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Abstract

Background

Atmospheric plasma jet has different medical applications due to its low temperature at room temperature. In recent years, the effect of nonthermal plasmas on cancer cells has been studied, and it has been shown that this type of plasma has anti-proliferative effects on cancer cells.

Objectives

To design a plasma jet handpiece, which can be used in cutting operations in less bleeding surgery, eliminating cancer cells without damage to healthy cells and reducing the duration of wound healing.

Methods

The plasma handpiece simply consists of a nozzle body and two cathode and anode electrodes and a fully insulated body against heat and high voltage. Argon is introduced into the handpiece, and by plasma treatment, it is used for special purposes. Each piece was made according to its own manufacturing process and by assembling; the final product of the atmospheric plasma jet handpiece was ready for testing. The jet pipeline was then tested, and the effective parameters were examined.

Results

The cold atmospheric plasma jet length depends on factors such as power supply, applied voltage, gas flow rate and the distance between the electrodes. The results showed with increasing velocity, the flame and jet lengths decreased greatly due to high losses of plasma, including ions and electrons. Also with increasing the velocity of argon gas, its concentration decreased.

Conclusions

It is concluded that the performance of the proposed design is successful. The advantages include low-cost manufacturing, highly stable performance, and low erosion and can be considered for future development.

Abstract

Background

Dabigatran, a direct oral anticoagulant, has been approved for the prevention of venous thromboembolism (VTE) after orthopedic surgery in many countries. The efficacy and safety of this agent were most studied in Western countries.

Objective

To assess the efficacy and safety of dabigatran in preventing venous thromboembolic diseases after total knee arthroplasty (TKA) in Asian patients.

Methods

We conducted a prospective nonrandomized controlled study in Thai patients undergoing TKA. Thirty-two patients received 220 mg of dabigatran once daily for 14 days as thromboprophylaxis and 32 patients in the control group received none. The primary efficacy outcome was deep vein thrombosis (DVT), which was identified by color Doppler ultrasonography and/or diagnosed pulmonary embolism (PE). The primary safety outcomes were major bleeding and clinically relevant nonmajor bleeding events.

Results

There were no DVTs or PEs diagnosed in either group. The difference in the composite incidence of major and clinically relevant nonmajor bleedings between the dabigatran and control groups did not reach significant (6.2% vs. 0%, P = 0.15).

Conclusion

Dabigatran might have no clear benefit for the prevention of VTE after TKA in Thai patients. We do not recommend the routine use of dabigatran as a chemical thromboprophylaxis after TKA in Thai patients. To determine the safety profile, further study with larger sample sizes is required.

Abstract

Background

Staphylococcus aureus is one of the common opportunistic gram-positive pathogens which are often associated with nosocomial infections. Detection of methicillin-resistant S. aureus (MRSA) has become complicated due to the complex phenotypic and genomic pattern.

Objective

To evaluate the sensitivity and specificity pattern of various phenotypic methods used in screening mec genes harboring MRSA.

Methods

Clinical isolates of S. aureus were collected from diagnostic centers in Tamil Nadu. Phenotypic identification methods such as Minimal Inhibitory Concentration for oxacillin, oxacillin screen agar (OSA), oxacillin disk diffusion, and cefoxitin disk diffusion (CFD) tests were compared. The clinical isolates were classified into MRSA and methicillin-susceptible S. aureus (MSSA) based on the polymerase chain reaction (PCR) amplification of the mecA gene.

Result

Out of 50 S. aureus, 21 were found to be MRSA based on the presence of the mecA gene. All 21 mecA-positive isolates were found to be resistant through minimum inhibitory concentration (MIC) and CFD test, having a sensitivity of 100% and specificity of 52% and 62%, respectively. OSA and oxacillin disk tests were found to have a sensitivity of 86% and specificity of 48% and 52%, respectively.

Conclusion

The combination of two phenotypic methods, CFD and oxacillin MIC, can be used for the detection of MRSA in clinical laboratories.

Abstract

Background

Leptospirosis, caused by pathogenic Leptospira spp., is a widespread zoonotic disease worldwide. Early diagnosis is required for proper patient management and reducing leptospirosis morbidity and mortality.

Objective

To summarize current literature regarding commonly used and new promising molecular approaches to Leptospira detection and diagnostic tests of human leptospirosis.

Method

The relevant articles in Leptospira and leptospirosis were retrieved from MEDLINE (PubMed) and Scopus.

Results

Several molecular techniques have been developed for diagnosis of human leptospirosis. Polymerase chain reaction-based techniques targeting on either lipL32 or 16S rRNA (rrs) gene are most commonly used to detect leptospiral DNA in various clinical specimens. Whole blood and urine are recommended specimens for suspected cases in the first (acute) and the second (immune) phases, respectively. Isothermal amplification with less expensive instrument is an alternative DNA detection technique that may be suitable for resource-limited laboratories.

Conclusion

Detection of leptospiral DNA in clinical specimens using molecular techniques enhances sensitivity for diagnosis of leptospirosis. The efficient and robust molecular detection especially in the early leptospiremic phase may prompt early and appropriate treatment leading to reduced morbidity and mortality of patients with leptospirosis.

Abstract

Background

The quadriceps tendon is a promising alternative graft choice for anterior cruciate ligament (ACL) reconstruction. Morphology of the graft directly affects the biomechanical properties. However, a few studies are evaluating the anatomical structures of quadriceps tendon as a graft in Asian population.

Objective

To define the anatomical structures of quadriceps tendon as a graft for ACL reconstruction.

Methods

Forty-nine quadriceps tendons were dissected and analyzed. Measurements were also done including length, width, and thickness.

Results

The maximum length of superficial quadriceps tendon was 63.2 ± 12.5 mm (range 37.6–83.4). The maximum length of tendon at the deepest part was 57.2 ± 11.5 (range 30.9–83.4). The maximum length of quadriceps tendon was located at 61.4% ± 13% (range 31.8–83.6) from medial edge of the patella insertion (approximately 5 mm lateral from the center of quadriceps tendon insertion). The width of quadriceps tendon at patella insertion was 42.4 ± 3.8 mm (range 33.8–50.5). The thickness of quadriceps tendon at its maximum length on patella insertion was 6.9 ± 2.0 mm (range 1.5–9.5). Positive correlation between the height of cadaver and the maximum length of quadriceps tendon was noted.

Conclusions

The maximum length of quadriceps tendon was located 5 mm lateral from the center of quadriceps tendon insertion. Thus, we recommend marking midline of the quadriceps tendon insertion as a medial border of the harvested graft to get maximum length of the graft. Graft length measurement using superficial anatomy should be cautioned because graft shortening might occur.

Abstract

Background

Trauma is a major cause of death in young adults. The mortality rate is one of the key performance indices of trauma centers.

Objective

To demonstrate a mortality rate, cause of death, and cause of nonpreventable death in a level-1 trauma center in Thailand.

Methods

There was a retrospective study of the death cases from a trauma registry. The number of trauma deaths during the study period was collected to identify the death rate. The causes of death and a death analysis were obtained from the morbidity and mortality.

Results

The death rate was 6.6%. The most common cause of overall death was head injury, and exsanguination was the most common cause of death in the first 24 h. The preventable death rate was 2%, and the most common cause of preventable death was exsanguination.

Conclusions

The mortality rate of trauma patients in Thailand was not higher than that in other countries. The majority of deaths were caused from head injury. Therefore, improvement in injury prevention is needed to decrease the number of deaths.

Abstract

Background

While the assisted reproductive technology (ART) relieves the burden of infertility in many couples, it presents significant public health challenges due to the substantial risk for multiple birth delivery and preterm birth, which are associated with poor maternal and fetal health outcomes. For this reason, it is important to monitor the development and effectiveness of ART services in Thailand.

Objective

To analyze the trends of ART services in Thailand between 2008 and 2014.

Methods

ART clinics in Thailand are required to submit data to the Royal Thai College of Obstetricians and Gynecologists via the National Reporting System. The data from 2008 to 2014 were collected and analyzed.

Results

The number of ART centers was increased from 35 to 47. The total fresh ART cycles were also increased from 3,723 to 6,516. The percentage values of intracytoplasmic sperm injection (ICSI), in vitro fertilization, gamete intrafallopian transfer, and zygote intrafallopian transfer cycles were changed from 77.87 to 95.59, 21.43 to 4.31, 0.21 to 0.09, and 0.45 to 0.05, respectively. The clinical pregnancy rates were 28.79–33.19, 22.84–51.34, 14.29–42.86, and 0.00–26.67, respectively. The clinical pregnancy rates in fresh vs. frozen-thawed cycles were 31.01–36.33 vs. 31.54–37.34 (P < 0.05). The clinical pregnancy rates in female age <35 vs. 35–39 vs. ≥40 years were 36.97–40.70 vs. 32.74–33.42 vs. 21.08–31.34, respectively (P < 0.001), and the percentage values of multifetal pregnancy rate were 18.75 vs. 13.30 and 13.69, respectively (P < 0.001). There were increasing preimplantation genetic screening (PGS) cycles, with the percentage of the clinical pregnancy rate (25.90–42.63, P < 0.05). The clinical pregnancy rates in medium-sized ART centers (100–300 cycles per year) vs. in small and large centers were 30.79–41.14 vs. 28.01–34.04 and 8.70–40.35, respectively (P < 0.001). Trends of increasing percentage of ART birth rate to total birth rate ratio were 0.24–0.34 (P < 0.05).

Conclusions

There were higher clinical pregnancy rates in frozen-thawed cycles. Higher multifetal pregnancy rate and clinical pregnancy rate were also found in younger females. There were increasing uses of ICSI and PGS. A trend toward increasing ART birth to total birth ratio was observed.

Abstract

Background

Autophagy and ubiquitin–proteasome (UPS) are two main degradation systems for intracellular proteins. They are essential for homeostasis of neurons during normal and pathological conditions, but their changes after nerve injury remain unclear.

Objective

To examine the protein expression of autophagy and UPS in the dorsal root ganglia (DRG), including intact and injured sciatic nerves after crush injury in rats.

Methods

Left sciatic nerve crush was done in all Wistar rats and the specimens were removed at 1, 3, 7, and 14 days after injury. Expression of the autophagic (Beclin-1 and p62) and UPS proteins [muscle ring finger-1 (MuRF1) and ubiquitinated proteins] was measured using Western blot analysis.

Results

Expression of p62 was significantly increased in the injured versus intact sciatic nerves on day 1 and day 7 (P < 0.05 and P < 0.01, respectively). There was a trend toward higher expression of Beclin-1 on the crushed nerve. In the DRG, expression of p62 and Beclin-1 was not significantly different between the two sides. Expression of MuRF1 and ubiquitinated proteins was not significantly different between the left and right DRG. The low quantity of MuRF1 and high variations in the ubiquitinated protein levels in the nerve prevented further analysis.

Conclusions

These results indicated the induction of autophagy with accumulation of autophagosomes in the nerve, but not DRG, after nerve injury. Future studies on the effects of the autophagic changes and the precise activity of UPS in nerve trauma are crucial.