Suphat Subongkot

Serum melatonin levels and antioxidant capacities after consumption of pineapple, orange, or banana by healthy male volunteers

Melatonin is a naturally occurring molecule biosynthesized by the pineal gland of vertebrates; it also has been identified in many plants. It is considered an important antioxidant and may retard the development of some neurodegenerative diseases and cancer. Previous studies in humans have measured melatonin metabolites in urine and have indicated that melatonin‐containing foods may provide dietary melatonin. This study tested whether the consumption of fruits or fruit juice containing melatonin would influence the serum melatonin concentration and antioxidant status. In this crossover study, 12 healthy male volunteers took either juice extracted from one kilogram of orange or pineapple or two whole bananas, with a 1‐wk washout period between the fruit or fruit juices. An enzyme‐linked immunosorbent (ELISA) assay was used to determine the serum melatonin concentration. Serum antioxidant capacity was determined by ferric reducing antioxidant power (FRAP) assay and oxygen radical antioxidant capacity (ORAC) assay. The highest serum melatonin concentration was observed at 120 min after fruit consumption, and compared with before consumption levels, their values were significantly increased for pineapple (146 versus 48 pg/mL P = 0.002), orange (151 versus 40 pg/mL, P = 0.005), and banana (140 versus 32 pg/mL, P = 0.008), respectively. Serum antioxidant capacity following fruit consumption also significantly increased in both the FRAP (7–14% increase, P ≤ 0.004) and ORAC (6–9% increase, P = 0.002) assays. Both the serum FRAP and ORAC values strongly correlated with serum melatonin concentration for all three fruits. These findings suggest that tropical fruit consumption increases the serum melatonin concentrations and also raises the antioxidant capacity in the serum of healthy volunteers in proportion to serum melatonin levels.

Cost-effectiveness analysis of olanzapine-containing antiemetic therapy for managing highly emetogenic chemotherapy in Southeast Asia: a multinational study

PurposeRecent studies suggested that olanzapine, together with dexamethasone and serotonin-3 receptor antagonist (5HT3RA), is effective in preventing chemotherapy-induced nausea and vomiting (CINV) following highly emetogenic chemotherapy (HEC). This regimen is particularly useful in Southeast Asia (SEA) countries where resources are limited. We aimed to evaluate the cost-effectiveness of incorporating olanzapine into standard antiemetic regimens for the prevention of CINV in patients receiving HEC among SEA countries.MethodsUsing a decision tree model, clinical and economic outcomes associated with olanzapine-containing regimen and standard antiemetic regimen (doublet antiemetic regimen: dexamethasone+first generation 5HT3RA) in most SEA countries except in Singapore (triplet antiemetic regimen: dexamethasone+first generation 5HT3RA + aprepitant) for CINV prevention following HEC were evaluated. This analysis was performed in Thailand, Malaysia, Indonesia, and Singapore, using societal perspective method with 5-day time horizon. Input parameters were derived from literature, network meta-analysis, government documents, and hospital databases. Outcomes were incremental cost-effectiveness ratio (ICER) in USD/quality-adjusted life year (QALY) gained. A series of sensitivity analyses including probabilistic sensitivity analysis were also performed.ResultsCompared to doublet antiemetic regimen, addition of olanzapine resulted in incremental QALY of 0.0022–0.0026 with cost saving of USD 2.98, USD 27.71, and USD 52.20 in Thailand, Malaysia, and Indonesia, respectively. Compared to triplet antiemetic regimen, switching aprepitant to olanzapine yields additional 0.0005 QALY with cost saving of USD 60.91 in Singapore. The probability of being cost-effective at a cost-effectiveness threshold of 1 GDP/capita varies from 14.7 to 85.2% across countries.ConclusionThe use of olanzapine as part of standard antiemetic regimen is cost-effective for the prevention of CINV in patients receiving HEC in multiple SEA countries.

Hospitalization and cost after switching from atypical to typical antipsychotics in schizophrenia patients in Thailand.

Background Several clinical practice guidelines suggest using atypical over typical antipsychotics in patients diagnosed with schizophrenia. Nevertheless, cost-containment policy urged restricting usage of atypical antipsychotics and switching from atypical to typical antipsychotics. Objective This study aimed to evaluate clinical and economic impacts of switching from atypical to typical antipsychotics in schizophrenia patients in Thailand. Methods From October 2010 through September 2013, a retrospective cohort study was performed utilizing electronic database of two tertiary hospitals. Schizophrenia patients aged 18 years or older and being treated with atypical antipsychotics were included. Patients were classified as atypical antipsychotic switching group if they switched to typical antipsychotics after 180 days of continual atypical antipsychotics therapy. Outcomes were schizophrenia-related hospitalization and total health care cost. Logistic and Poisson regression were used to evaluate the risk of hospitalization, and generalized linear model with gamma distribution was used to determine the health care cost. All analyses were adjusted by employing propensity score and multivariable analyses. All cost estimates were adjusted according to 2013 consumer price index and converted to US

Effectiveness of olanzapine for the treatment of breakthrough chemotherapy induced nausea and vomiting.

at an exchange rate of 32.85 Thai bahts/US

A phase II randomized double-blind placebo-controlled study of 6-gingerol as an anti-emetic in solid tumor patients receiving moderately to highly emetogenic chemotherapy

. Results A total of 2,354 patients were included. Of them, 166 (7.1%) patients switched to typical antipsychotics. The adjusted odds ratio for schizophrenia-related hospitalization in atypical antipsychotic switching group was 1.87 (95% confidence interval [CI] 1.23–2.83). The adjusted incidence rate ratio was 2.44 (95% CI 1.57–3.79) for schizophrenia-related hospitalizations. The average total health care cost was lower in patients with antipsychotic switching (−

A phase II randomized, double-blind placebo-controlled trial of an antiemetic, 6-gingerol in solid tumor patients receiving moderately to highly emetogenic adjuvant chemotherapy.

64; 95% CI −

Exploration the Results of Cancer Pain Management Following Implementation of World Health Organization (WHO) Pain Guideline

459 to

Off-label use and pharmacovigilance among infants: analysis of the Thai Health Product Vigilance National Database

332). Conclusion Switching from atypical to typical antipsychotics is associated with an increased risk of schizophrenia-related hospitalization. Nonetheless, association with average total health care cost was not observed. These findings can be of use as a part of evidence in executing prospective cost-containment policy.