Digital Commons Network^™

The Comparison Of Lung Shunt Fraction Calculation Using Tc-99m Maa Planar And Spect/Ct Imaging For Y-90 Radioembolization, Nut Noipinit, Thunyaluk Sawatnatee, Benchamat Phromphao, Peangtawan Ratsameechot, Sutida Thiambandit, Tanawat Sontrapornpol

Chulalongkorn Medical Journal

Background: The evaluation of hepatopulmonary blood vessels with Technetium-99m macroaggregated albumin (Tc-99m MAA) scintigraphy before radioembolization with Yttrium-90 (Y-90) microspheres is a test to assess and prevent radiation pneumonitis. It was determined by the lung shunt fraction (LSF) which was calculated from a planar and SPECT/CT images. This study aimed to compare of LSF calculation from Tc-99m MAA planar and SPECT/CT images for Y-90 radioembolization treatment of liver tumors. Methods: A total of 64 patients (42 men and 22 women, mean age 64 ± 12.5 years) who underwent Tc-99m MAA scanning between 2015 and 2022 were enrolled. LSF was calculated …

Prevalence Of Carbapenem-Resistant Klebsiella Pneumoniae In King Chulalongkorn Memorial Hospital, 2019-2023, Napawan Punakabutra, Thanittha Wongkejkit, Nopphon Wuthinantiwong, Tanittha Chatsuwan

Chulalongkorn Medical Journal

Background : Carbapenem-resistant Klebsiella pneumoniae(CR-KP) poses a significant threat to global public health, contributing to high rates of morbidity and mortality.

Objective : The aim of this study was to investigate the prevalence of CR-KP isolated at King Chulalongkorn Memorial Hospital from April 2019 to December 2023, focusing on its distribution across varoius hospital units, including in-patient (IPD), out-patient (OPD), emergency (ER), and intensive care units(ICU).

Methods : A total of 8,983 K. pneumoniae isolates from patients aged > 15 years at King Chulalongkorn Memorial Hospital between April 2019 and December 2023 were studied. The antimicrobial susceptibility to carbapenems was …

Dual Role Of Triphala Extracts In Breast Cancer Therapy: Enhanced Paclitaxel Cytotoxicity By Ethanolic Extract And Cytoprotection By Aqueous Extract, Supamas Charucharana, Poonlarp Cheepsunthorn Ph.D., Chalisa L. Cheepsunthorn Ph.D.

Chulalongkorn Medical Journal

Background: Combining antioxidants with chemotherapy is an emerging strategy to reduce chemotoxicity in normal cells. Triphala (TPL), a polyphenol-rich Thai herbal formulation, has shown promise in enhancing chemotherapy efficacy, but its interaction with paclitaxel (PX) in breast cancer treatment remains underexplored.

Objective: This study evaluates the effects of aqueous (TPL-w) and ethanolic (TPL-a) TPL extracts combined with low-dose PX on breast cancer cells and non-tumorigenic mammary epithelial cells.

Methods: The bioactive components of TPL-w and TPL-a were identified using high-performance liquid chromatography (HPLC). Thiazolyl blue tetrazolium bromide (MTT) and chloromethyl 2′,7′-dichlorodihydrofluorescein diacetate (CM-H₂DCFDA) assays assessed cell viability and …

Dengue At Photharam Hospital: One Among Ten Clinical Trial Sites Of The World's First Dengue Vaccine, Anongrat Tiawilai, Chawin Tiawilai, Thawat Tiawilai, Nattachai Srisawat, Umaporn Limothai, Terapong Tantawichien, Usa Thisyakorn

Chulalongkorn Medical Journal

Background: Dengue, a viral disease transmitted by vectors, is widespread worldwide, impacting more than 120 nations. In 2019, a concerning 5.2 million dengue cases were reported, with Asia bearing 70% of the global burden. Half of the global population faces the risk of dengue.

Objectives: The goal of this research was to illustrate the epidemiological pattern of dengue patients admitted to Photharam Hospital in Ratchaburi province, Thailand, one of the ten clinical trial sites for the world's first dengue vaccine.

Methods: Data from dengue patients admitted to Photharam Hospital, a provincial healthcare center in Ratchaburi province, Thailand, covering the period …

Incidence Of Cytogenetic Abnormalities Detected By Fish Analysis In Multiple Myeloma Cases: A Seven-Year Study From A Cytogenetic Laboratory In King Chulalongkorn Memorial Hospital, Thailand (2018–2024), Montakarn Tansatit, Nutcharee Jongpornchai, Suwannee Songchart, Kittipornpan Krajokpap, Hudadini Da-Oh

Chulalongkorn Medical Journal

Background: Multiple myeloma (MM) is a genetically heterogeneous plasma cell malignancy with cytogenetic abnormalities influencing prognosis and treatment outcomes. Fluorescence in situ hybridization (FISH) is crucial for detecting clinically significant abnormalities, including IGH translocations and deletions (e.g., del(17p)), particularly in non-dividing plasma cells. However, cost and accessibility challenges limit comprehensive testing in resource-constrained settings like Thailand. Objectives: To investigate the incidence of cytogenetic abnormalities detected by FISH in MM cases over seven years in a Thai population, highlighting regional trends and barriers to comprehensive testing. Methods: A retrospective analysis was conducted on 360 bone marrow samples from MM patients between …

Health-Related Quality Of Life Of Patients With And Without Diabetes On Hemodialysis In China: A Comparative Correlational Study, Ziting Han, Aurawamon Sriyuktasuth, Warunee Phligbua

Journal of Health Research

Background: Limited evidence exists on differences in health-related quality of life (HRQOL) and its determinants between diabetic and non-diabetic hemodialysis patients in China. This comparative correlational study aimed to compare HRQOL and identify associated determinants among patients with and without diabetes in Xinxiang, China.

Methods: A total of 300 hemodialysis patients (150 diabetic, 150 non-diabetic) were recruited through convenience sampling. Data were collected using a personal information form, the Kidney Disease Quality of Life Short-Form (KDQOL-SF), the Treatment Adherence Scale for Maintenance Hemodialysis, and the Family Support Scale. Independent t-tests compared HRQOL scores between groups, and multiple linear regression identified …

Developing A Participatory Resilience Quotient Program For Village Health Volunteers In Rural Thailand: An Action Research Study In The Post-Covid-19 Era, Orathai Katkhaw, Somkid Juwa, Taweewun Srisookkum, Tienthong Takaew, Sunanta Tangnitipong, Surangkana Chairinkam

Journal of Health Research

Background: Village Health Volunteers (VHVs) play a vital role in community health; however, their psychological resilience remains underexplored. This study aimed to assess the resilience levels of VHVs in rural Thailand and evaluate the effectiveness of a resilience enhancement program.

Methods: This action research study was conducted between April and October 2022 with 476 VHVs, selected through stratified random sampling across two sub-districts and five villages per sub-district in Phayao Province. Data collection included interviews and self-report questionnaires. A four-week Resilience Quotient (RQ) program was implemented with 40 VHVs, focusing on five structured activities: self-reflection, stress management, problem-solving, …

Variability Of Immune Response To Coronavac In The Indonesian Population: A Retrospective Cohort Study In Bantaeng, South Sulawesi,Indonesia, Sitti Musafirah Arif, Juliani Ibrahim, Antariksa P. Winarno, Andi Nur Anna, Andi Weri Sompa, Ami Febriza S. Achmad, Nurdiana Nurdiana, Zulkifli Zulkifli, Irwan Ashari

Journal of Health Research

Background: The COVID-19 vaccine, including CoronaVac, is crucial in reducing severe infections and mortality due to COVID-19. However, variability in antibody responses across different populations remains a subject of investigation. This study aimed to evaluate the impact of age and BMI on Immunoglobulin G (IgG) antibody levels three months post-CoronaVac vaccination in a healthy Indonesian cohort.

Methods: A retrospective cohort study was conducted on 299 healthy individuals aged 18–70 in Bantaeng, South Sulawesi, Indonesia. IgG levels against the SARS-CoV-2 spike protein receptor-binding domain (RBD) were measured using enzyme-linked immunosorbent assay (ELISA). Blood samples were collected about 90 ± 7 days …

Pulse Diagnosis In Thai Traditional Medicine: Comparing Tri-Dhātu Characteristics In Each Innate Body Element Between Experts And Device, Athippat Tantiwongsekunakorn, Suksalin Booranasubkajorn, Thanaphak Chaopeerapong, Angkana Apichartvorakit, Pravit Akarasereenont

Journal of Health Research

Background: Pulse diagnosis in Thai Traditional Medicine (TTM) evaluates the balance of the Tri-Dhātu—Vata, Pitta, and Semha—and their interaction with innate body elements (Dhātu Chao Ruean; DCR). Despite its clinical significance, scientific evidence and quantitative tools remain limited. This study aimed to compare Tri-Dhātu pulse characteristics across different DCR types using expert assessment and the DMP-Life™ pulse diagnostic device.

Method: One-way ANOVA with post hoc analysis was applied to data from 159 participants, each evaluated at six pulse positions for shape, depth, power, and rhythm by Applied Thai Traditional Medicine (ATM) experts and the DMP-Life™ device.

Results: There were no …

Managing Covid-19-Related Stigma In Border Trade Communities: A Qualitative Study In Mae Hong Son, Thailand, Siwaporn Mahathamnuchock

Journal of Health Research

Background: In the border trade communities of Mae Hong Son Province, Thailand, misinformation and fear surrounding COVID-19 led to increased discrimination.

Method: This study aims to: (1) examine the different forms of stigma, (2) understand how affected individuals manage and cope with stigma, and (3) investigate community-based interventions to reduce stigma in border regions. An interpretative paradigm was used in a qualitative research design. A total of 18 participants—including local traders, housewives facing mobility challenges, a community leader, and healthcare workers were interviewed semi-structurally from August to December 2022. Key data patterns were identified by thematic analysis.

Results: There …

Classification Of Dental Adverse Events Using Iterative Qualitative Analysis, Kiti Siriwatana, Sathirakorn Pongpanich

Journal of Health Research

Background: Effective incident reporting systems (IRS) are essential in dentistry for identifying and preventing adverse events (AEs), with standardized classifications ensuring consistent incident categorization. This study aimed to develop and validate a classification system for dental patient safety incidents based on a 5-year case study at the Dental Hospital at Chulalongkorn University, Thailand.

Methods: An iterative qualitative approach was used. A literature review explored existing accreditation standards and AE classification systems. Incident reports from 2018–2022 informed a draft classification system aligned with Thailand’s National Reporting and Learning System and accreditation standards. Reports from 2023 were used for validation. An expert …

Identifying Gaps In The Multidrug-Resistant Tuberculosis (Mdr-Tb) Cascade Of Care: Barriers And Improvement Opportunities In North Maluku, Indonesia, Eko Sudarmo Dahad Prihanto, Prayudi Santoso, Elsa Pudji Setiawati, Rovina Ruslami

Journal of Health Research

Background: The Multidrug-Resistant-Tuberculosis (MDR-TB) Cascade of Care includes MDR-TB treatments from suspicion to completion. Implementation gaps can lower treatment success. This study aimed to identify gap causes and opportunities to improve MDR-TB treatment in North Maluku, Indonesia

Methods: To identify gaps, we conducted in-depth interviews and focus group discussions with health workers at Puskesmas (Indonesian government's primary healthcare centers) and hospitals, MDR-TB patients, and patients’ families. Thematic analysis was conducted using the Consolidated Framework for Implementation Research (CFIR) for health workersand the health belief model (HBM) approach for patients and their families.

Results: Significant gaps were found …

Effects Of The Case Management With Community Support Program On Health Behaviors And Outcomes In Thai Buddhist Monks With Type 2 Diabetes And Early-Stage Chronic Kidney Disease, Napawadee Tangtrongvisolkit, Noppawan Piaseu, Porntip Malathum, Basia Belza

Journal of Health Research

Background: Patient engagement and community support are vital for promoting self-care in monks with early-stage chronic kidney disease (CKD). This study investigated the impact of an 18-week Case Management with Community Support Program (CMCSP) on self-care activities and health outcomes (hemoglobin A1c, HbA1c), blood pressure, and estimated glomerular filtration rate (eGFR) in Thai Buddhist monks with type 2 diabetes mellitus (T2DM) and CKD.

Methods: A Randomized Controlled Trial (RCT) with pretest and post-test measures was employed. Eighty-two monks with T2DM and stage 1–2 CKD were recruited from 33 subdistricts in Thailand and randomly assigned into experimental (n = …

Extended-Release Buprenorphine With Bupivacaine Effectively Provides Postoperative Analgesia In A Mouse Laparotomy Model, Monika K. Huss, Amber Kerk, Renee Cotton, Helen Chum, Michael Hsieh, Katechan Jampachaisri, Patrick Sharp, Cholowat Pacharinsak

The Thai Journal of Veterinary Medicine

Multimodal analgesia is widely encouraged for major survival surgery. This facilitates lower doses of individual drugs, thereby reducing side effects. Extended-release analgesics offer sustained analgesia coverage, prevent drug dosing nadirs, and reduce stress. Studies evaluating multimodal and extended-release analgesia combinations for major survival surgery in mice are limited. We compared the analgesic effect of bupivacaine and extended-release buprenorphine (Bupi-ER) to bupivacaine and buprenorphine HCl (Bupi-HCl). We hypothesized that preoperative Bupi-ER would provide more effective analgesia than Bupi-HCl. Mice were randomly assigned to 1 of 2 treatment groups: bupivacaine (2 mg/kg, local infiltration, once) with either 1) extended-release buprenorphine (0.6 mg/kg, …

Antimicrobial Susceptibility Profiles (Mic And Mmc) Against Mycoplasma Gallisepticum And M. Synoviae Isolated From Chicken Farms In Thailand, Kriengwich Limpavithayakul, Alongkorn Amonsin, Nataya Charoenvisal, Arithat Limsatanun, Katanyu Yangsuk, Sumrit Toopiya, Füsun Güngör, Esther Schonewille, Javier Uriarte, Somsak Pakpinyo

The Thai Journal of Veterinary Medicine

Mycoplasma gallisepticum (MG) and M. synoviae (MS) are important pathogens causing significant economic losses in poultry production. Disease prevention and control strategies include vaccination, antimicrobial therapy, and strict biosecurity measures. The present study provides, for the first time, both minimum inhibitory concentration (MIC) and minimum mycoplasmacidal concentration (MMC) values as antimicrobial susceptibility profiles of Thai MG and MS field isolates. This study aimed to evaluate the susceptibility of five MG and ten MS isolates to various antimycoplasma drugs: doxycycline, lincomycin-spectinomycin, tiamulin, tilmicosin, tylosin, and tylvalosin, using a microdilution broth assay. For MG isolates, tilmicosin had the highest mean MIC (12.5 …

Prevalence And Risk Factors Of Concurrent Osteoarthritis And Urolithiasis In Dogs In Thailand (2018–2020), Faiz Ihsanul Kamil, Kumpanart Soontornvipart

The Thai Journal of Veterinary Medicine

Osteoarthritis is a degenerative joint disease that significantly impacts dog health, often leading to chronic pain, reduced mobility, and behavioral changes that may predispose dogs to secondary conditions such as urolithiasis. This study aimed to investigate the association between osteoarthritis and urolithiasis in dogs using radiographic imaging data collected from the Small Animal Teaching Hospital, Chulalongkorn University, Thailand, over a three-year period (January 2018 to December 2020). A total of 16,377 dogs were included, and cases of osteoarthritis, urolithiasis, or the concurrent occurrence of both conditions were identified through a systematic database review. Binary logistic regression models were used to …

Life Of Moo Deng, The Internet Sensation Pygmy Hippopotamus: An Overview Of The Biology And Conservation Breeding Program In Thailand, Ampika Thongphakdee, Atthapon Nundee, Umaporn Maikeaw, Narongwit Chodchoy, Chainarong Punkong, Kaywalee Chatdarong

The Thai Journal of Veterinary Medicine

The hippopotamus, commonly known as the hippo, is classified into two extant species: the common hippopotamus (Hippopotamus amphibius) and the pygmy hippopotamus (Choeropsis liberiensis). Pygmy hippos are fascinating creatures native to the forests and swamps of West Africa. Their survival is increasingly threatened by habitat loss resulting from agricultural expansion and urban development. As the population declines, zoological institutions play a crucial role in conservation by acting as genetic reservoirs and promoting public awareness of wildlife and environmental protection. “Moo Deng”, a pygmy hippo, whose name in Thai has gained international recognition, represents a notable success …

Monitoring Of African Horse Sickness Virus-Specific Antibodies In Horses, Northeastern Thailand, Napawan Bunpapong, Kitikhun Udom, Ekkapat Chamsai, Patchara Phuektes, Suphattra Jittimanee, Suphannika Phutthachalee, Supassama Chaiyawong, Kamonpan Charoenkul, Alongkorn Amonsin Prof. Dr.

The Thai Journal of Veterinary Medicine

African horse sickness (AHS) is caused by infection with the African horse sickness virus (AHSV). In March 2020, AHS was first reported in Thailand due to the importation of subclinically infected host animals, such as zebras. In this study, we conducted a serological survey for AHSV-specific antibodies across 21 horse farms in the northeastern provinces (n=3) of Thailand. A total of 600 serum samples were collected for cross-sectional (n = 292) and longitudinal serological monitoring (n = 308). A cross-sectional study was conducted in 2020, during which serum samples (n = 292) were collected and tested for AHS antibodies using …

Effects Of 25-Hydroxyvitamin D₃ Supplementation As A Partial Replacement For Vitamin D₃ On Laying Performance, Egg Quality, And Bone Traits In Late-Stage Laying Hens, Morakot Nuntapaitoon, Nan Choisunirachon, Somporn Techangvamsuwan, Jiramate Jittidecha

The Thai Journal of Veterinary Medicine

The objective of this study was to assess the impact of dietary 25-hydroxy vitamin D₃ (25OHD₃) supplementation during the late laying hens on egg quality, hen performance and bone computerized tomography (CT) scanning parameters. In total, 24,862 Hy-Line Brownmax hens of 61 weeks old were randomly divided into two groups: the control group (n = 12,368) received a diet containing vitamin D₃ at 3,000 IU/kg, and the treatment group (n = 12,494) received a diet containing vitamin D3 at 1,500 IU/kg and 25OHD₃ at 1,500 IU/kg. The dietary intervention from 61 weeks of age to …

มาตรการทางกฎหมายในการกำกับดูแลเครื่องมือแพทย์ใช้แล้วที่ผ่านกระบวนการผลิตซ้ำ (Legal Measures Of The Regulatory Framework For Remanufactured Medical Device), Wimpat Rajpradit

Chulalongkorn University Law Journal

ความตกลงที่ครอบคลุมและก้าวหน้าสำหรับหุ้นส่วนทางเศรษฐกิจภาคพื้นแปซิฟิก (Comprehensive and Progressive Agreement for Trans-Pacific Partnership: CPTPP) กำหนดนิยามของสินค้าใช้แล้วที่ผ่านกระบวนการผลิตซ้ำ ว่าเป็นสินค้าที่มีส่วนประกอบของวัสดุเดิมที่มีการนำมาปรับแก้บางส่วนหรือทั้งหมด ทั้งมีอายุการใช้งานเท่าสินค้าใหม่และสามารถใช้งานได้เหมือนกับหรือใกล้เคียงกับสินค้าใหม่ และมีการรับประกันจากโรงงานเช่นเดียวกับสินค้าใหม่ อย่างไรก็ดี CPTPP ได้กำหนดห้ามมิให้ประเทศสมาชิกเลือกปฏิบัติต่อสินค้าดังกล่าว ซึ่งกฎหมายเกี่ยวกับเครื่องมือแพทย์มิได้กำหนดหลักเกณฑ์เกี่ยวกับเครื่องมือแพทย์ลักษณะดังกล่าวไว้ ดังนั้น หากประเทศไทยเข้าร่วมเป็นสมาชิกเป็นข้อผูกพันจะต้องยอมรับเครื่องมือแพทย์ใช้แล้วที่ผ่านกระบวนการผลิตซ้ำ ก็จำเป็นต้องพิจารณาตัวอย่างการกำกับดูแลเครื่องมือแพทย์ของต่างประเทศประกอบกับการบริหารจัดการความเสี่ยง ไม่ว่าจะเป็นความเสี่ยงต่อผู้รับบริการสาธารณสุข บุคลากรด้านสาธารณสุข ผู้ใช้แรงงานในอุตสาหกรรมการผลิตเครื่องมือแพทย์ ตลอดจนความเสี่ยงด้านสิ่งแวดล้อม ทั้งนี้ เพื่อจัดทำมาตรการทางกฎหมายในการกำกับดูแลเครื่องมือแพทย์ใช้แล้วที่ผ่านกระบวนการผลิตในประเทศไทยตั้งแต่ขั้นตอนการผลิตก่อนออกสู่ตลาด ระบบเฝ้าระวังและการติดตามตรวจสอบ รวมทั้งการจัดการขยะเครื่องมือแพทย์ที่เหมาะสม

แนวทางในการกำหนดความรับผิดทางอาญาและวิธีการเพื่อความปลอดภัยต่อผู้กระทำความผิดซึ่งมีสภาวะจิตผิดปกติ (Guideline For Determining The Criminal Liability And Security Measures For Insane Offenders), Natchapol Jittirat

Chulalongkorn University Law Journal

หลักเกณฑ์ในการพิจารณาความรับผิดทางอาญาของผู้กระทำความผิดที่มีสภาวะจิตผิดปกตินับเป็นปัญหาสำหรับศาลและนักกฎหมายมาช้านานในอดีต เนื่องจากผู้กระทำความผิดบางรายอาจกระทำความผิดไปโดยไม่รู้สึกตัว เพราะมีสาเหตุมาจากความบกพร่องทางประสาท สมอง จิตใจ อารมณ์และความเครียด ซึ่งความผิดปกติทางจิตขนาดใดจึงจะนำมาพิจารณาว่าผู้นั้นไม่มีความผิด หรือมีความผิดแต่ควรยกเว้นโทษหรือลดโทษนี้ ศาลของประเทศอังกฤษได้วางหลักสำคัญไว้ในการพิจารณาคดี McNaghten’s (1843) ว่าต้องสันนิษฐานไว้ก่อนว่ามนุษย์ทุกคนมีจิตปกติ เว้นแต่จะมีข้อสันนิษฐานซึ่งสามารถพิสูจน์ได้ว่าขณะกระทำความผิดจำเลยได้รับความเจ็บปวดจากโรคทางจิตจนไม่ทราบเนื้อหาและสาระสำคัญของการกระทำ กล่าวคือไม่สามารถรู้ได้ว่าสิ่งนั้นถูกหรือผิด หลักเกณฑ์ดังกล่าวนี้ได้ถูกนำไปใช้อย่างแพร่หลายทั้งในสหรัฐอเมริกาและประเทศในภูมิภาคยุโรป ซึ่งนำไปสู่การตัดสินว่าจำเลยไม่มีความผิดโดยศาลจะมีคำสั่งให้ควบคุมตัวจำเลยไปรับการบำบัดรักษาที่สถานพยาบาล สำหรับการพิจารณาถึงความรับผิดของผู้ที่มีจิตบกพร่อง โรคจิต หรือจิตฟั่นเฟือน ตามแนวทางในการพิจารณาคดีของศาลนั้นหากผู้กระทำไม่รู้สำนึกของการกระทำย่อมไม่มีความผิดตามประมวลกฎหมายอาญา มาตรา 59 ถ้าหากผู้กระทำรู้สำนึกแต่ไม่สามารถรู้ผิดชอบ หรือไม่สามารถบังคับตนเองได้ถือเป็นเหตุยกเว้นโทษ และถ้าผู้กระทำความผิดยังสามารถรู้ผิดชอบอยู่บ้าง หรือยังสามารถบังคับตนเองได้บ้าง ผู้นั้นต้องรับโทษสำหรับความผิดนั้น โดยศาลจะลงโทษน้อยกว่าที่กฎหมายกำหนดไว้สำหรับความผิดนั้นเพียงใดก็ได้ตามมาตรา 65 ซึ่งจะเห็นได้ว่าในกรณีที่ศาลตัดสินว่าจำเลยไม่มีความผิดนี้อาศัยความตามมาตรา 59 ถือว่าผู้กระทำความผิดไม่รู้สำนึกซึ่งใช้หลักเกณฑ์เดียวกับบุคคลทั่วไปซึ่งหากไม่รู้สำนึกในการกระทำก็ย่อมไม่มีความผิด ดังปรากฏตามคำพิพากษาฎีกาที่ 8743/2544 คำพิพากษาฎีกาที่ 2590/2562 แต่สำหรับผู้กระทำความผิดที่มีจิตบกพร่อง โรคจิต หรือจิตฟั่นเฟือนนั้นได้กระทำความผิดไปโดยไม่รู้ถึง “สภาพ” และ “สาระสำคัญ” ของการกระทำจึงควรบัญญัติแยกไว้เป็นอีกมาตราหนึ่งให้ผู้นั้นไม่มีความผิดและหากผลของการกระทำความผิดมีความร้ายแรงต่อชีวิต ร่างกายหรือทรัพย์สินของผู้อื่นก็ควรให้เป็นดุลพินิจของศาลในการมีคำสั่งให้ส่งตัวผู้นั้นเข้ารับการบำบัดรักษาในสถานพยาบาลได้เช่นเดียวกับที่บัญญัติความไว้ใน มาตรา 48 นอกจากนี้ หากผู้กระทำความผิดยังสามารถรู้ผิดชอบหรือยังสามารถบังคับตนเองได้บ้างก็ควรมีเกณฑ์ลดโทษตามความร้ายแรงของการกระทำความผิดดังเช่นหลักเกณฑ์ตามประมวลกฎหมายอาญาของสาธารณรัฐฝรั่งเศสเพื่อให้เกิดความเป็นธรรมต่อผู้เสียหาย ทั้งยังควรนำวิธีการคุมประพฤติมาใช้บังคับหลังจากที่จำเลยพ้นโทษในกรณีที่ผู้นั้นได้กระทำความผิดร้ายแรงดังเช่น สาธารณรัฐฝรั่งเศสและประเทศอังกฤษ เพื่อป้องกันมิให้ผู้นั้นกลับมากระทำความผิดซ้ำขึ้นอีก

Evaluation Of Antimicrobial And Wound Healing Activities Of Jatropha Podagrica Extracts, Reawfang Sriyom, Arunporn Itharat, Onmanee Prajuabjinda, Sumalee Panthong, Pakakrong Thongdeeying, Metar Siriwattanasathorn, Maneewan Panthong, Neal M. Davies

The Thai Journal of Pharmaceutical Sciences

Background: Jatropha podagrica has been traditionally used to treat skin infections and promote wound healing. However, there is currently no scientific research validating its antimicrobial or wound-healing properties.
Objectives: This study aimed to evaluate the antimicrobial and wound-healing activities of various extracts from all parts of J. podagrica, using different solvents. In addition, the chemical composition of the most effective extract was analyzed by Gas Chromatography-Mass Spectrometry (GC-MS).

Materials and Methods: The leaves, stem, and root of J. podagrica were extracted using hexane, 95% ethanol, ethanol-soluble hexane residue, and aqueous decoction. The antimicrobial effects of the extracts were assessed …

Exploring The Link Between Physicians’ Familiarity And Biosimilar Prescribing In Thailand, Ekapong Kachai, Chaoncin Sooksriwong, Wanruchada Katchamart, Tuangrat Phodha

The Thai Journal of Pharmaceutical Sciences

Background: Despite the availability of various biosimilars in Thailand, the link between physicians’ familiarity and biosimilars prescribing practice remains still unclear.

Objectives: This study aimed to find the association between physicians’ familiarity and biosimilars prescribing practice among physicians in Thailand.

Methods: This research adopted an extended analysis framework, utilizing survey data from a pilot study on the surveillance of Thai physicians regarding biosimilar uptake. The familiarity with biosimilars among respondents was evaluated.

Results: The result showed that 82 respondents were included in the study. There was 79.3% of respondents indicated prescribing biosimilars. Overall, most respondents (75.6%) showed an “adequate” level …

Concurrent Use Of Skeletal Muscle Relaxants And Nsaids In Low Back Pain Management: A Critical Review Of Current Evidence And Future Directions, Rupesh A. Saindane, Nilima A. Thombre

The Thai Journal of Pharmaceutical Sciences

Low back pain (LBP) represents a leading cause of non-fatal disability globally. Its high prevalence and disabling nature highlight the urgent need for effective management strategies. The exact cause of LBP still remains unclear, and thus, its treatment remains symptomatic. LBP is commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs). These agents are frequently used in combination to target both inflammation and muscle spasms. However, the clinical guidelines vary widely on the recommendation for the use of such combination therapy. The present review evaluates evidence from randomized clinical trials and systematic reviews on the concurrent use …

Pharmacogenetic-Guided Antiplatelet Therapy For Personalized Medicine In Patients With Stroke And Transient Ischemic Attack Without Cardioembolic Stroke: A Systematic Review Of Economic Evaluations, Nathapol Samprasit, Chamipa Phanudulkitti, Nattanichcha Kulthanachairojana, Jatapat Hemapanpairoa

The Thai Journal of Pharmaceutical Sciences

Background: Stroke is a major global public health burden. Ischemic stroke is the most common type of all stroke cases worldwide. Antiplatelet therapy is a key strategy for secondary prevention in patients with stroke and transient ischemic attacks (TIAs) without cardioembolic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel is recommended in patients with early mild stroke or high-risk TIA, followed by long-term single antiplatelet therapy (SAPT). Clopidogrel is often used as an alternative for patients with aspirin resistance or intolerance. However, clopidogrel is a prodrug metabolized by the CYP2C19 enzyme, leading to variability in its effectiveness.

Objectives: This study aims …

A Review Of Overlapping Severe Cutaneous Adverse Reaction, Ploylarp Lertvipapath, Roongrat Piyananjaruhsri, Diana Karimee

The Thai Journal of Pharmaceutical Sciences

Severe cutaneous adverse reactions (SCARs) are life-threatening drug hypersensitivity reactions, including acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). SCARs occur in approximately 0.1% of hospitalizations and have mortality rates ranging from 5% for AGEP to 5–35% for SJS/TEN. AGEP typically presents with acute erythematous areas, sterile pustules, fever, and neutrophilia within 48–72 h of drug exposure. In contrast, DRESS manifests as fever, facial edema, morbilliform rash, and exfoliative dermatitis, often accompanied by hematologic abnormalities and multi-organ involvement, including hepatitis, pneumonitis, and myocarditis. Moreover, SJS and TEN …

The Use Of Health And Herbal Products For Covid-19 Self-Prevention And Its Affecting Factors According To Theory Of Planned Behavior, Suppachai Insuk, Supanida Kittirattanasak, Mullika Sirithongkaset, Daranee Chiewchantanakit

The Thai Journal of Pharmaceutical Sciences

Introduction: Despite the World Health Organization’s recent declaration of the end of the COVID-19 pandemic, the lessons learned from the outbreak remain crucial for future public health responses. In Thailand, the pandemic’s impact led individuals to explore self-protection methods, including potentially ineffective health products. This study examined the prevalence of health and herbal products used for COVID-19 self-prevention, to identify the types of these products in use and to identify factors influencing their utilization.

Methods: A cross-sectional study surveyed 400 Thai participants aged 25–60 who had never contracted COVID-19. The study employed convenience sampling and self-administered online questionnaires based on …

Mechanistic Insights And Clinical Benefits Of Omega-3 Fatty Acids In Cardiovascular, Inflammatory, And Neurological Health, Anosh Tahir, Afshan Siddiq

The Thai Journal of Pharmaceutical Sciences

Background: Omega-3 polyunsaturated fatty acids (ω-3 PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are attributed with the capacity to prevent cardiovascular diseases (CVD), chronic inflammation, and neurodegenerative diseases. Their bioactive contribution consists on interfering with lipid metabolism, decreasing inflammation, and increasing neuroprotection. Still, the findings imply that there is a considerable need for greater clarification of their mechanisms and their application to clinical care.

Objectives: This narrative review is intended to discuss the potential target(s) of action, uses, and efficacy of ω-3 PUFAs in the context of CVD, inflammation, and neurodegenerative diseases.

Materials and Methods: This narrative review …

Effects Of Blended Learning On The Self-Directed Learning And Academic Achievement Of First-Year Nursing Students Studying Metabolic Biochemistry, Yuree Chaopipat, Pimrat Tokun, Jerapa Srithahai

Journal of Education Studies

This study examined the impact of blended learning on the self-directed learning and academic achievement of the first-year nursing students studying metabolic biochemistry. This quasi-experiment research recruited 150 first-year nursing students at one of the nursing college. A blended learning intervention, combining face-to-face instruction and various online activities, was implemented. Data were collected using a self-directed learning scale, pretest and posttest, and a final exam. Results indicated that blended learning significantly enhanced students' self-directed learning (t = -2.847, p = 0.005) and academic performance. Post-test scores across all chapters significantly improved after the intervention (t = -10.63, p …

Detective And Family: The Representation Of Same-Sex Family In Holmes & Moriarity By Josh Lanyon, Kanokwan Wichiansri, Thosaeng Chaochuti

Journal of Letters

This paper aims to study the questioning of in heteronormativity in early detective fiction by investigating the representation of homosexual family in the crime fiction series Holmes & Moriarity by Josh Lanyon. The study finds that the representations of the male detective and homosexual family are influenced by heteronormative standards. The selected texts raise questions about the conventions of early detective fiction that usually offer stereotypical representations of the male detective. The male detective in early detective fiction typically prefers a life of solitude and refuses to start a family. The selected texts, however, portray a protagonist who is able …