De novo subtelomeric deletion of 15q associated with satellite translocation in a child with developmental delay and severe growth retardation

We report on a case of satellited 15q with subtelomeric deletion in a girl with delayed development and severe growth retardation. The patient also has a triangular face, downturned angles of the mouth, micrognathia, and minor limb malformations including mild talipes equinovarus, genu recurvatum, and increased dorsiflexion of both limbs. Cytogenetic analysis using standard GTG banding showed a female karyotype with a satellited-like structure at the distal long arm of one chromosome 15. Silver staining of the nucleolar organizing region (AgNOR) confirmed the presence of a satellite DNA translocation at the lesion. Analysis using fluorescent in situ hybridization (FISH) detected a subtelomeric deletion of the terminal 15q. Additional molecular analysis using microsatellite markers along the long arm of chromosome 15 defined a maximally deleted region at approximately 4.7 Mb. Haploinsufficiency of the IGF1R gene expression is thought to be the cause of growth delay in all 15q terminal deletion including our patient.     

In vitro antimalarial activity of a Thai medicinal plant Picrasma javanica Bl

Picrasma javanica Bl., a medicinal plant used for the treatment of malaria in traditional medicine was evaluated for antimalarial activity. Primary screening demonstrated that the chloroform extract of the bark possessed the highest yield of antimalarial activity. Chemical isolation and purification of the active alkaloidal part yielded three different pure alkaloid components. Among these, one component was identified as the known major bark alkaloid, 4-methoxy-1-vinyl-β-carboline, and a second new alkaloid, 6-hydroxy-4-methoxy-1-vinyl-β-carboline. Complete characterization of the remaining alkaloid was not possible due to its inferior yield. The two identified alkaloids showed in vitro antimalarial activity against multi-drug resistant Thai isolates of Plasmodium falciparum.     

Development of influenza vaccine production capacity by the Government Pharmaceutical Organization of Thailand: addressing the threat of an influenza pandemic

In 2005, a year after highly pathogenic avian influenza outbreaks in Thailand, the Thai Government issued a National Strategy Plan for Pandemic Influenza Preparedness, a major objective of which was the domestic production of seasonal influenza vaccine. It was considered that sustained influenza vaccine production was the best guarantee of a pandemic vaccine in the event of a future pandemic. The Government decided to provide funds to establish an industrial-scale influenza vaccine production plant, and gave responsibility for this challenging project to the Government Pharmaceutical Organization (GPO). In 2007, with support from the World Health Organization (WHO), the GPO started to develop egg-based, trivalent inactivated influenza vaccine (IIV) in a renovated pilot plant. In early 2009, during the second year of the project, the GPO turned its attention to develop a pandemic live attenuated influenza vaccine (PLAIV) against the influenza A (H1N1) virus. By December 2010, the H1N1 PLAIV had successfully completed Phase II clinical trials and was awaiting registration approval from the Thai Food and Drug Administration (TFDA). The GPO has also started to develop an H5N2 PLAIV, which is expected to enter clinical trials in January 2011. The next step in 2011 will be the development and clinical evaluation of seasonal LAIV. To meet the needs of the national seasonal influenza vaccination programme, the GPO aims to produce 2 million doses of trivalent IIV in 2012 and progressively increase production to the maximum annual capacity of 10 million doses. This article relates how influenza vaccine production capacity was developed and how major challenges are being met in an expeditious manner, with strong local and global commitment.     

In Vitro Antimalarial Activity of Brucea javanica against Multi-Drug Resistant Plasmodium falciparum.

The medicinal plant, BRUCEA JAVANICA (L.) Merr. (Simaroubaceae) was examined for antimalarial properties. Among different crude solvent extracts of the fruit, the chloroform extract was shown to have the most potent IN VITRO antimalarial activity. Three active compounds were isolated and purified from the chloroform extract. These compounds were confirmed as bruceine A, bruceine B hydrate and bruceine C by UV, IR, NMR and mass spectra. When tested IN VITRO against multi-drug resistant isolates of P. FALCIPARUM bruceine A and bruceine B hydrate were similar in activity (ID50 of 8.66 and 8.15 ng/ml) whereas bruceine C had an ID50 of 1.95 ng/ml. These compounds were comparable in IN VITRO activity to the new antimalarial drug, mefloquine (ID50 of 6.26 ng/ml).     

Motor recovery of stroke patients after rehabilitation: one-year follow-up study

Purpose To investigate motor recovery of stroke patients 1 year after rehabilitation. Materials and Methods A cross-sectional study of 192 stroke patients discharged from rehabilitation wards in nine tertiary hospitals was conducted. Motor recovery was assessed using the Brunnstrom motor recovery stages (BMRS), at 6 and 12 months after discharge. Factors related to the BMRS of the hand, arm and leg were analyzed. Results The mean age of patients was 62.2 years (57.3% male). Significantly more patients presented improvement of at least one BMRS of the hand, arm and leg compared with those with decreasing BMRS (p < 0.001). The percentage of patients with BMRS III– VI at 6 months was greater than that at discharge, but the recovery at 12 months was slightly higher than that at 6 months. It seems that motor recovery from stroke was near maximal at six months. Regarding the factors related to motor recovery, only lengths of stay (LOS) <30 d during the first admission and Barthel index at discharge ≥10 were related to the improvement of BMRS of the hand, arm and leg on multivariate analysis. Additionally, no complication at discharge was associated with the improvement of BMRS of the leg. Conclusions Approximately half of our stroke patients had motor improvement of at least one stage of BMRS at one year. Motor recovery after stroke at the end of the first year was associated with shorter LOS during the first admission, higher discharge Barthel index score and absence of complications at discharge.     

Radiofrequency catheter ablation in symptomatic ventricular arrhythmia

Background: Radiofrequency catheter ablation (RFCA) is an effective method to cure both supraventricular and ventricular arrhythmia (VA) in certain centres.
Aim: To assess the results of RFCA in VA at Siriraj Hospital.
Method: Electrophysiologic study, mapping, using both earliest endocardial activation and pace mapping, and ablation were performed.
Results: Thirty patients with symptomatic VA underwent RFCA. The mean age was 44 years. Eight patients had underlying heart disease (two prolapsed mitral valve, three myocarditis, two dilated cardiomyopathy and one mitral stenosis). Thirty-six morphologies of VA were detected from the study. Thirty-three morphologic tachycardias attempted were successfully ablated; 17, 10 and six were right VT, left VT and premature ventricular contraction (PVC), respectively. Failure of ablation occurred in one patient with left VT. Only minor complications occurred in this study.
There was no difference in cycle length and endocardial activation time between right and left VT. 12/12 identical pace mapping was more easily performed in right VT than in left VT The fluoroscopic and procedure times in left VT were significantly longer than in right VT.
Relapse occurred in six patients. Re-ablation was successfully performed in four patients, giving a final success rate of 93%.     

Schizontocidal activity of Celastrus paniculatus Willd. against Plasmodium falciparum in vitro

Preparations from the plant Celastrus paniculatus Willd. have been used for treatment of malaria and other febrile illness in the traditional medicine practices of Thailand. Crude solvent extracts from the root bark and stem of C. paniculatus were screened for antimalarial activity against P. falciparum using an in vitro culture system. A fraction of the chloroform extract of the root bark showed the highest antimalarial activity. An active principle was isolated and characterized from the chloroform fraction and identified as a quinonoid triterpene, pristimerin. When tested in vitro against various multidrug resistant isolates of P. falciparum, pristimerin was less active than the conventional antimalarial drugs tested.     

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.     

Enzyme-linked immunosorbent assay for serodiagnosis of Helicobacter pylori in dyspeptic patients and volunteer blood donors

Helicobacter pylori, an important etiological agent in the development of gastritis, peptic ulcer and gastric carcinoma, can be detected by the enzyme-linked immunosorbent assay (ELISA). Our objectives were: (1) to evaluate the efficacy of a commercial ELISA kit (Pyloriset EIA-G III) in sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for diagnosis of H. pylori infection in Thai dyspeptic patients in Khon Kaen Thailand; and (2) to examine the seroprevalence of H. pylori among blood donors at Srinagarind Hospital's Blood Bank, Khon Kaen University, by the commercial ELISA. Gastric biopsies obtained from 137 dyspeptic patients were diagnosed by culture, rapid urease test (RUT) and histology. Serum samples from the same dyspeptic patients and 100 healthy blood donors were assayed using the commercial ELISA. H. pylori infection in dyspeptic patients was considered positive when the culture or both RUT and histology were positive. Using a cut-off value at a titer of 20 U/ml (as recommended by the manufacturer), we found the commercial ELISA kit had a sensitivity of 93.3%, specificity of 75.3%, PPV of 74.7%, NPV of 93.5% and accuracy of 83.2%. The overall H. pylori seroprevalence in the healthy blood donors was 57%. Of the 100 healthy blood donors, 39 (60.9%) of the males and 18 (50.0%) of the females were seropositive.