Primary care for diabetes in HIV-infected patients

Diabetes mellitus (DM) is a common disorder affecting individuals of all ages. Similar to general population, DM can also be seen in HIV infected cases. The prevalence of insulin resistance, glucose intolerance, and diabetes in the HIV-infected population has increased dramatically following the widespread use of highly active antiretroviral therapy (HAART). HIV disease being an important global problem, increasing prevalence of DM among these patients in the HAART era can be expected. Primary care for HIV-infected with reference to DM and follow up for related complications is therefore importan

Cost utility analysis of diagnostic method of syphilis

Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR) and for confirmation, the fluorescent treponemal antibody (FTA) and the treponema pallidum hemagglutination (TPHA) tests. The four alternative modes for diagnosis of syphilis can be a) VDRL + FTA, b) VDRL + TPHA, c) RPR + FTA and d) RPR + TPHA. Here the author reports an evaluation of cost utility of these tests in medical practice. It is shown that the cost per accurate diagnosis with VDRL + TPH is the least expensive choice. Therefore, this alternative is the best method for serological diagnosis for syphilis, based on medical laboratory economics principles

Interaction between cellular retinoic acid-binding protein II and histone hypoacetylation in renal cell carcinoma

Renal cell carcinoma is a rare but serious malignancy. Since a reduction in the level of retinoic acid receptor beta 2 (RARbeta2) expression in cancer cells due in part to histone hypoacetylation which is controlled by histone deacetylase (HD), the study on the interaction between cellular retinoic acid-binding proteins II (CRABP II), which is proposed to have its potential influence on retinoic acid (RA) response, and HD can be useful. Comparing to CARBP II and HD, the CARBP II-HD poses the same function and biological process as HD. This can confirm that HD has a significant suppressive effect on the expression of CARBP II. Therefore, reduction in the level of RARbeta2 expression in cancer cells can be expected and this can lead to failure in treatment of renal cell carcinoma with RA. The author hereby purpose that additional HD inhibitor should be added into the regiment of RA to increase the effectiveness of treatment

A note on the prothrombin time abnormality in the patients with amebic liver abscess

Amebic liver abscess is reported worldwide and can present with a a wide spectrum of clinical manifetations. Similar to the other liver diseases, the prothrombin time abnormality can be seen in the patients with amebic liver abscess. We retrospectively studied the prothrombin times among 30 Thai hospitalized patients with amebic liver abscesses and did not find any correlation between the prothrombin time and any other studied manifestatio

An observation on correlation between rainfall and the prevalence of clinical cases of dengue in Thailand

Background & objectives: An investigation was carried out in Thailand to study the correlationbetween rainfall and prevalence of dengue infection during 2002–03, which can be used for preventionand control of the disease.Methods: Rainfall data (2002–03) collected from Ministry of Public Health were utilised fortransformation of the infection and the rainfall data were derived from Royal Irrigation Department,Thailand. The correlation between the rainfall and the prevalence of dengue was assessed byregression analysis.Results: The least square equation plot prevalence (y) versus rainfall (x) is y = 3.0x + 4.6 (r = 0.78,p < 0.05) (r = 0.68, p < 0.05).Interpretation & conclusion: The study indicated that the prevalence of dengue infection in Thailandmay depend on rainfall. Therefore, the surveillance and control of mosquito should be intensifiedduring the period with high rainfall is recommended. However, the other confounding factors likeambient temperature and humidity which also determine the transmission of dengue should belooked into, before concluding that the increased prevalence is a result of rainfall alone. Further,similar studies to assess the correlation between the rainfall and prevalence of infection in the othercountries are required to confirm these observations

Genetic disorders and malaria in Indo-China region

High prevalence of malaria in Southeast Asia including Thailand is believed to be a major public health problem to the population in this area since time immemorial. Adaptation of the population in this area following the principle of natural selection coupled with genetic disorders can be expected. Some good examples for natural selection of malaria are the co-existence of high prevalence of thalassaemia as well as glucose-6-phosphate dehydrogenase deficiency. In this report, general aspects of some important genetic disorders and malaria in Indo-China area (Thailand, Laos, Cambodia, Myanmar, Vietnam, Yunnan and Manipur) are summarized and discussed

Bone marrow leishmaniasis: a review of situation in Thailand

AbstractLeishmaniasis is an important tropical vector-borne disease. This infection can be seen in tropical area and it is considered to be one of the most important vector-borne infections at present. The general situation of the leishmaniasis in Thailand is hereby reviewed. Although Thailand is a tropical country, the leishmaniasis is not endemic but sporadic. The imported cases are documented in some literatures. The serious form of leishmaniasis, the visceral leishmaniasis is also detectable in Thailand. Also, the author performed an in depth literature review of the reports of bone marrow leishmaniasis, a specific kind of visceral leishmaniasis, in Thailand in order to summarize the characteristics of this infection among Thai patients. According to this review, there have been at least 5 reports in the literature of 6 cases of bone marrow leishmaniasis in the Thai population, of which no case was lethal. Concerning the clinical manifestations, all except had prolonged fever with unknown origin. From physical examination, all had hepatosplenomegaly. The striking findings were active hemophagocytosis with increased proliferation of lymphoidplasma cell line in the bone marrow and amastigotes of Leishmania donovani was demonstrated. Considering the treatment, pantavalent antimony compound was used and the excellent improvement and complete recovery. Finally, the author also discussed on the importance of leishmaniasis in Thailand relating to the present globalization and good traveling system