plueme/wizJson huggingface dataset:
Background: There are several recommendations for the role of a physiotherapy program (PTP) in patients with COVID-19. However, the role of PTP in COVID-19 patients with mild to moderate severity during their hospital stay remains limited. In addition, there are lack of studies on the effects of telerehabilitation in COVID-19 after discharge from the hospital. Thus, these are the reason for the current study. Objectives: 1) to determine the feasibility, safety, and effect of PTP programs in acute phase of COVID-19 patients, and 2) to investigate the effect of home-based telerehabilitation (HBT) in COVID-19 patients after discharge from the hospital. Study design: This research was a quasi-experimental study design Methods: This study comprised of two phases. Phase I (In-patient phase): Fifty-two participants were equally assigned into two groups matched on gender and age (1:1 ratio). Most of participants were identified as mild to moderate severity of disease. Experimental Group one (Ex-G1) and Experimental Group two (Ex-G2) received 1-2 times and once a day of PTP, respectively. Outcome measures included the survival and mortality rates, length of hospitalization (LoH), referrals to the intensive care unit (ICU), in-hospital complications, adverse events for patients and the physiotherapists Phase II (Out-patient phase): Participants in the control group (n = 26) were instructed to perform stretching exercises, breathing exercises, and their preferred general exercise program. Participants in experimental group (HBT) (n = 25) received aerobic exercise combined with resisted exercise and breathing exercise for 3 months. Participants in control and experimental group were called by the physiotherapists one time/ month, and one time/ week, respectively for monitoring their exercise program. The outcome measurement comprised of six minutes walk test (6MWT), one minute sit to stand (1MSTS), pulmonary function test (PFT), hand grip dynamometer, body composition, and quality of life (SF-36). Results: Phase I (In-patient phase): The overall survival rate was 98%. There was no difference in LoH between groups. One participant from the Ex-G2 was referred to the ICU. Two and four of the participants had complications in Ex-G1 and Ex-G2, respectively. There were no participants who had serious adverse events during and immediately after PTP. None of the physiotherapists tested positive for COVID-19 after performed bedside PTP. Phase II (Out-patient phase): None of participants of both groups reported of any adverse events during performed their exercise at home. There were no physical fitness components found significant differences between the group. 6MWT, and 1MSTS, were significantly increased compared to the baseline of both groups. Conclusions Phase I: The PTP is safe and feasible for COVID-19 patients in the acute phase, and safe for physiotherapists. A randomized controlled group should be confirmed the beneficial effects in the future. Phase II: The HBT is safe and feasible for patients with mild to moderate severity of COVID- 19. The higher degree of COVID-19 severity might have seen the differences in outcome measurements.
Background and Objectives: Familial hypercholesterolemia (FH) is the most common genetic cause of cardiovascular disease. This study was aimed to examine the Achilles tendon thickness using plain radiograph of lateral heels in FH subjects (diagnosed using the Dutch Lipid Clinic Network [DLCN] score above 3 [possible, probable or definite FH]), non-FH subjects with elevated LDL-cholesterol (LDL-C) >130 mg/dL and subjects with LDL-C below 130 mg/dL. The sensitivity, specificity, and optimal cutoff values with the highest diagnostic accuracy for diagnosis of FH were determined. In addition, the coronary calcium score (CAC) and aortic valve calcium (AoVC) score using computed tomography were also investigated in FH and non-FH subjects. Results: Analysis was performed among 113 FH subjects, 58 non-FH subjects with high LDL-C and 55 subjects with LDL-C <130 mg/dL. The Achilles tendons in FH subjects were significantly thicker than those in the other 2 groups. Men had thicker Achilles tendons than women, but not significantly different. The cutoff thickness values ≥6.875 mm gave the highest diagnostic accuracy of 74% with 70% sensitivity and 78% specificity. For CAC scores among 112 FH subjects and 58 non-FH subjects, the proportion of FH subjects who had CAC >0 AU was not significantly different than that of non-FH subjects but the proportion of FH subjects who had AoVC > 0 AU was significantly higher that that of the non-FH subjects (10.7% vs. 1.7%, P= 0.029). CAC scores were significantly associated with age, LDL-C burden and Thai CV risk score Conclusions: Measurements of Achilles tendon thickness by plain radiographs in 133 FH subjects showed that cutoff values of ≥6.875 mm gave 74% accuracy with 70% sensitivity and 78% specificity. The proportion of FH subjects with CAC >0 was not significantly different than that of non-FH subjects but the proportion of FH subjects who had AoVC > 0 AU was significantly higher that that of the non-FH subjects.
The COVID-19 epidemic situation is affecting the health workforce in the public health is not enough to care for the infected people. This has led to home isolation and volunteer group was formed using a telehealth care model. The objectives of this study were to 1) learned lessons from the telehealth care model of home isolation in terms of health workforce in the public health region 12 2) study the role and operation process of health workforce 3) study the success factors, problems and obstacles in the implementation of the telehealth care model with the home isolation, and 4) to synthesize lessons to form a knowledge in the 12th health zone. Used qualitative research methodology. Data were collected through structured in-depth interviews. And online group discussions with 30 volunteers and 50 patients. Data were analyzed by qualitative content analysis. Data is checked at every step of the analysis. Using a triple check Content Analysis and interpretations creates conclusions. The results of the study revealed that the telehealth care operation model with the home isolation system consists of 1) Building human resources in the form of volunteering to help carry out work in caring for home isolation patients. 2) Understanding common goals by explaining the objectives and goals of work to all volunteers. 3) Organizing training sessions to provide knowledge on various issues related to the care of COVID-19 patients. and 4) Follow up on the activities of volunteers through online meetings. The role and operation process consisted of 3 teams: the central team, the patient follow-up team, the community team, and the corps volunteer team. The key success factors were attitudes, thoughts, beliefs towards volunteer work. Knowledge and process of developing knowledge and competence of the volunteer team the problems and obstacles encountered include accessing the database system. Health workers are not only health officials, but may also come from those who consciously go through the step-by-step construction and development process. Health promotion consultation during the operation of the system.
Currently, there are no epidemiological studies in Thailand on diabetes diagnosed before the age of 30. Long-term studies in Thai children and adolescents have been published periodically less 5 years ago. Recent evidence has shown that the ratio of type 2 diabetes in Thai children has increased as well as type 1 diabetes. The etiology and clinical features of diabetes in children and adolescents have tendency to change according to environmental factors and lifestyles. The study of diabetes diagnosed under 30 years old, The project was to collect baseline patient data for registration of diabetic patients admitted to network hospitals across the country. Basic data from the patients were analyzed. Autoantibodies against three islets antigens, GAD65, IA2 and ZnT8 were measured in the laboratory to determine the incidence of type 1 diabetes. To examine the molecular genetics of diabetic patients diagnosed before the age of 30. This study was conducted in patients who were clinically compatible with NDM and MODY. The subject who had negative autoantibodies will be used to study the variation of diabetic genes by whole exome sequencing. Data on the number of people with diabetes diagnosed before the age of 30 in Thailand were collected from 31 network hospitals nationwide. Sample specimens were obtained from 750 diabetic patients diagnosed before the age of 30 years. 448 cases of type 1 diabetes (59.7%), type 2 diabetes 156 (20.8%), 43 cases of MODY diabetes (5.7%) A study of autoantibodies against three antigens islets GAD65, IA2 and ZnT8 found that patients with type 1 diabetes were positive 61.3 %. Of the 316 patients with type 1 diabetes, GAD antibody positive 52.2%, IA2 antibody positive 34.8%, and ZnT8 antibody positive 28.7%. Fourty-four patients clinically compatible with MODY subtype, in which diabetes is a dominant familial trait and no islets autoantibodies. Based on exome sequencing analysis, gene variations associated with diabetes were reported in 15 cases, while the other 29 patients with MODY had no previously reported pathogenic genes (MODY-X). This study, systematic nationwide, is a preclinical and scientific study that directly contributes to Thailand's cognition related to diagnosed diabetes under 30 years of age in Thailand. It can be used as an empirical reference and may lead to the formulation of appropriate public health policies related to diagnosis. Treatment and prevention of diabetes in young people in Thailand as well.
Background: Hereditary angioedema (HAE) is a rare and life-threatening genetic disease. This disease can lead to recurrent attacks of severe swelling occurring in areas such as the face, gastrointestinal tract, and larynx. These attacks can result in hospitalization or death. Thus, effective medications are necessary for treating the acute attacks. However, Thailand did not specify medication for treatment and prophylaxis. Therefore, effective strategies for universal health coverage for the management of HAE patients remain a challenge in Thailand. This review aims to determine the extent of research in the published literature that examine benefit package and strategies for universal health coverage for the management of HAE patients in Thailand. Method: On 5th January 2022, Embase, Scopus, OpenGrey, PubMed, Science direct, Clinicaltrials.gov, and Cochrane were searched for literature published from inception. Studies evaluating the efficacy and safety of medication for treating acute attacks in HAE patients were included. Additionally, this study performed a survey of data from the drug company, experts in the field, and stakeholders. Our survey asked about the situation, cost, and health service systems for screening, diagnosis, treatment, and referring HAE patients in Thailand. Result: Of 4,834 articles identified, 28 studies were included. Twenty-four studies are original articles, one study was a systematic review and network meta-analysis, and three studies were cost-effectiveness analyses. From current trials, first-line therapy such as Plasma-derived C1 inhibitor, Recombinant C1 inhibitor Conestat alfa, Icatibant, and Ecallantide showed benefits over placebo.However, the study related to the full economic evaluation of first-line therapy in Thailand has not been provided. Conclusion: HAE may affect the budget of Thailand if patients do not receive appropriate treatment. Thus, screening, diagnosis, and effective medication for treating acute attacks are essential measures to decrease the overall HAE-related healthcare cost. However, full economic evaluation studies of first-line therapy in Thailand are needed.
Obesity has become one of the world's most serious public health issues. Because the causes of obesity are complex and multifactorial, new eras of research are opening for the effective control of obesity through gene and nutrition intake interactions. Individuals' obesity tendencies are thought to be determined by GWASs (genome-wide association studies), which leads to powerful discoveries relevant to population health. Over 300 Thai obesity participants in the Siriraj Genomic Thailand cohort to conduct a GWAS on obesity-related variables such as BMI, body composition, blood clinical profile, and dietary intake. We examined 446,370 single-nucleotide polymorphisms (SNPs) and obesity trait associations, yielding 50 SNPs with significant obesity-associated traits. We discovered five SNPs (rs114330431, rs4964357, rs12190237, rs140552528, rs12103676, and rs4713103) that were associated with increased weight, BMI, waist circumference, and hip circumference (P 0.05). Seven SNPs have been linked to rising lipid profile levels, including rs4964357, rs12190237, rs117828572, rs142722966, rs9577364, and rs11779272. We discovered the effect of genetic variants on the risk of obesity-related comorbidities, including rs142722966, rs116845541, and rs2059238 have been associated with Diabetes and metabolic syndrome difficulties, while 6 SNPs have been linked to high blood pressure issues (rs79392564, rs12033263, rs79949466, rs77592423, rs6111497, and rs1597468). Linear regression analyses of dietary energy and macronutrient intakes with the SNP. The risk allele at rs4739762 and rs75047180 was associated with increased total fat (per allele effect: 18.06 g/d (95%IC 3.83-32.29, p= 0.013)), animal protein intake (per allele effect: 23.45 g (95%IC 10.69-36.22, p<0.001)), Vitamin A intake (per allele effect: 993.86 RAE (95%IC 454.68-1533.03, p<0.001) and Niacin intake (per allele effect: 5.24 mg (95%IC 1.39-9.09, p=0.008)). In conclusion, the obesity-related genetic loci identified here provide new insights into the genetic underpinnings of adiposity in the Thai population. This study adds to our understanding of the factors that contribute to obesity, which can help influence precision nutrition for obesity prevention and treatment.
Periodontal infections are common problem in general populations, particularly in patients with inborn errors of immunity (IEI). The disease is chronic and deliberating, resulting in reduced quality of life. Due to limited understanding of oral characteristics of the IEI patients, the aims of this project were to investigate genetic variants, phenotypes, plaque microbiome, and salivary proteome of IEI and periodontitis patients using exome/genome sequencing, metagenomic sequencing, mass spectrometry, and bioinformatics. Seventy participants: 15 IEI, 15 periodontitis, and 45 healthy were recruited. Seventy-five plaque DNA, 75 salivary samples, 75 metagenome data, and 75 proteomics data were obtained. This project showed that the IEI patients had poor oral hygiene and gingival inflammation. Genetic variants in BTK, CD40LG, FERMT3, STAT3, ELANE, TTC37, and NCF1, and chromosome 22q11.2 deletion were identified. The diseases diagnosed such as X-linked agammaglobulinemia, hyper-IgM syndrome, leukocyte adhesion deficiency, and congenital neutropenia. Metagenomics revealed that IEI patients had alterations in oral microbe composition, alpha-diversity, and beta-diversity. Bacterial species that were significantly increased in IEI: T. denticola, S. gordonii, S. oralis, Actinomyces, and V. parvula were pathogenic species also observed in periodontitis patients. Moreover, salivary proteins, particularly those related to bacterial defense, host immunity, and glycolysis, were significantly changed in IEI and periodontitis patients. In summary, this project demonstrates IEI-causing variants, microbiome dysbiosis, and disturbed salivary proteome in IEI and periodontitis patients. The study expands understanding of genotype and phenotype of IEI, leading to identification of biomarkers of periodontal diseases and impaired immunity. We provide genetic counselling and personalized oral care to the patients and families, publish international papers, groom researchers and students, build network, and distribute knowledge in international conferences and organizations. The project produces outputs/outcomes in academics, research, community, and health care that will lead to utilization of research in policy-making in the future.
A cross-sectional study aimed to assess the impacts from the COVID-19 pandemic and adaptability to prevent and control the disease among the three groups (students, general population, and the elderly) of the hill tribe people lived in border areas in Chiang Rai province, Thailand. Validated questionnaires were used to gather information from participants. Data were collected between April 2021 and December 2021. A total of 2,208 participants were recruited into the study. Among students, their had got moderate level of the impact. Several barriers access education during the pandemic were detected such as inaccessible to internet and no educational technologies and materials available. The ability of their adaptations to follow COVID-19 prevention and control measures was found in moderate level. In general population, majority were impacted in moderate level. Several impacts were detected such as leaving job without compensation, salary reducing, not met the qualification from the national policy of compensation from the COVID-19 pandemic due to no Thai identification. Moreover, a large proportion had increased their family debt during the pandemic. The ability of their adaptations to follow COVID-19 prevention and control measures was found in moderate level. The elderly, a large proportion were working in agricultural section, and had got the impact in moderate level in particular their job and income. The main problem was unable to sell their agricultural products. The ability of their adaptations to follow COVID-19 prevention and control measures was found in good level. National educational policy should be focused on educational materials and technologies supported to children and schools. Creating and seeking markets and supply chains for general population and the elderly should be urgently executing. Moreover, the policy related to support prolong living environmental under the COVID-19 pandemic is crucial particularly those who are living in poor education and economic status.
A cross-sectional study was conducted to assess the capacities of COVID-19 prevention and control among healthcare workers and health system under the Ministry of Public Health and Ministry of Interior located in the border areas in Chiang Rai Province: Mae Fah Luang, Mae Sai, Chiang Saen, Mae Chan, Mae Suai, Wiang Pa Pao, Muang, and Chiang Khong Districts. Data were collected by validated questionnaires between April and December 2021. A total of 906 people were recruited into the study. In the aspect of management: healthcare workers working under health institutes belonging to the Ministry of Public Health, local government and health volunteers did not clearly understand the process of work. In the aspect of manpower: healthcare workers under the Ministry of Public Health reported having worked longer hours compared to the period of pre-COVID-19 epidemic, and healthcare workers shortage. In the aspect of communication: line application was favored among government officers. Mobile phones were commonly used among people in a community. In the aspect of materials for the implementation: N-95, PPE and face shield were not sufficient for working among healthcare workers, while the community members reported that masks and alcohol were not enough for them. In the aspect of budgetary: almost all government officers reported that they had a big challenge in the requesting process. Some of the officers did not get the compensation and used their personal money for buying equipment. In the governance aspect: the overload assigned from their director was the major concern. In the aspect of the health system: communities had established several commitments and agreements among them to prevent and control the disease. Moreover, most people followed the agreements. People in a community have good practices to prevent and control COVID-19. Personal and health system capacity related to COVID-19 prevention and control developments are crucial especially to people who are living in border areas. The main focus on improving the capacities are deploying processes of work in crisis situations to make them confident and accurately follow the instructions; the government sector is required to support budget sufficient and medical related materials to healthcare workers. Distribution of essential information to people should be prepared in appropriate languages. Communication channel is also one of the critical points to improve the prevention and control measures in a community. Encouraging people in a community in creating their commitments and implementing them are also very important concerns for improving the effectiveness of disease control and prevention.
A cross-sectional study was applied to assess the effectiveness of COVID-19 prevention and control measures in different kinds of schools (public schools, private schools, day care center, foreign language teaching schools, and religion teaching schools) located in border areas of Mae Fah Luang, Mae Chan, Mae Suai, Mae Sai, Muang, Wiang Pa Pao, and Chiang Saen Districts, Chiang rai Province. The study population were school directors, teachers, caregivers, students, and their parents. Validated questionnaires were used to collect data. Descriptive and inferential statistics were used to test the associations at the α = 0.05. A total of 2,240 participants were recruited into the study. Among 168 school directors, 50.50% were female, and working at the schools that belonged to the Office of the Basic Education Commission. Majority of teachers and caregivers were female (84.13%). While 66.18% of parents were female, and 21.75% were Akha. While 57.55% of students were female. 64.57% of primary schools and 64.29% of high schools were detected in the level of “pass but required improvement” according to the standard protocol of COVID-19 prevention and control measures which was able to operate their schools. While 78.29% of day care centers were detected in the level of “non-pass the safety level and could not operate their schools”. A large proportion of parents (97.43%), 93.81% of all primary schools, 92.86% of high schools followed the national COVID-19 prevention and control procedures to an excellent level. The size of day care centers and school, and types of administration departments were associated with the effectiveness of COVID-19 prevention and control of organization level significantly. Parents’ knowledge and practices related to disease control were associated with the effectiveness of COVID-19 prevention and control of organization level significantly. In implementation for COVID-19 prevention and control, it needs to focus on the size and their administration departments of schools including knowledge and practice in COVID-19 prevention and control of parents.