Evidence of Haplorchis taichui infection as pathogenic parasite: three case reports

Haplorchis taichui is the minute intestinal fluke which parasitizes the small intestine of humans and other mammals. We present the pathology in the small intestine of 3 human cases caused by H. taichui. Microscopic examination revealed mucosal ulceration, mucosal and submucosal haemorrhages, fusion and shortening villi, chronic inflammation, and fibrosis of the submucosa. This finding clearly indicated H. taichui as pathogenic; thus prevention of infection and treatment should be paramount.     

Friedolanostanes and lanostanes from the leaves of Garcinia hombroniana

Five new triterpenes, one 17,14-friedolanostane (garcihombronane F, 1), three 17,13-friedolanostanes (garcihombronanes G-I, 2-4), and one lanostane (garcihombronane J, 5), were isolated from the leaves of Garcinia hombroniana together with nine known compounds including five triterpenes, two ionone-derived glycosides, and two flavonoid glucosides. Their structures were identified by analysis of spectroscopic data and comparison of the NMR data with those previously reported.     

In vitro susceptibility of Thai seronegative donor CD8+ T lymphocytes to human immunodeficiency virus-1 (HIV-1) infection

To determine whether CD8+ T lymphocytes from Thai donor cells are susceptible to HIV-1 infection, undepleted peripheral blood mononuclear cells (PBMC) and CD8-enriched PBMC were infected with HIV-1 Thai subtype B and CRF01_AE (E) primary isolates. Virus kinetics in HIV-1 infection of CD4+ and CD8+ T lymphocytes peaked at day 7 or 10 post infection (pi); the TCID50 used for cell infection was proportional to the level of p24 production in the cultures. We also found that the level of p24 antigen in the supernatants of infected undepleted PBMC was significantly higher than that of infected CD8-enriched PBMC. Interestingly, both single positive T lymphocytes (CD4+ and CD8+ T lymphocytes) as well as double positive CD4+/CD8+ T lymphocytes were infected with HIV-1. The double positive T lymphocytes in PBMC were found only in the presence of both CD4+ and CD8+ T lymphocytes. The majority of p24+/CD4-/CD8- T lymphocytes were HIV-1 infected CD4 down-modulated PBMC. This report provides direct evidence that single positive CD8+ T lymphocytes and double positive CD4+/ CD8+ T lymphocytes from Thai donors can be infected with HIV-1 subtypes B and E in vitro.     

Rivastigmine patch for treatment of Alzheimer's disease in clinical practice in Thailand

Background: Rivastigmine is a cholinesterase inhibitor for treatment of mild to moderate Alzheimer's disease (AD) and dementia associated with Parkinson's disease. The new patch formulation was recently made available. We assessed the safety, tolerability, and cognitive outcome of rivastigmine patch in treatment of mild to moderate AD in clinical practice in Thailand. Methods: A multicentre, hospital‐based, prospective observational study was conducted in nine hospitals across Thailand. Patients with probable mild to moderate AD who received the rivastigmine patch were enrolled. Data were collected data at baseline, weeks 4–8 and after week16. Results: A total of 116 AD patients were screened, and three were excluded. Of 113 patients, 62.8% were women with a mean age of 73.3 ± 9.2 years; 79.7% were newly diagnosed. One‐third of all patients had been using antipsychotic or antidepressant medication. Common comorbidities were hypertension and dyslipidemia. The Thai Mental State Examination score significantly increased from 18.6 to 20.3 (weeks 4–8) and 20.4 (week 16+) (P < 0.001). Scores based on physicians’ (Clinical Global Impression) and caregivers’ (Patients’ Caregiver Global Impression of Change) impressions of improvement suggested minimal improvement. Because of adverse events, seven patients's dosages were reduced 10 cm² to 5 cm² or from 5 cm² to nothing. Itching was the most common adverse symptom. Conclusions: During the first 16 weeks after initiation of rivastigmine patch therapy, patients with probable mild to moderate AD had statistically significant improvement in cognitive function, but clinically marginal benefit. Rivastigmine was safe and well tolerated.     

Factors correlating quality of life in patients with myasthenia gravis

We studied factors associated with quality of life (QOL) among myasthenia gravis (MG) patients in two university hospitals in Thailand: Thammasat University (TU) and Khon Kaen University (KKU). Consecutive MG patients from an outpatient neurology clinic of both sites were enrolled and their clinical variables and QOL by the Short-Form 36 questionnaire were assessed. There were 31 and 40 subjects enrolled at TU and KKU, respectively. The mean values of the SF-36 score in seven dimensions were higher at the TU site. The significant factors between both sites were mean age, and numbers of participants with myasthenic symptoms and steroid treatment. The frequency of MG symptoms was the only factor associated with the SF-36 score (correlation coefficient −0.66, p value < 0.01). In conclusion, the frequency of MG symptoms might be the main factor that lowers QOL in MG patients in both physical and mental aspects.