Region 11 Medical Journal

Chronic Progressive Visual Loss due to Petrocavernous Meningioma: A Case Report

2026-05-17T22:31:32+07:00

Introduction: Chronic progressive visual loss in elderly patients is most commonly attributed to cataract; however, alternative etiologies such as compressive optic neuropathy should be considered when clinical findings are atypical.

Case Report: A 69-year-old Thai female presented with progressive left visual loss initially diagnosed as cataract. Examination revealed a relative afferent pupillary defect and optic disc pallor. Magnetic resonance imaging of brain and orbit demonstrated a petrocavernous meningioma compressing the left optic nerve. The patient underwent surgical decompression followed by radiotherapy, resulting in stable visual acuity and improved visual field.

Conclusion: This case highlights the importance of thorough evaluation to prevent misdiagnosis and irreversible visual loss.

Tooth replantation of Avulsed Permanent Anterior Teeth in Children: Two Case Reports with Long-Term Follow-Up

2026-04-09T10:23:33+07:00

Introduction: Avulsion of a permanent tooth is a dental injury that requires emergency management in children according to the guidelines of the International Association of Dental Traumatology (IADT) in order to minimize potential complications.

Case Report: This report presents two pediatric patients who underwent tooth replantation following traumatic avulsion. Case 1 was a 9-year-old girl with avulsion of the permanent maxillary incisor (Tooth 21), and Case 2 was an 8-year-old boy with avulsion of the permanent maxillary incisor (Tooth 11). In both cases, the parents stored the avulsed tooth in milk and brought the patient to the dentist within 20 and 30 minutes, respectively. After examination, the dentist cleaned the tooth with sterile saline and replanted it into the original socket. The tooth was then stabilized using a flexible splint for 2 weeks, antibiotics were prescribed, and root canal treatment was initiated within 1 week. Follow-up showed favorable outcomes at 3 years in Case 1 and 1.5 years in Case 2. The teeth were stable and the gingival tissues appeared normal. Case 1 exhibited slight discoloration of the crown. Radiographic examination in both cases demonstrated a continuous periodontal ligament space with no signs of root resorption or ankylosis.

Conclusion: Management according to the IADT guidelines can effectively preserve avulsed permanent teeth even when the extra-oral time reaches up to 30 minutes. Therefore, educating parents and teachers about the first aid management of tooth avulsion is extremely important.

A comparison of labor induction outcomes using a single dose of misoprostol followed by Oxytocin versus two doses of misoprostol in women undergoing labor induction at Surat thani Hospital

2026-04-01T15:00:58+07:00

Background: Induction of labor is a crucial obstetric procedure that plays a vital role in the care of pregnant women with medical indications, ensuring an appropriate and safe delivery. With the increasing rate of cesarean sections, induction of labor is essential to improving the chances of vaginal delivery. Choosing an effective and safe method is therefore necessary.

Objective: To compare vaginal delivery rates, induction time to vaginal delivery, maternal and neonatal outcomes between single-dose misoprostol combined with Oxytocin and two doses of misoprostol.

Methods: A quasi-experimental study was conducted among 104 pregnant women undergoing labor induction between April 2025 and January 2026 at Surat Thani Hospital. Participants were allocated into two groups: single-dose misoprostol with Oxytocin and two doses of misoprostol. Maternal and neonatal outcomes were compared between the groups.

Results: The combination group demonstrated a significantly higher vaginal delivery rate compared to the two doses of misoprostol group (50% vs 17.3%, P<0.001). The mean duration of labor was significantly shorter in the combination group (9.72 ± 1.92 vs 12.47 ± 3.59 hours, P<0.05). There was no statistically significant difference in postpartum hemorrhage (1.9% vs 3.8%, P=0.558), fetal heart rate abnormalities (17.3% vs 11.5%, P=0.402) and uterine rupture. (0% vs 0%).

Conclusion: Single-dose misoprostol combined with Oxytocin is more effective in increasing vaginal delivery rates and reducing labor duration compared with two doses of misoprostol, without increasing maternal or neonatal complications.

The comparison of pain reduction, quality of life and knee joint synovial thickness between Triamcinolone acetonide 20 mg and Triamcinolone acetonide 40 mg in patients with knee osteoarthritis.

2026-07-15T13:06:38+07:00

Background: Intra-articular steroid injections are used to treat osteoarthritis of the knee. The dosages used vary, but the most popular currently is 40 mg.
Objective: To compare the pain reduction, quality of life and synovial membrane thickness improvement between triamcinolone acetonide 20 mg (TA20) and 40 mg (TA40).
Methods: A quasi-experimental study was conducted on 70 patients with osteoarthritis of the knee, divided into two groups of 35 patients each. Evaluations were performed at three stages: baseline/pre-treatment, 4 weeks, and 12 weeks. The primary outcomes were visual analog scale (VAS), modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and knee joint synovial thickness.
Results: Baseline characteristics of both groups were similar. All patients showed improved pain levels and quality of life at 4 weeks, but at 12 weeks, the TA40 group showed a significant reduction in pain (p=0.017) and generally had a better quality of life. Knee joint synovial thickness decreased in both groups at 4 weeks, but at 12 weeks, the TA40 group showed a significantly greater reduction in knee joint synovial thickness (p=0.034).
Conclusion: TA40 was associated with better pain reduction, quality of life, and reduction of knee synovial thickness than TA20 when followed up at 12 weeks.

Outcomes of Fetal Down Syndrome Screening Using Quadruple Test at Surat Thani Hospital

2026-07-02T11:32:09+07:00

Background: Surat Thani Hospital has been providing Down syndrome screening for pregnant women using the quadruple test since January 2024. However, there have been no studies on its performance to date. For these reasons, the researchers conducted this study.

Objective: To evaluate the effectiveness of Down syndrome screening using the quadruple test at Surat Thani Hospital.

Method: A retrospective cross-sectional study design for diagnostic test was utilized through the review of patient medical records. Data were collected from 3,746 eligible pregnant women who underwent Down syndrome screening using the Quadruple test at Surat Thani Hospital between January 1, 2021, and December 31, 2024. The data were analyzed using descriptive statistics, and the accuracy of the Quadruple test was presented in terms of sensitivity, specificity, and false positive rate.

Results: A total of 215 women (5.74%) were classified as high-risk for Down syndrome and underwent confirmatory amniocentesis. The results revealed abnormal fetal chromosomes in 6 pregnancies, including 5 cases (2.3%) of Down Syndrome and 1 case of Edwards Syndrome. The remaining 209 pregnancies had normal fetal chromosomes. The screening test demonstrated sensitivity of 100%, a specificity of 94.34%, and a false positive rate of 5.66%

Conclusion: The implementation of the Quadruple test for Down syndrome screening at Surat Thani Hospital demonstrated high clinical efficacy.