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Predictors for Obesity Hypoventilation Syndrome in Thai Population
sarunya saeseow,Kittisak Sawanyawisuth,Sittichai khamsai,Panita Limpawattana,Jarin Chindaprasirt,Berajit Chotmonkol,Songkwan Silaruks,Vichai Senthong,paiboon chattkul 대한수면학회 2019 sleep medicine research Vol.10 No.1
Background and ObjectiveaaObesity Hypoventilation Syndrome (OHS), is a condition with high morbidity and mortality. Body Mass Index (BMI) of more than 30 kg/m2 is used, to diagnose OHS. As BMI for obesity for Thais is 25 kg/m2, BMI more than 25 kg/m2 is used in our institution, to diagnose OHS. The purpose of this study was to evaluate if BMI of 25 kg/m2 is appropriate crite- rion for OHS in Thai patients. MethodsaaThis study was a retrospective study conducted at Khon Kaen University. Inclusion criteria were adult patients diagnosed with OHS in 2016. Patients diagnosed with obstructive sleep apnea (OSA), were randomly selected as control subjects. The ratio of OHS:OSA, was 1:4. Clinical factors associated with OHS were examined, using multivariate logistic regression analysis. ResultsaaDuring the study period, there were 25 OHS and 108 OSA patients. The OHS group had a significantly higher average BMI (48.9 kg/m2 vs. 29.2 kg/m2), than the OSA group. The OHS group also had higher proportions of patients with pulmonary hypertension (50% vs. 2%), and heart failure (76% vs. 6.5%). There were two independent predictors for OHS, including BMI and serum bicarbonate levels. Adjusted odds ratio (95% CI) for each of these factors was 1.08 (1.01, 1.17) and 1.96 (1.15, 3.34), respectively. Body mass index greater than 25 kg/m2 and serum bicar- bonate more than 25 mEq/L, yielded 100% sensitivity for OHS. ConclusionsaaAppropriate diagnostic criteria for OHS for the Thai population, may be different from those for populations in Western countries.
Brain Metastases from Cholangiocarcinoma: a First Case Series in Thailand
Chindaprasirt, Jarin,Sookprasert, Aumkhae,Sawanyawisuth, Kittisak,Limpawattana, Panita,Tiamkao, Somsak Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5
Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of our knowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brain metastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated at Srinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewed clinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The median age of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered from symptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT), one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks (1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT. Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rare and associated with short survival time.
Cancer Patients Are at High Risk of Mortality if Presenting with Sepsis at an Emergency Department
Prachanukool, Thidathit,Tangkulpanich, Panvilai,Paosaree, Possawee,Sawanyawisuth, Kittisak,Sitthichanbuncha, Yuwares Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.7
Background: Sepsis is an emergency condition with high mortality and morbidity rate. There are limited data on the association of cancer as a risk factor for mortality in sepsis patients in the emergency department (ED). Materials and Methods: This retrospective study was conducted at the ED, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand. The study period was between January 1st and December $31^{st}$, 2014. The inclusion criteria were as follows: adult patients over 15 years of age who presented at the ED with suspicion of sepsis, received treatment at the ED, and whose blood culture was found to be positive. Clinical data were recorded from medical records including the Mortality in Emergency Department Sepsis score (MEDS score). The primary outcome of this study was mortality at one month. Multivariate logistic regression analysis was used to identify independent factors associated with death. Results: During the study period, there were 775 eligible patients. The two most common pathogens identified from blood cultures were Staphylococcus aureus (193 patients; 24.9%) and Escherichia coli (158 patients; 20.4%). At one month after presenting at the ED, 110 patients (14.2%) had died. There were four significant factors for death, having cancer, being on an endotracheal tube, initial diagnosis of bacteremia, and high MED scores. Having cancer had an adjusted OR of 2.12 (95% CI of 1.29, 3.47). Conclusions: Cancer patients have double the risk of mortality if presenting with sepsis at the ED.
Penchom Janwan,Pewpan M. Intapan,Hiroshi Yamasaki,Porntip Laummaunwai,Kittisak Sawanyawisuth,Chaisiri Wongkham,Chatchai Tayapiwatana,Amnat Kitkhuandee,Viraphong Lulitanond,Yukifumi Nawa,Wanchai Maleew 대한기생충학열대의학회 2013 The Korean Journal of Parasitology Vol.51 No.6
Neurognathostomiasis is a severe form of human gnathostomiasis which can lead to disease and death. Diagnosis of neurognathostomiasis is made presumptively by using clinical manifestations. Immunoblotting, which recognizes antigenic components of molecular mass 21 kDa and 24 kDa in larval extracts of Gnathostoma spinigerum (Gs 21/24), has high sensitivity and specificity for diagnosis of neurognathostomiasis. However, only very small amounts of the Gs 21/24 antigens can be prepared from parasites harvested from natural or experimental animals. To overcome this problem, we recently produced a recombinant matrix metalloproteinase (rMMP) protein from G. spinigerum. In this study, we evaluated this rMMP alongside the Gs 21/24 antigens for serodiagnosis of human neurognathostomiasis. We studied sera from 40 patients from Srinagarind Hospital, Khon Kaen University, Thailand, with clinical criteria consistent with those of neurognathostomiasis, and sera from 30 healthy control adults from Thailand. All sera were tested for specific IgG antibodies against both G. spinigerum crude larval extract and rMMP protein using immunoblot analysis. The sensitivity and specificity for both antigenic preparations were all 100%. These results show that G. spinigerum rMMP protein can be used as an alternative diagnostic antigen, in place of larval extract, for serodiagnosis of neurognathostomiasis.
Burdens among Caregivers of Older Adults with Advanced Cancer and Risk Factors
Chindaprasirt, Jarin,Limpawattana, Panita,Pakkaratho, Pornvaree,Wirasorn, Kosin,Sookprasert, Aumkhae,Kongbunkiat, Kannikar,Sawanyawisuth, Kittisak Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.4
Family caregivers of older cancer patients face many challenges in managing illness. The burden impacts physical, emotional, spiritual, and social health. The objective of this study was to identify burden among caregivers of older patients with advanced cancer, and associated factors. Materials and Methods: Caregivers of older cancer patients were randomly interviewed from March-September 2012. Information on baseline characteristics and caregiver burden using the Zarit Burden Inventory (ZBI) was collected. Descriptive statistics were used to analyze baseline data, with univariate and multiple linear regression to analyze factors associated with higher burden. Results: One hundred and fifty participants were assessed. The mean ZBI was $19.2{\pm}12.9$ (95%CI, 17.1, 21.2). Two-thirds of caregivers reported no burden (63%) and the main impact variable on ZBI was guilt. High burdens were associated with single caregiver, relationship with the patient as siblings, presence of migraines, and cancer types of the patients. Conclusions: Caregiver burden of Thai cancer patients is low. This unexpected small number could be the result of the socio-cultural viewpoint. Assessment of caregivers and focusing on related factors should be incorporated into treatment plans.
Rujikorn Rattanatham,Nongnuch Settasatian,Nantarat Komanasin,Upa Kukongviriyapan,Kittisak Sawanyawisuth,Phongsak Intharaphet,Vichai Senthong,Chatri Settasatian 대한당뇨병학회 2021 Diabetes and Metabolism Journal Vol.45 No.4
Background Vascular complications are the major morbid consequences of type 2 diabetes mellitus (T2DM). The transcription factor 7-like 2 (TCF7L2), potassium voltage-gated channel subfamily Q member 1 (KCNQ1), and inwardly-rectifying potassium channel, subfamily J, member 11 gene (KCNJ11) are common T2DM susceptibility genes in various populations. However, the associations between polymorphisms in these genes and diabetic complications are controversial. This study aimed to investigate the effects of combined gene-polymorphisms within TCF7L2, KCNQ1, and KCNJ11 on vascular complications in Thai subjects with T2DM. Methods We conducted a case-control study comprising 960 T2DM patients and 740 non-diabetes controls. Single nucleotide polymorphisms in TCF7L2, KCNQ1, and KCNJ11 were genotyped and evaluated for their association with diabetic vascular complications. Results The gene variants TCF7L2 rs290487-T, KCNQ1 rs2237892-C, and KCNQ1 rs2237897-C were associated with increased risk of T2DM. TCF7L2 rs7903146-C, TCF7L2 rs290487-C, KCNQ1 rs2237892-T, and KCNQ1 rs2237897-T revealed an association with hypertension. The specific combination of risk-alleles that have effects on T2DM and hypertension, TCF7L2 rs7903146-C, KCNQ1 rs2237892-C, and KCNQ1 rs2237897-T, as genetic risk score (GRS), pronounced significant association with coronary artery disease (CAD), cumulative nephropathy and CAD, and cumulative microvascular and macrovascular complications (respective odds ratios [ORs] with 95% confidence interval [95% CI], comparing between GRS 2-3 and GRS 5-6, were 7.31 [2.03 to 26.35], 3.92 [1.75 to 8.76], and 2.33 [1.13 to 4.79]). Conclusion This study demonstrated, for the first time, the effect conferred by specific combined genetic variants in TCF7L2 and KCNQ1 on diabetic vascular complications, predominantly with nephropathy and CAD. Such a specific pattern of gene variant combination may implicate in the progression of T2DM and life-threatening vascular complications.