Factors Associated with Mortality among Patients with Colorectal Cancer at the Secondary Care Hospital in Southern Thailand: Hospital-Based Retrospective Cohort Study.

Background: Globally and in Thailand, the incidence of colorectal cancer (CRC) is third-ranked behind lung and breast cancer, respectively. This hospital-based retrospective cohort study aimed to determine factors associated with mortality among patients with CRC. Methods: This study was performed by using the secondary data of the cancer registry among patients with CRC registered in Phatthalung Hospital. Two hundred twenty-eight patients with CRC were diagnosed and followed up from January 2014 to December 2018. Multiple logistic regression analysis was used to analyze factors associated with mortality among subjects with CRC. Results: The results revealed that the proportion of mortality among subjects with CRC was 50.44% (115 cases) at six months of following up. Subjects who had an increasing age every ten years (adjusted odds ratio [ORadj] = 1.40, 95 percent confidence interval [95% CI]: 1.09-1.80) were diagnosed with CRC at stage 3 (2.64, 1.19-5.84) and at stage 4 (11.63, 2.69-50.15) more likely to die. Also, subjects who received a combination of chemotherapy and radiotherapy treatment (3.44, 1.20-9.85), combination treatment of surgery, and postoperative care (2.46, 1.22-4.94) were more likely to die. Subjects who had not had surgery treatment were more likely to die (35.00, 7.44-168.27). Conclusions: In conclusion, factors such as the age of patients, stage of CRC, and treatment were associated with mortality among patients with CRC. Hence, medical and health professionals should consider these factors according to the treatment and optimization in patients with CRC.

Association between infant feeding practices and first meaningful words at first year of life: a prospective cohort study of Thai children.

Feeding practices show many benefits for child and cognitive development. The objective was to investigate the association between infant feeding practices and the first meaningful words of Thai children. The participants enrolled in this longitudinal study were 4245 children born between July 2000 and June 2002. They resided in 3 rural and 2 urban areas of Thailand and were followed from birth to childhood. The outcome was time from birth to expression of first meaningful words. Outcome and feeding information were gathered using a diary method, with parents and caregivers recording daily development. Nonstatistically significant corresponding reduction in time to expression of first meaningful words was found among children who were breastfed, and this increased with duration of breastfeeding. Breastfeeding may reduce the time taken for expression of first meaningful words by about 2% (hazard ratio = 0.98; 95% confidence interval = 0.94 to 1.01). No association between infant feeding practices and the expression of first meaningful words was found.

Mortality among HIV/AIDS patients coinfected with Mycobacterium tuberculosis in southern Thailand.

The purpose of this study was to investigate the mortality rate among HIV/AIDS patients coinfected with Mycobacterium tuberculosis in southern Thailand. A prospective, hospital-based cohort study was conducted among 52,459 HIV/AIDS patients registered at hospitals in 14 provinces of southern Thailand between January 1990 and April 2010. Twenty-seven point nine percent of the subjects were coinfected with Mycobacterium tuberculosis. Coinfection with Mycobacterium tuberculosis was not significantly associated with an increased mortality among subjects (HR 1.01; 95%CI 0.96-1.05). Subjects with pulmonary tuberculosis infection were 19% more likely to have a longer life (HR 0.81, 95%CI 0.73-0.91) and subjects with extrapulmonary tuberculosis were 31% more likely to have a longer life (HR 0.69; 95%CI 0.57-0.83). Early treatment of tuberculosis in HIV/AIDS patients can decrease mortality rates in southern Thailand.

Clinical risk factors on survival among HIV-infected children born to HIV-infected mothers.

OBJECTIVE: The present study was to investigate clinical risk factors of survival among HIV-infected children born from HIV-infected mothers in the Southern region of Thailand. MATERIAL AND METHOD: Data from routine prospective cohort studies between 1990 and 2010 were analyzed In these studies, 1,549 HIV-infected children born to HIV-infected mothers were enrolled at birth and followed longitudinally. Information on demographic, clinical manifestations, and HIV-infection status factors was collected Survival analysis was used to determine risk factors associated with mortality. RESULTS: Results found that one-fourth of HIV-infected children died (434, 28.02%) during the follow-up period. The follow-up available equals to 135,295 person-months. The incidence rate was 1.03 times per 100 person-months (95% CI: 0.97 to 1.08). The median survival time among HIV-infected children from diagnosis to death was 87.34 months (95% CI: 87.32 to 87.36). HIV-infected children were diagnosed to confirm as AIDS (88. 44%) and symptomatic HIV positive (11.56%). Clinical risk factors on survival among HIV-infected children were found HIV-infected children were more likely to die if they were infected with candidiasis (HR: 1.47, 95% CI: 1.07 to 2.00), Mycobacterium tuberculosis (HR: 1.51, 95% CI: 1.26 to 1.81), and Pneumocystis jiroveci (HR: 1.50, 95% CI: 1.27 to 1.76) as compared to HIV-infected children without clinical manifestation. CONCLUSION: Mortality among infected children born to HIV-positive mothers is high in the Southern region of Thailand Consequently, health service system related to prevent mother-to-child HIV-transmission is needed to improve child survival.

Early language delay and predictive factors in children aged 2 years.

OBJECTIVE: To investigate the predictive factors for early language delay (ELD) at age 2 years based on the Prospective Cohort Study of Thai children (PCTC). STUDY DESIGN: A prospective cohort study: secondary data retrieving. SUBJECTS: Three thousand nine hundred five children were recruited from four communities and one hospital in five areas of Thailand. MATERIAL AND METHOD: The Language Development Survey (LDS) was performed to identify children with early language delay (ELD) at age 2 years. Logistic regression analysis was used to investigate the association between possible factors (both biological and environment factors) and ELD. MAIN OUTCOME MEASURE: Number of children with ELD at age of 2 years. RESULTS: The incidence of ELD at age 2 years was 11.68%. Risk factors for ELD were birth weight (Odds Ratio: OR = 2.38, 95% Confidence interval: CI 1.65-3.42), male gender (OR = 2.12, 95% Confidence interval: CI 1.67-2.69), 3rd-4th and 5th child born or more (OR = 1.42, 95% CI = 1.02-1.96; OR = 1.88, 95% CI = 1.08-3.27, respectively), birth weight <2500 grams (OR = 2.38, 95% CI = 1.65-3.42), no first word within 1 year (OR = 2.25, 95% CI = 1.79-2.84), no walking within 1 year (OR = 1.34, 95% CI = 1.05-1.72), and maternal occupation (laborer or none) (OR = 1.36, 95% CI = 1.01-1.82). District living was a protective factor for ELD (OR = 0.42, 95% CI = 0.32- 0.54). There was no clear evidence for a link between breastfeeding and ELD. CONCLUSION: Significant factors identified here raise strong concerns that should be addressed clinically when counseling families and planning treatment. Further study using a longer longitudinal design and more detailed information is recommended to better determine predictive factors for ELD or specific language impairment (SLI).

Does prenatal ultrasound exposure influence the development of children?

The use of ultrasound in obstetrics nowadays is an integral part of prenatal care. As a non-invasive method it has a wide application for the detection of abnormalities. During the course of pregnancy the foetus may be exposed to ultrasound waves often several times. Presently it is not clear whether this has a negative effect on the health and development of children. A systematic review of scientific literature on possible harmful effects on child development of ultrasound investigation during pregnancy. Databases of scientific literature were screened through for publications dealing with the use of ultrasound on the development of children. Studies were included if they had been published since 1990. Sixteen studies were included in this review--13 randomised controlled trials, one cohort study, and two case-control studies. This included three for speech development, two for vision and hearing, one for school performance, three for handedness, and seven for birthweight and growth. All studies demonstrated that ultrasound examinations during pregnancy increased the risk of undesirable developmental outcomes. On average, the magnitude of such effects was minimal. However, most of the studies have some methodological defects, in particular, outcome measurements, overlooking possible bias and confounding factors, and statistical insufficiencies. It is concluded that there is no adverse effect of ultrasound examinations during pregnancy on child development outcomes.

Risk factors associated with language development problems in childhood--a literature review.

BACKGROUND: Children with language problems are found to have a higher risk for future academic difficulties and learning disabilities. Conclusions from related literature were in many ways inconsistent. OBJECTIVE: To identify systematically, the existing literature, and factors that influence language development in children. MATERIAL AND METHOD: Databases of scientific literature were screened through the internet for publications that involved factors effecting language development in childhood. Hard copies of related scientific journals were also sought for relevant topics by the authors, making use of reference lists of publications, and citation search. Studies were included if they were published since 1984 and investigated factors that affect language development in children. They were excluded if they were not original research articles. RESULTS: Fifteen studies were included for this review--a case-control study, a cross-sectional study, and thirteen longitudinal studies. Most studies demonstrated that the following factors affect language development--antenatal care, Apgar scores, birth weight, premature delivery, birth order, parental education, environmental factors, gender of the children, and family history with specific language impairment. CONCLUSION: Perinatal/postnatal and environmental factors influence language development. Such factors should be taken into account as confounding factors in further language development studies.