Effect of Emergency Scenario-Based Training Program on Knowledge, Self-confidence, and Competency of Elderly Caregiver Volunteers in a Rural Thai Community: A Quasi-Experimental Study.

Background: Many older people with comorbidities encounter emergency or life-threatening situations, but the response is often neglected or delayed, resulting in increased morbidity and mortality rates. Community preparedness to reduce the impact of emergency crises on older people is essential. This study aimed to determine the effect of an emergency scenario-based training program (ESBTP) for elderly care on the knowledge, self-confidence, and competency of volunteer caregivers in a rural Thai community. Methods: The one-group pre-post-test, quasi-experimental study, was conducted with a non-randomized research sampling of 40 community healthcare volunteers in Vibhavadi district, Surat Thani, Thailand. The research was conducted between October and December 2021. The ESBTP was based on Bloom's learning theory. The research instrument was a three-part questionnaire measuring knowledge, self-confidence, and competency in geriatric life-threatening surveillance and emergency assistance (GLTSEA) at one, four, and eight weeks of training. Data were analyzed using Bonferroni statistics and repeated measures ANOVA through the software IBM SPSS version 28 with hypothesis testing at P<0.05. Results: The results revealed that at Week 1, Week 4, and Week 8, the volunteers attending the ESBTP demonstrated significantly higher GLTSEA competency (P<0.001). Otherwise, the participants were not significantly different in GLTSEA knowledge (P=0.068) and self-confidence (P= 0.052) after the training. Conclusions: Volunteers' competency increased after ESBTP, but there must be continuity in community training to develop the relevant knowledge, self-confidence, and skills for emergencies.

Vietnamese people's behavior and future intention to purchase medicines and functional foods on the internet: a cross-sectional study.

This study investigated Vietnamese people's behavior and future intention to purchase medicines and functional foods online and their associated factors. From March to May 2023, a Google Form questionnaire was distributed via social networks and online platforms. Convenience and snowballing sampling methods were employed to recruit 1,305 Vietnamese people. In the past year, 50.3% of participants purchased at least one kind of medicine and/or functional foods online (medicines: 27.6%, functional foods: 45.1%). Among 656 buyers, nearly a third bought these products more than three times and only 5.9% felt dissatisfied with their previous experiences. This purchasing behavior was more prevalent among females, those married, having higher education levels, usually shopping online, having longer time of Internet use per day, and seeking health information on the Internet (p < 0.001). In addition, 77.5% of participants intended to purchase these products online in the future and 61.2% would introduce this kind of online purchase to other people. The purchase intention was significantly associated with the participants' previous experiences, area, contracting chronic diseases, and using the Internet for self-medication, while factors associated with the introducing intention included their education level, occupation, and previous experiences in online purchases (p < 0.001).

The Role of Complementary Feeding Practices in Addressing the Double Burden of Malnutrition among Children Aged 6-23 Months: Insight from the Vietnamese General Nutrition Survey 2020.

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6-23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6-11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12-23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.

Attitudes and perceptions of Thai medical students regarding artificial intelligence in radiology and medicine.

INTRODUCTION: Artificial Intelligence (AI) has made a profound impact on the medical sector, particularly in radiology. The integration of AI knowledge into medical education is essential to equip future healthcare professionals with the skills needed to effectively leverage these advancements in their practices. Despite its significance, many medical schools have yet to incorporate AI into their curricula. This study aims to assess the attitudes of medical students in Thailand toward AI and its application in radiology, with the objective of better planning for its inclusion. METHODS: Between February and June 2022, we conducted a survey in two Thai medical schools: Chiang Mai University in Northern Thailand and Prince of Songkla University in Southern Thailand. We employed 5-point Likert scale questions (ranging from strongly agree to strongly disagree) to evaluate students' opinions on three main aspects: (1) their understanding of AI, (2) the inclusion of AI in their medical education, and (3) the potential impact of AI on medicine and radiology. RESULTS: Our findings revealed that merely 31% of medical students perceived to have a basic understanding of AI. Nevertheless, nearly all students (93.6%) recognized the value of AI training for their careers and strongly advocated for its inclusion in the medical school curriculum. Furthermore, those students who had a better understanding of AI were more likely to believe that AI would revolutionize the field of radiology (p = 0.02), making it more captivating and impactful (p = 0.04). CONCLUSION: Our study highlights a noticeable gap in the understanding of AI among medical students in Thailand and its practical applications in healthcare. However, the overwhelming consensus among these students is their readiness to embrace the incorporation of AI training into their medical education. This enthusiasm holds the promise of enhancing AI adoption, ultimately leading to an improvement in the standard of healthcare services in Thailand, aligning with the country's healthcare vision.

Long-term immunogenicity of the SA14-14-2 Japanese encephalitis (JE) vaccine (CD.JEVAX®) booster following chimeric JE (IMOJEV®) vaccine priming in Thai children.

Japanese encephalitis (JE) is a significant public health concern in Asia, particularly in children, where vaccination plays a crucial role in prevention. In this study, we investigated the immunogenicity and safety of two different live-attenuated JE vaccines used as primary and booster doses. Fifty healthy participants aged 1-3 years, who were primed with the chimeric JE vaccine IMOJEV® a year earlier, received a booster dose of the SA14-14-2 JE vaccine CD.JEVAX®. To evaluate the immune response, JE-neutralizing antibody titers were assessed on day 0 (pre-booster), day 30, and annually from 1 to 5 years post-booster using the 50% plaque reduction neutralization test (JEPRNT50). The assessment revealed strong immunogenicity 30 d post-booster, with a geometric mean titer of 2092.4 [95% confidence interval (CI): 1473.9-2970.5] and a seroprotection rate of 100%, which gradually decreased to 97.5% at 5 years post-booster. No severe adverse events were observed. The most common reaction within 7 d of vaccination was fever (20%; 95% CI: 10.7-32.3). These results indicate that a booster dose of CD.JEVAX® elicits a strong immune response in children previously vaccinated with IMOJEV® while maintaining a good safety profile, thus supporting the interchangeability of these two live-attenuated JE vaccines. Registered at www.thaiclinicaltrials.org (TCTR ID: TCTR20221102003), our study suggests that CD.JEVAX® can be a viable option for booster vaccination in JE prevention programs, potentially enhancing vaccine flexibility and accessibility.

The epidemiology and outcomes of hospitalized drowning in Thai children: a national data analysis 2015-2019.

BACKGROUND: Drowning remains a common cause of death among children. However, the epidemiology and impact of drowning in Thailand was underexplored. This study aimed to analyze the epidemiology and clinical outcomes of pediatric drowning in Thailand and to determine the factors associated with the need for intubation and mortality. METHODS: Data derived from the Thai healthcare delivery system for the period between 2015 and 2019 were used to examine the monthly admissions, mortality rates, length of hospital stay, and the number of patients who received endotracheal intubation. Multivariate logistic regression analysis was employed to identify the risk factors associated with the need for intubation and mortality. RESULTS: Of the 4,911, 58.8% were under six years old, 63.5% were male, and 31.2% were from the Northeastern region. The majority drowned during April, which is the summer season in Thailand. Among these patients, 28.8% required intubation, with the highest proportion found in the 6-<12 years age group (35.9%). The independent risk factors for intubation were metabolic acidosis (adjusted odd ratio [aOR] 9.74; 95% confidence interval [CI] 7.14-13.29; p < 0.001) and pulmonary edema (aOR 5.82; 95%CI 3.92-8.65; p < 0.001). The overall mortality rate due to drowning was 12.6%. Factors significantly associated with mortality included in-hospital cardiac arrest (aOR 4.43; 95%CI 2.78-7.06; p < 0.001), and the presence of drowning-related complications, particularly renal failure (aOR 7.13; 95%CI 3.93-12.94; p < 0.001). CONCLUSION: Drowning admissions and mortality were highest among male children under six years old, occurring mainly during the summer season. Significant factors associated with intubation requirement included metabolic acidosis and pulmonary edema. The mortality was significantly associated with in-hospital cardiac arrest and drowning-related complications, particularly renal failure. TRIAL REGISTRATION: This is an observational study, does not include any intervention, and has therefore not been registered.

Dairy Consumption at Breakfast among Southeast Asian Children: Associations with Nutrient Intake from the South East Asian Nutrition Surveys II (SEANUTS II).

BACKGROUND: Children's rapid growth requires adequate nutrient intake, with breakfast, especially when incorporating dairy, playing an important role. This study examined associations between dairy consumption at breakfast and energy and nutrient intake among children in Southeast Asia. METHODS: Utilizing the cross-sectional South East Asian Nutrition Surveys II dataset, using a 24 h dietary recall and questionnaires distributed among 10,286 children aged 2 to 12 years from Malaysia, Thailand, Indonesia, and Vietnam, we investigated the impact of dairy consumption at breakfast on nutrient intake and examined associations between breakfast consumption and the prevalence of stunting and overweight/obesity among 10,135 children. RESULTS: Although most of the children consumed breakfast, only 37%, 27%, 16%, and 18% in Malaysia, Thailand, Indonesia, and Vietnam, respectively, included dairy in this meal, with younger children being significantly more likely to consume dairy at breakfast (p < 0.001). Dairy consumers had significantly higher intakes of vitamins A, B12, and D and calcium both at breakfast and throughout the day (p < 0.001). Breakfast skippers had a 29% increased risk of being overweight/obese. CONCLUSIONS: Dairy consumption at breakfast was associated with enhanced nutrient intake and overall diet quality among Southeast Asian children. The association between breakfast habits and anthropometric outcomes highlights the need to address nutritional deficiencies and promote healthy growth and development.

The contemporary management and coronary angioplasty outcomes in young patients with ST-Elevation myocardial infarction (STEMI) age < 40 years old: the insight from nationwide Thai PCI registry.

BACKGROUND: Cardiovascular disease (CVD) remains one of the major causes of death around the world in which ST elevation MI (STEMI) is in the lead. Although the mortality rate from STEMI seems to decline, this result might not be demonstrated in young adults who basically have different baseline characteristics and outcomes compared with older patients. METHODS: Data of the STEMI patients aged 18 years or older who underwent PCI during May 2018 to August 2019 from Thai PCI Registry, a prospective, multi-center, nationwide study, was included and aimed to investigate the predisposing factors and short-term outcomes of patients aged < 40 years compared with age 41-60, and > 61 years. RESULTS: Data of 5,479 STEMI patients were collected. The patients' mean age was 62.6 (SD = 12.6) years, and 73.6% were males. There were 204, 2,154, and 3,121 patients in the youngest, middle, and oldest groups. The young patients were mainly male gender (89.2% vs. 82.4% and 66.6%; p < 0.001), were current smokers (70.6%, 57.7%, 34.1%; p < 0.001), had BMI ≥ 25 kg/m2 more frequently (60.8%, 44.1%, 26.1%; p < 0.001), and had greater family history of premature CAD (6.9%, 7.2%, 2.9%; p < 0.001). The diseased vessel in the young STEMI patients was more often single vessel disease with the highest percentage of proximal LAD stenosis involvement. Interestingly, there were trends of higher events of procedural failure (2.9%, 2.1%, 3.3%; p = 0.028) and procedural complications (8.8%, 5.8%, 9.4%; p < 0.001) in both youngest and oldest groups compared to the middle-aged group. In-hospital death was found in 3.4% in the youngest group compared to 3.3% in the middle-aged patients and 9.2% in the older patients (p < 0.001). CONCLUSIONS: Despite experiencing higher rates of procedural failure and complications during treatment compared to middle-aged and older patients, young STEMI individuals demonstrate a significantly lower risk of death during hospitalization and within one year of the event. Younger patients might have a more robust physiological reserve or benefit from more aggressive post-procedure management. However, the higher prevalence of modifiable risk factors like smoking and obesity in younger individuals underscores the need for preventative measures. Encouraging smoking cessation and weight control in this demographic is crucial not only to prevent STEMI but also to potentially improve their long-term survival prospects.

Safety and pharmacokinetic properties of a new formulation of parenteral artesunate in healthy Thai volunteers.

BACKGROUND: Parenteral artesunate is the first-line therapy for severe malaria. Artesunate, in its current formulation, must be prepared immediately before administration by first dissolving in sodium bicarbonate solution and then diluting in saline. A novel solvent for rapid and stable single step reconstitution of artesunate was recently developed showing improved solubility and stability. This study aimed to compare the safety and pharmacokinetic properties of the currently available and newly developed parenteral formulation of artesunate in healthy Thai volunteers. METHODS: This was an open-label, randomized, 4 periods, 4-treatments, 24-sequence, single-dose, cross-over study in 72 male and female healthy Thai volunteers. Frequent pharmacokinetic samples were collected in all volunteers at each dose occasion. Observed concentration-time profiles were analysed with a non-compartmental approach followed by a bioequivalence evaluation. RESULTS: Both intramuscular and intravenous administrations of the new parenteral formulation of artesunate were safe and well-tolerated, with no additional safety signals compared to the currently used formulation. The pharmacokinetic properties of artesunate and its active metabolite, dihydroartemisinin, were well-characterized, and showed rapid conversion of artesunate into dihydroartemisinin. Intramuscular administration of the newly formulated artesunate resulted in almost complete bioavailability of dihydroartemisinin. The pharmacokinetic properties were similar between the old and new formulation. CONCLUSIONS: The new and more easily prepared formulation of artesunate was safe and well-tolerated, with similar pharmacokinetic properties compared to the currently used formulation. Dihydroartemisinin, the active metabolite responsible for the majority of the anti-malarial effect, showed equivalent exposure after both intravenous and intramuscular administration of artesunate, suggesting that both routes of administration should generate comparable therapeutic effects. TRIAL REGISTRATION: The study was registered to clinicaltrials.gov (#TCTR20170907002).

Utility of the oxygenation index in management of congenital diaphragmatic hernia: a report from a Thai University Surgical Centre.

BACKGROUND: Oxygenation index (OI) is associated with severity of newborn pulmonary hypertension (PH) in congenital diaphragmatic hernia (CDH). Higher OI may indicate worst degree(s) of PH. OBJECTIVES: This study reports OI dynamic(s) over the first 72 h of life and its correlation with (1) perioperative morbidity and (2) CDH mortality. METHODS: Medical records of inborn CDH babies during 2002-2022 were examined. OI on Days (s) 1-3 and perioperative OI trends were recorded. Operation (primary vs patch repair) and survival rates (%) were studied. RESULTS: Fifty-five CDH newborns (54.5% male: 45.5% female)-mean birth GA 37.5 ± 2.7 wks. had a mean birth weight 2813 ± 684 g with prenatal diagnosis in 32.7% cases. 52/55 (94.5%) were intubated at birth and HFOV deployed in 29 (55.8%). Those requiring HFOV had higher OI on DOL1 (24.8 ± 17 vs 10.3 ± 11.5; p < 0.05), DOL 2 (26.3 ± 22.9 vs 6.7 ± 12.1; p < 0.05) and DOL 3 (21.9 ± 33.8 vs 5.5 ± 9.3; p = 0.04). Operation was undertaken in 36/55 (65.5%). Preoperative mortality group had significant higher OI on DOL 2 (42.1 ± 21.0 vs 14.9 ± 9.3; p = 0.04). CDH defects were-Type A N = 27 (75%), Type B N = 7 (19.4%) and Type C N = 2 (5.6%). Overall mortality was 40% (22/55). Statistically significant OI trends were recorded in non-survival vs. survival groups on DOL 1 (31.6 ± 16.8. vs 10.5 ± 9.0; p < 0.05, DOL 2 (38.1 ± 21.9 vs 6.3 ± 7.1; p < 0.05), and DOL 3 (38.8 ± 39.4; p = 0.012). CONCLUSIONS: OI dynamics are highly predictive for accurate monitoring of CDH cardiorespiratory physiology and crucially may guide ventilatory management as well as timing of surgery.

The association between interdental cleaning and periodontitis in an urban Thai adult cohort: a cross-sectional study.

BACKGROUND: Plaque biofilm is a major etiologic factor of periodontitis, and its effective removal prevents or ameliorates the disease. However, toothbrushing alone does not sufficiently clean the interdental area, and additional interdental cleaning is required to completely remove the plaque from this locale. This cross-sectional study aimed to assess the association of interdental cleaning on the prevalence of periodontitis in a large urban Thai adult cohort. METHODS: Interdental cleaning data were retrieved from a dental survey of 1,743 employees of the Electricity Generating Authority of Thailand (EGAT) in 2019. The Centers for Disease Control and Prevention/American Association of Periodontology (CDC/AAP) periodontal case definitions were applied. The participants were subdivided into two groups as those with or without periodontitis depending on their oral health status assessed by calibrated professional examiners. The proportion of subjects who performed interdental cleaning was assessed through a self-reported questionnaire by frequency (daily/ ≥ 1 per week/ none) and profile (correct/ incorrect) of interdental cleaning. Then, the association between interdental cleaning and periodontitis was calculated using logistic regression analysis controlling for the common risk factors of periodontitis such as age, sex, education, smoking, and diabetes. RESULTS: Participants who performed interdental cleaning on a daily basis and ≥ 1 per week were 27.5% (95% CI: 25.4, 29.6) and 29.1% (95% CI: 27.0, 31.3), respectively while the remainder did not practice. Of those who used interdental cleaning, about one-half focused on sites with food impaction. There was a significant 44% lower prevalence of periodontitis (adjusted odds ratio of 0.56 (95%CI: 0.40, 0.79) in the cohort with a frequent and correct group. CONCLUSIONS: Our data indicate an inverse association between interdental cleaning and periodontitis, particularly in those who routinely adhered to it. Regular interdental cleaning is likely to have a salutary effect on oral health. TRIAL REGISTRATION: The study was registered retrospectively in Thai Clinical Trials Registry, Registration number: TCTR20240817005, on 17 Aug 2024 ( https://www.thaiclinicaltrials.org ).

Ecological and health implications of heavy metal bioaccumulation in Thai Fauna: A systematic review.

Heavy metals pose significant threats to ecosystems and human health due to their persistence and bioaccumulation. In Thailand, rapid industrialization, extensive agriculture, and urban development have exacerbated heavy metal pollution in both aquatic and terrestrial ecosystems. This systematic review, conducted according to PRISMA guidelines, evaluates study designs and methodologies to assess heavy metal bioaccumulation in Thai fauna, with a focus on ecological and health impacts. The review reveals that fish, particularly from families like Cyprinidae and Cichlidae, account for 42.11 % of studies, with species such as swamp eel, Henicorhynchus siamensis, Arius maculatus, Osteogeneiosus militaris, Puntioplites proctozystron, and Channa striata showing significant bioaccumulation. Molluscs (31.58 %), including Tegillarca granosa and Filopaludina martensi, serve as critical bioindicators of aquatic pollution due to their filter-feeding habits. Amphibians and crustaceans, like Fejervarya limnocharis and Fenneropenaeus merguiensis, also demonstrate vulnerability to heavy metal contamination. Key contamination hotspots include urban waterways in Bangkok, industrial discharges in Songkhla Lake, and mining sites in Loei Province, highlighting widespread environmental and health impacts. Despite extensive research, gaps remain, particularly concerning benthic scavengers and detritivores, which are vital for ecosystem functions. The review underscores the need for targeted monitoring and mitigation, including stricter regulations on industrial discharges, improved waste treatment, and better management of agricultural runoff. While metals like cadmium (Cd), lead (Pb), copper (Cu), and zinc (Zn) are well-studied, further research on less-examined metals and species-specific bioaccumulation patterns is crucial to enhancing environmental management, supporting biodiversity conservation, and improving ecosystem resilience in Thailand.

SEVERE DISEASE PROGRESSION OF POSTMOLAR GESTATIONAL NEOPLASM IN A VIETNAMESE YOUNG FEMALE PATIENT AFTER TREATMENT REFUSAL: INSIGHTS FROM A CASE REPORT AND LITERATURE REVIEW.

Choriocarcinoma is characterized as the most aggressive malignant alternation of gestational trophoblastic neoplasm; however, this illness is a curable malignancy. Although a rarity, this disease affects a female patient's life and causes a fatal condition. Choriocarcinoma is a life-threatening disease since it is initially insidious and can rapidly lead to masive hemorrhage, even death. Choriocarcinoma should be suspected in childbearing-age women with the high-risk scores according to FIGO. The study aims to report a severe case of widespread metastatic choriocarcinoma to optimize the treatment with multiagent chemotherapy and a multidisciplinary cooperation at our center. A G1P0 20-year-old woman was referred to the hospital for suspicion of metastatic choriocarcinoma after self-stopping chemotherapy because of the COVID-19 pandemic. During hospitalization, the tumor metastasized and presented profuse intraabdominal hemorrhage. The patient underwent immediate surgical intervention to control bleeding, and a definitive diagnosis was accurately established by the histopathological examination. After surgery, the EMA/CO regimen was administered as the first line of treatment, despite the patient being in a coma and requiring a ventilator machine. After 6 cycles of the EMA/CO regimen, her serum ß-hCG level decreased to 8 mUI/mL, however, her ß-hCG concentration was not down to a negative value. Thus, the patient received paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE regimen) for complete remission following 2 cycles. The delays in choriocarcinoma treatment are prognostic factors for worse outcomes, whereas chemotherapy may be considered a suitable treatment even in a patient's coma, thus improving a prognosis substantially.

Understanding stigma and attitudes towards hepatitis B among university students in Australia of Chinese and Vietnamese background.

INTRODUCTION: Hepatitis B is a significant public health concern and a leading cause of liver cancer across the world. In Australia, hepatitis B is largely endemic in migrant communities, particularly amongst the Chinese and Vietnamese communities. Negative attitudes towards hepatitis B can be a major barrier to hepatitis B testing and linkage to care. This mixed-methods research explores the attitudes and beliefs, including stigma, about hepatitis B among students of Vietnamese and Chinese background in Australia. Students were chosen as participants as there is little research examining hepatitis B among university students in Australia and they provide a point of entry to communities with high prevalence of hepatitis B, that otherwise may be hard to access. METHODS: Online surveys were distributed in Chinese, Vietnamese, and English via social media and completed by 112 students of Chinese and 95 students of Vietnamese backgrounds. In-depth interviews were also conducted with 13 Vietnamese and 10 Chinese participants to further explore the survey results. RESULTS: Survey findings suggest that students have varied attitudes towards people living with hepatitis B. Around half of the participants reported they would behave negatively towards other people with hepatitis B and that they would expect to experience stigma or discrimination if they had hepatitis B. While over 70% in both samples reported that people who have hepatitis B should not be isolated by family and friends, 47.6% of the Chinese sample and 28.3% of the Vietnamese sample reported they would avoid close contact with someone with hepatitis B. The qualitative data expands on the quantitative data. Four key themes were identified: (1) Caution not discrimination (2) Hepatitis B as a sign of immoral behaviour (3) Discriminatory behaviour based on perceived effects of hepatitis B and (4) Shifting attitudes. CONCLUSION: This research provides insights that could inform culturally sensitive health promotion programs to address negative attitudes towards hepatitis B among the broader Chinese and Vietnamese communities living in Australia.

Association between Thai language proficiency and adherence to COVID-19 protective behaviors (CPB) among Myanmar migrant workers in Southern Thailand.

The association between host country language proficiency and disease prevention among migrants is underexplored. The objective of this study is to assess the extent to which self-reported command of the Thai language is associated with adherence to COVID-19 protective behaviors (CPB) among Myanmar migrant workers in Thailand. We distributed a self-administered structured questionnaire in Burmese language to 1,050 Myanmar migrant workers in Southern Thailand from September 2022 to January 2023. The questionnaire included background characteristics, self-reported Thai language proficiency based on the Common European Framework Reference (CEFR), and self-reported CPB adherence at residence and workplace. We analyzed data using descriptive statistics and multivariate linear regression analysis. Although slightly less than half of the participants reported CEFR A1 level or higher in Thai speaking and listening skills, less than 10 percent did so for reading and writing skills. Workplace COVID-19 preventive adherence scores were initially found to be significantly associated with A1 level or higher speaking and listening skills. However, after adjusting for confounders, these associations were not statistically significant (Speaking skill's Adjusted Beta = 0.713, 95% CI = -0.011, 1.437; Listening skill's Adjusted Beta = -0.367, 95% CI = -1.087, 0.353). No significant associations were found between any language skill domain and residence COVID-19 preventive adherence scores for both unadjusted and adjusted analysis. The study findings may have implications for relevant stakeholders in migrant services, migrant health, and infectious disease control. However, information biases, language barriers, and lack of generalizability should be considered as caveats in the interpretation of the study findings.

Exploring molecular spectrum in thai patients with maple syrup urine disease: unveiling a common variant.

BACKGROUND: Maple syrup urine disease (MSUD) is a rare autosomal recessive metabolic disorder caused by variants in any of the following genes: BCKDHA, BCKDHB, and DBT gene. Previous reports have highlighted a variety of common causing genes and variants among different ethnic groups affected by MSUD. This study is the first to describe the molecular characteristics, potential common variants, clinical phenotypes, and treatment outcomes of 20 Thai MSUD patients before the implementation of expanded newborn screening in Thailand. RESULTS: A cross-sectional, multicenter study was conducted, including twenty Thai MSUD patients from 1997 to 2023. Most of the patients presented with classic neonatal onset (95%). The mortality rate was 20%, while global developmental delay was observed in 40% of the patients. Variants in the BCKDHB gene were detected in 85% (17/20) of the patients, while the BCKDHA gene accounted for 15% (3/20). The study identified the 11-kb deletion involving 5'UTR, exon 1, and intron 1 in the BCKDHB gene, from a position of g.80102385 to g.80113453 (NC_000006.12), accounting for 50% of all variants (20/40 alleles) in Thai MSUD patients. All patients with the 11-kb deletion in BCKDHB presented with the classic type. The gap-PCR for this common deletion was established in the study. CONCLUSION: This study is the first to describe the clinical and molecular spectrum of Thai MSUD patients before the implementation of expanded NBS. The 11-kb deletion involving exon 1 in the BCKDHB emerges as the most common variant among Thai individuals with MSUD. Furthermore, the gap-PCR test for detecting the 11-kb exon 1 deletion status holds the potential for integration into stepwise molecular analysis following positive expanded newborn screening.

Growth performance and ruminal fermentation characteristics of Thai-native beef cattle fed cassava pulp fermented with Lactobacillus casei TH14 and additives.

Raw cassava pulp is a low-nutritional agro-industry residue with a high moist content that is susceptible to rot. Biodegradation of cassava pulp by adding Lactobacillus spp. plus stimulants could boost bio-acidity to preserve cassava pulp as ruminant feed. This investigation assessed the effect of ensiled cassava pulp without or with Lactobacillus casei TH14 (LTH14), urea, and molasses on the intake, digestibility, rumen fermentation, and growth performance of native Thai beef cattle. Eight Thai-native beef bulls (170.3 ± 20.2 kg of initial body weight) were randomly assigned to two treatment groups in a completely randomized design: cassava pulp ensiled without additives (CPFNO; n = 4) and cassava pulp ensiled with the combination of LTH14 (2.5 g per ton of fresh material), urea (4% DM), and molasses (4% DM) (CPFWA; n = 4). The intake of the concentrate diet and ensiled cassava pulp did not differ (p > 0.05) between the CPFNO and CPFWA groups, including final body weight, average daily gain (ADG), and feed conversion ratio (p > 0.05). However, CPFWA affected higher rice straw intake compared to the CPFNO group (p < 0.05). The intake and digestibility of crude protein (CP) were greater for the CPFWA group at 43.86% and 30.87%, respectively, compared to the CPFNO group (p < 0.05). Ruminal ammonia-nitrogen (NH3-N) and blood urea-nitrogen (BUN) were increased when animals were fed with CPFWA (p < 0.05). The average total volatile fatty acids (VFA) concentration of CPFWA was greater than that of CPFNO by 27.49% (p < 0.05). In conclusion, CPFWA supplementation can enhance rice straw intake, CP intake and digestion, total ruminal VFA concentration, and BUN levels, without adversely affecting growth performance.

Changes of bone turnover markers and bone mineral density among postmenopausal Thai women with osteoporosis receiving generic risedronate.

BACKGROUND: Osteoporosis has been recognized as a significant health issue in Thailand. Pharmacological interventions are important way to prevent fracture. However, one of the main challenges in selecting a medication is high cost, particularly for brand-name drugs. Data on generic bisphosphonate use in Thai are still lacking. Therefore, our study aimed to assess the efficacy and safety of generic risedronate in postmenopausal Thai women with osteoporosis. METHODS: This prospective study was conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, from December 2022 to January 2024. Serum C-terminal cross-linking telopeptide of type I collagen (CTX) and procollagen type I N-propeptide (P1NP) were measured at baseline. All participants subsequently received 35 milligrams of oral risedronate once weekly for 52 weeks. Serum CTX and P1NP were remeasured at different time points. BMD was reevaluated at 52 weeks after risedronate treatment initiation. RESULTS: A total of 80 participants were included. The mean age was 65.2 ± 6.6 years. The mean body mass index (BMI) was 23.45 ± 3.49 kg/m2. The median (IQR) serum CTX level at 12 weeks was significantly lower than that at baseline (0.28 (0.16-0.46) ng/mL versus 0.44 (0.26-0.64) ng/mL, respectively; p value < 0.01). The suppression of serum CTX was confirmed at 52 weeks after treatment initiation. Compared with those at baseline, the serum P1NP levels were significantly lower at 24 weeks after treatment initiation (30.33 (19.19-39.58) ng/mL versus 41.90 (30.33-68.67) ng/mL, respectively; p value < 0.01). In terms of the BMD assessment at 52 weeks, significant improvements were observed in both areal BMD (g/cm2) and T scores at all measured sites compared with baseline. The lumbar spine, femoral neck, and total hip BMD increased from baseline by 4.76%, 3.84% and 4.54%, respectively. CONCLUSION: Postmenopausal women with osteoporosis who were treated with generic risedronate demonstrated significant suppression of the bone remodelling process at 3, 6, and 12 months after treatment initiation. Additionally, significant improvements in the lumbar spine, femoral neck, and total hip BMD were observed at 12 months of therapy. These findings suggest that generic risedronate could be considered a reasonable and interesting option for treating postmenopausal women with osteoporosis in Thailand.

A decrease in serum dihydrotestosterone levels in 9-year-old Vietnamese children from a dioxin exposure area.

BACKGROUND: Dioxin is an environmental pollutant as well as an endocrine disruptor in humans. Our longitudinal study wants to clarify the relationship between dioxin exposure and endocrine disorders in children living in the Vietnamese dioxin hotspot. METHOD: Seventeen congeners of polychlorinated dibenzo-p-dioxins/polychlorinated dibenzo-furans (PCDDs/PCDFs) in maternal breast milk and seven serum steroid hormones in children of 43 and 46 mothers and their 9-year-old children from the non-exposure and the hotspot areas were measured, respectively. The steroid metabolic enzyme ratios were calculated based on the hormone level ratio. RESULTS: Most dioxin/furan congeners and toxic equivalents (TEQs) levels were significantly higher in the hotspot than in the non-exposure area, except for 2,4,7,8-TeCDF. The height and weight of girls from the hotspot area were substantially lower and inversely correlated with dioxin congener levels/total TEQs level dioxin. The dihydrotestosterone (DHT) levels in the hotspot were markedly lower than those in non-exposed in both genders. The cortisol concentrations were significantly higher in the hotspot than those from the non-exposure area only in the girls. The DHT/testosterone ratios that exhibited the 5α- or 5ß-reductase activity declined by 50% in the hotspot area for both genders. The DHT levels showed strong inverse correlations with almost the PCDDs/PCDFs congeners and total TEQs dioxin in breast milk. CONCLUSIONS: This finding suggests that dioxin exposure in maternal breast milk might impact children's endocrine system until 9 years old, especially on the DHT biosynthesis.

Thai Fermented Soybean (Thua-Nao) Prevents Early Stages of Colorectal Carcinogenesis Induced by Diethylnitrosamine and 1,2-Dimethylhydrazine Through Modulations of Cell Proliferation and Gut Microbiota in Rats.

BACKGROUND: Thua-nao is a traditional fermented soybean product widely consumed in the northern areas of Thailand. There has been little research on the biological activity of Thua-nao, particularly its anticancer properties. OBJECTIVES: The objective of this study was to examine the cancer chemopreventive effects of dried Thua-nao on liver and colorectal carcinogenesis induced by carcinogens in rats. METHODS: Rats were injected with diethylnitrosamine (DEN) and 1,2-dimethylhydrazine (DMH) to induce preneoplastic lesions. Rats orally received dried Thua-nao for 13 weeks. The preneoplastic lesions, including glutathione S-transferase placental form (GST-P)-positive foci and aberrant crypt foci (ACF), were evaluated in the liver and colon, respectively. The cancer chemopreventive mechanisms of dried Thua-nao on liver and colorectal carcinogenesis were examined. RESULTS: Dried Thua-nao administration suppressed colorectal aberrant crypt foci. Moreover, dried Thua-nao reduced proliferation cell nuclear antigen (PCNA)-positive cells in the colon. Interestingly, dried Thua-nao modulated the gut microbiota in DEN- and DMH-induced rats. Isoflavones, including genistein and daidzein, represent promising chemopreventive agents in dried Thua-nao. CONCLUSIONS: In conclusion, these results highlight the cancer chemopreventive effect of dried Thua-nao in DEN and DMH-induced colorectal carcinogenesis through cell proliferation reduction and gut microbiota modulation.