bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of rabies immune globulin in seven urban emergency rooms in Pakistan
Authors: Salahuddin Naseem , Mubashar Khadija , Baig-Ansari Naila 
Published: August 2015

Abstract
Background: Human rabies is a fatal infectious disease that is entirely preventable if correct and timely postexposure prophylaxis is given. Unfortunately, rabies immune globulin (RIG) administration, a life-saving biological, is often avoided by Emergency Room health care providers (HCPs).
Objective: To understand the practices of HCPs for administration of RIG in severe dog-bite exposures, which are common causes of emergency room visits in Pakistan.
Methods: A cross-sectional study was conducted among 103 HCPs working in seven hospitals in three cities of Pakistan.
Results: Of 103 HCPs who responded to the questionnaires, 97.1% had administered rabies vaccine and 31.1% had administered ERIG in the past three years of their practice; three quarters said they would prefer to use HRIG if available; 35% said they would not inject wounds at all, 24.3% would only vaccinate a patient with severe dog bites, but not administer RIG. More than 55% were concerned about the cost of human and equine RIG.
Conclusion: Although there is awareness about use of RIG, this life saving biological is grossly underused because of poor availability in Emergency Rooms (ERs) even though stocked by local dealers. Animal bite centers must make RIG available for severe exposures.
Using a 360-degree assessment of pediatric residency training: experience at Prince of Songkla University, Thailand
Authors: Jaruratanasirikul Somchit , Khotchasing Wassana 
Published: August 2015

Abstract
Background: The Department of Pediatrics, Prince of Songkla University (PSU) with 7-10 pediatric residents per year has implied a 360-degree evaluating instrument for residency training since 2007.
Objective: We determined the competency ratings of pediatric residents during their training.
Methods: During 2007-2011, 23 pediatric residents finished the pediatric residency program. At each ward rotation, each pediatric resident was rated for competency skills by four different categories of raters: attending staff, nurses, medical students, and the patients’ parents. The average score of each competency given by each category of raters was calculated, and was compared to scores of multiple-choice questions (MCQ) and constructed response questions (CRQ) of Thai Board of Pediatric Examination.
Results: The mean overall scores of each resident rated by the attending staff, nurses, medical students, and patients’ parents increased with year of residency training. The mean overall scores of each resident rated by attending physicians were positively correlated with the MCQ (r = 0.42, p = 0.04) and CRQ (r = 0.71, p < 0.001) scores of the Thai Board of Pediatrics Examination.
Conclusion: The 360-degree assessments with ratings by attending physicians during the pediatric training are reliable for assessment the medical knowledge of the residents.
Behcet’s disease: from heat shock proteins to infections
Authors: Dabbagh Fatemeh , Haghighi Afshin Borhani , Ghasemi Younes 
Published: August 2015

AbstractBackground: Behcet’s disease (BD) is a chronic, inflammatory multisystemic condition of unknown etiology. Although the cause of BD is not clear, it is believed to be the result of an autoimmune process triggered by an infectious or environmental agent (possibly local to a geographic region) in a genetically predisposed individual.Objective: To detail current knowledge of the role of microorganisms in the pathogenesis of BD and review the infectious etiology of this disease.Methods: The review based on publication in SCOPUS, Science direct, and PubMed.Results: A microbial infection has been implicated in the development of the disease to explain the strong inflammatory reactions observed, the activation of monocytes and macrophages, and the induction of proinflammatory cytokines and chemokines detected. Common factors linking some of the possible pathogenetic agents are extrinsically induced tissue stress or heat shock proteins, which react with host tissues and elicit significant T-helper type 1 cell responses.Conclusion: Based on collected data, we conclude that the microorganisms discussed seem to participate and, at least in part, act as triggers during the course of BD. By clarifying the microbial associations of BD and finding its etiology, particularly the causative antigens leading to BD, it would be easier to suggest more effective treatment and preventive strategies for this disease.
Improved insulin sensitivity, central systolic pressure and inflammatory indicators achieved with minor weight reduction in overweight and obese subjects given education on lifestyle modification
Authors: Ariffin Farah Diana , Ismail A. A. A. , Sean Vina Tan Phei , Yusoff Zurkurnai , Awang Siti Azima , Rani Wan Rimei Wan Abdul , Rasool Hanum Ghulam 
Published: August 2015

Abstract
Background: Obesity is a global epidemic disease; lifestyle modification is an approach in the prevention and management of obesity.
Objective: We determined the effects of education on modified lifestyle intervention on arterial stiffness, metabolic and inflammatory markers.
Methods: Twenty-five generally healthy overweight and obese subjects completed nine months education on modified lifestyle intervention at Hospital Universiti Sains Malaysia, Kota Bharu. Subjects were regularly counselled to increase physical activity and modify their diet during intervention. Arterial stiffness was measured noninvasively using carotid femoral pulse wave velocity (PWV) and pulse wave analysis (PWA). Anthropometric measurements, body fat percentage and visceral fat, central and brachial blood pressures, lipid profile, the inflammatory marker high sensitivity C-reactive protein (hsCRP) and insulin sensitivity were also recorded.
Results: After nine months, a significant weight loss of 2.2 kg was observed associated with significant reductions in waist and hip circumference, aortic systolic blood pressure, serum fasting insulin, insulin resistance, and hsCRP levels. Insulin sensitivity was increased, while body fat and visceral fat percentages were marginally reduced (p = 0.058 and p = 0.059). No significant differences were seen in arterial stiffness, fasting plasma glucose and lipid profile.
Conclusion: Education on modified lifestyle intervention improved insulin sensitivity and resistance, reduced hsCRP and aortic systolic blood pressure despite the small weight reduction achieved.
Prognostic significance of p16, p53, Bcl-2, and Bax in oral and oropharyngeal squamous cell carcinoma
Authors: Thongsuksai Paramee , Pruegsanusak Kowit , Boonyaphiphat Pleumjit 
Published: August 2015

Abstract
Background: The proteins p16, p53, Bcl-2, and Bax are important cell cycle and apoptotic regulators involved in carcinogenesis and found to have prognostic significance in various cancers. However, the data for squamous cell carcinoma of oral cavity (OSCC) and of oropharynx (OPSCC) are conflicting.
Objective: We sought to determine if expression of p16, p53, Bcl-2, and Bax expression are associated with 5-year overall survival (OS) of patients with OSCC and OPSCC.
Methods: One-hundred thirty-seven cases of OSCC and 140 cases of OPSCC diagnosed from January 2002 to December 2004 at Songklanagrind Hospital, Songkhla, Thailand, were analyzed using a Cox proportional hazards model for 5-year OS in relation to immunohistochemical detection of Bcl-2, Bax, p53, and p16 proteins.
Results: The frequencies of p16, p53, Bcl-2, and Bax expression in OSCC were 13%, 45%, 4%, and 66%, and in OPSCC were 18%, 53%, 22%, and 75%, respectively. In univariate analysis, clinical variables including T stage, N stage and treatment were significantly associated with survival. In multivariate Cox regression, Bax overexpression was significantly associated with poor survival both in OSCC (HR 1.77, 95% CI 1.04-3.01) and in OPSCC (HR 2.21, 95% CI 1.00-4.85). We found no significant association of p16, Bcl-2, and p53 expression with survival.
Conclusion: The expression pattern of p16, p53, Bcl-2, and Bax are similar in OSCC and OPSCC. Only Bax expression has prognostic significance for both tumor sites.
Phylogenetic analysis of the king cobra, Ophiophagus hannah in Thailand based on mitochondrial DNA sequences
Authors: Suntrarachun Sunutcha , Chanhome Lawan , Sumontha Montri 
Published: August 2015

Abstract
Background: Snakes possess adaptive characteristics of morphology that may result in incorrect reconstruction of phylogeny. Molecular approaches have become the major source of new information for advancing our understanding of evolutionary, genetic relationships, and species identification.
Objective: We studied DNA sequences of Ophiophagus hannah in different parts of Thailand and compared them with those of O. hannah from other countries.
Materials and Methods: We studied the mitochondrial NADH dehydrogenase subunit 2 (ND2) and control region (CR) sequences of 12 individuals O. hannah from different localities across Thailand. Phylogenetic analysis of DNA sequences were compared to the published sequences of O. hannah deposited in NCBI GenBank database from other countries.
Results: O. hannah could be categorized into 2 Clades, 5 haplotypes, and 4 localities based on 43 different nucleotide positions from the 736 bp of ND2 and 673 bp of CR. Clade A was haplotype A from southern Thailand. Clade B consisted of haplotypes B, C, D, and E. Haplotype B and C came from northern Thailand. Haplotype D came from western Thailand, while haplotype E was O. hannah from central Thailand. The DNA sequences of Clade B were similar to the sequences of O. hannah in Myanmar and southern China that are already deposited in NCBI GenBank database.
Conclusion: We found a different genotype of O. hannah from southern Thailand and suggest that this may be a new species of O. hannah.
Original article. Nurse-controlled analgesia for postoperative pain in pediatric patients: effects on nurses’ attitudes and patient care
Authors: Suraseranivongse Suwannee , Wattanaamornkiet Parichart , Sanansilp Vimolluck , Srikwan Napamas , Termtor Somluck , Kaewchinda Umaporn , Chianvichai Saovanee 
Published: August 2015

AbstractBackground: Because of the limited number of patient-controlled analgesia (PCA) pumps in our developing country, we proposed a technique of modified nurse-controlled analgesia (NCA) to relieve postoperative pain in pediatric patients.Objective: We assessed efficacy, safety, compliance by nurses, and satisfaction including parent satisfaction of a modified NCA protocol compared with fixed-dose analgesia conventionally used for postoperative pain relief in pediatric patients.Methods: A prospective study design was conducted in pediatric patients who underwent major surgery in a university hospital. In the pre-NCA phase, patients received a conventional fixed-dose opioid after surgery. In the NCA phase, nurses could initiate two additional small doses autonomously, as prescribed, if the initial bolus was inadequate. Outcome measures were the number of moderate to severe pain scores, respiratory depression, compliance by nurses, and parent satisfaction.Results: There were 117 and 113 patients in the pre-NCA and NCA phases, respectively. Detection of moderate to severe pain ≥2 episodes in 24 h after surgery was significantly higher in the NCA phase especially in moderate to severe pain procedures. Respiratory depression was not found in either phase. The majority of nurses showed positive attitudes to routine use of a modified NCA protocol. Parent satisfaction was high in both groups.Conclusion: The attitude of nurses toward the modified NCA protocol was positive and it significantly increased detection of episodes of moderate to severe postoperative pain, which accordingly increased patient care and pain relief without severe untoward effects.
Original article. Biting behavior of Malaysian mosquitoes, Aedes albopictus Skuse, Armigeres kesseli Ramalingam, Culex quinquefasciatus Say, and Culex vishnui Theobald obtained from urban residential areas in Kuala Lumpur
Authors: Chen Chee Dhang , Lee Han Lim , Lau Koon Weng , Abdullah Abdul Ghani , Tan Swee Beng , Sa’diyah Ibrahim , Norma-Rashid Yusoff , Oh Pei Fen , Chan Chi Kian , Sofian-Azirun Mohd 
Published: August 2015

Abstract
Background: There are several species of mosquitoes that readily attack people, and some are capable of transmitting microbial organisms that cause human diseases including dengue, malaria, and Japanese encephalitis. The mosquitoes of major concern in Malaysia belong to the genera Culex, Aedes, and Armigeres.
Objective: To study the host-seeking behavior of four Malaysian mosquitoes commonly found in urban residential areas in Kuala Lumpur.
Methods: The host-seeking behavior of Aedes albopictus, Armigeres kesseli, Culex quinquefasciatus, and Culex vishnui was conducted in four urban residential areas in Fletcher Road, Kampung Baru, Taman Melati, and University of Malaya student hostel. The mosquito biting frequency was determined by using a bare leg catch (BLC) technique throughout the day (24 hours). The study was triplicated for each site.
Results: Biting activity of Ae. albopictus in urban residential areas in Kuala Lumpur was detected throughout the day, but the biting peaked between 0600-0900 and 1500-2000, and had low biting activity from late night until the next morning (2000-0500) with biting rate ≤1 mosquito/man/hour. Biting behavior of Ar. kesseli was distinctly crepuscular, which exhibited two peaks of activity at 0600-0700 and 1900-2000, while Culex quinquefasciatus and Cx. vishnui were nocturnal feeders with multiple biting peaks throughout the night.
Conclusion: This study recommends optimal time for fogging to be conducted in Malaysia and neighboring countries according to the peak biting peak obtained.
Original article. Repeatability assessment of the New Numbers Contrast Sensitivity Chart
Authors: Khambhiphant Bharkbhum , Chansangpetch Sunee , Tulvatana Wasee , Busayarat Mathu 
Published: August 2015

Abstract
Background: The validity and agreement of the New Numbers Contrast Sensitivity Chart with the original Mars chart have been found to be good. The two charts can be used interchangeably; however, evidence of the repeatability of the new chart remains to be sought. This study was to assess the repeatability of the New Numbers Contrast Sensitivity Chart.
Objectives: We assessed the repeatability of the Numbers Contrast Sensitivity Chart.
Methods: Two hundred subjects from the ophthalmic clinic of the King Chulalongkorn Memorial Hospital, who were able to communicate and read Arabic numerals were recruited. The contrast sensitivity (CS) scores were collected by reading the same Numbers Contrast Sensitivity Chart in the same environment with each eye and both eyes ten minutes apart. The repeatability of the CS score was assessed by Bland-Altman plot analysis.
Results: The visual acuity of subjects with variety in diagnoses ranged from 20/480 to 20/20. The mean differences were -0.006, -0.008, -0.002 log CS and the coefficients of repeatability were 0.155, 0.141, and 0.093 for the right eye, left eye, and both eyes, respectively. The plots showed a narrow range of 95% limit of agreement, which were (+0.146, -0.159) in the right eye, (+0.130, -0.147) in the left eye, and (+0.089, -0.093) in both eyes.
Conclusions: The New Numbers Contrast Sensitivity Chart has good repeatability. With proven good validity and repeatability, this easy and convenient numbers chart is beneficial for practical use in a clinical setting where English is not used as the primary language.
Original article. Cost-effectiveness of annual microalbuminuria screening in Thai diabetics
Authors: Srisubat Attasit , Sriratanaban Jiruth , Ngamkiatphaisan Sureerat , Tungsanga Kriang 
Published: August 2015

AbstractBackground: Diabetes is a leading cause of end stage renal disease (ESRD), which impacts on treatment costs and patients’ quality of life. Microalbuminuria screening in patients with diabetes as an early intervention is beneficial in slowing the progression of diabetic nephropathy.Objectives: We aimed to assess the cost-effectiveness of annual microalbuminuria screening in type 2 diabetic patients.Methods: We compared screening by urine dipsticks with a “do nothing” scenario. To replicate the natural history of diabetic nephropathy, a Markov model based on a simulated cohort of 10,000 45-year-old normotensive diabetic patients was utilized. We calculated the cost and quality of life gathered from a cross-sectional survey. The costs of dialysis were derived from The National Health Security Office (NHSO). We also calculated the incremental cost-effectiveness ratio (ICER) for lifetime with a future discount rate of 3%.Results: The ICER was 3,035 THB per quality-adjusted life year (QALY) gained. One-way and probabilistic sensitivity analyses showed that all ICERs were less than the Thai Gross Domestic Product (GDP) per capita (150,000 THB in 2011) based on World Health Organization’s suggested criteria.Conclusions: Annual microalbuminuria screening using urine dipsticks in type 2 diabetic patients is very costeffective in Thailand based on World Health Organization’s recommendations. This finding has corroborated the benefit of this screening in the public health benefit package.
Brief communication (Original). Rabies postexposure vaccination in Thailand: is it performed according to international guidelines?
Authors: Sittichanbuncha Yuwares , Chairat Chalermpon , Sawanyawisuth Kittisak 
Published: August 2015

Abstract
Background: Animal bites are one of the leading causes of visits to an emergency room (ER) in Thailand. Rabies is an almost invariably fatal disease.
Objectives: We evaluated the appropriateness of rabies vaccination in clinical practice following the World Health Organization (WHO) guidelines.
Methods: All patients who visited the ER at Ramathibodi Hospital of Mahidol University because of mammal bites and received rabies vaccination by the WHO rabies postexposure regimen were enrolled. Data were retrieved from medical records. Wound categories were classified by WHO guidelines both in real practice and by the investigators on subsequent investigation.
Results: The agreement between clinical practice and the WHO guidelines was calculated and reported as kappa statistics. There were 372 eligible patients. The mean age was 36 years and 172 patients were male. The agreement between clinical practice and the WHO guidelines was a disturbing 26.9% with a kappa statistic of -0.02, P = 0.56.
Conclusion: Even in a referral and teaching hospital, rabies postexposure vaccination in Thailand was not appropriate according to WHO guidelines.
Brief communication (Original). Effectiveness of influenza control using nonpharmaceutical interventions at primary schools in Nakhon Phanom Province, Northeast Thailand
Authors: Mangklakeree Nutcharat , Pinitsoontorn Somdej , Srisaenpang Sompong 
Published: August 2015

AbstractBackground: The world is entering the post-outbreak period of the 2009 A H1N1 strain of the influenza virus. The strain is expected to continue spreading, as seasonal influenza viruses do each year. The majority of children have relatively low immunity and engage in activities at school where opportunities abound for exposure to and spreading of diseases.Objectives: We compared the effectiveness of influenza prevention by using non-pharmaceutical measures in primary schools.Methods: This study was conducted at two medium-sized primary schools in Nakhon Phanom province, Thailand. Multistage sampling was used to select students from Grades 4 to 6. The study group consisted of 230 students from the 2 schools and the control group 224 students from the 2 schools. The research included (a) 8 h of instruction on influenza-like illnesses and their prevention integrated into health promotion and physical education classes and (b) building understanding among parents and in the community. Data were analyzed for frequencies, percentages, and multiple logistic regression.Results: Non-pharmaceutical influenza interventions reduced the rate of influenza-like illnesses by 77% (AOR = 0.23, 95% CI: 0.15"0.36). Students who did not receive the influenza-like prevention and control training had a morbidity of 54.9%; whereas those who received the training had a morbidity of 23.5%. Overall, the group receiving the educational model saw a 57% reduction in its morbidity compared with the control group. The students in the intervention group who washed their hands for 20 seconds three or more times per day had a morbidity of 38.9%, which resulted in an overall reduction in morbidity of 36.4%. The morbidity rate of students who missed school because they were ill was 39.5%. When comparing training methods, the hand-washing group saw morbidity reduced by 34.7%, while simply receiving news and information from public health officials resulted in only a 29.2% reduction in morbidity. Overall, the group receiving the disease prevention and control training was able to reduce morbidity by 58.7%.Conclusion: Influenza prevention education among students was integrated into the health education curriculum. Children were taught hand-washing and respiratory etiquette (i.e., covering the nose and face when sneezing, coughing, and nose-blowing). Cartoon media were used as visual teaching aids. The results from this program helped to decrease the number of cases of influenza-like illness and morbidity among students and families.
History of Asian Biomedicine. Sir Wilfrid Le Gros Clark: the Sarawak years
Authors: Strkalj Goran 
Published: August 2015

AbstractBritish scientist Sir Wilfrid Le Gros Clark was one of the most distinguished anatomists, neuroscientists and physical anthropologists of the twentieth century. He spent most of his career at the University of Oxford as the Chair of the Anatomy Department. This paper focuses on Le Gros Clark’s early career and provides a historical account of the three years he spent as a Principal Medical Officer in Sarawak, which was then a British controlled state on the island of Borneo. At Sarawak he carried out numerous medical, administrative, and educational duties, making significant improvements to the local health system. His success as the Principal Medical Officer came not only as a result of his medical knowledge and organizational skills, but also because of his extensive knowledge and understanding of the local cultures. Interested in the natural history of the country, Le Gros Clark also collected specimens of the local fauna. These would provide material for some of his most significant research carried out when he took an academic position in England. Years in Sarawak enriched Le Gros Clark not only as a scientist and medical practitioner, but also had a deep influence on his general outlook on life and personal development.