Dr. Supharuk Wicharanyan, known as Doctor Oak on the DoctorSixpack page, explains why triple-vessel coronary artery disease occurs and why many people have no warning symptoms until the disease is severe.

Using a recent case to educate the public, he describes what triple-vessel disease means. The heart works 24 hours a day and requires constant blood and oxygen supply through coronary arteries. When we say "coronary artery disease," we usually mean atherosclerosis, the buildup of plaque inside artery walls. "Triple-vessel disease" refers to significant narrowing found in all three main coronary artery territories, considered a severe form requiring specialist evaluation.

Contrary to what many believe, coronary disease does not appear suddenly. It accumulates silently over decades. The arteries start smooth and open, but risk factors like high LDL cholesterol, high blood pressure, diabetes, smoking, abdominal obesity, sedentary lifestyle, advancing age, and family history accelerate atherosclerosis.

The process begins when LDL particles deposit in artery walls, triggering inflammation. White blood cells called macrophages consume the fat and become foam cells. As this cycle repeats, fat accumulates, inflammation spreads, plaques form, and calcium deposits harden the artery walls. Blood flow gradually decreases, starving the heart muscle of oxygen—this is myocardial ischemia.

More dangerously, plaques can rupture, triggering sudden blood clot formation. If a clot blocks a coronary artery completely, the heart muscle dies from oxygen deprivation. This is a heart attack, which can cause irregular heartbeats, heart failure, cardiac arrest, or sudden death.

This is why coronary artery disease should not be ignored until symptoms appear. The post addresses why some people with severe narrowing have almost no symptoms.

Disease Control Office Region 12 reported that Songkhla province has recorded approximately 10,644 HIV infections, with the highest-risk groups being youth and working-age people, primarily through unprotected sexual contact. The office has partnered with the Rainbow Association and drug-user support groups in Songkhla and Hat Yai Village to run HIV testing campaigns, provide counseling, and conduct blood screenings for HIV, hepatitis B and C, and prostate cancer markers. These public health initiatives aim to raise awareness of the importance of HIV testing as a means to reduce transmission to others and improve the overall quality of life and health outcomes for those living with HIV.

At Parliament on August 20, 2026, Rangsiman Rom, a Democrat Party list member and deputy party leader, commented on allegations that Prime Minister Anutin Charnvirakul and Interior Minister had involvement in election fraud. He stated the government cannot accept the alleged misconduct and called it reprehensible, noting that the government denies any connection to the fraud case. Rangsiman explained that any no-confidence debate has not yet been scheduled, so conclusions about what will happen should not be rushed.

The opposition's role depends on evidence, he said, and investigations into alleged election fraud must rest on two foundations: legal grounds—determining what specific crime was committed and whether it constitutes fraud—and political oversight through parliamentary scrutiny. He emphasized that any investigation must be based on transparency accessible to the public. Rangsiman challenged whether government officials truly believe they can continue deceiving citizens, pointing out that the public has witnessed the work of senior figures and their interconnections, which may amount to more serious crimes than simple fraud.

When asked how the Democrat Party would continue exposing the alleged fraud before the Election Commission rules on the matter, Rangsiman said revelations would continue and the public would see strong action. Party colleague Rakchanok Srinok, also a Democrat list member, reiterated the party is following the case seriously but acknowledged the government is not cooperating adequately in resolving the fraud allegations.

Rangsiman further stated that it is clear the government is uncomfortable with these disclosures, particularly as they extend to claims of involvement by senior figures. He called for honesty, as there are clearly undisclosed references and mechanisms at work, yet questioned why nationalist groups remained silent on the matter. He described the alleged election fraud not merely as a seizure of state power through deception, but as bringing institutional authority into play for personal gain—using institutions to shield wrongdoing.

Rangsiman said he finds the situation inexplicable and unacceptable, questioning how Prime Minister Anutin could remain unmoved when his duty is to protect the rule of law and justice. He criticized the Prime Minister for allowing such matters to occur while appearing indifferent, as if nothing significant had happened. Meanwhile, Democrat member Rakchanok countered the Prime Minister by stating that Thai people eat rice, not grass, addressing accusations that the opposition was making baseless claims.

Dr. Akniset Srisukwattana, a cardiologist and sports cardiology specialist, shared guidance on heart disease prevention through his Facebook page, expressing sadness each time he learns of someone dying prematurely from heart disease. He stressed that coronary artery disease and cerebrovascular disease do not develop overnight but accumulate gradually from cholesterol deposits, high blood pressure, high blood sugar, and smoking. In some cases, symptoms develop slowly as chest pain during exertion, but in others, plaque ruptures can cause sudden heart failure and death.

Heart and cardiovascular disease, along with cancer, are the leading causes of death, ranking first and second. However, coronary artery disease risk can be significantly reduced through screening that detects risk before a cardiac event occurs. The doctor recommends six key areas of focus:

1. High Cholesterol Management: Adjust diet and lifestyle first; if cholesterol remains high, take prescribed medication. Do not disregard medical evidence and miss the opportunity for treatment.

2. Blood Pressure Control: Reduce salt intake, manage weight, exercise regularly, get sufficient sleep, and take medication consistently when indicated, as high blood pressure silently damages blood vessels.

3. Manage Abdominal Fat and Blood Sugar: If overweight with excess abdominal fat, high triglycerides, or high blood sugar, begin reducing and managing weight, as these accelerate inflammation and vessel deterioration.

4. Regular Exercise: Aerobic activities such as brisk walking, cycling, and swimming significantly reduce risk.

5. Quit Smoking: Smoking directly and severely damages blood vessel walls, increases inflammation, and raises heart attack risk. Quitting is one of the most valuable health investments.

6. Appropriate Cardiac Screening: Some people maintain good self-care but carry high genetic risk or family history of high cholesterol, so screening should be tailored to age, symptoms, risk factors, and family history rather than applied uniformly.

The greatest danger is losing the opportunity for treatment—knowing you have risk but failing to follow up, seek treatment, or stopping medication on your own, allowing cholesterol to accumulate in vessels until sudden heart failure occurs. Heart disease is preventable if you pay attention and complete all six steps above. The doctor expressed condolences to Ray McDonald and his family, following news reports of the late actor and broadcaster's death from three-vessel coronary artery blockage.

Southern Thailand's mangosteen production has surged 75% to 139,000 tonnes in 2025, prompting the Department of Internal Trade to open three auction centers in Nakhon Si Thammarat and Chumphon and launch a campaign urging Thai consumers to "eat southern mangosteen, help Thai farmers." Deputy Director Jirawut Suwannaacha said the department is proactively opening distribution channels through trade shows and department stores rather than waiting for market oversupply to become a crisis. The strategy includes partnering with influencer Supachai at the A FAIR event in Bangkok from August 13–19, 2025, where 4.5-kilogram baskets will sell for 180 baht, and coordinating with government agencies, state enterprises, and large organizations to expand retail access. Additional promotional events include the Premium Durian Fest 2026 at Central North Village and Larn Park Paragon in early September, alongside sales partnerships with Modern Trade stores, public agencies, and companies including the Thai Teachers Council, Thammasat Hospital, the Electricity Generating Authority of Thailand, the Customs Department, Thai Airways International, the Royal Thai Army, and the Commerce Ministry. Officials emphasized that supporting farmers requires building consumer demand and market awareness, not just procurement, and that consumer choices to buy Thai mangosteen directly benefit producers during this peak harvest period.

Highway Police are urging the public to check road conditions before traveling. Four provinces are affected with a total of 16 road sections impacted: eight passable and eight impassable. The breakdown by province is as follows:

Nan Province: 10 affected sections - Nan Highway Division 1: three sections (one passable, two impassable) - Nan Highway Division 2: seven sections (one passable, six impassable)

Phichit Province: one section - Phichit Highway Division 2: one section passable (flooded road)

Nong Bua Lamphu Province: four sections - Nong Bua Lamphu Highway Division: all four sections passable (flooded roads)

Nakhon Phanom Province: one section - Nakhon Phanom Highway Division: one section passable (flooded road)

Travelers should verify conditions before departure and exercise caution in affected areas. Road condition updates are available through the HDMS system by calling 1193.