bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence of unrecognized congenital heart disease among healthy elementary school students in northern Thailand
Authors: Sayasathid Jarun , Supachokchaipattana Pentip , Pipatvech Kraminee , Sukonpan Kanchapan , Somboonna Naraporn , Pannarunothai Supasit 
Published: April 2018

Abstract
Background: Congenital heart disease (CHD) is one of the major congenital anomalies among newborns. Although many infants with CHD are symptomatic and identified soon after birth, others remain undiagnosed until the disease becomes severe. Objectives: Unravel the number of CHD cases among 7-12 years old students who reported neither clinical complication nor history about cardiac diseases, stressing the importance for regular cardiac examination in children, even if they appeared healthy. Methods: The study selected students without clinical history of heart disease from 1,041 elementary schools in northern Thailand (Tak, Nakhon Sawan and Uttaradit). Certified nurses and health officers examined the students for abnormal heart conditions. Pediatric cardiologists scrutinized the students with suspected CHD for confirmation and characterization of cardiac lesion types. Results: Out of 144,293 students included in the study, 851 students showed atypical heart symptoms, and 87 were verified to have the CHD. This conferred the prevalence rate of unrecognized CHD among the elementary school children to be 0.60 per 1,000. The frequently-detected heart defects were ventricular septal defect (41.4%) and pulmonary stenosis (16.1%). Fifty-one children (58.6%) required surgery for cardiovascular correction. The prevalence of the CHD in elementary school students ranged from 0.41 to 1.05 cases per 1000 study subjects. The greatest number of incidences was found in Tak province where medical resources are inadequate. Conclusion: This study highlights the significance of routine cardiac examination among school-aged students, particularly in the regions with limited medical facilities, providing information essential for appropriate health care planning and managements.
Novel genetic marker in TGFB2 gene associated with expression of TGF-β2 in leukocyte and SLE susceptibility
Authors: Hirankarn Nattiya , Hemwijit Krongkamol , Benjachat Thitima , Avihingsanon Yingyos 
Published: April 2018

AbstractBackground: TGF-β2 has a role in immune regulation, and genetic variance within the gene might contribute to systemic lupus erythematosus (SLE) pathogenesis. The TGFB2 gene is one candidate gene within the major SLE genetic susceptibility loci. Objective: Investigate the TGFB2 gene located on chromosome 1q41 as a SLE susceptibility gene. Materials and methods: One hundred fifty three SLE patients and 133 healthy controls participated in this study. Four markers selected in two haplotype blocks that have a minor allele frequency greater than 5% in Thai population were genotyped and analyzed in the association study. Results: There was no significant association between SLE susceptibility and the polymorphism in the promoter area (+67_68insACAA) and +89835 (A/G) at the intron 5 of TGFB2 gene. Instead, minor allele of the two new genetic markers at the intron 1 (+720) (corrected p-value = 0.024, OR = 0.4141, 95%CI = 0.22-0.80) and intron 6 (+94399_94400) (corrected p-value = 0.000143, OR = 0.3367, 95%CI = 0.20-0.58) were independently associated as a protective factor to SLE. Additionally, the real time RT-PCR results showed that patients with the protective allele (minor allele) at the +94399_94400 position have higher TGF-β2 mRNA level in leukocytes than patients with the risk allele (p=0.011). Conclusion: Two new genetic markers at intron1 (+720) and intron 6 (+94399_94400) were independently associated with SLE. The observed results have to be confirmed in other populations with a large sample size.
Co-expression of human malaria parasite Plasmodium falciparum orotate phosphoribosyltransferase and orotidine 5’-monophosphate decarboxylase as enzyme complex in Escherichia coli: a novel strategy for drug development
Authors: Kanchanaphum Panan , Krungkrai Jerapan 
Published: April 2018

AbstractBackground: Human malaria parasite Plasmodium falciparum operates de novo pyrimidine biosynthetic pathway. The fifth and sixth enzymes of the pathway form a heterotetrameric complex, containing two molecules each of orotate phosphoribosyltransferase (OPRT) and orotidine 5’-monophosphate decarboxylase (OMPDC). Objective: Define the function of OPRT-OMPDC enzyme complex of P. falciparum by co-expressing the enzymes in Escherichia coli. Methods: The constructed plasmids containing either P. falciparum OPRT or OMPDC were cloned in E. coli by co-transformation. Both genes were co-expressed as OPRT-OMPDC enzyme complex and the complex was purified by chromatographic techniques, including N2+-NTA affinity, Hi Trap Q HP anion-exchange, uridine 5’- monophosphate affinity, and Superose 12 gel-filtration columns. Physical and kinetic properties of the enzyme complex were analyzed for its molecular mass. Results: Co-transformation of PfOPRT and PfOMPDC plasmids in E. coli were achieved with a clone containing DNA ratio of 1:2, respectively. Both plasmids remained stable and were functionally expressed in the E. coli cell for at least 20 weeks. The P. falciparum OPRT-OMPDC enzyme complex were co-expressed and the complex was co-eluted in all chromatographic columns during purification and physical analysis. The molecular mass of the complex was 130 kDa, whereas the PfOPRT and PfOMPDC component were 35.6 and 41.5 kDa, respectively. The enzymatic activities of the complex were competitively inhibited by their products of each enzyme component. Conclusion: P. falciparum OPRT and OMPDC in E. coli as an enzyme complex were co-transformed and functionally co-expressed. These have similar properties to the native enzyme purified directly from P. falciparum, and this character is different from that of the human host organism. The enzyme complex would be suitable as new target to research selective inhibitors as suitable drugs to better control this disease.
Intranasal location of lacrimal sac in Thai cadavers
Authors: Tanamai Napas , Ratanaanekchai Teeraporn , Thanaviratananich Sanguansak , Chaisiwamongkol Kowit , Chantaumpalee Thanarat 
Published: April 2018

AbstractBackground: Many current literatures have described that the lacrimal sac is located just anterior to the anterior attachment (axilla) of the middle turbinate. However, there was no data on the exact boundary of the sac, especially the distance related with a permanent landmark such as the middle turbinate attachment. Objective: Determine the intranasal location of the lacrimal sac related to the middle turbinate attachment in Thai fresh cadavers. Methods: The study was performed in 26 Thai fresh cadavers, donated to Khon Kaen University, Thailand between July 2006 and July 2007. The height and width of the lacrimal sac were recorded, as well as the distances from the upper, lower, anterior and posterior border of the lacrimal sac to the axilla of the middle turbinate were measured. Results: The mean height and width of 52 lacrimal sacs were 11.2 and 6.2 mm. The mean distances from the upper, lower, anterior, and posterior border of lacrimal sac to the axilla of the middle turbinate were 4.9 mm (95%CI=4.4-5.4), 5.6 mm (95%CI=5.1-6.1), 3 mm (95%CI=2.4-3.6), and 2.9 mm (95%CI=2.3-3.5), respectively. The upper border of all lacrimal sacs were located superior to the axilla of the middle turbinate (95%CI=93.1-100), and posterior border of 44 sacs (85%, 95%CI=72.5-92.0) were located posterior to the axilla. Additionally, the anterior wall did not extend anterior to the anterior attachment of the middle turbinate in 21% of the sac. Conclusion: This study revealed the more exact intranasal location of lacrimal sacs. This is useful for surgeons to perform adequate endoscopic dacryocystorhinostomy to prevent postoperative lacrimal sump syndrome.
Effect of omeprazole, rabeprazole, and rebamipide on the accuracy of urea breath test in patients with Helicobacter pylori infection
Authors: Thong-Ngam Duangporn , Chayanupatkul Maneerat , Thongbai Thirada 
Published: April 2018

Abstract
Background: The urea breath test (UBT) has been widely used for H. pylori eradication after treatment. The breath test could be adversely affected by various factors including proton pump inhibitors (PPIs) that are also used in the therapy for H. pylori infection. Objective: Determine the effect of omeprazole, rabeprazole and the mucoprotective agent rebamipide, on the UBT. Methods: Fifty-six patients with dyspepsia and positive for H. pylori by rapid urease test were enrolled. They were classified into three groups: Group 1 (n=25) received omeprazole 20 mg once daily, group 2 (n=13) received rabeprazole 20 mg once daily, and group 3 (n=18) received rebamipide 100 mg three times a day. All patients received a 14-day course of their medications. UBT was performed on day 0 as a baseline and on day 14 in all patients. In patient with negative results of UBT on day 14, the UBT was performed in consecutive week until the test became positive. Results: Fifty-six patients (20 men and 36 women) participated in the study. Their mean age was 46.77±14.3 years. False negative rate after 14-day treatment in omeprazole, rabeprazole and rebamipide group were 20.0%, 30.8%, and 0% respectively. There was a significant difference between 13C level in patients with negative and positive UBT results (2.7±0.7 vs.22.9±3.7/mL, p=0.025). The reversal of false negative to true positive tests occurred within two weeks after discontinuation of omeprazole and rabeprazole. Conclusion: Proton pump inhibitors had an effect on the accuracy of H. pylori detection using UBT. Rabeprazole revealed a higher false negative rate in the UBT than omeprazole. The mucoprotective drug, rebamipide, did not influence negative results in the UBT.
Modeling tuberculosis incidence in Nepal
Authors: Kakchapati Sampurna , Yotthanoo Sulawan , Choonpradup Chamnein 
Published: April 2018

Abstract
Background: Tuberculosis (TB) constitutes a large burden of infectious disease in Nepal. Objective: Model incidence of TB between 2003 and 2008 in Nepal. Methods: A retrospective study was conducted in Nepal of tuberculosis incidence by gender and location over the six years period. Data were obtained for 198,719 tuberculosis cases from the Nepal Tuberculosis Center (NTC). A negative binomial model with two multiplicative components as predictors was used and provided a good fit. Results: The model extracted a decreasing trend during the first five years followed by a drop in 2008.The overall incidence of TB was 1.31 cases per 1,000 population with a male to female incidence rate ratio of 1.86. There were pronounced spatial variations with higher rates occurring in the Terai region, followed by the Hill, and Mountain regions. Conclusion: Tuberculosis incidence showed a steady decreasing trend, but the number of cases was still very high. Gender differences existed in TB incidence in Nepal. Higher rates were observed in the Terai Region and urban areas. These findings highlight the need for the tuberculosis control measures to remain on a sustained and long-term basis for the high TB burden rate of Nepal.
Association of high sensitivity C-reactive protein concentrations and metabolic syndrome among Thai adults
Authors: Hillman Andrew J. , Lohsoonthorn Vitool , Hanvivatvong Orrawadee , Jiamjarasrangsi Wiroj 
Published: April 2018

Abstract
Background: Limited information is available regarding associations of metabolic syndrome with C-reactive protein (CRP) concentrations among Asian populations. Objective: Investigate the association of high sensitivity CRP (hsCRP) concentrations and metabolic syndrome among Thai adults. Methods: This cross-sectional study was comprised of 467 Thai participants (209 men and 258 women) receiving annual health check-up. Spearman’s rank correlation coefficients were used to assess the associations between metabolic parameters (age, waist circumference, blood pressure, triglycerides, HDL-C, fasting plasma glucose, fasting insulin and uric acid) with hsCRP concentrations for men and women, respectively. Multivariable logistic regression procedures were used to estimate the risk (odds ratios (OR), and 95% confidence intervals (CI) of metabolic syndrome according to low, moderate, and high hsCRP concentrations (<1.0, 1.0-3.0, and >3.0 mg/L, respectively). Results: Measures of adiposity and fasting insulin were positively and significantly correlated with hsCRP concentrations among women with and without metabolic syndrome. Similar associations were observed among men without metabolic syndrome. After controlling for confounders, moderately elevated hsCRP concentrations were associated with a 2.38-fold increased risk of metabolic syndrome (OR=2.38, 95%CI=1.20-4.72) among men. Men with high hsCRP concentrations had a 5.45-fold increased risk of metabolic syndrome (OR=5.45, 95%CI=2.24- 13.27) when compared with those who had low hsCRP concentrations. The corresponding OR for women with moderately elevated and high hsCRP concentrations were 4.92 (OR=4.92, 95%CI=2.34-10.35) and 11.93 (OR=11.93, 95%CI=5.54-25.72), respectively. Conclusions: These findings are consistent with the literature suggesting a role of hsCRP as a biomarker for metabolic syndrome.
Stapes fixation surgery: stapedectomy versus stapedotomy
Authors: Thamjarayakul Taweekiat , Supiyaphun Pakpoom , Snidvongs Kornkiat 
Published: April 2018

Abstract
Background: Stapedectomy and stapedotomy are the standard techniques for stapes fixation surgery. Both techniques depend on the size of window opening (total, partial stapedectomy and small-hole stapedotomy) and the type of prosthesis used. Outcome of technique and prosthesis are controversy. Objective: Evaluate the outcomes of the two surgical techniques (stapedectomy/stapedotomy) and two sizes of prosthesis (Cawthorn 0.6mm/0.3mm) in terms of effectiveness and safety. Material and methods: Sixty-four medical records of patients undergoing stapedectomy or stapedotomy between the year 1995 and 2005 were reviewed. The subjects were classified into three groups including 0.6-mm stapedectomy, 0.6-mm and 0.3-mm stapedotomy group. The pre and post operative air-conduction threshold (AC) and air-bone gap (A-B gap) were compared for each group. The pre-and post-operative differences in pure tone average of AC, pure tone average of bone conduction threshold (BC), AB gap, AC at 4KHz, BC at 4KHz, AC at 8KHz, and speech discrimination score (SDS) were analyzed. The surgical complications were also compared. Results: Means of post-operative AC, and A-B gap were significantly better in all three groups. The mean of postoperative AC at 4KHz was significantly improved only in stapedotomy groups (0.6-mm and 0.3-mm stapedotomy). To compare the hearing outcomes among the three groups, there were no statistically significant differences between 0.6-mm stapedectomy vs. 0.6-mm stapedotomy, and between 0.6- mm vs. 0.3-mm stapedotomy. The complications were found in all three groups. The 0.3-mm stapedotomy had the lowest rate. Conclusion: Stapedectomy versus stapedotomy yields comparable hearing outcomes but stapedotomy results had a better success rate than the stapedectomy. For 0.6-mm stapedotomy vs. 0.3-mm stapedotomy, the overall results in both groups are not significantly different, in terms of both the hearing outcomes and the success rate. In terms of complication rate, 0.6-mm stapedectomy had the highest rate, while 0.3-mm stapedotomy had the lowest.
Safety and efficacy of a new imidazole fungicide, Sertaconazole, in the treatment of fungal vulvo-vaginitis: a comparative study using Fluconazole and Clotrimazole
Authors: Roongpisuthipong Anuvat , Chalermchockcharoenkit Amphan , Sirimai Korakot , Wanitpongpan Prapat , Jaishuen Atthapon , Foongladda Suporn , Kongkergkiat Nisit , Prymanee Jeerawan 
Published: April 2018

Abstract
Background: Sertaconazole is a new imidazole fungicide introduced for vulvo-vaginal candidiasis. It has an azole group with benzothiophene that inhibits biosynthesis of ergosterol and brings about a massive leak of cytoplasm with consequent fungal cell death. Objective: Assess the safety and efficacy of Sertaconazole in the treatment of fungal vulvo-vaginitis for comparison with Fluconazole and Clotrimazole. Subjects and methods: One-hundred eighty-eight outpatients with fungal vulvo-vaginitis were recruited at Siriraj Hospital, Thailand between August 31, 2004 and January 30, 2006. The patients were given Sertaconazole, Fluconazole, or Clotrimazole, and received vaginal swab and culture for fungus at seventh and 28th days after treatment. Results: Out of 188 cases, 177 cases were followed-up completely. Sertaconazole group included 66 cases where 35 cure, 20 fail, and 7 recurrent cases. Fluconazole group included 60 cases and had 37 cure, six fail, and 20 recurrence cases. Clotrimazole group included 55 cases and had 32 cure, nine fail and 11 recurrent cases. There were risk factors of fungal vulvo-vaginitis, including frequent micturition and small toilet shower flushing. Conclusion: Sertaconazole had similar effectiveness and less side-effect as compared with Fluconazole and Clotrimazole. It appeared to work well with lowest recurrence.
Postoperative opacification of polymethylmethacrylateintraocular lens
Authors: Thanathanee Onsiri , Ratanapakorn Tanapat , Suwan-apichon Olan 
Published: April 2018

Abstract
Background: Opacification of ophthalmic devices has been previously reported in silicone scleral buckle, Molteno implant, and intraocular lens opacification. However, there is no report on polymethyl methacrylate (PMMA) intraocular lens (IOL) calcification. Objective: Report the clinical feature, histopathologic and spectrophotometer analysis of opacified three-piece PMMA IOL. Method: A 60-year-old diabetic patient reported decreased visual acuity in her right eye, which had undergone phacoemulsification with PMMA IOL implantation. The ophthalmic examination revealed a white homogeneous opacification of posterior surface of the IOL. The explanted IOL was analyzed using scanning electron microscopy, energy dispersive spectroscopy, and alizarin red staining. Results: The scanning electron microscope analysis showed granular deposits on posterior surface of the IOL. Using energy dispersive spectroscopy analysis, calcium and phosphate peaks were revealed, which was confirmed by positive for alizarin red staining. Conclusion: This case report provided evidence of PMMA IOL calcification caused by calcium and phosphate deposits. The possible etiologies were extrinsic and/or intrinsic factors.
d4T: keep it or abandon it?
Authors: Hill Andrew 
Published: April 2018

AbstractStavudine is a nucleoside analogue used widely for first-line treatment of HIV in developing and middleincome countries. The World Health Organization recommended that all patients should switch to stavudine (30mg BID). However, there is evidence from the dose-ranging trials that patients with body weight below 60kg should use a dose of 20mg BID. For patients who show adverse events on stavudine, a switch to other nucleoside analogues can be considered. This article reviews d4T to study if it should be kept or abandoned.
Cost-effectiveness of budesonide/formoterol maintenance and rescue therapy in Thailand
Authors: Boonsawat Watchara 
Published: April 2018

AbstractBackground: The prevalence of asthma has increased significantly in Thailand. Budesonide/formoterol maintenance and reliever therapy has been available for several years. However, cost-effectiveness of such treatment has never been examined in Thailand. Objective: Design a cost-effectiveness (CE) analysis conducted from a Thai healthcare perspective as a piggyback study accompanying a recent clinical trial. Methods: The CE analysis was conducted from the healthcare provider’s perspective. Data were collected from a six-month, double-blind, multi-national study involving 3321 symptomatic asthma patients randomized to either: bud/form maintenance and reliever therapy, bud/form 320/9 μg bid plus terbutaline as needed, or salmeterol/ fluticasone (salm/flut) 25/125 μg two inhalations bid plus terbutaline as needed. Efficacy was determined as the number of exacerbations per patient during a six-month period. Thai unit costs were collected from the national sources and expert opinions, and applied to the resource use data for a deterministic economic evaluation. Results: There were significantly fewer exacerbations in the bud/form maintenance and reliever therapy (0.12 events/patient/6 months) group vs. the bud/form (0.16 events/patient/6 months, p <0.01), or salm/flut groups (0.19 events/patient/6 months, p <0.001). Total direct costs (healthcare visits and drug costs) were 27.0% and 5.9% lower in the bud/form maintenance and reliever therapy group than in the bud/form and salm/flut groups, respectively. Conclusion: Bud/form maintenance and reliever therapy was associated with significantly fewer exacerbations, compared to other fixed combination treatments in a recent multi-national clinical trial. This might result in lower direct costs if applied to the Thai healthcare system.
Anterior displacement of anus: a common association with constipation in infancy
Authors: Rerksuppaphol Sanguansak , Rerksuppaphol Lakkana 
Published: April 2018

AbstractBackground: Anterior displacement of the anus (ADA), a common congenital abnormality of anorectal region, has been recognized as a common cause of constipation. However, the more recent studies have failed to demonstrate an association between the anterior displacement and constipation self. Objective: Investigate the association between ADA and constipation. Methods: Four hundred and three neonates have been examined and their anal position index (API) has been determined. API less than 0.46 and 0.34 in males and females, respectively, is defined as ADA. A 6-month prospective cohort study has been conducted to evaluate the association between ADA and constipation. Results: Overall incidence of ADA is 24.8%, while the incidence is significantly higher in females than males (32.0% and 17.7%, respectively; p <0.01). Compared to the first child, later birth order, especially the second child, trends to have an increased risk of ADA (Odd ratio=1.75; 95%CI=1.06-2.90). Average maternal age of ADA is higher than control (28.2 and 26.6 years, respectively; p=0.02). Overall incidence of constipation is 10.1% without any difference between ADA group and control (12.0 and 9.5%, respectively). Nevertheless, at six months incidence of constipation is higher in ADA than in control (6.7% and 0.8%, respectively; p < 0.01). The incidences of ADA in infants with constipated events at 2, 4 and 6 months of age are 10.0%, 33.3%, and 71.4%, respectively. Conclusion: ADA is a common finding with reported incidence of one-quarter of neonates. Female genre, later birth order and higher maternal age are risk factors of ADA. Children with ADA have an increased tendency toward constipation corresponding with increasing age. API measurement during pediatric examination is recommended to achieve a complete evaluation of infancy constipation.