Journal of Health Science of Thailand

A Study of Serotype and Genotype of Dengue Hemorrhagic Fever Virus in Thailand 2024

Fri, 14 Aug 2026 00:00:00 +0700

Dengue fever remains a significant public health concern in Thailand, with high annual incidence, particularly during the rainy season. Disease severity varies among individuals and may lead to fatal outcomes if not appropriately managed. Although dengue vaccines have been developed, their use remains limited and continues to be evaluated in different epidemiological settings. This study aimed to investigate the serotypes and genotypes of dengue virus circulating in Thailand in 2024. Samples were collected from multiple provinces and across Thailand, allowing assessment of nationwide serotype distribution. A total of 1,000 samples from dengue-suspected patients diagnosed with dengue fever or screened positive for NS1 antigen were included. Demographic data including sex, age, province, and month of illness were collected. Dengue virus serotypes were identified using real-time RT-PCR from 934 samples. All four dengue virus serotypes were detected: Dengue virus 1 (41.43%), Dengue virus 2 (33.94%), Dengue virus 3 (11.99%), and Dengue virus 4 (11.67%), with co-infection detected in 0.96% of the samples. Genotype analysis using Next Generation Sequencing (NGS) of 65 samples showed that most dengue virus 1 strains were Genotype I (94.44%), while one sample (5.56%) from a Brazilian tourist was identified as Genotype V, which has been rarely reported in Thailand. Dengue virus 2 consisted of Genotype V (55.56%) and Genotype II (44.44%). Dengue virus 3 and Dengue virus 4 were entirely Genotype III and Genotype I, respectively. Phylogenetic analysis confirmed the clustering of Thai strains with previously reported regional lineages. The results indicate that all four dengue virus serotypes were widely distributed across Thailand, with Dengue virus 1 as the dominant serotype. However, no major shift in genotype distribution was observed among the analyzed samples. These findings highlight the importance of continuous surveillance to monitor viral evolution and potential changes in circulating genotypes. This information provides useful insights for dengue surveillance, outbreak preparedness, and the development of diagnostic methods and vaccines.

Health Literacy Levels and Safe Vegetable Consumption Behaviors among People in Takrob Subdistrict, Chaiya District, Surat Thani Province

Poonsak Boonyoung, Kantarote Sookkul, Pattama Somsil, Nipaporn Nobnorb — Fri, 14 Aug 2026 00:00:00 +0700

This study aimed to investigate the level of health literacy and safe vegetable consumption behaviors among residents in Takrob Subdistrict, Chaiya District, Surat Thani Province. A survey research design was employed, involving a multi-stage random sample of 407 participants aged between 20 and 60 years. Data were collected using a structured questionnaire covering six dimensions of health literacy and behaviors related to the consumption of safe vegetables. Data analysis included descriptive statistics, correlation analysis, and multiple regression analysis. The findings revealed that the participants had a moderate level of health literacy with overall (mean = 3.24); and consumed vegetables regularly, with 44.23% consuming 6 - 7 days per week and 44.23% consumed 4 - 5 days per week. The mean daily consumption of cooked vegetables (4.3 tablespoons) was higer that that of raw vegetables (3.53 tablespoons). Multiple regression analysis indicated that the variable ‘media and information literacy’ was the most influential predictor of behavior (p<0.05), folowed by ‘access to information on safe vegetable consumption’ (p <0.05). The model accounted for a moderate proportion of variance in behavior (R² = 0.38). The results of this study can serve as a basis for developing targeted health promotion programs, community-based communication strategies, and food safety policies that are tailored to the local context, thereby contributing to the long-term improvement of public health.

Factors Influencing Wild Mushroom Consumption Practices: a Case Study of a Community Experiencing Mushroom Poisoning Deaths

Fri, 14 Aug 2026 00:00:00 +0700

Poisonous mushrooms are a significant cause of morbidity and mortality. Over the past five years,epidemiological data have shown that approximately one out of every ten patients dies. In 2024 (B.E.2567), Health Region 10 in Ubon Ratchathani Province reported the highest number of deaths (n=6),including a case involving a 10-year-old child. This study aimed to investigate factors associated with wild mushroom consumption behaviors among household representatives in a village where a child fatality occurred. A cross-sectional study was conducted using convenience sampling, yielding 81 participants.Data were collected through structured interviews using a questionnaire that included sections on demographic characteristics, experience, knowledge, beliefs, and behaviors related to the consumption of wild mushrooms. Content validity was assessed by three experts, with item-objective congruence (IOC) indices ranging from 0.67 to 1.00. Reliability testing was conducted with 30 participants, yielding Cronbach’s alpha coefficients of 0.75, 0.83, and 0.77 for knowledge, beliefs, and behaviors, respectively. Data were analyzed using the Chi-square test and Fisher’s exact test, the latter applied when more than 20% of expected cell counts were less than five, to determine associations between independent and dependent variables. The results showed that most participants were female (82.7%), with an age range of 26 to 81 years. The majority had completed primary education (63.0%) and worked in agriculture (60.5%). The participants reported receiving knowledge about wild mushrooms from elderly community members (54.3%). Overall, participants demonstrated unsafe wild mushroom consumption practices, characterized by moderate to low levels of knowledge (49.4%), inappropriate beliefs (100.0%), and unsafe consumption behaviors (81.5%). Factors significantly associated with wild mushroom consumption behaviors (p<0.05) included educational level, exposure to knowledge transfer, and key individuals providing such knowledge. Therefore, health education interventions on wild mushrooms should be designed to be simple, practical, and aligned with community lifestyles. Emphasis should be placed on engaging local experts in wild mushrooms, while public health agencies should collaborate to promote accurate knowledge that can be effectively disseminated within communities.

Theory of Planned Behavior and Stigma in Predicting Help-Seeking Intention Among Thai Undergraduates

Duong Hoang Anh Tran, Yokfah Isaranon, Watcharaporn Boonyasiriwat — Fri, 14 Aug 2026 00:00:00 +0700

The high prevalence of psychological distress among undergraduates highlights the need to investigate help-seeking intention in this population. This study applied the Theory of Planned Behavior (TPB), with social stigma and self-stigma incorporated as extended factors, to predict help-seeking intention. Help-seeking intention was operationalized as the intention to use free mental health services provided by the university. A total of 105 undergraduates (17 males, 88 females) from Chulalongkorn University, including 68 students from the Faculty of Psychology and 37 students from other faculties, completed self-report measures assessing help-seeking intention, attitudes toward help-seeking, subjective norms, perceived behavioral control (PBC), self-stigma, social stigma, prior help-seeking experience, and informal help-seeking. Hierarchical regression analysis indicated that attitudes toward help-seeking, subjective norms, and PBC significantly predicted help-seeking intention (p<0.05), whereas self-stigma and social stigma were not significant predictors (p>0.05) after controlling for the core TPB variables. Additionally, PBC and prior help-seeking experience emerged as the strongest predictors. Overall, the findings support TPB as a robust model for predicting help-seeking intention. The non-significant effects of social stigma and self-stigma may be partly explained by their shared variance with TPB components, particularly attitudes toward help-seeking,subjective norms, and PBC. However, the results should be interpreted with caution due to the cross-sectional design of the study. Implications for future research and intervention are discussed.

Factors Related to Thai Fast-Food Consumption among the Healthcare Undergraduate Students in Thailand

Fri, 14 Aug 2026 00:00:00 +0700

Fast-food consumption behavior represented a significant health-related issue, particularly among adolescents. Contemporary research on Thai fast-food and its health implications remained remarkably limited.This study aimed to assess the behavior of Thai fast-food consumption and analyze the factors related to Thai fast-food consumption in the healthcare undergraduate students. The sample consisted of 295 undergraduate students from a public health college in Thailand during the 2023 academic year, selected through multi-stage random sampling. Data collection was conducted using a questionnaire that underwent content validity testing by three experts and reliability testing, yielding Cronbach’s alpha coefficients between 0.71 and 0.91. The data were analyzed using frequency, percentage, mean, standard deviation (SD), median, maximum, minimum, and chi-square tests at a 95% confidence interval (CI). The study found that the majority of participants exhibited a moderate level of Thai fast-food consumption behavior (58.65%). Factors related to Thai fast-food consumption included body mass index (BMI) and the study program (p = 0.022 and 0.008, respectively). According to the Theory of Planned Behavior (TPB), all five aspects: intention (OR=0.252, 95%CI=0.19 - 0.34), attitude (OR=0.107,95%CI=0.02 - 0.47), subjective norms (OR=0.147,95%CI= 0.09 - 0.25), perceived behavioral control (OR=0.360 95%CI=0.28 - 0.47), and actual behavioral control (OR=0.517,95%CI=0.40 - 0.67) were significantly related to Thai fast-food consumption behavior (p<0.001). This study found that most healthcare undergraduate students showed moderate to good Thai fast-food consumption behaviors, but low to moderate understanding of the concept. Future research should focus on identifying clearer causal relationships and behavioral patterns in Thai fast-food consumption in the mass population for future monitoring.

Risk Assessment of Benzoic Acid, Sorbic Acid, and Propionic Acid in Vegetarian Festival Foods in Trang Province

Somsri Aedkleing, Soontaree Thongsom, Alisara Ruangkhum — Fri, 14 Aug 2026 00:00:00 +0700

The vegetarian festival is one of the most important events in Trang Province. The objective of this study was to evaluate the risk assessment of preservatives within food products associated with the Vegetarian Festival. This study was conducted to analyze preservatives, including benzoic acid, sorbic acid, and propionic acid, in vegetarian foods such as tofu, textured vegetable protein, and bakery products during the Vegetarian Festival. A total of 81 samples, collected in 2020, 2022, and 2024, were analyzed using the HPLC method. Risk assessment was performed by comparing the estimated intake of each preservative with the Acceptable Daily Intake (ADI). The results presented that tofu samples were contained benzoic acid in 14 samples (87.5%) and sorbic acid in 12 samples (12.5%). Textured vegetable proteins were found benzoic acid in 33 samples (67.3%) and sorbic acid in 10 samples (20.4%). Bakery products were found benzoic acid in 16 samples (100%), sorbic acid in 5 samples (31.3%) and propionic acid in 10 samples (43.8%). Exposure assessments for benzoic and sorbic acids in vegetarian festival foods indicated that estimated intakes did not exceed the ADI, even at the 97.5th percentile level. The highest contribution to the ADI for benzoic acid was observed in tofu samples, while the minimum contribution was found in textured vegetable protein. In addition, the highest contribution to the ADI for sorbic acid was observed in textured vegetable protein, while the minimum contribution was found in bakery. In contrast, the risk assessment of propionic acid exposure in bakery products was limited due to the absence of established ADI value. Therefore, consumers who consume a vegetarian diet are protected from exposure to benzoic and sorbic acids.

Development of a Solid Waste Management Model for Sustainable Well-being through Youth Network Participation in Maha Sarakham Province: a Case Study of Rajabhat Maha Sarakham University

Fri, 14 Aug 2026 00:00:00 +0700

This mixed-methods study aimed to develop a sustainable solid waste management model through the participation of youth networks in Maha Sarakham Province, using Rajabhat Maha Sarakham University as a case study. The study was conducted in three phases: (1) assessment of the situation and factors associated with solid waste management behaviors; (2) development of a sustainable solid waste management model through youth network participation; and (3) evaluation of the developed model. The participants included first- and second-year students and members of the primary care network, comprising student leaders and members of the primary care board, with a total of 1,249 participants. Research instruments included questionnaires, in-depth interview guides, evaluation forms, observation records, and focus group discussions. Data were analyzed using descriptive statistics, inferential statistics, and content analysis. The results showed that the participants had moderate levels of knowledge, awareness, literacy, participation, and solid waste management behaviors, and there was a lack of participation and integration among network partners. Factors significantly associated with solid waste management behaviors included grade point average of 2.50 or higher (ORadj = 1.87; 95%CI = 1.06-3.30), high awareness (ORadj = 4.51; 95%CI = 3.03–6.73), high participation (ORadj = 1.63; 95%CI = 1.01–2.63), and high waste management literacy (ORadj = 3.98; 95%CI = 2.19–7.24). The developed model was the RMU–WELL Model. After implementation, the mean scores for knowledge increased by 1.48 points (95%CI = 1.11–2.85), awareness by 1.45 points (95%CI = 1.30–1.60), literacy by 1.44 points (95%CI = 1.29–1.59), participation by 2.67 points (95%CI = 2.52–2.82), and solid waste management behaviors by 1.35 points (95%CI = 1.24–1.46), all with statistical significance (p<0.05). In addition, the amount of solid waste decreased by 1.55%, and the per capita solid waste generation rate decreased from 0.94 to 0.74 kilograms per person per day. These findings reflect the effectiveness of the model in practice, resulting in system-level outcomes, including reduction of waste at the source,establishment of youth network role models, strengthened collaboration among stakeholders, and the development of innovations supporting solid waste management. The RMU–WELL Model is therefore effective and has the potential for scaling up to enhance sustainable solid waste management and health promotion in educational institutions and communities.

Applying Social Network and Social Support in Dengue Hemorrhagic Fever Control and Prevention through Participation Concept: Case Study of Anusorn-Ajarn-Thong Community, Moo 4 Khlonghae Sub-District, Hat Yai District, Songkhla Province

Fri, 14 Aug 2026 00:00:00 +0700

The dengue hemorrhagic fever (DHF) situation in Khlonghae Sub-district, Hat Yai District, Songkhla Province, remains a significant public health problem, with an overall incidence rate exceeding the threshold (50 per 100,000 population). Village No. 4 had the highest incidence rate at 83.74 per 100,000 population (in 2020). This study aimed to investigate the application guideline of the concept of social network and social support toward DHF prevention and control. The study employed a participatory action research model, utilizing the social network of community health volunteers (CHVs) within the Anusorn-Ajarn-Thong community (AJT), Village No. 4 (n=7) and at-risk populations within the community (n=10), along with external social networks including CHVs leaders (n=8) and volunteers (1 person) from the CHVs group of Ban Nongnaikhui community, Village No. 6, together with public health officials (2 persons) and municipal officials (2 persons), for a total of 30 individual persons. By applying the concepts of social network and social support, collaborative efforts were made to control and prevent the spread of DHF. Data was collected through semi-structured interviews, inquiring about network relationships, social support, and satisfaction with the received social support. The data were analyzed using descriptive statistics (quantitative data) and content analysis (qualitative data). The study found that the social networks of the two communities collaborated effectively, receiving social support from external networks in all aspects, especially in gaining knowledge, risk communication, and receiving helpful tools. The innovative “Bergamot Spray “ and “Cyclic Law” solution was effectively implemented; and was able to control the outbreak in a single wave. In summary, the collaborative work of the social network of village health volunteers (VHVs) (within and outside the community) and the social support received from all parties played a significant role in the success of DHF control and prevention measures.

Study of the Effectiveness of Artificial Intelligence in Diagnosing Pulmonary Tuberculosis from Chest Radiographs at Samrongthap Hospital, Surin Province

Sakorn Anuleejun , Janliya Anuleejun — Fri, 14 Aug 2026 00:00:00 +0700

Pulmonary tuberculosis (TB) remains a significant public health concern, particularly among populations with limited access to diagnostic services. The integration of artificial intelligence (AI) in chest radiograph analysis presents a promising approach to enhance the efficiency of TB screening. This study aimed to evaluate the diagnostic performance of an AI-based system in detecting pulmonary TB from chest radiographs within the context of a community hospital setting. Secondary data were retrieved from the radiology department’s image processing system, including AI-generated TB scores and reference results from sputum acid-fast bacilli (AFB) staining using the Kinyoun carbol fuchsin method. A purposive sampling method was employed to select 1,238 individuals aged 18 years and older who underwent both chest radiography and AFB testing between October 2024 and June 2025 at Samrong Thap Hospital. Data were analyzed using IBM SPSS version 25 to assess the accuracy and applicability of the AI model. The AI system demonstrated a sensitivity of 71.11%, specificity of 81.31%, positive predictive value (PPV) of 12.55%, negative predictive value (NPV) of 98.87%, and overall accuracy of 80.94%. The area under the ROC curve (AUC) was 0.754, indicating good diagnostic performance. These findings suggest that the AI model is capable of reliably identifying TB cases and holds potential as a preliminary screening tool in resource-limited community hospitals. Given its high specificity and NPV, the system is particularly effective in ruling out non-TB cases in high-volume settings. However, it is not recommended as a standalone diagnostic tool and should be used in conjunction with clinical evaluation and other diagnostic methods. This approach supports the development of efficient TB screening strategies that enhance accessibility, coverage, and resource utilization in Thailand’s healthcare system.

Effectiveness of a Health Literacy Enhancement Program for DM Remission and Prevention Service on Health Behaviors and Clinical Outcomes among Type 2 Diabetes Patients

Jittima Intapibool — Fri, 14 Aug 2026 00:00:00 +0700

The objective of this study was to evaluate a health literacy enhancement program for diabetes remission and prevention service on health behaviors and clinical outcomes among type 2 diabetes patients. It employed a two-group pretest–posttest quasi-experimental design. The sample comprised 70 patients with type 2 diabetes mellitus whose HbA1c ranged from 6.5% to 10.0%, selected through purposive sampling and allocated to groups by simple random assignment. The experimental group (n=35) received the health literacy enhancement program integrating the six-dimensional framework of the Health Education Division, Department of Health Service Support, Ministry of Public Health; while the control group (n=35) received standard care. Data were collected from January to May 2026. The research instruments were verified for content validity by three experts (S-CVI/Ave=0.94) and for reliability with a pilot group of 30 participants (Cronbach’s alpha=0.81). Data were analyzed using paired t-test, independent t-test, and chi-square test at a significance level of 0.05. The results revealed that after the intervention, the experimental group had significantly higher health literacy scores than the control group (51.63±2.68 vs. 37.60±2.68; p<0.05), as well as significantly higher scores across allhealth behavior domains (p<0.001). HbA1c in the experimental group decreased from 8.23±0.96% to 6.65±1.00% (p<0.05); and after the intervention the experimental group had a significantly lower HbA1c than the control group (6.65% vs. 7.85%; p<0.05). Furthermore, the proportion of patients achieving diabetes remission in the experimental group was 25.7%, compared with 0% in the control group (p<0.05). In conclusion, the DM remission and prevention service program effectively enhanced health literacy, improved health behaviors, and improved clinical outcomes, with a DM remission rate of 25.7%, exceeding the national target, and should therefore be scaled up as a primary care service model.

Development of a Scoring System for Differential Diagnosis Between Gout and Septic Arthritis at NongKhai Hospital

Jintara Tinnahaphat — Fri, 14 Aug 2026 00:00:00 +0700

Patients presenting with acute arthritis must always be differentially diagnosed between gout and septic arthritis, as these conditions share overlapping clinical manifestations but necessitate significantly different management strategies. Although synovial fluid analysis is the diagnostic gold standard, its availability is limited in many healthcare settings due to technical and resource constraints. This study aimed to identify clinical and laboratory factors with statistically significant differences between gout and septic arthritis to develop a screening score for differential diagnosis. A retrospective descriptive study was conducted using the medical records of patients with acute arthritis treated at NongKhai Hospital between 2016 and 2024. Clinical and laboratory variables were compared using the Chi-square test and Multivariable binary logistic regression, with regression coefficients subsequently used to develop the scoring system. Eight significant variables were identified: diabetes mellitus, hypertension and/ or cardiovascular disease (at least one condition), previous arthritis, onset within 1 day, fever, first metatarsophalangeal joint involvement, ankle involvement, and serum uric acid levels greater than 5.88 mg/dL. The 15-point scoring system was categorized into High (≥9 points), Intermediate (5-8 points), and Low (≤4 points) probability groups, with gout probabilities of 97.5%, 55.8%, and 5.6%, respectively. The scoring system showed excellent diagnostic performance, with an AUC of 0.926 (p<0.001, 95%CI 0.884-0.969). This scoring system provides a simple and practical tool, particularly useful in healthcare facilities with limited access to synovial fluid analysis, facilitating accurate diagnosis and timely intervention.

Development of Medication Safety Standard System for Primary Care Units in Lampang Province

Sarawout Maneewong, Penkarn Kanjanarat — Fri, 14 Aug 2026 00:00:00 +0700

This study aimed to investigate the input factors influencing the development of a medication safety standards system, assess the awareness of medication safety standards, develop necessary and contextually relevant criteria, and evaluate the baseline status of implementation according to these criteria within primary care units. The study population comprised pharmacists working in primary care units, personnel responsible for primary healthcare at the provincial, district, and primary care unit levels under the Lampang Provincial Public Health Office and local administrative organizations, as well as primary care units within Lampang Province, totaling 61 units. The research was conducted in three phases: Phase 1 involved a qualitative study of the situation and input factors through focus group discussions, employing purposive sampling with two groups totaling 18 participants (8 and 10 participants, respectively). For the awareness survey, the sample included all personnel within the primary care units. Phase 2 consisted of participatory workshops to develop draft standards and guidelines for monitoring and evaluation, using purposive sampling to select two groups totaling 22 participants (14 and 8 participants, respectively) for workshop participation. Phase 3 involved pilot testing the criteria and evaluating an online assessment approach, with the sample comprising 61 primary care units, each represented by one key informant. Analyze qualitative data using content analysis based on the specified key issues and present it descriptively. For quantitative data, process it with descriptive statistics, including frequency distribution, percentage, mean, and standard deviation. The findings revealed four interrelated systemic factors influencing the development of medication safety standards: policy factors, support factors, standards criteria, and evaluation system factors. Awareness of medication safety standards among primary care units ranged from 35.78% to 56.05%, with the highest awareness observed in outpatient pharmaceutical services and the lowest in personnel competency development. The medication safety standards selected by experts were deemed appropriate and contextually suitable. A total of 178 criteria from the initial draft of 233 criteria cover 4 dimensions and 12 areas. The baseline survey results from 34 service units (accounting for 55.73%) found that more than 50% of the criteria were implemented in frontline service areas such as medication dispensing, pharmaceutical care, adverse event monitoring basic drug inventory management. The dimensions posing challenges with a high proportion of “not yet implemented” are Procurement Real-time information systems. The evaluation of the online self-assessment system (SarPCU) showed that users understood the criteria, found it convenient to use, and they were satisfied with the system at a good level. In summary, the development of safety standards for primary care service units aligns with the local context, and baseline data on awareness and implementation can be used to continuously improve medication quality and safety.

Enhancing DNA/RNA Extraction Efficiency in Viscous Samples Using Mucolytic Agents

Kingkan Rakmanee, Treewat Watthanachockchai — Fri, 14 Aug 2026 00:00:00 +0700

The importance and application of mucus solutions in sample preparation, a crucial step in genetic material extraction. This enables the extraction of both deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) to higher purity and quality. Mucolytic agents, including dithiothreitol, N-acetyl-L-cysteine, and proteinase K, have been employed to reduce the viscosity or enhance the homogeneity of highly viscous samples, such as sputum, saliva, and bronchial lavage fluid. The objective of this study was to collate and present information on commonly used mucolytic agents, including the principles for their appropriate selection for various types of medical samples, to prevent loss and preserve DNA and RNA during nucleic acid extraction. The research methodology involved searching and collecting literature from the PubMed database and other academic sources concerning the use of mucolytic agents in molecular processes, specifically focusing on their impact on nucleic acid extraction efficiency and amplification. The collected literature was analyzed and synthesized to compare key aspects, including properties, mechanisms of action, advantages, limitations, and practical applications of each agent. The findings demonstrated that viscosity-reducing agents significantly enhanced sample homogeneity, reduced false negatives due to sample agglutination, and enhanced the accuracy of biomolecular analysis using the nucleic acid amplification test (NAAT). These agents employed diverse mechanisms, including chemical bond disruption and enzymatic degradation, to optimize samples for the extraction of high-purity DNA and RNA. Crucially, the study highlights that factors such as concentration, exposure time, and temperature must be carefully optimized to prevent inhibition of downstream molecular reactions. Furthermore, integrating these agents with physical methods and rigorous residual removal protocols is essential for significantly increasing the accuracy and efficiency of diagnostic testing.

Effects of Adjunctive Hydrocortisone on Mortality and Clinical Outcomes in Patients with Severe Community-Acquired Pneumonia: a Randomized, Double-Blind, Placebo-Controlled Trial at Nakhon Phanom Hospital, Thailand

Fri, 14 Aug 2026 00:00:00 +0700

Pneumonia is a major global health problem, particularly severe pneumonia, which is associated with a markedly high mortality rate. Its pathophysiology involves a dysregulated inflammatory response, resulting in multiorgan dysfunction and death. This study aimed to compare all-cause in-hospital mortality between patients with severe community-acquired pneumonia receiving adjunctive hydrocortisone versus placebo. This was a single-center, randomized, double-blind, placebo-controlled trial conducted in patients with severe community-acquired pneumonia diagnosed according to the ATS/IDSA 2019 criteria, admitted to the medical intensive care unit and respiratory intensive care unit at Nakhon Phanom Hospital from January 1 to December 31, 2025. A total of 84 patients were enrolled and randomized to receive hydrocortisone (n = 42) or placebo (n = 42). The primary analysis was per-protocol (37 Adjunctive hydrocortisone therapy significantly reduced all-cause in-hospital mortality, reduced 28-day all-cause mortality, increased the rate of successful extubation within 14 days, and resulted in a greater reduction in C-reactive protein level (p<0.05), compared with placebo. No serious adverse events were observed, except for hyperglycemia (67.6% in the hydrocortisone group vs. 31.7% in the placebo group; p=0.05). In conclusion, adjunctive hydrocortisone therapy in patients with severe community-acquired pneumonia reduced in-hospital mortality and 28-day mortality, increased successful extubation rates, and decreased systemic inflammation, with hyperglycemia as a common adverse event. This study has several limitations, including its single-center design, relatively small sample size, and a lower-than-anticipated mortality rate in the control group compared with that used for sample size estimation. Therefore, larger multicenter randomized controlled trials are warranted to confirm these findings.

Personal Factors Associated with the Quality of Stroke Patient Care among Healthcare Personnel in Primary Healthcare Services: a Case Study in Khuan Khanun District, Phatthalung Province

Chanakarn Noonduang, Dusanee Suwankhong, Kusumarn Noipha — Fri, 14 Aug 2026 00:00:00 +0700

This study aimed to examine the level of quality of care for stroke patients based on the Assessment of Chronic Illness Care (ACIC) and investigate the relationship between personal factors and the quality of care for stroke patients among health personnel working in primary health care units in Khuan Khanun District, Phatthalung Province. Data were collected from 156 participants using the ACIC questionnaire, which consists of seven dimensions: (1) organization of the healthcare delivery system, (2) community linkages, (3) self-management support, (4) decision support, (5) delivery system design, (6) clinical information systems and (7) integration of chronic care model components. The data were analyzed using descriptive statistics (frequency, percentage, mean, standard deviation, maximum and minimum) and inferential statistics (Fisher’s exact test) to examine the relationship between personal factors and quality of care levels. The results revealed that the overall mean score of quality of care across seven dimensions was at a good level (Mean = 6.81, SD = 1.66). The highest-scoring dimension was community linkages (Mean = 8.07, SD = 1.90), while the lowest was at operational level (Mean = 7.22, SD = 2.14). Marital status and education level were found to be significantly associated with the quality of care for stroke patients (p<0.05). However, limitations were identified in terms of interagency coordination, community support and continuity of patient follow-up. These findings highlight the necessity to develop a comprehensive and continuous care system emphasizing collaboration among health service units, multidisciplinary teams and communities to reduce stroke complications and enhance patients’ long-term quality of life.

Introduction