of functional loading.

Materials and Methods: A retrospective study was conducted in 10 patients (2 males, 8 females) receiving 10 PRK implants at Trang Hospital, Thailand. Clinical parameters including probing depth and bleeding on probing were recorded. Marginal bone loss was assessed using standardized periapical radiographs.

Results: Implant survival rate was 100%. Mean marginal bone loss after three years was 0.7±0.1 mm. No peri-implantitis was observed.

Conclusion: The PRK implant system demonstrated favorable clinical and radiographic outcomes after three years of functional loading. Further long-term studies with larger samples are recommended.

The Role of Interventional Radiology Nurses in Managing Severe Epistaxis undergoing Endovascular Treatment

Anchalee Churojana — 2026-05-14

Epistaxis, defined as abnormal bleeding from the nasal cavity that could represent a significant emergency due to the risk of life-threatening massive blood loss and potential airway obstruction. This condition arises from various causes. Most frequently associated to trauma at the mid-facial region. Accurate assessment and rapid recognition of the cause are crucial for starting the right treatment. Emergency management focuses on early nursing and medical interventions such as keeping the airway open, giving fluids, monitoring vital signs, and using special devices to stop the bleeding, included endovascular treatment which can help resolved this condition. Understanding the main treatment options and working together as a healthcare team helps nurses provide more effective care. This approach supports faster control of bleeding and improves the patient’s chance of recovery.

The Study Comparison the Outcomes of Mandibular Condylar Fracture Treatment between Close Reduction and Open Reduction with Internal Fixation

Kanokporn Tungsakul — 2026-08-21

This study aims to compare the outcomes of mandibular condylar fracture treatment between closed reduction and open reduction with internal fixation including function, form and complication at Chonburi hospital. Data of 132 patients with a mandibular condylar fracture treated by closed reduction and open reduction with internal fixation who came to Chonburi hospital between January 2009 and August 2019 was collected. 101 patients were treated by closed reduction (76.5 %). 35 patients were treated by open reduction with internal fixation (23.5 %). No statistically significant differences were noted for maximum mouth opening, ramus height shortening and complications while statistical significant differences for operation time and days of admission were noted. In conclusion, both closed reduction and open reduction with internal fixation provide comparable functional, form and complication outcomes. However, surgical treatment is associated with longer treatment duration and hospital stay. Therefore, treatment selection should be individualized based on appropriate clinical indications.

The Clinical Changes of Oral Cavity in Acute Phase in Head and Neck Cancer Patients Treated with Volumetric Modulated Arc Therapy

Sittichai Tantipasawasin — 2026-08-21

Objectives: To investigate the incidence of acute radiation-induced toxicities including mucositis, xerostomia, dysgeusia, pulp vitality, weight loss, and quality of life (QOL) in patients with head and neck cancer (HNC) treated with volumetric modulated arc therapy (VMAT). In addition, this study aims to investigate the relationships between patient-related factors, treatment modalities, and intraoral changes during and post-treatment.

Materials and Methods: This prospective study was conducted in HNC patients receiving VMAT during January 2, 2024, to April 30, 2024. Data was collected through interviews and clinical examinations during radiotherapy and follow-ups in the first three months after treatment. Toxicity grading was assessed according to RTOG and CTCAE criteria while QOL assessment was performed using University of Washington Quality of Life Questionnaire (Version 4). The statistical analysis was done using descriptive statistics, Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazard models with a significance level of p < 0.05.

Results: The patients included in this study were 31 cases totally. All experienced mucositis, xerostomia, and taste alterations during radiotherapy which occurred after a median of 10 fractions (95% confidence interval (CI): 8.66–11.34 for mucositis, 8.94–11.06 for xerostomia, 8.98–11.02 for taste alterations). The maximal grades of toxicities were grade 3 mucositis (RTOG criteria), grade 2 xerostomia (RTOG criteria), and grade 2 dysgeusia (CTCAE criteria). Tumor location in the oropharynx/oral cavity had significantly higher risk of mucositis and dysgeusia (adjusted hazard ratio (HR) 3.15 [95% CI: 1.03–9.65] and 3.34 [95% CI: 1.11–11.04], respectively). Concurrent or neoadjuvant chemotherapy increased the risk of mucositis and xerostomia (adjusted HRs for mucositis: 7.17 [95% CI: 1.17–44.16] and 11.98 [95% CI: 1.11–129.18]; for xerostomia: 4.51 [95% CI: 1.08–18.89] and 6.54 [95% CI: 1.15–37.30]). Salty and bitter taste impairments were more prevalent than sweet and sour impairments. Non-vital pulps were observed in 2.86% (3/105 teeth) during and one month after radiotherapy, with no statistically significant differences in electric pulp test across time points. At the final session of treatment, 73% of patients experienced weight loss with an average of 4.24 kg. VMAT affected body weight by 28.2%, after adjusting for feeding route differences (p < 0.001, Partial η² = 0.282). Significant changes in QOL were observed in taste alteration which started from the 11^th fraction, whereas pain, appearance, daily activity, recreation, swallowing, and salivation had significant changes from the 22^nd fraction and changes in speech occurred by the final session. There were no significant differences in chewing, shoulder function, mood, or anxiety. At three months post-treatment, persistent changes in xerostomia, salty/bitter taste alterations, and weight loss remained significant compared to pre-treatment levels.

Conclusion: Acute radiation-induced oral toxicities were observed in all patients undergoing VMAT. Most common toxicities were mucositis, xerostomia, and dysgeusia with severity of toxicity correlated with cumulative radiation dose. There were no the worst toxicity grade of mucositis and xerostomia in our study. At three months post-treatment, most toxicities showed substantial recovery to pre-treatment levels. However, xerostomia, salty/bitter taste alterations, and weight loss persisted and remained significantly different from baseline.

Letter from Editor

Sittichai Tantipasawasin — 2026-05-14

Dear Reader

Chonburi Hospital Journal Vol.51 No. 1 (2026) has been released. This edition contains many interesting original paper including: oral health litracy and factors associated with oral healthcare behaviors of village volunteers in region 6 health provider, a retrospective study of the PRK implant system: clinical and radiographic outcomes after three years of functional loading, the role of interventional radiology nurses in manageing severe epitaxis undergoing endovascular treatment, the study comparison the outcomes of mandibular condyle fracture treatment between close reduction and open reduction with internal fixation. The case report article is subcutaneous panniculitis-like T-cell lymphoma complicated by autoimmune hemolytic anemia: a case report. The review article is fibrinolytic agent for patient with acute coronary syndrome. The special article is How to survive in war disaster. Finally, the Interesting Thai traditional Medicine about Cissus quadrangularis: a natural alternative for effective hemorrhoid relief.

Lastly, the editorial staff would like to thank everyone who play attention, support and submit an article for publication. This has made Chonburi Hospital journal successful in the eyes of readers.

Sittichai Tantipasawasin

Editor of Chonburi Hospital Journal

Cicada BA.3.2

Sittichai Tantipasawasin — 2026-05-01

Chonburi Hospital Journal

How to Survive in War Disaster

Sittichai Tantipasawasin — 2026-05-14

A war disaster is a situation caused by a military operation between states or armed groups. It is classified as a disaster caused by human actions. It will not only cause damage to people's lives and property. It also affects the country's economic, social and security systems. Therefore, dealing with war disasters must take into account both physical safety and domestic security, as well as the management of information to avoid panic and other security problems that may follow.

War disaster preparedness is to plan ahead to deal with high-risk situations. Good preparation will not only help prevent damage to property. It can also increase the chances of survival as well as reduce physical and psychological damage. Initially, we can prepare for war disasters and other disasters as follows:

Participate in and practice disaster evacuation
Ensuring safety in a state of war
Prepare a Survival Bag
Follow official news
Monitor physical and mental health

Conclusion, war is something that creates great tension and danger. But we can cope with the situation if you stay mindful and follow the right steps. Collect and maintain as many supplies as you can. Find a reliable source of food and water during food shortages. Avoid confrontations as much as possible, move to a safe area when necessary, and finally, learn basic first aid skills to treat any injuries or illnesses you may be facing. These skills will help you and your loved ones stay safe in survival situations.