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Open access

Ramin Tavakoli, Hamid Yaghooti, Robab Daghagheleh, Rohollah Yousofi and Parisa Rahimifar

Abstract

Background

Depression is a neuroprogressive disorder that is characterized by neurotransmitter derangement and decreased neurogenesis and neurotrophic factors including brain-derived neurotrophic factor (BDNF).

Objectives

To determine the lipid profiles and BDNF levels in university students at an institution in Iran and association of these factors with Beck Depression Inventory (BDI) scores.

Methods

We conducted an observational study of a cross-section of male students at the Ahvaz Jundishapur University of Medical Sciences in Iran. For each of the 100 participants, a BDI score was obtained and serum levels of BDNF were measured by enzyme-linked immunosorbent assay. Levels of serum lipids, including cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were measured using a biochemical analyzer. Castelli’s risk index type I (CRI-I), Castelli’s risk index type II (CRI-II), CRI-I = TG/HDL-C and CRI-II = LDL-cholesterol/ HDL-cholesterol, and atherogenic index of plasma (AIP), AIP = log (triglycerides/HDL-cholesterol), were calculated.

Results

Based on BDI scores, lower levels of BDNF, triglycerides, cholesterol, and HDL, but higher levels of LDL were found in participants with higher BDI scores. CRI-I was also increased in participants with depression.

Conclusion

The levels of BDNF and lipid factors are associated with the severity of depression in Iranian male university students. Deranged levels of BDNF and lipids may predispose depressed students to cardiovascular diseases.

Open access

Prangmalee Leurcharusmee, Guy Kositratna, De Q. Tran and Thomas Schricker

Abstract

Surgical patients commonly develop hyperglycemia secondary to the neuroendocrine stress response. Insulin treatment of hyperglycemia is required to overcome the perioperative catabolic state and acute insulin resistance. Besides its metabolic actions on glucose metabolism, insulin also displays nonmetabolic physiological effects. Preoperative glycemic assessment, maintenance of normoglycemia, and avoidance of glucose variability are paramount to optimize surgical outcomes. This review discusses the basic physiology and effects of insulin as well as practical issues pertaining to its management during the perioperative period.

Open access

Ratikorn Methavigul and Komsing Methavigul

Abstract

Background

Coronary angiography (CAG) or stress imaging has been performed in almost all Thai patients with left ventricular (LV) systolic dysfunction. If CAG results reveal insignificant coronary stenosis, such patients are diagnosed with nonischemic cardiomyopathy (NICM); however, CAG is considered to provide no benefit and may even harm these patients because it is invasive.

Objectives

To identify predictors associated with significant coronary artery disease (CAD) (stenosis) in Thai patients with LV systolic dysfunction without angina and without LV regional wall motion abnormality and create a prediction score.

Method

Retrospective data from patients at a single tertiary-care center with LV systolic dysfunction (LV ejection fraction <50%) diagnosed between August 2000 and October 2014 were separated into a group with ischemic cardiomyopathy (ICM) and a group with NICM according to CAG. Predictors associated with CAD found in normal populations were determined. Multivariate analysis was used to identify predictors associated with significant coronary stenosis in patients with LV systolic dysfunction to develop a model to create a prediction score.

Results

We included data registered from 240 Thai patients with LV systolic dysfunction. Predictors associated with ICM were age (>60 years), sex (male), and a history of diabetes mellitus (DM). Predictors associated with NICM were body mass index (BMI) >25 kg/m2 and the presence of left bundle branch block (LBBB) on electrocardiography. A simplified equation to predict significant CAD in patients with LV systolic dysfunction is: 3(male sex) + 3(age >60 y) – 5(BMI >25 kg/m2) - 5(LBBB) + 5(DM) - 5. The sensitivity and specificity of this score are 60.5% and 85.1%, respectively.

Conclusion

Our prediction score has modest sensitivity, but high specificity for predicting significant CAD and can be used to determine who should not undergo CAG.

Open access

Supat Chamnanchanunt, Pravinwan Thungthong, Sirvicha Kudsood, Waraporn Somwong and Manassamon Hirunmassuwan

Abstract

Background

Anemia is a common problem among patients with malaria infection, which induces hemolysis during treatment. A few patients present with autoimmune hemolytic anemia (AIHA) and autoantibodies, such as autoanti-E and autoanti-I, during malaria infection.

Objective

To report the clinical response of a patient with Plasmodium falciparum malaria infection with a hemolytic condition.

Methods

We reviewed medical records of a patient with P. falciparum malaria and related literature.

Results

Our patient presented with P. falciparum malaria infection and received artesunate and ceftriaxone to cover potential tropical infectious diseases. After malaria parasite was eradicated, her hemoglobin declined, and AIHA and autoantibodies were found, explaining the cause of anemia. Corticosteroid was given at a standard dosage, and her hemoglobin became normal within 1 week.

Conclusion

Patients with falciparum malaria and both AIHA and autoantibody complications are rare. Our patient responded to malaria eradication and corticosteroid treatment. Most cases reported seem to respond to corticosteroid with a variety of recovery times. However, corticosteroids might increase the severity of infection; more clinical data to support a standard regimen to treat properly rare hematologic complications (AIHA and autoantibodies) in malaria patients are warranted.

Open access

Duy Toan Pham, Thi My Huong Vo, Phuong Truong, Phuoc Tinh Ho and Manh Quan Nguyen

Abstract

Background

Infectious diseases, especially those caused by multidrug-resistant bacteria, are becoming a serious problem worldwide because of the lack of effective therapeutic agents. Moreover, most antifungal drugs exhibit low efficacy and high toxicity because of the similarity between fungal and human cells. These issues warrant the search for potential new agents.

Objectives

To synthesize potent 2-(2-iodophenylimino)-5-arylidenethiazolidin-4-one derivatives, improve the synthetic process, elucidate their structures, and determine their antimicrobial activity.

Methods

2-Iodoaniline was used as an initial reactant in a 3-step process for the synthesis of 2-(2-iodophenylimino)-5-arylidenethiazolidin-4-one derivatives, including an acylation reaction, a cyclization reaction, and aldol condensation reactions. The structures of the obtained derivatives were investigated and elucidated using spectral methods. Antimicrobial activity toward 5 bacterial strains and 2 fungal strains was determined using Kirby–Bauer and agar dilution methods.

Results

We successfully synthesized 12 novel compounds and elucidated their structures. The derivatives had no antifungal activities. By contrast, they showed remarkable antibacterial activities. Some of them with minimum inhibitory concentrations (MICs) ≤8 μg/mL in both Staphylococcus aureus and methicillin-resistant S. aureus.

Conclusions

A simple and flexible way to synthesize new compounds with a thiazolidin-4-one ring was determined. Some of these new compounds have outstanding effects with low MICs for bacteria. Their further investigation as therapeutic agents is warranted.

Open access
Open access

Thanin Asawavichienjinda, Pongpat Vorasayan, Jirawadee Noiwattanakul and Kammant Phanthumchinda

Abstract

Background

The Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQv2.1) is used to evaluate the impact of symptoms on the quality of life (QoL) of migraineurs.

Objective

To evaluate primarily the concurrent validity, test–retest reliability, and internal consistency, and secondarily the sensitivity to change of a Thai version of the MSQv2.1.

Methods

The original English version of the MSQv2.1 was translated into a Thai version. The Thai version of the MSQv2.1 was assessed for content and language equivalence. Validity of the Thai version of the MSQv2.1 was assessed using migraine characteristics in a prospective study conducted at the Chulalongkorn Comprehensive Headache Centre of King Chulalongkorn Memorial Hospital. Test–retest reliability and internal consistency were tested in migraineurs. Sensitivity to change was evaluated in another group of migraineurs using an 8-week follow-up.

Results

We recruited 30 migraineurs to test the validity, test–retest reliability, and internal consistency of the Thai version of the MSQv2.1 and 11 migraineurs to test its sensitivity to change. The Thai version of the MSQv2.1 scores were significantly correlated with migraine symptoms (inverse coefficient range from –0.62 to –0.39) except for associated symptoms, which had no correlation with any of the dimensions or overall QoL score. Spearman’s correlation coefficient for test–retest reliability was 0.56–0.83, and Cronbach’s α for internal consistency was 0.91–0.96. Headache, including average pain duration per attack, pain severity score (numeric rating scale), associated symptoms and dimensions, and overall QoL score of the Thai version of MSQv2.1 improved over time (P < 0.05). Moreover, improvement in headache correlated (coefficient range 0.67–0.77) with improvement in overall QoL score and some dimensions of the Thai version of the MSQv2.1 (coefficient range 0.66–0.77).

Conclusion

The Thai version of the MSQv2.1 had validity, acceptable internal consistency, moderate-to-strong test–retest reliability, and strong correlation between improvement in headache severity and overall QoL score. A future study with a larger sample size and longer follow-up is required for better estimates of internal consistency and sensitivity to change.

Open access

Krairerk Pitaksontayothin, Wichai Santimaleeworagun, Manat Pongchaidecha, Jantana Houngsaitong and Panuwit Srisena

Abstract

Background

To our knowledge, no study reported so far has investigated appropriate vancomycin dosing, which is important for treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection in Thai patients of various ages and with varying degrees of renal function.

Objectives

To predict vancomycin dosing for MRSA in Thai patients of various ages and with varying degrees of renal functions.

Methods

Monte Carlo simulation and minimal inhibitory concentration (MIC) distribution of MRSA from a hospital in Thailand were used to predict the area under the curve in 24 h/MIC >400 and trough concentration (C trough) <20 mg/L of 9 vancomycin dosage regimens for Thai patients stratified by age and renal function.

Results

Vancomycin dosing at least 2.5 g per day can attain cumulative fraction of response (CFR) of ≥90% in every age group. Vancomycin dosage achieving CFR of ≥90% for simulated patients with creatinine clearance (CLcr) was calculated using the Cockcroft–Gault equation. Appropriate vancomycin doses for Thai patients infected with MRSA with CLcr of <40, 40–60, >60–80, and >80 mL/min were 1.5 g every 24 h, 1.25 g every 12 h, 1 g every 8 h, and 1.75 g every 12 h, respectively. However, more than a half of patients simulated using these regimens have a vancomycin C trough of >20 mg/L.

Conclusions

Although vancomycin doses attaining a CFR of ≥90% can treat MRSA infection effectively, the regimens may cause kidney injury. The regimens have a probability of target attainment of 100%, and most patients can attain C trough of <20 mg/L.

Open access

Jate Ratanachina and Pornchai Sithisarankul

Abstract

For 2 decades, the Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, has served the Occupational Medicine Residency training program in Thailand. Graduates of this program undertake to work in occupational medicine to promote health and prevent morbidity and mortality in the workplace and provide occupational medical services for the working population in Thailand. Qualifying for a Postgraduate Diploma in Occupational Medicine in Thailand can be achieved in 2 ways: through a 3-year residency training or 5 years of working experience in the field of occupational medicine combined with an elective 2-month short course. There are currently 159 Thai board-certified occupational medicine physicians. Occupational medicine physicians in Thailand work in both public and private healthcare facilities. A number of certified occupational physicians occupy leading national health positions in various government and academic organizations. Knowledge of occupational medicine is currently essential for undergraduate medical students as specified in the medical competency assessment criteria of the Thai Medical Council. Updating content and incorporating needs of employers are keys to success for Thailand, as a country with an occupational medicine training program in its initial stages. In Thailand, the supply of occupational medicine physicians is still less than the increasing demand. Advancement of health research schemes would contribute to the curriculum. Occupational medicine development in Thailand needs to address challenges in local issues including work in the informal sector, particularly in agriculture, and incorporate standardization and international consistency into the training curriculum and qualifying management.