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Echinocytes in the peripheral blood of patients infected with dengue virus may be a predictor of disease severity

Abstract

Background

Echinocytes have been demonstrated as sequelae to serum high-density lipoprotein decreases in patients with liver disease, but not to our knowledge in dengue virus infection.

Objective

To investigate any association between echinocytosis and dengue infection.

Methods

We retrospectively studied a cross-section of patients at Mahasarakham University Hospital infected with dengue in August 2015. Infection was diagnosed clinically, and by rapid immunochromatography when nonstructural protein 1 antigen, or IgM or IgG antibodies were detected in the serum. We used World Health Organization 2009 and 2011 criteria to define dengue severity. We examined peripheral blood smears made before and after defervescence.

Result

Two patients had warning signs, 6 did not, 1 had dengue hemorrhagic fever (DHF), and 7 had uncomplicated dengue fever (DF). The ages of patients with and without warning signs was not significantly different (P > 0.99). Patients with warning signs had a mean (SD) alanine transaminase (ALT) level of 354.50 (291.91) IU/L, while the level was 29.67 (20.61) IU/L in those without. The lowest mean platelet count in the patients with warning signs was 35.5 (21.9) × 103 cells/mm3, while the count was 98 (66.1) × 103 cells/mm3 in those without. There was no significant difference in mean ALT level (P = 0.28) or the platelet count (P = 0.09) between patients with and without warning signs. Echinocytes were significantly associated with DWS (P = 0.04), but did not differ significantly between the DHF and DF patients (P = 0.13).

Conclusion

Echinocytosis may be associated with severe disease.

Open access
Economic impact of investment in maternal and newborn health care under the National Health Security Scheme of Thailand

Abstract

Background

Evidence for the impact of health care spending in the area of maternal, newborn and child health (MCH) in developing countries is limited.

Objectives

To examine the investment and medical care expenses for MCH under Universal Health Coverage (UHC) in Thailand.

Methods

A prevention–appraisal–failure (PAF) cost element method was applied. Using a payer perspective, data related to PAF elements of MCH were collected from the Universal Coverage Scheme (UCS) inpatient claim database, UCS liability claims, the health-budget administration and health resource databases of the Ministry of Public Health, and the population census of The National Statistical Office in fiscal years 2007–2011. The main outcome measures included payments and budgets for MCH at a provincial level.

Results

Investment and medical care costs of antenatal care to prevent and manage complications increased from US$7.77 per person per year (PPPY) in 2007 to US$11.69 PPPY in 2011. The payments to support quality-focused activities ranged from US$0.60 to US$1.19 PPPY, whereas failure costs resulting from postpartum complications and UHC liability claims were US$1.92, 2.24, 2.35, 2.48, and 2.56 PPPY. Univariate regression analyses of year-on-year changes in prevention and appraisal costs for providing MCH and changes in the failure costs showed significant negative associations between 3 of 4 pairs of years

Conclusions

Increased year-on-year costs of preventing MCH problems were associated with a reduction in year-on-year costs incurred for correcting problems. Despite increasing trends for all the costs, this finding indicated improvements in allocation of resources to address MCH challenges in Thailand.

Open access
The effect of p-coumaric acid and ellagic acid on the liver and lungs in a rat model of sepsis

Abstract

Background

Sepsis pathophysiology includes oxidative stress and inflammatory processes.

Objectives

To investigate the antioxidant and anti-inflammatory effects of p-coumaric acid (PC) and ellagic acid (EA) in a rat model of sepsis.

Methods

Wistar rats were assigned to 5 groups: control (C), sepsis (S), and S with treatment by PC, EA, or PC and EA combined (PCE). We determined the liver and lung tissue levels of pro- and anti-inflammatory cytokines, oxidative stress, and antioxidant markers.

Results

In the model of sepsis, proinflammatory cytokine levels increased, anti-inflammatory cytokines decreased, oxidative stress markers increased, and activity of antioxidant enzymes decreased significantly. In the liver of rats treated with PC, EA, or PCE, TNF-α levels were reduced significantly, whereas IL-1β and IL-6 levels were reduced significantly in rats treated with EA or PCE. Despite an increase in anti-inflammatory cytokines in the liver and lungs in all the treatment groups compared with S, an increase in IL-10 was only found in the liver of rats treated with PCE. The levels of malondialdehyde decreased significantly in the liver and lungs in rats in all treatment groups. The catalase and superoxide dismutase activity increased significantly in rats treated with PCE. While glutathione peroxidase activity in the liver only increased significantly in rats treated with PCE, it increased in the lungs of rats in all treatment groups.

Conclusions

PC and EA treatment had antioxidant and anti-inflammatory effects, which were stronger when these treatments were combined. Combined treatment with these substances may be beneficial in the treatment of sepsis.

Open access
Frequency of hepatitis B envelope antigen-negative chronic hepatitis B virus infection in untreated patients from three cities in Pakistan

Abstract

Background

Hepatitis B envelope antigen (HBeAg)-negative chronic hepatitis B virus (CHB) infection is a clinical entity refractory to treatment and has implications for disease outcome.

Objectives

To determine the frequency of HBeAg-negative CHB in untreated hepatitis B surface antigen (HBsAg)-positive patients.

Methods

We conducted this cross-sectional study of untreated HBsAg-positive patients from 3 cities in Pakistan for more than 6 months.

Results

Of495 patients, 276 (47.7%) had detectable hepatitis B virus (HBV) DNA (mean 5.3 ± 1.96 log10 copies/mL), 81 (16.4%) were HBeAg positive and 414 (83.6%) were HBeAg negative. All 81 (100%) HBeAg-positive patients had detectable HBV DNA. Frequency of HBeAg-negative CHB infection was 155 (31.3%) among HBsAg-positive patients. One hundred and sixteen (74.8%) of the HBeAg-negative patients with CHB infection were in the age range of 15–35 years.

Conclusions

HBeAg-negative patients constitute a considerable proportion of patients with CHB infection. HBsAg-positive patients, especially with younger age, should be thoroughly investigated for this entity to avoid the devastating long-term complications of this disease.

Open access
Genetic characteristics of Mycobacterium bovis BCG Thai Red Cross Society strain

Abstract

Background

Bacillus Calmette–Guérin (BCG) Tokyo 172-1 strain has been used as a parent strain since 1988 by Queen Saovabha Memorial Institute, Thai Red Cross Society to manufacture BCG vaccine in Thailand. In general, the BCG Tokyo strain includes 2 BCG type populations: types I and II. Several studies have found that the type I population is higher than type II. Polymerase chain reaction has shown the presence of 2 types of subpopulations in the BCG Thai Red Cross Society (TRCS) strain. However, the characteristics of all genes from BCG TRCS have not been studied in depth, including whether or not the original features of the BCG Tokyo 172-1 strain are still retained.

Objectives

To compare BCG TRCS and BCG Tokyo 172-1 for differences between their genomes.

Methods

The whole genome of BCG TRCS was analyzed by next-generation sequencing.

Results

BCG TRCS contained 23 different points and was 4 bases less in length than BCG Tokyo 172-1. However, its main features remain similar to those of the original BCG Tokyo 172-1 strain.

Conclusions

The changes in the genome may be caused by a variety of factors including the strain of Tokyo 172, vaccine processing, storage, and natural changes in the genome.

Open access
Genotype distributions of CYP2C9 and VKORC1 in southern Thais and their association with warfarin maintenance dose in patients with cardiac surgery

Abstract

Background

Pharmacodynamics of warfarin are influenced by genetic polymorphisms of its metabolic enzymes.

Objectives

To determine CYP2C9 and VKORC1 genotypes in a population in southern Thailand, and their association with warfarin maintenance doses.

Methods

We genotyped CYP2C9*2 (rs1799853), CYP2C9*3 (rs1057910), VKORC1 (rs9923231 and rs9934438) from the blood DNA of 210 healthy controls, and determined the association of 2 polymorphic markers (CYP2C9*3 and rs9923231) in 154 patients with aortic valve protheses, with warfarin maintenance dose and coagulopathy.

Results

CYP2C9*3 was detected in 17/210 controls; all were heterozygous variants (-*1*3). No CYP2C9*2 polymorphisms were detected. The 2 VKORC1 polymorphisms were in complete linkage disequilibrium. The genotype distribution of VKORC1 (rs9923231) was 118:72:20 for AA:AG:GG. The warfarin maintenance dose in patients with CYP2C9*1*3 (20.7 mg/week) was significantly less than in patients with CYP2C9*1*1 (31.7 mg/week; P < 0.01). In VKORC1 patients, the warfarin maintenance dose increased significantly with minor variants (AA:AG:GG; 23.8:35.3:47.3 mg/week). The incidence of prolonged prothrombin time (INR > 5) was significantly higher in the VKORC1-AA group (45/76) than the AG (22/64) or GG (3/16) groups. The median time to achieve a stable INR was highest for patients with a GG genotype (342 days) compared with 20 days for those with AA, and 160 days for those with AG. Other factors associated with warfarin maintenance dose were body surface area, age (>45 years), and concomitant drug use.

Conclusion

Polymorphisms of CYP2C9*3 and VKORC1 are present in southern Thais. We recommend pharmacogenetic studies of these markers as a component of warfarin therapy.

Open access
Higher prevalence of metabolic syndrome among male employees of a gas refinery than in their counterparts in nonindustrial environments

Abstract

Background

Occupation and working conditions may affect the risk of developing metabolic syndrome (MetS), an important risk factor for diabetes and cardiovascular disease (CVD).

Objective

To investigate the prevalence of MetS and its risk factors in employees in an industrial workplace and compare them with those in employees from a nonindustrial setting.

Methods

Male employees (n = 757) from a gas-refinery and 2700 adult men from the general population of whom 750 were nonindustrial employees (Khorasan province, Iran), were evaluated for CVD risk factors, including those used to define MetS. Individuals were matched for age and educational attainment, and 670 industrial and 681 nonindustrial employees were included in the final analysis. International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III criteria were used for diagnosis of MetS. We compared MetS and its risk factors between the two groups.

Results

There were more gas refinery employees with a body mass index > 30 kg/m2, abdominal obesity, and a high fasting blood glucose level than nonindustrial employees (P < 0.01). A diagnosis of MetS was significantly more likely in refinery workers than in nonindustrial employees (OR 1.38, 95% CI 1.10 to 1,737; P = 0.005). Scores of IDF and ATP III criteria in the refinery employees were significantly higher than for the nonindustrial employees (P < 0.01). The prevalence of hypertriglyceridemia in the refinery employees tended to be higher than in nonindustrial employees, but the difference was not quite significant (P = 0.052). Blood pressure in nonindustrial employees was significantly higher than in refinery employees (P < 0.001).

Conclusions

The prevalence of MetS among male gas refinery employees was higher than for male nonindustrial employees.

Open access
Menopause-related symptoms and quality of life in peri- and postmenopausal women in Thailand: a multicenter study

Abstract

Background

Menopausal symptoms can affect the quality of life (QoL) of women.

Objectives

To determine menopause-related symptoms and QoL in peri- and postmenopausal women in Thailand undergoing various treatment.

Methods

A prospective cohort study was conducted at 9 menopause clinics in 4 regions of Thailand. Peri- and postmenopausal women newly registered at the clinics were recruited and followed up for 12 months. A standardized medical record form was used to collect data regarding demographic characteristics, menopause-related symptoms, and treatment. QoL was evaluated using a specific questionnaire.

Results

We included 870 women who were 51.8 ± 5.6 years old. We compared demographic characteristics and baseline health profiles of women with normal QoL and impaired QoL. Women with impaired QoL were significantly younger (51.2 ± 4.4 vs. 52.0 ± 6.0 y, P = 0.035) and included more from northeast Thailand (11.4% vs. 6.6%, P = 0.022). The 3 most common menopause-related symptoms were psychoemotional distress, musculoskeletal pain, and hot flushes. All QoL scores improved with time in both users and nonusers of postmenopausal hormone therapy (pHT), and the scores of both groups converged during months 3 to 12 of the follow-up period.

Conclusions

The most common menopause-related symptom in peri- and postmenopausal women in Thailand is psychoemotional distress. QoL scores of women with moderate-to-severe menopause-related symptoms at baseline improve over time, whether or not they use of pHT. The pHT users had poorer QoL at baseline than nonusers, but their QoL improves and matches that of their peers after 3 months.

Open access
Nanoparticles in therapeutic applications and role of albumin and casein nanoparticles in cancer therapy

Abstract

Background

Nanoparticles are widely used for various therapeutic treatments. Proteins have the advantage of being naturally occurring, with relative lack of toxicity and antigenicity, but easy biodegradability and potent ability to bind other compounds. Proteins have been produced in nanoformulations, which have been made by various methods including desolvation and precipitation. Biopolymeric nanoparticles including proteins are used in delivery of genes and drugs, and in tissue engineering. Protein nanoparticulate drug delivery systems are used to treat several diseases because of their high drug-binding capacity, biocompatibility, nutritional value, stability, and potent site-specific action. Among the various proteins, casein and albumin nanoparticles are used widely as nanocarriers for various therapeutic drugs.

Objectives

To review the types of nanoparticles and their role in therapeutic applications, and the important role of casein and albumin nanoparticles in cancer therapy.

Methods

A literature search based on nanoparticles, their types, and their roles in medical applications was conducted using websites including Google Scholar, SpringerLink, ResearchGate, and the U.S. National Institutes of Health’s National Library of Medicine’s National Center for Biotechnology Information PubMed database including PubMed Central covering from 2000 to 2016.

Results

Nanoparticles, especially albumin and casein had been found effective drug delivery systems.

Conclusion

Protein based nanoparticles such as albumin and casein nanoparticles are widely used for targeting cancers and can be used as effective vehicles for the delivery of various anticancer drugs.

Open access