Objectives: The objectives of the present study were to determine the prevalence and risk factors of prehypertensivepopulation in the catchment areas of Lukhoke primary care unit, Maung district, Pathumthani province. Method: This was a cross sectional study in the participants who lived in the catchment areas of Lukhoke primarycare unit (PCU) between June and November 2010. Baseline demographic data were obtained and physicalexamination was performed in all 469 participants, aged 35-59 years. All participants were classifi edinto three groups according to their blood pressure using the Joint National Committee (JNC) 7 criteria;group 1: normal (BP 140/90 mmHg). The prevalence of prehypertension was calculated and thefactors correlated with increasing prevalence of prehypertension were identifi ed using logisticregression analysis. Results: Out of 469 participants were 196 (41.8%) men and 273 (58.2%) women with mean age 46.29 ±7.06 years. The prevalence of prehypertension was 149/469 (31.8%). From multivariate analysis, factorswhich were independently associated with increasing prevalence of prehypertension included fi rstly,increased eating salt diet (taste); second, history of chronic diseases e.g. diabetes mellitus and highcholesterol; third, physical activity; fourth, eating high fat diet; and fi nally, high body mass index (BMI)(p < 0.05) Conclusion: This study showed that the prevalence of prehypertension was relatively high compared with Thaipopulation and South East Asian population. The important risk factors associated with health behaviors. The furtherstudies should encourage the people to establish lifestyle modifi cation among high risk population forreduction of the prevalence of hypertension. Key words: Prevalence, Prehypertension, Risk factors
Background: Clomiphene responsiveness has been varied in WHO group II anovulatory patients. Our study evaluates factors associated with clomiphene citrate responsiveness in this population. Various parameters were studied, including anthropometric, hormonal and transvaginal ultrasonographic measurements. Methods: A retrospective case-control study was done over a period of three years. A total of 260 women with WHO group II anovulatory related infertility treated with clomiphene citrate 100 mg/d for five consecutive days were enrolled. 173 women were categorized in clomiphene citrate resonsive group (CCR), defined as patients with at least one dominant follicle ≥17 mm or at least 2 dominant follicles ≥15 mm. 87 women were categorized in the non-ovulatory group (NCCR), defined as patients who not meet the responsive group criteria. Various clinical, metabolic, hormonal and ultrasound features were compared between two groups. Logistic regression analysis was used to analyze the significant factors. Results: Among all participants, the mean age was 32.6 ± 4.0 years. The mean body mass index in CCR and NCCR group was 23.9 ± 10.7 kg/m2 and 24.0 ± 4.0 kg/m2, respectively. The mean waist-hip ratio (WHR) of the NCCR group was higher than that of the CCR group, i.e., 0.83 ± 0.06 vs 0.81 ± 0.05 (p = 0.004). The waist-hip ratio was the most sensitive anthropometric predictor of non-responsiveness to clomiphene: cut-off value of 0.775 (90.8% sensitivity and 20.2% specificity) and cut-off value of 0.805 (73.6% sensitivity and 42.2% specificity). Age, clinical hyperandrogenism, polycystic ovarian morphology, low antral follicle count (≤5 follicles), baseline follicle-stimulating hormones and estradiol levels were not significantly different. Conclusions: The waist-hip ratio is a clinically useful parameter in predicting clomiphene responsiveness in normogonadotropic anovulatory women (WHO group II anovulation).
Background: A two-group-quasi-experimental design was carried out to test whether nutrition education with an empowering approach can motivate dietary self management among rural Thais with impaired fasting glucose. Methods: Through screening for pre-diabetes in Phetchabun province, 90 subjects were recruited from rural district with 44 in the intervention group and 46 in the control group. The empowerment process consisted of a total of six sessions that covered active learning in nutrition knowledge and skill practice in dietary self-management. Empowerment outcomes and related health indicators were assessed at three interval times in a 1 year follow up. Results: Critical thinking ability and participatory behavior were enhanced through a supportive environment. Subjects increase their self eff icacy in tailoring a meal plan with proper caloric intake and in the decision of food choice. This resulted in better related health outcomes. The percentage of subjects with fasting blood glucose less than 100 mg/dl was significantly higher in the intervention group compared with the control group, 36.4 [95%CI 22.1-50.6] vs. 10.9 [95% CI 1.9-19.9]. In group of BMI ≥ 23 kg/m2, the percentage of subjects who lost weight ≥ 5 % from baseline value was signif icantly higher in the intervention group, 48.3 [95% CI 30.1- 66.5] vs.10.8 [95% CI 0.8-20.8]. Conclusions: Results from this study suggested that nutrition education with an empowering approach is possible among rural Thais. Improvement of related health outcomes was shown. There may be a delay in the realization period in the case of some individuals relative to diabetes mellitus. Further study is needed to ensure healthy eating sustainability.
Cause-specific mortality statistics by age and sex are primary evidence for epidemiological research and health policy. Annual mortality statistics from vital registration systems in Thailand are of limited utility because about 40% of deaths are registered with unknown or nonspecific causes. This paper reports the rationale, methods, and broad results from a comprehensive study to verify registered causes in Thailand. A nationally representative sample of 11,984 deaths was selected using a multistage stratified cluster sampling approach, distributed across 28 districts located in nine provinces of Thailand. Registered causes were verified through medical record review for deaths in hospitals and standard verbal autopsy procedures for deaths outside hospitals, the results of which were used to measure validity and reliability of registration data. Study findings were used to develop descriptive estimates of cause-specific mortality by age and sex in Thailand. Causes of death were verified for a total of 9,644 deaths in the study sample, comprised of 3,316 deaths in hospitals and 6,328 deaths outside hospitals. Field studies yielded specific diagnoses in almost all deaths in the sample originally assigned an ill-defined cause of death at registration. Study findings suggest that the leading causes of death in Thailand among males are stroke (9.4%); transport accidents (8.1%); HIV/AIDS (7.9%); ischemic heart diseases (6.4%); and chronic obstructive lung diseases (5.7%). Among females, the leading causes are stroke (11.3%); diabetes (8%); ischemic heart disease (7.5%); HIV/AIDS (5.7%); and renal diseases (4%). Empirical investigation of registered causes of death in the study sample yielded adequate information to enable estimation of cause-specific mortality patterns in Thailand. These findings will inform burden of disease estimation and economic evaluation of health policy choices in the country. The development and implementation of research methods in this study will contribute to improvements in the quality of annual mortality statistics in Thailand. Similar research is recommended for other countries where the quality of mortality statistics is poor.
Objective: The aim of this study was to assess knowledge, attitude, and practices towards cervical cancer screening among postpartum subjects. Study design: This cross-sectional study was conducted at inpatient obstetrics ward at Thammasat University Hospital (TUH), Thailand. The period of study was between July 2020 and July 2021. Subjects were term Thai pregnant women who had age between 20 and 45 years old and delivered at TUH. Demographic characters, knowledge, attitude and practices regarding cervical cancer screening were collected. Results: A total of 388 parturient was recruited into the study. Average age was 31 years old. Around 90 percent of subjects knew that every woman age between 21and 65 years old with or without children should be screened for cervical cancer despite having only 46.6 percent (181/388) of subjects that underwent postpartum cervical cancer screening. Almost half of the participant agreed that risky sexual behavior of both genders was not the cause of cervical cancer. Despite the availability of the HPV vaccine throughout the country, only 74.2 percent acknowledged that HPV was the cause and only 70.4% heard about the HPV vaccine. The mean attitude about the cervical cancer was relatively high with the mean of 3.19±0.46. Although the higher the score the better the attitude toward the statement, there were several correlations of having such attitude. Conclusion: Attention to postpartum cervical cancer screening was quite low even though high knowledge of cervical cancer and screening. Scant knowledge was not all of the troubles that we believed long time ago.
Background: Plantar fasciitis is a chronic inflammatory disease originating at the medial calcaneal tuberosity. Eight-five percent of people who walk extensively at work have plantar fasciitis. The efficacy of court-type Thai traditional massage (CTTM) has never been established. This study investigated the efficacies of CTTM, elastic taping (ET), and stretching (ST) in plantar fasciitis patient.
Objective: To study the accuracy of self vaginal douching and collection for HPV types 16, 18, 31 and 33 in women visiting Thammasat Hospital for the explicit purpose of cervical screening. Methods: A pelvic examination and Pap smear were performed for all women who came for cervical screening. Specimens were also collected by self vaginal douching before cervical screening and sent to the cell and molecular biology laboratory for analysis of human papillomavirus (HPV) types 16, 18, 31 and 33 using the polymerase chain reaction (PCR). Results: HPV prevalence was 3.6% overall from 250 women in this study. Twenty-four (9.6%) women had an abnormal cytology screening result. No cancer was found. Four women had a high grade squamous intraepithelial lesion (HSIL) and 14 had a low grade squamous intraepithelial lesion (LSIL) from colposcopic biopsy. Self vaginal douching for HPV 16, 18, 31 and 33 was used to predict abnormal Pap smear. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 12.5%, 97.5%, 33.3% and 91.3%, respectively. Conclusion: From our analysis of self vaginal douching for HPV detection using cases from Thammasat university hospital, it cannot replace the Pap smear.
To determine the prevalence of abnormal cervical cytology by liquid based cytology (LBC) in pregnant women who attended the antenatal care clinic at Thammasat University Hospital.LBC was performed on specimens from the collecting vial containing preserved cell solution (Cytyc, Boxborough, MA) in pregnant women who attended antenatal care at the antenatal care clinic, Thammasat University Hospital between March and July 2010. One hundred forty three pregnant women were recruited in the present study. All cytological reports were reviewed by senior cytopathologists for accurate diagnosis using the Bethesda System 2001 criteria. Patients with abnormal results as "abnormal squamous/glandular cells of undetermined significant" or more over were referred for colposcopic examination.One hundred forty three pregnant women participated in the present study. The average age was 27.09 years. There were 10 abnormal Pap smear results with four, five, and one cases of ASC-US, LSIL and HSIL respectively The prevalence of abnormal cervical cytology in this investigation was 7% with 0.7% high-grade cervical intraepithelial neoplacia. Only 6% of participants had the correct understanding of the necessity of Pap smear testing. Thirty-one percent of multiparous pregnant women in the present study had no previous Pap smear screening. The majority of participants had coitarche before the age of 20.The prevalence of abnormal cervical cytology in pregnant patients attending the antenatal care clinic at Thammasat University Hospital was 7%. The cervical cytology and related education were highly recommended in antenatal care clinic to increase cervical cancer screening coverage among reproductive age women.
This study aimed to identify the recent risk factors for Opisthorchis viverrini infection and cholangiocarcinoma (CCA) to improve disease prevention. The participants were divided into the following 3 groups based on their health status: healthy control (nonOV and nonCCA), those with O. viverrini infection (OV), and those with CCA. A questionnaire was used to explore their lifestyle and behaviors. Multivariate logistic regression and backward elimination were used to identify the significant risk factors. The results showed that the significant risk factors for both O. viverrini infection and CCA were age>50 years (odd ratio (OR)=8.44, P<0.001, 95% confidence intervals (CI) 2.98-23.90 and OR=43.47, P=0.001, 95% CI 14.71-128.45, respectively) and raw fish consumption (OR=8.48, P< 0.001, 95% CI 3.18-22.63 and OR=3.15, P=0.048, 95% CI 1.01-9.86, respectively). A history of O. viverrini infection was identified as an additional risk factor for CCA (OR=20.93, P=0.011, 95% CI 2.04-215.10). This study provided an update on the risk factors for O. viverrini infection and CCA. Asymptomatic patients with O. viverrini infection, particularly those>50 years old, should be carefully monitored to prevent CCA.
