It is the largest regional hospital in Thailand under the responsibility of the ministry and has 1,387 beds. It has a CPIRD Medical Education Center which mainly trains medical students in the MOPH-Mahidol CPIRD Program of Mahidol University, as well as being an affiliated hospital to the Faculty of Medicine Ramathibodi Hospital, Mahidol University, Phramongkutklao College of Medicine.
Peritoneal dialysis (PD) is a feasible option for acute kidney injury (AKI) in hemodynamically unstable patients. However, the optimal timing for initiating PD in cardiorenal syndrome type 1 (CRS1) remains unclear. In a cardiac care unit of a tertiary hospital in Thailand, CRS1 patients who had AKI stage II between October 2020 and September 2021 were enrolled in a randomized, open-label controlled study. Patients were randomized into two groups: early-start PD strategy (starting PD within 24 h after AKI stage II) and conventional-start PD strategy (starting PD at 72 h if reaching AKI stage III or with an indication). The primary outcome was 30-day mortality. Secondary outcomes included fluid balance, sodium removal during the first 5 days, and PD safety. 77 CRS1 patients were enrolled, and 53 eligible participants were included in a modified intention-to-treat analysis (26 in the early-start group and 27 in the conventional-start group). Dialysis was initiated in 26 patients (100
Antimicrobial resistance in Streptococcus suis represents an increasing global health concern, particularly in Thailand, where human and swine infections remain common and severe. A descriptive study was conducted in northeastern Thailand from January 2020 to December 2024 to examine the association between clinical characteristics and penicillin susceptibility (susceptible, intermediate, resistant) among S. suis isolates. In vitro antibiotic interactions were assessed by checkerboard microdilution in 23 drug-resistant isolates. Among 373 culture-confirmed S. suis cases, 161 isolates (43.2
Background In Thai patients with non-valvular atrial fibrillation (NVAF), anticoagulation quality with warfarin remains suboptimal. Existing prediction tools for poor international normalized ratio (INR) control, such as the SAMe-TT 2 R 2 score, perform poorly in this population. Identifying population-specific determinants of time in therapeutic range (TTR) may improve risk stratification and inform clinical decision-making. Methods We conducted a single-center, retrospective cohort study of adult patients with NVAF taking warfarin between 2016 and 2019. TTR was calculated using the Rosendaal method, with a target INR range of 2.0–3.0. Logistic regression analysis was performed to identify independent predictors of suboptimal anticoagulation control (TTR <65%). A novel risk score was derived from the regression coefficients and evaluated using receiver operating characteristic (ROC) curve analysis. Results Among 1,322 patients (median age 68 years; 57% female), median TTR was 50.5% (IQR 29.8–69.0), and 70% had TTR <65%. Independent predictors of suboptimal TTR included age ≥65 years, heart failure, hypertension, and drug–drug interactions with warfarin, while prior warfarin use ≥1 year was protective (all P<0.05). These variables were incorporated into the AHfHDP score (range, −2 to 4). The AHfHDP score showed modest discrimination (C-statistic 0.64; 95% CI 0.61–0.67), outperforming SAMe-TT 2 R 2 (C-statistic, 0.53). Conclusions Warfarin anticoagulation control in Thai patients with NVAF remains suboptimal. The AHfHDP score demonstrated modest predictive performance and superior discrimination compared to the SAMe-TT 2 R 2 score. However, its overall predictive ability remained limited, and external validation is required before clinical application.
Frailty is a common geriatric syndrome associated with falls, disability, hospitalization, and mortality. Primary care screening tools must be simple, time-efficient, and accurate. This study aimed to develop and validate the Frailty Questionnaire-5 (FQ-5), adapted from the PRISMA-7, for frailty screening in a primary care setting. We conducted a cross-sectional study of 328 ambulatory, community-dwelling older adults (age 60–91 years; 84 males, 244 females) recruited via consecutive sampling in suburban Northeast Thailand. Following linguistic validation of PRISMA-7, the FQ-5 was developed by removing two low-performing items and adjusting the age threshold. Criterion validity and clinical association were assessed against the modified Thai Frailty Index (mTFI). Internal consistency and 7–14-day test–retest reliability (n = 33) were also evaluated. Frailty prevalence was 29.9
SUMMARYStreptococcus suis is a swine pathogen causing significant economic losses and an important zoonotic agent in humans. Southeast Asia is a high-incidence region, where infection is strongly linked to consumption of raw or undercooked pork and occupational exposure to pigs or pork products. Thailand and Vietnam report the highest case numbers, with additional cases in Indonesia (Bali), Malaysia, Singapore, Lao PDR, and Cambodia. Serotype 2 predominates in both humans and pigs, followed by serotype 14, while other serotypes (1, 4, 5, 7, 9, 16, 24, and 31) are also reported in humans. In pigs, a broader serotype range is observed, including 1 or 14, 2, 4, 5, 6, 7, 8, 9, 15, 16, 18, 21, 29, 31, and nontypeable strains. Human infections involve multiple clonal complexes (CC1, CC16, CC25, CC28, CC94, CC104, CC233, CC221/234, and CC1688), several overlapping with porcine lineages. The region is also challenged by increasing antimicrobial resistance, with rising non-susceptibility to macrolides and tetracyclines and occasional reduced susceptibility to penicillin. Diagnostic limitations due to misidentification, limited molecular tools, and reliance on conventional methods further complicate surveillance. The economic burden is substantial, driven by swine losses, treatment costs, outbreaks, and severe human disease. Vaccination remains suboptimal due to limited protection against genetically and antigenically diverse strains across serotypes and CCs. An urgent One Health approach integrating animal health, food safety, and human health is needed to monitor S. suis dynamics. Control measures should target farms, slaughterhouses, and retail markets while promoting community-accepted behavioral changes to reduce transmission risk.
