Chaowanee Chupeerach

Effect of malarial infection on haematological parameters in population near Thailand-Myanmar border

BackgroundMalaria is a major mosquito-borne public health problem in Thailand with varied haematological consequences. The study sought to elucidate the haematological changes in people who suspected malaria infection and their possible predictive values of malaria infection.MethodsHaematological parameters of 4,985 patients, including 703 malaria-infected and 4,282 non-malaria infected, who admitted at Phop Phra Hospital, Tak Province, an area of malaria endemic transmission in Thailand during 2009 were evaluated.ResultsThe following parameters were significantly lower in malaria-infected patients; red blood cells (RBCs) count, haemoglobin (Hb), platelets count, white blood cells (WBCs) count, neutrophil, monocyte, lymphocyte and eosinophil counts, while mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), Mean corpuscular haemoglobin concentration (MCHC), neutrophil-lymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR) were higher in comparison to non-malaria infected patients. Patients with platelet counts < 150,000/uL were 31.8 times (odds ratio) more likely to have a malaria infection. Thrombocytopenia was present in 84.9% of malaria-infected patients and was independent of age, gender and nationality (P value < 0.0001).ConclusionPatients infected with malaria exhibited important changes in most of haematological parameters with low platelet, WBCs, and lymphocyte counts being the most important predictors of malaria infection. When used in combination with other clinical and microscopy methods, these parameters could improve malaria diagnosis and treatment.

Effects of malaria parasite density on blood cell parameters.

Changes in blood cell parameters are already a well-known feature of malarial infections. To add to this information, the objective of this study was to investigate the varying effects that different levels of parasite density have on blood cell parameters. Patients diagnosed with malaria at Phobphra Hospital, Tak Province, Thailand between January 1st 2009 and January 1st 2012 were recruited as subjects for data collection. Blood cell parameters of 2,024 malaria-infected patients were evaluated and statistically analyzed. Neutrophil and platelet counts were significantly higher, however, RBC count was significantly lower in patients with P. falciparum infection compared to those with P. vivax infection (p<0.0001). Leukocyte counts were also significantly higher in patients with high parasitemia compared to those with low and moderate parasitemia. In terms of differential leukocyte count, neutrophil count was significantly higher in patients with high parasitemia compared to those with low and moderate parasitemia (p<0.0001). On the other hand, both lymphocyte and monocyte counts were significantly lower in patients with high parasitemia (p<0.0001). RBC count and Hb concentration, as well as platelet count were also significantly reduced (p<0.05) and (p<0.0001), respectively. To summarize, patients infected with different malaria parasites exhibited important distinctive hematological parameters, with neutrophil and eosinophil counts being the two hematological parameters most affected. In addition, patients infected with different malarial densities also exhibited important changes in leukocyte count, platelet count and hemoglobin concentration during the infection. These findings offer the opportunity to recognize and diagnose malaria related anemia, help support the treatment thereof, as well as relieve symptoms of severe malaria in endemic regions.

Age Distribution of Breast Cancer from a Thailand Population- Based Cancer Registry

BACKGROUND Breast cancer is a common cancer worldwide. With the establishment of Thailands population- based cancer registry and availability of complete data from 2002-2011, it is of interest to investigate the epidemiologic and clinic-pathological profiles of breast cancer based on the population-based registry data. METHODS The data of all breast cancer patients in the registry for the period of 2002-2011 were included. All medical records of the patients diagnosed from documents of National Cancer Registry of Thailand were retrieved and the following information abstracted: age, clinical characteristics, and histological variables. Thailand census data for the period of 2002-2011 were used to provide the general populations statistics on age, gender, and other related demographic factors. RESULTS Over the 10 year-period, 7,711 breast cancer cases were included. The disease incidence under age 40 years was relatively low (4.13/105) while the incidence in the age groups 40 and older was very high (39.2/105). The vast majority of breast cancer cases (88.8%) were diagnosed by histology as primary lesions in the breast. The most common of patients with breast cancer (36.4%) had regional lymph node involvement and the most common of histopathology diagnosed in patients (84.2%) was an infiltrating duct carcinoma. CONCLUSIONS This study showed a high incidence of breast cancer in older subjects, and high rate of breast cancer in Thailand. Future studies should explore clinical and molecular disease patterns.

Association of Thr420Lys polymorphism in DBP gene with fat-soluble vitamins and low radial bone mineral density in postmenopausal Thai women

AIMS To investigate the genetic markers for osteoporosis bone mineral density by the genotyping of rs7041, rs4588 and rs1352845 in the DBP gene with either bone mineral density or serum 25-hydroxycholecalciferol, retinol and α-tocopherol, among 365 postmenopausal Thai women. MATERIALS & METHODS The DBP genotypes were analyzed by a PCR restriction fragment-length polymorphism method. Serum 25-hydroxycholecalciferol was assessed using a commercial chemiluminescent immunoassay. Serum retinol and α-tocopherol were measured by reverse-phase high-performance liquid chromatography. RESULTS After adjustment for age >50 years, elder Thai subjects with low BMI (≤25 kg/m(2)) and carrying the rs4588 CC genotype had a higher risk of radial bone mineral density osteoporosis (odds ratio: 6.29; p = 0.048). The rs1352845 genotype also had a statistical association with total hip bone mineral density; however, it disappeared after adjustment for age and BMI. No association was found in fat-soluble vitamins with bone mineral density. CONCLUSION DBP genotypes may influence the osteoporosis bone mineral density in postmenopausal Thai women.

Knowledge, attitudes and practice of breast cancer screening among female personnel of Walailak University

Breast cancer is the most common cancer among women worldwide.

The Effect of Coconut Jelly with Stevia as a Natural Sweetener on Blood Glucose, Insulin and C-Peptide Responses in Twelve Healthy Subjects

BACKGROUND Coconut jelly is a popular dessert among Asian people. However, it contains high levels of sugar. The recent patents on steviol glycoside (WO2015014969A1), steviol glycoside compositions for oral ingestion or use (WO2017095932A1) and sweetener composition for preventing and improving obesity, containing glycolysis inhibitor ingredient (EP2756764B1) help to select the sweetener for development of coconut jelly. OBJECTIVE Therefore, the purposes of this study were to develop a healthier coconut jelly formula by using stevia as a natural sweetener as well as to investigate the short-term effects of Modified Coconut Jelly (MCJ) compared to Control Formula (CCJ) consumption on glycemic and insulin responses in twelve healthy participants. METHODS The sensory evaluation found that MCJ with 50% sugar replacement using stevia obtained the highest acceptability score compared to other formulas. In a cross-over design, participants were required to consume MCJ and CCJ containing 50 g of available carbohydrates. Blood samples were collected at 0 (baseline), 30, 60, 90 and 120 minutes for postprandial blood glucose, insulin, and C-peptide. RESULTS The incremental Areas Under the Curve (iAUC) of blood glucose and insulin of MCJ had a lower trend than CCJ by 15.7 and 5.4 percent, respectively. MCJ consumption had blood glucose slowly decline after 60 to 120 minute. MCJ tended to decrease in postprandial blood glucose level without inducing insulin secretion. CONCLUSION This might be an effect of stevia. Nutrient composition is lower in total sugar and higher in fiber, which has been reported as antihyperglycemia in humans. Therefore, MCJ might be an optional food product for healthy people or patients with Non-Communicable Diseases (NCDs) such as diabetes mellitus.

Differential expression of matrix metalloproteinase-13 in association with invasion of breast cancer

Matrix metalloproteinase-13 (MMP-13) has a potential role in tumour invasion and metastasis. However, its relevance to the prognosis of human breast cancer is poorly understood. The aim of this study is to investigate the expression patterns of MMP-13 protein and to determine its prognostic value in breast cancer, and to define its relation to the clinicopathological features. Immunohistochemistry analysis of MMP-13 was performed on formalin-fixed, paraffin-embedded sections of cancerous breast tissue (n = 76) and normal breast tissue (n = 20), all of which had clinicopathological information available. Based on the principle of immunoreactivity, the detection of MMP-13 on breast tissue was conducted using monoclonal antibodies against MMP-13. A semi-quantitative scoring system was used to assess the presence of, as well as the cellular localisation of MMP-13. MMP-13 expression was significantly greater in the cancerous breast tissues in comparison to those of normal breast tissues. In addition, high levels of MMP-13 expression were also found to be related to the positive detection of breast cancer cells in lymph nodes-amongst breast cancer patients. The results of this study showed that MMP-13 was frequently present in breast tumours, especially when tumours were accompanied by positive breast cancer cell detection in lymph nodes. This suggests that MMP-13 plays a potentially significant role in breast cancer invasion and metastasis.