Relationship between soluble leptin receptor, leptin, lipid profiles and anthropometric parameters in overweight and obese Thai subjects.

Median, range and 95% confidence interval (CI) for median of age, anthropometric variables, soluble leptin receptor, serum leptin and lipid profile levels of 48 overweight (Body mass index (BMI) = 25.00-29.99 kg/m2) and obese (BMI > or = 30. 00 kg/m2) Thai males and 166 overweight and obese Thai females, compared with 26 males and 81 females in a control group (BMI = 18.50-24.99 kg/m2), were determined The study subjects were persons who turned up regularly for physical check-ups at the Out-patient Department, General Practice Section, Ratchawithi Hospital, Bangkok, aged between 18-60 years. Serum leptin, triglyceride and low density lipoprotein cholesterol/high density lipoprotein cholesterol ratios (LDL-C/ HDL-C ratio) were significantly higher in the overweight and obese males and females. Soluble leptin receptor and HDL-C were significantly lower in the overweight and obese males and females. Cholesterol and LDL-C were significantly higher in the overweight and obese females, but there was no significant difference in the overweight and obese males when compared with the control males. Low soluble leptin receptor levels were found in 38.1% (8/21) of the overweight and obese males, while 31.5% (29/92) were found in the overweight and obese females. Elevated leptin levels were found in 66.7% (32/48) and 89.8% (149/166) of the overweight and obese males and females, respectively. Both low soluble leptin receptor levels and elevated leptin levels were found in 9.5% (2/21) and 29.4% (27/92) of the overweight and obese males and females, respectively. A significant positive correlation was found between soluble leptin receptor and cholesterol, and between weight, BMI, waist, hip and HDL-C, with leptin. Serum soluble leptin receptor levels were significantly negatively correlated with leptin and BMI. The results can elucidate the causes and consequences of obesity, and are expected to aid the provision of care for overweight and obese Thai people.

Experience with a self-administered device for cervical cancer screening by Thai women with different educational backgrounds.

Background: This descriptive study was carried out to test the acceptability of a self-administered device for cervical cancer screening and assess certain risk factors in relation to the cancer in two districts of Khon Kaen province in Northeast Thailand. Methods: A total of 354 women from the villages were selected (including 143 teachers from secondary and primary schools; 24 health officers from the rural health centres, and 37 nurses from the University Hospital, Khon Kaen University). The Kato device was introduced and used by the women, who were then asked to give their opinion on its usage. Results: The Kato device was generally well accepted by the women. However, many of those with a higher educational background were more sceptical towards the device than their counterparts from the villages. Conclusions: A suitable approach to strengthen the control of cervical cancer in the rural areas of Thailand might be to introduce the Kato device as an integral part of primary health care. The introduction of the device should go along with health education on the importance of avoiding infection with the papilloma viruses. This message should be transmitted to both females and males.

Advantages of trained TBA and the perception of females and their experiences with reproductive health in two districts of the Luangprabang Province, Lao PDR.

The study describes reproductive health in two districts of the Luangprabang Province in northern Lao PDR. The aim was to find out whether training traditional birth attendants (TBA) might have an impact on reproductive health. In June/July 2000, a total of 298 women of reproductive age, with children below two years of age, from 30 villages were interviewed by means of a closed questionnaire. In 1996/1997, a training course for TBA was conducted in one of the districts under survey. Information was obtained for demography, symptoms and risks during pregnancy and delivery, antenatal care (ANC), tetanus immunization, food taboos, place of delivery, birth attendant, practising of birth spacing and their attitude towards the services of TBA. The results obtained indirectly pointed towards a high fertility rate and a high rate of child death and abortion. An overwhelming majority of the women delivered at home, attended only by untrained individuals. During pregnancy and after delivery, the women claimed that they often suffered from edema of legs and feet, high fever and hemorrhages. Only 50% of the females in the district where TBA training were conducted, made use of the services of trained TBA. Nevertheless, females in the district with trained TBA, who made use of the TBA service in comparison with women in the same district not using the service of TBA, were 3.8 times more likely to also make use of the ANC service; 3.3 times more likely to seek immunization, and 8.6 times more likely to give colostrum to their new-borns. The educational level of the females proved to be an important factor. Literate women were more likely to practise birth spacing and have been vaccinated. Illiterate women were more likely to be at higher risk for losing a child. In the district without TBA service the loss of a child was less likely among literate than illiterate women. It is concluded that through adequately trained TBA and through their continuous support and supervision, ANC and health education can be improved. In addition to the improvement of the referral system for emergency cases and manpower development within the obstetric curative service, the training of TBA will have a positive impact on reproductive health. However, maternal health depends, to a large extent, on the educational level of the women.