A preliminary study of thiamine status in northeastern Thai children with acute diarrhea.

This study is a preliminary determination of thiamine status in children with diarrhea and metabolic acidosis admitted to hospital. Children with diarrhea (N = 14; age 2 m-6 yr) were divided into 2 groups according to anion gap type; group 1 (21.4%) with a normal anion gap (5.5 +/- 5.2 mmol/l) and group 2 (78.6%) with a wide anion gap (21.2 +/- 5.2 mmol/l). Blood was taken on the day of admission to determine thiamine and lactate levels. Sixty-six point seven percent of patients in group 1 had a normal lactate level (1.5 +/- 0.8 mmol/l) and 33.3% had a high lactate level (2.2 mmol/l); none had thiamine deficiency (TPPE < 20%). High lactate (3.5 +/- 1.4 mmol/l) was found in 54.5% of group 2 and thiamine deficiency was observed in 18.2% of this group. In conclusion, no thiamine deficiency was noted in patients with normal anion gap, but thiamine deficiency was not uncommon in patients with a wide anion gap, regardless of lactic acidosis.

Cystic fibrosis in three northeast Thai infants is CF really a rare disease in the Thai population?

The authors report on three infants with cystic fibrosis (CF), with different genotypes, presenting with different clinical manifestations, but having similar abnormal serum electrolytes (i.e. hyponatremia, severe hypochloremia and metabolic alkalosis). Despite the diagnostic investigations, the child who presents with severe electrolyte imbalance especially persistent hypochloremia and a family history of early infant death with respiratory or gastrointestinal problems should point to a diagnosis of CF Early identification and treatment remain critical to effective management. The diagnostic tool used, especially the sweat test, is needed for diagnostic investigations in Thailand.

Plasma ascorbate and ceruloplasmin levels in Thai premature infants.

BACKGROUND: Free radicals have been implicated in the pathogenesis of some complications among premature infants. Even though ascorbate is an important anti-oxidant in human plasma, it can also act as a pro-oxidant at high concentrations in the presence of metal ions, which causes oxidative damage in premature infants. OBJECTIVE: To determine plasma ascorbate and ceruloplasmin levels in premature infants (and their mothers) and full-term infants and to compare between groups. MATERIAL AND METHOD: Premature (n = 27) and full-term infants (n = 24) and the mothers of the premature infants (n = 13) admitted to Srinagarind Hospital, Khon Kaen University, Thailand, were enrolled in the study. Plasma ascorbate and ceruloplasmin levels were determined and compared among various clinical presentations. RESULTS: Plasma ascorbate has negative correlation with gestational age of infants. Its level on day 1 of the premature infants was significantly higher than full-term group (52.62 vs 39.00 micromol/L) and then decline after birth. Premature infants receiving oxygen therapy had lower plasma ascorbate than premature infants without oxygen therapy (p = 0.017). Plasma ascorbate in premature infants who died was higher than in those that survived (p = 0.029). Premature infants with poor outcomes had a higher ratio of plasma ascorbate to ceruloplasmin than those with good outcomes (p < 0.05). CONCLUSION: This study shows that high plasma ascorbate and low ceruloplasmin levels are associated with poor outcomes of premature infants; that is, ascorbate can act as either an anti-oxidant or a pro-oxidant.