Prevalence and hematological parameters of thalassemia in Tha Kradarn subdistrict Chachoengsao Province, Thailand.

OBJECTIVE: To determine the prevalence, molecular characteristics and hematological study of thalassemia in Tha Kradarn Subdistrict Chachoengsao Province. MATERIAL AND METHOD: The present study population consisted of266 participants from Moo 19 Baan Na-Ngam, Chachoengsao Province, Thailand. After blood collection, all samples were screened for thalassemia by initial screening with the OF and DCIP tests and additional testing by CBC, RBC indices, hemoglobin typing and determination of Hb A2 and Hb E. All common alpha-thalassemia mutations were determined using the PCR with allele specific primers and Gap PCR for common deletions. RESULTS: The prevalence of alpha-thal 1, alpha-thal 2 and beta-thal were found as 2.72%, 11.26% and 0.97%, respectively. Regarding the abnormal hemoglobins, the prevalence of Hb E, Hb Constant Spring and Hb Pakse was 38.45%, 3.69% and 0.78%, respectively. MCV and MCH were significantly different between P-thalassemia as well as a-thal 1 carriers and normal subjects. In all alpha-thal 1 traits, it was found that the MCV and MCH were less than 75 fL and 25 pg, therefore, these parameters can be used for alpha-thal 1 screening. CONCLUSION: In the present study, the prevalence of thalassemia was similar to previous studies. Moreover, using the combination of OF and DCIP tests compared with MCV, MCH and DCIP tests for the initial thalassemia screening, it was found that the OF and DCIP tests gave more false positive results, which increased the need for further Hb typing. Hence, the MCV and MCH combined with DCIP tests provide cost minimization and practical for a large population-based screening program.

A survey of metabolic syndrome and its components in Thai medical cadets.

OBJECTIVES: To determine the prevalence of the metabolic syndrome (MS) and its components in Thai medical cadets. MATERIAL AND METHOD: The study was conducted at Phramongkutklao College of Medicine. Ninety six participants (78 men and 18 women) were the healthy medical cadets class 34 who firstly enrolled as the second year medical students in the academic year 2008. Data on anthropometry, blood pressure and blood studies were collected. The MS was defined using the age-specific NCEP ATP III criteria with a modified waist circumference by WHO. RESULTS: The prevalence of the MS in the second year Thai medical students was 1.04%. The high percentage of MS components was attributed to low HDL-cholesterol and high blood pressure. In addition, the prevalence rates of one and two abnormalities of MS components were 31.25% and 8.33%, respectively. Overweight and obesity were found at the percentage of 21.88 and 15.62, respectively and significantly more prevalent among men than among women. CONCLUSION: This study shows that the metabolic syndrome exists among second year medical cadets with the prevalence of 1.04%. This group is under the military rules and regulations. Though the prevalence of MS among this group is not high, the study reveals that the prevalence of one abnormality of MS components is very high up to 31.25%. These findings call for attention for developing appropriate intervention programs for early detection and promotion of proper health behaviors and lifestyles. These programs may help to decrease the incidence and morbidity associated with cardiovascular disease and diabetes in Thai young adults.

Dyslipidemia in Thai rural adults.

The present study aimed to determine the prevalence of dyslipidemia in adults in a rural area of Thailand. Random sampling was conducted in 443 volunteers, 187 males and 256 females, aged > or = 35 years in Chachoengsao Province. After a 12-hour fast, the blood was drawn for the analysis of total cholesterol, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol. Mean serum lipids of cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were 207.79 +/- 46.98, 117.26 +/- 36.59, 50.53 +/- 2.14 and 201.21 +/- 131.07 mg/dL, respectively. Nineteen percent of them had cholesterol > or = 240 mg/dL and 10% had LDL cholesterol > or = 160 mg/dL. Seven percent had HDL cholesterol < or = 35 mg/dL. However, LDL/HDL cholesterol ratios > 5, were found in only 0.9%. In conclusion, the prevalence of dyslipidemia was high in rural Thai adults. Further surveillance in this population is essential in verifying the impact of dyslipidemia as a risk of cardiovascular disease in rural Thai adults.

Screening for thalassemia and hemoglobinopathy in a rural area of Thailand: a preliminary study.

The present study aimed to screen thalassemia and hemoglobinopathy in Baan Na-Ngam, Chachoengsao Province, Thailand. Blood samples were obtained from 266 volunteers; 105 males and 161 females aged 7 to 49 years. Blood samples screened for thalassemia combining the OF and modified DCIP precipitation tests. CBC, RBC indices, hemoglobin typing, HbA2 and Hb E were determined. Combined OF and DCIP tests found that in normal subjects, 128 out of 155 were negative for both, 3 were -/+ pattern, 22 were +/- pattern and 2 was positive for both. Interestingly, one sample showed an abnormal hemoglobin pattern, which could not be determined by automated LPLC. Three beta-thalassemia trait subjects were positive for only the OF test. For the Hb E trait, 57 out of 94 were -/+ pattern; 37 were positive for both tests. Moreover, 14 homozygous Hb E subjects were positive for both tests. The prevalence of beta-thalassemia trait was 1.1%, Hb E trait was 35.3% and homozygous Hb E was 5.3%. Since DNA analysis was not performed, alpha-thalassemia1 and alpha-thalassemia2 traits cannot be excluded. In conclusion, a combination of the OF and DCIP tests is suitable for preliminary screening for thalassemia and hemoglobinopathy. However, RBC parameters, hemoglobin typing and PCR analysis will provide more specific diagnosis, especially in alpha-thalassemias.

Thalassemia screening among Royal Thai Army medical cadets.

Thalassemia, common in Thailand, varies from mild to severe anemia, resulting in work inefficiency, particularly during exertion. Therefore, it is important for military cadets to be screened. The objective of this study was to screen for thalassemia and hemoglobinopathies among Royal Thai Army medical cadets. We tested 358 third-year Royal Thai Army medical cadets for complete blood count, red blood cell indices, hemoglobin (Hb) typing, inclusion bodies, and Hb A2, and Hb E. DNA analysis confirmed alpha-thalassemia, trait detection. The Hb E trait was the most frequent, respectively, in men and women, at 12.61% and 12%, followed by the a-thalassemia1 trait, at 3.3% and 4% and the beta-trait, at 1.5% and 0%. Two cases of homozygous Hb E were found only in men. Interestingly, a mild form of 1-thalassemia/Hb E was found in one male RTA medical cadet. These findings suggest that consistent thalassemia screening should be considered.

The validity of the Medisafe self-monitoring blood glucose system.

Self-monitoring blood glucose (SMBG) meters are widely used in the management of diabetes. The new SMBG meter Medisafe, which is based on the optoelectric colorimetry method, has been introduced. The objective of this study was to validate the Medisafe SMBG meters in comparison with the reference autoanalyzer (Hitachi 717) and to assess the repeatability of the instrument as well as variations of tip replacement. Samples of capillary and venous blood from 299 patients were tested. The correlation coefficients between the Medisafe-measured capillary and venous blood glucose levels and the reference autoanalyzer venous plasma glucose levels were 0.976 and 0.975, respectively. The range of differences from the reference value was examined; only 4% was in excess of +/- 20% of the reference laboratory value, and more than 40% of the values were within 5% of the reference laboratory value. Moreover, repeatability of the Medisafe capillary blood samples measured in three patients with three different blood glucose levels was determined. The coefficients of variation of blood glucose values are within 5%. In addition, the results of mean and SEM from each replication in three patients and glucose measurement from different lots of tips showed no significant difference (p > 0.05). It is concluded that the Medisafe SMBG meter has shown good results in terms of validity and repeatability. Furthermore, it provides safety from blood contamination, which is recommended in countries with a high prevalence of human immunodeficiency virus.