Radiologic findings in tsunami trauma: experience with 225 patients injured in the 2004 tsunami

The objective of this study was to determine the spectrum of radiographic findings, frequency, and type of injuries in tsunami victims. From December 2004 to May 2005, all tsunami victims admitted to our hospital were retrospectively identified by a search of medical records. Patients who received radiologic examinations were reviewed for their radiographic findings. The authors identified 225 tsunami victims. One hundred eight victims received radiologic evaluations on admission that included 350 plain radiographs, 19 ultrasound exams, 18 computed tomography (CT) scans and 3 magnetic resonance imaging (MRI) scans. Overall positivity rate was 48% (187/390). Most common trauma involved musculoskeleton (102/187, 54.5%). Retained foreign bodies in soft tissues, pneumonia/aspiration, and tsunami sinusitis were found in 22, 28, and 31 patients (9.8, 12.4, and 13.8%), respectively. These were unique findings in tsunami trauma. Imaging played an important role in detection of these abnormalities.     

Molecular analysis of haemoglobin E in Southeast Asian populations

Haemoglobin (Hb) E is the most common Hb variant in Asia where its gene frequency approaches 0.3 in some areas. We studied genetic background of Hb E genes among Southeast Asian populations. This study examined β-globin gene haplotypes linked to haemoglobin E (Hb E) in diverse groups of Southeast Asian populations. The study was conducted on southern Thai (22 alleles), Cambodian (84 alleles), Laotian (120 alleles), Vietnamese (87 alleles) and Burmese (one allele) subjects. Results were compared with those of previous studies in northeast Thailand, the Yunnan of China, West India and Europe. Ten different haplotypes were observed. The four most common haplotypes were haplotypes 1 (–?+?–?+?+?+?–) and 2 (+?–?–?–?–?+?–) on chromosomes with framework 2 and haplotypes 6 (–?+?–?+?+?–?+) and 7 (+?– – – – –?+) on chromosomes with framework 3 variety. Phylogenetic analysis indicated that haplotype 1 is a relatively recent haplotype found in all populations, whereas haplotype 6 is found predominately in Cambodians. The results indicate that at least two genetic origins of Hb E are responsible for the high prevalence and spread of Hb E among Southeast Asian populations.     

Coinheritance of Hb A2-Melbourne (HBD: c.130G>A) and Hb E (HBB: c.79G>A) in Laos and Simultaneous High Resolution Melt Detection of Hb A2-Melbourne and Hb A2-Lampang (HBD: c.142G>A) in a Single Tube

Abstract

We report the molecular and hematological identifications of a Hb A₂ variant [coinheritance of Hb A₂-Melbourne (HBD: c.130G>A) and Hb E (HBB: c.79G>A)] found for the first time in the Lao People’s Democratic Republic (PDR). The subject was a 29-year-old pregnant Laotian woman who was a foreign worker in Thailand and was diagnosed with thalassemia and hemoglobinopathies. Capillary electrophoresis (CE) demonstrated 1.6% of Hb A₂, with a minor unknown peak at the initial Z1 zone (1.7%). Identification of abnormal hemoglobin (Hb) using direct DNA sequencing showed a genetic defect causing a δ-globin gene missense mutation at codon 43 (GAG>AAG) causing a glutamic acid to lysine substitution corresponding to Hb A₂-Melbourne. The origin of Hb A₂-Melbourne in Lao PDR may be similar to a case found in Thailand with the [+ –?– –?– + +] haplotype. We developed a method that could clearly detect Hb A₂-Melbourne and Hb A₂-Lampang (HBD: c.142G>A) mutations in a single tube using high resolution melt (HRM) analysis. The HRM analysis is a more effective method for rapid detection than conventional polymerase chain reaction (PCR), as there is no need for a post-PCR step, and no exposure to ethidium bromide. This new method would be a useful addition for the first investigation of a suspected Hb A₂ variant in the routine molecular setting.     

Prevalence of alcohol problems among emergency room patients in Thailand

Aims. To determine prevalence rates of alcohol problems among emergency room patients. Design. This was a cross-sectional survey including patient interviews and record reviews. The questionnaire included the Alcohol Use Disorders Identification Test to screen for hazardous or harmful alcohol use (alcohol problems). It also contained questions regarding the chief complaint and factors precipitating the admission . Setting. Emergency rooms of three regional hospitals in Thailand . Participants. Consecutive emergency room admissions aged 14 and older, admitted from 18.00-02.00 h . Findings. Risk factors for alcohol problems included male gender, age 20-49, higher monthly income, less than university graduate education status and admission to the northeast regional ER. Among non-trauma patients, those with alcohol-related diagnoses and certain gastrointestinal disorders had the highest rates of alcohol problems. Patients with transportation injuries were twice as likely, and those with assault-, fall-, or burn-related injuries were at least three times more likely to screen positive compared to the non-injured comparison group. The estimated overall prevalence rate of alcohol problems for this population, adjusted for age and diagnostic classification, was 0.39 for males and 0.08 for females. Conclusion. Especially among patients with specified diagnoses, the emergency room is an ideal setting for implementing alcohol screening and intervention programmes in Thailand.     

Traditional knowledge on medicinal plant of the Karen in northern Thailand: A comparative study

Ethnopharmacological relevance

We studied traditional medicinal plant knowledge among the Karen in northern Thailand.

Aim of the study

To compare traditional medicinal knowledge in 14 Karen villages in northern Thailand and determine culturally important medicinal plant species in each Karen village.

Materials and methods

We interviewed 14 key informants and 438 non-specialist informants about their traditional knowledge of medicinal plants. We tested normality of the data and correlations with distance to the nearest city using Kolmogorov–Smirnov tests and Spearman's rank correlation coefficient. Cluster analysis and cultural importance index (CI) were calculated for the similarity of medicinal plant used and culturally importance medicinal plant species among Karen villages respectively.

Results

In total 379 medicinal plant species were used. Number of medicinal plants used positively correlate with distance to the nearest city. Relatively low similarities of medicinal plant species and different CI values for species among the different areas were found.

Conclusions

Traditional medicinal plants still play an important role in medicinal practice of the Karen. Local environments, availability of medicinal plant and distance between Karen villages and the nearest city affect the amount of traditional medicinal knowledge in each Karen village. The medicinal plants in this study with high CI values might give some useful leads for further biomedical research.     

Kaempferia parviflora, a plant used in traditional medicine to enhance sexual performance contains large amounts of low affinity PDE5 inhibitors

Aim of the study

A number of medicinal plants are used in traditional medicine to treat erectile dysfunction. Since cyclic nucleotide PDEs inhibitors underlie several current treatments for this condition, we sought to show whether these plants might contain substantial amounts of PDE5 inhibitors.

Materials and methods

Forty one plant extracts and eight 7-methoxyflavones from Kaempferia parviflora Wall. ex Baker were screened for PDE5 and PDE6 inhibitory activities using the two-step radioactive assay. The PDE5 and PDE6 were prepared from mice lung and chicken retinas, respectively. All plant extracts were tested at 50 μg/ml whereas the pure compounds were tested at 10 μM.

Results

From forty one plant extracts tested, four showed the PDE5 inhibitory effect. The chemical constituents isolated from rhizomes of Kaempferia parviflora were further investigated on inhibitory activity against PDE5 and PDE6. The results showed that 7-methoxyflavones from this plant showed inhibition toward both enzymes. The most potent PDE5 inhibitor was 5,7-dimethoxyflavone (IC₅₀ = 10.64 ± 2.09 μM, selectivity on PDE5 over PDE6 = 3.71). Structure activity relationship showed that the methoxyl group at C-5 position of 7-methoxyflavones was necessary for PDE5 inhibition.

Conclusions

Kaempferia parviflora rhizome extract and its 7-methoxyflavone constituents had moderate inhibitory activity against PDE5. This finding provides an explanation for enhancing sexual performance in the traditional use of Kaempferia parviflora. Moreover, 5,7-dimethoxyflavones should make a useful lead compound to further develop clinically efficacious PDE5 inhibitors.     

Screening for phosphodiesterase inhibitory activity of Thai medicinal plants

INTRODUCTION: Phosphodiesterases (PDEs) are a group of enzymes that have powerful effects on cellular signaling because they regulate the second messenger, cAMP or cGMP. PDE inhibitors have been used for treatment of many indications such as cardiovascular diseases, chronic obstructive pulmonary diseases, erectile dysfunction and pulmonary hypertension. THE AIM OF THE STUDY: The aim of the study was to search for sources of PDE inhibitors from Thai biodiversity. MATERIALS AND METHODS: Some Thai medicinal plants used as aphrodisiac and neurotonic agents together with plants from Leguminosae collected from the North of Thailand were screened for PDE inhibitory activity using a radioassay. RESULTS: Seven from nineteen aphrodisiac and neurotonic plants as well as three from twelve Leguminosae plants showed potent PDEs inhibitory activity. The concentrations that could inhibit 50% PDE activity (IC(50)) of the active extracts were determined in comparison to the standard inhibitor, 3-isobutyl-1-methylxanthine (IBMX). Betula alnoides, Hiptage benghalensis, Leea indica and Senna surrattensis showed IC(50) values in the range of microgram per milliliter while IBMX standard showed an IC(50) value of 0.68+/-0.13 microg/ml. CONCLUSION: Thai biodiversity was the great sources of PDE inhibitors.