Napaphat Poprom

Background: Dengue is an acute infectious tropical disease that poses a significant public health burden in the Philippines; however, studies employing spatial distribution modeling and ecological approaches to analyze dengue occurrence data remain limited. This study aims to determine the high-risk areas suitable for dengue occurrence and its determinants in the Philippines. Methods: Dengue case data from 2017 to 2024 were analyzed using kernel density estimation (KDE) and inverse distance weighting (IDW) spatial interpolation to characterize spatial intensity and estimate incidence in unsampled areas. An ecological niche model was developed using maximum entropy modeling, implemented through the MaxEnt software, with climatic, environmental, and socioeconomic predictors. Model performance was evaluated using the area under the curve (AUC), and predictor importance was assessed using jackknife testing. Results: Results show highest intensity in 2019 and consistent high case density in the National Capital Region (NCR). Meanwhile, high predicted incidence rates were consistently exhibited in northern Luzon. The maximum entropy model had a strong performance in predicting the suitable areas for dengue with a mean area under curve (AUC) of 0.847. Nighttime lights (32.3%), land cover (31.1%), and population density (9.4%) significantly contributed to the model. The NCR was found to be a high-risk suitable area for dengue occurrence along with some parts of other provinces. Conclusions: This study represents the first application of ecological niche modeling to dengue in the Philippines. The integration of KDE, IDW, and maximum entropy model provides a robust framework for identifying high-risk areas and key determinants, emphasizing the role of urbanization in dengue distribution. These findings are valuable to authorities for an informed risk-based surveillance, genotype-specific monitoring, and decision-making for geospatially targeted disease risk management. Graphical

Oral health literacy (OHL) is increasingly recognized as a determinant of oral health outcomes; however, its relationship with children’s oral health related quality of life (OHRQoL) in rural Latin-American settings remains unclear. The objective was to examine the correlation between caregiver’s OHL and children’s OHRQoL in rural schools in Arauco, Chile. A cross-sectional study was conducted with 152 caregivers. Data was collected using the validated Cupé-Araujo OHL scale and the Early Childhood Oral Health Impact Scale (ECOHIS). OHRQoL was assessed through caregiver’s proxy reporting. Normality was tested with the Kolmogorov–Smirnov test, and Spearman’s rho (ρ) was used to evaluate associations. The average OHL score was 2.98 ± 0.9, and the mean ECOHIS score was 5.79 ± 6.17. A weak but statistically significant negative correlation was observed between OHL and OHRQoL (ρ = –0.173, P = 0.033). Higher OHL was observed among caregivers with greater education and better access to oral-health information (P < 0.05). Although no significant correlation was identified between caregivers’ OHL and children’s OHRQoL, socio-educational and informational factors appear to influence oral-health outcomes. These findings highlight the need for culturally tailored interventions to strengthen oral-health literacy in rural communities.

Purpose: Laparoscopic complete mesocolon excision (LCME) for right colonic cancer improves oncological outcomes. This meta-analysis aimed to compare the rate of chylous leakage between laparoscopic and open right colectomy with CME for right-sided colonic cancers.Methods: A literature search was performed up to February 2022. The primary outcome was the rate of chylous leakage. Secondary outcomes included related surgical and clinical parameters. A meta-analysis was performed to calculate risk ratios.Results: Eleven studies were included. The rate of postoperative chylous leakage was lower in laparoscopic surgery compared to open surgery (risk ratio, 0.63; 95% confidence interval, 0.33–1.20), although this difference was not statistically significant. LCME showed superior outcomes to open CME (OCME) in secondary outcomes, such as reduced blood loss, increased harvested lymph node count, and decreased overall morbidity.Conclusion: There was no significant difference between LCME and OCME regarding the rates of chylous leakage, anastomosis leakage, or operative time. However, LCME demonstrated superiority in blood loss reduction, harvested lymph node number, and overall morbidity in patients undergoing surgery for right colon cancer.

Purpose: Postoperative ileus is the physiologic hypomotility of the gastrointestinal tract that occurs immediately after abdominal surgery. Mosapride citrate is known to enhance gastrointestinal motility. This study aimed to evaluate mosapride’s impact on postoperative ileus and gastrointestinal motility in patients undergoing elective colorectal surgery.Methods: Forty-four patients with colorectal cancer undergoing surgery at Ramathibodi Hospital between July 2021 and August 2022 were randomly assigned to either a mosapride group or a control group. The mosapride group received 5 mg of mosapride via the enteric route with 50 mL of water 3 times daily, beginning on postoperative day 1, while the control group received 5 mg of a placebo with 50 mL of water on the same schedule. A single investigator, blinded to the treatment assignments in this triple-blind study, evaluated the postoperative time to the first bowel movement and passage of flatus. Secondary outcomes included the time to step diet, length of postoperative hospital stay, and adverse effects.Results: There were 23 patients in the control group and 21 in the mosapride group. There were no significant differences in baseline patient characteristics between the 2 groups. The mosapride group demonstrated significantly shorter times to the first bowel movement (26 hours vs. 50 hours, P=0.004) and passage of flatus (40 hours vs. 70 hours, P=0.003).Conclusion: Mosapride significantly improved the recovery of gastrointestinal motility and reduced the length of hospital stay without causing any serious adverse effects in patients undergoing elective colorectal surgery.Trial registration: ClinicalTrials.gov identifier: NCT04905147

Prediction of dengue continues to be valuable in endemic countries. Time series forecasting methods have been widely employed for predicting future dengue trends and outbreaks. The study aimed to determine the spatial distribution, trends, and seasonality of dengue cases and compare the predictive accuracy of seasonal autoregressive integrated moving average (SARIMA), neural network autoregression (NNAR), random forest (RF), long–short term memory (LSTM), trigonometric exponential smoothing state–space model with Box–Cox transformation, ARMA errors, trend and seasonal components (TBATS), and Prophet in forecasting dengue cases in the Philippines. Monthly data from 2017 to 2024 across all provinces were obtained and were partitioned into training (January 2017–December 2023) and testing segments (January 2024–December 2024). Model performance was assessed by analyzing the training data using time series techniques and comparing the resulting forecasts with empirical values from the test dataset. In total, 3‐year projections were generated by implementing the models on the entire dataset. The study analyzed 1,903,425 dengue cases with a mean monthly incidence of 17.66 ± 15.97 per 100,000 population. Regular seasonal epidemics were identified, peaking from July to September. NNAR outperformed the other models and predicted an annual average of 444,678 cases from 2025 to 2027. This is the first study to apply SARIMA, RF, LSTM, TBATS, and Prophet in forecasting dengue cases in the Philippines at a national scale. The study offers new insights into disease forecasting, particularly in the application of advanced time series methodologies. These findings should be considered to strengthen surveillance, prevention, and control against dengue.

Background: The Emergency Medical Services (EMS) system is a network of coordinated medical service providers and resources that respond to medical emergencies. The Thai government implemented a national plan aimed to develop of the EMS services system. To our knowledge, there was little or no previous research about the factors associated with services use. The study aimed to explore the factors associated with using EMS services in Chiang Mai province, Thailand. Method: The cross-sectional study was conducted in Chiang Mai province, Thailand. The first step was the selection of covariates associated with the using EMS/ ambulance services using simple logistic regression. The final step of model selection was confirmation of the factors’ association with each outcome using multivariable logistic regression. Results: The study population consisted of 579 individuals. Nearly half of ED users (46.45%, n = 269) arrived at emergency departments (EDs) by EMS transport or ambulance, while 53.36% (n = 309) used other means of transportation. The mean age of EMS-users was 43.23 (15.89) years, and 43.63 (16.78) years for non-users. Variables associated with using EMS services included educational level, level of district urbanization, patient symptoms, familiarity with the Thai emergency telephone number (1669), and ambulance service fees. Conclusion: These results imply that EMS utilization has a multifaceted nature which require addressing various determinants to optimize access and enhance patient awareness during emergencies. Improving patient access and awareness can ultimately lead to more efficient emergency response and improved healthcare outcomes. Keywords: Emergency Medical System, Ambulance service, Medical emergency, Thailand

Purpose There is no evidence comparing the treatment results of hemoglobin spray and hyperbaric oxygen therapy (HBOT) in chronic wounds. Therefore, we conducted a systematic review and network meta-analysis to explore the efficacy and role of hemoglobin spray in the treatment of chronic wounds. The probabilities of being the best treatment option were estimated and ranked between hemoglobin spray and HBOT. Methods A systematic review and network meta-analysis (NMA) were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines and PROSPERO number: CRD42020161396. Results A total of 934 studies were identified from PUBMED and SCOPUS databases, and 112 articles were deleted. Among the 24 studies, 16 RCTs and eight cohort studies met our inclusion criteria. In direct meta-analysis, HBOT had higher proportion of wound healing rate than control with pooled risk ratios (RRs) of 1.67 (95%CI: 1.10, 2.52). Hemoglobin spray had a higher wound healing rate than the control, with a pooled odds ratio (OR) of 1.92 (95%CI: 1.35, 2.73). In the network meta-analysis, the probability of being the best treatment was hemoglobin spray, followed by hyperbaric, with surface under the cumulative ranking curve (SUCRAs) of 67.9, and 32.1, respectively. Conclusions Our evidence suggests that the proportion of wound healing in the hemoglobin spray and HBOT groups was higher than that in the control group. A network meta-analysis demonstrated that hemoglobin spray had the highest chance of treatment success. There is a need for further studies using well-designed RCTs and updated meta-analyses to provide enough evidence to compare the effectiveness of hemoglobin spray and HBOT in clinical practice.

Introduction Antiseptic and antibacterial solutions are increasingly used in the treatment of various types of wounds. The successful stabilization of wounds using a combination Sodium Hypochlorite/Hypochlorous acid (NaOCl/HOCl) or superoxidized solution (SOS) has been reported, serving as an effective solution without irritating mammal cells and without posing a carcinogenic hazard. Presently, no systematic review or meta-analysis is available that compares the effectiveness of these antiseptic solutions. The present study aims to investigate the role of NaOCl/HOCl in the treatment of wounds. Methods The systematic review with extended to network meta-analysis (NMA) was conducted using NaOCl/HOCl, povidone-iodine, octenidine dihydrochloride, polyhexamethylene biguanide, alcohol, and silver compared with normal saline. The primary outcome was wound healing. Using surface under the cumulative ranking curve (SUCRA), the direct and indirect comparisons were conducted with the probability of selecting the best treatment. Results A total of 507 studies were identified from PUBMED and SCOPUS databases, and 64 articles were duplicates. Among 29 studies included, 22 randomized controlled trials (RCTs) and 7 cohort studies met our inclusion criteria. NaOCl/HOCl had a higher chance of wound healing 1.07-1.30 times compared with all the regimens. NaOCl/HOCl has the probability of providing the best treatment, followed by silver and octenidine with SUCRAs of 36.9, 23.1, and 21.8, respectively. Conclusions NaOCl/HOCl ranks first and proves to have the highest efficacy, followed by silver, octenidine, and PHMB for treatment.

Colonoscopy is the standard procedure for screening, and surveillance of colorectal cancer, including the treatment for colonic lesions. Colonic spasm is an important problem from colonoscopy that affects both surgeons and patients. The spasm also might be the cause of longer cecal intubation time, difficulty of the procedure, and increased pain. Previous reports indicated that antispasmodic agents can decrease such symptoms. Therefore, we conducted this study to investigate the cecal intubation time of antispasmodic agents. A single blinded randomized controlled trial was conducted from 01/11/2020 to 31/08/2021. One hundred four patients were allocated to antispasmodic agent group and control group, in 1:1 ratio. The efficacy of median (range) cecal intubation time showed similar results of 5 (2, 14) and 5 (2, 15) minutes with no statistically significant difference. The mean scores of all domains i.e., pain, spasm, cleanliness, and difficulty were better in the antispasmodic agent group about 2.6 (1.4), 1.8 (0.8), 2.4 (0.9), and 2.0 (0.9), respectively, than control group but there were spasm and cleanliness showed statistically significant difference. Moreover, the satisfaction scores showed better efficacy in decreased spasm, decreased difficulty, and increased cleanliness than control group. Prescribing of antispasmodic drugs before colonoscopy might be the choice of treatment for the patients. The antispasmodic drugs will be beneficial to both of the patient and the doctor.