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Kuptniratsaikul V.,Mahidol University | Dajpratham P.,Mahidol University | Taechaarpornkul W.,Sirindhorn national Medical Rehabilitation Center | Buntragulpoontawee M.,Chiang Mai University | And 5 more authors.
Clinical Interventions in Aging | Year: 2014

Objective: To determine the efficacy and safety of Curcuma domestica extracts in pain reduction and functional improvement. Methods: 367 primary knee osteoarthritis patients with a pain score of 5 or higher were randomized to receive ibuprofen 1,200 mg/day or C. domestica extracts 1,500 mg/day for 4 weeks. The main outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, WOMAC pain, WOMAC stiffness, and WOMAC function scores. Adverse events (AEs) were also recorded. Results: 185 and 182 patients were randomly assigned into C. domestica extracts and ibuprofen groups, respectively. The baseline characteristics were no different between groups. The mean of all WOMAC scores at weeks 0, 2, and 4 showed significant improvement when compared with the baseline in both groups. After using the noninferiority test, the mean difference (95% confidence interval) of WOMAC total, WOMAC pain, and WOMAC function scores at week 4 adjusted by values at week 0 of C. domestica extracts were noninferior to those for the ibuprofen group (P=0.010, P=0.018, and P=0.010, respectively), except for the WOMAC stiffness subscale, which showed a trend toward significance (P=0.060). The number of patients who developed AEs was no different between groups. However, the number of events of abdominal pain/ discomfort was significantly higher in the ibuprofen group than that in the C. domestica extracts group (P=0.046). Most subjects (96%-97%) were satisfied with the treatment, and two-thirds rated themselves as improved in a global assessment. Conclusion: C. domestica extracts are as effective as ibuprofen for the treatment of knee osteoarthritis. The side effect profile was similar but with fewer gastrointestinal AE reports in the C. domestica extracts group. © 2014 Kuptniratsaikul et al.


PubMed | Vachira Phuket Hospital, Ratchaburi Hospital, Khon Kaen University, Rajvithi Hospital and 4 more.
Type: | Journal: Clinical interventions in aging | Year: 2014

To determine the efficacy and safety of Curcuma domestica extracts in pain reduction and functional improvement.367 primary knee osteoarthritis patients with a pain score of 5 or higher were randomized to receive ibuprofen 1,200 mg/day or C. domestica extracts 1,500 mg/day for 4 weeks. The main outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, WOMAC pain, WOMAC stiffness, and WOMAC function scores. Adverse events (AEs) were also recorded.185 and 182 patients were randomly assigned into C. domestica extracts and ibuprofen groups, respectively. The baseline characteristics were no different between groups. The mean of all WOMAC scores at weeks 0, 2, and 4 showed significant improvement when compared with the baseline in both groups. After using the noninferiority test, the mean difference (95% confidence interval) of WOMAC total, WOMAC pain, and WOMAC function scores at week 4 adjusted by values at week 0 of C. domestica extracts were noninferior to those for the ibuprofen group (P=0.010, P=0.018, and P=0.010, respectively), except for the WOMAC stiffness subscale, which showed a trend toward significance (P=0.060). The number of patients who developed AEs was no different between groups. However, the number of events of abdominal pain/discomfort was significantly higher in the ibuprofen group than that in the C. domestica extracts group (P=0.046). Most subjects (96%-97%) were satisfied with the treatment, and two-thirds rated themselves as improved in a global assessment.C. domestica extracts are as effective as ibuprofen for the treatment of knee osteoarthritis. The side effect profile was similar but with fewer gastrointestinal AE reports in the C. domestica extracts group.


Wilailak S.,Mahidol University | Vipupinyo C.,Rajvithi Hospital | Suraseranivong V.,Bhumipol Hospital | Chotivanich K.,Mahidol University | And 12 more authors.
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2012

Objective To evaluate the effect of depot medroxyprogesterone acetate (DMPA) in protecting against epithelial ovarian cancer (EOC) and to evaluate factors associated with the risk of EOC. Design A multicentre, case-control study. Setting Twelve hospitals located across Thailand. Population Three hundred and thirty patients with EOC ('cases') and 982 matched controls were recruited from the 12 hospitals. Cases were newly diagnosed patients with EOC, demonstrated pathologically. Controls were age-matched patients admitted to different wards in the same hospital. Methods Cases and controls were interviewed by trained interviewers using a standardised pre-tested questionnaire. The factors associated with EOC were evaluated using univariate and multivariate analyses. Main outcome measures The odds ratio (OR) and 95% confidence interval (95% CI) were calculated to assess the relationship between DMPA and EOC. Results The use of DMPA was found to be associated with a 39% reduction in the risk of EOC with an OR of 0.61 and a 95% CI of 0.44-0.85 (P = 0.002). A significant risk reduction (83%) was observed when the duration of DMPA use was >3 years (OR 0.17; 95% CI 0.07-0.39; P < 0.001). Other factors associated with a reduced risk of EOC were the use of combined oral contraceptive pills and breastfeeding. A factor associated with an increased risk of EOC was a family history of gynaecological cancer. Conclusions The results suggest that DMPA may have a protective effect against EOC. If this effect is real, then it represents an important non-contraceptive benefit of DMPA. © 2012 RCOG.


Leungwattanakij S.,Bangkok Hospital | Watanachote D.,Bangkok Hospital | Noppakulsatit P.,Thammasat University | Petchpaibuol T.,Thammasat University | And 10 more authors.
Journal of Sexual Medicine | Year: 2010

Introduction: Benign prostatic hyperplasia (BPH) is a common condition among elderly men. The aim of therapy is to improve lower urinary tract symptoms (LUTS) and quality of life (QoL) and to prevent complications. Aim: The primary objective was to assess the effect on ejaculatory dysfunction (EjD) of 6 months treatment with alfuzosin (XATRAL) 10 mg once daily (OD) in men with LUTS suggestive of BPH in Thailand. Secondary objectives were to evaluate the efficacy of alfuzosin on LUTS, bother score (International Prostate Symptom Score [IPSS] 8th question), erectile dysfunction (ED), onset of action, and tolerability. Methods: Overall, 99 men with moderate to severe LUTS suggestive of BPH (mean IPSS 18.9, bother score 4.3) were enrolled in an open-label study. Sexual function was evaluated at baseline and after 6 months treatment, using the International Index of Erectile Function-5 and the Male Sexual Health Questionnaire (MSHQ) ejaculation score, a new validated questionnaire assessing seven EjD symptoms. Main Outcome Measure: The main outcome measure is mean change from baseline to the end of treatment in the MSHQ Ejaculation score. Results: MHSQ ejaculation score significantly improved from 23.09 at baseline to 21.54 at 6 months (P = 0.022). Overall, 70% of patients perceived an improvement in LUTS within 1 week (36.3% within 3 days). IPSS total score significantly improved from 18.93 at baseline to 9.59 at 6 months (P < 0.001). IPSS voiding and irritative subscores also significantly improved. The percentage of patients with moderate or severe ED decreased from 35.3% at baseline to 21.8% at 6 months. Most adverse events were dizziness (3%) and orthostatic hypotension (1%) with minor intensity. No significant change in blood pressure and heart rate was observed. Conclusions: Alfuzosin 10 mg OD administered for 6 months provides a marked and rapid (within 1 week) improvement in LUTS and bother score while improving both ED and EjD. © 2010 International Society for Sexual Medicine.


Tongtawee T.,Suranaree University of Technology | Kaewpitoon S.J.,Suranaree University of Technology | Loyd R.,Suranaree University of Technology | Chanvitan S.,Rajvithi Hospital | And 5 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: Cholangiocarcinoma (CHCA) is serious public health problem in Thailand, especially in the northeastern and northern regions. CHCA is known as one of the most aggressive malignant tumors associated with local invasion and a high rate of metastasis. A crucial step in the invasion process is the proteolytic degradation of the extracellular matrix (ECM) and basal membranes, for which several studies have shown a critical role played by matrix metalloproteinase-11 (MMP-11). Objective: This study aim to detect MMP-11 expression in CHCA specimens and any correlation with survival time. Materials and Methods: A retrospective analysis was conducted of 30 patients with CHCA in Rajvithi hospital, who had undergone immunohistochemical staining of MMP-11. Relationships between clinicopathological data and MMP-11 expression in CHCA specimens were analyzed by the X2 test or Fisher's exact test. The estimated survival and the survival differences were analyzed by the Kaplan-Meier method and the log-rank test, respectively. Results: MMP-11 expression was found in 15 specimens (50%). The overall mean survival time is 237.0 days (95% CI 135.4-338.5, SD 271.9). Specimens with a positive MMP-11 had an average survival time of 136.7 days (95%CI 50.3-223.1, SD 156.0). Survival differences was signficant for the positive and negative MMP-11(p=0.022), but not well differentiated tumor and moderate to poor differentiated tumor (p=0.755), CA19-9 level of >1,000 and <1,000 (p=0.488), and between advanced and non-advanced staging (p=0.388). Conclusions: The positive MMP-11 expression indicates poor prognosis in CHCA specimens.


Mitranun W.,Chulalongkorn University | Deerochanawong C.,Rajvithi Hospital | Tanaka H.,University of Texas at Austin | Suksom D.,Chulalongkorn University
Scandinavian Journal of Medicine and Science in Sports | Year: 2014

To determine the effects of continuous aerobic exercise training (CON) vs interval aerobic exercise training (INT) on glycemic control and endothelium-dependent vasodilatation, 43 participants with type 2 diabetes were randomly allocated to the sedentary, CON, and INT groups. The CON and INT exercise training programs were designed to yield the same energy expenditure/exercise session and included walking on treadmill for 30 and 40min/day, 3 times/week for 12weeks. Body fatness and heart rate at rest decreased and leg muscle strength increased (all P<0.05) in both the CON and INT groups. Fasting blood glucose levels decreased (P<0.05) in both exercise groups but glycosylated hemoglobin levels decreased (P<0.05) only in the INT group. Maximal aerobic capacity, flow-mediated dilation, and cutaneous reactive hyperemia increased significantly in both exercise groups; however, the magnitude of improvements was greater in the INT group. Only the INT group experienced reductions in erythrocyte malondialdehyde and serum von Willebrand factor and increases in plasma glutathione peroxidase and nitric oxide (all P<0.05). We concluded that both continuous and interval training were effective in improving glycemic control, aerobic fitness, and endothelium-dependent vasodilation, but the interval training program appears to confer greater improvements than the continuous training program. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


Onpanna P.,Kuchinarai Crown Prince Hospital | Daosodsai P.,Khon Kaen University | Leelawat K.,Rajvithi Hospital | Porasuphatana S.,Khon Kaen University
Asian Biomedicine | Year: 2015

Background: Cross-sex hormone (CSH) use is widespread among transsexuals in Thailand. CSHs are used by male-to-female (MtF) transsexuals for feminization. Objectives: To determine effects of self-medication with CSH on cardiovascular risk biomarkers, C-reactive protein (CRP) and fibrinogen (Fb), in Thai MtF transsexuals. Methods: Data were collected from healthy MtF transsexual cabaret dancers in Pattaya city, Thailand, using a questionnaire and descriptive interview. Blood samples were collected to determine lipid profile, CRP, Fb, and sex hormone levels. ANOVA, Pearson correlation, and logistic regression were analyzed for effects of CSH on biomarkers; comparing CSH users with non-using controls. Results: We grouped 102 MtF transsexual participants (average age 28 years) as CSH (n = 66) and non-hormone using controls (n = 36). Several female and antimale hormonal products were used in CSH self-medication, with an average 12.5-year exposure. In the CSH group, significantly higher HDL with lower CRP levels and a negative correlation between total cholesterol, LDL, and 17β-estradiol were observed. Risk prevalence analysis exhibited lower prevalence of disease susceptibility in the CSH group. Logistic regression accordingly revealed the effect of CSH on CRP levels with odds ratios of 0.26 (CI 0.1-0.68) and 0.34 (CI 0.13-0.93) in crude and adjusted models, respectively. Conclusions: Moderate exposure to low doses of CSH use showed no serious risk or health problems in healthy MtF transsexuals in terms of cardiovascular risk biomarkers.


Kongsengdao S.,Rajvithi Hospital
Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2012

Hemifacial spasm (HFS) is a common movement disorder presented with unilateral, intermittent, irregular tonic or clonic contraction of facial expression muscles without any identifiable etiology. Comparison of quality of life (QoL) between Dysport and Neuronox has not been studied in HFS patients. To evaluate the QoL after treatment with botulinum toxin A (Dysport and Neuronox) injection in HFS patient. A 24-week, double-blind, randomized, cross-over comparison of QoL in HFS patients after being treated with botulinum toxin A (Dysport) and botulinum toxin A (Neuronox) was performed. Assessment of QoL composed of hemifacial spasm-30 (HFS-30), medical outcome study short form 36 items (SF-36), abnormal involuntary movement scale (AIMS) and center for epidemiologic studies-depression (CES-D) questionnaire, were performed at week 0, week 12, and week 24. The 24-hour HFS diary, recorded for 4 weeks after treatment was also evaluated. Total of 26 HFS patients were enrolled between May 2010 and January 2011. The mean HFS-30, AIMS and CES-D were reduced after treatment without any difference between the two groups. The mean SF-36 was not changed in both groups. However mean HFS-30 (p = 0.09), AIMS (p = 0.02) and CES-D (p < 0.001) of all treated patients were reduced across the treatment period. Total intensity score of HFS, duration of facial muscles spasm per day and duration of functional impairment per day in Dysport group were significantly lower than the Neuronox group (p < 0.001). There was no difference between Dysport and Neuronox in the aspect of QoL in HFS patients. However, there was improvement of QoL after multiple botulinum toxin A injection.


Chamnanchanunt S.,Mahidol University | Thungthong P.,Rajvithi Hospital | Nakhakes C.,Rajvithi Hospital | Suwanban T.,Rajvithi Hospital | Iam-Arunthai K.,Rajvithi Hospital
Southeast Asian Journal of Tropical Medicine and Public Health | Year: 2012

This is a case report of a patient with chronic myeloid leukemia (CML) undergoing imatinib treatment who became infected with dengue virus. The patient presented with classic dengue symptoms, along with early minor bleeding (blood-stained sputum) during the first 5 days of illness. Continuous inpatient imatinib treatment for CML was given without blood transfusion. The hemoglobin and white blood-cell count slowly improved over 30 days while recovering from the dengue viral infection. The patient recovered from the dengue virus infection without complication. Clinical monitoring of hematologic changes is needed in dengue patients undergoing anticancer treatment.


PubMed | Rajvithi Hospital
Type: | Journal: Journal of the Medical Association of Thailand = Chotmaihet thangphaet | Year: 2012

Hemifacial spasm (HFS) is a common movement disorder presented with unilateral, intermittent, irregular tonic or clonic contraction of facial expression muscles without any identifiable etiology. Comparison of quality of life (QoL) between Dysport and Neuronox has not been studied in HFS patients.To evaluate the QoL after treatment with botulinum toxin A (Dysport and Neuronox) injection in HFS patient.A 24-week, double-blind, randomized, cross-over comparison of QoL in HFS patients after being treated with botulinum toxin A (Dysport) and botulinum toxin A (Neuronox) was performed. Assessment of QoL composed of hemifacial spasm-30 (HFS-30), medical outcome study short form 36 items (SF-36), abnormal involuntary movement scale (AIMS) and center for epidemiologic studies-depression (CES-D) questionnaire, were performed at week 0, week 12, and week 24. The 24-hour HFS diary, recorded for 4 weeks after treatment was also evaluated.Total of 26 HFS patients were enrolled between May 2010 and January 2011. The mean HFS-30, AIMS and CES-D were reduced after treatment without any difference between the two groups. The mean SF-36 was not changed in both groups. However mean HFS-30 (p = 0.09), AIMS (p = 0.02) and CES-D (p < 0.001) of all treated patients were reduced across the treatment period. Total intensity score of HFS, duration of facial muscles spasm per day and duration of functional impairment per day in Dysport group were significantly lower than the Neuronox group (p < 0.001).There was no difference between Dysport and Neuronox in the aspect of QoL in HFS patients. However, there was improvement of QoL after multiple botulinum toxin A injection.

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