Medical Journal of Sakon Nakhon Hospital

Nursing Care of a Monkeypox Patient with Immunodeficiency in the Emerging Infectious Disease Intensive Care Unit, Sakon Nakhon Hospital

2025-12-17T14:16:00+07:00

Background: This case study aimed to comprehensively present nursing care for an immunocompromised patient with monkeypox (mpox) by applying Orem's Self-Care Deficit Nursing Theory. Case studies are characterized by the absence of comparison groups, emphasize descriptive narration, and are particularly suitable for studying rare or complex diseases and situations.

Objective: To apply Orem's Self-Care Deficit Nursing Theory in providing nursing care for one immunocompromised patient with monkeypox.

Methods: A 31-year-old Thai male patient with immunocompromised condition who received care from January 2023 to September 2024 was selected. Data were collected through interviews, medical record reviews, and nursing documentation. Nursing diagnoses were established, care plans developed and implemented according to Orem's theory, and outcomes evaluated.

Results: The patient received nursing care applying all three systems of Orem's theory: (1) Wholly compensatory system during the critical phase when the patient was intubated and unable to perform self-care, with nurses providing comprehensive care including life support, infection control, and complication prevention; (2) Partially compensatory system when the patient's condition improved, promoting patient participation in self-care activities such as pain management and physical therapy; and (3) Supportive-educative system, providing education about the disease, infection prevention, and psychological support. Outcomes showed negative infection results following completion of treatment, no preventable complications during both critical and recovery phases, excellent patient and family cooperation with treatment, and reduced anxiety levels.

Conclusion: Application of Orem's Self-Care Deficit Nursing Theory in caring for an immunocompromised patient with monkeypox yielded positive patient outcomes. The adaptation of nursing systems according to the patient's self-care capabilities at each stage of illness enhanced rehabilitation, reduced complications, and improved quality of care.

Prevalence and Serological Characteristics of Hepatitis B, Hepatitis C, Syphilis, and HIV Infections among Blood Donors after Follow-up Testing in Sakon Nakhon Hospital

2025-11-03T16:08:26+07:00

The study aimed to investigate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and human immunodeficiency virus (HIV) infections, as well as the serological characteristics of each pathogen, among blood donors after follow-up testing at Sakon Nakhon hospital. This cross-sectional retrospective study was conducted among blood donors from October 2021 to September 2024. A total of 454 blood donors or 464 samples met the inclusion criteria. The follow-up testing included 234 samples for HBV, 91 for HCV, 101 for syphilis, and 38 for HIV. Data were analyzed using descriptive statistics, including frequency and percentage.

This retrospective study cross-sectional aimed to investigate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, and human immunodeficiency virus (HIV) infections, as well as the serological characteristics of each pathogen, among blood donors after follow-up testing at Sakon Nakhon hospital. This cross-sectional retrospective study was conducted among blood donors from October 2021 to September 2024. A total of 454 blood donors or 464 samples met the inclusion criteria. The follow-up testing included 234 samples for HBV, 91 for HCV, 101 for syphilis, and 38 for HIV. Data were analyzed using the descriptive statistics.

The study found that there were 349 infected blood donors (76.87%). The prevalence of infection was as follows: HBV at 48.90%, syphilis at 18.06%, HCV at 5.73%, HIV at 3.08%, HIV and syphilis co-infection at 0.66%, HBV and syphilis co-infection at 0.22%, and HIV and HCV co-infection at 0.22%. These donors were deferred from blood donation and referred for treatment. Ninety-on donors (20.04%) were non-infected and were allowed to continue blood donation while 14 donors (3.08%) with inconclusive results were scheduled for retesting. Regarding the serological characteristics, the majority of follow-up blood donors were infected. The rate of HBsAg positive results for HBV infection was 57.26%. For syphilis, the rate of Treponemal Ab positive and RPR reactive results was 80.23%. For HIV, the rate of HIV Ag/Ab positive results was 47.37%. In contrast, the majority of HCV results were anti-HCV negative at 70.33%.

In summary, the majority of follow-up blood donors were confirmed to have actual infections. Screening through both serological and Nucleic Acid Testing (NAT) methods can enhance patient blood transfusion safety. The continuation of blood donation depends on several factors including the testing methods, the duration of follow-up, and donor’s cooperation.

Correlation between cytology and pathology reports in diagnosis of thyroid carcinoma

2025-11-10T13:42:25+07:00

Thyroid cancer diagnosis by needle aspiration and cytological evaluation is a more convenient pathological evaluation method than pathological examination. One particularly common cytological evaluation system is The Bethesda System for Reposting Thyroid Cancer (TBSRTC), which has been used in the United States since 2007 and is widely adopted worldwide. Nevertheless, due to genetic differences and differences in factors that may affect genetics (epigenetics), this study aimed to evaluate the relationship between thyroid cancer results by cytological examination and pathological examination for patients in Sakon Nakhon Province, Thailand.

The study collected data from 372 thyroid tumor patients who underwent cytological examination using the TBSRTC system and received thyroid surgery at Sakon Nakhon Hospital from 2019-2023. Rank biserial correlation analysis found a large correlation between thyroid cancer examination results by cytological examination and pathological examination (coefficient 0.497714, 95% confidence interval 0.343475-0.6519531, large effect size). Analysis of the diagnostic performance found that the cytological examination had a sensitivity of 12.5%, a specificity of 100%, a probability that thyroid cancer patients would be examined by aspirating a needle for cytological examination with a positive predictive value of 100%, a probability that thyroid cancer patients would be examined by aspirating a needle for cytological examination with a negative predictive value of 74.7%, an accuracy of cytological examination of 75%, and a precision of 100%.

The Effects of an Isan Folk Music Therapy and Integrated Media Program on Depression in Nursing Students at a Nursing College

2025-11-04T11:26:20+07:00

This two-group quasi-experimental research aimed to compare the mean depression scores of students in the experimental group before and after receiving the program and to compare the mean depression scores of students in the experimental group and the control group after receiving the integrated program of Isan folk music therapy and mixed media. The sample consisted of 50 nursing students in years 1–4 of the academic year 2025. Fifty students with depression scores ranging from 7 to 12 were purposefully selected. 25 students were assigned to the experimental group and 25 students to the control group. The control group received normal care. The experimental group received the program via the Line application for 4 weeks, a total of 12 sessions, 3 days a week, 30–40 minutes a day. The experimental instrument was an integrated program of Isan folk music therapy and mixed media. It was tested for content validity with a CVI of 0.80. The data collection tools included a general information questionnaire, the 11Q depression assessment form, and a satisfaction assessment form. The Cronbach's alpha coefficient was 0.80. Data were analyzed using descriptive statistics, paired t-tests, and independent t-tests.

The results revealed that students who received the program had a mean depression score after the program (M=5.80, S.D. = 4.830) that was significantly lower than before (M = 9.40, S.D. = 1.354), at a statistically significant level of .05. The experimental group also had a mean depression score after the program (M = 5.80, S.D. = 4.830) that was significantly lower than the control group (M = 9.20, S.D. = 2.550), at a statistically significant level of .05. The results indicated that the integrated Isan music therapy and mixed media program reduced students' depression. Therefore, the program should be used in other student groups.

Epidemiology of Open Globe Injuries in Sakon Nakhon Hospital: A Single Tertiary-Care Center Retrospective Chart Review

2025-11-06T11:04:03+07:00

This descriptive study examined the demographic characteristics, injury mechanisms, clinical features, and factors associated with visual outcomes in patients with open globe injuries at Sakon Nakhon Hospital. A retrospective review was conducted of all 217 patients treated at Sakon Nakhon Hospital between January 1, 2015, and December 31, 2024. Data were collected on demographics, injury mechanisms, wound characteristics, treatment modalities, and visual acuity. Statistical analyses included descriptive statistics, univariate analysis, and multivariable logistic regression to identify independent predictive factors.

The results revealed that the majority of patients were male (84.3%) and of working age (65.9%). The primary cause was sharp objects (66.4%). The cornea was the most common injury site (88.5%). Following treatment, most patients continued to have unfavorable final visual outcomes (< 20/200). Multivariable logistic regression analysis identified factors independently associated with unfavorable final visual acuity with statistical significance, including: wound size greater than 10 millimeters (p < 0.05), vitreous hemorrhage (p < 0.05), retinal detachment (p < 0.05), and poor initial visual acuity (p < 0.05).

Open globe injuries at Sakon Nakhon Hospital predominantly affect working-age males. Independent prognostic factors associated with unfavorable visual outcomes include wound size exceeding 10 millimeters, vitreous hemorrhage, retinal detachment, and poor initial visual acuity. These findings are crucial for disease assessment, patient counseling, and appropriate treatment I.

Patient Satisfaction with One Day Surgery and Minimally Invasive Surgery Services In Sakon Nakhon Hospital

2025-11-04T14:57:03+07:00

This cross-sectional descriptive study aimed to examine the satisfaction of patient who underwent One Day Surgery and Minimally Invasive Surgery at Sakon Nakhon Hospital. The sample consisted of 422 patients who received One Day Surgery and Minimally Invasive Surgery services. The research instrument was a patient satisfaction questionnaire for One Day Surgery and Minimally Invasive Surgery, developed and adapted by the researcher from the Outpatient Service Satisfaction Questionnaire of the Thailand Nursing and Midwifery Council, the One Day Surgery Satisfaction Questionnaire from Bueng Kan Hospital, in combination with the patient care process evaluation form (Part 3) of the Healthcare Accreditation Institute. The questionnaire was validated for content validity by three experts with a Content Validity Index (CVI) of 0.89 and tested for reliability using Cronbach's alpha coefficient of 0.92. Data were analyzed using descriptive statistics including frequency, percentage, mean, and standard deviation. 4.43 (SD = 0.57)

The results showed that

The overall satisfaction of patients who received day surgery and minimally invasivesurgery services was at a high level (𝑥̄ = 4.43, SD = 0.57). Item-level analysis indicated that four items were rated at the highest level of satisfaction, while thirteen items were rated at a high level. The highest level of patient satisfaction was observed in overall satisfaction with the services received, accounting for 63.5% (𝑥̄ = 4.63, SD = 0.52). This was followed by satisfaction with postoperative follow-up appointments scheduled one week after surgery (62.3%; 𝑥̄ = 4.59, SD = 0.55), satisfaction with receiving necessary information for self-care after surgery (62.3%; 𝑥̄ = 4.57, SD = 0.59), and satisfaction with guidance and recommendations supporting self-care for patients and their families (𝑥̄ = 4.53, SD = 0.52), respectively.

The satisfaction with Nursing Care Based on the 7 Aspects of Care revealed that patients reported the highest level of satisfaction in two aspects and a high level of satisfaction in five aspects. The aspect with the highest level of satisfaction was continuity of care (𝑥̄ = 4.57, SD = 0.59), followed by support for self-care and family involvement (𝑥̄ = 4.55, SD = 0.56).

Effects of a Reduced Severity of Knee Osteoarthritis and Improved Range of Motion Program Using a Thai Traditional Medicine Among Older People in Phayao Province

2025-11-05T11:37:03+07:00

This quasi–experimental research was a one-group pre-test and post-test design before and after participating in the program. The aim was to evaluate effects of a reduced severity of knee osteoarthritis (KOA) and improved range of motion (ROM) program (ROAROM-program) using the Thai traditional medicine among older people in Pha Yao province using a mixed-methods study. The participants were 30 older people aged 60-year-old or over having an Oxford Knee Score for severity of knee osteoarthritis between 0-39 points. The instrument was the program consisted of three treatments for one week: first time a Thai court-type massage with herbal compression, second time herbal compression with knee exercise and third time herbal poultice with knee exercise. Quantitative and qualitative data were collected using a questionnaire and interview guide and were subjected to paired sample t-test and a qualitative content analysis. The results revealed that the participants reduced the severity of KOA (p < .05), including between before the program and follow-up time, score reduced 13 points (11.50-14.49, p < .0001). ROM for Extension was 0 degree at each point, while that for Flexion increased 16.80 degrees (13.97-19.60, p < .001) at follow-up time. The theme emerged: the developed Thai traditional medicine program is appropriate for treating KOA among older people. This study suggests that the program can reduce severity of KOA and improve ROM and is an option for treating knee osteoarthritis among older people.

Pharmaceutical care of patients with type 2 diabetes treated with insulin injections at Sukasem Primary Care Cluster in Sakon Nakhon Province

2025-11-17T10:49:07+07:00

This study is Quasi-experimental research.The objective of this research was to study the results of Pharmaceutical care to knowledges and skills of insulin injection, average of fasting blood sugar, Heamoglobin A1C, and drug- related problem in patients with type 2 diabetes treated with insulin injections at Sukkasem Primary care cluster in Sakon Nakhon province. From 1 August 2022 – 30 July 2023. The data collection tools included interview questionnaire, knowledges and Insulin injection skill assessment form and Drug-related problem assessment based on Pharmaceutical Care Network Europe (PCNE) classification version 9.1. Data were analyzed using descriptive statistics. Mean scores for knowledges and Insulin injection skill were compared using Paired–T Test statistic.

The results showed that knowledges and skills of insulin injection increased significantly (p<0.01), The average of fasting blood sugar and Heamoglobin A1C decreased significantly (p<0.01) after received Pharmaceutical care intervention. The most common patient-related causes of drug problems were patients intentionally using less medication than prescribed or not taking medication at all secondary cause were patients forgetting to take medication. So Pharmaceutical care intervention helps patients have increased knowledges and skills of insulin injection, reduced problem cause of medication, and this process assists in identifying problems, determining causes, and resolving drug-related issues in patients.This results in improved blood glucose control for patients.

Retrospective Comparative Analysis of Surgical Efficacy: Jones Procedure versus Combined Jones-Hotz Technique in the Management of Involutional Entropion

2025-12-17T13:17:05+07:00

Background: Involutional entropion represents a prevalent ophthalmic disorder in Asian populations, particularly amid the demographic transition toward aging societies. The condition significantly impairs patients' quality of life through ocular discomfort and visual disturbances. Age-related attenuation and laxity of the capsulopalpebral fascia (CPF) fundamentally limits the efficacy of isolated Jones retractor plication, necessitating supplementary surgical interventions. This study evaluates the comparative effectiveness of the Jones procedure alone versus a combined Jones-Hotz approach in entropion correction.

Methods: A retrospective comparative cohort study was conducted examining patients who underwent lower eyelid entropion repair between January 2015 and December 2023. All procedures were performed by a single surgeon. The study comprised 88 eyelids divided into two groups: Group A (n=47) underwent Jones retractor plication exclusively, while Group B (n=41) received combined Jones retractor plication with modified Hotz procedure. Inclusion criteria specified involutional entropion without horizontal eyelid laxity and minimum six-month follow-up. Primary outcome measure was recurrence rate; secondary outcome was operative duration.

Results: Demographic characteristics demonstrated no statistically significant intergroup differences (mean age 70.6 years, range 61-92; male predominance 72%). Complete correction of ciliary orientation was achieved in all patients with universal patient satisfaction. Group A demonstrated a recurrence rate of 19.15% (9/47 cases) with mean operative time of 30.6 minutes. Group B exhibited significantly superior outcomes with a recurrence rate of 4.65% (2/41 cases; p<0.05, Fisher's exact test) and mean operative time of 41.4 minutes. The odds ratio of 0.21 indicated Group B patients had approximately 4.76-fold lower recurrence odds compared to Group A. One case of mild, self-resolving ectropion occurred in Group B.

Conclusions: The combined Jones-Hotz procedure demonstrates statistically significant superiority over isolated Jones retractor plication in treating involutional entropion without horizontal laxity, reducing recurrence rates from 19% to 5%. The incremental operative time of 10.8 minutes represents a clinically acceptable trade-off for substantially improved long-term outcomes. This combined approach addresses multiple pathophysiological factors—specifically CPF dehiscence and preseptal orbicularis override—thereby providing comprehensive anatomical correction. These findings support adoption of the combined technique as the preferred surgical intervention for involutional entropion in appropriate candidates.

Comparative Clinical Outcomes of Intravenous r-tPA Administration for Acute Stroke Patients: Hospital-Based vs. Telestroke in Community Hospitals in Sakon Nakhon Province

2025-08-30T17:34:49+07:00

Background: Limited access to acute ischemic stroke treatment leads to delays in administering intravenous thrombolysis (rtPA). This study aims to compare clinical outcomes between patients treated at Sakon Nakhon Hospital (Hub) and those treated via the Telestroke network at community hospitals.

Methods: A prospective cohort study was conducted from 2018 to 2024, involving 457 acute ischemic stroke patients receiving rtPA (262 at the Hub hospital and 195 at community hospitals). The primary outcome was a good functional recovery (modified Rankin Scale [mRS] 0–1) at 90 days. Generalized Linear Models were utilized to identify predictors of good outcomes.

Results: The community hospital group demonstrated a significantly higher rate of good recovery compared to the Hub group (74.36% vs. 57.2%; OR = 0.462, p < 0.001) and a higher rate of improvement within 24 hours (84.1% vs. 72.14%). The mean length of hospital stay was significantly shorter in the Telestroke group (5.09 vs. 7.32 days; p < 0.001). No significant differences were observed in mortality rates (3.1% vs. 4.6%) or symptomatic intracerebral hemorrhage (4.6% vs. 7.3%). Significant predictors for good recovery included age $<60$ years, higher ASPECTS scores, onset-to-door time $<60$ minutes, mechanical thrombectomy, and lower baseline NIHSS scores.

Conclusion: Administering rtPA via Telestroke in community hospitals yields comparable or superior efficacy and safety profiles compared to the stroke center. These findings support the expansion of Telestroke technology to enhance treatment accessibility in rural areas.

The immediate effect after a single session of using Repetitive Peripheral Magnetic Stimulation (rPMS) in patients with Carpal Tunnel Syndrome

2025-12-23T09:32:23+07:00

The study aimed to investigate the efficacy of a single session of repetitive peripheral magnetic stimulation (rPMS) in patients with carpal tunnel syndrome (CTS) caused by median nerve compression. The sample consisted of 34 CTS patients who had been receiving treatment for more than six weeks (medication and exercise). They were randomly divided into two groups: 17 participants in the experimental group received a single session of rPMS, while 17 participants in the control group received sham rPMS. Both groups continued receiving standard treatment. Evaluations included pain scores (VAS), grip strength, and the Thai version of the Boston Carpal Tunnel Questionnaire (Thai BCTQ). Assessments were conducted at baseline, 15 minutes after treatment (VAS, grip strength), and one week post-treatment (VAS, Thai BCTQ).The research instrument used was a repetitive peripheral magnetic stimulation machine, following a protocol designed by the researchers. Data analysis was performed using the following statistical methods: 1) comparison of pain and numbness scores (VAS) with the Independent t-test, 2) comparison of grip strength with the Independent t-test, and 3) comparison of Thai BCTQ scores with the Independent t-test.

The results showed that a single session of rPMS in CTS patients did not demonstrate superior effects compared to the sham group in reducing pain and numbness (15 minutes post-treatment: -0.59 (-1.87, 0.70), P = 0.370; one week post-treatment: -1.00 (-2.44, 0.44) or in improving hand strength (-0.12 (2.04, 1.81), P = 0.902) and Thai BCTQ scores (-0.09 (-0.47, 0.30), P = 0.652).

Effectiveness of Direct-Acting Antivirals for Treatment of Non-cirrhotic patients with Chronic Hepatitis C: A Retrospective Study in Sakon Nakhon Hospital

2025-10-20T14:37:29+07:00

The retrospective cohort study aimed to determine the effectiveness of antiviral medications for treatment of non-cirrhotic patients with chronic hepatitis C, who were examined by infectious disease physicians. The participants were chronic hepatitis C patients without cirrhosis who underwent treatment at the outpatient department of Sakon Nakhon Hospital between January 1^st, 2023 to December 31^st, 2024. Data were collected by searching patient information from medical records. Effectiveness was determined as an undetectable HCV RNA in the blood (<25 IU/mL) at 12 weeks post-treatment. Data were analyzed using the descriptive statistic. The inferential statistics either the Chi-squared test or Fisher’s exact test were applied. Analysis factors effecting SVR by using multivariate logistic regression analysis. The 95% confidence interval and statistical significance level of 0.05 were designated. The study results found that there were 103 patients with a mean age of 47.7 14.2 years, 72.8 % were male, 43.7% were co-infected with HIV, 1.9% were co-infection with HBV, median baseline HV RNA 2,870,000 (720,000-7,143,641) IU/mL, median BMI 21.5 (19.7-24.1) kg/m². Underlying diseases were found 68.9%, divided into diabetes mellitus in 27.2% and hypertension in 34%. Alcohol drinking was found 31.1%. Sustained virological response (SVR) was 96.7%. Co-infection with HIV, HBV, age, sex, BMI and underlying disease did not affect the outcome of treatment.

Conclusion: the effectiveness of DAAs in treating chronic hepatitis C patients without cirrhosis, as determined by non-gastroenterologists, resulted in a 96.7% cure rate and people living with HIV have treatment outcomes no different from those of the general population.

Editorial

2025-12-26T09:35:15+07:00

Editorial Board

2025-12-26T09:36:09+07:00

Content

2025-12-26T09:37:10+07:00