ABSTRACT
A randomized double blind placebo controlled trial was conducted to determine the efficacy of Gymnostemma pentaphyllum in patients with hyperlipidemia. Twenty-three patients were allocated to receive Gymnostemma pentaphyllum powder in capsule at the dosage of 5 grams thrice a day for 3 months. Twenty-one patients received placebo in identical capsules thrice a day for 3 months. Lipid profiles (cholesterol, triglyceride, high density lipoprotein and low density lipoprotein) were determined prior to taking medication and every month thereafter. Lipid profiles of all patients at entry were not significantly different from those after therapy. Lipid profiles of the patients in both groups at month 1, 2 and 3 were not significantly different. Oxidative stress & anti-oxidant activity and anti-platelet activity in the serum samples taken from patients in both groups were not significantly different. Adverse events and abnormal laboratory tests were not observed in patients receiving Gymnostemma pentaphyllum. Most of the patients were satisfied with the treatment they received. It is concluded that Gymnostemma pentaphyllum powder in capsules prepared by Department of Medical Sciences, Ministry of Public Health at the dosage of 5 grams thrice a day for 3 months is safe but not efficacious in reducing lipids in patients with hyperlipidemia.
ABSTRACT
Body mass index (BMI) is an indicator for nutritional status which correlates with mortality. Studies in the past indicated that undernutrition was one of the major nutritional problems in elderly Thais especially in the rural area. The objective of this study is to determine the BMI of the elderly who live in rural areas of central Thailand. Random sampling of volunteers age > 60 years in 3 districts of Samut Songkram and Rajaburi provinces was done. One hundred and ninety-three elderly people, 77 men and 116 women, age 60-87 years old, were included in the study. BMI of male and female participants was 22.76 + 3.81 and 24.51+ 3.94 kg/m2 respectively. Women had significantly higher BMI than men. When used a BMI of <18.5 kg/m2 as cut-off point, 13.0% of male and 6.9% of female were suffering from under-nutrition. However, grade III malnutrition was found in only 1.5% of the participants of the study. In contrary, overweight and obesity was found 20.8% and 2.6% in male subjects and 33.6% and 11.2% in female subjects respectively. The prevalence of over-nutrition has increased during the past decade. A survey of over-nutrition related diseases is required and further surveillance in this population is essential to verify the impact of increasing BMI on morbidity and mortality in elderly people.
ABSTRACT
The study were to apply a systematic review to answer the question whether routine preoperative investigation affected health outcomes; and to construct clinical practice guidelines for preoperative checking of blood glucose, BUN, creatinine and electrolytes. The guidelines were prepared for elective, non-cardiothoracic surgery in adult patients. Methods of the study were Medline search (1980-1998) and a search of studies published in Thailand. Criteria for high validity and reliability were applied to paper selection. The results of the systematic review were discussed among anesthesiologists and other specialists and the guidelines were drawn by consensus. Results from the systematic review suggested there were no randomized controlled trials to answer the question and no studies reported health outcomes. From this review and the consensus, we proposed guidelines which consisted of a history questionnaire, physical examination and indications for investigation. For the preoperative checking of blood glucose, the indications were: age > 60 years, obesity, diabetes, hypoglycemia, liver disease, alcoholism, severe infection, alteration of consciousness, hypothalamic, pituitary, pancreatic and adrenal disease, and steroid therapy. The common indications for both BUN/creatinine and electrolytes checking were: age > 60 years, undergoing TURP, TUR-BT and major KUB surgery, obesity, diabetes, hypertension, chronic renal failure, renal disease, liver disease, alcoholism, severe infection, severe vomiting or diarrhea, history of fluid, acid base or electrolyte disturbance, alteration of consciousness, hypothalamic, pituitary, pancreatic and adrenal disease, ADH abnormality and diuretic or digoxin therapy. The additional indications for electrolyte checking were: convulsion or muscle weakness, CNS disease with increased ICP and steroid therapy.
ABSTRACT
The study was conducted to determine the type and prevalence of malnutrition in 14 patients undergoing continuous ambulatory peritoneal dialysis. Height, weight, and anthropometric indicators were measured and venous blood samples were analyzed. A three-day dietary record was made. When ideal body weights were used as cut-off points,14% were underweight and 35.5% were obese. Fourteen percents had a body mass index (BMI) < 20 kg/m2 and 21.4% had BMI > 24.9 kg/m2. Seven and 14% of them had triceps skinfold thickness or mid arm muscle area below the 5th percentile and above the 95th percentile respectively. All of the patients were anemic. Lymphopenia, hypoalbuminemia, hypokalemia, hyperphosphatemia and hyperlipoproteinemia were present in 50%, 14%, 36%, 64% and 71% of the patients respectively. Sixty-two percent of them received >80% of their energy requirement. Protein intake was 0.97 + 0.39 gm/kg/day while protein loss was 6.5 + 1.4 gm/day into the dialysate and 0.3+ 0.04 gm/day in the urine. There were large variations in nutritional status in patients undergoing continuous peritoneal dialysis. The patients should have appropriate energy intake, taking into account the energy from glucose absorbed from the dialysate, and protein intake should be increased to cover the losses. Nutritional counseling should be made individually.
ABSTRACT
The study was conducted to determine the prevalence of anaemia in 3,275 males and 155 females intending to work abroad. Information about age, sex and geographical residence was taken and haemoglobin levels were determined by spectrophotometry using the cyanmethaemoglobin method. Forty-four percent of the total came from the north-eastern part of Thailand while 37 percent and 19 percent came from the northern and other parts of the country, respectively. Their ages ranged from 17 to 59 years. The mean haemoglobin levels of males was higher than that of females (13.9+1.35 vs 12.6+1.26 g/dl, P<0.001). The overall prevalence of anaemia was 11.9 percent and was significantly higher in females (24.5% compared with 11.3% in males, [P<0.0001]). This difference could be demonstreated for each part of the country and each age group. Among the males, there was a difference in the females because of the small sample size. Anaemia is common among Thai labourers; thus the screening of their haemoglobin levels should be performed routinely before they go abroad.
ABSTRACT
Five hundreds and sixty-one patients hospitalized in Siriraj Hospital during the period from August – December 1988 were evaluated for their nutritional status. There were 349 surgical patients and 212 medical patients; 332 female and 229 males. Based on anthropometric parameters, the status of protein calorie-malnutrition was found to be 33.4% by weight-height, 33.9% by sum skinfold thickness, 28.1% by proportion of baby fat, and 9.7% by mid-arm muscle circumference. Abnormal caloric status was more prevalent than their protein status. Obesity was detected in 41.1, 40 and 11.1%, and overnutrition 7.5, 11.9 and 13.2%, according to sum skinfold thickness, proportion of body fat and weight-height, respectively. There were 35.4, 3.8 and 12.2% patients who had haemoglobin, serum protein and albumin levels below the occeptable range. The present study in this group of patients disclosed not only undernutrition but also overnutrition.