Mirtazapine in amphetamine detoxification: a placebo-controlled pilot study

The present study aimed to assess the safety and efficacy of mirtazapine in amphetamine detoxification in a 14-day randomized, placebo-controlled pilot trial in a Thai population. Subjects retained at a Specialized Probation Center, Department of Probation, Ministry of Justice, Thailand (n=20), who met DSM-IV criteria for amphetamine dependence and the inclusion criteria of the study, were randomized for either mirtazapine treatment or placebo. Efficacy was assessed by the Amphetamine Withdrawal Questionnaire (AWQ) for amphetamine withdrawal symptoms and the Montgomery-Asberg Depression rating scale (MADRS) for depression. Mirtazapine safety was assessed by interview during each follow-up period on days 3 and 14 after treatment. Nine subjects were randomized to the mirtazapine group and 11 to the placebo group. Among the initial 20 subjects, 16 (seven in the mirtazapine and nine in the placebo group) completed the study. There were significant improvements in the total AWQ score changes in the mirtazapine group versus placebo both at days 3 (P<0.005) and 14 (P<0.030). Significant improvements in favour of mirtazapine were also seen in the hyperarousal and the anxiety subscale score changes at days 3 (P<0.029) and 14 (P<0.018), respectively. No significant differences were seen (P>0.05) in the MADRS scores changes within or between the groups. Mild adverse events, such as headache, sedation, nausea and vomiting, were reported. In conclusion, despite its small sample size, this randomized, placebo-controlled pilot trial lends support to the hypothesis that mirtazapine may be an option in the meager armamentarium of amphetamine detoxification treatment.     

HIV Prevalence,Risk Behavior,Hormone Use and Surgical History Among Transgender Persons in Thailand

While Male-to-female transgender persons (TG) are believed to often engage in sex work and have high HIV infection risk, little is known about demographics, surgical and hormone use history, risk behaviors and HIV prevalence. Between March and October 2005, 474 TG from Bangkok, Chiangmai, and Phuket were surveyed using venue-day-time sampling. Of 474 participants, overall HIV prevalence was 13.5%. Most participants had completed at least secondary or vocational education (79.2%), gender self-identified as female (89.0%), had received money, gifts or valuables for sex (60.8%), and reported hormone use (88.6%). Surgical history was taken from 325 participants. Of these, 68.6% reported some form of surgery and 11.1% had undergone penile-vaginal reconstructive surgery. In multivariate analysis, being recruited from a park/street; older age, anal sex role identification as “versatile” and anal sex debut before age 13 were independently associated with HIV prevalence. The development, implementation and evaluation of culturally appropriate sexual health interventions for Thai TG is urgently needed.     

Causes and time-course of vertigo in an ear, nose, and throat clinic

The purpose of this study is to review etiologies and identify the time-course of vertigo presenting in an ear, nose, and throat clinic, and serve as a reference guide for other clinics. The study includes retrospective chart review in a tertiary care, university hospital. The patient data with reported ICD-10 codes as causes of vertigo between April 2005 and December 2007 were extracted from the database. At each visit, the main diagnosis as to etiology, characteristics of the vertigo, its time-course, and patient demographic data were recorded. Of 547 cases, 17 diagnoses were made in 73.9%. Diagnostic categories included peripheral vertigo 72.9%, central vertigo 0.8%, psychogenic cause 0.2%, and unknown 26.1%. Common causes of vertigo were benign paroxysmal positional vertigo (BPPV) 52.5%, Meniere’s disease 14.6%, and sudden idiopathic hearing loss 2.9%. Less common diagnoses were benign paroxysmal vertigo of childhood 0.7%, labyrinthitis 0.7%, and vestibular schwannoma 0.3%. Rare conditions were delayed endolymphatic hydrops, Ramsey Hunt syndrome, otosyphilis, vestibular neuritis, temporal bone fracture, post-concussion syndrome, cerebellar infarction, epilepsy, cervical vertigo, Streptococcus suis meningitis, and psychogenic vertigo. Ninety-nine cases who reported remission of vertigo during the study period had median onset of the remission at 4 weeks. In the ear, nose, and throat clinic at Chiang Mai University, a tertiary university hospital, peripheral vestibular disorders were the main etiology of vertigo. The three most common causes were BPPV, Meniere’s disease, and sudden idiopathic hearing loss. Half of the cases who returned for follow up had remitted symptoms within 4 weeks.     

HLA-A, -B, -DRB1, -DQA1, and -DQB1 polymorphism in thais

In this study we examined HLA-A, -B, -DRB1, -DQA1, and -DQB1 gene, allele, and haplotype frequencies in two ethnic Thai populations. We compared these frequencies to the known HLA class I and II allele profiles of non-Thai mainland and insular Southeast (SE) Asians. HLA-A locus gene and allele frequencies, are comparatively homogeneous in both Thai and non-Thai SE Asians. In contrast, HLA-B, -DRB1, -DQA1, and -DQB1 gene and allele frequencies, show more ethnic and geographic variation in SE Asians. Conserved haplotypes, or combinations of linked HLA class I and II alleles were detected in Thais, but at relatively low frequencies. It would appear that ethnic Thais, reflect an admixture of peoples from both the northern mainland and southern island groups of SE Asia.     

Existence of an egg-laying hormone-like peptide in male reproductive system of the giant freshwater prawn, Macrobrachium rosenbergii

The giant freshwater prawn, Macrobrachium rosenbergii, is an important aquaculture species. A better understanding of the molecular components of reproduction in this species would help to advance the prawn production. In the present study, we demonstrated the presence of an egg laying hormone (ELH)-like peptide in the male reproductive system. First, an antibody to the abalone (a)ELH was generated, and by Western blot it was shown to specifically bound to a protein from the male M. rosenbergii reproductive tissues with a similar size to molluscan ELH. This aELH-like peptide was localized in spermatogonia in the testes of all three male morphotypes: blue claw, orange claw and small males. Moreover, the aELH-like peptide was detected in the epithelium of the spermatic duct and its associated smooth muscle cell layers and on the outer surface of spermatozoa. As well, the aELH-like peptide was detected in the spermatophore located in the female thelycum at 4–6?h post-mating, indicating that it was transferred to the female during copulation. Taken together, we suggest that this aELH-like peptide could be as a male inducing factor that helped to accelerate female spawning. Liquid chromatography of crude extracts and immunoblot analysis suggested that the aELH-like peptide could be further purified for ultimate characterization.     

Hepatitis E virus genotype 3f sequences from pigs in Thailand, 2011–2012

Phylogenetic analysis of partial ORF1 and ORF2 genes of Hepatitis E virus (HEV) strains from pigs in Thailand during 2011–2012 was performed. The result indicated that the current Thai strains belonged to the genotype 3 subgroup 3f, which were similar to the previous HEVs circulating in humans in Thailand.     

Inconsistent Condom Use with Steady and Casual Partners and Associated Factors among Sexually-Active Men who Have Sex with Men in Bangkok, Thailand

HIV/STD risk behavior has not been examined in community samples of men who have sex with men (MSM) in Thailand. The sexually-active sample (n=927) was recruited from bars, saunas, and parks; 20% identified as bisexual and 17% tested HIV-positive. Inconsistent (<100%) condom use was reported by 45% of those with steady partners and 21% of those with casual partners in the prior three months. 21% had heard of effective HIV treatments (n=194), among whom 44% believed HIV was less serious and 36% said their risk behavior had increased after hearing about the treatments. In multivariate analysis, HIV-positive status, gay-identification, getting most HIV information from the radio, believing HIV can be transmitted by mosquito bite, and concern about acquiring an STD were associated with inconsistent condom use during anal sex; slightly older age (25–29 vs. 18–24 years) was associated with more consistent condom use. HIV/STD risk-reduction strategies for MSM in Bangkok should clearly state sexual risk to individuals in this population.     

Sexual Behavior and Risk Factors for HIV Infection Among Homosexual and Bisexual Men in Thailand

HIV prevalence and associated risk behaviors were examined among Thai bisexually active men (MSMW, n = 450) and men who have sex with men only (MSM-only, n = 1,125). Cross sectional venue-day-time sampling was used to collect data. Chi-square and logistic regression were used to identify HIV risk factors. HIV prevalence was 8.2% among MSMW and 21.2% among MSM-only. Consistent condom use with male partners was higher among MSMW (77.6%) than MSM-only (62.9%), and lower with female partners (44.4%). Lack of family confidant, migration, concern about acquiring HIV infection, and self-reported STD were associated with HIV prevalence among MSMW. Older age, lower educational level, residing in Bangkok or Chiang Mai, living away from family, recruitment from a sauna, increased frequency of visiting the surveyed venue, practicing receptive or both receptive and insertive anal intercourse, inconsistent condom use with male paying partners, and a history of drug use were associated with HIV prevalence in MSM-only.