Eleven-year experience on anti-TB drugs direct susceptibility testing from Siriraj Hospital,Thailand

The early detection of drug-resistant tuberculosis (TB) strains is of utmost importance for patient management and effective TB control programs. This study aimed to demonstrate the performance of direct drug susceptibility testing (DST) performed in our laboratory in the past 11 years. The direct DST was performed on Middlebrook 7H10 medium using isoniazid (INH) and rifampicin (RIF), and the results were compared with those obtained from indirect DST (gold standard). The direct DST was performed with 15,598 smear-positive sputum samples, of which 11,284 (72%) yielded reportable results. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated and revealed 89%, 99%, 95%, and 99%, respectively, for RIF and 90%, 98%, 93%, and 97%, respectively, for INH. Direct DST results could be reported within 1 month after sample processing. This method was also shown to be suitable for use in resource-limited countries, particularly in settings with high numbers of TB cases.     

Traditional beliefs about pregnancy and child birth among women from Chiang Mai, Northern Thailand

OBJECTIVE: To examine women's embodied knowledge of pregnancy and birth, women's explanations of precautions during pregnancy and birth and preparations for easy birth and the role of a traditional midwife in a Thai birthing care. DESIGN: In-depth interviews relating to traditional and changed beliefs and practices of pregnancy and childbirth with Thai women in Northern Thailand. SETTING: Chiang Mai city and Mae On sub-district in Chiang Mai province, Northern Thailand. PARTICIPANTS: 30 Thai women living in Chiang Mai in Thailand. FINDINGS: The social meaning of childbirth in Thai culture is part of the larger social system, which involves the woman, her family, the community, society and the supernatural world. Traditional beliefs and practices in Thai culture clearly aim to preserve the life and well-being of a new mother and her baby. It seems that traditional childbirth practices have not totally disappeared in northern Thailand, but have gradually diminished. Women's social backgrounds influence traditional beliefs and practices. The traditions are followed by most rural and some urban poor women in Chiang Mai. IMPLICATIONS FOR PRACTICE: The findings of this study may assist health professionals to better understand women from different cultures. It is important to recognise many factors discussed in this paper within the context of Thai lives and traditions. This will prevent misunderstanding and, consequently, encourage more sensitive pregnancy and birthing care for pregnant women.     

Impaired wound contraction and delayed myofibroblast differentiation in restraint-stressed mice

Previous research has shown that psychological stress delays wound closure by >25%. Gene expression of pro-inflammatory cytokines and the maturation of the epithelium were also impaired by stress (Mercado et al.). Wound contraction contributes to the speed of wound closure (Hunt and Hopf). In the current study, wound contraction was decreased by >45% (p<.01) in restraint stressed mice. Fibroblast migration and differentiation into smooth muscle alpha-actin (SmalphaA) -expressing myofibroblasts were delayed in RST mice through day 7 post-wounding. In addition, there was a 25 (p<.01), 48 (p<.01), and 38% (p<.05) decrease in SmalphaA mRNA levels at days 1, 3, and 5 post-wounding in RST mice, respectively. Cytokines that regulate fibroblast migration and differentiation include transforming growth factors-beta1, -beta2, and -beta3 (TGF-betas). Although expression of TGF-beta1 mRNA was downregulated by >25% (p<.01) in RST mice on day 3 post-wounding, no significant differences were detected in active or total TGF-beta1 protein levels. Stress did not alter the expression of TGF-beta2 or -beta3 through day 5 post-wounding. Thus, these data indicate that stress delays wound contraction and myofibroblast differentiation, which are likely independent of expression of TGF-beta1, -beta2, and -beta3.     

Anti-insulin resistance effect of constituents from Senna siamea on zebrafish model,its molecular docking,and structure–activity relationships

Journal of Natural Medicines - Senna siamea has been used as an antidiabetic drug since antiquity. With regard to traditional Thai medicine, the use of S. siamea was described for diabetes therapy....     

Homocysteine, MTHFR C677 T, vitamin B12, and folate levels in Thai children with ischemic stroke: a case-control study

Hyperhomocysteinemia has been identified as a risk factor for venous and arterial thrombosis especially in adult populations. Twenty-eight patients with an initial diagnosis of ischemic stroke and 100 controls, aged 相似文献   

The inflammatory milieu in the rheumatic joint reduces regulatory T-cell function

Regulatory T cells (Tregs) are important for maintaining immune homeostasis, but many studies suggest that Tregs are functionally impaired in autoimmune and chronic inflammatory disorders. In addition, effector T cells may vary in sensitivity toward Treg suppression. Herein, we have studied the interplay between T effectors and Tregs in the rheumatic joint. Synovial Tregs demonstrated a high degree of FOXP3 demethylation and displayed only marginal IL-17 and virtually no IFN-γ production following in vitro stimulation, altogether indicating suppressive capacity. Still, the frequency of FOXP3 expression could not predict the degree of suppression. Instead, the inflammatory milieu in the joint, i.e. proliferative capacity of effector T cells and in situ levels of pro-inflammatory cytokines influenced Treg function. Indeed, blocking IL-6 or TNF increased the suppression by Tregs in co-cultures. Additionally, approximately 30% of the synovial FOXP3(+) T cells were Ki67(+) and hence actively dividing, but proliferation did not overlap with cytokine production, suggesting that these cells represent functional Tregs having met their cognate antigen and expanded in an attempt to alleviate joint inflammation. Overall, our data argue against a general functional deficit in joint-derived Tregs and instead emphasize the importance of the inflammatory milieu to set the threshold for immune regulation.     

Safety of Local Anesthesia Combined with Monitored Intravenous Sedation for American Society of Anesthesiologists 3 and 4 Patients Undergoing Lower Limb–preservation Procedures

The aim of this retrospective study is to evaluate the prognostic value of American Society of Anesthesiologists (ASA) classification with regard to perioperative variables of cardiac complications, pulmonary complications, and mortality in patients undergoing limb salvage procedures with monitored intravenous sedation and foot and ankle blocks. None of the ASA 3 or 4 patients experienced any pulmonary or cardiac complication; no patient required invasive monitoring or postoperative cardiac care unit admission. We suggest that the performance of peripheral foot and ankle blocks with monitored intravenous sedation appears to be a safe and useful option for ASA 3 and 4 patients undergoing limb-preservation surgery.