HLA class II (DRB1, DQA1 and DQB1) allele and haplotype frequencies among HIV-infection discordant Thai couples.

We investigated the association of HLA-DRB1, -DQA1 and -DQB1 alleles and haplotypes in 33 Thai HIV discordant couples. A significantly lower frequencies of DRB1*14 (3.0% vs 11.3%, p = 0.048) and DQA1*0103 (0.0% vs 5.63%, p = 0.042) alleles were found in the seropositive individuals when compared with HIV-negative controls. In contrast, there was no significant difference in HLA-DQB1* allele frequencies. The haplotype analysis revealed that DRB1*1501-DQA1*0102-DQB1*0601 (7.6% vs 0.0%, p = 0.002), DRB1*0405-DQA1*0302-DQB1*0401 (7.6% vs 1.3%, p = 0.024) and DRB1*1401-DQA1*0104-DQB1*05031 (6.1% vs 0.0%, p = 0.007) were found to be significantly higher frequencies when compared between HIV seronegative partners and HIV negative controls, but DRB1*1501-DQA1*0102-DQB1*0502 (0.0% vs 8.1%, p = 0.01) was significantly lower. The DRB1*1602-DQA1*0101-DQB1*0502 (4.6% vs 0.0%, p = 0.024) haplotype was found to be significantly higher frequencies in HIV seropositive individuals when compared to HIV negative controls but the DRB1*1502-DQA1*0101-DQB1*0501 (1.5% vs 8.1%, p = 0.049) haplotype was lower.

The combined oral contraceptive pill versus bromocriptine to suppress lactation in puerperium: a randomized double blind study.

A randomised double blind comparative study of 230 HIV infected mothers who had a normal delivery at 37-42 weeks' gestation were divided into two groups; 116 combined pill users and 114 bromocriptine users to suppress lactation. There were 33 cases (28.5%) of combined pills users and 29 cases (25.4%) of bromocriptine users who had breast engorgement without statistical difference. All of them had mild breast engorgement without any treatment except one case (0.9%) in the bromocriptine group had severe breast engorgement with puerperal fever and needed an analgesic drug. There were no side effects of the drugs. This study showed that combined pills were beneficial to suppress lactation in HIV infected mothers to prevent postnatal mother-to-child transmission because of low risk and low cost.

Cervical cancer in elderly Thais.

BACKGROUND: Neoplasm is the second most common cause of death in Thai women and cervical cancer is the most common. The prevalence of cervical cancer in Thai elderly women is unknown. What is the optimum time for a regular Papanicolaou smear check up. METHOD: A cross-sectional study of healthy elderly women (age >60 years) who lived within a 10-kilometer radius of Siriraj Hospital was carried out. All had their history taken and were examined by vaginal examination and Papanicolaou smear for cancer screening three times; on the day of enrollment, at one-year and two-years. RESULTS: Six hundred and eighty two women aged 60-88 years were recruited. There were 7 cases (1.0%) who had a positive Papanicolaou smear on the day of enrollment. Six cases (0.9%) had complete investigations: 2 cases (33.3%) had invasive cervical cancer stage III b, 4 cases had CIN III. There was one case out of 268 (0.4%) at one-year and one case out of 342 (0.3%) at two-years who had a positive Papanicolaou smear and the final diagnosis was CIN III. CONCLUSION: The prevalence of cervical cancer in Thai elderly women in this study was 1 per cent. Thai elderly women need a yearly Papanicolaou smear check up.

Integrated health research program for the Thai elderly: prevalence of genital prolapse and effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly women.

BACKGROUND: Genital prolapse is a common health problem in elderly women. It is prevalent among elderly females and affects their quality of life. Those with a severe degree of genital prolapse may need operative treatment which may be risky due to co-morbid conditions such as hypertension, respiratory disease, cardiovascular disease and diabetes mellitus. The aim of this study was to determine the prevalence of genital prolapse and the effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly females. METHOD: The authors conducted a cross sectional study to determine the prevalence of genital prolapse in 682 elderly women (aged > or = 60 years) who lived within a 10-kilometer radius of Siriraj Hospital. 654 subjects were eligible for the controlled trial to determine the effectiveness of pelvic floor exercise to prevent worsening of genital prolapse. There were 324 subjects in the control group and 330 subjects in the experimental group. The experimental group received training in pelvic floor exercise and were asked to perform the exercise 30 times after one meal, every day for 24 months. The subjects were followed-up every 6 months for 24 months to assess worsening of genital prolapse. RESULTS: The prevalence of genital prolapse was 70 per cent. There were 324 subjects in the control group and 330 subjects in the experimental group. After 24 months of pelvic floor exercise, the rate of worsening of genital prolapse was 72.2 per cent in the control group and 27.3 per cent in the experimental group (p = 0.005). The rate of worsening of genital prolapse was not significantly different between the control group and the study group in those who had a mild degree of genital prolapse. CONCLUSION: The prevalence of genital prolapse in elderly Thai women was 70 per cent. A 24 months pelvic floor exercise program was effective to prevent worsening of genital prolapse in the women who had severe genital prolapse.