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Apivatgaroon A.,Thammasat UniversityPathumthani | Sanguanjit P.,Thammasat UniversityPathumthani
Arthroscopy Techniques | Year: 2017

Acromioclavicular joint osteoarthritis can lead to persistent shoulder pain. Distal clavicle excision is the most common operative procedure in patients with failed, conservative symptomatic acromioclavicular joint osteoarthritis treatment, with some reports of complications. This report describes an alternative procedure that can be used to excise the distal clavicle together with the medial border of the acromion. This technique is a simple procedure because the standard distal clavicle excision can preserve the acromioclavicular ligament, as well as the joint capsule, and achieve an adequate resection length. © 2016 Arthroscopy Association of North America

Rudeekulthamrong P.,Phramongkutklao Hospital | Kaulpiboon J.,Thammasat UniversityPathumthani
Carbohydrate Research | Year: 2016

The focus of this study was the synthesis of α-glucosyl derivatives of salicin by a transglucosylation reaction. The reaction was catalyzed by recombinant amylomaltase using tapioca starch as a glucosyl donor. Several reaction parameters, such as the enzyme-substrate concentrations, pH, temperature and incubation time, were optimized. Using the optimum conditions, at least three products with retention times (Rt) of 6.2, 9.2 and 14.1 were observed. The maximum yield of glucosylated salicin derivatives was 63% (w/w) of the total products. The structures of the glucosylated salicin derivatives were confirmed to be salicin-α-D-glucopyranoside, salicin-α-D-maltopyranoside and salicin-α-D-maltotriopyranoside through a combination of enzyme treatments, mass spectrometry and NMR analyses. The glycosidic bond between glucose units consisted of an α-1,4-configuration. The water solubility of salicin-α-D-glucopyranoside, salicin-α-D-maltopyranoside and salicin-α-D-maltotriopyranoside was 3-, 5- and 8-fold higher, respectively, than that of salicin, whereas their relative sweetness values were lower than that of sucrose. Interestingly, the long-chain salicin-α-D-glucosides showed greater anticoagulant and anti-inflammatory activities than salicin. In addition, the synthesized salicin-α-D-glucosides were able to tolerate acidic and high temperature conditions, but not α-glucosidase or human digestive enzymes. Therefore, these salicin-α-D-glucosides should be applied by the injection route to achieve greater bioavailability than is possible by the oral route. © 2016 Elsevier Ltd

Limvorapitak W.,Thammasat UniversityPathumthani | Auewarakul C.U.,Mahidol University
Journal of the Medical Association of Thailand | Year: 2016

Background: Anemia is a major public health issue despite preventive interventions. Data on non-iron nutritional deficiency anemia in hospitalized patients are limited. Objective: This study explored the incidence, clinical features, and outcomes of hospitalized patients diagnosed with non-iron nutritional deficiency anemia at a major teaching hospital in Thailand. Material and Method: Medical records of in-patient departments dated between January 2001 and June 2011 were retrospectively reviewed. Results: One hundred and two cases were identified, including 40 patients with vitamin B12 deficiency, 46 with folate deficiency, and 16 with other nutritional deficiency anemias; corresponding incidence rates were 0.4, 0.6, and 0.2 cases per 100,000 per year, respectively. Patients with vitamin B12 deficiency were mostly female, while patients with folate deficiency were preponderantly male. Glossitis and pancytopenia were common characteristics of vitamin B12 deficiency cases, whereas alcohol abuse and cirrhosis were more frequent in folate deficiency cases, as expected. Serum ferritin levels were relatively high across all categories. A significant proportion of anemia cases across all subgroups presented concomitantly with anorexia or poor food intake, which indicates underlying nutritional problems in these patients. Survival of patients with folate and other types of nutritional deficiency anemia was lower than for patients with vitamin B12 deficiency anemia (hazard ratio [HR] and p-values were 2.65, 0.001 and 2.35, 0.023, respectively). Hemoglobin normalization in patients with vitamin B12 deficiency anemia could be achieved by intramuscular injection and oral vitamin B12 treatment in 55.56% and 33.33% (p = 0.248), with a median response time of 9 and 86 weeks (p = 0.151), respectively. Conclusion: Non-iron nutritional deficiency anemia was not common in hospitalized patients in this study. Vitamin B12 injections resulted in faster responses, but with similar efficacy compared with oral treatments. Survival of patients with vitamin B12 deficiency anemia was significantly better than that of those with folate or other types of nutritional anemia. © 2016, Medical Association of Thailand. All rights reserved.

Suthiwartnarueput W.,Thammasat UniversityPathumthani
Journal of the Medical Association of Thailand | Year: 2015

Perianal Paget’s disease is an uncommon intraepidermal carcinoma characterized by the presence of Paget cells. It usually affects older patients and commonly presents as chronic perianal pruritus with scaly plaques. The disease is categorized into primary perianal Paget’s disease of cutaneous origin and secondary perianal Paget’s disease, which is due to extension of a visceral malignancy such as that of the anorectum or colon. Cytokeratin 7 (CK7), cytokeratin 20 (CK20), and gross cystic disease fluid protein-15 (GCDFP15) expression are useful for differentiation between these two types. A tumor immunohistochemical profile of CK7+/CK20−/GCDFP15+ suggests the primary type, whereas CK7+/CK20+/GCDFP15− suggests the secondary type. The expression of caudal homeobox 2 (CDX2) suggests the secondary type from anorectal or colonic adenocarcinoma. However, approximately onethird of patients without visceral malignancy have a tumor that is CK7+/CK20+/GCDFP15−. Two percents of primary perianal Paget’s disease can express CDX2. The author reports a case of an 86-year-old man who presented with chronic perianal pruritus and a scaly plaque. A skin biopsy showed intraepidermal Paget cells with immunohistochemical profile of CK7+/CK20+/GCDFP15-/CDX2+. Initially, secondary perianal Paget’s disease from colorectal adenocarcinoma was suspected. However, extensive investigations found no visceral malignancy. The patient underwent wide excision of the perianal skin. Pathological examination showed diffuse intraepidermal Paget cells with focal dermal invasion by intestinal-type adenocarcinoma and signet-ring cell differentiation. In conclusion, the final diagnosis was primary perianal Paget’s disease with focal adenocarcinoma and signetring cell differentiation. The disease was consistent with primary perianal Paget’s disease, because no visceral malignancy was found. © 2015, Medical Association of Thailand. All rights reserved.

Kiatipunsodsai S.,Thammasat UniversityPathumthani
Journal of the Medical Association of Thailand | Year: 2015

Objective: To study the complications from gastrostomy tube replacement using Foley’s catheters. Material and Method: This is a retrospective descriptive study that included children (aged 0-15 years), who had their gastrostomy tubes replaced during 1 October 2006 and 30 September 2011. Results: There were 353 gastrostomy tube replacements in total. Majority of them were using Foley’s catheters, 339 times in 28 children. In this group, 275 of them were performed as scheduled, mean while 64 were emergency events. The most frequent cause of the emergency replacement was the tube displacement, comprising 82.81% of all causes. Most events were usual replacements. Only one case required endoscopy with gastrostomy tract dilation under general anesthesia. Complications were found in 81.12%; the first and second most common found were dislodgement and granulation tissues, respectively. No severe complications were found. Conclusion: The gastrostomy tube replacement using Foley’s catheters instead of the commercial gastrostomy ones is a safe and convenient practice without any severe complications. However, further studies should be conducted in order to improve the skin fixation to prevent granulation tissue and the dislodgement. © 2015, Medical Association of Thailand. All rights reserved.

Angthong C.,Thammasat UniversityPathumthani
Journal of the Medical Association of Thailand | Year: 2015

Background: Little is known about health-related quality of life and functional outcomes in candidate patients with indications for total ankle replacement (TAR) when compared to patients without indications. This study is to compare the quality of life and functional outcomes in patients who have ankle arthritis and are with and without indications for TAR. Material and Method: An evaluation was conducted on 40 patients who had developed ankle arthritis from various causes. Forty patients were divided into two groups in accordance with their indications for TAR; the TAR-indicated group (11 patients) and the non-TAR indicated group (29 patients). Medical records of each patient were reviewed to collect pretreatment visual analogue scale (VAS-pain) scores, visual analogue scale foot and ankle (VAS-FA) scores, health-related quality of life scores as ascertained from short-form 36 (SF-36), and baseline data. Results: VAS-pain, VAS-FA, and SF-36 scores were insignificantly poorer in TAR-indicated group (p>0.05). There were no significant differences in scores among the three groups of treatment as non-operative treatments, joint-preserving treatments, and joint-sacrificing treatments or between TAR-indicated group and arthrodesis group (p>0.05). There were significant correlations between VAS-pain and VAS-FA scores (Pearson’s r-correlation-coefficient (r) = -0.389; p = 0.019) or between VAS-FA and SF-36 scores (r = 0.564; p<0.01). There were no significant correlations between VAS-pain and SF-36 scores (p>0.05). Only SF-36 scores were significantly negative correlated with radiographic grades in Takakura (r = -0.382; p = 0.015) and the author’s (r = -0.378; p = 0.016) classifications. Conclusion: Quality of life and functional outcomes in candidate patients with indications for TAR was insignificantly poorer than those in the patients without indications or patients in arthrodesis subgroup. Poorer radiographic grades of ankle arthritis were significantly correlated with poorer quality of life, which is reflected via SF-36 scores. © 2015, Medical Association of Thailand. All rights reserved.

Peanpadungrat P.,Thammasat UniversityPathumthani
Journal of the Medical Association of Thailand | Year: 2015

Objective: To study efficacy and safety of fish oil in treatment of knee osteoarthritis. Material and Method: 75 participants had divided into three groups of 25 people to study efficacy results after taking fish oil 1,000 mg and 2,000 mg once a day for 8 weeks. 1,000 mg of fish oil have EPA 400 mg and DHA 200 mg. All participants had complete visual analog scale for measuring knee pain and knee function. They also had measured 100 meters walking velocity and three steps walking time before taking fish oil. Then they had re-measured all parameters again at 8-12 weeks after taking fish oil to compare the results. Results: All parameters had statistically significant better differences in the group of participants who had taken fish oil when compared to the control group. The average score of patient’s satisfaction was 9.06 of 10 and also by verbal response of 50 participants; everyone felt good and happy with fish oil. One participant had hematuria from silent CA bladder at 10th week but the other 49 participants were safe without any complications from fish oil. Conclusion: Fish oil 1,000-2,000 mg daily supplementation had significant efficacy to improve knee performance and also are safe in mild to moderate stages of knee osteoarthritics patients. However higher dose 2,000 mg of fish oil had not significant higher efficacy than 1,000 mg of fish oil. © 2015, Medical Association of Thailand. All rights reserved.

Kosulwit L.,Thammasat UniversityPathumthani
Journal of the Medical Association of Thailand | Year: 2015

Objective: To survey the mental health and quality of life among Thai psychiatrists. Material and Method: This cross-sectional descriptive study included all Thai psychiatrists. The postal survey was mailed out to all psychiatrists. The questionnaires consisted of three parts: demographic data, the WHO Quality of Life-BREF-Thai version and the Symptom Checklist 90-Revised-Thai edition. Correlation analysis was set up at 95% confident interval and p<0.05. Results: Response rate was 28% from all 650 psychiatrists. The respondents described normal state of mental health but female psychiatrists had tended more to suppress the psychological symptoms than male psychiatrists. The mental problem that might most disturb male psychiatrists under stress condition was obsessive-compulsive symptoms. Female psychiatrists tended to be disturbed when distressed by (1) anxiety, (2) somatization, (3) phobia, (4) depression, and (5) paranoia, respectively. The quality of life (QOL) of most psychiatrists was in the average level (77.5%). The older (>40 years old) psychiatrists had higher QOL than younger psychiatrists significantly (p = 0.027). QOL correlated significantly with not getting enough support from work place (p = 0.007), colleagues (p = 0.026), lack of consultancy (p = 0.011) and low job satisfaction (p = 0.007). Better life quality in psychiatrists’ group had better QOL in social relationships and satisfaction with the environment. Conclusion: Thai psychiatrists had mental health status within normal range. Male psychiatrists had obsessive-compulsive traits in stress response, but female psychiatrists had anxiety and somatization traits. Thai psychiatrists’ quality of life was on the average level and most of them satisfied with their QOL. © 2015, Medical Association of Thailand. All rights reserved.

Viwatpanich K.,Thammasat UniversityPathumthani
Journal of the Medical Association of Thailand | Year: 2015

The combination between quantitative and qualitative research, “Homelessness among the Elderly in Bangkok Metropolitan” aimed to study causes of homelessness, patterns of living, problems, health status, social and health needs. Purposive sampling of 60 older homeless people could be divided into two groups; temporary and permanent homeless. Causes of homelessness were health problems, money problems, family background, emotional management, cultural sensitivities, limitation of extended family, financial management, political control, and domestic violence. Their living problems included: financial insecurity, police suppression, social and medical services, attacks from the young generations, sexual harassment, stealing, and social hierarchy of homelessness. 63.3% reported having hearing problems and a peptic ulcer before becoming homeless. These evolved into musculo-skeletal problems, accident-injuries, and skin diseases. 95% performed ADL/IADLs independently, 78.3% were depressed, 5% diagnosed with severe stress depression. 70% rated themselves happier than the rest of the population, and 75% were identified as having normal cognition. 58.3% had a good relationship with a religious network, 55% still had some contacts with their family members. More than 90% indicated that they were satisfied, could sustainin a life on the street, were happy with their freedom, liked being close to green areas, learned about human life, fulfilled the dhamma, and felt close to the king. © 2015, Medical Association of Thailand. All rights reserved.

Charernboon T.,Thammasat UniversityPathumthani | Jaisin K.,Thammasat UniversityPathumthani
Journal of the Medical Association of Thailand | Year: 2015

Objective: To determine the efficacy of Ginkgo biloba for the prevention of dementia in individuals without dementia. Material and Method: English databases including Medline, Embase, Cochrane Library and PsycINFO, were searched, and randomized double-blind controlled studies comparing Ginkgo biloba with placebo in prevention of dementia were considered. Two trials met inclusion criteria. Methodological quality was assessed using the Jadad criteria. Results: Meta-analysis of the two trials involving 5,889 participants indicated no significant difference in dementia rate between Ginkgo biloba and the placebo (347/2,951 vs. 330/2,938, odds ratio = 1.05, 95% CI 0.89-1.23) and there was no considerable heterogeneity between the trials. The two studies revealed no statistically significant differences in the rate of serious adverse effect between Ginko biloba and the placebo. Conclusion: There is no convincing evidence from this review that demonstrated Ginkgo biloba in late-life can prevent the development of dementia. Using it for this indication is not suggested at present. © 2015, Medical Association of Thailand. All rights reserved.

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