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Objective: To assess a multifaceted postpartum hemorrhage (PPH)-management intervention in community hospitals in Southern Thailand.Methods: The present prospective study was conducted from November 1, 2012 to April 30, 2015. The medical records of women with PPH were collected before (January 1, 2011, and October 31, 2012) and after (March 1, 2013, and December 31, 2014) the implementation of a multifaceted PPH-management intervention at three community hospitals in Southern Thailand; these patients were compared with patients diagnosed with PPH at three control hospitals in the same provinces during the same time periods. The intervention, delivered to general practitioners and nurses, utilized previously developed PPH-management guidelines. PPH management was compared between the intervention and control hospitals and factors associated with PPH management were evaluated using univariate and multiple logistic regressions.Results: The post-intervention median blood loss within 2 hours of delivery was lower in intervention hospitals (P<0.001) and post-intervention indwelling bladder catheterization was higher (P=0.004). Increased odds of indwelling bladder catheterization were recorded among patients treated at intervention hospitals (adjusted odds ratio [aOR] 2.79, 95% confidence interval [CI] 1.40-5.55) and patients who experienced more than 500 mL of blood loss (501-1000 mL [aOR 2.41, 95% CI 1.22-4.76] or >1000 mL [aOR 16.45, 95% CI 2.04-132.80]).Conclusion: Implementation of the multifaceted intervention improved PPH management at community hospitals. [ABSTRACT FROM AUTHOR]

The article presents a study on the production of Halal herbal medicine in Chanae Community Hospital in Narathiwas Province, Thailand. The researchers have described the procedure for the set-up of a mini-plant in an unrest area in Thailand to become a model community hospital in the country. They find that the cooperation between Rangsit University and Chanae community hospital can promote the production of herbal medicinal products.

Introduction: Leadership is crucial in all professions and organisations, including the oral health profession., Objectives: The aims of this analytical cross-sectional study were to evaluate the self-reported leadership behaviours and the factors influencing leadership behaviours among dentists who were heads of dental departments in community hospitals, southern Thailand., Materials and Methods: The self-administered questionnaire was composed of four parts: personal data; a 45-item Multifactor Leadership Questionnaire version 5× short (MLQ 5× short); a 34-item organisational climate perception; and a 52-item emotional intelligence screening test., Results: Of 134 dentists, 133 returned the questionnaire, providing a 99.3% response rate. The scores on the transactional component had a mean score of 2.98 (SD = 0.46). The transformational scores ranged with a mean of 2.90 (SD = 0.49). The scores of the passive leadership component had the lowest results, with a mean of 1.21 (SD = 0.57). Afterwards, the highest score for each head of the dental department was examined and compared across the three components. Approximately 60% of the dentists fell on the transactional, 34.6% on the transformational and 2.3% on the passive-avoidant scale. Multiple linear regression showed that the factors influencing the leadership of the dentists included emotional intelligence, the professional position of the dentists and the perception of the organisational climate., Conclusions: The majority of heads of dental departments had transactional leadership style followed by transformational leadership style, and passive-avoidance was the least common. Emotional intelligence, the professional position and the perception of the organisational climate significantly increased the transformational leadership score., (© 2020 FDI World Dental Federation.)

Background: Compulsory 3-year public service was implemented in 1967 as a measure to tackle the maldistribution of doctors in Thailand. Currently, therefore, most medical graduates work in rural community hospitals for their first jobs. This research explored doctors' perceptions of preparedness for practice using a critical incident technique.Methods: A self-administered critical incident questionnaire was developed. Convenient samples were used, i.e. Family Medicine residents at Ramathibodi Hospital who had worked in a community hospital after graduation before returning to residency training. Participants were asked to write about two incidents that had occurred while working in a community hospital, one in which they felt the knowledge and skills obtained in medical school had prepared them for managing the situation effectively and the other in which they felt ill-prepared. Data were thematically analysed.Results: Fifty-six critical incidents were reported from 28 participants. There were representatives from both normal and rural tracks of undergraduate training and community hospitals of all sizes and all regions. Doctors felt well-prepared to provide care for patients in emergency situations and as in-patients, but under-prepared for obstetric and paediatric emergencies, out-patient care, and palliative care. Moreover, they felt poorly prepared to deal with difficult patients, hospital administration and quality assurance.Conclusions: Long-term solutions are needed to solve the rural doctor shortage. Medical graduates from both normal and rural tracks felt poorly prepared for working effectively in community hospitals. Medical training should prepare doctors for rural work, and they should be supported while in post. [ABSTRACT FROM AUTHOR]

Background: Fever without a source (FWS) in young children can result from occult bacteremia, urinary tract infection (UTI), meningitis, or certain viral infections. In rural areas of Thailand, where bacterial cultures are not available in some community hospitals, the appropriate examination and management of FWS remain controversial. Methods: We retrospectively searched electronic medical records for medical diagnoses associated with FWS and evaluated the characteristics and clinical courses of children aged 3 to 36 months with FWS who were admitted to a community hospital in southern Thailand between January 2015 and December 2016. Results: Sixty-seven children aged 3 to 36 months with an initial diagnosis of FWS were enrolled. The median age was 11 months (interquartile range [IQR] 8-21 months). Complete blood counts, blood cultures, urine analysis results and urinary cultures were obtained from 67 (100.0%), 31 (46.3%), 47 (70.1%), and 7 (10.5%) patients, respectively. The most common empirical antibiotic administered to these patients was ceftriaxone (71.6%); however, 4 patients recovered without antibiotic administration. The median duration of intravenous antibiotic administration was 4 days (IQR 2-4 days). Intravenous antibiotics were replaced by oral antibiotics in 38 patients (62.3%). The median time to fever subsidence was 30 hours (IQR 12-60 hours). Regarding final diagnoses, 5 patients (7.5%) were diagnosed with culture-confirmed UTI, and 2 (3.0%) had bacteremia (due to contamination). The majority of the children (60, 89.6%) retained the diagnosis of FWS. Presentation at the hospital was significantly earlier in children with culture-confirmed UTI (median 1 day) than in those with culture-negative FWS (median 3 days) ( P = .019). Discussion: We evaluated the characteristics and clinical courses of young children with FWS presenting at a community hospital and the treatment approaches utilized by physicians. Although all patients had good prognoses during the study period, we identified several areas for improvement in conducting proper examinations (especially assessments for UTI in children presenting within the first day of fever onset).