ABSTRACT
Analgesic abuse is common in Thailand. Heavy use of analgesic may also increase risk of chronic nephropathy. However, the extent of this risk remains unclear. We carried out a case-control study in three referral hospitals. A total of 84 patients with newly diagnosed of chronic tubulointerstitial nephritis were enrolled as cases. Two control groups were randomly selected, 192 from hospitalized patients who had no renal disease and serum creatinine below 1.2 mg/dl and 166 from relatives of friends visiting the hospitals. Both cases and controls were interviewed by a standardized pre-coded questionnaire to obtain histories of analgesic use before diagnosis of renal disease. On multiple logistic regression analysis, patients whose estimated lifetime use of acetaminophen of 1,000 g or more had an increased risk of chronic nephropathy compared with non-users, the odds ratio (OR) was 5.9 (95% confidence interval (CI) 1.3-25.6, hospital controls) and OR = 5.8 (95% CI 1.04-31.9, visitor controls). Also, uses of aspirin showed a similar relationship. Patients who used aspirin 1,000 g or more per lifetime had higher risk of chronic nephropathy when compared to non-users, the odds ratio were 7.1 (95% CI 2.0-25.8, hospital controls) and 20.4 (95% CI 2.4-174.2) for visitor controls. These data indicate that analgesic abuse increased risk of chronic nephropathy in Thailand.
Subject(s)
Acetaminophen , Adult , Analgesics, Non-Narcotic , Anti-Inflammatory Agents, Non-Steroidal , Aspirin , Case-Control Studies , Chronic Disease , Female , Humans , Logistic Models , Male , Middle Aged , Nephritis, Interstitial/chemically induced , Odds Ratio , Surveys and Questionnaires , Risk Factors , Substance-Related Disorders/complications , ThailandABSTRACT
A therapeutic trial of single mebendazole, 300 mg polymorph A, 300 mg polymorph C and 500 mg polymorph C, in the treatment of hookworm and Trichuris infections was carried out at primary schools in Southern Thailand. The total of 958 children were randomly allocated in seven treatment groups including the placebo control and the standard dose control (100 mg polymorph C bid for 3 days). The egg reduction rates and the cure rates of 300 mg and 500 mg polymorph C were similar, but inferior to those of the standard dose in both hookworm and Trichuris infections. The efficacy of single dose 300 mg polymorph A was not different from that of the placebo control (alpha = 0.05) in both infections.
Subject(s)
Child , Dose-Response Relationship, Drug , Feces/parasitology , Female , Hookworm Infections/drug therapy , Humans , Male , Mebendazole/administration & dosage , Parasite Egg Count , Trichuriasis/drug therapyABSTRACT
Favism, a hemolytic condition associated with fava bean consumption among the glucose-6-phosphate dehydrogenase (G6PD) deficient persons, is well described in the Middle East and Mediterranean areas. However, it is not well documented among the Thais or other Southeast Asians. It is possible that it does exist but that hemolysis which develops is of very minor degree and thus escapes clinical detection. This cross-sectional study hypothesizes that if the fava bean and G6PD deficiency interact in the Thai population, they should cause a significant difference in hematocrit level. The study was carried out in a community hospital in a malaria endemic area. We found that there was a trivial difference of the hematocrit (approximately 1%) which was too small to warrant any clinical significance after controlling for the extraneous effects of age, sex, use of malaria chemoprophylaxis, falciparum infection, use of analgesics/antipyretics and admission status of the patients (p = 0.668). This may be due to the presence of different G6PD mutants to those found elsewhere or due to different consumption patterns of fava beans among the Thais compared to people in other areas with high prevalence of G6PD deficiency.
Subject(s)
Adolescent , Adult , Age Factors , Analgesics , Animals , Anti-Inflammatory Agents, Non-Steroidal , Antimalarials , Cross-Sectional Studies , Fabaceae , Favism/epidemiology , Female , Feeding Behavior , Glucosephosphate Dehydrogenase Deficiency/epidemiology , Hematocrit , Hemolysis , Humans , Malaria, Falciparum , Male , Middle Aged , Plants, Medicinal , Surveys and Questionnaires , Regression Analysis , Sex Factors , Thailand/epidemiologyABSTRACT
Age-adjusted morbidity rates of Dengue Haemorrhagic Fever in Thailand during the period 1983-1987 were analysed. The 1983 data were used as standard baseline rates. The age-adjusted rates showed increasing trend in the disease morbidity, i.e., 60.2, 138.2, 159.6, 55.2 and 344.7 (per 100,000 capita) respectively. These rates were consistently higher than the crude rates. The Standardised Morbidity Ratios (SMRs) as compared with the baseline 1983 were 1.00, 2.30, 2.65, 0.92 and 5.73 respectively. Regional comparisons revealed annual increases in Bangkok areas, other Central provinces, the North and the Northeast with fluctuations observed in the South. The epidemic was most of the time higher in the Central provinces other than Bangkok areas. The authors suggest that age-adjusted rates (or possibly sex) should be applied in the study of DHF morbidity data, since there were discrepancies in the age distribution among different regions of the country.