Samutprakan Hospital Journal (SMPK HOS J)

Comparison Effects of Nine-Square Exercise Program and a Conventional Exercise Program on Postural Balance in Post-Acute Stroke Patients at Bangplee Hospital

2025-04-19T08:40:29+07:00

Patients with stroke often experience multiple issues, including weakness and instability, which impact daily life and increase the risk of falls. Exercise is a method that helps in rehabilitation and prevents these problems. The Nine-Square Step Exercise (NSSE) program is a training format that can improve balance and strengthen leg muscles; however, this program has not been studied in patients with post-acute stroke before.

This study is a quasi-experimental design aims at comparing balance and mobility between a group receiving the Nine-Square Step Exercise (NSSE) program and a group following standard exercise programs. The target group consisted of 30 post-acute stroke patients, randomly assigned to an experimental group (n = 15) receiving the NSSE program and a control group (n = 15) receiving standard exercise. Balance was assessed using the Time Up and Go test (TUG) and the Berg Balance Scale (BBS), while the ability to perform daily activities was evaluated using the Barthel Index (BI). Assessments were conducted before and after an 8-week exercise program. Comparative analysis between groups was performed using the Mann-Whitney U Test, and pre- and post-training results were compared using the Wilcoxon Signed-Rank test.

The results showed that the BBS, TUG, and BI tests exhibited statistically significant differences before and after training (p < 0.05), with no significant differences between groups (p > 0.05). In conclusion, the nine-square step exercise can enhance balance and mobility in patients with post-acute stroke.

Results of Change of Health Behavior in Type 2 Diabetic Patients Being Treated with Insulin at NCDs Clinic, Samutprakan Hospital

2025-03-13T10:59:11+07:00

This study aims to develop a care management system for insulin-treated patients with diabetes through individualized behavioral modification based on each patient’s specific problems. It also compared diabetes knowledge and blood sugar control before and after participation in a case-management process. The study sample consisted of 32 insulin-treated diabetic patients registered at Samutprakan Hospital. Research instruments included a questionnaire divided into four parts: general information, a knowledge assessment, a self-care behavior assessment, and a satisfaction survey. Content validity was verified by experts, and instrument reliability assessed using Cronbach’s alpha yielded a coefficient of 0.73. Data were analyzed using descriptive statistics - percentage, mean, and standard deviation - and inferential statistics using the independent t-test.

Results showed that the mean knowledge scores before and after case management were M = 14.84 (SD = 2.24) and M = 16.65 (SD = 0.60), respectively. Mean self-care behavior scores before and after participation were M = 37.0 (SD = 3.98) and M = 43.0 (SD = 6.17), respectively. Statistical analysis indicated that both knowledge and self-care behavior scores significantly improved following case management (p = 0.01). Mean blood sugar levels decreased from 200 mg/dL (SD = 50.87) before the intervention to 159 mg/dL (SD = 47.03) afterward. Glycated hemoglobin (HbA1c) levels decreased from 10.30 mg% (SD = 1.48) to 9.55 mg% (SD = 1.43), representing a statistically significant reduction (p = 0.01). Overall satisfaction with the case-management process was high (M = 3.0).

In conclusion, case management is an essential nursing role that enhances knowledge and self-care behaviors among insulin-treated diabetic patients, leading to improved blood sugar control. This approach can be adapted and applied to suit the context of different healthcare settings.

Factors Associated with Birth Asphyxia in Bangbo Hospital, Samut Prakan Province

2025-09-24T10:11:01+07:00

Birth asphyxia is a significant cause of perinatal mortality. This condition can arise from various preventable and correctable factors. This study aims to investigate the factors influencing the occurrence of birth asphyxia at Bangbo Hospital. This retrospective study collected data from medical records of pregnant women who delivered at Bangbo Hospital from October 1, 2018, to September 30, 2023, involving 327 participants. The subjects were divided into two groups: the study group, consisting of 109 infants with an APGAR score of 1 minute less than or equal to 7, and the control group, comprising 218 infants with an APGAR score of 1 minute greater than 7. Comparisons between the study and control groups were made using Chi-square statistics, and statistical calculations were performed using univariate logistic regression analysis. And then the factors associated with the occurrence of birth asphyxia were analyzed simultaneously using multiple logistic regression analysis.

The results revealed that the factors influencing the occurrence of birth asphyxia, ranked from highest to lowest impact, included: prolonged second-stage labor (OR = 26.80, 95% CI = 3.16 - 226.96), fetal distress (OR = 17.37, 95% CI = 3.63 - 83.06), breech presentation (OR = 6.45, 95% CI = 2.39 - 17.43), cephalopelvic disproportion (OR = 5.10, 95% CI = 1.36 - 19.09), gestational age less than 37 weeks (OR = 2.63, 95% CI = 1.11 - 6.22), premature rupture of membranes (OR = 2.48, 95% CI = 1.13 - 5.44), and primigravidarum (OR = 2.30, 95% CI = 1.22 - 4.34).

In conclusion, all seven factors identified in this study significantly influence the occurrence of birth asphyxia. Increased prevention and monitoring, along with prompt and appropriate care, can help reduce birth asphyxia.

A Retrospective Study in Elderly Patients with Hip Fractures at Bangplee Hospital: Delayed Surgery is Associated with Increased Morbidity, Mortality, and Length of Stay

2025-10-17T14:20:58+07:00

Hip fracture in elderly is a common orthopedic emergency. Delayed surgery may increase the risk of complications, mortality, and length of stay. This study aims to compare clinical outcomes between patients who underwent surgery within 72 hours and those who underwent surgery after 72 hours at Bangplee Hospital. A retrospective analytical study was conducted in patients aged ≥ 65 years who underwent hip fracture surgery at Bangplee Hospital between 2023 and 2024. A total of 36 patients were included and divided into two groups: an early surgery group (within 72 hours; n = 18) and a delayed surgery group (> 72 hours; n = 18). Data were collected from medical records, including baseline characteristics, postoperative complications, in-hospital mortality, and length of stay. Descriptive statistics were used, while group comparisons were performed using the t-test for continuous variables and Fisher’s exact test for categorical variables.

The results showed that the delayed surgery group had significantly higher rates of urinary tract infection (66.7% vs. 16.7%, p = 0.006), pressure ulcers (77.7% vs. 16.7%, p < 0.001), and acute delirium (61.1% vs. 11.1%, p = 0.005) compared with the early surgery group. In addition, the delayed surgery group had a significantly longer mean hospital stay (18.4 ± 6.3 days vs. 10.2 ± 5.5 days, p < 0.001). No in-hospital mortality was observed in this study.

In conclusion, delayed hip fracture surgery beyond 72 hours in elderly is associated with increased postoperative complications-particularly urinary tract infection, pressure ulcers, and acute delirium-as well as prolonged length of stay. Enhancing systems to reduce surgical waiting times is therefore crucial for improving the quality of care for this patient population.

Incidence and Clinical Predictors of Recurrent Febrile Seizures Within 24 Hours in Children with Febrile Seizures at Samutprakan Hospital

2025-10-13T11:04:58+07:00

Febrile seizure (FS) is the most common neurological disorder in young children. A proportion of patients experience recurrent febrile seizures (RFS) within 24 hours; however, studies on this condition in Thailand remain limited. This study aims to determine the prevalence of recurrent febrile seizures within 24 hours and to identify factors associated with recurrence among children aged 6 months to 5 years admitted to the pediatric ward of Samutprakan Hospital between 1 January 2024 and 31 December 2024. A retrospective study design was employed.

A total of 208 patients with febrile seizures were identified, accounting for 5.14% of all pediatric admissions during the study period. The incidence of recurrent febrile seizures within 24 hours was 25 cases (12.02%). Multivariate logistic regression analysis demonstrated that two factors were significantly associated with recurrence at the 0.05 significance level: duration of fever prior to seizure ≤12 hours (OR = 1.45, 95% CI [1.03, 1.86]) and white blood cell count < 15,000/μL (OR = 1.25, 95% CI [1.01, 1.55]). Other factors-including age, sex, body temperature at seizure onset, seizure characteristics, number of prior febrile seizures, family history of febrile seizure or epilepsy, administration of acetaminophen and/or ibuprofen in the emergency department, tepid sponging in the emergency department, underlying causes of fever, presence of anemia, and serum sodium level-showed no statistically significant differences between recurrence and non-recurrence groups. Most recurrent seizures occurred within the first 6 hours and did not exceed 24 hours after admission.

These findings may inform clinical management strategies for children with febrile seizures, helping guide risk stratification and prioritization of care.

Perioperative Nursing Care for Patients Undergoing Total Thyroidectomy at Samutprakan Hospital: A Two-Case Study

2025-10-28T16:51:07+07:00

Total thyroidectomy is a high-risk surgical procedure that may result in serious complications and potential harm to patients. Therefore, perioperative nurses must possess comprehensive knowledge and understanding to provide holistic care before, during, and after surgery, thereby ensuring patient safety and minimizing risks.

This case study presents two patients who underwent total thyroidectomy at Samutprakan Hospital. The first case was a 74-year-old female who had a neck mass for two years. Fine-needle aspiration confirmed papillary thyroid carcinoma. She underwent total thyroidectomy, which lasted 3 hours and 40 minutes, and was hospitalized for six days. The second case was a 48-year-old female with a history of hypertension, who presented with bilateral neck masses, neck tightness, and hoarseness for five years. Computed tomography revealed compression of adjacent structures. She underwent total thyroidectomy, which lasted 2 hours and 25 minutes, and was hospitalized for five days.

Both patients received continuous perioperative nursing care across the preoperative, intraoperative, and postoperative phases, with an emphasis on complication monitoring and collaborative discharge planning with the inpatient ward. As a result, both patients were discharged safely within the expected timeframe. This case study underscores the critical role of perioperative nursing in enhancing patient safety and supporting effective recovery following total thyroidectomy.

A Clinical Case Report on Burning Mouth Syndrome Associated with Hypothyroidism

2025-10-14T10:50:33+07:00

This case report aims to describe the clinical characteristics of a patient with hypothyroidism associated with burning mouth syndrome (BMS), as well as the diagnostic process and management approach. The purpose is to provide clinical insights and reference information for dentists and healthcare professionals in evaluating and managing patients presenting with similar symptoms in the future.

A 62-year-old female patient presented with a burning sensation on the tongue without any visible oral lesions. Laboratory investigations revealed hypothyroidism and anemia, both of which are systemic conditions that may contribute to or exacerbate burning mouth symptoms. The patient was treated with Levothyroxine and vitamin B supplementation, together with oral hygiene modification and behavioral advice.

The patient’s burning sensation decreased from a Visual Analog Scale (VAS) score of 8 to 5 within one month and completely resolved within six months. Follow-up laboratory tests showed normalization of hemoglobin and thyroid hormone levels. This case highlights the importance of accurate diagnosis and individualized treatment planning through multidisciplinary collaboration to ensure comprehensive and etiology-based care. Integrating systemic evaluation with holistic management can effectively reduce symptoms and improve the patient’s quality of life.

Dentists should consider evaluating possible systemic disorders in patients presenting with burning mouth symptoms without clinical lesions, to enable precise diagnosis and achieve optimal treatment outcomes.