Exploring the Impact of Combined Thai Yoga and Elastic Band Exercise on Physical Fitness and Exercise Capacity in Older Patients with Type 2 Diabetes

Study purpose. Although it is acknowledged that exercise can positively affect both physical and biochemical markers in older individuals with type 2 diabetes (T2DM), there are still uncertainties about the specific impacts of combining Thai yoga with an elastic band exercise in this population. The objective of the study was to assess the impact of a 12-week program involving Thai yoga combined with an elastic band exercise on the physical fitness and functional exercise capacity among older individuals with T2DM. Materials and methods. A total of 42 participants, consisting of 20 men and 22 women with T2DM and a mean age of 64.6±3.6 years, were randomly assigned to two groups: the control group and the exercise group. The exercise group engaged in a daily regimen of Thai yoga combined with an elastic band exercise for 40 minutes, 5 days a week, over a 12-week period. In contrast, the control group maintained their regular routines. Physical fitness and functional exercise capacity were assessed both before and after the 12-week intervention. Results. The exercise group showed significant reductions in body weight (58.7±11.9 vs. 58.0±12.0 kg), body mass index (24.2±3.0 vs. 23.9±3.0 kg/m2), waist circumference (33.6±3.6 vs. 33.1±3.6 in), and waist-hip ratio (0.90±0.06 vs. 0.89±0.06) (p < 0.001). Additionally, there were notable improvements in physical fitness parameters, including hand grips, back strength, leg strength (p < 0.01), and trunk flexibility (p < 0.001). Functional exercise capacity, indicated by the 6-minute walk test and estimated peak oxygen consumption (p < 0.01), also improved significantly. Conclusions. Thai yoga combined with an elastic band exercise enhances physical fitness and functional exercise capacity in older individuals with T2DM. This improvement has the potential to enhance their cardiopulmonary performance. Consequently, this exercise regimen is considered a health alternative for older individuals with T2DM

The Neuroprotective Effect of Zingiber cassumunar Roxb. Extract on LPS-Induced Neuronal Cell Loss and Astroglial Activation within the Hippocampus

The systemic administration of lipopolysaccharide (LPS) has been recognized to induce neuroinflammation which plays a significant role in the pathogenesis of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. In this study, we aimed to determine the protective effect of Zingiber cassumunar (Z. cassumunar) or Phlai (in Thai) against LPS-induced neuronal cell loss and the upregulation of glial fibrillary acidic protein (GFAP) of astrocytes in the hippocampus. Adult male Wistar rats were orally administered with Z. cassumunar extract at various doses (50, 100, and 200 mg/kg body weight) for 14 days before a single injection of LPS (250 μg/kg/i.p.). The results indicated that LPS-treated animals exhibited neuronal cell loss and the activation of astrocytes and also increased proinflammatory cytokine interleukin- (IL-) 1β in the hippocampus. Pretreatment with Z. cassumunar markedly reduced neuronal cell loss in the hippocampus. In addition, Z. cassumunar extract at a dose of 200 mg/kg BW significantly suppressed the inflammatory response by reducing the expression of GFAP and IL-1ß in the hippocampus. Therefore, the results suggested that Z. cassumunar extract might be valuable as a neuroprotective agent in neuroinflammation-induced brain damage. However, further investigations are essential to validate the possible active ingredients and mechanisms of its neuroprotective effect

Validation of Simple Methods to Select a Suitable Nostril for Nasotracheal Intubation

Background. Nasotracheal intubation is a blind procedure that may lead to complications; therefore, several tests were introduced to assess a suitable nostril for nasotracheal intubation. However, the value of simple tests in clinical practice was insufficient to evaluate. Method. A diagnostic prospective study was conducted in 42 patients, ASA classes I–III, undergoing surgery requiring nasotracheal intubation for general anesthesia. Two simple methods for assessing the patency of nostrils were investigated. Firstly, the occlusion test was evaluated by asking for the patient’s own assessment of nasal airflow during occlusion of each contralateral nostril while in a sitting posture. Secondly, patients breathed onto a spatula held 1 cm below the nostrils while in a sitting posture. All patients were assessed using these two simple tests. Nasal endoscopic examination of each patient was used as a gold standard. Results. The diagnostic value of the occlusion test (sensitivity of 91.7%, specificity of 61.1%, PPV of 75.9%, NPV of 84.6%, LR+ of 2.36, and LR− of 0.14) seemed better than that of the spatula test (sensitivity of 95.8%, specificity of 25.0%, PPV of 63.0%, NPV of 81.8%, LR+ of 1.28, and LR− of 0.17). When both tests were combined in series, the diagnostic value increased (sensitivity of 87.9%, specificity of 70.8%, PPV of 80.1%, NPV of 81.4%, LR+ of 3.01, and LR− of 0.17). Conclusion and Recommendations. The simple occlusion test is more useful than the spatula test. However, combining the results from both tests in series helped to improve the diagnostic value for selecting a suitable nostril for nasotracheal intubation

Comparison of dexmedetomidine and fentanyl to prevent haemodynamic response to skull pin application in neurosurgery: double blind randomized controlled trial

  BACKGROUND: Skull pin application during craniotomy is a highly noxious stimulus. Therefore, the attenuated effect between dexmedetomidine and fentanyl was investigated. METHOD: A randomized, double-blind controlled trial included sixty patients, randomly allocated into groups A and B. After patients entered the operative room, blood pressure and heart rate were measured (T1). At 5 minutes after propofol induction (T2), group A received dexmedetomidine 1 µg kg-1 whereas group B received normal saline. At 3 minutes before skull pin insertion (T3), group B received a single bolus of fentanyl 1 µg kg-1 whereas group A received normal saline. The hemodynamic responses were recorded at 1 minute before skull pin insertion (T4), during skull pin insertion (T5), then repeated every minute for 5 minutes (T6-T10). RESULTS: Controlling blood pressure in the dexmedetomidine group (Group A) was better than in the fentanyl group (Group B) at T4 and T10 (P &lt; 0.05) and T5-T8 (P &lt; 0.01) for systolic blood pressure whereas diastolic blood pressure was significantly different at T4 and T8 (P &lt; 0.05) and T5-T7 (P &lt; 0.01). Mean arterial pressure, also was better controlled in group A at T4 and T10 (P &lt; 0.05) and T5-T8 (P &lt; 0.01). The heart rate in group A was lower than group B at T9 (P &lt; 0.05) and T3-T6 (P &lt; 0.01). Regarding adverse events, 11 hypertensive and 2 hypotensive responses occurred in group B whereas group A just only had 7 incidences of hypotension. CONCLUSION: The attenuated effect of dexmedetomidine infusion is significantly greater than fentanyl infusion.    BACKGROUND: Skull pin application during craniotomy is a highly noxious stimulus. Therefore, the attenuated effect between dexmedetomidine and fentanyl was investigated. METHOD: A randomized, double-blind controlled trial included sixty patients, randomly allocated into groups A and B. After patients entered the operative room, blood pressure and heart rate were measured (T1). At 5 minutes after propofol induction (T2), group A received dexmedetomidine 1 µg kg-1 whereas group B received normal saline. At 3 minutes before skull pin insertion (T3), group B received a single bolus of fentanyl 1 µg kg-1 whereas group A received normal saline. The hemodynamic responses were recorded at 1 minute before skull pin insertion (T4), during skull pin insertion (T5), then repeated every minute for 5 minutes (T6-T10). RESULTS: Controlling blood pressure in the dexmedetomidine group (Group A) was better than in the fentanyl group (Group B) at T4 and T10 (P &lt; 0.05) and T5-T8 (P &lt; 0.01) for systolic blood pressure whereas diastolic blood pressure was significantly different at T4 and T8 (P &lt; 0.05) and T5-T7 (P &lt; 0.01). Mean arterial pressure, also was better controlled in group A at T4 and T10 (P &lt; 0.05) and T5-T8 (P &lt; 0.01). The heart rate in group A was lower than group B at T9 (P &lt; 0.05) and T3-T6 (P &lt; 0.01). Regarding adverse events, 11 hypertensive and 2 hypotensive responses occurred in group B whereas group A just only had 7 incidences of hypotension. CONCLUSION: The attenuated effect of dexmedetomidine infusion is significantly greater than fentanyl infusion.

Appropriate Blood Pressure in Cerebral Aneurysm Clipping for Prevention of Delayed Ischemic Neurologic Deficits

Background. Delayed ischemic neurologic deficit (DNID) is a problem after cerebral aneurysm clipping. Intraoperative hypotension seems to be indicated as a risk factor, but it remains a controversial issue with varying low-blood pressure levels accepted. Methods. A retrospective, hospital-based, case-control study was performed with patients who received general anesthesia for cerebral aneurysm clipping. 42 medical record charts were randomly selected and matched 1 : 2 (1 case with DNID : 2 controls without DNID) based on the type of general anesthetic techniques and severity of subarachnoid hemorrhage. The optimal cutoff points of hemodynamic response were calculated by the area under the curve. Results. Data suggested that the optimal cutoff points for lowest blood pressure for prevention of DNID should be systolic blood pressure (SBP) of 95 mmHg (sensitivity of 78.6%; specificity of 53.6%), diastolic blood pressure (DBP) of 50 mmHg (sensitivity of 71.4%; specificity of 67.9%), and mean arterial pressure (MAP) of 61.7 mmHg (sensitivity of 85.7%; specificity of 35.7%). Furthermore, the optimal cutoff point mean difference baseline blood pressure was recommended as Δ SBP of 36 mmHg (sensitivity of 85.7%; specificity of 60.7%), Δ DBP of 27 mmHg (sensitivity of 92.9%; specificity of 71.4%), and Δ MAP of 32 mmHg (sensitivity of 92.9%; specificity of 85.7%). No significant difference between DNID and non-DNID groups was found for end-tidal carbon dioxide (ETCO2) and has poor diagnostic value for predicting DNID. Conclusion. To prevent DNID, we recommend that optimal blood pressure should not be lower than 95 for SBP, 50 for DBP, and 61.7 mmHg for MAP. Additionally, we suggest that Δ SBP, Δ DBP, and Δ MAP should be less than 36, 27, and 32 mmHg, respectively

Appropriateness of Preoperative Screenings in Patients Undergoing Elective Gynecologic Surgery at Srinagarind Hospital, Khon Kaen University, Thailand: An observational study

Objectives: To evaluate the appropriateness of routine preoperative screening for patients who undergoing elective major gynecologic surgery at a tertiary care university hospital, Khon Kaen Province based on the hospital guideline.Materials and Methods: This retrospective descriptive study reviewed 808 medical records of gynecologic patients undergoing elective surgery in 2014.results: The mean age of the patients was 44.2 years. Approximately 36% of patients had associated co-morbidity. Almost 90% of the patients had inappropriate screening tests. Complete blood count and chest x-ray were the two most appropriate screening test. The most inappropriate tests were urinalysis and fasting blood sugar. Patients were classified into 4 groups: 1) patients < 45 years old with no underlying conditions; 2) patients < 45 years old with at least one underlying conditions; 3) patients ≥ 45 years old with no underlying conditions and 4) patients ≥ 45 years old with at least one underlying conditions. The first group had highest rate of performing inappropriate preoperative tests with blood urea nitrogen/creatinine as the most overuse test. The costs of inappropriateness preoperative tests were 39.8% of the total costs of preoperative assessment.Conclusion: Almost 90% of the patients had inappropriate screening tests which increased the cost by about 40%. Hospital administrators should find appropriate mechanisms to reinforce doctors to strict their requests for only tests that are necessary