Anti-mitragynine monoclonal antibody-based ELISA for determination of alkaloids in the kratom cocktail

Kratom cocktail or the fatal 4 × 100 formula is defined as a mixture of boiled kratom leaves, cola drink, and cough syrup. In the present study, we focused on application of the indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) using the anti-mitragynine (MG) monoclonal antibody (anti-MG mAb) to the kratom cocktail. The ic-ELISA is a rapid method for quantification of the major kratom alkaloids including MG, paynantheine, and speciogynine in kratom cocktails. Because some matrices or additives may influence the binding affinity between the alkaloids and the anti-MG mAb, a liquid–liquid extraction method using chloroform was used to clean-up samples and minimize any cross-reactivity with anti-MG mAb. The anti-MG mAb showed slight cross-reactivity to caffeine, codeine, morphine, tramadol, and dextromethorphan (<0.5 %), which are also commonly added to a kratom cocktail. When applied to eight different kratom cocktail samples, the ic-ELISA using the anti-MG mAb allowed the determination of the combined kratom alkaloid content in the range of 0.083–576 mg/L, and these values were in agreement with the results of the high-performance liquid chromatography method (R ² = 0.9689). To our knowledge, this is the first report for the quantification of total amounts of kratom alkaloids including MG in kratom cocktail by a simple immunoassay. Because of the sharp rise in kratom cocktail abuse in the world, this method will be a useful tool for detection of kratom cocktail consumption.     

Postoperative Depot Medroxyprogesterone Acetate versus Continuous Oral Contraceptive Pills in the Treatment of Endometriosis-Associated Pain: A Randomized Comparative Trial

Background/Aim: To evaluate the efficacy and tolerability of postoperative depot medroxyprogesterone acetate (DMPA) versus postoperative continuous oral contraceptive (OC) pills in the treatment of endometriosis-associated pain. Methods: After a conservative surgery, 84 patients with symptomatic endometriosis were randomized to receive either intramuscular DMPA (150 mg) every 12 weeks for 24 weeks or continuous OC pills (ethinyl estradiol 0.03 mg and gestodene 0.075 mg) daily for 24 weeks. At weeks 12 and 24 of the treatment phase, patients rated their satisfaction with treatment and reported pain improvement and adverse effects. Results: There was no significant difference in the percentages of patients who reported satisfaction between the DMPA group and the OC group at weeks 12 and 24 (92.9 vs. 90.5%, and 92.9 vs. 88.1%, respectively). The rates of withdrawal because of persistent pain or side effects in the two groups were similar. Pain scores improved significantly in both groups, but dysmenorrhea scores on a visual analog scale at week 24 were significantly higher in the OC group than in the DMPA group (p = 0.039). Conclusion: Both postoperative DMPA and postoperative OC pills for 24 weeks were found to be effective and acceptable options for treating endometriosis-associated pain.     

Timing of voiding cystourethrogram after urinary tract infection

Of the 363 Thai children upon whom a voiding cystouretrogram was performed, a vesicoureteral reflux was detected in 22.8% (17.1%-28.5%) of those for whom it was performed within 7 days (n = 215) of a urinary tract infection diagnosis and in 24.3% (17.4%-31.2%) of those for whom it was performed 7 days (n = 148) after diagnosis. There was no statistically significant difference in reflux prevalence between these two groups.     

Factors associated with bed sharing and sleep position in Thai neonates

Background   Sleep in a supine position and in a bed separate from but proximate to adults is recommended, in several Western countries, to prevent Sudden Infant Death Syndrome (SIDS). Cultural differences and a lower rate of SIDS in Asian populations may affect concern with this problem and thus infant sleeping arrangements.
Objective   To study bed sharing and sleep position in Thai neonates and the relationship to infant and maternal characteristics.
Methods   A cross-sectional survey based on interviews with parents of infants aged 21 days old, was conducted under the Prospective Cohort Study of Thai Children.
Results   Of the total sample, 2236/3692 (60.6%) infants shared a bed with their parents. Sixty per cent of the parents placed their infants to sleep in a supine position, 32.2% on their side and 4.9% in a prone position. Bed sharing was associated with older maternal age, higher education, Muslim mother, and with work status of professional career or unemployed. Placing the infants to sleep in a prone position was associated with infant birth weight of greater than 2500 g, older maternal age, higher education, Buddhist mother, mother with professional career and middle-class household economic status.
Conclusions   Infant bed sharing is a common practice in the Thai culture, as in other Asian countries. The prone sleep position is less common than in Western populations. The main factor associated with both bed sharing and putting infants to sleep in the prone position was a higher maternal socioeconomic status (SES), in contrast to previous studies in some Western countries in which both practices were associated with low maternal SES. Cultural differences may play an important role in these different findings.     

Confirmatory factor analysis of the revised version of the Thai multidimensional scale of perceived social support among the elderly with depression

ABSTRACT

Objective: Difficulties in modeling the Multidimensional Scale of Perceived Social Support (MSPSS) have occurred, and these were corrected in the revised version of the Thai MSPSS. However, the revised version has not been tested in elderly populations. The present study aimed at confirming the factor structure of the revised version of the MSPSS among the elderly with depressive disorders, in populations with or without depressive disorders.

Methods: Eight hundred and three elderly patients were recruited from four tertiary hospitals; 190 (23.7%) had depressive disorders. All completed the revised Thai MSPSS consisting of 12 items, using a 7-point Likert scale. Confirmatory factor analysis (CFA) of the MSPSS was conducted in both groups.

Results: The mean age was 69.24 years (SD 6.88), and 70% of the sample was female. There were no significant difference in demographic data between two groups. The revised version of the Thai MSPSS provided excellent internal consistency. The three-factor model was clearly superior to other alternative models in both depressed and non-depressed groups. CFA for the whole group revealed an acceptable model fit: χ² = 147.44, df = 45, p < 0.001; Tucker-Lewis Index 0.975; Comparative Fit Index 0.982; Good Fit Index 0.966; and root-mean-square error of approximation 0.056. The fit statistics in the depressed group was better than in the non-depressed group across all models.

Conclusions: Due to its robust factor structure, these data support the use of the revised MSPSS as a brief instrument for assessing perceived social support in the elderly with or without depressive disorders.     

A pilot pharmacokinetic study of miroestrol and deoxymiroestrol on rabbit sera using polyclonal antibody‐based icELISA analysis

Miroestrol (ME) and deoxymiroestrol (DME) are the most potent phytoestrogens and bioactive markers in Pueraria candollei var. mirifica tuberous roots. To understand their pharmacokinetic profiles, a pharmacokinetic study of ME and DME, at 0.43 and 0.21 mg per kg body weight, respectively, in three rabbits was performed after orally administering a single dose of P. candollei var. mirifica enriched fraction extract. Two established polyclonal antibody‐based indirect competitive enzyme‐linked immunosorbent assays were validated to determine ME and DME in rabbit sera. In rabbits, the area under the 0‐ to 48‐hr concentration‐time curve of ME and DME were 854.92 and 1,692.84 ng·h/ml, respectively. The maximum concentration of ME was measured 1 hr after administration as 69.62 ± 8.28 ng/ml, and the maximum concentration of DME was measured at 3 hr as 81.8 ± 5.43 ng/ml. These results provide an initial approach for designing and studying the relationship between the ME and DME levels and their therapeutic effects based on their pharmacokinetic profiles.     

A cyclopeptide from the Insect pathogenic fungus Cordyceps sp. BCC 1788

A new cycloheptapeptide, cordyheptapeptide A (1), was isolated from the insect pathogenic fungus Cordyceps sp. BCC 1788 along with four known bioxanthracenes (2-5). The structure was elucidated by spectroscopic data. The absolute configuration of amino acid residues was determined by HPLC and X-ray diffraction analyses.     

Chromone derivatives from the filamentous fungus Lachnum sp. BCC 2424

Five new chromones, named lachnones A-E (1-5), were isolated from the filamentous fungus Lachnum sp. BCC 2424 along with known (2E,6S)-2,6-dimethyl-2,7-octadiene-1,6-diol. Their structures were elucidated by spectroscopic methods. Lachnones B (2) and D (4) mildly inhibited the growth of Mycobacterium tuberculosis, both with MIC values of 200 microg/mL.     

Assessment of the physical properties of laparoscopic myoma-fixation devices

Background The physical properties of three commercial 5-mm myoma-fixation devices available for clinical use (short-pitch corkscrew, long-pitch corkscrew, buttress-thread screw) and a standard wood screw were examined.Methods Fresh specimens of uterine leiomyoma masses were used to test the maximum traction force obtained from each device on 31 occasions. The myoma tissue at each traction site was evaluated histologically to determine its density. The maximal traction forces in each myoma density group were compared using a generalized estimating equations approach to linear regression based on repeated measures within each myoma. The bending strength also was determined for each device.Results A wide range of maximum traction forces with a mean of 130.8 ± 71.5 N (range, 21.6–341.6 N) over all devices and tissue densities was recorded. The mean maximum traction force provided by the short-pitch corkscrew (159.2 ± 12.2 N) was significantly higher (p < 0.01) than that of the other devices in medium-density myomas, and not significantly lower than that of other devices in low-density myomas. The mean maximum traction force provided by the buttress-thread screw was significantly lower than that of the short-pitch corkscrew only in medium density myomas, and did not differ significantly from that of the wood screw in any density group. The wood screw provided the highest bending strength (6.73 × 10⁴ N/m) (whereas the short- and long-pitch corkscrew provided the lowest (9.70 × 10² N/m and 1.95 × 10³ N/m, respectively) and the buttress-thread screw an intermediate (2.24 × 10⁴ N/m) strength (p < 0.0005 for all comparisons except for the two corkscrews).Conclusions Screw-type myoma-fixation devices can provide comparable traction force with high bending strength. A long-pitch corkscrew should not be used for laparoscopic myomectomy because of its low traction force and bending strength. When a commercial screw is not available, a standard wood screw can be used with acceptable traction force and very high strength for bending.