Chonburi Hospital Journal-วารสารโรงพยาบาลชลบุรี

Guidelines of Management in Accidental Swallowing or Choking during Dental Treatment

Pattira Tantipasawasin — 2026-01-01

Accidental swallowing or choking on foreign objects into the digestive tract or the airway during dental treatment are less common. The incidence is about 1-12%. of all accidental dental events, however, when it happens, it can be dangerous and even fatal especially in the case of choking on a foreign body into the respiratory tract. Guidelines for managing patients after an accident will be determined based on the patient's symptoms, position, size and shape of the foreign body. Dentist should be aware of these risks and implement preventive measures. Prompt and proper assistance can significantly reduce complications

Letter from Editor

Sittichai Tantipasawasin — 2026-01-01

Dear readers

Chonburi Hospital Journal Vol.50 No. 3 (2025) has been released. This edition contains many interesting original paper including: the clinical changes of oral cavity in acute phase in head and neck cancer patients treated with volumetric modulated arc therapy, the study comparison the outcomes of mandibular condyle fracture treatment between close reduction and open reduction with internal fixation, one year patency rate and primary failure rate as vascular access in end-stage renal disease, the effects of oral health care program by applying the protection motivation theory to prevent dental caries among students undergoing orthodontic treatment at Sirindhorn college of public health Chonburi province, and the result of preterm prevention program by micronized progesterone vaginal suppository in Chonburi province. The case report article is nursing care for patients with behavioral and psychological symptoms of dementia at home: nursing case study experience. The review article is management of foot callus in diabetic patients: the challenging role of professional nurses. The special article is guidelines of management in accidental swallowing or choking during dental treatmen. Finally, the Interesting Thai traditional Medicine about disease treatment based on elemental pathogenesis integrated with conventional medicine.

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.

Geodisasters: Earthquake

Sittichai Tantipasawasin — 2026-01-01

Geodisasters: Earthquake

Instruction

Sittichai Tantipasawasin — 2026-01-01

Disease Treatment Based on Elemental Pathogenesis Integrated with Conventional

Natrada Burusliam — 2026-01-01

Current healthcare focuses on the holistic medicine concept, which emphasizes the integration of body, mind, and lifestyle. Traditional Thai Medicine (TTM), rooted in Elemental Theory, aligns perfectly with this approach. It describes the human body as an integral part of nature, where optimal health results from the equilibrium of four elements: Earth, Water, Wind, and Fire. Any imbalance or disturbance in these elements inevitably leads to disease. Conversely, conventional medicine explains pathogenesis through pathophysiology and biomedical principles, excelling in evidence-based diagnosis and treatment. The integration of these two disciplines represents a crucial strategy for enhancing patient care and addressing contemporary public health needs. This article aims to elucidate disease pathogenesis based on Elemental Theory and propose practical guidelines for integrating these principles with conventional medicine in holistic patient care.

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

Nutnicha Sirijariyawat — 2026-01-01

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.

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

Kanokporn Tungsakul — 2026-01-01

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.

One Year Patency Rate and Primary Failure Rate as Vascular Access in End-Stage Renal Disease

Monlada Tulachom — 2026-01-01

Background: End-stage renal disease patients are increasing. Treatment for patients in this stage is renal replacement therapy and hemodialysis is one method of treatment. The long-term hemodialysis option is permanent vascular access surgery, divided into arteriovenous fistula(AVF) and prosthetic arteriovenous graft(AV-graft)

Objective: Report on the result of permanent vascular access in patients with end-stage renal disease, one year patency rate and primary failure rate.

method: This is a retrospective cohort study from the medical records of 175 patients who were diagnosed with end-stage renal disease and underwent permanent vascular access surgery at Samut Prakan Hospital from 1 June 2022 to 31 May 2024. Collect general characteristics of patients. Surgery method Results of treatment and postoperative complications were analyzed for statistical data

Results: There were 175 patients who underwent permanent vascular access surgery. The average age was 57.27 years. Sixty eight percent were males. The most common associated disease was hypertension, 172 (98.28%). The most commonly used permanent hemodialysis surgery method was radiocephalic AVF in 115 cases (65.70%) followed by brachiocephalic AVF in 46 cases (26.30%). One year patency rate was 73.71 percent. Primary failure of hemodialysis in 37 cases (21.10%) and complications of bleeding were found after surgery in 1 case (0.6%). By the surgical method that found the least one year patency (64.35 percent) and the highest primary failure (29.56 percent) was radiocephalic AVF.

Conclusion: In research, permanent vascular access surgery has a one year patency rate and primary failure is similar to other studies. Preemptive hemodialysis access can increase patency rate and the use of duplex ultrasound can reduce Primary failure is possible.

The Effects of Oral Health Care Program by Applying the Protection Motivation Theory to Prevent Dental Caries among Students undergoing Orthodontic Treatment at Sirindhorn College of Public Health Chonburi Province

Sasiprapha Lokaew — 2026-01-01

This quasi-experimental research aimed to examine the effects of an oral health care program applying the Protection Motivation Theory to prevent dental caries among orthodontic students at Sirindhorn College of Public Health, Chonburi Province. A total of 30 participants joined the program, which was implemented over a 4-week period. Data were collected before and after the intervention. Descriptive statistics including frequency distribution, percentage, mean, and standard deviation were used, while differences within the experimental group were analyzed using the paired sample t-test.

Result: The results after the intervention showed that, the mean scores of the experimental group for dental caries, perceived severity, self-efficacy in caries prevention, response efficacy and preventive behaviors compared with pre-intervention scores .05 (p-value < .05).

Conclusion: The oral health care program applying the Protection Motivation Theory effectively enhanced perceptions and preventive behaviors regarding dental caries. Health agencies and individuals undergoing orthodontic treatment can implement this in the form of health promotion programs to apply it in their daily lives to enhance and maintain good oral health. Health agencies and individuals undergoing orthodontic treatment can implement this in the form of health promotion programs to apply it in their daily lives to enhance and maintain good oral health

The Result of Preterm Prevention Program by Micronized Progesterone Vaginal Suppository in Chonburi Province

Teera Siwadung — 2026-01-01

Purpose: To examine the effect of the preterm prevention program by micronized progesterone vaginal suppository

Design: Descriptive study

Methods: The participants consisted of 243 pregnant women with high risk for preterm pregnancy. They were Thai nationality which gestational age between 20 – 24 weeks and received antenatal care in hospital in Chonburi Province. The program emphasized on screening for preterm pregnancy and individual advisory for prevent preterm labor and consequence of preterm birth. After the participants sign consent forms, they received micronized progesterone vaginal suppository and recommendation for drug used and side effect. Data record in http://journal.cbh.moph.go.th/drug. Home visit telephone provided by Chonburi hospital staff. Data collection was gathered by the Expected Date of Confinement (EDC), Birth date and Birth weight. Analysis was performed by descriptive statistic and Correlation

Result: The findings revealed that after the program, data could be collected from 146 participants (60.08%). Most of them had previous preterm birth (93.8%) and had previous low birth weight baby (birth weight between 600 – 1,990 grams, average 1,664.04 grams). The participants had 34 preterm births which gestational age less than 37 weeks (23.3%) and 15 participants had preterm births gestational age less than weeks (10.3%). Birth weight was average 2,843 grams (1,100 – 4,200 grams, median 588 grams). There were 28 babies had birth weight less than 2,500 gram (19.2%). There was correlation between gestational age and birth weight with statistically significant (r = 0.755, p = 0.001).

Conclusion: The results of the study suggest that the guideline for preventing preterm labor including screening for risk for preterm labor and using progesterone would be able to prevent preterm birth when compared with unthreatened.

Table of Content

Sittichai Tantipasawasin — 2026-01-01

The 8-Year-Old Thai Girl from Chonburi Province Came with a Fever for 2 Weeks. She was a Red Rash on the Body 1 Day Prior to the Hospital.

Woranart Ratanakorn — 2026-01-01

The 8-year-old Thai girl from Chonburi Province came with a fever for 2 weeks. She was a red rash on the body 1 day prior to the hospital.

Physical examination: Temperature 39 C, Blood pressure 140/89 mmHg, mild pale, generalized erythematous target lesion at face, torso, back, buttocks and extremities, others were normal

CBC: Hb 10.4 g/dL, Hct 32.5%, MCV 48.8 fL, WBC 3680 cells/cumm, N 32%, L 34%, M 2%, E 15%, band 13%, platelet 227,000/uL

C3 0.39 g/L, C4 2.5 g/L, Anti-Smith antibody negative, Direct antiglobulin test positive 3+

Anti-dsDNA 1:160, Homogenous pattern 1:1280, ANA positive

UA: pH 5.5, Sp gr 1.014, protein 3+, blood 2+, RBC 10-20 cells/HPF, WBC 2-3 cells/HPF

24-hour urine protein 2.8 gm/day

The patient underwent a renal biopsy.

The result is as shown in the picture.

Quiz

Please describe what is found in the histo-pathological section.

Answer:

Please provides the diagnostics.

Answer:

What is the most appropriated treatment of choice?

Answer:

Masthead

Sittichai Tantipasawasin — 2026-01-01

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

Geodisasters: Earthquake

Sittichai Tantipasawasin — 2026-01-01

Geodisasters is a natural disaster caused by the process of geological change.to bring the earth's surface to equilibrium. For example : landslides, fissures, sinkhole and earthquakes. Most of the geodisasters will occur suddenly and are difficult to predict in advance. Extreme cases can cause loss of life and property. It affects the overall economic and social development of the country.

Earthquake is a natural disaster caused by the vibration of the earth's surface due to the sudden release of the energy stored within the earth to reduce stress and stabilize the balance of the earth's crust. The latest severe earthquake occurred on March 28, 2025 around 13:25 hours..An earthquake of magnitude 7.7 Richter occurred which is centered in the Sakai region of Myanmar. This makes the building of the new Audit Office which is tall. 33 floors and under construction was collapsed. As a result, at least 95 people were killed,1 person was missing and only 9 were survived. It also caused damage to many high-rise buildings in Bangkok. Earthquakes are caused by two main reasons: 1) cause by human actions, such as: atomic bomb test, dam water retention and mining Explosion 2) Spontaneous occurrence from nature due to the movement of tectonic plates.

Thailand is in a position that is considered relatively earthquake-free. Most of them are small to moderate earthquakes. The earthquake in Thailand is part of the Eurasian tectonic plate It was found that there was a group of active fault in the northern region and western region of Thailand, It continues to the east of Myanmar. Currently, there are still 16 fault groups in motion.The northern and western regions are more vulnerable to severe and very severe earthquake disasters than the central region, eastern region and northeastern regions. Provinces at risk of severe earthquake disasters include Chiang Rai, Chiang Mai, Lampang, Phrae, Mae Hong Son, Tak and Kanchanaburi. Guidelines for earthquake prevention and mitigation preparation and practice are required.

Nursing Care for Patients with Behavioral and Psychological Symptoms of Dementia at Home: Nursing Case Study Experience

Natchaya Piyacokanan — 2026-01-01

This article aims to share the experience of nursing care for behavioral and psychological symptoms of dementia, a common mental health issue, including delusions, hallucinations, apathy, anxiety, depression, and deviant emotions, perceptions, and behaviors. These issues can have significant impacts on patients, families, caregivers, and healthcare costs. If caregivers lack understanding and adaptability, they may experience stress, feelings of burden, and stigma. The case study findings highlight the importance of caregivers' and families' adaptation and acceptance of the patient's condition as the key to providing quality care and improving the patient's quality at the end of life. It is hoped that this article will be beneficial for readers, particularly caregivers.

Management of Foot Callus in Diabetic Patients: The Challenging Role of Professional Nurses

chayaphon siriniyomchai — 2026-01-01

Diabetic peripheral neuropathy (DPN) is a significant chronic complication of diabetes that leads to numbness in the feet, loss of protective sensation, and abnormal plantar pressure distribution. These changes promote calluses which is a critical risk factor for foot ulcer development that adversely affect patients’ quality of life. Appropriate managing of foot calluses in diabetic patients represents a challenging role for professional nurses, as it requires specialized skills in risk assessment, appropriate clinical decision-making, and safe callus management, along with expertise in patient education and promotion of self-care foot behaviors. This article compiles evidence-based information and clinical experience regarding the challenges and management approaches for foot calluses in diabetic patients, aiming to enhance nursing competency and effective practice in preventing foot ulcers, reducing lower limb amputation risk, and improving the quality of life for diabetic patients.