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Publication Open Access The dementia and disability project in Thai elderly: rational, design, methodology and early results(2013) Vorapun Senanarong; Kamolthip Harnphadungkit; Niphon Poungvarin; Sathit Vannasaeng; Samut Chongwisal; Tipa Chakorn; Piyanuch Jamjumrus; Atthapon Raksthaput; Sinisa Chaichanettee; Nattapol Aoonkaew; Suthipol Udompunthurak; Doody, Rachelle S.; Cummings, Jeffrey L.; Mahidol University. Faculty of Medicine Siriraj Hospital.chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive declinePublication Open Access Overexpression of receptor for advanced glycation end products and high-mobility group box 1 in human dental pulp inflammation.(2014-07-10) Salunya Tancharoen; ศรัณยา ตันเจริญ; Tassanee Tengrungsun; ทัศนีย์ เต็งรังสรรค์; Theeralaksna Suddhasthira; ธีรลักษณ์ สุทธเสถียร; Kikuchi, Kiyoshi; Vechvongvan, Nuttavun; Tokuda, Masayuki; Maruyama, Ikuro; Mahidol University. Faculty of Dentistry. Department of Pharmacology; Mahidol University. Faculty of Dentistry. Department of Advanced General Dentistry; Mahidol University. Faculty of Dentistry. Department of PharmacologyHigh mobility group box 1 (HMGB1), a nonhistone DNA-binding protein, is released into the extracellular space and promotes inflammation. HMGB1 binds to related cell signaling transduction receptors, including receptor for advanced glycation end products (RAGE), which actively participate in vascular and inflammatory diseases. The aim of this study was to examine whether RAGE and HMGB1 are involved in the pathogenesis of pulpitis and investigate the effect of Prevotella intermedia (P. intermedia) lipopolysaccharide (LPS) on RAGE and HMGB1 expression in odontoblast-like cells (OLC-1). RAGE and HMGB1 expression levels in clinically inflamed dental pulp were higher than those in healthy dental pulp. Upregulated expression of RAGE was observed in odontoblasts, stromal pulp fibroblasts-like cells, and endothelial-like cell lining human pulpitis tissue. Strong cytoplasmic HMGB1 immunoreactivity was noted in odontoblasts, whereas nuclear HMGB1 immunoreactivity was seen in stromal pulp fibroblasts-like cells in human pulpitis tissue. LPS stimulated OLC-1 cells produced HMGB1 in a dose-dependent manner through RAGE. HMGB1 translocation towards the cytoplasm and secretion from OLC-1 in response to LPS was inhibited by TPCA-1, an inhibitor of NF-κB activation. These findings suggest that RAGE and HMGB1 play an important role in the pulpal immune response to oral bacterial infection.Publication Open Access Ethnoveterinary medicine based on Ayurveda plants(2012) Sookruetai Boonmasawai; Mahidol University. Faculty of Veterinary Science. Department of Pre-clinic and Applied Animal ScienceTraditional plants used for medicine exist for several thousand years ago in India to solve human health problems. The Ayurveda concept involved in the balancing of five basic elements including earth, water, fire, air, and space (ether) because of various active ingredients in remedies. Nowadays, traditional plant uses in veterinary medicine in many regions have been documented and reported such as in Spain, Italy, Argentina, Brazil and Kenya. Catharanthus roseus (Apocynaceae) is an important medicinal plant containing vincristine used in veterinary medicine for treatment of canine transmissible venereal tumor and canine lymphoma. Additional evidences in China showed that Salacia oblonga root in Ayurvedic recipe was able to ameliorate hypertriglyceridemia and excessive ectopic fat accumulation in laying hens. Moreover, crude extract from Terminalia arjuna L. (Combretaceae) bark decreased blood pressure in anaesthetized dogs. However, World Health Organization (WHO) recently focuses in standardization, safety and efficacy of Ayurveda medicine to establish this herbal medicine system. Ayurveda in veterinary medicine still need further clinical research to provide more clear, comprehensive, and practical pharmacological information to improve constantly therapeutic qualities.Publication Open Access Discrepant association of serum C-3 epimer of 25-hydroxyvitamin D versus non-epimeric 25-hydroxyvitamin D with serum lipid levels(2016) La-or Chailurkit; Wichai Aekplakorn; Kriangsuk Srijaruskul; Boonsong Ongphiphadhanakul; Mahidol University. Ramathibodi Hospital. Department of MedicineBackground: Low vitamin D status has been associated with a number of chronic diseases. For dyslipidemia, vitamin D deficiency has been associated with higher low density lipoprotein-cholesterol (LDL-C) in a number of studies, but with inconsistent results in clinical trials. The purpose of the present study is to explore the relative importance of 3-epi-25-hydroxyvitamin D (25(OH)D) as compared with the non-epimeric form in relation to serum lipid. Method: This study used data from 1068 randomly selected volunteers in the Thai 4th National Health Examination Survey (NHES IV). Serum 25(OH)D2, 25(OH)D3, 3-epi-25(OH)D2 and 3-epi-25(OH)D3 were analyzed by liquid chromatography–tandem mass spectrometry. Results: There was no association between serum total 25(OH)D and serum LDL-C. However, circulating 3-epi-25(OH)D3 was negatively related to serum LDL-C (r = −0.077, P <0.05), while no such association was found for non-epimeric 25(OH)D3 (r =0.030, P = 0.33). On the other hand, both 3-epi-25(OH)D3 (r = 0.175, P <0.001) and non-epimeric 25(OH)D3 (r = 0.142, P <0.001) were positively related to serum triglyceride (TRIG) levels. In multiple linear regression models with age, gender, body mass index , urban residence, education, hypertension and education as covariates, it was found that 3-epi-25(OH)D3 was independently associated with serum LDL-C (beta = −0.12, P <0.01), while non-epimeric 25(OH)D3 was positively related to LDL-C (beta = 0.13, P = 0.002). For TRIG, there were positive association with 3-epi-25(OH)D3 (beta = 0.27, P <0.001) and negative association with non-epimeric 25(OH)D3 (beta = − 0.10, P = 0.011) independent of age, gender, urban resident and education. Conclusions: There is a discrepant association of 25(OH)D levels with serum lipids according to 25(OH)D epimeric forms.Publication Open Access Nuclear scintigraphic examination in veterinary medicine(2015) Somkiat Huaijantug; Mahidol University. Faculty of Veterinary Science. Department of Clinical Sciences and Public HealthThe present review will discuss the information of nuclear scintigraphic examination in veterinary medicine. The main focus is on the introduction of nuclear medicine procedures in animal patients and describes conventional nuclear medicine (brain scintigraphy, bone scintigraphy, thyroid scintigraphy, inflammation and oncological scintigraphy). Single photon emission scintigraphy (SPECT) and positron emission tomography (PET) have recently been developed using for nuclear scintigraphic examination to provide functional and physiological imaging, the quantification of biochemical processes, molecular interactions, and neoplasias. Radiopharmaceuticals or radionuclides have a longer physical half-life allowing that need longer acquisition times used for specific investigation purposes. In veterinary medicine, scintigraphy can be the basis of a sensitive, specific and non-invasive diagnostic method, which information has been applied to support the diagnostic process and treatment planning for animal patients.Publication Open Access Potential of the angiotensin receptor blockers (ARBs) telmisartan, irbesartan, and candesartan for inhibiting the HMGB1/RAGE axis in prevention and acute treatment of stroke.(2013-09) Salunya Tancharoen; ศรัณยา ตันเจริญ; Kikuchi, Kiyoshi; Ito, Takashi; Morimoto-Yamashita, Yoko; Miura, Naoki; Kawahara, Ko-ichi; Maruyama, Ikuro; Murai, Yoshinaka; Tanaka, Eiichiro; Tanaka, Eiichiro; Mahidol University. Faculty of Dentistry. Department of PharmacologyStroke is a major cause of mortality and disability worldwide. The main cause of stroke is atherosclerosis, and the most common risk factor for atherosclerosis is hypertension. Therefore, antihypertensive treatments are recommended for the prevention of stroke. Three angiotensin receptor blockers (ARBs), telmisartan, irbesartan and candesartan, inhibit the expression of the receptor for advanced glycation end-products (RAGE), which is one of the pleiotropic effects of these drugs. High mobility group box 1 (HMGB1) is the ligand of RAGE, and has been recently identified as a lethal mediator of severe sepsis. HMGB1 is an intracellular protein, which acts as an inflammatory cytokine when released into the extracellular milieu. Extracellular HMGB1 causes multiple organ failure and contributes to the pathogenesis of hypertension, hyperlipidemia, diabetes mellitus, atherosclerosis, thrombosis, and stroke. This is the first review of the literature evaluating the potential of three ARBs for the HMGB1-RAGE axis on stroke therapy, including prevention and acute treatment. This review covers clinical and experimental studies conducted between 1976 and 2013. We propose that ARBs, which inhibit the HMGB1/RAGE axis, may offer a novel option for prevention and acute treatment of stroke. However, additional clinical studies are necessary to verify the efficacy of ARBs.Publication Open Access ปัจจัยที่มีความสัมพันธ์กับการฟื้นตัวด้านร่างกายระยะแรกของผู้ป่วยกระดูกเท้าและข้อเท้าหัก หลังได้รับการรักษาด้วยการเข้าเฝือก(2559) พิตะวัน กุลาสา; Pitawan Kulasa; วัลย์ลดา ฉันท์เรืองวณิชย์; Wallada Chanruangvanich; อรพรรณ โตสิงห์; Orapan Thosing; ก้องเขต เหรียญสุวรรณ; Kongkhet Riansuwan; มหาวิทยาลัยมหิดล. คณะพยาบาลศาสตร์วัตถุประสงค์: เพื่อการศึกษาความสัมพันธ์ระหว่างดัชนีมวลกาย การรับรู้ภาวะสุขภาพ และการสนับสนุนทางสังคมกับการฟื้นตัวด้านร่างกายของผู้ป่วยกระดูกเท้าและข้อเท้าหัก หลังได้รับการรักษาด้วยการเข้าเฝือก รูปแบบการวิจัย: ศึกษาเชิงสหสัมพันธ์ วิธีดำเนินการวิจัย: กลุ่มตัวอย่างเป็นผู้ป่วยผู้ใหญ่ที่กระดูกเท้าและข้อเท้าหัก และรักษาด้วยการเข้าเฝือก กลุ่มตัวอย่างมี จำนวน 85 รายจากโรงพยาบาลระดับตติยภูมิ 2 แห่ง โดยใช้แบบบันทึกข้อมูลส่วนบุคคลแบบบันทึกประวัติการเจ็บป่วย การประเมินดัชนีมวลกาย แบบวัดการรับรู้ภาวะสุขภาพ แบบวัดการสนับสนุนทางสังคม แบบประเมินการทำหน้าที่ของขาวิเคราะห์ข้อมูลด้วยสถิติพรรณนา และวิเคราะห์ความสัมพันธ์โดยใช้ค่าสัมประสิทธ์สิ หสัมพันธ์ของเพียร์สัน ผลการวิจัย : กลุ่มตัวอย่างมีดัชนีมวลกายในระดับน้ำหนักเกิน (M = 24.15, SD = 4.82) มีการรับรู้ภาวะสุขภาพ โดยรวมอยู่ในระดับดี (M = 129.60, SD = 14.77) ได้รับการสนับสนุนทางสังคมโดยรวมในระดับมาก (M = 69.29, SD = 11.73) มีค่าเฉลี่ยการทำหน้าที่ของขาเท่ากับ 43.52 (SD = 9.62) ค่าดัชนีมวลกายมีความสัมพันธ์ทางลบกับ การฟื้นตัวด้านร่างกายระยะแรกอย่างมีนัยสำคัญทางสถิติ (r = - .31, p < .05) การรับรู้ภาวะสุขภาพและการสนับสนุนทางสัมคมมีความสัมพันธ์ทางบวกกับการฟื้นตัวด้านร่างกายระยะแรกอย่างมีระยะสำคัญทางสถิติ (r = .46, r = .28; p < .05) สรุปและข้อเสนอแนะ: พยาบาลควรส่งเสริมให้ผู้ป่วยมีการรับรู้ภาวะสุขภาพที่ถูกต้อง และได้รับการสนับสนุนทางสังคมอย่างต่อเนื่อง โดยให้คำแนะนำการทำกิจกรรมที่เหมาะสม เพื่อช่วยให้มีการฟื้นตัวที่ดียิ่งขึ้นภายหลังเข้าเฝือกPublication Open Access Thai traditional massage increases biochemical markers of bone formation in postmenopausal women: a randomized crossover trial(2013) Sunee Saetung; La-or Chailurkit; Boonsong Ongphiphadhanakul; Mahidol University. Ramathibodi Hospital. Department of MedicineBackground: The effect of massage therapy on bone metabolism in adults has only scarcely been explored. In a randomized crossover trial, we investigated the skeletal effect of Thai traditional massage by examining the changes in biochemical markers of bone turnover. Methods: Forty-eight postmenopausal women participated in the study. All volunteers were randomized to a 2-hour session of Thai traditional massage twice a week for 4 weeks and a 4-week control period after a 2-week washout, or vice versa. Twenty-one subjects were allocated to receiving Thai traditional massage first, followed by the control period, while 27 were initially allocated to the control period. Results: Serum P1NP increased significantly after Thai traditional massage (P <0.01), while there was no change in serum osteocalcin or CTX. During the control period, there was no significant change in P1NP, osteocalcin or CTX compared to baseline. When age and height were taken into account, P1NP in postmenopausal women whose ages were in the middle and higher tertiles and whose heights were in the lower and middle tertiles (n = 22) had a 14.8 ± 3.3% increase in P1NP after massage (P <0.001), while no change in P1NP was found in the rest of the women (n = 26). Conclusions: Thai traditional massage results in an increase in bone formation as assessed by serum P1NP, particularly in postmenopausal women who are older and have a smaller body build. Future studies with larger samples and additional design features are warranted.Publication Open Access Efficacy of low-dose intra-articular tranexamic acid in total knee replacement; a prospective triple-blinded randomized controlled trial(2013) Paphon Sa-ngasoongsong; Siwadol Wongsak; Pongsthorn Chanplakorn; Patarawan Woratanarat; Supaporn Wechmongkolgorn; Bussanee Wibulpolprasert; Pornchai Mulpruek; Viroj Kawinwonggowit; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Department of OrthopedicsBackground: Recently, a number of studies using intra-articular application of tranexamic acid (IA-TXA), with different dosage and techniques, successfully reduced postoperative blood loss in total knee replacement (TKR). However, best of our knowledge, the very low dose of IA-TXA with drain clamping technique in conventional TKR has not been yet studied. This study aimed to evaluate the effectiveness and dose-response effect of two low-dose IA-TXA regimens in conventional TKR on blood loss and blood transfusion reduction. Methods: Between 2010 and 2011, a triple-blinded randomized controlled study was conducted in 135 patients undergoing conventional TKR. The patients were allocated into three groups according to intra-articular solution received: Control group (physiologic saline), TXA-250 group (TXA 250 mg), and TXA-500 group (TXA 500 mg). The solution was injected after wound closure followed by drain clamping for 2 hours. Blood loss and transfusion were recorded. Duplex ultrasound was performed. Functional outcome and complication were followed for one year. Results: There were forty-five patients per groups. The mean total hemoglobin loss was 2.9 g/dL in control group compared with 2.2 g/dL in both TXA groups (p > 0.001). Ten patients (22%, control), six patients (13%, TXA-250) and none (TXA-500) required transfusion (p = 0.005). Thromboembolic events were detected in 7 patients (4 controls, 1 TXA-250, and 2 TXA-500). Functional outcome was non-significant difference between groups. Conclusions: Combined low-dose IA-TXA, as 500 mg, with 2-hour clamp drain is effective for reducing postoperative blood loss and transfusion in conventional TKR without significant difference in postoperative knee function or complication.Publication Open Access Efficacy of a church-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members: a randomized controlled trial in Pretoria, South Africa(2014) Supa Pengpid; Peltzer, Karl; Skaal, Linda; Hendry Van der Heever; Mahidol University. ASEAN Institute for Health DevelopmentBackground: In persons 15 years and above in South Africa the prevalence of pre-diabetes and diabetes has been estimated at 9.1% and 9.6%, respectively, and the prevalence of systolic prehypertension and hypertension, 38.2% and 24.6%, respectively. Elevated blood glucose and elevated blood pressure are prototype of preventable chronic cardiovascular disease risk factors. Lifestyle interventions have been shown to control high normal blood pressure and/or high normal blood glucose. Methods/Design: This study proposes to evaluate the efficacy of a community (church)-based lifestyle intervention programme to control high normal blood pressure and/or high normal blood glucose in church members in a randomized controlled trial in Gauteng, South Africa. The objectives are to: (1) measure non-communicable diseases profile, including hypertension and diabetes, health behaviours, weight management and psychological distress of church members; (2) measure the reduction of blood glucose and blood pressure levels after the intervention; (3) prevent the development of impaired glucose tolerance; (4) compare health behaviours, weight management and psychological distress, blood glucose and blood pressure levels between intervention and control groups, and within group during 6, 12, 24 and 36 months during and post intervention. The study will use a group-randomized design, recruiting 300 church members from 12 churches. Churches will be randomly assigned to experimental and control conditions. Discussion: Lifestyle interventions may prevent from the development of high blood pressure and/or diabetes. The findings will impact public health and will enable the health ministry to formulate policy related to lifestyle interventions to control blood pressure and glucose. Trial registration number: PACTR201105000297151