Lerdsin Hospital

Oil palm trunks (OPT) are a significant palm oil waste with limited utilizations because of their large moisture content. In this work, hydrothermal carbonization (HTC) was employed with variations in temperatures and times to convert OPT into high value-carbon material. Experimental results indicated that elevating temperature from 200 to 280 degrees C resulted in declining in yield, while simultaneously increasing carbon content. Remarkably, hydrochar produced by HTC at 240 degrees C had carbon content and carbon yield of 42% and 68%, respectively. After HTC, hydrochar obtained at 240 degrees C was activated using different activating agents (KOH, ZnCl2 and FeCl3) to produce porous carbon. Characteristic results indicated that KOH produced the largest surface area (1743 m2/g) and interconnected structures, which in turn resulted in outstanding electrochemical capacity. Maximum capacity of 125 F/g was accomplished at 0.5 A/g. Stability testing revealed capacity retention nearly 100% over 10,000 cycles. Moreover, two electrodes fabricated from KOH-activated hydrochar showed energy density of 8.5 Wh/kg at 117 W/kg and capacity retention of 90% for 5000 cycles at 0.5 A/g. These results present successful method for turning high-moisture agricultural wastes into value-added carbon for energy storage.

Background Tuberculosis remains a pressing public health concern in Thailand, where medication adherence largely determines treatment success and the prevention of drug resistance. This study sought to examine factors influencing anti-tuberculosis medication adherence among patients attending Lerdsin Hospital in Bangkok. Methods We employed a sequential explanatory mixed methods design. The quantitative phase surveyed 100 tuberculosis patients using a questionnaire grounded in the WHO five-dimensional adherence framework. The qualitative phase involved in-depth interviews with 12 patients selected through purposive sampling. Survey data were analysed using descriptive statistics and binary logistic regression; interview transcripts underwent thematic analysis. Results Eighty-seven percent of participants demonstrated good adherence. Logistic regression identified medication-related factors (OR = 0.178, 95% CI: 0.039–0.804, p = 0.025) and healthcare system factors (OR = 0.327, 95% CI: 0.108–0.985, p = 0.047) as significant negative predictors, with the model explaining 81.5% of variance. Five qualitative themes emerged: the protective role of universal health coverage, barriers to access and continuity, economic burden, social and family support, and cultural beliefs. Joint display analysis revealed both convergence and partial discordance—high satisfaction scores coexisted with process-level frustrations voiced during interviews. Conclusion Although Thailand's universal coverage schemes effectively absorb direct treatment costs, adverse drug reactions and indirect expenses persist as formidable obstacles. Strengthening proactive adverse event management, offsetting hidden costs, and screening for social support gaps at treatment initiation may enhance adherence and curb drug resistance.

Background:Survival following critical illness has improved substantially; however, many individuals experience persistent psychological sequelae after discharge from intensive care units. These outcomes may adversely affect long-term recovery, quality of life, and reintegration into daily roles, underscoring the need for a comprehensive synthesis of current evidence. Objective:To synthesize evidence published between 2021 and 2025 on psychological outcomes among ICU survivors and identify associated factors. Methods:This systematic review employed a convergent integrated approach for data synthesis. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six electronic databases (PubMed, MEDLINE via EBSCO, ScienceDirect, Scopus, Nursing & Allied Health Premium, and the Cochrane Library) were searched for studies published between 2021 and 2025. Studies were included if they reported psychological outcomes and associated factors among adult ICU survivors. Data were synthesized following the Joanna Briggs Institute methodology. Results:Thirteen studies met the inclusion criteria. The most frequently reported psychological outcomes were depression, (9 studies; 69.2%), anxiety (8 studies; 61.5%), post-traumatic stress disorder (8 studies; 61.5%), and stress-related symptoms (1 study; 7.7%). Associated factors were grouped into seven domains: personal characteristics, length of stay, distress-related factors, pre-existing mental health or substance use, physical and cognitive function, and protective factors. Women were more frequently reported to experience higher psychological distress across several studies, while some evidence suggested higher symptom burden among patients with longer ICU stays and poorer physical or cognitive function. While consistent patterns were observed, the strength of evidence varied across domains. Conclusion:Psychological outcomes are commonly reported among ICU survivors and appear to be influenced by multiple interrelated factors. However, given the limited number, heterogeneity, and predominantly observational nature of included studies, these findings should be interpreted with caution. Further research is warranted to strengthen the evidence base and inform targeted interventions.

Background and Aim: Breast cancer remains one of the leading causes of cancer-related mortality worldwide, despite advances in surgery, chemotherapy, endocrine therapy, and targeted treatments. Cannabinoids derived from Cannabis sativa, particularly tetrahydrocannabinol (THC) and cannabidiol (CBD), have demonstrated anticancer properties in several experimental models; however, in vivo evidence in estrogen receptor (ER)-positive breast cancer remains limited. This study aimed to evaluate the antitumor effects of a THC:CBD (1:6) cannabis extract in a Michigan Cancer Foundation-7 breast cancer cell line (MCF-7) xenograft mouse model of ER-positive breast cancer. Materials and Methods: Female BALB/c nude mice bearing MCF-7 xenograft tumors were randomly assigned into five groups (n = 5/group): negative control (sesame oil), positive control treated with 5-fluorouracil (5-FU; 20 mg/kg), and three treatment groups receiving oral THC:CBD (1:6) extract at doses of 2, 10, or 20 mg/kg body weight for 30 consecutive days. Tumor growth was monitored throughout the experiment. Histopathological examination and immunohistochemical analysis of proliferating cell nuclear antigen (PCNA) expression were performed to evaluate apoptosis-related morphology and tumor cell proliferation. Hematological and biochemical parameters were assessed to determine systemic safety. Results: Cannabinoid-treated groups exhibited significant suppression of tumor growth compared with the negative control group. Tumor volume reduction was observed in all treatment groups, with the greatest reduction detected in the high-dose THC:CBD group. Histopathological evaluation revealed increased numbers of tumor cells exhibiting morphological features consistent with apoptosis in cannabinoid-treated mice. Immunohistochemical analysis demonstrated significantly lower PCNA expression scores in all THC:CBD-treated groups compared with both negative and positive controls, indicating reduced tumor cell proliferation. Hematological parameters remained within normal physiological ranges in cannabinoid-treated animals. However, elevated alanine aminotransferase and aspartate aminotransferase levels were observed in the high-dose group, suggesting potential dose-related hepatic stress. Conclusion: The THC:CBD (1:6) cannabis extract demonstrated significant antitumor activity in an MCF-7 xenograft model by suppressing tumor progression primarily through inhibition of tumor cell proliferation, with supportive apoptosis-related histological features. These findings provide novel in vivo evidence supporting the potential of cannabinoid-based formulations as adjunctive therapeutic approaches for ER-positive breast cancer.

Continuous electroencephalography (cEEG) has been recommended in critically ill patients although its efficacy for improving patients’ functional status remains unclear. This study aimed to compare the efficacy of Tele-cEEG with Tele-routine EEG (Tele-rEEG), in terms of seizure detection rate, mortality and functional outcomes. This study is a 3-year randomized, controlled, parallel, multicenter trial, conducted in eight regional hospitals across Thailand. Eligible participants were critically ill patients aged ≥ 15 years and at-risk for developing nonconvulsive seizure (NCS)/nonconvulsive status epilepticus (NCSE). Study interventions were 24–72 h Tele-cEEG versus 30-min Tele-rEEG. Study outcomes were seizure detection rate, mortality and functional outcomes (mRS), assessed at hospital discharge, ≤ 7 days, 3-, 6-, 9-months and 1 year. Two hundred and fifty-four patients were randomized, 128 and 126 patients received Tele-cEEG and Tele-rEEG, respectively. NCS/NCSE were detected more commonly in the Tele-cEEG (21.88