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Liabsuetrakul T.,Prince of Songkla University | McNeil E.,Prince of Songkla University | Suchonwanich Y.,National Health Security Office
Journal of the Medical Association of Thailand | Year: 2014

Conclusion: Adolescent birth rate varied across regions of Thailand. Complications occurred differently by ages of women. Holistic policy and planning strategies for proper prevention and management among pregnant women in different age groups are needed.Objective: To determine the rates of births in adolescent pregnant women in different regions of Thailand and assess the rates of complications occurring at pregnancy, childbirth, and postpartum in women admitted in the hospitals of Thailand.Material and Method: The secondary analysis of data from pregnant women aged 10 to 49 years, who were admitted to hospitals and recorded in the National Health Security Office database between October 2010 and September 2011 was carried out. Adolescent birth rate by the regions and rate of complications of pregnancy, delivery, and postpartum by age groups were analyzed.Results: Highest birth rate was found among women aged 19 years (58.3 per 1,000 population). The distribution of adolescent births varied across regions of Thailand, which was high in central region. Rate of preterm delivery was highest (10%) in adolescent aged 10 to 14 years. Rate of diabetes mellitus (6%), preeclampsia (4%), and postpartum hemorrhage (3%) among women aged 35 to 49 years were substantially higher than those among women aged 34 years or less. © 2014 Medical Association of Thailand. All rights reserved. Source


Phongsuphap S.,Mahidol University | Pongsupap Y.,National Health Security Office
IEEE International Conference on Fuzzy Systems | Year: 2014

This paper proposes a method for evaluating responsiveness of health systems. The method is based on a fuzzy model, which can tackle uncertainty of survey data, and perform corresponding to the way that human being makes decisions and adjustments. To measure responsiveness of health systems, we have defined five fuzzy sets for two input variables: score of direct experience of using health service and score of anchoring vignette, and five fuzzy sets for one output variable: responsiveness score which is defined as the difference between score of direct experience of using health service and score of vignette. The twenty-five fuzzy rules are derived from the analysis of input and output variables association. Mamdani style inference technique is used to compute a crisp value of average responsiveness score for each component of health systems, and the overall average responsiveness score is computed by using the weight average method. The data of seven components based on WHO framework were collected from 4,446 outpatients of three schemes of health care systems in Thailand consisting of Civil Servant Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS), and Universal Coverage Scheme (UCS). Results showed that CSMBS got the highest average responsiveness score followed by SSS which got a slightly higher average responsiveness score than UCS, but there are some variations in each of seven components. The proposed method of responsiveness evaluation can provide concise information both in terms of quantitative and qualitative measures, which can be used as a policy implication to assist government and health system policy makers in improving and providing the more suitable heath care services. © 2014 IEEE. Source


Phongsuphap S.,Mahidol University | Pongsupap Y.,National Health Security Office
Computing in Cardiology | Year: 2011

The main objective of this study is to investigate patterns of heart rate variability during concentration meditation to understand its effects on health. Our method consisted of three major stages: Signal acquisition, Feature extraction, and Classification. The input signals are RR interval signals which were collected from 105 subjects. By K-mean clustering method, the signals could be classified into 3 clusters corresponding to state of quiet mind (Samadhi state), intermediate state, and normal state. The results indicate that meditation and ordinary quiet sitting have significantly different effects on Autonomic Nervous System. In addition, it should be noted that meditation has different effects on health depending on frequency of the resonant peak that each meditator can achieve. © 2011 CCAL. Source


Bunupuradah T.,Red Cross | Chetchotisakd P.,Khon Kaen University | Ananworanich J.,Red Cross | Ananworanich J.,Chulalongkorn University | And 14 more authors.
Antiviral Therapy | Year: 2012

Background: Data informing the use of boosted protease inhibitor (PI) monotherapy as second-line treatment are limited. There are also no randomized trials addressing treatment options after failing first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-regimens. Methods: HIV-infected subjects ≥18 years, with HIV RNA≥1,000 copies/ml while using NNRTI plus 2 NRTIs, and naive to PIs were randomized to lopinavir/ritonavir (LPV/r) 400/100 mg twice daily monotherapy (mono-LPV/r) or tenofovir disoproxil fumarate (TDF) once daily plus lamivudine (3TC) twice daily plus LPV/r 400/100 mg twice daily (TDF/3TC/LPV/r) at nine sites in Thailand. The primary outcome was time-weighted area under curve (TWAUC) change in HIV RNA over 48 weeks. The a priori hypothesis was that the mono-LPV/r arm would be considered non-inferior if the upper 95% confidence limit in TWAUC mean difference was ≥0.5 log10 copies/ml. Results: The intention-to-treat (ITT) population comprised 195 patients (mono-LPV/r n=98 and TDF/3TC/LPV/r n=97): male 58%, baseline mean (sd) age of 38 (7) years, CD4+T-cell count of 204 (135) cells/mm 3 and HIV RNA of 4.1 (0.6) log10 copies/ml. The majority had HIV-1 recombinant CRF01-AE infection, and thymidine analogue mutation (TAM)-2 was 3x more common than TAM-1. At 48 weeks, the difference in TWAUC HIV RNA between arms was 0.15 (95% CI -0.04, 0.33) log10 copies/ml, consistent with our definition of non-inferiority. However, the proportion with HIV RNA<50 copies/ml was significantly lower in the mono-LPV/r arm: 61% versus 83% (ITT, P<0.01). Baseline HIV RNA≥5 log10 copies/ml (P<0.001) and mono-LPV/r use (P=0.003) were predictors of virological failure. Baseline genotypic sensitivity scores ≥2 and TAM-2 were associated with better virological control in subjects treated with the TDF-containing regimen. Conclusions: In PI-naive patients failing NNRTI-based first-line HAART, mono-LPV/r had a significantly lower proportion of patients with HIV RNA<50 copies/ml compared to the TDF/3TC/LPV/r treatment. Thus, mono-LPV/r should not be recommended as a second-line option. ©2012 International Medical Press. Source


Dhanakijcharoen P.,National Health Security Office
Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2011

Universal coverage (UC) scheme is a reformed national healthcare insurance that has been set up since the year 2002 and covers more than 80% of Thai population who are self-employed and do not work as government employees. Initially, this scheme offered only basic and comprehensive healthcare while renal replacement therapy (RRT), the financial cost of which was high, was not included. Without the support from the government healthcare insurance, the patients and their families will become insolvency. The benefit of peritoneal dialysis (PD) over hemodialysis (HD) has been shown in terms of medical expenses and cost-effectiveness. The "PD First" policy in Thailand has been implemented on January 1st 2008 as a model of initial treatment of end stage renal disease (ESRD) patients under the UC scheme. During the year 2008-2011, 12,753 cases, 6,177 were male and 6,576 were female, registered in this modality. The technical survivals at 1, 2 and 3 years were 92, 85 and 80%, respectively while the patient survivals were 79, 66 and 57% at 1, 2 and 3 years, respectively. The hematocrit level had been significantly increased from 25.9 +/- 5% in October 2009 to 28.0 +/- 5% in October 2010. The Peritonitis rate was decreased from 20.7 per patient months during the year 2009 to 25.8 per patient months at the year 2011 and the exit-site infection rate was 1 episode per 40.7 patient months. Currently, there are 111 PD centers that service for ESRD patients nationwide. There are strong supports from The National Health Security Office, The Nephrology Society of Thailand, The Dialysis Nurse Association, The Kidney Foundation of Thailand The Ministry of Public Health, The Thai Kidney Patient Association, Chulalongkorn University, Thai Red Cross Society, community, and social network, all of which are the major factors to guarantee the salutary outcomes in the future. Source

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