rss_2.0Asian Biomedicine FeedSciendo RSS Feed for Asian Biomedicine Biomedicine 's Cover search of cost effective control of leptospirosis—a common zoonotic disease in developing countries giant fourth-ventricular tuberculoma mimicking a primary posterior fossa tumor<abstract> <title style='display:none'>Abstract</title> <p>Typically, an intracranial tuberculoma occurs within the brain parenchyma. Intraventricular tuberculomas are rare in the absence of systemic tuberculosis (TB), and the differential diagnosis between tuberculoma and other lesions, such as primary brain tumors, can be difficult. We report an extremely unusual case of solitary fourth-ventricular tuberculoma, which occurred in a 3-year-old female patient, with no indication of TB. This lesion appeared as a primary intraventricular tumor in the fourth ventricle in both clinical and radiological examinations. In this scenario, a surgical treatment option was pursued. Histopathological testing supported the diagnosis of tuberculoma. The patient was subsequently treated with 18 months’ therapy for tuberculous, without adverse events.</p> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00Potential of amentoflavone with antiviral properties in COVID-19 treatment<abstract> <title style='display:none'>Abstract</title> <p>Amentoflavone is one of the flavonoids that are known for their antiviral effects and many of them are predicted to have inhibitory effects against severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome Coronavirus (MERS-CoV) enzymes 3-chymotrypsin-like protease (3CLpro) and papain-like protease (PLpro). Amentoflavone is a biflavonoid found in the herbal extracts of St. John's wort (<italic>Hypericum perforatum</italic>), <italic>Gingko biloba</italic>, <italic>Selaginella tamariscina, Torreya nucifera</italic>, and many other plants. Its pharmacological actions have been listed as antiviral, antibacterial, antioxidant, anti-inflammatory, antidiabetic, antidepressant, and neuroprotective. Molecular docking studies have found that amentoflavone binds strongly to the active site of the main protease (M<sup>pro</sup>) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). As conventional antiviral medications are met with limited success against coronavirus disease-2019 (COVID-19) and vaccines are one of the only weapons against COVID-19 in the pharmaceutical armamentarium, traditional medicines are being considered for the forefront battle against COVID-19. Clinical studies with <italic>Hypericum</italic> and <italic>Gingko</italic> extract as additional or alternative drugs/supplements are registered. Here we review the potential of amentoflavone, an active agent in both <italic>Hypericum</italic> and <italic>Gingko</italic> extract as an adjunct therapy for COVID-19. Its anti-inflammatory, antioxidant, and sepsis preventive actions could provide protection against the “cytokine storm.” Compared with the herbal extracts, which induce cytochrome P450 (CYP) and uridine 5′-diphospho (UDP)-glucuronosyltransferases (UGT) activity producing a negative herb–drug interaction, amentoflavone is a potent inhibitor of CYP3A4, CYP2C9, and UGT. Further studies into the therapeutic potential of amentoflavone against the coronavirus infection are warranted.</p> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00Clinical characteristics and outcomes of Langerhans cell histiocytosis at a single institution in Thailand: a 20-year retrospective study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Langerhans cell histiocytosis (LCH) is a rare disease characterized by the various systems involved and clinical manifestations with a wide range of symptoms.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To describe clinical characteristics, imaging, treatment, and outcomes of pediatric LCH at Phramongkutklao Hospital, Bangkok, Thailand.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a 20-year retrospective review of the medical records of patients diagnosed with LCH from birth to 21 years old from January 1, 1997, to December 31, 2016.</p> </sec> <sec><title style='display:none'>Results</title> <p>In all, 14 patients with median age of 2.5 years were studied. Six (43%) patients had single-system (SS) LCH. Five patients (63%) with multisystem (MS) LCH (n = 8. 57%) had risk-organ involvement (RO+). All patients had plain X-ray imaging of their skull with 11 (79%) showing abnormal findings. Tc-99m bone imaging and fluorodeoxyglucose F18 (FDG) positron emission tomography (PET)-computed tomography (CT) demonstrated abnormal findings in 8 (89%) and 4 (29%) patients, respectively. The 5-year event-free survival (EFS) for patients with RO+ MS-LCH was less than that for those without risk-organ involvement (RO−) MS-LCH and SS-LCH (20% vs. 100%, <italic>P</italic> = 0.005). Hematological dysfunction, hypoalbuminemia, and conjugated hyperbilirubinemia may be worse prognostic factors for RO+ MS-LCH.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>FDG-PET-CT might have a greater accuracy to detect LCH disease than conventional plain X-ray and Tc-99m bone imaging. RO+ MS-LCH has been encountered with relapse and poor outcomes. Hematopoietic involvement, hypoalbuminemia, and conjugated hyperbilirubinemia may be worse prognostic factors for RO+ MS-LCH.</p> </sec> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00 variation and the clinical characteristics of patients newly diagnosed with type 2 diabetes mellitus in Yogyakarta, Indonesia<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Adenosine monophosphate (AMP)-activated protein kinase (AMPK; EC enzymes play a pivotal role in cell metabolism. They are involved in type 2 diabetes mellitus (T2DM) pathogenesis. Genetic variation of <italic>PRKAA2</italic> coding for the AMPK α2 catalytic subunit (AMPKα2) is reported to be associated with susceptibility for T2DM.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To determine the association between <italic>PRKAA2</italic> genetic variations (rs2796498, rs9803799, and rs2746342) with clinical characteristics in patients newly diagnosed with T2DM.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We performed a cross-sectional study including 166 T2DM patients from 10 primary health care centers in Yogyakarta, Indonesia. We measured fasting plasma glucose, hemoglobin A1c, serum creatinine, glomerular filtration rate, blood pressure, and body mass index as clinical characteristics. <italic>PRKAA2</italic> genetic variations were determined by TaqMan SNP genotyping assay. Hardy–Weinberg equilibrium was calculated using χ<sup>2</sup> tests.</p> </sec> <sec><title style='display:none'>Results</title> <p>There was no difference in clinical characteristics for genotypes rs2796498, rs9803799, or rs2746342 (<italic>P</italic> &gt; 0.05). No significant association was found between <italic>PRKAA2</italic> genetic variations and any clinical feature observed. Further subgroup analysis adjusting for age, sex, and waist circumference did not detect any significant association of <italic>PRKAA2</italic> genetic variations with clinical characteristics (<italic>P</italic> &gt; 0.05).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p><italic>PRKAA2</italic> genetic variation is not associated with the clinical characteristics of Indonesian patients with newly diagnosed T2DM.</p> </sec> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00Room-temperature stable loop-mediated isothermal amplification (LAMP) reagents to detect leptospiral DNA<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Loop-mediated isothermal amplification (LAMP) is one of the most promising tools for rapidly detecting <italic>Leptospira</italic> spp. However, LAMP is hampered by cold storage to maintain the enzymatic activity of <italic>Bst</italic> DNA polymerase.</p> </sec> <sec><title style='display:none'>Objective</title> <p>To overcome the drawback of cold storage requirement for LAMP reagents we modified the reagents by adding sucrose as stabilizer. We then sought to determine the stability at room temperature of the premixed LAMP reagents containing sucrose.</p> </sec> <sec><title style='display:none'>Method</title> <p>Premixed LAMP reagents with sucrose and without sucrose were prepared. The prepared mixtures were stored at room temperature for up to 60 days, and were subjected to LAMP reactions at various intervals using rat kidney samples to detect leptospiral DNA.</p> </sec> <sec><title style='display:none'>Results</title> <p>The premixed LAMP reagents with sucrose remained stable for 45 days while sucrose-free premixed LAMP reagents showed no amplification from day 1 of storage at room temperature up to day 14.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The LAMP reagent system can be refined by using sucrose as stabilizer, thus allowing their storage at room temperature without the need for cold storage. The modified method enables greater feasibility of LAMP for field surveillance and epidemiology in resource-limited settings.</p> </sec> </abstract>ARTICLE2021-08-20T00:00:00.000+00:00Identification of a mitochondrial 12S rRNA A1555G mutation causing aminoglycoside-induced deafness in a large Thai family<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.389_s_004_w2aab3b7c12b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e36609_w2aab3b7c12b1b6b1aab1c17b1aAa">Background</title><p>Hearing loss is among the most frequent sensory disorders. Preventable causes include medications given to genetically susceptible individuals. Several families around the world with an A1555G mitochondrial mutation who became profoundly deaf after receiving aminoglycosides have been described. However, none has been reported in Thailand.</p></sec><sec id="j_1905-7415.0902.389_s_005_w2aab3b7c12b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e36617_w2aab3b7c12b1b6b1aab1c17b2aAa">Objectives</title><p>To identify the cause of hearing loss of a large Thai family with 11 members who reportedly turned deaf after receiving antibiotics.</p></sec><sec id="j_1905-7415.0902.389_s_006_w2aab3b7c12b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e36625_w2aab3b7c12b1b6b1aab1c17b3aAa">Methods</title><p>We obtained blood samples from 5 members; 4 of whom had hearing loss. Mutation analyses were performed using molecular techniques including polymerase chain reaction, Sanger sequencing, and restriction fragment length polymorphism.</p></sec><sec id="j_1905-7415.0902.389_s_007_w2aab3b7c12b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e36633_w2aab3b7c12b1b6b1aab1c17b4aAa">Results</title><p>All 4 affected members were found to harbor the same A1555G mitochondrial mutation, while the unaffected had only the wild-type A.</p></sec><sec id="j_1905-7415.0902.389_s_008_w2aab3b7c12b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e36642_w2aab3b7c12b1b6b1aab1c17b5aAa">Conclusions</title><p>We have identified the mitochondrial mutation leading to aminoglycoside-induced hearing loss in a Thai population. Raising awareness for medical practitioners of this genetic susceptibility in Thailand is warranted. Avoidance of certain medications in these individuals would prevent this acquired permanent hearing loss.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Doppler waveform patterns and reference ranges of fetal renal artery blood flow indices in normal Thai fetuses during the second trimester<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.390_s_004_w2aab3b7c13b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e18235_w2aab3b7c13b1b6b1aab1c17b1aAa">Background</title><p>Fetal hemodynamics can be assessed by Doppler ultrasonography, but the normal Doppler waveform pattern and reference range of fetal renal artery blood flow indices in normal Thai fetuses during the second trimester have not been studied.</p></sec><sec id="j_1905-7415.0902.390_s_005_w2aab3b7c13b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e18243_w2aab3b7c13b1b6b1aab1c17b2aAa">Objectives</title><p>To study the pattern and establish the normal reference range of fetal renal artery blood flow indices in the normal Thai fetus during the second trimester.</p></sec><sec id="j_1905-7415.0902.390_s_006_w2aab3b7c13b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e18251_w2aab3b7c13b1b6b1aab1c17b3aAa">Materials and methods</title><p>This cross-sectional descriptive study included 512 normal singleton pregnant women, gestational age between 14<sup>(+0)</sup> and 28<sup>(+6)</sup> weeks. Ultrasonography was performed to assess the Doppler waveform pattern and estimate the normal reference range of fetal renal artery blood flow indices. All fetuses were delivered at term with normal outcomes at birth. The mean and 95<sup>th</sup> and 5<sup>th</sup> percentiles of the Doppler indices for each gestational week were estimated.</p></sec><sec id="j_1905-7415.0902.390_s_007_w2aab3b7c13b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e18271_w2aab3b7c13b1b6b1aab1c17b4aAa">Results</title><p>Doppler patterns with absence of diastolic flow in the entire cardiac cycle (type I), and absence of diastolic flow at the end of cardiac cycle (type II) were presented in about 10.4% of normal fetuses during the second trimester of pregnancy. Values for pulsatility index, peak systolic velocity, systolic-to-diastolic ratio, and resistance index (with absent end-diastolic velocity (AEDV) removed) each increased significantly with gestational age. The increase in end-diastolic velocity (with AEDV removed) with gestational age was not significant.</p></sec><sec id="j_1905-7415.0902.390_s_008_w2aab3b7c13b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e18280_w2aab3b7c13b1b6b1aab1c17b5aAa">Conclusion</title><p>These normative data could serve as a basis for evaluation of the fetal renal artery blood flow, which should be of benefit for pregnancy management, especially in situations that interfere with fetal renal perfusion.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Observational study of omeprazole for gastroesophageal reflux on pulmonary function in adult asthmatics<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.378_s_004_s_001_w2aab3b7b2b1b6b1aab1c16b1Aa"><title style='display:none' id="d1389236e14046_w2aab3b7b2b1b6b1aab1c16b1aAa">Background</title><p>Asthma is a chronic inflammatory disease of airways. Gastroesophageal reflux disease (GERD) is known to be associated with worsening asthma. We hypothesized that treatment of GERD in asthmatics will improve asthma control and quality of life. We reviewed our experience of treatment of GERD in asthmatics in Thailand.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_002_w2aab3b7b2b1b6b1aab1c16b2Aa"><title style='display:none' id="d1389236e14053_w2aab3b7b2b1b6b1aab1c16b2aAa">Objectives</title><p>To study the effects of omeprazole for treatment of GERD in patients with poorly controlled asthma on pulmonary function tests and asthma control test (ACT) scores.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_003_w2aab3b7b2b1b6b1aab1c16b3Aa"><title style='display:none' id="d1389236e14060_w2aab3b7b2b1b6b1aab1c16b3aAa">Methods</title><p>This study was conducted at King Chulalongkorn Memorial Hospital between August 2009 and December 2010. Patients with partly controlled and uncontrolled asthma who were found to have GERD by 24 hour esophageal pH monitoring were administered omeprazole 40 mg per day for 8 weeks. Pulmonary function tests and ACT scores before and after treatment were compared at 4-weeks and 8-weeks follow up.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_004_w2aab3b7b2b1b6b1aab1c16b4Aa"><title style='display:none' id="d1389236e14067_w2aab3b7b2b1b6b1aab1c16b4aAa">Results</title><p>Twenty four patients were included in this study. None of them had asthmatic attacks during the study. After 4 and 8 weeks of omeprazole treatment, the mean FEV1 (2.20 ± 0.64 L, 2.36 ± 0.58 L, respectively) and the mean ACT score (20.82 ± 3.30, 23.00 ± 1.69, respectively) were significantly higher than the pretreatment values (mean FEV1 1.99 ± 0.56 L and ACT score 16.36 ± 3.97) (<italic>P</italic> &lt; 0.05).</p></sec><sec id="j_1905-7415.0902.378_s_004_s_005_w2aab3b7b2b1b6b1aab1c16b5Aa"><title style='display:none' id="d1389236e14078_w2aab3b7b2b1b6b1aab1c16b5aAa">Conclusion</title><p>High-dose omeprazole may improve pulmonary function and the level of asthma control in Thai patients with partly controlled or uncontrolled asthma and coexisting GERD.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Stevens-Johnson Syndrome and toxic epidermal necrolysis in children: a retrospective study at Srinagarind Hospital, Khon Kaen, Thailand 1992–2012<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.386_s_005_w2aab3b7b9b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e7217_w2aab3b7b9b1b6b1aab1c17b1aAa">Background</title><p>Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening skin conditions with an etiology of drug exposure or infections.</p></sec><sec id="j_1905-7415.0902.386_s_006_w2aab3b7b9b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e7225_w2aab3b7b9b1b6b1aab1c17b2aAa">Objectives</title><p>To determine the cause, treatments, complications, and outcomes of SJS/TEN in children admitted to Srinagrind Hospital during 1992–2012.</p></sec><sec id="j_1905-7415.0902.386_s_007_w2aab3b7b9b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e7233_w2aab3b7b9b1b6b1aab1c17b3aAa">Methods</title><p>Retrospective chart review. A diagnosis of SJS and TEN was confirmed by pediatric dermatologists.</p></sec><sec id="j_1905-7415.0902.386_s_008_w2aab3b7b9b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e7241_w2aab3b7b9b1b6b1aab1c17b4aAa">Results</title><p>A total of 38 patients was recorded. They consisted 31 (82%) SJS patients and 7 (18%) TEN patients. Mean age 6.6 years (range 1 to 14 years). Male to female was 1.1:1. Most cases (30 or 79%) were caused by drug exposure. Three cases (8%) by infection, and 5 cases (13%) were of unknown cause. The antiepileptic drug group was the most common cause. Systemic corticosteroids were used in 33 cases (87%). Intravenous immunoglobulin was used in one TEN patient (3%). There were 18 cases (47%) with acute complications. Ocular complications (7 cases, 39%), septicemia (4 cases, 22%), and secondary skin infections (3 cases, 17%) were the most common. Mean difference in length of hospital stay between those with and without acute complications was 12.3 days (<italic>P</italic> &lt; 0.01, 95% CI 5.9–18.6). Ocular complications were the only long-term complications at 1-year follow up, and included symblepharon, corneal pannus, and dry eyes. Two patients (5%), both having cases of TEN, died.</p></sec><sec id="j_1905-7415.0902.386_s_009_w2aab3b7b9b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e7253_w2aab3b7b9b1b6b1aab1c17b5aAa">Conclusions</title><p>Antiepileptic drugs were the most common causes of SJS/TEN in our study. Good ophthalmologic care of the prevalent acute eye complications in these patients is needed to prevent long-term ophthalmic complications.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Hepatic resection using ultrasonic surgical aspirator<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.384_s_004_w2aab3b7b7b1b6b1aab1c16b1Aa"><title style='display:none' id="d1389236e245_w2aab3b7b7b1b6b1aab1c16b1aAa">Background</title><p>Hepatic resections conducted for malignant tumors can be difficult because of the need to create cancer-free margins.</p></sec><sec id="j_1905-7415.0902.384_s_005_w2aab3b7b7b1b6b1aab1c16b2Aa"><title style='display:none' id="d1389236e253_w2aab3b7b7b1b6b1aab1c16b2aAa">Objectives</title><p>To examine the outcome of hepatic resections after the introduction of a Cavitron Ultrasonic Surgical Aspirator (CUSA).</p></sec><sec id="j_1905-7415.0902.384_s_006_w2aab3b7b7b1b6b1aab1c16b3Aa"><title style='display:none' id="d1389236e261_w2aab3b7b7b1b6b1aab1c16b3aAa">Methods</title><p>A retrospective study of patients who underwent hepatic resection by a single surgeon between April 1999 to March 2013.</p></sec><sec id="j_1905-7415.0902.384_s_007_w2aab3b7b7b1b6b1aab1c16b4Aa"><title style='display:none' id="d1389236e269_w2aab3b7b7b1b6b1aab1c16b4aAa">Results</title><p>We included 101 patients with 104 hepatectomies. Most hepatic parenchymal transections were performed using a CUSA under intermittent hepatic inflow occlusion (Pringle maneuver). Thirty-five patients underwent a right hepatectomy, 11 a left hepatectomy, 6 a right hepatectomy and segment I resection, 6 a right lobectomy, and 46 underwent segmentectomies, wedge resections, or other types of hepatic resections. Biliary-enteric reconstruction with a Roux-en-Y limb of the jejunum to a hepatic duct of the hepatic remnant was performed in 28 patients. Operative time was 90–720 min (median 300 min, mean 327 ± 149 min). Operative blood transfusion was 0–17 units (median 3 units, mean 3.9 ± 3.6 units). Twenty-one hepatectomies were conducted without blood transfusion. Thirty-four postoperative complications occurred in 30 patients with a 9% reoperation rate. Perioperative mortality was 6%. Age, operative time, operative blood transfusion, reoperation, and complications were significantly associated with mortality.</p></sec><sec id="j_1905-7415.0902.384_s_008_w2aab3b7b7b1b6b1aab1c16b5Aa"><title style='display:none' id="d1389236e278_w2aab3b7b7b1b6b1aab1c16b5aAa">Conclusion</title><p>Careful preoperative diagnosis and evaluation of patients, faultless surgical techniques, and excellent postoperative care are important to avoid potentially serious postoperative complications and mortality. The CUSA is an effective assisting device during hepatic parenchymal transection with a concomitant Pringle maneuver, apparently reducing operative blood loss.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Comprehensive care for thalassemia: not just the treatment of anemia function in patients with regular blood transfusion for thalassemia major<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.385_s_005_w2aab3b7b8b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e23217_w2aab3b7b8b1b6b1aab1c17b1aAa">Background</title><p>Regular blood transfusion and iron chelation therapy have improved the quality of life of patients with thalassemia and increased their longevity, but transfusion also increases the frequency of endocrine complications, possibly because of iron deposition in the pituitary gland or the gonads, or both.</p></sec><sec id="j_1905-7415.0902.385_s_006_w2aab3b7b8b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e23225_w2aab3b7b8b1b6b1aab1c17b2aAa">Objective</title><p>To evaluate testicular function in patients with thalassemia major by basal hormonal study, and identify risk factors for dysfunction.</p></sec><sec id="j_1905-7415.0902.385_s_007_w2aab3b7b8b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e23233_w2aab3b7b8b1b6b1aab1c17b3aAa">Methods</title><p>We performed a cross-sectional study of 28 patients with thalassemia major aged 11.7 ± 1.8 (8–14.9) years (15 in prepuberty, 13 in puberty with no delayed puberty) who had regular blood transfusions. A normal control group comprised 64 boys who were matched for age and Tanner genital stage.</p></sec><sec id="j_1905-7415.0902.385_s_008_w2aab3b7b8b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e23241_w2aab3b7b8b1b6b1aab1c17b4aAa">Results</title><p>The mean level of serum ferritin in the previous year was 1,575 ± 642 ng/mL, and the onset of blood transfusion was at 3.8 ± 2.3 years and iron chelation therapy was 6.6 ± 2.8 years. The trend for anti-Müllerian hormone levels in patients and controls was similar with age, and although higher in the patients, particularly at Tanner stage II, was not significantly different. Testosterone levels were lower in the patients compared with controls; particularly at Tanner stages IV–V (290.88 vs. 537.4 ng/dL, <italic>P</italic> &lt; 0.05). Serum follicle-stimulating hormone and luteinizing hormone levels were not significantly different between the groups at any Tanner stage.</p></sec><sec id="j_1905-7415.0902.385_s_009_w2aab3b7b8b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e23253_w2aab3b7b8b1b6b1aab1c17b5aAa">Conclusion</title><p>Patients who received regular blood transfusions had normal Sertoli cell function. Leydig cell dysfunction may occur, even though the patients had a normal pubertal onset.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Assessment of health-related quality of life in Thai patients after heart surgery<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.388_s_005_w2aab3b7c11b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e37824_w2aab3b7c11b1b6b1aab1c17b1aAa">Background</title><p>Little is known about health-related quality of life (HRQoL) of Thai patients after heart surgery. The Thai government initiated a cardiac surgery project to celebrate the 80<sup>th</sup> birthday anniversary of His Majesty The King.</p></sec><sec id="j_1905-7415.0902.388_s_006_w2aab3b7c11b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e37835_w2aab3b7c11b1b6b1aab1c17b2aAa">Objectives</title><p>To evaluate the HRQoL of Thai patients after heart surgery, as part of the Thai government’s cardiac surgery project, and to investigate the association of HRQoL instruments and patient characteristics.</p></sec><sec id="j_1905-7415.0902.388_s_007_w2aab3b7c11b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e37843_w2aab3b7c11b1b6b1aab1c17b3aAa">Methods</title><p>Of 7,863 patients in the project, 386 were randomly selected for a telephone interview by trained researchers during June–November 2008. The HRQoL of Thai patients was measured using 12-item Short Form version 2 and EuroQoL (EQ-5D) plus an EQ-5D visual analog scale (EQ-VAS).</p></sec><sec id="j_1905-7415.0902.388_s_008_w2aab3b7c11b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e37851_w2aab3b7c11b1b6b1aab1c17b4aAa">Results</title><p>The mean age of patient participants was 50.4 ± 13.7 years (range 17–82) and 49.5% were male. The Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were reported as 46.91 and 54.44, respectively, compared with the US norm scores of 50. The EQ-5D and EQ-VAS utility scores of 0.81 and 0.84 were comparable to those of Thai general population (0.77–0.84), but higher than those of Thai patients with heart disease (0.73–0.75). Patients with older age, female sex, unemployment, and presence of comorbidity rated a lower HRQoL. The multiple linear regression models showed that both EQ-5D and EQ-VAS were associated with PCS and MCS and could be predicted by 40%–50%.</p></sec><sec id="j_1905-7415.0902.388_s_009_w2aab3b7c11b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e37859_w2aab3b7c11b1b6b1aab1c17b5aAa">Conclusion</title><p>Overall, the HRQoL of patients after the heart surgery was satisfactory. The QoL in patients with a specific types of heart surgery warrants further study.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00The age of onset of pubertal development in healthy Thai boys in Khon Kaen, Thailand<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.391_s_006_w2aab3b7c14b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e8414_w2aab3b7c14b1b6b1aab1c17b1aAa">Background</title><p>There is variation of the age of onset of puberty in a population. The secular trends in the timing of pubertal development have decreased in some parts of the world.</p></sec><sec id="j_1905-7415.0902.391_s_007_w2aab3b7c14b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e8422_w2aab3b7c14b1b6b1aab1c17b2aAa">Objective</title><p>To determine the age of pubertal development in healthy Thai boys in Khon Kaen, Thailand and compare it with that in previous studies of Thai boys.</p></sec><sec id="j_1905-7415.0902.391_s_008_w2aab3b7c14b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e8430_w2aab3b7c14b1b6b1aab1c17b3aAa">Methods</title><p>A descriptive, cross-sectional study was performed in 316 school boys aged 5–16 years between May and July 2011. Development of the genitals and pubic hair was determined by Tanner staging, and testicular volume was assessed using a Prader orchidometer. All boys were examined by a male pediatrician.</p></sec><sec id="j_1905-7415.0902.391_s_009_w2aab3b7c14b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e8438_w2aab3b7c14b1b6b1aab1c17b4aAa">Results</title><p>Genital stage of puberty in boys occurred at a median age of 11.3 years and a mean ± SD age of 11.3 ± 1.3 (mean ± SD, range 8.0–14.9) years, and pubarche occurred at a median age of 12.8 years and a mean ± SD of 12.5 ± 1.2 years (range 9.1–14.9) years.</p></sec><sec id="j_1905-7415.0902.391_s_010_w2aab3b7c14b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e8447_w2aab3b7c14b1b6b1aab1c17b5aAa">Conclusions</title><p>No secular trend towards earlier age at pubertal onset for gonadarche in Khon Kaen boys, but pubarche seems to be later than found in previous studies in Thai boys.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Short-term outcomes after anterior stapling rectotomy using a single stapler device for rectocele<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.378_s_004_s_001_w2aab3b7b1b1b6b1aab1c16b1Aa"><title style='display:none' id="d1389236e27341_w2aab3b7b1b1b6b1aab1c16b1aAa">Background</title><p>Stapled transanal rectal segmental resection (STARR) is a technique for treatment of obstructive defecation syndrome (ODS) when associated with rectocele and/or intussusceptions.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_002_w2aab3b7b1b1b6b1aab1c16b2Aa"><title style='display:none' id="d1389236e27348_w2aab3b7b1b1b6b1aab1c16b2aAa">Objectives</title><p>To evaluate a simplified method using a single stapler device for isolated anterior rectal wall correction of structural abnormalities (single-STARR technique).</p></sec><sec id="j_1905-7415.0902.378_s_004_s_003_w2aab3b7b1b1b6b1aab1c16b3Aa"><title style='display:none' id="d1389236e27355_w2aab3b7b1b1b6b1aab1c16b3aAa">Materials and methods</title><p>Patients who were diagnosed with ODS underwent the single-STARR procedure. Their baseline symptoms were measured by using a modified obstructed defecation syndrome (MODS) questionnaire score. Evacuation proctography was performed to exclude functional anorectal disorders. Colonoscopy was selectively performed and for all patients older than 50 years. Single-STARR procedure was performed in cases where there was no evidence of an inflammatory, metabolic, neoplastic process, or functional disorders. The summed global score of ODS ranged from 0 (normal) to 24 (severe). Outcomes were determined by evaluating the postoperative improvement using a MODS score.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_004_w2aab3b7b1b1b6b1aab1c16b4Aa"><title style='display:none' id="d1389236e27362_w2aab3b7b1b1b6b1aab1c16b4aAa">Results</title><p>A total of 9 patients (mean (SD) age 53 (13.6) years) with ODS were eligible for the study. Both rectocele and intussusceptions were diagnosed from preoperative defecography in 7 of the patients. Single-STARR was successfully performed without intraoperative complications in all patients with a mean operative time of 52 (12.7) min. The mean severity of symptoms decreased significantly at the 3<sup>rd</sup> and 6<sup>th</sup> (<italic>P</italic> &lt; 0.01) month after surgery. However, one-third of patients experienced persistence of symptoms or symptom score deterioration on the 12<sup>th</sup> month after surgery.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_005_w2aab3b7b1b1b6b1aab1c16b5Aa"><title style='display:none' id="d1389236e27382_w2aab3b7b1b1b6b1aab1c16b5aAa">Conclusion</title><p>The single-STARR procedure provided short-term symptom relief with no serious postoperative complication in a small series of 9 cases.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Publication of pediatric residency research theses from Prince of Songkla University, Hat Yai, Thailand<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.392_s_004_w2aab3b7c15b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e16530_w2aab3b7c15b1b6b1aab1c17b1aAa">Background</title><p>The Royal College of Pediatricians of Thailand requires that all its residents complete a full thesis before their final Thai Pediatric Board Examination. The Department of Pediatrics of the Faculty of Medicine, Prince of Songkla University (PSU) has been certified for pediatric residency training since 1985.</p></sec><sec id="j_1905-7415.0902.392_s_005_w2aab3b7c15b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e16538_w2aab3b7c15b1b6b1aab1c17b2aAa">Objectives</title><p>To determine the number of articles published in medical journals that are based on the theses of residents during 25 years of pediatric resident training, and how long after finishing their residency training the articles were published.</p></sec><sec id="j_1905-7415.0902.392_s_006_w2aab3b7c15b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e16546_w2aab3b7c15b1b6b1aab1c17b3aAa">Methods</title><p>Medical journal databases were searched for the names of former pediatric residents. The faculty staff who had supervised them during their training were asked to confirm whether the residents had published their work.</p></sec><sec id="j_1905-7415.0902.392_s_007_w2aab3b7c15b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e16554_w2aab3b7c15b1b6b1aab1c17b4aAa">Results</title><p>During the 25 years (1988–2012), we found records of 34 articles based on the theses of 130 residents published in a medical journal (26%). In the early phase (1988–2002), 15 articles from 67 theses (22%) were published: 10 (67%) in Thai or regional English language journals, and 5 (33%) in international peer-reviewed journals. In the second phase (2003–2012), 19 articles from 63 theses (30%) were published: 6 (32%) in regional English language journals, and 13 (68%) in peer-reviewed international journals.</p></sec><sec id="j_1905-7415.0902.392_s_008_w2aab3b7c15b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e16563_w2aab3b7c15b1b6b1aab1c17b5aAa">Conclusions</title><p>The publication rate of PSU pediatric residency research theses during the 25 years was 26%. We recommend that our faculty devote more time to ensuring supervision of the thesis writing component of the residency training to increase the publication rate of research theses by our residents.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Time course of concurrent infection with dengue virus serotypes 2 and 4 detected in urine<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.387_s_005_w2aab3b7c10b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e20582_w2aab3b7c10b1b6b1aab1c17b1aAa">Background</title><p>In hyperendemic areas, concurrent multiserotype dengue virus (DENV) infections commonly occur in both humans and in mosquito vectors. Previous studies have focused on single blood specimens.</p></sec><sec id="j_1905-7415.0902.387_s_006_w2aab3b7c10b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e20590_w2aab3b7c10b1b6b1aab1c17b2aAa">Objectives</title><p>To illustrate and characterize the time course of mixed infection with DENV serotypes 2 (DENV2) and 4 (DENV4) in a single case.</p></sec><sec id="j_1905-7415.0902.387_s_007_w2aab3b7c10b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e20598_w2aab3b7c10b1b6b1aab1c17b3aAa">Materials and methods</title><p>Plasma, saliva, and urine were collected from a patient diagnosed with dengue hemorrhagic fever grade II and secondary DENV infection on days 7, 18, and 31 of his illness. DENV RNA detection was performed using 2 DENV-specific reverse transcriptase-polymerase chain reaction protocols. Cloning and sequencing were performed to quantify the major and minor viral populations in dual-serotype-infected specimen(s). Genotypes of both DENV serotypes were characterized.</p></sec><sec id="j_1905-7415.0902.387_s_008_w2aab3b7c10b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e20606_w2aab3b7c10b1b6b1aab1c17b4aAa">Results</title><p>DENV genome was detected in plasma and saliva only at the first time point (day 7 of illness), but in urine at both the first and second time points (days 7 and 18 of illness). DENV4 serotype was found in all DENV genome-positive specimens. DENV2 serotype was unexpectedly also detected in the first urine specimen. DENV4 as the major and DENV2 as the minor population. The DENV2 serotype was clustered in genotype Asian I and DENV4 serotype in genotype I.</p></sec><sec id="j_1905-7415.0902.387_s_009_w2aab3b7c10b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e20615_w2aab3b7c10b1b6b1aab1c17b5aAa">Conclusion</title><p>To our knowledge, this is the first report of concurrent multiserotype DENV infection detected solely in urine. Prospective noninvasive investigations may determine the prevalence of this phenomenon. Clinical and public health implications of this finding need to be explored.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Comparison of exercise treadmill test, flow mediated dilatation, and inflammation in individuals with low risk of adverse cardiovascular events<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.380_s_004_s_001_w2aab3b7b3b1b6b1aab1c16b1Aa"><title style='display:none' id="d1389236e10685_w2aab3b7b3b1b6b1aab1c16b1aAa">Background</title><p>The relationship between endothelial dysfunction, a risk factor for coronary artery disease, and the incidence of cardiovascular disease (CVD) in the general population is not well known.</p></sec><sec id="j_1905-7415.0902.380_s_004_s_002_w2aab3b7b3b1b6b1aab1c16b2Aa"><title style='display:none' id="d1389236e10692_w2aab3b7b3b1b6b1aab1c16b2aAa">Objectives</title><p>To determine the utility of an exercise treadmill test (ETT) combined with inflammatory markers to show endothelial dysfunction for individuals with a low risk of adverse cardiovascular (CV) events.</p></sec><sec id="j_1905-7415.0902.380_s_004_s_003_w2aab3b7b3b1b6b1aab1c16b3Aa"><title style='display:none' id="d1389236e10699_w2aab3b7b3b1b6b1aab1c16b3aAa">Methods</title><p>Biomarkers of inflammation (lipoprotein-related phospholipase A<sub>2</sub> (Lp-PLA<sub>2</sub>) and high-sensitive C-reactive protein (hs-CRP)) and biomarkers of endothelial dysfunction (nitric oxide, oxidized low-density lipoprotein (Ox-LDL), and sialic acid) were assessed in 60 apparently healthy patients with a positive (+) or negative (−) ETT and across endothelial function assessed by flow mediated dilatation (FMD) and Lp-PLA<sub>2</sub> tertiles.</p></sec><sec id="j_1905-7415.0902.380_s_004_s_004_w2aab3b7b3b1b6b1aab1c16b4Aa"><title style='display:none' id="d1389236e10715_w2aab3b7b3b1b6b1aab1c16b4aAa">Results</title><p>Lp-PLA<sub>2</sub> levels were increased in ETT (−) compared with ETT (+) patients. Half of ETT (−) patients were found to have levels of Lp-PLA<sub>2</sub> in the highest tertile. There was a significant inverse relationship between ETT and inflammatory biomarkers when adjusted for age, Lp-PLA<sub>2</sub> (<italic>r</italic> = −0.28, <italic>P</italic> = 0.04), or hs-CRP (<italic>r</italic> = −0.35, <italic>P</italic> = 0.01). No differences were found for biomarkers of endothelial dysfunction. All variables were reassessed across FMD tertiles. Total lipids, Ox-LDL, triglyceride, and Lp-PLA<sub>2</sub> were higher for the lowest FMD tertile.</p></sec><sec id="j_1905-7415.0902.380_s_004_s_005_w2aab3b7b3b1b6b1aab1c16b5Aa"><title style='display:none' id="d1389236e10748_w2aab3b7b3b1b6b1aab1c16b5aAa">Conclusion</title><p>The elevation of Lp-PLA<sub>2</sub> in ETT (−) patients and the inverse relationship with inflammatory biomarkers, suggest that ETT cannot address endothelial dysfunction for individuals with apparently low risk of adverse CV events, and cannot be used for risk stratification of the general population.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Plasma levels of leptin and ghrelin and their correlation with BMI, and circulating lipids and glucose in obese Tunisian women<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0902.382_s_005_w2aab3b7b5b1b6b1aab1c17b1Aa"><title style='display:none' id="d1389236e3966_w2aab3b7b5b1b6b1aab1c17b1aAa">Background</title><p>A National Survey on the Effect of Nutrition conducted in 1996−1997 showed a 14% overall prevalence of obesity in Tunisia with a female predominance. Leptin and ghrelin play crucial roles in regulating body weight and energy balance. Leptin, an anorectic hormone, and ghrelin, an orexigenic hormone, appear to interact with glucose and lipid metabolism.</p></sec><sec id="j_1905-7415.0902.382_s_006_w2aab3b7b5b1b6b1aab1c17b2Aa"><title style='display:none' id="d1389236e3973_w2aab3b7b5b1b6b1aab1c17b2aAa">Objectives</title><p>To determine the circulating levels of ghrelin and leptin in obese Tunisian women and to investigate the correlations of these hormones with body mass index (BMI), and circulating lipids and glucose.</p></sec><sec id="j_1905-7415.0902.382_s_007_w2aab3b7b5b1b6b1aab1c17b3Aa"><title style='display:none' id="d1389236e3980_w2aab3b7b5b1b6b1aab1c17b3aAa">Methods</title><p>Forty obese women were recruited from patients in the “C” Unit of the National Institute of Nutrition and Food Technology. Twenty normal women were recruited as controls. Plasma levels of the studied variables were measured in patients from both groups and findings were analyzed.</p></sec><sec id="j_1905-7415.0902.382_s_008_w2aab3b7b5b1b6b1aab1c17b4Aa"><title style='display:none' id="d1389236e3987_w2aab3b7b5b1b6b1aab1c17b4aAa">Results</title><p>Circulating levels of leptin were significantly higher, while high-density lipoprotein (HDL)-cholesterol and ghrelin levels were significantly lower in the obese women. In the obese women, significant positive correlations were found between circulating levels of leptin and low-density lipoprotein (LDL)-cholesterol, BMI, and glucose; and ghrelin and HDL-cholesterol. Significant negative correlations were found between circulating levels of leptin and HDL-cholesterol and ghrelin; and ghrelin and leptin, LDL-cholesterol, BMI, and glucose. Multivariate analysis revealed that ghrelin was significantly associated with HDL-cholesterol, LDL-cholesterol, and blood glucose.</p></sec><sec id="j_1905-7415.0902.382_s_009_w2aab3b7b5b1b6b1aab1c17b5Aa"><title style='display:none' id="d1389236e3995_w2aab3b7b5b1b6b1aab1c17b5aAa">Conclusions</title><p>The significant negative correlation between leptin and ghrelin suggests that these two hormones may be antagonistic. Increased levels of ghrelin are correlated with decreased circulating levels of HDL-cholesterol and increased levels of LDL-cholesterol.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00en-us-1