The response pattern of intravitreal triamcinolone injection for non-AMD macular edema.

OBJECTIVE: To determine the pattern of functional and anatomical responses after intravitreal triamcinolone (IVTA) for macular edema in diabetic retinopathy, retinal vein occlusion, uveitis, and macular telangiectasia. MATERIAL AND METHOD: A Retrospective interventional study was carried out between January 2004 and July 2006. Thirty-eight eyes from 36 patients who had undergone an IVTA injection for macular edema from etiologies other than age-related macular degeneration (non-AMD macular edema) were included in the present study. Visual improvement and retinal thickness were the main outcomes. Potential complications, including increased intraocular pressure (IOP), intraocular bleeding, and postoperative endophthalmitis were also recorded. RESULTS: The mean pre-operative logarithm of Minimum Angle of Resolution (logMAR) visual acuity (VA) was 1.0 with an average macular thickness of 463.2 +/- 141.4 microns and mean IOP of 12.9 +/- 2.7 mmHg. The macular thickness rapidly decreased in the first week after an injection with a trough at two months (p < 0.001) and began to rise thereafter. The overall VA started to improve significantly at one month and lasted for two months. The IOP significantly increased from the mean baseline during the first two months in 31.6%, which could be controlled only by the medication. No other serious complications were observed. CONCLUSION: IVTA has the potential to improve both functional and anatomical outcomes in non-AMD macular edema. The decrease in macular thickness occurs from one week after an injection but the visual function improves more slowly and has a short-time effect.

Factors influencing home modification of stroke patients.

BACKGROUND: Home modification for stroke victims is often necessary to prevent falls and enable them to have a better quality of life. Up-to-date relationship between personal factors and home modifications in post-stroke patients has not been investigated. OBJECTIVE: To identify significant personal factors influencing the requirement for home modification in post-stroke patients. STUDY DESIGN: Prospective, analytical study. MATERIAL AND METHOD: Two hundred eighty one post-stroke patients were recruited from nine tertiary rehabilitation centers in Thailand. All patients received inpatient rehabilitation programs until either they reached the rehabilitation goals or registered two consecutive stable weeks as measured by their Barthel index score. Personal factors related to home modification were assessed at study entry, during hospital stay and at discharge. The correlation between personal factors and necessities of home modification in post-stroke patients were reported through univariate and multivariate modeling. RESULTS: The results of univariate analysis showed that a low Barthel index score (< or = 14/20) (at baseline and discharge), low Brunnstrom stage of arm or leg (< or = IV/VI) at baseline, and intolerance to intensive rehabilitation programs (< 3 hr/day) indicated a necessity for modifications in the patient's home (p < 0.05). The results of multivariate modeling showed that a low Barthel index score (at baseline and discharge), and intolerance to intensive rehabilitation were significant predictors of a requirement for home modification (p < 0.05). CONCLUSION: A low level of physical functioning and intolerance to intensive rehabilitation are significant predictors for the necessity of home modifications in stroke victims.

Night waking in Thai infants at 3 months of age: association between parental practices and infant sleep.

BACKGROUND AND PURPOSE: Night waking is common among infants and can create sleep deficit in both parents and infants. Sleep practices are influenced by cultural variations which may affect the prevalence and associated factors of frequent night waking. Our objective was to determine whether differences in parental practices related to infant sleep are associated with frequent night waking in Thai infants. METHODS: A cross-sectional survey based on interviews with parents of infants aged three months, birth weight greater than 2500 g, conducted under the Prospective Cohort study of Thai Children (PCTC). RESULTS: Of the total sample, 82.9% (3172 of 3826) of parents provided completed night waking information. The mean number (+/-standard deviation [SD]) of awakenings per night was 2.7+/-1.1, 47.3% awoke 1-2 times per night, and 46.9% awoke 3-4 times per night. The group of frequent night wakers (more than 14 night wakings per week, n=1634) was compared with the group of infrequent night wakers (n=1538). Significant and independent associations were present between frequent night waking and male gender (odds ratio [OR] of 1.5; 95% confidence interval [CI], 1.3-1.8), more than three naps per day (OR, 1.3; CI, 1.1-1.5), use of a swinging or rocking cradle (OR, 1.5; CI, 1.2-1.98), falling asleep while feeding (OR, 1.3; CI, 1.1-1.5), and breastfeeding only (OR, 1.2; CI, 1.1-1.4). No significant association was noted between frequent night waking and parental age, education, occupation, household income, type of parental response to infant's nighttime crying, or type of diaper. CONCLUSION: An association with frequent night waking was demonstrated with various factors of parental practice related to infant sleep, such as number of naps, use of a swinging or rocking cradle, breastfeeding only, and falling asleep while feeding. Further documentation of these associations may be clinically important. Implementing preventive interventions may be able to reduce frequent night waking in early infancy.

Prevalence and associated factors of passive smoking in Thai infants.

BACKGROUND: Passive smoking or exposure to environmental tobacco smoke (ETS) is associated with an increased risk of several respiratory illnesses for infants. OBJECTIVE: To assess the prevalence and the associated factors of ETS exposure in Thai infants. METHODS: A cross-sectional survey based on interviews with parents of infants aged 1 year old, conducted during October 2001-August 2003, under the Prospective Cohort study of Thai Children. RESULTS: A total of 3256 parents (76.7% of eligible subjects) provided the required information. The prevalences of father or mother smoking in the same room as the infants were 35.1 and 0.3% respectively. Smoking in the presence of an infant was significantly associated with paternal age of 25-34 or more than 44 years, education at or less than secondary school, and a Muslim father. CONCLUSIONS: The results suggest that ETS exposure is common in Thai infants and the main source of exposure is from a smoking father. This finding is different from other studies in Western countries where both the father and mother made substantial contributions to infant exposure to ETS. Interventions should be considered to reduce infant exposure to ETS.

Exposure to environmental tobacco smoke among infants in southern Thailand: a study of urinary cotinine.

We performed a survey to assess the exposure to environmental tobacco smoke (ETS) in 1-year-old infants in Thailand. Of the 725 infants, it was reported that 73.3% had household smoking and 40.7% had detectable urinary cotinine. Twenty-five infants (3.4%) had urinary cotinine in the range of adult heavy smokers. The prevalence of ETS exposure was significantly higher in infants with a father whose education was < or = grade 6 than in those with father's education >6 years (44.0% vs. 36.0%, p = 0.039). Data on the exposure to ETS among infants will provide prevalence information and identify population subgroups at increased risk for exposure.