Effectiveness of contextual education for self-management in Thai Muslims with type 2 diabetes mellitus during Ramadan.

BACKGROUND: Fasting in Ramadan has adverse effects on health of Muslims with diabetes. Key strategies to prepare the patients are to provide appropriate health education to the patients prior to Ramadan and to adjust anti-diabetic medicines during Ramadan. OBJECTIVE: To study outcomes of the specific health care services that providing health education in parallel with counseling by Islamic leader MATERIAL AND METHOD: The Thai Muslims with type 2 diabetes mellitus were divided into two groups. There were 62patients in experimental group that was provided with specific health care service for Thai Muslims with diabetes in which health education prior to Ramadan and adjustment ofanti-diabetic medicine applied. The other was control group with 28patients that was provided only with original health care service. The results were monitored after Ramadan by interviews, weight and waist measurements, blood pressure measurement and blood tests. RESULTS: Both mean systolic and diastolic blood pressure were well controlled in both groups and slightly decreased after Ramnadan. The mean diastolic blood pressure of the experimental group decreased after Ramadan (p-value = 0.041). From behavior point of view, it was found that the patients in the experimental group had consumed less sweetenedfood (p-value = 0.002). There was no incidence ofsevere hypoglycemia in either experimental or control group. The number and portion of patients with hypoglycemic symptoms in experimental group were lower than those in controlled group (p-value = 0.013). CONCLUSION: Specific health care service by providing health education prior to Ramadan and adjustment ofanti-diabetic medicine application resulted in a positive effect as the patients tended to consume less sweetenedfood to keep blood sugar level in control. Fasting could affect the patients 'health in apositive way as it helps to control blood pressure, while in parallel, adjustment of anti-diabetic medicine application helps to prevent hypoglycemia. This health care service, which can be achieved in collaboration with a health care team and Islamic leaders, is useful and suitable for Thai Muslims with diabetes mellitus type 2.

Comparison of essential trace elements in blood of patients receiving Ramathibodi Standard Parenteral Nutrition with Ramatrace or a commercial formular.

OBJECTIVE: Commercially intravenous trace element product is very expensive compared to Ramatrace. Therefore, the present research was designed to compare the levels of zinc, copper chromium and manganese in the blood of patients receiving Ramathibodi Standard Parenteral Nutrition (STD) containing the Ramatrace or the commercial product. MATERIAL AND METHOD: Two groups of patients receiving STD were recruited. Group 1 (19 males and 11 females) received Ramatrace and Group 2 (19 males and 11 females) received a commercial product. Blood samples on day 0, day 3 and day 10 were measured for zinc, copper chromium and manganese levels by atomic absorption spectrophotometer (model 3100, Perkin Elmer). RESULTS: The present results showed that levels of zinc, copper, chromium and manganese were not significantly different between the two groups. On day 0, day 3 and day 10, the levels of zinc, copper and manganese in the blood of both groups were significantly increased (p < 0.05). Blood chromium levels of Group 1 were significantly increased from day 0 (0.14 +/- 0.02 microg/dL) to day 3 (0.23 +/- 0.02 microg/dL) but there was no significant difference between day 3 and day 10. In Group 2, the blood levels of chromium from day 0 to day 10 were significantly increased. CONCLUSION: In patients receiving STD, Ramatrace could improve the levels of zinc, copper, chromium and manganese as well as the commercial product. This may be one way to reduce the cost of treatment.

Antioxidant capacity, total phenolics and sugar content of selected Thai health beverages.

This study was to determine antioxidant capacity, total phenolics and sugar content of 12 pasteurized and sterilized Thai health beverages, products of The Royal Chitralada Projects. The antioxidant capacities were analyzed using 2,2-diphenyl-l-picrylhydrazyl radical scavenging and the photochemiluminescence (PCL) assay. Folin-Ciocalteu assay and Nelson's reducing sugar test were used to determine total phenolic compounds and sugar contents, respectively. Sacred lotus root drink showed the significantly highest antioxidant capacity in both equivalents to trolox and equivalents to ascorbic acid but not in the PCL test. In contrast, chrysanthemum drink and roselle drink showed the significantly highest values of both the total antioxidant capacity of water and lipid-soluble substances in the PCL assay. Bael fruit drink had the significantly highest total phenolic compounds. There were significant correlations between the total phenolic compounds and the antioxidant capacity values of both assays (r = 0.4-0.5).

The effect of a soy-rich diet on urogenital atrophy: a randomized, cross-over trial.

OBJECTIVE: To evaluate the effect of a soy-rich diet on urogenital symptoms, vaginal health index, and vaginal cytology in perimenopausal and postmenopausal women. MATERIALS AND METHODS: Thirty-six perimenopausal and postmenopausal women (mean age 52.5+/-5.1 years) participated in a randomized, cross-over trial with two 12-week diet periods and two 4-week washout periods before and between treatments. The study diet consisted of a control diet (soy-free diet) and an isocaloric soy-rich diet (25 g soy protein in various forms of soy food containing more than 50 mg/day of isoflavones substituted for an equivalent amount of animal protein). Subjects were assessed for urogenital symptoms, vaginal health index, vaginal pH and vaginal cytology. The single physician and the single cytopathologist were blinded with regard to onset, period and randomization number. Statistical analyses were performed using paired t-test or Wilcoxon Signed Ranks Test, significance was set as P<0.05. RESULTS: Good compliance to the diet was shown by the significant elevation of serum levels of daidzein and genistein during the soy-rich diet period. The symptoms of urge incontinence and vaginal dryness had significantly increased after 12-week of soy-free diet. All other urogenital symptoms did not change in both periods. The vaginal health index, the vaginal pH, the karyopyknotic index, and the maturation value were not significantly changed in both periods. CONCLUSION: A soy-rich diet did not relieve the urogenital symptoms or restore the vaginal epithelium or improve the vaginal health in perimenopausal and postmenopausal Thai women.

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.

Iron bioavailability in Thai diets.

Dietary low iron bioavailability intake is an important causation factor of iron deficiency anemia in Asian countries including Thailand. The aim of this study was to estimate the iron bioavailability in the Thai diet by a calculation method that is based on dependent factors, dietary components and physiological iron store. Based on the the latest national nutrition survey of the Thai diet, 1995, the data of nutrient intake per capita per day by region were used for calculating the iron bioavailability at physiological iron store levels; 0, 250, 500 and 1,000 mg of iron. The results showed that the diets consumed by the populations in the Central, North, Northeast and South of Thailand were classified under the calculation method as being of moderate nonheme iron availability. The per cent iron bioavailability values of the Thai diets were within the range 3.7-12.4 per cent of total iron, depending on physiological iron store. The values of all region Thai diets at each iron store level were similar. By the same method, the dietary iron bioavailability of the total Thai diet at any iron store level was markedly lower than the general US diet, which was classified as high nonheme iron availability. When comparison of the iron bioavailability among other different diets was carried out, the values of the total Thai diet were slightly lower than Utah, but higher than US vegetarian and Regional Latin American diets.