The Journal of Chulabhorn Royal Academy

Use of antiseptic solutions in traumatic wound care

2025-09-05T10:18:21+07:00

Traumatic wounds, resulting from accidents or injuries, carry a high risk of infection due to the introduction of pathogens into the body. Therefore, effective wound care is essential to promote healing and prevent complications. A key component of wound management is the use of antiseptic solutions, which work through various mechanisms to curb microbial growth. This includes disrupting cell membranes, denaturing proteins, and interfering with metabolic processes. Moreover, these solutions have broad-spectrum activity against a wide range of microorganisms, including bacteria, fungi, and viruses.

The application of antiseptic solutions requires thoughtful consideration. This involves choosing an appropriate antiseptic, determining the optimal concentration, and using the most effective application method. These factors are critical in ensuring optimal efficacy and maintaining patient safety. Additionally, selection of an appropriate antiseptic should also involve consideration of wound type, patient characteristics, and underlying medical conditions.

Further research is essential to optimize antiseptic selection, establish appropriate dosing regimens, and enhance application techniques in wound care. By advancing wound care practices, researchers aim to enhance patient outcomes in the field of traumatic wound management.

Optimal Comprehensive Geriatric Assessment in Hospital-to-Home Transitional Care for Older Patients: A Review of Concept and Evidence-Based Practices

2025-08-21T14:15:19+07:00

A comprehensive geriatric assessment (CGA) during the transition from hospital to home is essential for identifying those at risk of hospital-acquired complications and readmission to the hospital. The assessment enables timely care planning and risk management through a multidisciplinary approach.

This literature review sought to provide empirical evidence on CGA during transitional care from hospital to home. Literature was searched across five databases—CINAHL, PubMed, ScienceDirect, and Google Scholar—using the keywords "comprehensive geriatric assessment," "discharge plan," "older adults," and "transitional care." A total of 45 articles were identified, of which 19 were included in the analysis after excluding those that did not meet the objectives or lacked full-text access. Each article was independently reviewed and appraised by the authors. Seventeen studies were rated as level 1 evidence, while two were rated as level 2 and level 4 evidence, respectively. The extracted data were synthesized and presented collaboratively.

Findings indicate that there is no standardized model for conducting comprehensive geriatric assessment during care transitions. Institutions may adopt or develop assessment tools tailored to their specific context. Nevertheless, it is recommended that assessments address all relevant domains, including health problems, physical health, mental and cognitive status, functional ability, and environmental factors. Assessments should be systematically scheduled from admission through discharge and extended to follow-up at home. Post-discharge monitoring may be conducted by healthcare providers through home visits or telehealth technologies, which can also facilitate the active participation of patients, caregivers, and community volunteers in the assessment process.

Artificial Intelligence and Nursing Profession: Driving Sustainable Healthcare in the Digital 5.0 Era

2025-09-24T13:29:16+07:00

The technological transformations of the 21st century have been a driving force propelling society into the Digital 5.0 or Society 5.0 era. This era focuses on the seamless integration of the physical and virtual worlds with the ultimate goal of solving societal problems and improving people's lives. As the core of the healthcare system, the nursing profession faces an urgent need to adapt effectively to this disruptive trend. This academic article aims to analyze the role of Artificial Intelligence (AI) in nursing, covering four key dimensions: nursing education, patient care, nursing administration, and nursing research. It seeks to debunk the misconception that AI will replace nurses, demonstrating that AI serves as an empowering tool that reduces administrative burdens and gives nurses more time to dedicate to patient care. Furthermore, the article delves into the complex ethical issues associated with the application of AI and presents solutions aligned with international standards from leading organizations. This article emphasizes the transition of nurses' roles in the digital age from "task implementers" to "strategic leaders" and "ethical overseers". In conclusion, the intelligent, ethical, and creative integration of AI technology is the key factor that will shape the future of the nursing profession, ensuring its sustainability while preserving the value of compassionate care.

Efficacy of Platelet-Rich Plasma in the Management of Knee Osteoarthritis: A Preliminary Study

2025-05-06T09:41:28+07:00

Introduction: Platelet-rich plasma (PRP) is an alternative treatment for osteoarthritis of the knee (OA Knee). While PRP treatment has shown promising clinical outcomes through its anti-inflammatory mechanisms and growth factors, literature reviews reveal debates regarding its short- and long-term efficacy, as well as safety concerns and the complexity of the preparation process, which may hinder its therapeutic outcomes. Objective: To standardize the PRP preparation process for treating OA Knee and evaluate the treatment outcomes. Methods: The study was conducted on 50 patients with OA Knee from December 1, 2021, to November 30, 2022. PRP was prepared according to standardized protocols, and the outcomes at 1, 3, and 6 months post-treatment. The primary outcomes included platelet concentration in the PRP, pain intensity measured by Visual Analogue Scale (VAS), and functional improvement assessed by the WOMAC score. Results: A total of 47 patients completed follow-up, with a mean age of 64.76 ± 7.3 years. The majority had advanced OA (stage 3-4; 41 patients). Platelet concentration in PRP significantly increased by 2.7 times after centrifugation compared to baseline (258,562 ± 78,204 vs. 702,621 ± 718,621 platelets/mm³). Pain levels measured by the Visual Analogue Scale (VAS) significantly decreased from a baseline of 6.7 ± 1.19 to 3.7 ± 1.38, 2.77 ± 1.20, and 2.68 ± 1.2 at 1, 3, and 6 months, respectively. Knee function and quality of life, as assessed by the WOMAC score, also showed significant improvement. The baseline score of 43.32 ± 14.91 decreased to 31.00 ± 16.26, 26.80 ± 15.41, and 25.31 ± 13.74 at the same time intervals. Conclusion: Standardizing the PRP preparation process is feasible in hospital settings and offers an effective treatment option for OA Knee. The treatment demonstrated significant pain reduction and improved knee quality of life (WOMAC score) for up to 6 months post-treatment.

The Relationship between Oral Health Perception, Oral Health Literacy and Oral Health Behaviors among Dental Service Recipients, Trang Hospital, Trang Province, Thailand

2025-07-15T11:21:02+07:00

This cross-sectional descriptive study aimed to investigate personal information, oral health perception, oral health literacy, oral health care behaviors, and factors associated with oral health care behaviors among dental service users at Trang Hospital. A total of 340 participants were selected from dental service recipients using accidental sampling. Data were collected using a self-administered questionnaire during June-July 2024. Data analysis was performed using descriptive statistics and inferential statistics, including the Chi-square test and Spearman rank correlation coefficient at a significance level of 0.05.

Study results showed that the majority of participants were female, with an average age of 33.37±12.39 years. Approximately 81.76% had previously received oral health education. Overall oral health literacy across six domains was rated at a moderate level (mean score: 104.88±17.26). Toothbrushing behavior was rated at a high level (mean score 4.05±0.60), while the use of additional oral hygiene adjuncts was rated at a moderate level (mean score 3.17±0.82).

Factors significantly associated with toothbrushing behavior (p-value < 0.05) included gender, perceived satisfaction with oral health, having received oral health education, and overall oral health literacy. Specific domains of oral health literacy found to be significantly associated with toothbrushing behavior were: access to health information and services, knowledge and understanding, communication skills for enhancing expertise, and self-management skills.

Factors significantly associated with the use of additional oral hygiene adjuncts (p-value < 0.05) included: education level, perceived satisfaction with oral health, and 5 of oral health literacy domains which are the access to health information and services, knowledge and understanding, communication skills for enhancing expertise, self-management skills, and decision-making skills.

Therefore, programs or activities should be implemented to enhance oral health literacy, with a focus on improving access to health information, developing understanding, and strengthening communication skills. These efforts will help the working-age population effectively manage their oral health care

Development of Koklan Formula 3 Recipe in Effervescent Tablet Form

2025-09-04T15:08:51+07:00

Background: Muscle pain is a common health problem in older people and those maintaining prolonged static postures. While anti-inflammatory medications are effective in relieving symptoms, long-term use can lead to side effects. The Koklan formula, which is on the National List of Essential Medicines, offers an effective alternative for pain relief, but its traditional form is inconvenient to use. Objective: To develop Koklan formula 3 in effervescent tablet form and evaluate user satisfaction. Methods: The study involved the development of Koklan formula 3 as effervescent tablets, evaluation of pharmaceutical properties and assessment of user satisfaction. Results: The optimal formulation per tablet contained Koklan formula 3 extract (100 mg) in combination with pharmaceutical excipients such as sodium bicarbonate, tartaric acid, lactose, citric acid, polyethylene glycol 6000 and talc, using monk fruit sweetener suitable for individuals with sugar restrictions. The product met the standard requirements for disintegration, hardness, friability and pH. The user satisfaction evaluation showed the highest satisfaction in all aspects. Conclusion: The development of traditional herbal medicines into a standardized effervescent tablet form with high user satisfaction represents a significant advance in the modernization of Thai herbal products for improved convenience and ease of use.

Method validation of SYBR Green RT-PCR Assay for Identification of Strains of Pentavalent Rotavirus Vaccine

2025-08-28T10:53:25+07:00

Rotavirus is a leading cause of severe gastroenteritis in infants and young children, contributing to significant global morbidity and mortality. Vaccination with rotavirus vaccines, particularly the pentavalent vaccine targeting G1P7, G2P7, G3P7, G4P7, and G6P[8] strains, provides broad protection against multiple serotypes responsible for severe disease. Accurate identification of these strains is essential for monitoring vaccine efficacy and safety. The World Health Organization (WHO) has established strict quality control guidelines to ensure the safety, efficacy, and consistency of rotavirus vaccines. This study aims to validate a SYBR Green-based reverse transcription polymerase chain reaction (SYBR Green-based RT-PCR) assay for the precise identification of strains included in the pentavalent rotavirus vaccine. The validated assay showed high specificity and reproducibility. Positive identification was confirmed for all target strains with cycle threshold (Ct) values <40.00. The assay yielded Ct values of 27.76±0.48 (G1P7), 27.76±0.74 (G2P7), 28.45±1.43 (G3P7), 28.35±0.42 (G4P7) and 30.19±1.30 (G6P[8]). Melting curve analysis confirmed specificity with single peaks at 77.03±0.03°C (G1P7), 74.50±0.07°C (G2P7), 76.42±0.21°C (G3P7), 75.58±0.17°C (G4P7), and 77.29±0.29°C (G6P[8]). Intra-assay repeatability showed %CV values of 0.14-11.47 (Ct) and 0.01-0.38 (Tm), while inter-assay reproducibility ranged from 0.68-9.51 (Ct) and 0.06-0.26 (Tm). Ruggedness/robustness testing across analysts yielded %CV 2.17-11.47 (Ct) and 0.04-0.32 (Tm). These results confirm the method’s consistency and effectively identified rotavirus strains in vaccines, supporting reliable vaccine quality control and surveillance efforts.

Development of a Practice Guideline for Patient Preparation for Colonoscopy, Tapan Hin Crown Prince Hospital, Phichit Province

2025-07-30T09:04:32+07:00

Colorectal cancer is a significant public health issue. Colonoscopy is an effective screening method that reduces mortality rates. However, its success relies heavily on adequate bowel preparation. Inadequate bowel preparation may hinder the physician’s ability to detect abnormalities in the colon effectively. Objective: To develop a clinical practice guideline for bowel preparation in patients undergoing colonoscopy for colorectal cancer screening and to assess its feasibility in application at Tapan Hin Crown Prince Hospital, Phichit Province. Methods: This developmental research was conducted from February to April 2025, utilizing the One Day Surgery (ODS) concept from the Department of Medical Services, Ministry of Public Health, in combination with the NHMRC clinical practice guideline development framework from Australia. The participants included 5 healthcare professionals involved in developing the guidelines, 10 healthcare providers who piloted its implementation and 10 patients who received the implemented guidelines. The research instruments included the Appraisal of Guidelines for Research and Evaluation II (AGREE II), the feasibility assessment form of the guideline, and the bowel cleanliness assessment form. All instruments were evaluated for content validity by five experts, an index of item-objective congruence (IOC) of 1.00. Reliability analysis using Cronbach’s alpha coefficient demonstrated a reliability value of 0.87. Results: The developed guideline consists of two phases: (1) Pre-colonoscopy phase, which includes FIT test screening, patient education for bowel preparation, and bowel cleanliness assessment; and (2) Post-colonoscopy phase, which includes post-procedural care and the provision of discharge instructions. The guideline was evaluated for quality by five experts using the Appraisal of Guidelines for Research and Evaluation II (AGREE) criteria. The quality scores ranged from 95.00% to 97.77%. The overall quality score of the guideline was 96.66%. All experts agreed that the guideline was appropriate for implementation. All participants involved in the implementation of the guideline agreed that the protocol demonstrated clarity, promoted consistent understanding among healthcare teams, was easy to implement, exhibited practical feasibility within clinical settings, and was associated with a high level of user satisfaction. Intestinal cleanliness was at a very good level ( = 3.90, SD = .316). Conclusion: The developed guideline was found to be appropriate and feasible for implementation at Tapan Hin Crown Prince Hospital, Phichit Province. Recommendation: The guidelines should be implemented to evaluate its effectiveness and extended to hospitals with similar contexts.

Effectiveness of the SKT Meditation Program on Body Mass Index, Waist Circumference, and Health Behaviors in Overweight Students

2025-08-26T13:48:02+07:00

The prevalence of adolescent overweight conditions poses a considerable challenge, requiring innovative and effective behavioral interventions. This study utilized a quasi-experimental, one-group time-series design to investigate the efficacy of the SKT Meditation Program on Body Mass Index (BMI), waist circumference (WC), and health behaviors among 27 overweight university students (BMI ≥ 23 kg/m²). Participants engaged in an 8-week SKT program (Techniques 1, 2, and 7) alongside nutrition and 3 A’s 2 S’s health behaviors promotion, with outcomes measured pre- and post-intervention. The results demonstrated a statistically significant elevation in mean scores for nutritional knowledge and 3 A’s 2 S’s health behaviors promotion (p < 0.01), with large effect sizes ( = 2.87 - 4.77). Furthermore, the program led to a statistically significant decrease in BMI, WC, and FBG (p<0.01). Repeated Measures ANOVA established a substantial practical effect size ( : 0.49−0.68) across all physiological variables, with FBG demonstrating a significant and rapid decrease beginning in Week 2 and exhibiting the highest effect size ( = 0.68), indicating a marked efficacy on glucose metabolism. In summary, the SKT Meditation Program exhibits significant potential and minimal expense for enhancing holistic health and mitigating cardiometabolic risk among students, thereby endorsing its implementation as a scalable, integrated health promotion strategy for analogous populations in the future.

Comparative Study of Immunogenicity and reactogenicity of ChAdOx1 vaccine in patients with autoimmune inflammatory rheumatic diseases and healthy controls

2025-04-25T08:34:29+07:00

The data are limited on vaccine responses in patients with autoimmune inflammatory rheumatic disease (AIRD), especially for the adenoviral vector ChAdOx1 vaccine. This single-center prospective cohort study evaluated the immunogenicity and safety of ChAdOx1 vaccine in patients with AIRD at Chulabhorn Hospital, Thailand. Thirty-five patients with AIRDs were enrolled between June 9 and July 1, 2021. The immune response and reactogenicity data of 70 healthcare workers (age- and sex-frequency matched) were used as a control group. All participants were vaccinated with two doses of ChAdOx1 vaccine with a 3-month interval. Antibodies against the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein were assessed prevaccination, 3 months after the first dose, and 1 month after the second dose. Disease activity and reactogenicity were assessed before and 7 days after both vaccinations.

The geometric mean concentration of SARS-CoV-2 antibodies at 3 months after the first vaccination was significantly lower in patients than that in healthy controls (21.82 vs 66.01 BAU/mL, P = 0.002), although there was an insignificant decrease in antibody response in patients with AIRDs compared with that in healthy controls at 1 month after the second vaccination (647.05 vs 814.08 BAU/mL, P = 0.484). Vaccines were mostly well tolerated with mild adverse reactions, and no patients experienced a disease flare. The antibody responses of patients with AIRDs did not significantly differ from those of healthy controls but did tend to be lower. Most vaccinations were well-tolerated without postvaccination disease flares.