Epidemiological correlation between chromium content in gallstones and cholesterol in blood.

The authors measured the chromium in gallstones and bile from patients in three areas (Kawasaki (a city adjacent to Tokyo) in Japan, Chiang Mai and Bangkok in Thailand) by means of neutron activation analysis. The chromium in three types of gallstones (cholesterol, pigment, and rare stones) and bile from patients living in Bangkok were evidently larger than those from patients living in Kawasaki and Chiang Mai. The high chromium intake by Bangkok patients continued from the start of gallstone formation until the time the stones were removed. The total-cholesterol, triglyceride, and hemoglobin A(1C) levels in the blood from Bangkok residents with high chromium intake over a long period were clearly lower than those of Japanese and Chiang Mai residents. The authors showed that the high dietary intake of chromium over a long period may play a role in the lowering of total-cholesterol, triglyceride, and hemoglobin A(1C) in blood.

Outpatients’ satisfaction with social security service of Siriraj Hospital.

We interviewed 872 outpatients who came for Social Security Service of Siriraj Hospital. On average, this was the 1.88th time the patients had come for treatment. Most of them were younger than 40, 55 percent had finished elementary education. Most were workers in factories and the average wage was 4,131 baht/month. Female:male ratio was 6:4 and about half of them were married. Sixty-nine percent of the patients did not know what disease caused their illness. The average cost of traveling from home to the hospital was 129.65 baht. Traveling time was less than 30 minutes in 38.5 percent, 30 minutes to 1 hour in 28.7 percent, 1-2 hours in 25.8 percent. There was no problem in coming for treatment in 87.4 percent of cases; in the group who had a problem, the problem was the long distance from home to the hospital. The average time that the patients spent waiting in front of the registration card room was 10.3 minutes, examination room 43.5 minutes and pharmacy room 19.8 minutes, total waiting time 73.6 minutes. Before examination, 88.3 percent were satisfied that they were insured with Siriraj Hospital. After examination and pharmacy rooms, 78.7 percent were satisfied. Eighty-two percent answered that there was no aspect they wanted Siriraj Hospital to improve in. We investigated the satisfaction of these outpatients by using rating-scale questionnaire, 12 questions for registration card room, 14 questions for examination room and 8 questions for pharmacy. Using step-wise multiple regression, we found that the satisfaction score of each room was 81.1, 78.1 and 74.6 problem in coming for treatment and wages. For the examination room the were sex, work character, education level and traveling expense. Fore pharmacy they were waiting time and age.

A study on socioeconomic status of the Thai employee working abroad.

Descriptive epidemiology was applied to 1,000 Thai employee proposing to work abroad, during the period of February to April, 1987. 59.1% of the workers never traveled but another 40.9% experienced at least once. Mostly 92.5%, occupied within the age-group of 22-44, while the age-range was between 19-59. The male population was six times over the female, 72.4% married. Most of the worker (40.1%) lived in the North-east, rarely came from the South (0.6%). Agriculture (50.8%) was the common occupation. The previous average income was 8,794.66 Bahts per year. 92.3% of the destination was Saudi Arabia. Janpan, Iraq, Kuwait, Barhein and Singapore were respectively less popularity. Skilled labour (37.1%) was highly required for the male but house-wife (12%) for the females. The contract signed one year (28%) and two years (66%) for the period of employment. The monthly expected average income was 7,145.20 and 6,573.86 Bahts of the salary could be sent back home. Concerning the expense required from the agency, 30,000-40,000 Bahts was the sum (51.8%). Time spent for the arrangement (50.8%) was 1-4 months. 47.4% loaned from the bank, only 24.0% had their own financial support.

Acute abdominal pain from methyl bromide poisoning.

An unusual chief complaint of methyl bromide poisoning was reported. The patient, a single 32 years-old Thai female, working as a librarian for nine years was the victim. She kept on inhaling vapourized toxic gas from the books and documents previously fumigated for insecticidal purpose during the process of her daily work. She had experienced sniffing and felt weak since starting her career. Serious abnormal feeling occurred three days before admission. Nausea and abrupt abdominal pain around the right iliac fossa were manifested. Acute appendicitis was first diagnosed by a surgeon. The clue that lead to a correct diagnosis was about her occupation. The blood was sent to the toxicology center assessing for toxic materials. The result showed 32.2 mg./100 ml. of methyl bromide contained in the blood. She fortunately escaped from open laparotomy. After six days of hospitalization, she returned to work in a new position as recommended. A follow-up was carried out two months later. The methyl bromide blood level had fallen to 3.21 mg./100 ml. and her health had returned to normal. This was the first reported case of methyl bromide poisoning in Thailand.

Epidemiological study on the health hazard of castor bean dust.

Castor bean is one of the agricultural cash crops of economic importance, the health hazards of castor bean dust that recently made headlines in the mass media alerted many governmental agencies concerned to take action. The castor oil mill started operation in 1979, at Phra Pradaeng, Samut Prokan 50 km east of Bangkok. A few months after the operation, people who lived within 2 kilometres of the mill began to develop respiratory ailments: cough, sneezing, headache, nasal blockage, wheezing, violent attacks of asthma. An epidemiological survey carried out showed that castor bean dust was the major health hazards in the villages within 2 kilometres of the castor oil mill in Phra Pradaeng. The patients suffering from asthma due to castor bean had no further attacks after closure of the factory. The study indicated that to minimize the health hazard problem, the castor bean oil mill should improve its method of collecting the castor bean pomace.