Medicine In Thailand Research Articles

Enhancing the oxidative stability of rice crackers by addition of the ethanolic extract of phytochemicals from Cratoxylum formosum Dyer.

Cratoxylum formosum Dyer is consumed throughout the year as food and medicine in Thailand. It contains large amounts of chlorogenic acid and quinic acid derivatives. The antioxidative activity of the extract was studied in refined soybean oil coating on rice crackers without any seasoning. They were stored in accelerated oxidation conditions at 40oC, 80% relative humidity (RH) in the dark for 18 days. The oxidative state of each sample was monitored by analyzing of the peroxide value (PV) and thiobarbituric acid reactive substances (TBARS) as well as by odor analysis by quantitative descriptive analysis (QDA). The C. formosum extract was more effective than alpha-tocopherol due to metal ions present in the crackers, which resulted in alpha-tocopherol being less effective as an antioxidant. Sensory odor attributes of rice crackers were related more closely to TBARS than to PV values by linear regression analysis. The present study indicated that C. formosum extract was a promising source of a natural food antioxidant and was effective in inhibiting lipid oxidation in rice crackers.

Study on Variations in Price of Prescription Medicines in Thailand

There are evidences describing that the prices of prescription medicines can affect users, suppliers, and, in particular, payers in the health care system. Despite the significant effects of prices, the information regarding their characteristics is scarce. The objective of this study was to examine the prices and price variations of prescription medicines in an actual setting. A cross-sectional study on the prices of prescription medicines listed in a hospital formulary was undertaken. The medicines (n=1531) listed in the formulary were recorded according to the category of the medicine (essential or non-essential medicines), manufacturer types (local or foreign), dosage forms, therapeutic classifications (classes), and prices per unit in Baht. This study used coefficients of relative variations (CRVs) to determine the extent of price variations. Results revealed that the mean prices of non-essential and foreign medicines were significantly greater than those of its counterparts by 1.7 and 21.2 times, respectively. On an average, the classes with the highest prices were blood-related, antineoplastic, and endocrinological agents, while those with the lowest prices were the psychotherapeutic, CNS, and cardiovascular agents. The majority of the medicines (37%) were in the price range of >10-100 Baht. The price variations of different classes of medicines varied from about 100% to 600%. The mean price and CRV levels (low and high) formed four groups of medicines with different risks of high prices and variations to payers. In conclusion, the prices are associated with the category and manufacturer type. The prices and their variations could be used to distinguish the classes of medicines that possess different risks of high prices and variations to payers. Identifying the classes with high prices and high variations, high prices and low variations, and low prices and high variations is necessary for careful intervention to reduce the effect of prices and their variations on payers.

Antitumor activity of spinasterol isolated from Pueraria roots

We purified phytoestrogens from Pueraria root (Pueraria mirifica from Thailand and Pueraria lobata from Korea), which is used as a rejuvenating folk medicine in Thailand and China. Dried, powdered plant material was extracted with 100% ethanol and further separated by concentration, filtration, and thin layer silica gel chromatography. Using the fractions obtained during separation, we first investigated their cytotoxicity in several cancer cell lines from various tissues. The ethanol-extracted components (PE1, PE4) had significant antiproliferative effects on breast cancer cell lines, including MCF-7, ZR-75-1, MDA-MB-231, SK-BR-3, and Hs578T. Second, we compared these results with the cytotoxic effects of known flavonoids, sterols, and coumarins from Pueraria root. The known compounds were not as effective, and occurred in a different polarity region on HPLC. Third, further separation resulted in the isolation of eight different components (Sub PE-A to -H). One of these, PE-D, affected the growth of some breast cancer cell lines (MCF-7, MDA- MB-231) in a dose- and time-dependent manner, as well as the growth of ovarian (2774) and cervical cancer cells (HeLa). Finally, a transfection assay showed that this component had an estrogenic effect similar to 17beta - estradiol, which activates both estrogen receptor alpha (ERalpha) and ERbeta. The NMR analysis determined that spinasterol (stigmasta-7, 22-dien-3beta-ol) is an active cytotoxic component of Pueraria root.

Memorial for our Editorial Board Member, Kanok Pavusithipaisit

On June 16, 2005, I received the sad news that Professor Kanok Pavusithipaisit had passed away. He was recommended to the Board by Dr Francesco Marotta, an Editorial Board member from Milano who met Professor Kanok on one of his many travels in Asia and wrote, ‘He is a great man as well as professor of Endocrinology & Reproductive Biology, Director of the Institute of Science & Technology for Research and Development in Mahidol University, Thailand. The Institute is a powerful one, with strong government links and grants, and high level conferences such as the one I attended on thalassemia where there was much discussion concerning natural compounds potentially useful for RBC haemolysis and iron-deposition, etc. He is currently working on the protective benefits of antioxidant Vitamin E on spermatogenesis after exposure to gamma radiation and the protective powers of curcumin from radiation. So, once again, natural compounds and solid basic science are being combined in a country where the need for inexpensive biotechnological applications is a reality’. After hearing of his death, Dr Marotta described how Dr Kanok gave him his own running shoes so that he could take a morning run on the beach. As well as his impressive achievements in science, Dr Kanok was a wonderful human being and loved by all those who worked with him. On a trip for eCAM to learn more about traditional medicine in Thailand, I experienced his generosity firsthand in early December of last year. To give you an idea of his gentle character, I include an excerpt of his New Year's message for it shows something of his kind spirit. Right before my visit, he had an accident and broke his arm quite badly. In his message, he wrote of what he had learned from this experience: Encouragement and friendship are the most precious gifts that are always appreciated. Accidents can take place anytime. We have to be careful ‘all the time’. The disabled are truly admirable as they can cope with hardships although they must suffer bitterness immeasurably. The medical profession, including nurses and physical therapists, is an honorable profession. Their helpful hands and will to serve have given ‘life’ to many patients. He closed with: As the New Year is around the corner, let me send you my love and respect to all who are very considerate, kind and helpful. May all of you stay in good health, enjoy life and reap all the good things you have sown. Dr Kanok's actions reaped many great benefits, as expressed in the letter that announced his death: ‘Please share with us the deepest sympathy to his family for the unexpected and insurmountable loss of the great person named Kanok Pavasuthipaisit, who was very gentle, kind and passionate. A man who cared for others more than himself and gave more than he took’.

Immunomodulation by Dok Din Daeng (Aeginetia indica Roxb.) extracts in female B6C3F1 mice: II. Humoral immunity, innate immunity and hematology

In the previous report, we have provided evidence that Aeginetia indica Roxbert (DDD) extracts enhance T cell-mediated immune responses. The study reported here was focused on the hematological and immunological effects, including B cells, natural killer (NK) cells, macrophages and neutrophils, of the whole plant extract using water (WDDD) or ethanol (EDDD) as the solvent. The extracts were administered to female B6C3F1 mice by gavage for WDDD (10–100%) and intraperitoneally for EDDD (0.25–250 mg/kg) for 28 days. In addition to hematological evaluation, several quantitative measures and functional assays (e.g., the splenic phenotypic analysis, IgM antibody-forming cell responses, natural killer cell activity, mononuclear phagocyte system [MPS] and neutrophil activity) were employed to examine the effects of DDD extracts on the innate and humoral immunities. The results from this study demonstrated that exposure to WDDD and EDDD produced minimal changes in the activities of B cells and natural killer cells, macrophages and neutrophils. Overall, hematological parameters were not affected by exposure to WDDD or EDDD. Taken together, the enhancing effect of DDD extracts on T cells may be primarily responsible for the successful and long-time use of this traditional herbal medicine in Thailand.

Four New Sesquiterpenoid Derivatives from the Heartwood of Mansonia gagei

Four new sesquiterpenoid derivatives named mansonones N (1), O (2), P (3), and Q (4) were isolated from a dichloromethane extract of the heartwood of Mansonia gagei, a plant used in folk medicine in Thailand. Their structures were resolved on the basis of spectrometric data interpretation and the single-crystal X-ray analysis of 1 and 2.

Education of Rehabilitation Medicine in Thailand.

Training and education in Rehabilitation Medicine in Thailand was started at Siriraj Hospital for 6th year medical students in 1958. The Society for Thai Rehabilitation Medicine was founded in 1972, developed into the Thai Rehabilitation Medicine Association in 1988 and was established as the Royal College of Physiatrists of Thailand in 1998. A Board Certification system for Rehabilitation Medicine was initiated in 1985 and the present number of certified physiatrists is 211.Teaching and training in Rehabilitation Medicine in Thailand is divided into undergraduate and postgraduate programs. The objective of undergraduate education is to develop attitudes that will enable medical students to see the patients holistically and to teach basic diagnostic and therapeutic skills to 5th and 6th year medical students. At Siriraj Hospital, Mahidol University, rehabilitation medicine is included in the Orthopedic rotation which earns 6 credits and elective clinical experience in rehabilitation medicine earns another 2 credits out of a total of 263 credits towards a medical degree. The postgraduate program consists of a 3-year residency training program approved by the Thai Medical Council. There are 6 university hospitals responsible for training with a total of 10-14 residency positions available per year. The components of training include: basic science, clinical science, clinical evaluation and treatment, electrodiagnosis, orthotics and prosthetics. Subspecialty training in pain, pediatrics, orthopaedics, neurology, rheumatology, cardiopulmonary rehabilitation, etc. are included in this 3 year training course. Elective periods of 1-2 months in the Department of Medicine, Orthopedic surgery and Neurology are also provided. The trainees are required to work in the training center for not less than 36 months and must publish at least one acceptable research study within their 3 year course. Residents who have fullfilled all of the requirements will be eligible for the board examination which comprises 40% of written examination and 60% of oral and skill examination which includes 4 parts; oral (20%), OSCE (15%), electrodiagnosis (15%) and orthotics/prosthetic (10%). After passing the board examination the specialty diplomas will be conferred upon them by the Thai Medical Council.

Requirement of Metabolic Activation for Estrogenic Activity of Pueraria mirifica

A wide range of chemicals derived from plant and human-made xenobiotics are reported to have hormonal activities. The present study was performed to examine the estrogenic effect of Kwao Keur, Pueraria mirifica (PM), that has been used as a rejuvenating folk medicine in Thailand, using recombinant yeast, MCF-7 cell proliferation and HepG2 cell transient transfection assay. In recombinant yeast assay, 0.025, 0.25, 2.5, 25, 2.5 x 10(2), 2.5 x 10(3), 2.5 x 10(4) ng/ml concentrations of PM did not show any estrogenic activities, while 10(-9) of 17 beta-estradiol (positive control) showed high estrogenic activity. Estrogenic activities were induced at 2.5 ng/ml to 25 microg/ml concentrations of PM in a dose-dependent manner on MCF-7 cells and the estrogenic effect of PM was blocked by tamoxifen treatment, a well-known anti-estrogen. PM also showed estrogenic effect on human hepatoma cell line, HepG2 cells, containing estrogen receptor and luciferase reporter gene. Taken together, PM in itself may have no estrogenicity in yeast system, but it has estrogenicity in MCF-7 & HepG2 cells that have human metabolic enzymes. The results indicated that PM may require metabolic activation for estrogenic activity.

The Education of Rehabilitation Medicine in Thailand

The Education of Rehabilitation Medicine in Thailand

Emergency Medicine in Thailand

Typical of developing countries, Thailand, located in Southeast Asia, is only beginning to consider the importance of emergency medicine and prehospital care. Medical emergencies in Thailand have traditionally had relatively high rates of occurrence and are currently increasing in the context of rapid economic development and urbanization, yet no formal emergency care training for physicians or prehospital care workers exists.[Church AL, Plitponkarnpim A: Emergency medicine in Thailand. Ann Emerg Med July 1998;32:93-97.]

Human pythiosis in Thailand

Pythium insidiosum is a protoctista and causes diseases in plants and animals. In Thailand it can cause a unique human infection of three types. The first type is a subcutaneous lesion in thalassaemic patients, with the pathological findings of a granulomatous reaction, diffuse infiltration, and oedema of the vessel walls. The patients responded to a saturated solution of potassium iodide. The second type is chronic inflammation and occlusion of blood vessels mainly in the lower extremities which results in gangrene or aneurysm formation. This type of infection is only found in thalassaemic patients and leads to amputation of the affected extremities or resection of the involved arteries. The third type is keratitis. This type of infection may or may not be associated with thalassaemia. The clinical signs and symptoms do not differentiate it from other types of myocotic keratitis. The patients end up with keratoplasty, evisceration or enucleation. Thailand is an agricultural country, and there are plenty of swampy areas and several plants to support the life cycle of Pythium. Moreover, many people suffer from thalassaemia, and there is no drug available for Pythium. Pythiosis plays an important role in medicine in Thailand.

Sports medicine in Thailand.

Sports medicine in Thailand.

American Missionaries and the Introduction of Western Science and Medicine in Thailand, 1830–1900

American Missionaries and the Introduction of Western Science and Medicine in Thailand, 1830–1900