Vajira Medical Journal : Journal of Urban Medicine

Reviewer Acknowledgement, 2025

2025-09-05T11:42:36+07:00

In order to maintain the high standards of the Vajira Medical Journal: Journal of Urban Medicine, our editorial team relies on the expertise of numerous professionals. They play a pivotal role in determining the topics to explore, deciding which manuscripts to publish, and making necessary adjustments to ensure the scientific integrity and reliability of the information provided. This fosters the growth and advancement of medical and health science research. I deeply appreciative of the dedication and proficiency exhibited by the individuals who reviewed manuscripts for the journal from September 1st, 2024, through August 31st, 2025.

Editorial Statement: The Last Issue of Vajira Medical Journal: Journal of Urban Medicine

2025-09-05T11:18:14+07:00

With this issue, we mark the final publication under the name Vajira Medical Journal: Journal of Urban Medicine. Since its inception in 1957, the journal has served as a trusted platform for disseminating high-quality research, including basic sciences, clinical insights, and medical innovations from the Vajira Hospital community and beyond in Thailand. Over the years, it has grown significantly in the number of high-quality submissions, the diversity of contributing authors, the volume of citations, and the breadth of its readership. This progress has been recognized by its recent inclusion in Tier 1 of the Thai-Journal Citation Index (TCI), as officially announced by the TCI Center on February 4th, 2025.
We are proud to announce that, beginning with our next issue, the journal will be relaunched under the new title Journal of Medicine and Urban Health. This change signifies far more than a new name—it marks a comprehensive transformation in our identity, vision, and global engagement. To support this transition, we have welcomed a distinguished group of national and international editorial board members who bring diverse expertise and a strong commitment to academic excellence. Our goal is to establish a leading international platform for research that addresses medical and public health challenges, with a particular focus on urban populations around the world.
We are also pleased to share that the journal’s next major goal is to be indexed in Scopus or another internationally recognized database—an important step in expanding our global reach and impact. As we move forward under our new name, we remain firmly committed to publishing high-quality, peer-reviewed content that integrates clinical research (including basic science), medical innovation, public health, and health policy—particularly within the context of urban health.
We extend our sincere gratitude to our contributors, reviewers, and readers for your continued support. This transition is not an end, but the beginning of an exciting new chapter.

Prevalence, Symptoms, and Associated Factors of Long COVID-19: A Cross-Sectional Survey Study

2025-11-13T13:58:48+07:00

OBJECTIVE: Long COVID is defined as persistent or newly developed symptoms after the acute phase of COVID-19 infection. This study aimed to evaluate the prevalence of long COVID, types of symptoms, and associated factors.
METHODS: This was a cross-sectional survey including individuals with a history of COVID-19 infection aged ≥ 18 years who were followed up at our hospital. The presence of abnormal symptoms and clinical features were obtained through a questionnaire.
RESULTS: A total of 307 individuals with a median age of 58 years (interquartile range 35–74 years) were included in this study. Among them, 53.1% were females, and 56.0% had underlying diseases. The prevalence of long COVID was 40.1%. Cardiopulmonary (36.6%) and nonspecific general symptoms (22.0%) were the most common symptoms. We did not find significant association long COVID and any characteristic features of the participants, numbers of COVID vaccination or infection episodes.
CONCLUSION: The prevalence of long COVID was 40.1%. No factors significantly associated with long COVID were observed. Cardiopulmonary and general symptoms were the most common symptoms.

Assessing COVID-19 Preparedness and Perception among Thai Paramedics in Thailand: A Cross-Sectional Study

2025-11-13T14:11:43+07:00

OBJECTIVE: The coronavirus disease (COVID-19) outbreak has had widespread impacts on global public health systems, including Thailand’s. Preparedness for public health emergencies is therefore critical. This study aimed to assess Thai paramedics’ operational preparedness and perception in response to the COVID-19 pandemic.
METHODS: A cross-sectional descriptive study was conducted among 225 paramedics in Thailand. Data were collected via an online questionnaire between August and December 2021, covering general information, perceptions of infectious diseases, and COVID-19 response preparedness. The questionnaire on preparedness was a binary response format, with yes scored as 1 and no scored as 0. In contrast, the questionnaire on COVID-19 perception was measured using a 5-point rating scale, with the lowest score being 1 and the highest score being 5. The results were then categorized into three levels: high, moderate, and low. Analyses included frequencies, percentages, means, and standard deviations. Logistic regression was used to assess relationships between basic characteristics, perceptions, and preparedness.
RESULTS: Operational preparedness was moderate, with structural preparedness at 53.3% and operational preparedness at 54.2%. Only 38.7% of the participants were fully prepared across all aspects. Meanwhile, perceived was found to be at a high level for both risk perception and perceived severity (mean scores: 4.50 ± 0.44 and 4.60 ± 0.44 respectively). Logistic regression identified key predictors of preparedness: prior training in COVID-19 patient management (adjusted odds ratio (OR) = 1.79, 95% confidence interval (CI) = 1.01-3.17) and hands-on experience with COVID-19 patients (adjusted OR = 3.33, 95%CI = 1.56-7.12).
CONCLUSION: Integrating knowledge with practical experience enhances emergency preparedness. To improve readiness, capacity development through targeted training, simulation exercises, and real-world practice opportunities is essential for paramedics.

Prevalence of Left Ventricular Hypertrophy and Its Association with Blood Pressure Control in Hypertensive Patients at Vajira Hospital, Navamindradhiraj University

2025-05-29T11:32:24+07:00

OBJECTIVES: This study aimed to determine the prevalence of left ventricular hypertrophy (LVH) diagnosed via echocardiography and the relationship between blood pressure (BP) control and LVH and identify factors associated with LVH among patients with hypertension in Thailand.
METHODS: This cross-sectional study included 107 patients with hypertension who visited a cardiology clinic between March 2024 and August 2024. The baseline characteristics, office BP, and morning and evening home BP measurements of the participants were obtained. Echocardiographic criteria for LVH diagnosis are left ventricular mass index > 95 g/m² in women and > 115 g/m² in men. The primary outcomes were to determine the prevalence of LVH and assess the relationship between BP control and LVH.
RESULTS: The prevalence of LVH was 32.70%, with all the patients diagnosed with LVH exhibiting a concentric hypertrophy phenotype. Among the patients, 59.80% had controlled home BP, whereas 42% had controlled office BP. The prevalence of LVH was 22.50% among patients with both controlled office and home BP, 44.70% among those with both uncontrolled office and home BP, 20% in the group with controlled office but uncontrolled home BP, and 33.30% in the group with uncontrolled office BP but controlled home BP. Multivariate analysis showed that the number of antihypertensive drugs use was the only significant associated factor.
CONCLUSION: The prevalence of LVH is high among patients with hypertension, particularly those with uncontrolled office and home BP. This indicates the need for effective hypertension management strategies to prevent hypertension-mediated organ damage associated with LVH.

Impact of Oral Health Knowledge and Attitude on the Severity of Periodontitis among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

2025-07-01T08:40:03+07:00

OBJECTIVES: The aim of this study was to evaluate whether the level of oral health knowledge and attitudes of type 2 diabetes mellitus (T2DM) patients affected their periodontitis severity.
METHODS: Descriptive and statistical analysis of secondary data collected from follow-up 184 T2DM patients attending at Endocrinology Unit, Faculty of Medicine Vajira Hospital, was used.
RESULTS: All T2DM subjects were diagnosed as having periodontitis but with different degrees of severity: 64.7% and 70.0% of subjects with mild-to-moderate periodontitis had high knowledge and high attitude scores, respectively. A higher proportion of subjects (76.3%) with severe periodontitis had low attitude score. Of well-controlled diabetic subjects 20.6% had severe periodontitis, while of uncontrolled patients 40.8% suffered severe periodontitis. There was no significant difference between knowledge or attitude score and the level of periodontitis severity in T2DM. However, experiencing gingival problems was significantly related to periodontitis severity (p = 0.024).
CONCLUSION: General oral health knowledge does not have any impact on periodontitis severity while attitude seemingly does. Emphasize the knowledge on characteristic of gingival problems might affect periodontal health in people living with diabetes.

COVID-19 Infection Rate and Cofactor in Non-Patients under Investigation: Rethinking the COVID-19 Screening Policy

2025-06-13T13:46:36+07:00

OBJECTIVE: To determine the infection rate and cofactors of coronavirus disease (COVID-19) in individuals who are not patients under investigation (non-PUIs) at a tertiary hospital.
METHODS: In this cross-sectional descriptive study conducted between October 2022 and April 2023, the infection rate of COVID-19 in non-PUIs was determined, and the general characteristics, underlying diseases, occupations, number of vaccinations, and signs and symptoms were studied.
RESULTS: The infection rate in non-PUIs was 9.9% (n = 31), and 90.1% (n = 282) were negative. The signs and symptoms significantly associated with COVID-19 positivity were fever (odds ratio (OR) 22.32, 95% confidence interval (CI) 5.26-94.68), malaise (OR 19.10, 95% CI 8.10-45.06), myalgia (OR 16.61, 95% CI 6.14-44.95), sore throat (OR 11.71, 95% CI 4.62-29.67), tiredness (OR 10.00, 95% CI 4.26-23.42), headache (OR 7.94, 95% CI 3.55-17.77), diarrhea (OR 7.42, 95% CI 3.02-18.23), cough (OR 7.39, 95% CI 3.17-17.21), rhinorrhea (OR 6.40, 95% CI 2.82-14.49), phlegm (OR 3.94, 95% CI 1.81-8.58), and vaccination with 0-2 shots (OR 2.22, 95% CI 1.01-4.90). Anosmia (OR 1.67, 95% CI 0.54-5.18), rash (OR 1.86, 95% CI 0.72-4.92), and dizziness (OR 1.08, 95% CI 0.36-3.28) were not significantly associated (p > 0.05).
CONCLUSION: Symptom-based screening among pre-admission patients not meeting PUI criteria may help detect overlooked COVID-19 cases. Key symptoms associated with infection included fever, cough, sore throat, phlegm, and myalgia. Additionally, individuals who received fewer than three vaccine doses had higher infection rates. These findings support the need to refine screening protocols to include clinical and vaccination risk factors in non-PUI populations.

Scattered Radiation Dose and Safety Assessment from Mobile X-Ray Radiography

2025-08-21T14:31:07+07:00

OBJECTIVE: This study aimed to measure the scattered radiation levels that surround a mobile X-ray machine during chest radiography using adult and pediatric phantoms and to estimate the radiation exposure experienced by nearby individuals in simulated clinical ward settings.
METHODS: Scattered radiation was measured using a solid-state scatter probe at distances of 1.0, 1.5, and 2.0 meter (m), and at nine angular positions around the X-ray tube. Chest X-ray (CXR) exposures were performed using two parameter sets: 80 kilovoltage peak (kVp) and 2 milliampere-seconds (mAs) for the adult phantom, and 55 kVp and 1.6 mAs for the pediatric phantom. The data obtained regarding the dose were used to simulate and calculate the potential scattered radiation exposure in hospital wards under three different scenarios: (1) without walls or shielding, (2) using measured distances based on the experimental setup, and (3) with shielding barriers, incorporating attenuation coefficients for common building materials.
RESULTS: For the adult phantom, the highest scattered dose was 0.26 microgray (μGy) at 1.0 m and the lowest was 0.03 μGy at 2.0 m. For the pediatric phantom, values ranged from 0.107 μGy to 0.002 μGy. The calculations of radiation dose using ward layouts showed that the annual exposure to adjacent patients and health care workers, based on 730 imaging sessions per year, did not exceed the International Commission on Radiological Protection annual public dose limit of 1 millisievert.
CONCLUSION: Scattered radiation levels during mobile CXR procedures decrease with distance and remain within safe limits. However, the cumulative low-dose exposure may contribute to long-term stochastic risks. Measures to protect against radiation, such as maintaining a minimum 2-m distance and wearing lead aprons, are recommended for safety.