The Journal of Chulabhorn Royal Academy

A study of local wisdom regarding therapeutics in Sisaket province

2025-03-05T14:05:24+07:00

Background: The use of local wisdom is an alternative treatment with various methods, which is treated with local resources by experienced folk healers. Objective: Study knowledge about local wisdom regarding therapeutics in Sisaket province. Methods: Descriptive qualitative research, the informants were 25 traditional doctors in Sisaket province. The research instrument were a researchers and Semi-structured in-depth interview guideline. Data were collected through in-depth interviews, participant and non-participant observation. Data were analyzed using a content analysis method with a non-theoretical situation analysis approach.. Results: The knowledge of local wisdom regarding disease treatment can be categorized into six groups: (1) Sources of knowledge and transmission of local wisdom, (2) Herbal wisdom in therapeutics which were divided into 12 groups of symptoms, (4) Regulations for patients receiving treatment from folk healers, (5) Ethical practices of folk healers, and (6) Challenges and obstacles in transferring knowledge to the next generations. Conclusion: Therapeutics with the local wisdom remains popular due to its simplicity, minimal side effects, less expenses, and less suffer from treatment. Therefore, it serves as an alternative treatment that should be appropriately integrated with modern medical practices.

Integrating coronary artery calcium scores into primary prevention for acute coronary syndrome in patients with noncommunicable disease: A system development approach in Phetchabun Hospital

2025-02-11T09:24:06+07:00

Background: Acute coronary syndrome (ACS) is a major public health issue and a leading cause of death in Thailand. Primary prevention, holistic management, and secondary prevention play vital roles in its management. Objective: This study aimed to identify systemic issues in ACS primary prevention in Phetchabun Hospital and examine the impact of a new holistic, multidisciplinary paradigm approach for ACS primary prevention. Methods: This research and development study included patients being treated for noncommunicable disease (NCD) at Phetchabun Hospital. The patients’ coronary artery calcium scores (CACSs) were compared between the ACS and non-ACS groups. Treatment outcomes before and after the implementation of the holistic integration approach were also compared. Results: Of the 171 patients with NCD, 55% were treated with an inappropriate level of statins (75.3% undertreated and the rest overtreated) based on their 10-year atherosclerotic cardiovascular disease risk score. The average CACS was significantly higher in the ACS group (417.50; interquartile range [IQR]: 147.25–688.27) than in the non-ACS group (0; IQR: 0–27.90, p < 0.001). In addition, the holistic approach significantly reduced total cholesterol (200.16 ± 53.22 vs. 148.26 ± 38.53, p < 0.001), low-density lipoprotein cholesterol (127.48 ± 43.28 vs. 77.70 ± 32.24, p < 0.001), fasting blood glucose (130.38 ± 56.48 vs. 115.78 ± 50.45, p = 0.022), and body weight (67.12 ± 12.60 vs. 66.03 ± 11.73, p = 0.01). Conclusion: Over half of the patients with NCD received suboptimal management. CACS effectively helped distinguish ACS from non-ACS cases. A multidisciplinary, holistic approach significantly improved primary prevention outcomes for patients with NCD.

Importance of early ambulation after abdominal surgery : Nurses’ role

2024-12-12T14:49:31+07:00

Abdominal surgery is a surgical procedure performed that involves opening the abdominal cavity and/or pelvic cavity to diagnose and/or treat conditions affecting the organs and tissues in that area. The operation commonly causes pain which usually leads to postoperative complications; such as lung atelectasis and post-operative ileus which resulting in increased hospital cost and length of stay. Nurses are responsible for providing closely and continuity patient care. Therefore, they have significant in preventing postoperative complications and ensure safety via providing proper pre operative and post operative recommendations, control post-operative pain, discomfort after abdominal surgery and encourage the patients to move and engage in early ambulation activities.

Contamination of Phthalates and Policy Recommendations for Thailand

2024-12-26T08:13:10+07:00

This article provides an overview of phthalate contamination in Thailand, reviews the existing laws on phthalate regulation, and provides policy recommendations to strengthen the regulation and monitoring of phthalates domestically. According to the literature review, phthalates have been detected in children's toys, exceeding the permissible level by approximately 31%. Phthalates have also been found to average 2,382.3 µg/g of dust in household dust at concentrations higher than in Korea. In addition, phthalate metabolites were detected in the urine of Thai children and adolescents, suggesting widespread exposure to phthalates among these vulnerable populations. Although the health impacts of phthalates have been reported in the literature (e.g., disrupting the endocrine system, causing abnormalities in various organs and systems, etc.), only a few phthalates have been regulated in Thailand. Four out of >30 existing phthalates are listed on the Thailand Hazardous Substance Act as Type III Hazardous Substances, which requires specific registration and permission from the Department of Industrial Works to produce, import, export, and possess these substances. In Thailand, phthalates are regulated only in 3 types of products: food wrapping films, cosmetics, and children's toys. Thus, to protect the health of Thai people from phthalate exposure, integrative efforts are required to strengthen the existing regulations to cover more than four phthalates by adding DiNP, DnOP, DnPP, and DBP to the Thailand Hazardous Substance Act, provide detailed information on the phthalate quantity or concentration in product labels, communicate health risk information to the public frequently, develop more laboratory facilities to measure phthalates in products, the environment, and humans, and consider the use of appropriate phthalate alternatives.

Neurofeedback for children with attention deficit hyperactivity disorder

2025-01-30T13:04:05+07:00

Attention Deficit/Hyperactivity Disorder (ADHD) in Children discusses ADHD as a significant psychiatric disorder in children and adolescents. The condition results from dysfunction in the frontal lobe of the brain and reduced secretion of the neurotransmitters dopamine and noradrenaline. These abnormalities lead to symptoms such as inattention, hyperactivity, and impulsivity, which are more pronounced compared to typically developing children. Symptoms can be observed as early as the preschool years and become more prevalent in school-aged children. Currently, standardized and globally recognized screening and diagnostic guidelines for ADHD enable timely diagnosis and treatment. Various treatment approaches are available, including stimulant medications, behavioral therapy, neurofeedback, and combined methods. The primary goal of treatment is to help children regulate their behavior, improve learning, and enhance social interactions, though treatment effectiveness varies across different approaches. This article aims to present neurofeedback therapy as an alternative treatment for children with ADHD. Neurofeedback has been shown to yield positive outcomes in managing core ADHD symptoms, offering a safe and internationally recognized therapeutic option.

Perioperative Nursing: Challenges and Opportunities in the Gastrointestinal Endoscopy Units

2024-11-01T15:10:33+07:00

Perioperative nursing in the Gastrointestinal endoscopy units plays a pivotal role in ensuring safe and effective patient care during endoscopic procedures. This article explores the multifaceted challenges and promising opportunities within this specialized nursing discipline. The challenges encompass diverse domains, including addressing patient anxiety through effective education and emotional support, meticulous infection control practices to prevent healthcare-associated infections, vigilant monitoring of sedated patients, and adept management of emergencies during procedures. Additionally, this article underscores the importance of accommodating special considerations for pediatric and geriatric patients, navigating ethical dilemmas, and respecting cultural diversity.

Conversely, opportunities for improvement in perioperative nursing are abundant. These encompass technological advancements in endoscopic equipment and the integration of health information technology, enhanced training and education through continuing education programs and simulation-based training, fostering multidisciplinary collaboration for comprehensive patient care, and the establishment of robust quality assurance and best practices. Moreover, the article highlights the significance of patient-centered care. It discusses patient education and informed consent, enhancing the patient experience, addressing cultural and ethical considerations, and ensuring privacy and dignity in the perioperative setting.