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3,580 full-text articles. Page 28 of 123.

The Susceptibility Of Penicillin, Ceftriaxone, And Cefotaxime Against Streptococcus Pneumoniae Isolated From Patients With Invasive Pneumococcal Diseases At A Teaching Hospital In Thailand, Jantima Traipattanakul, Sudaluck Thunyaharn, Juthathip Suphanklang, Wichai Santimaleeworagun 2022 Chulalongkorn University

The Susceptibility Of Penicillin, Ceftriaxone, And Cefotaxime Against Streptococcus Pneumoniae Isolated From Patients With Invasive Pneumococcal Diseases At A Teaching Hospital In Thailand, Jantima Traipattanakul, Sudaluck Thunyaharn, Juthathip Suphanklang, Wichai Santimaleeworagun

The Thai Journal of Pharmaceutical Sciences

Objective: Pneumococcal disease is a severe invasive infection causing morbidity and death, so the appropriate antimicrobials are greatly important. We aimed to determine the minimum inhibitory concentration (MIC) of penicillin, cefotaxime and ceftriaxone against S. pneumoniae. Methods: The clinical isolates were obtained from patients with invasive pneumococcal disease admitted to Phramongkutklao Hospital, Thailand over a period of 10 years between 2006 and 2015. The in vitro antimicrobial susceptibility testing of antibiotics including penicillin, ceftriaxone and cefotaxime against S. pneumoniae isolates were determined by E-test. The MIC range, MIC50, and MIC90 (μg/ml) and percentage of susceptible isolates were recorded. Results: Forty …


Prevalence, Distribution, Treatment, And Modern Methods For In Vitro Diagnosis Of Alzheimer’S Disease In India: Challenges And Future Prospective, Sopan Nangare, Pravin Patil 2022 Chulalongkorn University

Prevalence, Distribution, Treatment, And Modern Methods For In Vitro Diagnosis Of Alzheimer’S Disease In India: Challenges And Future Prospective, Sopan Nangare, Pravin Patil

The Thai Journal of Pharmaceutical Sciences

In India, the plethora of evidence indicates that neurodegenerative conditions are a significant public health issue wherein over 4 million Indian peoples have been affected. For the past two decades, the prevalence of Alzheimer’s disease (AD) is growing rapidly in India that may due to the significant lack of health-care services and poor knowledge of AD and another form of dementia. Therefore, this in turn to develop ultramodern techniques for the efficient detection of AD biomarkers that helps to the prognosis and diagnosis of AD. Recently, significant progress has been observed in the area of AD that includes prognosis, and …


Gc-Ms Fingerprints Combined With Chemometric Analysis For The Authentication Of Morus Alba Leaves From Thailand, Malai Satiraphan, Aye Thida, Lawan Sratthaphut, Patcharawan Tanamatayarat, Onoomar Toyama 2022 Chulalongkorn University

Gc-Ms Fingerprints Combined With Chemometric Analysis For The Authentication Of Morus Alba Leaves From Thailand, Malai Satiraphan, Aye Thida, Lawan Sratthaphut, Patcharawan Tanamatayarat, Onoomar Toyama

The Thai Journal of Pharmaceutical Sciences

Introduction: Morus alba L. is one of the economic plants in Thailand. Several varieties are grown in various parts of the country. Different varieties from different regions may produce dissimilar chemical fingerprints. Objectives: The gas chromatography coupled to mass spectrometry (GC-MS) fingerprints of 2 varieties of M. alba leaves from three locations in Thailand, along with tea products will be established. Materials and Methods: The GC-MS chromatograms combined with chemometric analysis were used to analyze the extracts of M. alba leaves and their tea products. Results: A total of 83 compounds comprising terpenes, saturated fatty acids, unsaturated fatty acids and …


Determination Of Sugars And Amino Acids In Japanese Wine Using Core-Shell Liquid Chromatography Tandem Electrochemical Detection, Kana Yoshimura, Aiko Sano, Ryuichiro Suzuki, Shun-ichi Mitomo, Yukiko Negishi, Toshiki Mutai, Florencio Arce Jr., Gerard Lee See, Takashi Tanikawa 2022 Chulalongkorn University

Determination Of Sugars And Amino Acids In Japanese Wine Using Core-Shell Liquid Chromatography Tandem Electrochemical Detection, Kana Yoshimura, Aiko Sano, Ryuichiro Suzuki, Shun-Ichi Mitomo, Yukiko Negishi, Toshiki Mutai, Florencio Arce Jr., Gerard Lee See, Takashi Tanikawa

The Thai Journal of Pharmaceutical Sciences

In this study, sugars (glucose, fructose, and sucrose) and amino acids in plum and yuzu wines were quantified with a new and simple method involving an electrochemical detector (ECD) and core-shell column [S-30/70=St (styrene)/DVB (divinylbenzene)-5TMDAH (tetramethyldiaminohexane)]. Analysis was conducted under the following conditions: A column temperature (40°C), flow rate (0.3 mL/min), injection volume (20 μL), and mobile phase (0.1 mol/L NaOH). Glucose, fructose, and sucrose had retention times of 14.68 min, 16.22 min, and 19.29 min, respectively, when measured using an ECD. When the sugar content was compared among the plum wines, plum wine A had the lowest sugar content. …


Effect Of Chronic Kidney Disease On Warfarin Responsiveness Among Thai Patients, Sasimaporn Yaengkratok, Manat Pongchaidecha, Wichai Santimaleeworagun, Pornwalai Boonmuang 2022 Chulalongkorn University

Effect Of Chronic Kidney Disease On Warfarin Responsiveness Among Thai Patients, Sasimaporn Yaengkratok, Manat Pongchaidecha, Wichai Santimaleeworagun, Pornwalai Boonmuang

The Thai Journal of Pharmaceutical Sciences

This study aims to determine the effect of chronic kidney disease on warfarin response, including initial doses, maintenance doses, time in therapeutic range (TTR), and international normalized ratio (INR) variability. This is a retrospective cohort study at Rajavithi Hospital from 2015 to 2018. A total of 189 patients were included and divided into five groups based on estimated glomerular filtration rate (eGFR) (G1, eGFR ≥ 60 mL/min/1.73 m2; G2, 30–59 mL/min/1.73 m2; G3, 15–29 mL/min/1.73 m2; G4, ≤ 15 mL/min/1.73 m2; and G5, ≤ 15 mL/min/1.73 m2 with dialysis). The median age was 65.00 years, and 60.9% of patients were …


Neuroprotective And Nootropic Evaluation Of Myristica Malabarica On Diabetes-Induced Cognitive Impairment In Experimental Animals: Promising For Controlling The Risk Of Alzheimer’S Disease, Kolguri Jagadeeshwar, Rajasekhar Reddy Alavala, Subhakar Raju Ravula, Umasankar Kulandaivelu, G.S.N. Koteswara Rao 2022 Chulalongkorn University

Neuroprotective And Nootropic Evaluation Of Myristica Malabarica On Diabetes-Induced Cognitive Impairment In Experimental Animals: Promising For Controlling The Risk Of Alzheimer’S Disease, Kolguri Jagadeeshwar, Rajasekhar Reddy Alavala, Subhakar Raju Ravula, Umasankar Kulandaivelu, G.S.N. Koteswara Rao

The Thai Journal of Pharmaceutical Sciences

This study intends to explore the neuroprotective and memory-enhancing properties of Myristica malabarica (MM) leaf extracts on diabetic-induced cognitive decline rats. The models of Y maze and Morris water maze were selected for nootropic activity and neuroprotective properties were deliberate by assessing the levels of Ach, malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO), catalase (CAT) and glutathione hormone (GSH) in diabetic rat brains. Significantly improved memory and learning with 100 mg/kg (P < 0.01) and 200 mg/kg (P < 0.001) of EAMM (L) and MAMM (L) in Y maze and Morris water maze models. Significant effect was observed in all the extracts with two doses when compared with diabetic control on day 75. The levels of AChE (P < 0.001), MDA (P < 0.01), and NO (P < 0.05) were decreased significantly and significantly raised (P < 0.01) levels of SOD, CAT, and GSH with MAMM (100 and 200 mg/kg) compared with disease control. Further studies on MM leaf are needed as evidence of cognitive impairment in defense against diabetes has been shown to expose its mode of action.


Fluid Properties Of Solvents And Oils Used In In Situ Forming Microparticles, Sai Myo Thu Rein, Torsak Intaraphairot 2022 Chulalongkorn University

Fluid Properties Of Solvents And Oils Used In In Situ Forming Microparticles, Sai Myo Thu Rein, Torsak Intaraphairot

The Thai Journal of Pharmaceutical Sciences

In situ forming microparticle (ISM) has been recently used as the injectable drug delivery system prepared from polymeric non-aqueous phase in oil emulsion. Solvents and oils used in ISM including N-methyl pyrrolidone (NMP), 2-pyrrolidone (PYR), dimethyl sulfoxide (DMSO), glycofurol, triacetin, olive oil, camellia oil and isopropyl myristate (IPM) were evaluated for pH, density, viscosity, flow time, surface tension, contact angle, color distribution, injectability, antimicrobial activities and cytotoxicity. The most viscous camellia oil and olive oil showed the highest flow time with lowest color diffusion and lower injectability; thus, they were suitable for performing as external phase of ISM to prolong …


Metabolite Profiling And Activity Study Of Ethanol Extract Of Chrysophyllum Cainito L. Leaves In Increasing Bone Density In Male Mice, Burhan Ma’arif, Kurniawan Hidayat Perdana Putra, Miftah Saiful ‘Arifin, Rukiana, Reyhan Amiruddin, Weka Sidha Bhagawan, Arief Suryadinata, Fidia Rizkia Inayatilah, Roihatul Muti’ah, Agnis Aditama 2022 Chulalongkorn University

Metabolite Profiling And Activity Study Of Ethanol Extract Of Chrysophyllum Cainito L. Leaves In Increasing Bone Density In Male Mice, Burhan Ma’Arif, Kurniawan Hidayat Perdana Putra, Miftah Saiful ‘Arifin, Rukiana, Reyhan Amiruddin, Weka Sidha Bhagawan, Arief Suryadinata, Fidia Rizkia Inayatilah, Roihatul Muti’Ah, Agnis Aditama

The Thai Journal of Pharmaceutical Sciences

Phytoestrogen is a group compound which has an estrogen-like structure or function. One of its roles was in the bone formation. Chrysophyllum cainito L. is a plant that contains phytoestrogen. The purpose of this research is to determine the metabolite profile and activity of1ethanolpextract of C. cainitoxleaves to increase trabecular femur bone density in male mice. The metabolite profiling analysis was done using ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry/mass spectrometry and analyzed using Masslynx 4.1 software. Four doses of ethanol extract of C. cainito leaves were prepared for treatment. Which are 2,14,48, and 316 mg/ body weight (BW) mice/day …


Inhibition Of Phospholipase A2 And Prostaglandin Synthase Activities As Possible Mechanistic Insight Into The Anti-Inflammatory Activity Of Brenania Brieyi Methanol And Chloroform Fractions, Ifeoma Felicia Chukwuma, Victor Onukwube Apeh, Florence Nkechi Nworah, Chinelo Chinenye Nkwocha, John Emaimo, Lawrence Uchenna Sunday Ezeanyika, Victor Nwadiogo 2022 Chulalongkorn University

Inhibition Of Phospholipase A2 And Prostaglandin Synthase Activities As Possible Mechanistic Insight Into The Anti-Inflammatory Activity Of Brenania Brieyi Methanol And Chloroform Fractions, Ifeoma Felicia Chukwuma, Victor Onukwube Apeh, Florence Nkechi Nworah, Chinelo Chinenye Nkwocha, John Emaimo, Lawrence Uchenna Sunday Ezeanyika, Victor Nwadiogo

The Thai Journal of Pharmaceutical Sciences

Objectives: The pharmacological basis of anti-inflammatory agents is geared toward maintaining body homeostasis. This study investigated the scientific underpinning and mechanisms of anti-inflammatory activity of root bark of Brenania brieyi. Material and Methods: The plant material was extracted with a mixture of methanol and chloroform (2:1) and fractionated with 0.2 volume water. Egg albumin-induced edema and cotton pellet-induced granuloma models were used to investigate anti-inflammatory activity while the possible mechanisms of actions were evaluated using standard methods. Results: Significant (P < 0.05) reduction in edema and granuloma tissue formation were recorded in fractions treated groups compared with the normal control. There was a significant (P < 0.05) inhibition of membrane hemolysis and phospholipase A2 (PLA2) activity by the fractions compared with the standard drugs, indomethacin, and prednisolone, respectively. Both fractions significantly (P < 0.05) inhibited prostaglandin (PG) synthase and nitric oxide radical activities compared with the control. However, varying doses of both fractions did not inhibit leukocyte migration compared with rats in indomethacin and control groups. The methanol fraction was found to be more potent in most of the tests. Conclusion: These results show that B. brieyi root bark has anti-inflammatory activity, and the potential underlying mechanisms of its action are inhibition of PLA2 and PG involved in inflammatory responses.


Application Of Fluorotag In Quantification Of Metformin In Tablet Dosage Form And Biological Samples, Panikumar Durga Anumolu, Sunitha Gurrala, Sahitya Menkana, Ceema Mathew, Lavanya Srimantula 2022 Chulalongkorn University

Application Of Fluorotag In Quantification Of Metformin In Tablet Dosage Form And Biological Samples, Panikumar Durga Anumolu, Sunitha Gurrala, Sahitya Menkana, Ceema Mathew, Lavanya Srimantula

The Thai Journal of Pharmaceutical Sciences

Background: New specific and sensitive spectrofluorimetric fluorotag method has been developed and validated for the quantification of metformin hydrochloride. Materials and Methods: The derivatization reaction was carried out using 1,2-naphthoquinone-4-sulfonic sulfonate as (NQS) fluorotag in the presence of strong alkaline medium (potassium hydroxide) to form the highly fluorescent product. The fluorescence was observed at emission wavelength 453 nm after excitation at 359 nm. The different experimental conditions affecting the reaction product formation and stability were carefully studied and optimized as 2% w/v of potassium hydroxide solution, 0.5% w/v NQS reagent. Results: At optimum reaction conditions, good linear relationship was found …


Preferences Of Thai Head Pharmacists For Pharmacy Technician Education: Certification Versus Bachelor’S Degree Program, Sukunta Muadthong, Nusaraporn Kessomboon, Tsutomu Kitajima, Kamolnut Muangyim, Surachat Ngorsuraches, Pattapong Kessomboon 2022 Chulalongkorn University

Preferences Of Thai Head Pharmacists For Pharmacy Technician Education: Certification Versus Bachelor’S Degree Program, Sukunta Muadthong, Nusaraporn Kessomboon, Tsutomu Kitajima, Kamolnut Muangyim, Surachat Ngorsuraches, Pattapong Kessomboon

The Thai Journal of Pharmaceutical Sciences

Objective: This study aimed to investigate Thai hospital pharmacists’ preferences for a proposed bachelor’s degree curriculum for pharmacy technicians (PhTs), preparing PhTs to fill an advanced role in pharmacy, compared to the existing high vocational certificate (HVC) curriculum for PhTs. Methods: A labeled discrete choice experiment (DCE) questionnaire was sent by post to head pharmacists of 814 Thai Ministry of Public Health hospitals over a 2-month period. Respondents’ preferences for the proposed bachelor’s degree or the existing HVC of PhT were determined based on their selections among three attributes: Competency in pharmaceutical information services, competency in pharmaceutical inventory management, and …


Virgin Coconut Oil Ameliorates Arsenic Hepatorenal Toxicity And No-Mediated Inflammation Through Suppression Of Oxidative Stress In Rats, Ademola C. Famurewa, Ekenechukwu K. Maduagwuna, Chinyere Aloke, Sharon O. Azubuike-Osu, Arunaksharan Narayanankutty 2022 Chulalongkorn University

Virgin Coconut Oil Ameliorates Arsenic Hepatorenal Toxicity And No-Mediated Inflammation Through Suppression Of Oxidative Stress In Rats, Ademola C. Famurewa, Ekenechukwu K. Maduagwuna, Chinyere Aloke, Sharon O. Azubuike-Osu, Arunaksharan Narayanankutty

The Thai Journal of Pharmaceutical Sciences

Background: Compelling evidence has implicated oxidative stress as a leading mechanism for arsenic (As)-induced pathologies. We evaluated antioxidant effect of virgin coconut oil (VCO) against arsenic-induced oxidative stress-mediated hepatorenal damage in rats. Methods: Rats were randomly divided into three groups: Control group, as group, and VCO + As group. VCO was orally administered before and along with arsenic (10 mg/kg body weight, orally) for 21 days. Subsequently, serum liver enzymes, albumin (ALB), creatinine, urea, antioxidant enzymes, malondialdehyde, and nitric oxide (NO) level were evaluated. The histology of the tissues was analyzed with standard procedures. Results: Arsenic caused marked increases in …


Screening Of Process Variables Using Box–Behnken Design In The Fabrication Of Berberine Hydrochloride-Loaded Transethosomes For Enhanced Transdermal Delivery, Koushlesh Kumar Mishra, Chanchal Deep Kaur 2022 Chulalongkorn University

Screening Of Process Variables Using Box–Behnken Design In The Fabrication Of Berberine Hydrochloride-Loaded Transethosomes For Enhanced Transdermal Delivery, Koushlesh Kumar Mishra, Chanchal Deep Kaur

The Thai Journal of Pharmaceutical Sciences

Objective: The objective of the present work was to develop, optimize, and characterize berberine hydrochloride (BBN-HCl)-loaded transethosomes (TEs) for enhanced transdermal delivery. In this study, screening of formulation and process variables was conducted using Box–Behnken design approach to observe significant and insignificant influence on the TEs. Materials and Methods: The TEs was developed by homogenization technique (hot method). The optimized BBN-HCl-loaded TEs were evaluated for its vesicle size (VS), polydispersity index (PDI), zeta potential (ZP), loading capacity, and entrapment efficiency. Characterization was done by powder X-ray diffraction (P-XRD), differential scanning calorimetric (DSC), and transmission electron microscopy. Further, in vitro drug …


Analysis Of Pharmaceutical Inventory Management In A State Hospital In Myanmar, Mya Pann Thazin, Rungpetch Sakulbumrungsil 2022 Chulalongkorn University

Analysis Of Pharmaceutical Inventory Management In A State Hospital In Myanmar, Mya Pann Thazin, Rungpetch Sakulbumrungsil

The Thai Journal of Pharmaceutical Sciences

Inventory management analysis for a state-level hospital pharmacy of Myanmar was conducted using ABC-VEN matrix analysis to identify the drug categories that require stringent management control. The annual expenditure of all drug items managed by pharmacy department for the years 2016 and 2017 was analyzed and application of ABC, VEN, and ABC-VEN matrix analysis was performed. The study showed that the average annual expenditure was 288,414 USD. Of the total 297 items of medicines, 7.7% (23), 16.8% (50), and 75.4% (224) were classified as A, B, and C category items, respectively, accounting for 70.4%, 19.7%, and 9.9% of drug expenditure. …


Population Pharmacokinetics Of Phenytoin In Epileptic Children And Dosage Regimens Using Monte Carlo Simulation, Leena Mekloy, Wanchai Treyaprasert 2022 Chulalongkorn University

Population Pharmacokinetics Of Phenytoin In Epileptic Children And Dosage Regimens Using Monte Carlo Simulation, Leena Mekloy, Wanchai Treyaprasert

The Thai Journal of Pharmaceutical Sciences

Objective: The study aimed at a population pharmacokinetic analysis of phenytoin in epileptic children so as to determine optimal dosage regimen for achieving the therapeutic range. Materials and Methods: A total of 370 blood level concentrations from 225 patients were collected retrospectively from clinical routine therapeutic drug monitoring data. The data were analyzed based on population pharmacokinetics using NONMEM software.A base model was developed to handle covariates, including age, gender, weight, liver function test results, and co-anticonvulsants. The final model was done until the precision of parameters with minimum objective function value achieved. Monte Carlo simulation was utilized to determine …


Effects Of The Mobile Serious Game (Herbarian) With Location-Based Learning On Students’ Retention Of Botanical Terms And Their Experiences, Sornkanok Vimolmangkang, Nattanichcha Kulthanachairojana, Taksina Chuanasa, Supotchana Sitthigool, Anuchai Theeraroungchaisri 2022 Chulalongkorn University

Effects Of The Mobile Serious Game (Herbarian) With Location-Based Learning On Students’ Retention Of Botanical Terms And Their Experiences, Sornkanok Vimolmangkang, Nattanichcha Kulthanachairojana, Taksina Chuanasa, Supotchana Sitthigool, Anuchai Theeraroungchaisri

The Thai Journal of Pharmaceutical Sciences

Background: A serious game was developed from the use of learning through drill and practice principle to enhance the knowledge memorizing together with the principle of game-based learning in education application. The aim of this study was to investigate the effectiveness of using game-based and location-based learning concepts on the student knowledge score and knowledge retention score. Methods: A mobile application game named “Herbarian” was developed and used in the pharmaceutical botany course as a part of the undergraduate pharmacy curriculum. The content in the game was botanical jargon linked to plant morphology. Twenty-one and 51 undergraduate students voluntarily used …


Chloroquine And Eye Problems At A General Hospital In Western Thailand, Nunthaluxna Sthapornnanon, Chattraporn Chumchit, Supakarn Suksajjee, Sukanya Boonnum, Suphitchaya Neramitwanchai, Chitthathep Chaisaen 2022 Chulalongkorn University

Chloroquine And Eye Problems At A General Hospital In Western Thailand, Nunthaluxna Sthapornnanon, Chattraporn Chumchit, Supakarn Suksajjee, Sukanya Boonnum, Suphitchaya Neramitwanchai, Chitthathep Chaisaen

The Thai Journal of Pharmaceutical Sciences

Objective: This study aimed to explore the eye problems after CQ use, to review if the eye examinations were performed during patients were treated with CQ and to identify factors related to those eye problems. Method: Retrospective study was done. Data were collected from both electronic medical records and medical records. Patients who were treated with CQ during May15, 2010- May 31, 2019 at a general hospital in western Thailand were included. Results: There were 123 patients who were treated with CQ. Eye problems were found in 26 patients (21.14 %). Majority of those had blurred vision (13/26; 50.00%). Focus …


Investigation Of Film Thickness Uniformity On Tablets By Handheld Raman Spectrometer, Srisakul Srisuk, Jittima Chatchawalsaisin 2022 Chulalongkorn University

Investigation Of Film Thickness Uniformity On Tablets By Handheld Raman Spectrometer, Srisakul Srisuk, Jittima Chatchawalsaisin

The Thai Journal of Pharmaceutical Sciences

Purpose: The aim of this study was to investigate the uniformity of film thickness on coated tablets using handheld Raman spectrometer. Methods: Oval-shaped tablets were coated with Opadry® II blue at a pan speed of 8 rpm and spray rates of 8.2 and 10.5 g/min. The coating process was also carried out at the pan speed of 14 rpm and spray rate of 8.2 g/min. Other process parameters, that is, inlet air temperature and atomizing air pressure were kept constant. Twenty coated tablets were taken at 10 min intervals for determination of weight gain. The film deposited on both faces …


Recent Advancements On Biological Activity Of Indole And Their Derivatives: A Review, Punet Kumar, Md Iftekhar Ahma, Sangam Singh, Mohammad Rizki Fadhil Pratam, Arun K. Mishra 2022 Chulalongkorn University

Recent Advancements On Biological Activity Of Indole And Their Derivatives: A Review, Punet Kumar, Md Iftekhar Ahma, Sangam Singh, Mohammad Rizki Fadhil Pratam, Arun K. Mishra

The Thai Journal of Pharmaceutical Sciences

Indole, a versatile outstanding heterocyclic compound, engaged in numerous pharmacological properties due to their multiple biochemical processes. The remarkable indole moiety resembles with numerous protein structures. The fascinating molecular framework of indole makes its suitable for drug development. Indole derivatives mimic the peptides structure and bind reversibly to several enzymes, which contribute enormous opportunities to develop novel drugs with distinct mechanism of action. The presence of nitrogen-based heterocycles in several compounds has been investigated enormously as the core structures comprise several biologically appropriate molecules found active in different diseases. The investigations conducted worldwide have shown outstanding impact for scientists, working …


Complexity Of Implementing Harm Reduction Services In Community Hospitals: A Two-Phase Qualitative Study, Kanittha Nimsakul, Puckwipa Suwannaprom, Siritree Suttajit 2022 Chulalongkorn University

Complexity Of Implementing Harm Reduction Services In Community Hospitals: A Two-Phase Qualitative Study, Kanittha Nimsakul, Puckwipa Suwannaprom, Siritree Suttajit

The Thai Journal of Pharmaceutical Sciences

Objective: Regardless of effective harm reduction services (HRS) in Thanyarak Hospital, difficulties exist while implementing them in community hospitals. This study aimed to investigate the complexities of HRS implementation in two community hospitals in Mae Hong Son. Methods: Phase 1, in-depth interviews were conducted with 21 participants to investigate the complexity of HRS dissemination. An interview guide was developed from the seven domains of the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability framework, and thematic analysis was used. Phase 2 involved two rounds of a Delphi technique with 17 experts to evaluate the HRS’s complexity level (complex, complicated, and simple). Results: …


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