Determinants of hospital loss in Thailand: experience from the first year of a universal coverage health insurance program

The objective of this study was to examine determinants of hospital loss in Thailand. Administration national data for 640 public hospitals of fiscal year 2002 from Ministry of Public Health were analyzed. Results showed that various managerial, service mix, and market variables were significantly associated with the likelihood of the hospital being unprofitable. Hospital characteristics were associated with the amount of loss. The results also suggested that managing the number of hospital employees, inventory, and patient hospitalization could control the amount of loss. In conclusion, most of identified factors associated with hospital loss were manageable. The ramification of this study was to help policy makers understand the hospital loss situation in Thailand after implementing the UC scheme and design policy to resolve the hospital loss problems.     

Dammarane triterpenes from the hypocotyls and fruits of Ceriops tagal

Three new dammarane triterpenes, cereotagaloperoxide, cereotagalol A, and cereotagalol B, together with four known dammarane triterpenes, an oleanane triterpene, and 13 known lupane triterpenes were isolated from the hypocotyls and fruits of Ceriops tagal. The structures of 1-3 were characterized on the basis of their spectroscopic data.     

Hirsutane sesquiterpenes from the fungus Lentinus connatus BCC 8996

Two new hirsutane sesquiterpenes, connatusins A (1) and B (2), were isolated from the fungus Lentinus connatus BCC 8996. The structures, closely related to hypnophilin, were elucidated on the basis of the spectroscopic data. An X-ray analysis was performed to confirm the structure of 1. Six known compounds were also obtained. Panepoxydone (5), panepoxydione (6), and dihydrohypnophilin (8) exhibited significant antimalarial and cytotoxic activities.     

The effects of extracts from anti-diarrheic Thai medicinal plants on the in vitro growth of the intestinal protozoa parasite: Blastocystis hominis

The activities of n-hexane, dichloromethane and methanol extracts from five anti-diarrheic Thai medicinal plants, Acacia catechu (Fabaceae) resin, Amaranthus spinosus (Amaranthaceae) whole plant, Brucea javanica (Simaroubaceae) seed, Piper longum (Piperaceae) fruit and Quercus infectoria (Fagaceae) nut gall were tested against the in vitro growth of fresh isolates of the intestinal protozoan parasite, Blastocystis hominis. The extracts at concentrations that ranged from 62.5 to 2000 microg/mL, were incubated with several isolates of Blastocystis hominis for 48 h. The activities were classified as killed, inhibited, moderately inhibited and not-inhibited. Dichloromethane and methanol extracts from the Brucea javanica seed and a methanol extract from Quercus infectoria nut gall showed the highest activity. At a concentration of 2000 microg/mL, the three extracts killed 82, 75 and 67% of the Blastocystis hominis samples tested and inhibited 94, 100 and 76% of them, respectively. Metronidazole, used as a reference antiprotozoan drug, at a concentration of 40 microg/mL, killed 97% of the Blastocystis hominis isolates and inhibited all samples tested at concentrations that ranged from 1.25 to 20 microg/mL.     

Fabrication and characterization of novel nano hydroxyapatite/β-tricalcium phosphate scaffolds in three different composition ratios

The biphasic calcium phosphate (BCP) concept was introduced to overcome disadvantages of single phase biomaterials. Different composition ratios of BCP bioceramics have been studied, yet controversies regarding the effects of ratio on biomaterial behavior still exist. In this study, BCP scaffolds were prepared from nano hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) that were synthesized via a solid state reaction. Three different composition ratios of pure BCP and collagen-based BCP scaffolds (%HA/%β-TCP; 30/70, 40/60, and 50/50) were produced using a polymeric sponge method. Physical and mechanical properties of all materials and scaffolds were investigated. SEM showed overall distribution of both macropores (80-200 μm) and micropores (0.5-2 μm) with high interconnected porosities. Total porosity of pure BCP (90% ± 3%) was found to be higher than collagen-based BCP (85% ± 2%). It was observed that following sintering process, dimensional shrinkage of large scaffolds (39% ± 4%) was lower than small ones (42% ± 5%) and scaffolds with high HA ratios (50%) experienced higher dimensional changes than those with higher β-TCP (70%) ratios (45% ± 3% and 36% ± 1%, respectively). Compressive strength of both groups was less than 0.1 MPa and collagen coating had almost no influence on mechanical behavior. Further studies may improve the physical properties of these scaffolds and investigate their exact biological behaviors.     

Effects of estrogen via estrogen receptors on parvalbumin levels in cardiac myocytes of ovariectomized rats

The study investigated the effects of estrogen on parvalbumin (PV) levels in cardiac myocytes of ovariectomized rats, which is a model system for postmenopausal woman. Parvalbumin acts as a relaxing factor in cardiac myocytes. Adult female Wistar rats, 12 weeks old, were randomly divided into 5 groups of 10: sham-operated (SHAM), ovariectomized (OVX), and OVX receiving estrogen replacement of 10 μg/kg (Es10), 20 μg/kg (Es20) and 40 μg/kg (Es40). After 10 weeks, serum estrogen levels were measured and the α and β estrogen receptors in cardiac myocytes were investigated by immunohistochemistry. PV levels were examined by immunohistochemistry and Western blot analysis. Cardiac myocytes of all animals showed strong staining intensities for α immunoreactive (Es α-ir), but weak staining for β immunoreactive (Es β-ir) estrogen receptors. The Es α-ir was reduced in the cardiac myocytes of the OVX groups, but increased in the Es10, Es20 and Es40 groups. We therefore suggest that estrogen effects are mediated via Es α receptors rather than Es β receptors in female rat hearts. Estrogen and PV immunoreactive (PV-ir) levels and the intensity of the PV band observed in the OVX group were less than those of the SHAM group. In the Es10, Es20 and Es40 groups, the increased intensity of the PV-ir and PV bands correlated with the increased estrogen levels. The low PV levels in cardiac myocytes induced by low estrogen were restored by estrogen replacement therapy. Therefore a reduction of PV may lead to diastolic dysfunction in menopause.     

Screening for pre-hypertension and elevated cardiovascular risk factors in a Thai community pharmacy

Objectives To identify subjects with pre-hypertension and elevated cardiovascular risk factors in a community pharmacy and to assess their readiness to adopt lifestyle changes. Setting An accredited community pharmacy in Songkla province, Thailand. Method Subjects aged ≥ 35 years old and reporting no hypertension or other cardiovascular disease were included. Blood pressure was measured using the Microlife BP 3AC1-1. Those with pre-hypertension or hypertension defined by the JNC 7, and reporting no diabetes and/or dyslipidemia, were checked for blood glucose and/or total cholesterol with the Accutrend GCT monitor. Other risk factors were collected. Their readiness to adopt healthy lifestyles was evaluated. Main outcome measure The prevalence of pre-hypertension and elevated cardiovascular risk factors. Results 350 subjects met the study criteria. Approximately 36 and 29% were pre-hypertensive and hypertensive, respectively. Two of these had blood glucose > 200 mg/dl but about 47% had total cholesterol > 200 mg/dl. Most common modifiable cardiovascular risks were inadequate exercise and elevated body mass index (~52% each). Almost 40% were ready to adopt healthy lifestyles within 1–6 months. Conclusion Subjects at risk for hypertension and cardiovascular disease can be identified by community pharmacists, with the use of point-of-care devices and careful interview.     

Anti-allergic and Antioxidative Activities of Some Compounds from Thai Medicinal Plants

Evaluation of the anti-allergic and antioxidative activities of compounds from Thai medicinal plants demonstrated that lawsone methyl ether significantly exhibited the inhibitory effect on degranulation in RBL-2H3 cells with an EC₅₀ of 26.71?µM, while quercetin, a standard control, had an EC₅₀ of 10.02?µM. Other compounds from Thai medicinal plants including lucidin-ω-methyl ether, bergenin, homorapanone, strictosidinic acid and barakol, had no effect on the degranulation assay. In a DPPH radical scavenging assay, strictosidinic acid and barakol were more potent than the positive control, BHT. The EC₅₀ values of strictosidinic acid and barakol were 27.68 and 39.62?µM, respectively. Other tested compounds, including lawsone methyl ether, bergenin, homorapanone and lucidin-ω-methyl ether, had weak antioxidative activities or no activity. In a nitrite assay, only lawsone methyl ether reduced nitrite production with an EC₅₀ of 10.27?µM in RAW 264.7 cells. In conclusion, lawsone methyl ether suppresses degranulation in RBL-2H3 cells and reduces nitrite production in RAW 264.7 cells whereas strictosidinic acid and barakol have an antiradical action against DPPH.