Thai Population Research Articles

Anatomical investigation of the morphometry of the cerebral arteries using digital subtraction angiography in the Thai population.

The main purpose of this study was to investigate the dimensions of cerebral arteries in the Thai population using digital subtraction angiography (DSA), with a focus on the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA). The research aimed to explore anatomical variations in diameters and lengths of these arteries across different sexes and age groups, which are crucial for cerebrovascular interventions. This retrospective study measured the diameters and lengths of the ACA, MCA, and PCA in 177 Thai patients with an average age of 47.6 years (range: 11-82 years) with normal cerebral angiograms. Digital subtraction angiography (DSA) was used for the measurements. The study found significant sex-based differences in the mean diameters of the left ACA (males: 2.12 ± 0.28mm, females: 1.92 ± 0.20mm; p < 0.01), right MCA (males: 2.50 ± 0.25mm, females: 2.31 ± 0.17mm; p < 0.01), and left MCA (males: 2.44 ± 0.19mm, females: 2.30 ± 0.17mm; p < 0.01) with males exhibiting larger diameters. The right ACA length was significantly longer in males (15.46 ± 1.74mm) compared to females (13.98 ± 1.92mm; p < 0.01). While no significant age-related differences were observed in diameters, a significant increase in length with age was noted for the left ACA in the ≥ 60 years group (13.61 ± 1.64mm) compared to the < 60 years group (12.63 ± 1.36mm; p < 0.01). Among others, significant correlations were found between the diameters of the left ACA and right MCA (r = 0.699; p < 0.01), and a strong correlation between left ACA length and left PCA diameter (r = 0.975; p < 0.01). The findings provide invaluable data for tailoring neurosurgical approaches and designing angiographic equipment for the Thai population, emphasizing the importance of considering anatomical variations in clinical practice. These results highlight the necessity for personalized medical care based on anatomical differences to improve cerebrovascular intervention outcomes.

Perceived social measures and drinking behavior during the COVID-19 pandemic in Thailand.

During the COVID-19 pandemic, national policymakers implemented many public health social measures to cease the spread of the disease, while, those interventions also affected population health behaviors, including drinking alcohol. We analyzed national survey data of 7731 respondents to investigate drinking behavioral patterns, as well as measure the strength of association between social measures and alcohol consumption among the Thai populations during the COVID-19 pandemic. We demonstrated that perceptions on temporary suspension of entertainment events and a ban on alcohol sales during the pandemic were significantly associated with alcohol consumption behaviors. Specifically, the negative perceptions of these social measures were associated with the increase of drinking: OR = 1.42; 95% CI = [1.19, 1.69] and OR = 2.50; 95% CI = [2.11, 2.97], respectively. We recommended to assess the long-term effects of targeted social measures on drinking behavior, especially the post pandemic.

Sensitivity analysis and global stability of epidemic between Thais and tourists for Covid -19

This study employs a mathematical model to analyze and forecast the severe outbreak of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), focusing on the socio-economic ramifications within the Thai population and among foreign tourists. Specifically, the model examines the impact of the disease on various population groups, including susceptible (S), exposed (E), infected (I), quarantined (Q), and recovered (R) individuals among tourists visiting the country. The stability theory of differential equations is utilized to validate the mathematical model. This involves assessing the stability of both the disease-free equilibrium and the endemic equilibrium using the basic reproduction number. Emphasis is placed on local stability, the positivity of solutions, and the invariant regions of solutions. Additionally, a sensitivity analysis of the model is conducted. The computation of the basic reproduction number (R0) reveals that the disease-free equilibrium is locally asymptotically stable when R0 is less than 1, whereas the endemic equilibrium is locally asymptotically stable when R0 exceeds 1. Notably, both equilibriums are globally asymptotically stable under the same conditions. Through numerical simulations, the study concludes that the outcome of COVID-19 is most sensitive to reductions in transmission rates. Furthermore, the sensitivity of the model to all parameters is thoroughly considered, informing strategies for disease control through various intervention measures.

Incidence and prevalence of idiopathic inflammatory myopathies in Thailand from the Ministry of Public Health data analysis

The epidemiology of idiopathic inflammatory myopathies (IIMs) varies by country. Investigating the epidemiological profile among Thai IIMs could help to inform public health policy, potentially leading to cost-reducing strategies. We aimed to assess the prevalence and incidence of IIM in the Thai population between 2017 and 2020. A descriptive epidemiological study was conducted on patients 18 or older, using data from the Information and Communication Technology Center, Ministry of Public Health, with a primary diagnosis of dermatopolymyositis, as indicated by the ICD-10 codes M33. The prevalence and incidence of IIMs were analyzed with their 95% confidence intervals (CIs) and then categorized by sex and region. In 2017, the IIM cases numbered 9,074 among 65,204,797 Thais, resulting in a prevalence of 13.9 per 100,000 population (95% CI 13.6–14.2). IIMs were slightly more prevalent among women than men (16.8 vs 10.9 per 100,000). Between 2018 and 2020, the incidence of IIMs slightly declined from 5.09 (95% CI 4.92–5.27) in 2017 and 4.92 (95% CI 4.76–5.10) in 2019 to 4.43 (95% CI 4.27–4.60) per 100,000 person-years in 2020. The peak age group was 50–69 years. Between 2018 and 2020, the majority of cases occurred in southern Thailand, with incidence rates of 7.60, 8.34, and 8.74 per 100,000 person-years. IIMs are uncommon among Thais, with a peak incidence in individuals between 60 and 69, especially in southern Thailand. The incidence of IIMs decreased between 2019 and 2020, most likely due to the COVID-19 pandemic, which reduced reports and investigations.

A Study of Psychometric Properties of Difficulty in Emotion Regulation Scale – Thai Version among Thai Population

Objective: Individuals with psychiatric disorders are found to struggle with emotion regulation, which is considered a transdiagnostic factor. However, due to a limitation in the assessment of emotion regulation in Thailand, this study aimed to translate the Difficulty in Emotion Regulation Scale (DERS) into Thai (DERS-Thai) and evaluate its psychometric properties. Materials and Methods: The DERS-Thai was initially translated by one of the researchers before being re-reviewed. A pre-testing phase was then conducted to preliminarily evaluate the psychometric properties of the DERS-Thai. Subsequently, the testing phase involved 446 participants who completed an online questionnaire platform containing demographic data, DERS-Thai, the Emotion Regulation Scale (ERQ), and the Depression Anxiety Stress Scale 21 (DASS-21). The factor structure was then evaluated, along with its concurrent and criterion validity, as well as its internal consistency. Results: DERS-Thai demonstrated acceptable content validity (I-CVI = 0.8 to 1.0, S-CVI/Ave = 0.85). In the testing phase with 446 participants (mean age = 29.19, SD = 8.50), predominantly female (81.8%), and mostly residing in central Thailand (81.31%), the original model did not fit well. After modification, fit indices were improved. DERS-Thai showed a negative correlation with ERQ and a moderate to strong correlation with DASS-21. Known-group analysis revealed significant differences in DERS-Thai scores between DASS-21 groups (p-value &lt; 0.001). The scale exhibited excellent internal consistency (α = 0.94, ω = 0.96). Conclusion: The DERS-Thai has demonstrated appropriate psychometric properties for assessing emotion regulationskills in individuals.

Understanding Cardiac Cachexia among Patients with Heart Failure Using a Mixed-Methods Sequential Explanatory Design

In heart failure, cardiac cachexia often presents in people as weight loss accompanied by muscle wastage, loss of appetite and reduced quality of life. Such people often have a poor prognosis. However, the impact of these symptoms on Thai patients’ quality of life is unknown. Therefore, this study aimed to explore cardiac cachexia, its symptoms, and its effect on quality of life using a mixed-method sequential explanatory design. Data for this study were collected from a specific cardiac failure clinic in a large hospital in Bangkok, Thailand, from August 2022 to January 2023. Forty-two patients with heart failure were screened for cardiac cachexia using cachexia consensus criteria and bioelectrical impedance vector analysis. They also completed the Simplified Nutritional Appetite Questionnaire, the Thirst Distress Scale for Heart Failure and the Kansas City Cardiomyopathy Questionnaire to assess appetite, thirst, and quality of life, respectively. Thirty-eight participants were included for statistical analysis and divided into two groups: those with confirmed or suspected cardiac cachexia (n = 7) and those without (n = 31). The former group reported low appetite scores; however, no significant differences were observed between the two groups’ appetite, thirst, or quality of life. After identifying patients with cardiac cachexia, six semi-structured interviews were conducted using an interview guide and analyzed through thematic analysis. The interviews revealed two common themes: Changes in diet and thirst and a Reduction in physical activity levels. Both themes complement the quantitative results. This study initiates a significant step in the understanding of cardiac cachexia in the Thai population with heart failure. Nurses can play a crucial role in identifying and managing patients with or at risk of cardiac cachexia.

Investigating common mutations in ATP7B gene and the prevalence of Wilson's disease in the Thai population using population-based genome-wide datasets.

Wilson's disease (WD) is a rare metabolic disorder caused by variations in the ATP7B gene. It usually manifests hepatic, neurologic, and psychiatric symptoms due to excessive copper accumulation. The prevalence of WD and its common variants differ across populations. This study aimed to examine these aspects of WD within the Thai population, where information has been limited. We reviewed ClinVar and the Wilson Disease Mutation Database, organizing variants classified as pathogenic or likely pathogenic in one or both databases as "relaxed" and "strict" lists. Allele frequencies were estimated from genotyping array data (Asian Screening Array: ASA; Illumina Corp, CA) of 6291 Thai subjects, which also underwent genotype imputation. The prevalence of WD in the Thai population was estimated assuming Hardy-Weinberg Equilibrium. The strict list yielded a prevalence of 1/24,128 (carrier frequency=1/78), while the relaxed list yielded a prevalence of 1/9971 (carrier frequency=1/50). The most common WD variants in Thai subjects were c.2333 G > T, c.3443 T > C, and c.813 C > A from the strict list, and c.3316 G > A and c.2605 G > A from the relaxed list. The ASA chip covered approximately 59 and 24% of WD variants from the strict and relaxed lists, respectively. Based on the estimated prevalence, a carrier screening program for WD is not currently required in Thailand. However, as genotyping services become more affordable and accessible, such a program would facilitate early identification, treatment, and prevention of WD.

Prevalence and clinical outcomes of off‐label gabapentin prescription in neuropathic orofacial pain

AbstractObjectivesThis study aimed to assess the prevalence, purposes, and clinical outcomes of off‐label gabapentin prescriptions, and to identify potential risks of gabapentin misuse.MethodsA retrospective cohort study was conducted from January 2014 to December 2022 at a single‐referral dental hospital. The study reviewed demographic data, clinical information, outcomes, side effects, and co‐prescribed drugs, utilizing statistical analyses to address objectives.ResultsAmong 1365 patients, 87 received gabapentin, representing about 6.37% of off‐label prescriptions. Trigeminal neuralgia (TN) was the most common indication (52.87%), often chosen as the clinician's first choice (51.72%), followed by use as an interim medication pending HLA‐B*15:02 results (14.94%). Nortriptyline was frequently co‐prescribed. Overall, gabapentin was prescribed at a mean dosage of 726.44 ± 42.87 (SE) mg per day, with a common dose range of 300–900 mg/day. Patients with TN and other neuropathies/facial pain experienced significant pain reduction from baseline (mean difference = −4.73 ± 0.77, p &lt; 0.0001, and −3.06 ± 0.91, p = 0.0036, respectively). However, only 5 patients achieved a full response (NRS = 0) to gabapentin. Six patients (0.44%; 6 out of 1365 patients) received off‐label gabapentin without clinical diagnosis or treatment records, possibly indicating misuse.ConclusionsOff‐label gabapentin use was prevalent, especially in cases of TN. Despite significant pain reduction observed, only a small number of patients achieved pain‐free periods with their neuropathic pain condition. Therefore, optimal dosing is advisable. Off‐label gabapentin use also benefits patients as an interim medication while waiting for carbamazepine‐related gene screening in the Thai population and as a main drug therapy for HLA‐B*15:02 gene‐positive patients. Given the high prevalence of off‐label use and its potential to interact and enhance centrally mediated effects with other drugs, pre‐screening could aid in identifying potential risks of misuse and abuse.

Normative Values and Anthropometric Prediction Models for Lean Mass and Fat Mass in the Northeastern Thai Population.

Background: Data on reference values for lean mass (LM) and fat mass (FM) in the Southeast Asian populations are currently lacking. Therefore, we aimed to estimate the normative values and generate anthropometric prediction models for LM and FM in the Thai population. Methods: Consecutive community-dwelling individuals aged 20-90 years were recruited from Srinagarind Hospital, Khon Kaen, Thailand, between 2010 and 2015. LM and FM were measured using dual energy X-ray absorptiometry. Age and sex stratified percentile of LM and FM were presented. Anthropometric prediction models for LM and FM were developed by using linear regression to generate competing models. Results: A total of 832 individuals (334 males and 498 females) were included in the study. The mean ± SD age, LM, and FM were 50.0 ± 16.2 years, 38.9 ± 8.0 kg, and 15.5 ± 7.7 kg, respectively. LM decreased with age from 49.4 kg in 20-29 years group to 42.3 kg in ≥70 years group in male and 34.6 kg in 30-39 years group to 30.8 kg in ≥70 years group in females. FM has an inverse U-shaped association with age, which peaked at 11.9 kg in 60-69 years group in males and 20.7 kg in 50-59 years group in females. Among the various anthropometric models, the models incorporating age, sex, weight, and height were considered the best fit for predicting both LM and FM. Conclusion: In the Thai population, peak LM was reached during early adulthood and decline with age, whereas FM showed an inverse U-shaped association with age. The prediction models incorporating age, sex, weight, and height were proposed as practical tools for assessing LM and FM in clinical practice.

Etiologies of non-surgical root canal treatment and its association with risk factors in a selected Thai population

BackgroundThe aim of this study was to investigate the etiologies of non-surgical root canal treatment (NS-RCT) in a Thai population and examine their association with risk factors.MethodsA cross-sectional observational study was performed to examine the etiologies of NS-RCT and risk factors among Thai-nationality patients treated at a tertiary care dental hospital in Thailand from 2019–2023. Treatment records and radiographs were retrospectively reviewed to identify NS-RCT etiologies, and associated contributing factors were analyzed. Statistical analysis used univariate logistic regression followed by multivariate logistic regression, with a significance level set at P < 0.05.ResultsThe data from 1500 teeth were analyzed, comprising 59.1% females and 40.9% males, with ages ranging from 7–91 years (mean = 48.56 years). The most prevalent age group was 61–70 years-old. Among the treated teeth, the mandibular first molar was the most frequently involved (13.9%), followed by the maxillary first molar (9.9%) and mandibular second premolar (9.7%). The primary etiologies of NS-RCT were dental caries (53.7%), old and large restorations (7.9%), and attrition (5.9%). Analysis of etiology of NS-RCT due to caries revealed that the most commonly affected sites were the occlusal (32.6%), distal (31.6%), and mesial (17.2%) surfaces. In immature teeth requiring NS-RCT, the predominant etiologies were dens evaginatus (32.1%), dental caries (28.6%), and traumatic injury (21.4%). The association between the etiology of NS-RCT and investigated associated factors were identified.ConclusionsThe etiologies of NS-RCT in the selected Thai population were mainly attributed to dental caries, with additional factors being old and large restorations and attrition. Notably, due to the aging society, the elderly population experiences a higher demand for NS-RCT, particularly due to attrition, non-carious cervical lesions, and erosion. In contrast, in immature teeth, the most common etiologies leading to NS-RCT comprise dens evaginatus, dental caries, and traumatic injuries. The distinct etiological patterns observed in different age groups emphasize the importance of specific oral health prevention programs to address individual needs.

Genetic variability of 23 autosomal STRs in Austroasiatic-speaking populations from Thailand.

Austroasiatic (AA) speakers constitute around 4% of the population of Thailand, while the majority (89.4%) speak Kra-Dai (KD) languages. Previous forensic and population genetic studies in various Thai populations have employed a limited number of short tandem repeats (STRs). This study aims to expand the investigation of the genetic makeup of AA populations in Thailand and their relationship to KD populations using a larger number of autosomal STRs with the VeriFiler™ Plus PCR Amplification Kit. We generated 593 new genotypes from AA-speaking groups and combined them with previously reported data from AA and KD groups. A total of 1,129 genotypes across 23 STR loci were used to construct the largest allelic frequency profile for Thai and Lao populations. However, several loci deviated from Hardy-Weinberg equilibrium, likely due to the reduced genetic diversity in some highland populations, which should be considered in forensic investigations. Beyond forensic applications, our findings reveal genetic differences between AA-speaking groups in Northern and Northeastern Thailand. The AA groups from Northeastern Thailand exhibit greater genetic homogeneity and diversity, likely due to population interactions. In contrast, reduced diversity and increased heterogeneity in AA groups from Northern Thailand are possibly driven by genetic drift and cultural and geographic isolation. In conclusion, we emphasize the usefulness of increasing the number of autosomal STRs in forensic and anthropological genetic studies. Additional Y-STR and X-STR data from various AA-speaking groups in Thailand would further enhance and strengthen forensic STR databases in the region.

Clinical and Psychological Implications of Genital Vitiligo in a Thai Population.

The understanding of genital vitiligo among Thai individuals is limited. This study evaluated the clinical presentation, quality of life, and sexual health consequences of genital vitiligo. This cross-sectional, questionnaire-based study involving vitiligo patients aged 18 years or older with past or present genital involvement was conducted at Siriraj Hospital. It also measured aspects of sexual health and quality of life. The mean age of the 41 participants was 48.2 years, and 24 (58.5%) were males. All participants presented with genital vitiligo. In males, the penile shaft (45.8%), scrotum (45.8%), and glans (33.3%) were predominantly affected. In females, the mons pubis (64.7%), labia majora (23.5%), and labia minora (23.5%) were frequently involved. Both sexes reported afflictions in the pubic area (41.5%), inguinal region (36.6%), buttocks (34.1%), and oral mucosa (34.1%). Itching was the principal symptom in 26.8% of the patients. The median Dermatology Life Quality Index scores were significantly different (females 6, males 3.5). Compared with their male counterparts, females exhibited lower self-esteem (41.2% vs 29.2%), greater apprehension about marriage (11.8% vs 8.3%), and embarrassment about sexual activities (23.5% vs 16.7%). Remarkably, 65.9% of patients had not discussed their genital vitiligo with their doctors, and 51.2% of physicians had not inquired about or examined for genital involvement. Genital vitiligo adversely impacts quality of life and self-esteem, particularly among female patients. The lack of discourse between patients and physicians highlights a need for increased awareness and proactive clinical investigations to enhance patient care and satisfaction.

Variations of the abductor pollicis longus tendon and its insertion in the Thai population: Cadaveric study with clinical relevance

BackgroundThe abductor pollicis longus (APL) tendon exhibits significant anatomical variability, which is crucial for understanding its clinical implications in surgeries involving the thumb. While several studies have documented these variations in different populations, a systematic classification providing insights for surgical interventions targeting the thumb and its associated anatomical structures is rare. MethodsThis cadaveric study involved the dissection of 87 upper extremities from 44 embalmed cadavers (22 males, 22 females). The APL tendons were meticulously dissected, and the number of tendons slips and their insertion sites were recorded. Data were analyzed using Chi-square and Fisher's exact tests to assess differences in insertion sites between sexes and sides. ResultsThe number of APL tendon slips distal to the first extensor compartment ranged from 1 to 5, with double slips being the most common configuration. The primary insertion site was consistently the base of the first metacarpal bone, observed in all specimens. Secondary insertion sites included the abductor pollicis brevis muscle (67.82 %), trapezium (17.24 %), opponens pollicis muscle (5.75 %), and proximal phalanx (2.30 %). Statistical analysis showed no significant differences in the insertion sites between sides and sexes. A new classification system for APL tendon slips was developed, categorizing them into three main types (Type I, II, III), and two minor types (Type IV and V), based on the number and insertion sites of the tendons. Type II with double tendon slips was the most prevalent (48.28 %). Symmetrical findings were found in 21 cases (48.84 %), with subtype IIb being the most common pattern. ConclusionThis study highlights significant anatomical variations of the APL tendon in the Thai population, with important clinical implications for surgical planning and treatment of thumb-related conditions. The proposed classification system provides a structured framework for understanding these variations, aiding in the diagnosis and surgical management.

Comprehensive breast cancer risk analysis with whole exome sequencing and the prevalence of BRCA1 and ABCG2 mutations and oncogenic HPV.

Breast cancer is the most prevalent cancer and also the leading cause of cancer death in women worldwide. A comprehensive understanding of breast cancer risk factors and their incidences is useful information for breast cancer prevention and control planning. The present study aimed to provide information on single nucleotide polymorphisms (SNPs) and copy number variations (CNVs) in breast cancer, the allele frequency of two SNPs in breast cancer-related genes BRCA1 DNA repair associated (BRCA1; rs799917) and ATP binding cassette subfamily G member 2 (ABCG2; rs2231142), and the prevalence of human papillomavirus (HPV) infections in a normal population living in Phayao Province, Northern Thailand. One breast cancer and 10 healthy samples were investigated by whole exome sequencing (WES) and compared for genetic variation. The WES data contained SNPs in genes previously implicated in breast cancer and provided data on CNVs. The allele frequencies for SNPs rs799917 and rs2231142 were also examined. The SNP genotype frequencies were 35.88% CC, 46.54% CT, and 17.58% TT for rs799917 and 33.20% CC, 46.88% CA, and 19.92% AA for rs2231142. A total of 825 human whole blood samples were examined for HPV infection by PCR, and the pooled DNA was tested for HPV infection using metagenomic sequencing. No HPV infections were detected among all 825 samples or the pooled blood samples. The incidence of breast cancer among the tested samples was estimated based on acceptable breast cancer risk factors and demographic data and was 1.47%. The present study provided data on SNPs and CNVs in breast cancer-related genes. The associations between SNPs rs2231142 and rs799917 and breast cancer should be further investigated in a case-control study since heterozygous and homozygous variants are more common. Based on the detection of HPV infection in the blood samples, HPV may not be associated with breast cancer, at least in the Northern Thai population.

Nicotine Gum in Thai Smokers with Different CYP2A6 Enzymes: A Population Pharmacokinetic Analysis

Objective: Despite the popularity of nicotine gum in Thailand, population pharmacokinetics of nicotine gum in the Thai population has not been investigated. This study aimed to develop a population pharmacokinetic (POPPK) model of nicotine and to quantify the effects of genetic and non-genetic factors to nicotine pharmacokinetics. Materials and Methods: Secondary data collected from a previous clinical trial assessing cytochrome P450 2A6 (CYP2A6) genotypes in Thai smokers was investigated. Eighteen participants who had received a single dose of 2 mg nicotine gum were included. Blood samples were collected before, at 0.25, 0.5, 1, 1.5, 2, 2.5, 3, 4.5 and 6 hours after nicotine administration. POPPK analysis was performed using nonlinear mixed effect modelling. Results: One-compartment with 1st order elimination and absorption with 6-transit compartments best described the data. CYP2A6 enzyme activity was a significant covariate on the nicotine clearance. Apparent elimination clearance (CL/F) for a person with 100% CYP2A6 activity was 266.0 L/h. CL/F would be 36.0 L/h in a subject with 0% CYP2A6 activity. However, the impact of non-genetic factors (monthly alcohol consumption, Fagerstrom Test for Nicotine Dependence score and the number of cigarettes per day) on pharmacokinetics of nicotine were not found. Conclusion: This first report on population pharmacokinetics of nicotine gum in Thai smokers provided the pharmacokinetic model and quantified CL/F for smokers with different CYP2A6 genotypes. A markedly lower exposure to nicotine in the Thai population compared to others highlights the need for more studies to ensure the efficacy of nicotine gum in the Thai population.

Sex Determination from the Patella in a Thai Population

Sex Determination from the Patella in a Thai Population

Dual approaches in pharmacogenetics: Developing PCR-SSP and RT-PCR methods for HLA-B*13:01 screening to prevent dapsone and Co-trimoxazole SCARs

Dapsone and co-trimoxazole are potent antibiotics for treating various infections and inflammations. However, several studies reported the strongly association between severe cutaneous adverse drug reactions (SCARs) to both drugs and the HLA-B*13:01 allele. Rapid and reliable screening for the HLA-B*13:01 allele can mitigate the risk of dapsone-induced SCARs. We developed two methods, multiplex sequence-specific primer PCR (PCR-SSP) and real-time PCR (RT-PCR), tailored for different clinical settings. These methods were optimized to minimize false positives among the Thai population. Clinical validation demonstrated excellent reproducibility, with both methods showing 100 % concordance in repeated tests. PCR-SSP achieved a limit of detection as low as 100 pg of genomic DNA, while RT-PCR reached 1 pg. Overall statistical accuracy was 100.00 % (95 % CI: 98.18 %–100.00 %). Screening for drug-related HLA alleles is crucial for reducing mortality from severe cutaneous adverse drug reactions, especially dapsone hypersensitivity syndrome (DHS) and dapsone-induced hypersensitivity reactions (DIHRs). Our screening approach for dapsone can also be extended to co-trimoxazole, representing a significant advancement in personalized medicine and preemptive pharmacogenetic testing for tailored patient care and safety, albeit further validation in diverse ethnic populations is warranted to ensure universal applicability.

Parental Attitudes and Practices regarding Atopic Dermatitis: A Cross-Sectional Study among a Thai Population.

Atopic dermatitis (AD) is a chronic inflammatory skin disorder common in children. Successful pediatric AD therapy requires parental assistance. Thus, evaluating parental knowledge, attitudes, and behaviors regarding childhood AD may lead to more educational recommendations to help children control AD in the future. This study examined parents' knowledge, attitudes, and conduct concerning AD in families with and without children with AD. The Pediatric Department, Faculty of Medicine, Khon Kaen University, Thailand, conducted a cross-sectional study from June to December 2023. Parents of children who visited the dermatology clinic with or without AD were asked to complete a Google form questionnaire. A total of 372 parents answered a questionnaire about AD pathophysiology, knowledge, attitudes, and practices. The participants were 293 (78.8%) female participants and 79 (21.2%) male participants. The average age was 29.79 (SD 4.91). Most parents (319, 85.8%) did not work in the medical field, and more than half (228 instances, 61.29%) had children diagnosed with AD. Parents of children with AD understood AD causes and triggers better than parents of children without AD. But, "exposure to furry toys" that may contain dust and allergies and "infection" that may cause AD flare-ups were the most common triggers, regardless of the group. Appropriate information should be supplied because both the parents of children with AD and those of children without AD reported immediate food avoidance without confirmatory testing, which might lead to malnutrition. Clinicians and families handling patients with AD require further education.

Leishmania Infection among HIV-Infected Patients in a Southern Province of Thailand: A Cross-Sectional Study.

Leishmaniasis, a neglected tropical disease, imposes a notable health burden, especially on immunocompromised individuals such as HIV patients. Recognizing its prevalence and risk factors in specific populations is vital for effective prevention. This study in Satun Province, southern Thailand, aimed to ascertain leishmaniasis prevalence and identify associated risks among HIV-infected patients. A cross-sectional study was conducted among 650 HIV-infected individuals at a tertiary care hospital. Data on demographic characteristics, clinical parameters, and potential risk factors were collected. Individual plasma, buffy coat, and saliva samples were collected. Leishmania infection was determined using the direct agglutination test and nested polymerase chain reaction (nPCR) of nPCR-buffy coat and nPCR-saliva. The association between risk factors and Leishmania infection was assessed with logistic regression analysis. The prevalence of Leishmania infection was 8.61% (56/650). Species was identified among 20 HIV-infected patients as follows: Leishmania orientalis (N = 14), Leishmania martiniquensis (N = 4), and Leishmania donovani complex (N = 2). The factors associated with Leishmania infection included age (adjusted odds ratio [OR] = 1.03), intravenous drug use (adjusted OR = 2.39), CD4 cell count <500 cells/mm3 (adjusted OR = 2.40), and a viral load ≥50 copies/mL (adjusted OR = 5.16). The prevalence of Leishmania infection among HIV-infected patients in Satun Province was considerable. These findings underscore the need for integrated care and targeted interventions to address this infection and improve public health outcomes. Further research and collaborative efforts are warranted to develop effective prevention and control strategies for Leishmania infection in the HIV-infected Thai population.

The Diversity of CYP2C19 Polymorphisms in the Thai Population: Implications for Precision Medicine.

CYP2C19 plays a major role in the metabolism of various drugs. The most common genetic variants were the CYP2C19*2 and *3 alleles (rs4244285 and rs4986893, non-functional variants). In previous studies, we found that genetic polymorphisms in CYP2C19 variants influenced the active metabolites of clopidogrel and caused major adverse cardiovascular and cerebrovascular effects. However, the distribution of CYP2C19 varies among ethnic groups and according to adverse drug reactions. This study aimed to investigate the frequency of CYP2C19 genetic polymorphisms in the Thai population and analyze the differences in the frequency of CYP2C19 genetic polymorphisms between Thai and other populations. This study enrolled 211 unrelated healthy Thai individuals in total. We performed a real-time polymerase chain reaction to genotype CYP2C19*2 (681G > A) and CYP2C19*3 (636G > A). In the Thai population, the CYP2C19*1 allele was the most prevalent at 70.14%, while the CYP2C19*2 and *3 alleles were found at frequencies of 25.36% and 4.50%, respectively. Conversely, the CYP2C19*3 allele was not detected in Caucasian, Hispanic, African, Italian, Macedonian, Tanzanian, or North Indian populations. The phenotypic profile of this gene revealed that the frequency of intermediate metabolizers (IMs) is nearly equal to that of extensive metabolizers (EMs), at 42.65% and 48.82% respectively, with genotypes *1/*2 (36.02%) and *1/*3 (6.63%). Likewise, poor metabolizers (PMs) with genotypes *2/*2 (6.16%), *2/*3 (2.37%), and *3/*3 (<1%) are more prevalent in our population as well. The distribution of CYP2C19 genotype and phenotype influenced by non-functional alleles has potential as a pharmacogenomics biomarker for precision medicine and is dependent on an ethnic-specific genetic variation database.