Utilizing hydroglycolic extract from myrobalan fruits to counteract reactive oxygen species.

The hydroglycolic (HG) extract from 70% propylene glycol (PG) extraction of myrobalan fruits showed the most appreciable antioxidant efficiency towards 1,1-diphenyl-2-picrylhydrazyl (DPPH) in comparison to the extracts from 30, 50, 70 and 100% ethyl alcohol (EA), and 30, 50 and 100% PG . Its total polyphenols were also higher than others. The additional analysis of antioxidant power revealed that this HG extract was able to counteract the induced oxidation caused by hydrogen peroxide (H(2) O(2) ) and 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH). The quantification for the antioxidant capacity of the extract showed it was equivalent to 93.78 mg of 6-hydroxy-2,5,7,8-tetramethychroman-2-carboxylic acid (Trolox) g(-1) by 2,2'-azino-bis(3-ethylbenzthiazoline-6-suphonic acid) diammonium (ABTS) assay, and was 140.17 mg ascorbic acid (AA) equivalent g(-1) and 107.50 mg Trolox equivalent g(-1) by photochemiluminescence (PCL) assay. The incorporation of the HG myrobalan extract into lotion and sunscreen lotion rendered these products to provide the similar antioxidant power as the extract alone.

Small dense low-density lipoprotein concentration and oxidative susceptibility changes after consumption of soybean oil, rice bran oil, palm oil and mixed rice bran/palm oil in hypercholesterolaemic women.

The effects of a diet containing soybean oil (SBO), rice bran oil (RBO), palm oil (PO) or a RBO/PO (3:1) mixture on the composition and oxidation of small dense low-density lipoproteins (sdLDL) in 16 hypercholesterolaemic women were investigated. During the 8-week control period, participants consumed a free-choice weight-maintaining diet comprising carbohydrate (55% energy), protein (15% energy) and fat (30% energy) with < 300 mg/day of cholesterol. During each 10-week study period, participants consumed this same diet but with the addition of one of the three test oils or the RBO/PO mixture. Total cholesterol and low-density lipoprotein (LDL)-cholesterol levels were significantly reduced during SBO, RBO and RBO/PO consumption, while high-density lipoprotein cholesterol was significantly decreased by SBO consumption. There was a significant reduction in sdLDL-cholesterol levels only after using SBO and it tended to be reduced during RBO/PO consumption, whereas it was significantly increased following PO consumption. The sdLDL oxidation lag time was significantly increased during PO, RBO/PO and RBO consumption, but significantly reduced following SBO. The results for the RBO/PO mixture suggest that this oil mixture might further reduce the risk of atherosclerosis.

Beriberi outbreak among commercial fishermen, Thailand 2005.

In April 2005, The Tahi Bureau of Epidemiology investigated a reported outbreak of beriberi among commercial fishermen in Maha Chai, a port city in the Gulf of Thailand. The objective of this study was to verify the diagnosis of beriberi in affected individuals, describe the possible outbreak, ascertain risk factors, and provide prevention and control measures. We interviewed ill persons and treating doctors, and reviewed medical records to conduct a descriptive study. A probable case was defined as a crewmember of Ship A with one of the following: leg edema scrotal edema or ascites, dyspnea, chest discomfort, chest pain, extremity numbness, or extremity weakness. Confirmed cases were those with clinical criteria and laboratory findings consistent with thiamine deficiency. The outbreak started in early March, 2005 and continued until March 31, 2005. Ship A had 28 crewmembers (four Thai, 24 Myanmar). Overall, there were 15 probable cases (attack rate 53.6%, with three confirmed and 12 probable cases). Only three were tested for Vitamin B1 deficiency. All cases were male, with a median age of 28 years (range 20-45). Fourteen of the 15 cases were Myanmar and one Thai. Due to limited resources, the crew ate only seafood and polished rice for almost two months prior to symptoms. Symptoms included edema (60%), chest discomfort (54%), and dyspnea (27%). Two persons died while on board the ship (case fatality 13%). The total time at sea for Ship A was 18 months, including a five-month delay in docking due to licensing problems.

Nutritional assessment in various stages of liver cirrhosis.

OBJECTIVES: The aims of this study were to determine the prevalence of protein-calorie malnutrition, characteristics, and clinical importance of nutrition disorders in patients with liver cirrhosis according to severity of disease. METHODS: Nutrition assessments such as subjective global assessment, anthropometric and biochemical measurements, immunocompentency, thiamin and riboflavin status in 60 patients with cirrhosis (33 male and 27 female) were recorded between June 1999 and December 1999 at an outpatient clinic at Ramathibodi Hospital, Bangkok, Thailand. The origin of liver disease was alcohol related in 50% of patients. Child-Pugh criteria were used to establish the severity of liver disease. RESULTS: In terms of energy malnutrition, 13.3% of patients had ideal body weights below 90% and 11.7% had body mass indexes below 18.5 kg/m(2). Protein malnutrition (low albumin) and immunoincompetence (abnormal response to skin tests) were found much more frequently (45% and 22%) than energy malnutrition. Patients with alcoholic cirrhosis had ascites (P < 0.05) and hepatic encephalopathy (P < 0.001) more frequently and less triceps skinfold thickness than those with non-alcoholic cirrhosis. Subjective global assessment and serum proteins correlated with the degree of liver-function impairment, but immunologic tests correlated inversely in cirrhosis patients. Mean values for creatinine-height index, hemoglobin, cholesterol, and complement C4 showed significant decreases in severe liver failure (Child-Pugh class C) only in patients with alcoholic cirrhosis (P < 0.05). Malnutrition was correlated with the clinical severity of liver disease. CONCLUSIONS: The study showed that protein-energy malnutrition is a common complication of liver cirrhosis. Nutritional disorders appeared to be related to the degree of liver injury and the etiology of nutritional disorders. Nutritional disorders were more severe with alcoholic cirrhosis than with non-alcoholic cirrhosis.

Impact of liver cirrhosis on nutritional and immunological status.

The aims of the study were to determine the prevalence of protein calorie malnutrition (PCM) in Thai cirrhotic patients and to evaluate nutritional and immunological status in various stages of cirrhosis. Subjective Global Assessment (SGA) and anthropometric measurement were used as nutritional assessment in sixty cirrhotic patients. Delayed-type hypersensitivity skin test, lymphocyte count, immunoglobulin and complement were assessed for immune status. Blood samples were sent for routine tests, prealbumin, thiamine and riboflavin level. There were 7/60 (11.7%) patients with percentage of ideal body weight (%IBW) less than 90 per cent. SGA, hemoglobin, protein indices and cholesterol level showed the deterioration of nutritional status in the late stage of the disease. Five (8.3%) patients with thiamine deficiency, and thirteen (21.7%) patients with riboflavine deficiency were detected. Lowest levels of complement and highest levels of immunoglobulin also occurred in the late stage of the disease. In conclusion, defining %IBW <90 per cent as malnutrition, the prevalence of malnutrition in Thai cirrhotic patients was 11.7 per cent. Nutritional and immunological status deteriorated according to the advanced stage of disease. If nutritional support is given in the early stage, it may improve nutritional status and reduce morbidity and mortality in cirrhotic patients.

Serum copper and zinc levels in Thai patients with various diseases.

This study was conducted to evaluate the possible alteration of serum Cu and Zn levels in 118 medical inpatients (53 women and 65 men) in Ramathibodi Hospital. Patients were classified according to their main clinical diseases: pulmonary (n = 12), renal (14), infectious (30), malignant (9), cardiovascular (22), GI & hepatic (13) and hematological (18) diseases. Significantly increased serum Cu concentrations were found in patients with pulmonary, malignant, cardiovascular and infectious diseases; moreover, 75, 75, 50 and 37 per cent of these diseases, respectively, had serum levels greater than the normal mean + 2SD (23.6 mumol/L). Besides, 5 per cent of patients (3 in renal, 1 in infectious and 2 in GI & hepatic diseases) had low serum Cu levels suggestive of Cu depletion. By contrast, significantly decreased serum Zn concentrations were found in patients with GI & hepatic, infectious, renal, cardiovascular and malignant diseases. Serum Zn levels below the normal mean - 2SD (8.1 mumol/L) were presented in 46, 37, 29, 23 and 22 per cent of cases, respectively. It was found that serum Cu/Zn ratio in our patients not only with cancer but also with other diseases were statistically significant from the normal group. Hence, the use of serum Cu/Zn ratios as markers for the diagnosis of cancer or for staging tumors must be interpreted cautiously.

Zinc and copper intake and sources in healthy adults living in Bangkok and surrounding districts.

The levels of intake and food sources of zinc and copper in 231 20-80 yr old healthy adults living in Bangkok and surrounding districts were determined. Dietary data from 3-d food records collected and validated at Research Center, Ramathibodi Hospital were analyzed. Levels of zinc and copper intake were compared between sexes and age groups (20-39, 40-59, and 60-80 yr). Mean daily zinc and copper intakes (+/-SEM) in men were 6.3+/-0.2 and 1.9+/-0.1 mg, respectively. Mean daily zinc and copper intakes (+/-SEM) estimated in women (5.5+/-0.2 and 1.6+/-0.1 mg) were significantly lower. Higher zinc and copper intakes were found in the younger (20-39 yr) age group of both sexes. This could be explained by higher density and percentage from animal source of both nutrients. Consumption of various types of meat, fish, egg, and milk accounted for 42 and 22%, and rice, the staple food of Thai people for 9 and 23% of total dietary zinc and copper, respectively.

Thiamin and riboflavin status of medical inpatients.

Thiamin status was assessed by erythrocyte transketolase activity (ETKA) and thiamin pyrophosphate effect (TPPE) and riboflavin status by erythrocyte glutathione reductase activity (EGRA) and activity coefficient (AC) in 165 medical inpatients in Ramathibodi Hospital. Based on TPPE > 15 per cent, 9 per cent of the medical inpatients had thiamin depletion. Most of them were patients with renal, cardiovascular, hematological and infectious diseases. Based on AC > or = 1.2, 17 per cent of these inpatients had riboflavin depletion. Most of them were patients with pulmonary, cardiovascular and hematological diseases. Only one patient with pulmonary disease had both thiamin and riboflavin depletion. The proportion of thiamin depletion (2/37) in subjects with thiamin supplementation (mean 32.4, median 6, mode 2 md/d) tended to be less than those without (9/98). But, subjects with riboflavin supplementation (mean 3.3, median 4, mode 1 md/d) had the proportion of riboflavin depletion (0/31) significantly (Z-test, p < 0.005) lower than without supplementation (23/104). The data suggested that although the usual dose of vitamin supplementation in medical inpatients is beneficial thiamin depletion can still be present in catabolic patients.

Effects of dietary counseling on vitamin A, B-1, B-2 and zinc status of chronic hemodialysis patients.

Twenty-one chronic hemodialysis patients underwent nutritional evaluation and regular dietary counseling to improve the protein and energy intake for 8 weeks. As a result, the mean serum potassium and phosphorus concentrations were increased but were still within the normal ranges. After counseling, the frequency of abnormal TPPE and EGRAC were decreased (9.5 to 4.8 per cent and 19 to 14.3 per cent, respectively) while the frequency of hypervitaminosis A was increased from 67 to 81 per cent. Though the evidence of zinc deficiency was decreased from 81 to 62 per cent after counseling, mean serum zinc levels were low in both periods and inadequate vitamin B status cannot be totally eradicated due to the limitation of food selection. Therefore, regular supplementation of vitamin B complex is required, whereas, vitamin A supplementation must be prohibited in chronic HD patients. Small daily doses of potassium chelator and phosphate binder are mandatory if improvement of nutritional status is aimed to be one of the therapeutic goals.

Serum zinc and copper in healthy adults living in Bangkok and surrounding districts.

Serum zinc and copper concentrations were evaluated in 312 healthy adults aged 20-80 years, living in Bangkok and surrounding districts, Thailand. Serum zinc and copper levels were related to a range of factors such as sex, age, body mass index (BMI), blood pressure, drinking and smoking habits. Serum zinc and copper concentrations in this population were 12.7 +/- 2.3 (mean +/- S.D.) and 18.0 +/- 2.8 mumol/L. Mean serum zinc concentrations in males and females were 12.7 +/- 2.2 and 12.7 +/- 2.3 mumol/L, whereas, mean serum copper was 17.0 +/- 2.8 and 18.6 +/- 2.7 mumol/L, respectively. Serum copper concentrations in women were significantly higher than in men (p < 0.001) while there were significant differences in serum zinc and copper levels with age. Serum copper was found to be elevated in hypertensives. In general, the results of this study agree with previously reported values from different countries.

Hydrocortisone, heparin, and peripheral intravenous infusion.

We studied the effect of low-dose hydrocortisone and heparin added to peripheral intravenous fluid on episodes and severity of thrombophlebitis. Osmolal solutions of 860 mOsm/kg H2O with heparin and hydrocortisone (feed A) and without heparin and hydrocortisone (feed B) were infused into surgical and ear, nose, and throat patients for peripheral intravenous nutrition. The addition of heparin (500 U/L) and hydrocortisone (10 mg/L) in 10% dextrose in half-strength normal saline and 500 ml 5% crystalline amino acid solution infused simultaneously via a Y line significantly reduced the episodes and severity of thrombophlebitis. Thus, the administration of low-dose hydrocortisone and heparin with peripheral fluids is beneficial in preventing thrombophlebitis.