Region 11 Medical Journal

Effectiveness of Silver diamine fluoride on arresting dental caries and Oral Health-Related Quality of Life in Koh Samui prisoners

Sirinart Saewong — 2026-03-04

Background: Dental caries remains a major oral health problem among prisoners due to overcrowding, limited resources, and restricted access to dental care. Silver diamine fluoride (SDF) at 38% concentration is a low-cost, non-invasive agent widely recognized for its effectiveness in arresting dental caries. However, evidence regarding its impact on oral health–related quality of life (OHRQoL) among prison populations is still limited.

Objective: To evaluate the effectiveness of 38% SDF in arresting active caries and to assess changes in OHRQoL using the Oral Impacts on Daily Performances (OIDP) index among inmates at Koh Samui District Prison, Surat Thani.

Methods: A quasi-experimental study was conducted with 27 inmates diagnosed with dental caries. Participants received topical application of 38% SDF to cavitated lesions and were re-evaluated after 3 months. Clinical parameters (active/arrested caries) and OIDP scores were assessed. Data were analyzed using the Wilcoxon signed-rank test.

Results: After 3 months, 97.7% of treated teeth showed arrested caries. The mean OIDP score decreased significantly from 6.63±5.09 to 2.63±3.90 (p < 0.05), with notable improvements in eating and oral hygiene activities.

Conclusion: The application of 38% SDF is a simple, cost-effective, and non-invasive approach for managing dental caries in resource-limited prison settings. Beyond clinical benefits, SDF contributes to improving OHRQoL among inmates, supporting its integration into prison oral health services and policies.

Comparison of Internal Organ Weights in Sudden Cardiovascular System Autopsy Cases with Others

Pan Junthanasatien — 2026-03-04

Background: Diagnosis of acute myocardial ischemia death. However, according to the researcher's observation, corpses that die suddenly from cardiovascular disease often have a much higher weight of internal organs, such as lung weight, than those that die from other causes.

Objective: To correlate and compare the internal organ weight of a group of people who died suddenly from cardiovascular disease, and those who died from other causes. It helps to make diagnostics faster and more accurate.

Method: Retrospective analytic research combined with a case-control study using data from autopsy reports at Maharaj Nakhon Si Thammarat Hospital. During the period from 1 January 2022 to 30 June 2025, the research criteria were applied without randomization, then divided into samples and control groups, and then the data were analyzed separately by gender. Explain the results using descriptive statistics and use an independent T-test.

Results: 1. The average age of body weight, body weight, and internal organ weight, including heart, lungs, liver, spleen, and kidneys, and the average weight of internal organs to body weight of internal organs in the group that died from cardiovascular disease was higher than that of the group that died from other causes, both male and female. 2. In males, the average body weight, total organ weight, and average organ weight per body weight were significantly higher than those in the group that died from other causes (p ≤0.05), but in females, the average weights of the heart, liver, and spleen were significantly higher than those that died from other causes (p ≤0.05).

Conclusion: Average Visceral Weight to Body Weight. In the cardiovascular disease group, it was significantly higher than the group of deaths from other causes

Accuracy of Visual Postpartum Blood Loss Estimation Before and After Educational Intervention in Simulated and Real Clinical Settings

Primrata Chumsri — 2026-03-09

Background: Postpartum hemorrhage (PPH) remains a major maternal safety concern in healthcare systems. Visual estimation of blood loss is widely practiced due to its convenience and rapid application, however, it is prone to significant inaccuracy, potentially leading to delayed diagnosis and management. Simulation-based training may enhance healthcare personnel’s ability to estimate blood loss more accurately.

Objectives: To evaluate the accuracy of visual postpartum blood loss estimation in both simulated and real clinical settings and to examine the effect of an educational intervention on estimation accuracy among health care personnel at Somdet Phra Yuparat Wiang Sa Hospital.

Methods: This pre-experimental study employed a one-group pretest–posttest design. The simulated phase (May 1–7, 2025) involving 39 participants, including intern physicians and nurses responsible for intrapartum care, who assessed blood loss across 12 simulation stations. The real clinical phase (May 20–July 30, 2025) 13 labor room nurses and nurse anesthetists assessed blood loss in 60 women who delivered at the hospital, with each patient independently evaluated by two assessors. Calculated blood loss was derived from pre- and post-delivery hematocrit values. An educational intervention on blood loss estimation was then provided, followed by reassessment in both settings. Data were analyzed using descriptive and inferential statistics, with statistical significance set at p < 0.05.

Results: In the simulated setting, significant estimation errors were observed before the educational intervention, particularly underestimation in scenarios involving blood loss greater than 500 mL. After the intervention, estimation accuracy improved, with no significant difference between visually estimated and calculated blood loss in 7 of 12 simulation stations. Professional background significantly influenced estimation error (p = 0.011), whereas years of work experience did not affect accuracy. In the real clinical setting, mean calculated blood loss was 395.65 ± 348.65 mL, visual estimation yielded lower mean values by approximately 82–89 mL (20.8–22.5%). Although the difference was not statistically significant, a tendency toward underestimation was observed in higher blood loss cases.

Conclusion: Visual estimation of postpartum blood loss demonstrates limited accuracy in both simulated and clinical settings. Educational training improves accuracy but does not eliminate discrepancies. Combining staff training with quantitative measurement methods, particularly in high-risk patients, may improve maternal safety within health care systems.