The prevalence of undiagnosed cognitive impairment and prevalence of undiagnosed depressive mood in over 60’s with type 2 diabetes in a Thai community: a cross-sectional study

Type 2 diabetes is a lifelong disease and a major health problem in Thai older people. Declining cognitive function and depressive mood can potentially present a barrier to self-care management. To date, there is no primary research data of cognitive impairment related to diabetes in Thailand, particularly in primary care settings which are the first important place for health care service in Thai community. This study contributes to the estimated prevalence of undiagnosed cognitive impairment and undiagnosed depressive mood in Thai older people with type 2 diabetes. In order to promote an early detection of cognitive impairment, a Thai version of Mini-Cog, a brief cognitive screening test for using in primary care settings was developed. A cross-sectional study design was conducted in a group of older diabetic patients aged 60 and over in the primary care settings of San-sai district, Chiang Mai, Thailand. Overall 556 participants were recruited and the following screening tests were applied on them: Mini-Cog Thai version, Mini-Mental State Examination (MMSE) Thai 2002, and the depressive mood screening test of Thai Geriatric Depression Scale (TGDS). The study shows the prevalence of Thai older people with type 2 diabetes who were probably undiagnosed with cognitive impairment to be 65.4% (95% CI 59.7%, 70.7%) for Mini-Cog, and 12.4% (95% CI 9.0%, 16.7%) for MMSE Thai 2002. The prevalence of people who were probably undiagnosed with depressive mood by TGDS is shown to be 19.4% (95% CI 15.2%, 24.4%). Logistic regression has been used to identify the associated characteristics of cognitive impairment and the associated characteristics of depressive mood. Using Mini-Cog, age, education, BMI and HDL were found to have effects on cognitive impairment. While using MMSE Thai 2002, only the effect of age and education were associated with cognitive impairment. The associated factor with depressive mood was retinopathy. The differences of prevalence rate and associated characteristics between the two cognitive screening tests are probably due to the different foci on cognitive domain tests. Mini-Cog may be more sensitive in detecting an earlier stage of cognitive impairment better than MMSE Thai 2002. Mini-Cog Thai version shows a good inter-rater reliability (K=0.8, p<0.001, 95% CI 0.54, 1.06). This study encourages health care providers’ awareness of cognitive decline and depressive mood that may affect self-care diabetes. Mini-Cog Thai version might be used as a brief cognitive screening tool in primary care settings

Aqueous Methanol Extracts of Cochlospermum tinctorium (A. Rich) Possess Analgesic and Anti-inflammatory Activities

Cochlopermum tinctorium A. Rich. (Cochlospermaceae) is a commonly used medicinal plant in the West Africa sub-region for the management of various conditions including pain and inflammatory conditions. In the present study, we report the analgesic and anti-inflammatory activities of the aqueous methanol leaf (20–80 mg/kg), root (7.5–30 mg/kg), and root bark (20–80 mg/kg) extracts of the plant. The analgesic potentials of the extracts were studied using acetic acid induced writhing and hot plate tests in mice while the anti-inflammatory activity was investigated using carrageenan-induced paw edema in rats.The extracts significantly and dose dependently inhibited the acetic acid-induced writhing in mice. However, the highest protection against writhing was produced by aqueous methanol leaf extract at the dose of 80 mg/kg (96.65%) which even was greater than that of the standard agent, ketoprofen (82.30%). The extracts did not significantly increase mean latency of response in the hot plate test. However, aqueous methanol root bark extract at the dose of 20 mg/kg significantly (P < 0.05) increased the mean latency of pain response. While the extracts of the root and root bark extracts of the plant afforded non dose-dependent protection against carrageenan-induced edema, the aqueous methanol leaf extract significantly and dose-dependently inhibited carrageenan-induced hind paw edema at the end of the third hour.The present study suggests that the aqueous methanol leaf, root, and root bark extracts of Cochlopermum tinctorium possess analgesic and anti-inflammatory activities which lend some credence to the ethnomedical claim of the use of the plant in the management of pain and inflammatory conditions

Correlation between cognitive impairment and depressive mood of Thai elderly with type 2 diabetes in a primary care setting

The prevalence of type 2 diabetes increases with age.1 More than 80% of people with diabetes live in low-and middle-income countries.2 Diabetes care is important in lowering blood glucose level and maintaining a good metabolic control in order to help prevent complication of diabetes. For successful diabetes self-management, individuals must commit to lifelong daily self-care tasks such as adhering to diet, exercise, medication regimens and checking blood glucose level. The coordination of these tasks often requires complex cognitive functioning.

Analgesic activity, toxicity study and phytochemical screening of standardized Cinnomomum iners leaves methanolic extract

Cinnomomum iners standardized leaves methanolic extract (CSLE) was subjected to analgesic, toxicity and phytochemical studies. The analgesic activity of CSLE was evaluated using formalin, hot plate and tail flick tests at doses of 100, 200 and 500 mg/kg. CSLE showed significant activity (P < 0.05) in the formalin model (late phase) on the rats at doses of 200 and 500 mg/kg. However, CSLE did not show activity in the hot plate and tail flick tests. The results obtained suggest that CSLE acts peripherally to relieve pain. For the toxicity study, CSLE was orally administered to the Swiss albino mice according to the Organization for Economic Co-Operation and Development (OECD) guideline 423. There was no lethality or toxic symptoms observed for all the tested doses throughout the 14-day period. Phytochemical screening of CSLE showed the presence of cardiac glycoside, flavonoid, polyphenol, saponin, sugar, tannin and terpenoid