Piyapat Dajpratham

Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study

Objective To determine the efficacy and safety of Curcuma domestica extracts in pain reduction and functional improvement. Methods 367 primary knee osteoarthritis patients with a pain score of 5 or higher were randomized to receive ibuprofen 1,200 mg/day or C. domestica extracts 1,500 mg/day for 4 weeks. The main outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, WOMAC pain, WOMAC stiffness, and WOMAC function scores. Adverse events (AEs) were also recorded. Results 185 and 182 patients were randomly assigned into C. domestica extracts and ibuprofen groups, respectively. The baseline characteristics were no different between groups. The mean of all WOMAC scores at weeks 0, 2, and 4 showed significant improvement when compared with the baseline in both groups. After using the noninferiority test, the mean difference (95% confidence interval) of WOMAC total, WOMAC pain, and WOMAC function scores at week 4 adjusted by values at week 0 of C. domestica extracts were noninferior to those for the ibuprofen group (P=0.010, P=0.018, and P=0.010, respectively), except for the WOMAC stiffness subscale, which showed a trend toward significance (P=0.060). The number of patients who developed AEs was no different between groups. However, the number of events of abdominal pain/discomfort was significantly higher in the ibuprofen group than that in the C. domestica extracts group (P=0.046). Most subjects (96%–97%) were satisfied with the treatment, and two-thirds rated themselves as improved in a global assessment. Conclusion C. domestica extracts are as effective as ibuprofen for the treatment of knee osteoarthritis. The side effect profile was similar but with fewer gastrointestinal AE reports in the C. domestica extracts group.

MAIN OUTCOMES OF STROKE REHABILITATION: A MULTI-CENTRE STUDY IN THAILAND

OBJECTIVE To estimate the efficiency of inpatient rehabilitation for patients after stroke in Thailand. DESIGN Multi-centre, prospective study. SUBJECTS Patients after stroke, aged >or= 18 years, with stable medical signs, able to follow 1-step commands and to sit for at least 30 min. METHODS Main outcomes included Barthel Index (BI) scores, BI effectiveness, BI efficiency, length of stay, Thai Hospital Anxiety and Depression Scale (HADS) scores, and quality of life. RESULTS Of a total of 327 patients, 285 completed the programmes, with a mean length of stay of 27.3 days. Mean age was 62.1 (standard deviation (SD) 12.1) years and 59% of patients were male. Mean BI scores on admission and at discharge were 7.48 (SD 3.96; range 0-19) and 13.27 (SD 4.86; range 0-20), respectively. The change score was 5.79 (SD 3.89) and the efficiency of functional score was 0.28 points/day. Using multivariate analysis, factors associated with change in BI score were age, previous stroke and length of stay. Sixty-four patients (25.5%) had anxiety and 95 (37.8%) had depression on admission. At discharge, the numbers of patients with anxiety and depression decreased to 17 (6.8%) and 41 (16.3%), respectively. The quality of life scores at discharge were significantly higher than those on admission. CONCLUSION Inpatient rehabilitation enabled stroke patients to reach optimal functional ability, and improved psychological status and quality of life.

First-Year Outcomes after Stroke Rehabilitation: A Multicenter Study in Thailand

Stroke affects the long-term quality of life and the well-being of patients and families. Stroke patients gain benefits from rehabilitation. Authors reported 1-year outcomes of stroke rehabilitation in 327 patients registered to the Thai Stroke Rehabilitation Registry. The outcomes included death rate, readmission rate, functional ability score (Barthel Index, BI), and factors affecting BI score. Of 327 patients, 214 (65.4%) had adequate follow-up data for analysis. The average age was 62.1 ± 12.5 years, and 57.9% were male. The mortality rate was 2.5% and the readmission rate was 11.2%. The number of the patients who could function independently increased from 5.5% at discharge to 22.9% and 25.5% at month 6 and month 12, respectively. The change in functional ability level of 214 patients included improvement (51.5%), deterioration (12.8%), and equivocal (35.7%). The low functional score at month 12 was significantly correlated with longer length of stay (LOS), longer onset to admission interval, and higher depression score at month-12. In conclusion, approximately half of the patients had an improvement in the disability level for at least one grade at 1-year follow-up. The low functional score by the end of the first year is associated with longer LOS during the first admission, delay in rehabilitation program, and psychological depression.

Self-physical rehabilitation system using the microsoft kinect

In this paper, We present a Self-Physical Rehabilitation System (SPRS) that assists patients to rehab correctly at home by themselves without physical therapists for solving the problem of access to medical service. SPRS uses KINECT to detect movement of patients body while doing self-rehab and processing of data from motion detection of patients by KINECT to determine accuracy of gesture. This software that allows patients to exercises with 9 gestures of balance physical therapies which are Hip extension, Side Leg raise, Knee flexion, Hip flexion, Plantar flexion, Tandem walk, Side walk, Chair Stands, and Timed Up &Go. The results show SPRS allows patients rehab correctly with a slight error that better than exercise without assisted by software.

Post-Fall Intelligence Supporting Fall Severity Diagnosis Using Kinect Sensor

This paper proposes a fall severity analytic and post-fall intelligence system with three interdependent modules. Module I is the analysis of fall severity based on factors extracted in the phases of during and after fall which include innovative measures of the sequence of body impact, level of impact, and duration of motionlessness. Module II is a timely autonomic notification to relevant persons with context-dependent fall severity alert via electronic communication channels (e.g., smartphone, tablet, or smart TV set). Lastly, Module III is the diagnostic support for caregivers and doctors to have information for making a well-informed decision of first aid or postcure with the chronologically traceable intelligence of information and knowledge found in Modules I and II. The system shall be beneficial to caregivers or doctors, in giving first aid/diagnosis/treatment to the subject, especially, in cases where the subject has lost consciousness and is unable to respond.