Initial experience and result of a Swedish adjustable gastric banding by laparoscopic approach in Thai cohorts.

BACKGROUND: Morbid obesity is a growing problem in Thailand. Several surgical procedures are available for weight reduction. The laparoscopic gastric banding has been shown to be an effective weight loss with a low post or perioperative complication. OBJECTIVE: The aim of this report was to evaluate the early preliminary outcome of the laparoscopic Swedish adjustable gastric banding operation in Thai cohort patients. MATERIAL AND METHOD: From November 2003 until March 2005, ten patients with a median age of 31 (range, 18-61) underwent laparoscopic Swedish adjustable gastric banding for morbid obesity at Ramathibodi Hospital. Demography, clinical course and outcome including excess weight loss and peri-operative complications were reviewed and studied. Descriptive statistics were used for data summary. RESULTS: There were 3 men and 7 women with a median preoperative body weight of 142.5 kg (range, 98-164 kg), and median body mass index (BMI) of 49.2 kg/m2 (range, 40.3-62.4 kg/m2). The operations were successful in 9 out of 10 patients with median operative time of 195 minutes (range, 125-275 minutes). One patient with a BMI of 62.4 had a failed operation due to poor operative exposure from a very large left lobe of the liver. None of the remaining patients required conversion to the opened technique. The mean hospital stay was 4 days with no perioperative mortality. There was no major post operative complication except one minor wound infection. The excess weight loss was within the range of 33.5% to 62.1% during the short-term follow-up (range, 1-15 months) CONCLUSION: The presented early preliminary result of the laparoscopic Swedish adjustable gastric banding showed a good technical success with a significant short-term weight loss. The authors believe this minimally invasive operation is appropriate for morbidly obese Thai patient. However a longer follow-up study is needed.

Polyneuropathy from thiamin deficiency associated with thyrotoxicosis.

Polyneuropathy from thiamin deficiency can occur in persons who consume a diet consisting mainly of polished rice with low protein and thiamin content in the setting of excessive physical activity or hypermetabolic states. The authors report here a 17-year-old fisherman who presented with a 3-month history of symptoms and signs consistent with polyneuropathy. There were also clinical features of thyrotoxicosis which was confirmed by thyroid function test. His dietary intake consisted mainly of polished rice and fish both of which contain a small amount of thiamin. This could not cope with his hypermetabolic condition from thyrotoxicosis resulting in thiamin deficiency with polyneuropathy.

Long-term treatment of N-3 PUFAS on plasma lipoprotein levels and fatty acid composition of total serum and erythrocyte lipids in hypertriglyceridemic patients.

The low incidence of coronary heart disease in Greenland Eskimos and Japanese fishermen who have high consumption of fish and seafood has called the attention in the role of eicosapentaenoic (EPA = 20:5n-3) and docosahexaenoic (DHA = 22: 6n-3) acids, the major n-3 polyunsaturated fatty acids (PUFAs) in fish oils, in reducing cardiovascular risk. N-3 PUFAs may reduce serum lipids by promoting fatty acid oxidation and decrease VLDL producing from the liver, depress tissue arachidonate synthesis and alter the composition and tissue PUFAs. Plasma lipoprotein and fatty acid composition of total serum and erythrocyte lipids in 9 hypertriglyceridemic patients consisting of 4 males and 5 females aged 39-72 yr who attended the Nutrition Clinic, Ramathibodi Hospital were investigated. The study period consisted of 4 wks of dietary advice only followed by 48 wks of dietary advice with a daily intake of 6 g of fish oil capsules (FOC). Six grams of FOC provided 1080 mg of 2:5n-3 and 720 mg of 22:6n-3. Their plasma triglyceride (TG) levels at wk 0, 12, 24, 36, 48 were 356.7, 230.1, 209.7, 192.9, 22 7.4 mg/dL and M-particle (equivalent to very low density lipoprotein, VLDL) were 484.4, 354.8, 383.1, 349.7, 453.2 mg/dL respectively that decreased significantly, whereas their plasma low density lipoprotein cholesterol (LDL-C) levels at the same periods were 139.4, 164.9, 171.0, 157.1, 158.3 mg/dL that increased significantly. Serum and erythrocyte 20:5n-3 and 22:6n-3 in these subjects were significantly higher than those at wk 0 throughout the study. These findings indicate the bioavailability of 20: 5n-3 and 22:6n-3 in TG lowering effect of FOC. Fatty acids from fish oil have a remarkable effect on the synthesis and clearance of TG-rich lipoproteins, especially VLDL and chylomicrons. Though daily treatment with 6 g of FOC has a striking effect in increasing plasma LDL-C levels.

Phytate and fiber content in Thai fruits commonly consumed by diabetic patients.

The amount of phytate and total dietary fiber of 6 popular tropical fruits eaten by diabetic patient residing in Bangkok were studied. They were dragon fruit, durian, guava, longan, mango, and pineapple. Fruit containing the highest content of total dietary fiber was guava which had about 2.7%. Longan contained the lowest fiber content equal to 0.19%. The highest content of phytate was found in pineapple about 0.09% and the lowest content was in longan about 0.037%. It was noticed that longan contained the lowest total dietary fiber and the lowest phytate content.

Effect of chili pepper (Capsicum frutescens) ingestion on plasma glucose response and metabolic rate in Thai women.

OBJECTIVES: To evaluate the effect of 5 g fresh chili pepper (CAP) on glucose response after a glucose drink and metabolic rate (MR) in Thai women. MATERIAL AND METHOD: The glucose response after a glucose drink was evaluated in 10 healthy women. The plasma glucose levels at 0, 15, 30 and 60 min after glucose load with and without 5 g fresh CAP were compared. Evaluation of MR was performed in an additional 12 subjects. MR was measured by the ventilated-hood indirect calorimetry system before and for 60 min after CAP ingestion. RESULTS: The rise of plasma glucose at 30 min after CAP ingestion was significantly lower than the rise of plasma glucose after a plain glucose drink by 20.6 per cent (p < 0.01). On the other hand, the CAP ingestion significantly increased MR above resting MR. Moreover, MR immediately increased by 20 per cent within a few minutes after CAP ingestion and showed a remarkable increase of 7.2-17.4 per cent from baseline for 11 min. The significance of thermogenic change was present up to 30 min (p < 0.05). CONCLUSIONS: Within 30 min after consumption of 5 g of Capsicum frutescens, plasma glucose level during the absorption period was significantly inhibited. The metabolic rate was also immediately increased after ingestion and sustained up to 30 min.