Electronic ISSN 2287-0237




We are proud to bring you Volume 15-2 of the Bangkok Medical Journal with contributions frommedical professionals on preventive health care and first of its kind surgical technology and innovation.

Globally, TB is one of the top 10 causes of mortality and the primary cause from a single infectiousagent over and above HIV/AIDS. Hence, to efficiently reduce the high rate of unidentified Latent TBcases that might lead to active TB in the future; a unified, well implemented, and sophisticated approachis crucial. Dr Sawang Saenghirunvattana, et al present a clinical series, which to our knowledge, is thefirst to report 20% conversion of QFT-Plus among LTB participants prescribed with a nine-monthIsoniazid prophylaxis. As there is no gold standard in the definition of conversion and reversion, furtherstudies are now needed to optimize the correlation between the efficacy of varied LTBI and TB treatmentregimen and conversion of QFT-Plus results.

In our Special Feature by Dr Van de Werf F. cardiovascular mortality rates are compared withtremendous differences among countries and regions. These differences can be partly explained by agreater cardiovascular risk, socio-economic factors and the quality of health care. Important changes areforecasted in South and Southeast Asia, as in these regions, life expectance is expected to increase from63.6 years in 1980 to 79.8 years on average in 2040. It is estimated that non-communicable diseases willbecome the most important cause of death (83.2%). Preventive measures will be critically important toavoid a large transient increase in CVD mortality in the next decade.

A variety of clinical presentations are observed in pulmonary inflammatory myofibroblastic tumors.Diagnosis can be difficult and requires a high index of suspicion due to rarity of the disease. Dr PadungkiatTangpiroontham report two patients who were treated via thoracoscopic and bronchoscopic approach asoptions of investigation and treatment in this era of minimally invasive surgery. In early pulmonaryinflammatory myofibroblastic tumor, thoracoscopic complete resection has an excellent short termoutcome and may result in long-term survival. Even in metastatic cases, palliative airway control alsohas good short and mid-term outcomes.

Dr Pawee Chalidapong et al present two cases of hemicorporectomy (also known as translumbaramputation, halfectomy) an operation of amputation of the pelvis and lower extremities by disarticulationthrough the lumbar spine. This is a complex, rare, and major procedure and can be a life-saving operation.It relies on expert surgical intervention and smooth co-operation of an extensive multi-disciplinary team.

Dr Kriwut Leurmprasert compared articular exposure of distal humerus with oleocranon osteotomyand triceps-reflecting anconeus pedicle. To our knowledge, the current study is the first anatomical studyto compare these approaches, with the oleocranon osteotomy technique offering more visualization.

Finally, we reported on studies with a focus on improving patient care with effective managementof hospital management resources. The study by Dr Nantana Suppapitnarm was conducted to determinethe potential factors influencing medical specialist allocation, as this is crucial for achieving equitableaccess to specialized care. This is in response to a shortage and maldistribution of physicians in Thailandcompared to other developed countries worldwide. The study by Dr Chatree Duangnet examines thedifferent levels of percentages and relative weighting of simple diseases to help monitor hospital performance.A traffic light system is proposed to improve the standard of care for all patients in super tertiary, hubtertiary, secondary tertiary, and basic tertiary care.

Chirotchana Suchato, MD
Editor in Chief
Chaiyos Kunanusont, MD, MPH, MSc, PhD