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Background and Objectives: Despite the proven benefits of oral nutrition supplements (ONS), its prescription in Thailand are far less than it should mainly due to limitation of reimbursement. Our aim was to compare hospital outcomes between hospitalized patients receiving only hospital food to those receiving hospital food with ONS., Methods and Study Design: An annual cross-sectional survey, NutritionDay (nD), in Thailand was conducted in 2 hospitals from 2010 to 2015. The hospital outcomes were followed at day 30 after first evaluation. Logistic regression and Cox regression were performed to compare outcome between groups., Results: 524 hospitalized patients, 472 with only hospital food and 52 with ONS, were included. Patients with ONS had longer hospital stay prior to recruitment, reported more physical dependencies, and ate less food. The ONS group was less likely to be discharged within 30 days as compared to hospital food group (unadjusted OR 0.28, 95% CI 0.16-0.52) but this effect was not significant after adjustment for length of stay before nD and PANDORA score (adjusted OR 0.62, 95% CI 0.3-1.34). Cox regression showed a trend to decreased rate of discharge within 30 days in the ONS group., Conclusions: This cross-sectional study showed a trend of worse outcomes associated with ONS prescription which might be related with higher mortality risk according to PANDORA score and longer previous hospital stay of the patients in the ONS group. Since the 2 studied groups were not comparable, further studies in this specific population should be performed., (Copyright © 2019. Published by Elsevier Ltd.)

Background: Morbid obesity is a growing problem in Thailand. Several surgical procedures are available for weight reduction. The laparoscopic gastric banding has been shown to be an effective weight loss with a low post or perioperative complication., Objective: The aim of this report was to evaluate the early preliminary outcome of the laparoscopic Swedish adjustable gastric banding operation in Thai cohort patients., Material and Method: From November 2003 until March 2005, ten patients with a median age of 31 (range, 18-61) underwent laparoscopic Swedish adjustable gastric banding for morbid obesity at Ramathibodi Hospital. Demography, clinical course and outcome including excess weight loss and peri-operative complications were reviewed and studied. Descriptive statistics were used for data summary., Results: There were 3 men and 7 women with a median preoperative body weight of 142.5 kg (range, 98-164 kg), and median body mass index (BMI) of 49.2 kg/m2 (range, 40.3-62.4 kg/m2). The operations were successful in 9 out of 10 patients with median operative time of 195 minutes (range, 125-275 minutes). One patient with a BMI of 62.4 had a failed operation due to poor operative exposure from a very large left lobe of the liver. None of the remaining patients required conversion to the opened technique. The mean hospital stay was 4 days with no perioperative mortality. There was no major post operative complication except one minor wound infection. The excess weight loss was within the range of 33.5% to 62.1% during the short-term follow-up (range, 1-15 months), Conclusion: The presented early preliminary result of the laparoscopic Swedish adjustable gastric banding showed a good technical success with a significant short-term weight loss. The authors believe this minimally invasive operation is appropriate for morbidly obese Thai patient. However a longer follow-up study is needed.

The major source of vitamin D is endogenous synthesis under sunlight exposure, thus, vitamin D deficiency is uncommon in healthy people living in a tropical area where sunshine is plentiful. However, long-stay hospitalized patients who do not get direct sunlight may become vitamin D deficient. The authors studied the prevalence of vitamin D deficiency in patients without other risk factors for vitamin D deficiency who had been admitted to Songklanagarind Hospital for longer than 27 days. The second objective was to identify predictive factors for vitamin D deficiency. Considered variables were clinical character, basic laboratory results, and intact parathyroid hormone level (iPTH). Among 60 patients studied, there were 12 patients who were vitamin D deficient and only one had a level lower than 8 ng/ml. Despite vitamin D deficiency, average serum calcium was normal. Patients in the vitamin D deficient group had lower serum corrected calcium and higher iPTH level than patients in the vitamin D sufficient group. No other clinical or laboratory data could predict a vitamin D deficiency state. In summary, the present tropical area study showed that 20 per cent of long-stay hospitalized patients who had a mild degree of vitamin D deficiency and 1.7 per cent had severe vitamin D deficit. Vitamin D supplementation is unnecessary in this group of patients.