A simplified financial cost-effectiveness analysis of programs for prevention of hepatitis B accidental inoculation among hospital personnel in Thailand

There are four main strategies for preventing medical personnel from hepatitis B infection following accidental inoculation. These are: pre-exposure vaccination with and without screening for anti-HBc, post-exposure immunization with and without prior screening and with or without additional vaccination. The average cost for each strategy depends on the prevalence of exposed personnel, the cost and sensitivity of the diagnostic test, and the cumulative risk. In Thailand, if the price of vaccination decreases to US$ 10 or lower, vaccination without screening test will cost least. At present, if the cumulative risk is lower than 1 in 28, the cheapest strategy will be post-exposure immunization alone, even with vaccination. If the cumulative risk is higher than 1 in 2.5, screening test followed by vaccination with anti-HBc will be the most cost-effective.     

A new tool for mini-open carpal tunnel release – the PSU retractor

Background  

Mini-open carpal tunnel release has become increasingly popular for the treatment of carpal tunnel surgery. The main advantages are shortening recovery time and return-to-work time. However, the risk of neurovascular injury still remains worrisome.     

Molecular basis of beta thalassemia in the south of Thailand.

A total of 103 beta thalassemia genes from 78 children (45 with Hb E/beta thalassemia, 8 with beta thalassemia heterozygotes, and 25 with homozygous beta thalassemia) were analyzed using dot-blot hybridization of the polymerase chain reaction-amplified DNA and direct DNA sequencing. Nine mutations were characterized in 98/103 (95%) of beta thalassemia alleles, of which six (a 4 bp deletion in codons 41-42, a G-C transition at position 5 of IVS-1, A-G transition at codon 19, an A-T transition at codon 17, an A-G transition at position -28 upstream of the beta globin gene, a G-T transition at position 1 of IVS-1), accounted for 92%. The spectrum of beta thalassemia mutations in Chinese Thai is similar to that reported among the Chinese from other parts of the world. The distribution of beta thalassemia mutations in Muslim Thai is similar to that reported among Malaysians. The most common beta thalassemia mutation in Thai and Chinese Thai patients is the frameshift mutation at codons 41-42, in comparison with the Muslim Thai in whom the G-C transition at position 5 of the IVS-1 mutation predominates. The heterogeneity of molecular defects causing beta thalassemia should aid in the planning of a prenatal diagnosis program for beta thalassemia in the South of Thailand.     

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.     

Gradual surface degradation of restorative materials by acidic agents

The aim of this study was to investigate the effect of acidic agents on surface roughness and characteristics of four restorative materials. Fifty-two discs were created from each restorative material: metal-reinforced glass ionomer cement (Ketac-S), resin-modified glass ionomer cement (Fuji II LC), resin composite (Filtek Z250), and amalgam (Valiant-PhD); each disc was 12 mm in diameter and 2.5 mm thick. The specimens were divided into four subgroups (n=13) and immersed for 168 hours in four storage media: deionized water (control); citrate buffer solution; green mango juice; and pineapple juice. Surface roughness measurements were performed with a profilometer, both before and after storage media immersion. Surface characteristics were examined using scanning electron microscopy (SEM). Statistical significance among each group was analyzed using two-way repeated ANOVA and Tukey's tests. Ketac-S demonstrated the highest roughness changes after immersion in acidic agents (p<0.05), followed by Fuji II LC. Valiant-PhD and Filtek Z250 illustrated some minor changes over 168 hours. The mango juice produced the greatest degradation effect of all materials tested (p<0.05). SEM photographs demonstrated gradual surface changes of all materials tested after immersions. Of the materials evaluated, amalgam and resin composite may be the most suitable for restorations for patients with tooth surface loss.     

Anxiety and Depression among Patients with Uveitis and Ocular Inflammatory Disease at a Tertiary Center in Southern Thailand: Vision-Related Quality of Life,Sociodemographics, and Clinical Characteristics Associated

Purpose: To estimate the prevalence of positive anxiety and depression screening in patients with ocular inflammatory disease (OID). The predictors associated with anxiety and depressive symptoms were investigated.

Methods: A cross-sectional study was conducted. The Thai Hospital Anxiety and Depression Scale (HADS), a sociodemographic questionnaire, and the Thai Visual Functioning Questionnaire 28 were administered to all participants. Associations were estimated using the Cox regression.

Results: Of the 86 participants, 12.8% and 8.1% screened positive for anxiety and depression, respectively. Predictors of an increase in both HADS-Anxiety and HADS-Depression scores comprised poor understanding of OIDs [adjusted relative probability (aRP) = 1.56; p = 0.021 and 1.59; p = 0.012, respectively], and low overall composite score (aRP = 1.45; p = 0.022 and 1.6; p = 0.002, respectively).

Conclusions: Approximately one-tenth of our patients screened positive for anxiety and depression. Patients with poor understanding of their OID and poor self-reported visual function were at an increased risk.     

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.