Long stick exercise to improve muscular strength and flexibility in sedentary individuals

The objective of this study was to investigate the effects of long stick exercise training on the strength and flexibility of sedentary individuals. An observational prospective study was conducted at the Prince of Songkla University. Eighty-five subjects who did not engage in any regular physical activity for at least three months before the study. A long stick exercise program was taught by a master for 45 minutes, at least three times weekly, for three months. Handgrip strength, back-leg strength, and flexibility were measured at the beginning of the program as a baseline, and at one, two, and three months of training. The subjects had increased back-leg strength and flexibility. Median back-leg strength increased from the baseline by 0.07 kg/weight, 0.19 kg/weight, and 0.21 kg/weight, at one, two, and three months, respectively (p< 0.05). Median flexibility (sit-and-reach test) improved from the baseline by 4.34 cm, 4.71 cm, and 5.56 cm, at one, two, and three months, respectively (p = 0.001). There were no statistically significant changes in handgrip strength.     

Effects of a School-based Intervention Program on Attitude and Knowledge of Household Members Towards a Smoke-free Home: a Cluster Controlled Trial

Background: A school-based smoke free home (SFH) program is useful in empowering the mother and child to reduce secondhand smoke exposure but the effects of pretesting on knowledge and attitude has been largely ignored. We aimed to test whether such a program can be effective in Southern Thailand with an additional assessment of the net effect of the pretest. Materials and Methods: A Solomon four-group design was used. Twelve rural primary schools were assigned to one of the four conditions (each with 3 schools): intervention with and without a pretest, control with and without the same pretest. The intervention was performed in the classroom and home over a period of 1 month. Outcomes were assessed at baseline and 3 months after the intervention on whether the home was smoke free and related knowledge and attitude. Results: The intervention could lead to a smoke-free home without statistical significance. Attitude, knowledge and self-confidence on creating a smoke-free home, and self-confidence in avoidance of secondhand smoke exposure and persuading smokers to not smoke in their home were significantly improved. No pretest effect was observed. Conclusions: Gain in attitude, knowledge and self-confidence among family members from the brief school-based education should be enhanced by other measures.     

Endoscopic ultrasound-guided biliary intervention in patients with surgically altered anatomy

AIM: To evaluate the efficacy of endoscopic ultrasound guided biliary drainage(EUS-BD) in patients with surgically altered anatomies.METHODS: We performed a search of the MEDLINE database for studies published between 2001 to July2014 reporting on EUS-BD in patients with surgically altered anatomy using the terms "EUS drainage" and "altered anatomy". All relevant articles were accessed in full text. A manual search of the reference lists of relevant retrieved articles was also performed. Only fulltext English papers were included. Data regarding age, gender, diagnosis, method of EUS-BD and intervention, type of altered anatomy, technical success, clinical success, and complications were extracted and collected. Anatomic alterations were categorized as: group 1, Billroth Ⅰ; group 2, Billroth Ⅱ; group 4, Rouxen-Y with gastric bypass; and group 3, all other types. RESULTS: Twenty three articles identified in the literature search, three reports were from the same group with different numbers of cases. In total, 101 cases of EUS-BD in patients with altered anatomy were identified. Twenty-seven cases had no information and were excluded. Seventy four cases were included for analysis. Data of EUS-BD in patients categorized as group 1, 2 and 4 were limited with 2, 3 and 6 cases with EUS-BD done respectively. Thirty four cases with EUS-BD were reported in group 3. The pooled technical success, clinical success, and complication rates of all reports with available data were 89.18%, 91.07% and 17.5%, respectively. The results are similar to the reported outcomes of EUS-BD in general, however, with limited data of EUS-BD in patients with altered anatomy rendered it difficult to draw a firm conclusion. CONCLUSION: EUS-BD may be an option for patients with altered anatomy after a failed endoscopic-retrogradecholangiography in centers with expertise in EUS-BD procedures in a research setting.     

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.     

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.     

Radiographic relationship of the origin of the bronchial arteries to the left main bronchus

The purpose of this study was to demonstrate that the relationship of the left main bronchus to the bronchial arteries is a reliable radiographic landmark for accurate catheterization of the right and left bronchial arteries. Sixty-six bronchial angiograms and chest radiographs in 43 patients were reviewed. The relationship of the tip of the catheter during initial bronchial angiography (used as the point of bronchial arterial origin) and the radiolucent shadow of the left main bronchus in patients with and without radiographic evidence of anatomic distortion caused by pulmonary disease was categorized into three groups: within the shadow of the left main bronchus, near the left main bronchus, and far from the left main bronchus. The origin of the right and left bronchial arteries was within or near the shadow of the left main bronchus in 94% of bronchial angiograms performed in patients with and without distorted thoracic anatomy. The most frequent location was within the shadow of the left main bronchus. The left main bronchus can be used as a reliable reference point for catheterization of the right or left bronchial arteries in patients with and without thoracic anatomic distortion.     

Surgical site infections in patients undergoing major operations in a university hospital: using standardized infection ratio as a benchmarking tool

BACKGROUND: Because patterns of infection acquired in patients undergoing operation are ever changing, it is an essential part of nosocomial infection surveillance programs to periodically document the epidemiologic features of infection in these patients. This study was conducted with the primary intention of describing the incidence and risk factors of the surgical site infection (SSI). METHODS: We performed a prospective study in patients undergoing certain major operations at a 750-bed university hospital in Thailand. The National Nosocomial Infection Surveillance (NNIS) system method and criteria were used for identifying and diagnosing infection. The infection rates were benchmarked with the NNIS report by means of indirect standardization and reported in terms of standardized infection ratio. Risk factors for SSI were evaluated using the multiple logistic regression model. RESULTS: From September 1998 to March 2000, the study included 4193 patients with 4437 major operations. The study identified 192 SSIs, 76 urinary catheter-related urinary tract infections, 26 central line-related bloodstream infections, and 39 instances of ventilator-associated pneumonia (VAP), yielding an infection rate of 4.3 SSIs/100 operations, 11.0 catheter-related urinary tract infections/1000 urinary catheter-days, 6.1 central line-related bloodstream infections/1000 central line-days, and 11.0 VAPs/1000 ventilator-days. When compared with data from NNIS, the standardized infection ratio of SSI, catheter-related urinary tract infection, central line-related bloodstream infection, and VAP were 2.3, 2.1, 1.1, and 0.8, respectively. The factors that significantly associated with SSI were duration of operation in minutes, American Society of Anesthesiologists (ASA) class, and degree of wound contamination. CONCLUSION: All of the infection rates identified, except VAP, were higher than the average NNIS rates. The risk factors for SSI were prolonged duration of operation, poor physical status according to ASA classification, and higher degree of wound contamination.