Buddhasothorn Hospital Journal

Diagnosis of Upper aerodigestive tract (UADT) Foreign Bodies: A Retrospective Comparison between Plain Film Neck and Laryngeal Endoscopy

Salinee Jansutrukwong — 2026-04-01

Introduction : Foreign bodies in the upper aerodigestive tract (UADT) are a common emergency encountered at Buddhasothorn Hospital. Delayed diagnosis or treatment can lead to significant complications. Plain Film Neck is often used as an initial diagnostic tool; however, its accuracy may be limited when the foreign body is radiolucent or obscured by overlying anatomical structures. In contrast, laryngeal endoscopy provides direct visualization of UADT, and also allows for simultaneous removal of foreign bodies.

Objectives : This study aimed to compare the diagnostic accuracy of Plain Film Neck with Laryngeal Endoscopy for detecting foreign bodies in the UADT, to assess the strengths and limitations of each modality, and to propose the most appropriate diagnostic approach for use at Buddhasothorn Hospital.

Methods : A retrospective observational study was conducted on patients presenting with symptoms suspected UADT foreign bodies at Buddhasothorn Hospital between 1 January and 31 December 2024. A total of 111 patients who underwent both Plain Film Neck and Laryngeal Endoscopy were included. Diagnostic results from each modality were compared with the final confirmed diagnosis, which served as the reference standard.

Results : The most commonly found foreign bodies were fish bones, and the base of the tongue was the most frequent site of impaction. Laryngeal Endoscopy demonstrated an accuracy of 100% (95% CI, 96.72–100.00%), with both sensitivity and specificity of 100%. In contrast, Plain Film Neck showed an accuracy of 40.54% (95% CI, 31.29–49.79%), sensitivity of 23.26%, and specificity of 51.47%. Statistical comparison yielded a P-value of 0.90 and a Kappa coefficient of –0.25

Conclusion : Laryngeal endoscopy is appropriate as the primary diagnostic modality for detecting foreign bodies in the upper aerodigestive tract, owing to its high accuracy. Conversely, plain neck radiography demonstrates limited sensitivity and diagnostic accuracy for this condition. In clinical practice, early laryngeal endoscopy should be considered, particularly in patients with clear indicative symptoms, to reduce complications and enhance treatment efficiency.

Comparison of Postoperative Complications Before and After Implementation of a Care Protocol for Upper Eyelid Ptosis Surgery With Assessment of Patient Satisfaction and Compliance Following Protocol Use

Naphan Buarabporn — 2026-04-01

Background:
Upper eyelid ptosis is a common condition that affects both visual function and facial appearance, particularly in patients undergoing correction with the levator advancement technique. In the absence of standardized postoperative care guidelines, misunderstandings in self-care may occur, leading to an increased risk of postoperative complications and reduced patient satisfaction. Samutprakan Hospital therefore developed a written postoperative care protocol for patients undergoing ptosis correction surgery to ensure consistent and clear postoperative management.

Objective:
To compare postoperative complication rates, patient satisfaction, and adherence to postoperative instructions before and after implementation of the written postoperative care protocol.

Methods:
This comparative descriptive study included 80 patients diagnosed with upper eyelid ptosis who underwent correction using the levator advancement technique with a standardized surgical approach. Patients were divided into two groups: 40 patients treated before and 40 patients treated after protocol implementation. The postoperative care protocol consisted of written instructions regarding wound care, medication use, cold compress application, and postoperative follow-up. The protocol was explained to patients by the surgeon preoperatively and reinforced by nursing staff postoperatively. Data were analyzed using Chi-square test, Fisher’s exact test, and Independent t-test.

Results:
Postoperative complications were observed in 9 patients (22.5%) in the pre-protocol group, whereas no complications were reported in the post-protocol group. The overall patient satisfaction score increased from 4.0 to 4.5 (p < 0.001), and adherence to postoperative instructions improved from 8.3 to 9.5 (p < 0.001).

Conclusion:
The implementation of a written postoperative care protocol for patients undergoing upper eyelid ptosis correction surgery effectively reduced postoperative complications, improved adherence to postoperative instructions, and significantly increased patient satisfaction.

Factors related to Hearing Loss in Patients with Type 2 Diabetes at Trat Hospital

Taratip Treeratrudee — 2026-04-01

Background

Hearing loss is characterized by a reduction in an individual’s ability to perceive sound at levels considered normal, thereby compromising the capacity to detect auditory signals essential for understanding speech and environmental sounds. The condition typically progresses insidiously, with minimal impact on communication during its early stages. As the impairment advances, however, affected individuals increasingly experience significant difficulties in auditory perception and verbal communication, which may substantially disrupt daily functioning. Diabetes constitutes a chronic, multisystem disease and remains a growing global public health challenge. Its complications frequently involve microvascular damage to the small blood vessels supplying peripheral nerves, resulting in diminished neural conduction and gradual functional deterioration. The auditory nerve is among the neural structures susceptible to such pathological changes. A substantial body of literature has demonstrated a significant association between diabetes and hearing impairment, indicating that individuals with diabetes exhibit a higher prevalence of hearing loss compared with non-diabetic populations. At present, sensorineural hearing loss is an irreversible condition. Current management strategies, including the use of hearing aids, focus on alleviating functional limitations and improving patients’ quality of life to a certain extent. Consequently, early identification of hearing impairment is of critical importance. Timely detection enables appropriate clinical management and longitudinal monitoring, which may help attenuate the progression of auditory decline and reduce the likelihood of premature or advanced hearing deterioration.

Objectives

To assess the hearing levels of patients with type 2 diabetes.
To determine the prevalence of sensorineural hearing loss among patients with type 2 diabetes.
To identify factors related to sensorineural hearing loss in patients with type 2 diabetes.
To examine the magnitude of the factors associated with sensorineural hearing loss in patients with type 2 diabetes.

Methods

This study employed a cross-sectional analytical design to determine the prevalence of sensorineural hearing loss and identify associated factors among patients with type 2 diabetes attending the Diabetes Clinic at Trat Hospital during the 2025 fiscal year. Participants were selected using purposive sampling based on predefined inclusion criteria.

Data collection included general demographic information—such as sex, age, and occupation—as well as relevant health-related variables, including duration of diabetes, comorbid conditions, smoking status, body mass index, and laboratory parameters (fasting blood sugar, HbA1c, and estimated glomerular filtration rate). Following data collection, all eligible participants were referred for audiometric evaluation at the Otolaryngology Clinic of Trat Hospital to assess their hearing levels.

Results

Among patients with type 2 diabetes, the majority exhibited normal hearing thresholds in the speech-frequency range in both ears. Among those with hearing impairment, mild sensorineural hearing loss was most commonly observed, followed by moderate and moderately severe levels, respectively. No cases of severe hearing loss or profound deafness were identified.

The prevalence of speech-frequency hearing loss in either ear or both ears was 21.5%, while high-frequency hearing loss was observed in 55.4% of the participants. Male patients demonstrated a higher tendency toward high-frequency hearing impairment compared with female patients. The highest prevalence of both speech-frequency and high-frequency hearing loss was found among individuals aged 51–60 years. Analysis of factors associated with speech-frequency hearing loss indicated that age was significantly associated with hearing impairment among patients with type 2 diabetes. Patients aged 51–60 years had a 12.04-fold increased risk compared with those aged 30–40 years. For high-frequency hearing loss, sex, age, duration of diabetes, and body mass index were significantly associated factors. Male patients had a 6.07-fold higher risk compared with female patients. Patients aged 41–50 years and 51–60 years had 4.04-fold and 15.09-fold higher risks, respectively, compared with those aged 30–40 years. In addition, patients with a duration of diabetes greater than 10 years had a 4.06-fold increased risk compared with those with a duration of less than 5 years.

Conclusion

Most patients with type 2 diabetes exhibited normal hearing thresholds within the speech-frequency range. Among those with hearing impairment, mild hearing loss was the most commonly observed severity level. In contrast, a markedly higher proportion of patients demonstrated high-frequency hearing loss, indicating that auditory dysfunction in individuals with type 2 diabetes tends to manifest initially at high frequencies. Age was identified as the factor associated with speech-frequency hearing loss. For high-frequency hearing loss, the associated factors included sex, age, duration of diabetes, and body mass index. Increasing age was the strongest risk factor for high-frequency hearing loss, followed by male sex and longer duration of diabetes.

Prevalence and Factors Associated with Pre-Participation Health Screening among Runners in Thailand

Natchaya Kaewma — 2026-04-01

Background: Running is highly popular in Thailand, yet the risk of sudden cardiac arrest in runners with underlying conditions remains a concern. Pre-participation health screening is crucial, but data in the Thai context is lacking.

Objective: To assess the prevalence of having undergone pre-participation screening and associated factors, combined with an assessment of health risks using the PAR-Q+ questionnaire.

Methods: A descriptive cross-sectional study was conducted on 394 runners at a running event in Nakhon Phanom. Data were collected via an online questionnaire, and associations were analyzed using Chi-square and Fisher’s exact tests.

Results: Only 3.05% of runners had undergone pre-participation health screening, significantly lower than the 25.38% classified as "high risk" by PAR-Q+. The primary risks identified were hypertension and musculoskeletal problems. Although 92.64% agreed with mandatory screening, actual screening practice was significantly associated with education level (p < 0.001) and income (p = 0.010), whereas health risk status showed no correlation (p = 1.000).

Conclusion: Thai runners face high health risks but have low access to screening, limited by socioeconomic factors. Promoting accessible preliminary screening tools is therefore essential to reduce adverse events from running.