Region 11 Medical Journal

Factors Associated with Late Antenatal Care after gestational age 12 Weeks at Thalang Hospital, Phuket Province.

Parinya Saringkanan — 2025-12-08

Background: Antenatal care (ANC) is a crucial component of maternal healthcare services, enabling pregnant women to receive regular health check-ups to prevent, detect, and treat complications that may arise during pregnancy. It was found that pregnant women who came for antenatal care at Thalang Hospital received antenatal care late after 12 weeks, which was higher than the standard and affected the health of the mother and the baby.

Objectives: To study the factors associated with delayed antenatal care after gestational age 12 weeks of pregnancy among pregnant women who first attended antenatal care at Thalang Hospital, Phuket Province.

Method: The study employed a descriptive research design. The sample consisted of 182 pregnant women who came for their first antenatal visit after 12 weeks of pregnancy at Thalang Hospital. The research instruments consisted of a questionnaire on personal characteristics and health perception, with a Cronbach’s alpha reliability of 0.87. Data were analyzed using descriptive statistics and correlation analysis using the Chi-square Test.

Results: The results showed that factors related to delayed antenatal care included personal characteristics, such as marital status, education level, occupation, income, number of pregnancies, number of children, and use of contraception. Health perception related to delayed antenatal care included perception of pregnancy risks and perception of the benefits of antenatal care, perceived barriers to antenatal care, pregnancy intention, acceptance of pregnancy by spouses, and acceptance of pregnancy by the community.

Conclusion: To achieve the goal of antenatal care, there should be two parts of action: in the hospital and in the community, to raise awareness among pregnant women of the importance of early antenatal care.

Incidence and factors associated with postoperative intensive care unit admission in Thungsong Hospital, Nakhon Si Thammarat Province

Pattiya Suttidate — 2025-10-16

Background: High-risk surgical patients were recommended to admitted to the intensive care unit (ICU) in order to reduce postoperative complications and mortality. However, ICU resources are limited. Identifying factors thus is crucial to operate the ICU admissions efficiently.

Objectives: To identify the incidence and factors associated with the postoperative ICU admissions.

Methods: A retrospective, case-control study was conducted in patients who underwent the surgeries in Thungsong hospital between October 1^st, 2018 to September 30^th, 2023. The associations between the surgical patients with the potential factors were analyzed using univariate and multiple logistic regressions.

Results: 695 out of 30,671 patients (2.3%) underwent the postoperative ICU admissions. The results showed that ASA class III, coronary artery disease, heart failure, general anesthesia, operative time ≥ 180 minute, blood loss 750-1,500 ml, blood loss > 1,500 ml, hypotension, hypoxemia, bronchospasm, difficult intubation and MEWS after surgery ≥ 4 significantly contributed to the postoperative ICU admissions. Also, the inotrope or vasopressor infusion, MEWS at ICU 6-7 and MEWS at ICU ≥ 8 were significant factors associated with the ICU mortality.

Conclusion: The findings highlighted the important factors related to the postoperative ICU admissions. The patients with these factors require the attentive care from health professions to reduce the risk of morbidity and mortality.

The predictive factors of precancerous lesions and colorectal cancer in Wiengsa Crown Prince Hospital, Surat Thani

Thep Jusuwan — 2025-10-16

Background Colorectal cancer (CRC) is one of the leading causes of global cancer-related mortality. Most CRC cases arise from precancerous lesions, such as adenomatous and sessile serrated polyps, which can be detected and removed through colonoscopy. However, the epidemiological profile and risk factors for CRC and precancerous lesions in Thailand, especially in secondary care settings, remain underexplored.

Objective This study identified the demographic and clinical predictors of colorectal neoplasia, including precancerous lesions and CRC, among patients undergoing colonoscopy at Wiengsa Crown Prince Hospital in Surat Thani, Thailand.

Materials and methods A retrospective analysis was conducted on 481 individuals who underwent colonoscopy from June 2023 to December 2024. Data collected included demographic characteristics, comorbidities, smoking history, and colonoscopy findings. Multivariable logistic regression was used to identify independent predictors of neoplastic polyps and CRC.

Results Among the 481 individuals who underwent colonoscopy, 453 patients were included in the final analysis, with 28 patients excluded due to incomplete data. Among these, 25.6% had precancerous colorectal lesions, and 3.31% were diagnosed with colorectal cancer (CRC). Multivariable logistic regression identified male gender (adjusted odds ratio [aOR] 2.08, 95% CI: 1.25–3.45, P=0.005), smoking (aOR = 3.66, 95% CI: 1.76–7.59, P<0.001), hyperlipidemia (aOR = 1.73, 95% CI: 1.01–2.97, P=0.047), and increasing age (aOR per year = 1.03, 95% CI: 1.01–1.06, P=0.004) as independent predictors of precancerous lesions. For CRC, independent predictors included smoking (aOR = 11.2, 95% CI: 2.49–50.27, P=0.002), hematochezia or change in bowel habits (aOR = 17.66, 95% CI: 4.76–65.53, P<0.001), and American Society of Anesthesiologists (ASA) Physical Status Classification Class 3 (aOR = 7.71, 95% CI: 1.52–39.14, P=0.014).

Conclusions Precancerous colorectal lesions and colorectal cancer were significantly associated with modifiable and demographic risk factors. Male gender, smoking, hyperlipidemia, and advancing age were identified as independent predictors of precancerous lesions, while smoking, lower bowel symptoms, and higher ASA classification were strongly associated with colorectal cancer. These findings support the implementation of risk-based screening strategies, particularly in resource-limited settings, and underscore the clinical value of symptom-driven colonoscopy in early CRC detection.

Development of Anaphylaxis Surveillance System for Iodinated Contrast Media at Suratthani Hospital

Sahusa Ruangsri — 2025-12-08

This article focuses on a significant public health issue—the occurrence of allergic reactions to contrast media used in radiological examinations, which has shown an increasing trend alongside rapid advancements in medical technology. The objective is to develop an appropriate initial management system for patients experiencing severe allergic reactions to contrast media and to reduce subsequent complications. A multidisciplinary working group was established, consisting of physicians, pharmacists, nurses, and other related personnel, to monitor allergic reactions in two stages: before and after contrast administration. The results showed improved patient safety, with reductions in the incidence of renal failure and extravasation of contrast media. In conclusion, the use of nonionic iodinated contrast media (nonionic ICM) has significantly decreased the mortality rate from allergic reactions to only 0.1 per 100,000 patients. Therefore, the Radiology Department of Surat Thani Hospital has developed a comprehensive monitoring system for severe contrast media allergy to enhance efficiency and patient safety in clinical practice.