Ramathibodi Medical Journal

Barriers to Achieving Passing BioMedical Admissions Test Scores for Medical and Dental School Admission in Thailand

Sira Pornsiriprasert — 2025-10-10

Background: The BioMedical Admissions Test (BMAT), developed and validated under the UK curriculum, is utilized by many medical and dental schools worldwide for applicant selection. No studies have investigated the fairness of the BMAT in countries with non-UK curricula and limited English usage.

Objectives: To determine the effects of the barriers and compare the disparities in the prevalence between candidates in the Bangkok Metropolitan Region (BMR) and other provinces.

Methods: This study was cross-sectional and quantitative, using contingency tables and nonparametric tests, retrospectively analyzing secondary data from the survey conducted by the RAdiator, a free online education platform targeted at university admission preparation.

Results: From 108 participants with available score data, the presence of BMAT barriers was associated with lower odds of passing the BMAT requirement satisfactory by most medical schools in Thailand and was significantly more prevalent in non-BMR group. The language barrier was the biggest impeding factor to passing the requirement (OR [95% CI], 0.236 [0.103-0.539]; P < .001) and the most pronounced difference in prevalence between BMR and non-BMR groups (OR [95% CI], 2.423 [1.277-4.596]; P = .009). About 82% of the participants used the RAdiator, limiting the samples to those using free unofficial BMAT resources to alleviate the barriers.

Conclusions: There were BMAT barriers for medical and dental admissions which were more prevalent outside the BMR. English proficiency was the core skill to achieve satisfactory BMAT scores. Admission criteria should be adjusted to align with the context, faculty’s values, and learning outcomes.

Development of Muscle Pain Assessment Tool in Thai Traditional Medicine Based on the Praboromarajchanok Institute Model and 7-Color Ping-Pong Life Traffic

Aumpol Bunpean — 2025-10-10

Background: The assessment of muscle pain is essential in determining appropriate self-care practices for initial symptom relief.

Objectives: To develop and evaluate the quality of a Thai traditional medicine-based muscle pain assessment tool following the Praboromarajchanok Institute (PBRI) model.

Methods: In-depth interviews were conducted with 8 Thai traditional medicine practitioners to explore the current situation and needs for developing a Thai traditional medicine muscle pain assessment form based on the concept of the PBRI model. Thirty-two Thai traditional medicine practitioners performed the quality evaluation. The research tools included interview forms and quality assessment forms. Data were analyzed using content analysis and descriptive statistics.

Results: Interviews revealed the need for a simple, easy-to-understand assessment tool that included self-care guidance. The Thai traditional medicine muscle pain assessment form based on the PBRI model consists of 3 parts: a 15-cm visual analogue scale (VAS), a color-coded, 7-level system based on VAS score ranges, ranging from normal (0 cm) to severe (12-15 cm), and self-care practice recommendations for each level. The content validity received an item objective congruence (IOC) value of 1.00. The overall quality of the tool was rated as very good, with an average score of 4.40 out of 5.00.

Conclusions: The developed tool shows potential for use in Thai traditional medical practice. However, further studies are recommended to evaluate its effectiveness in real patient settings and to identify any limitations.

Evaluation of an In-House Melting Curve Analysis Assay for HSV-1 and HSV-2 Detection via Multiplex Real-Time PCR

Kingkan Rakmanee — 2025-10-10

Background: Herpes simplex virus (HSV) has developed mechanisms that allow it to evade the immune system and persist in the body, thus causing diseases and conditions such as sexually transmitted diseases and serious neurological infections.

Objective: To evaluate an in-house melting curve analysis (IHMCA) assay for multiplex real-time polymerase chain reaction (PCR) product to minimize false positive and false negative results in HSV detection.

Methods: A total of 233 clinical specimens were subjected to analysis using the HSV1&2 VZV R-GENE® multiplex real-time PCR assay with melting curve analysis. This analysis was then compared to the Luminex ARIES HSV 1&2 assay.

Results: HSV-1 and HSV-2 demonstrated sensitivity of 90.91% and 96.77%, and specificity of 99.50% and 96.55%. The positive predictive values were 96.77% and 81.08% , and the negative predictive values were 98.51% and 99.49%. The overall accuracy was 98.28% and 96.58%. The assay demonstrated strong agreement with the reference method with statistically significant results (HSV-1: P < .001, SE = 0.04, = 0.93 [95% CI, 0.86-1.00]; HSV-2: P < .001, SE = 0.05, = 0.86 [95% CI, 0.77-0.96]).

Conclusions: Amplicon analysis of the multiplexed real-time PCR product was performed in the same reaction tube without interference from multiple TaqMan probe signals due to the use of a DNA binding dye. The integration of multiplex real-time PCR with melting curve analysis enhances the accuracy and efficiency of HSV detection while potentially reducing costs and turnaround time. Importantly, the IHMCA should be considered as a complementary post-PCR method rather than a replacement for standard assays.

Enhancing the Performance of the CDC Protocol for Real-Time RT-PCR Detection of Influenza A Virus via Post-PCR Melting Curve Analysis

Treewat Watthanachokchai — 2025-10-10

Background: Influenza has a significant impact on health, society and the economy worldwide.

Objective: To enhance the accuracy and precision of influenza A virus detection.

Methods: Detection of viral genetic material was performed using real-time reverse transcription-polymerase chain reaction (RT-PCR), followed by melting curve analysis of the real-time RT-PCR product.

Results: To enhance diagnostic performance, a novel in-house melting curve analysis assay developed for real-time RT-PCR product, achieving a sensitivity of 96.06% (95% CI, 91.05-98.71) and specificity of 100.00% (95% CI, 95.94-100.00). The assay also demonstrated a positive predictive value of 100.00% (95% CI, 97.02-100.00), a negative predictive value of 94.68% (95% CI, 88.29-97.68) and an accuracy of 97.69% (95% CI, 94.68-99.24). The assay showed high concordance with the NxTAG® Respiratory Pathogen Panel (, 0.95; 95% CI, 0.91-0.99; SE, 0.02; P < .001).

Conclusions: This study demonstrated that post-PCR amplicon analysis via melting curve analysis can be performed in a single tube without interference from the hydrolysis probe. Integrating both methods into the same workflow reduces turnaround time for repeat testing, lowers costs, and minimizes labor requirements. As a result, this combined approach improves the efficiency, sensitivity, and specificity of influenza A virus detection, making it a robust tool for laboratory diagnostics.

Factors Influencing the Research and Development Performance of Support Staff in the Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University

Paichit Inpanya — 2025-10-10

Background: Previous surveys have indicated limited academic output among support staff in the Department of Family Medicine. Accordingly, this study investigates the factors that promote their participation in research and development activities.

Objective: To investigate the factors influencing research and development performance among support staff in the Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University.

Methods: A mixed methods research study using an explanatory sequential design was conducted. The quantitative phase involved 33 support staff participants who completed a questionnaire. In the qualitative phase, 18 participants were selected through purposive sampling for in-depth interviews. The results were synthesized using qualitative data to support and expand upon the quantitative results.

Results: The study identified factors with a strong influence as follows: 1) individual factors, including time management and attitude toward research and development; 2) motivational factors, such as career advancement and job responsibilities; and 3) facilitating factors, including organizational support, access to equipment and facilities, funding, and a conducive work environment. Qualitative data further revealed additional influencing factors, such as curiosity, responsibility, inspiration from a positive role model, career advancement, increased compensation, challenges, acquisition of new knowledge, work improvement, professional credibility, strong organizational support, access to mentors or advisors, teamwork, work environment, and facilities.

Conclusions: This study demonstrates factors influencing participation in research and development performance, particularly time management, career advancement, and organizational support, including advisors and team collaboration. With appropriate support and encouragement, these factors can enhance academic engagement and productivity among support staff.

Factors Related to Sexually Transmitted Disease Prevention Behavior Among Female Sex Workers in the Thai-Malaysian Border Area

Fareeda Kasor — 2025-10-10

Background: The incidence of sexually transmitted infections (STIs) in Thailand continues to rise. In Songkhla province, the number of female sex workers undergoing STI screening has declined, while new cases of HIV and other STIs are still reported annually.

Objectives: To study the level of sexually transmitted disease prevention behavior and the factors related to sexually transmitted disease prevention behavior among female sex workers in the Thai-Malaysian border area.

Methods: A cross-sectional survey was conducted among 242 female sex workers in the Thai-Malaysian border area. Participants were selected using convenience sampling. Data were collected using a structured questionnaire and analyzed using descriptive statistics and multiple logistic regression.

Results: The results showed that the sample had a non-risky level of sexually transmitted disease prevention behavior (52.48 %). Factors associated with sexually transmitted disease prevention behavior among female sex workers include monthly income/compensation, household composition, history of STI screening, predisposing factors including attitude, enabling factors such as access to health services and condoms, and reinforcing factors such as social support.

Conclusions: Only about half of the female sex workers had a non-risky level of sexually transmitted disease prevention behavior. Healthcare providers should implement proactive screening services, promote access to health services, and strengthen social support mechanisms to improve preventive behaviors in this population.

Hepatotoxicity in Elderly Tuberculosis Patient With Low NAT2 Activity Receiving Isoniazid: A Case Report

Benyapa Phetpavararak — 2025-10-10

Background: Isoniazid is a medication used in the treatment of tuberculosis. Hepatotoxicity is a common side effect associated with this drug. Currently, studies have investigated the N-acetyltransferase 2 (NAT2) gene, which plays a role in the metabolism of isoniazid in the liver, converting it into non-hepatotoxic substances that are eliminated from the body. NAT2 polymorphisms determine acetylation phenotype, which can be classified into rapid, intermediate, and slow acetylators.

Case Presentation: A 92-year-old Thai female patient weighing 39.6 kg, diagnosed with pulmonary tuberculosis and malnutrition. Genetic testing showed that she had the slow acetylation phenotype of NAT2. The patient was started on a standard anti-tuberculosis regimen, which included isoniazid, rifampicin, pyrazinamide, and ethambutol, with a daily dose of 300 mg of isoniazid. Liver function tests, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin, were monitored regularly. After 16 days of treatment, the levels of AST increased to more than 3 times the upper limit of normal, with no clinical signs. By day 18, these levels surged to more than 5 times the upper limit, leading to a change in the treatment regimen to ethambutol, amikacin, and levofloxacin. Subsequently, AST levels decreased to below twice the normal range, allowing the reintroduction of rifampicin, ethambutol, and levofloxacin. Within 8 days, AST levels returned to normal.

Conclusions: This case study presents risk factors that may contribute to isoniazid-induced hepatotoxicity, including advanced age, low NAT2 enzyme activity, and the consideration of an appropriate duration for monitoring liver enzyme levels to prevent severe liver toxicity.

Sleep Quality of Health Status and Health Promotion in School-Age Children

Waraphan Wongchan — 2025-10-10

Getting adequate and high-quality sleep is a key component of good health, particularly for school-age children, as it plays a crucial role in stimulating growth hormones, supporting bone and muscle development, repairing numerous, systems and allowing the body to recuperate. Additionally, it supports learning, memory, focus, a positive outlook, a calm mind, and an openness to new experiences every day. Moreover, getting an adequate amount of sleep gives children the confidence they need to engage and communicate with others. As a result, it helps build a positive personality, strengthens immunity, and guards against long-term and noncommunicable illnesses. On the other hand, school-age children's physical, mental, emotional, social, and intellectual development, as well as their general health, would be impacted if they experience inadequate sleep or poor sleep quality. In conclusion, promoting good sleep quality is a crucial aspect of preventative health. This article aims to present the importance of sleep quality, factors affecting sleep quality, benefits, and effects of sleep quality in school-age children. This academic paper can be a guideline for proactively promoting health and helping prevent diseases in school-age children, both now and future.