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Purpose: To assess the potential influence of serum biochemical factors, specifically lipid profile parameters, on visual outcomes in patients with non-arteritic anterior ischemic optic neuropathy (NAION). Patients and Methods: All patients diagnosed with NAION at Rajavithi Hospital between 1 January 2011 and 31 December 2020 were retrospectively reviewed. The primary outcome was defined as visual recovery, measured by an improvement of at least 0.2 logarithm of the minimal angle of resolution (logMAR) in their best-corrected visual acuity (BCVA) at the 12-weeks follow-up visit compared to the initial visit and determine whether those lipid profiles parameters are predictive of 12 weeks-visual outcomes. Factors of an initial poor VA were evaluated using logistic regression analysis. Results: In this study, 84 patients with NAION were included to assess the impact of lipid parameters on visual outcomes. Majority of participants were male. The group with initial VA worse than 20/200 had significantly higher mean age of 58.3± 7.6 years and levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL) (all p < 0.05 respectively). Throughout 12 weeks, a significant difference in change of BCVA between the two groups of initial VA was observed (p< 0.001). Regarding lipid parameters on visual prognosis, lipid profile between the two groups of VA improvement of 0.2 logMAR was comparable different. The probability of VA improvement showed a weak association with TC levels. A gradual increase in probability slightly related to LDL parameter, while TG showed an inverse relationship. At elevated lipid levels, there was a greater degree of uncertainty in predicting visual outcomes. Conclusion: While older age and elevated lipid levels, specifically TC, TGs, and LDL, were correlated with poorer initial visual acuity in NAION patients, no significant associations were identified between lipid parameters and long-term visual recovery. Early detection for individuals with dyslipidemia (DLP) and advanced age merit attention. [ABSTRACT FROM AUTHOR]

Introduction: Although single-stage bilateral total knee arthroplasty (BTKA) presents several advantages, higher perioperative blood loss is a potentiate drawback that is still inevitable. Cruciate retaining (CR) TKA may theoretically result in less blood loss, offer better proprioception, and more physiologic kinematics compared to posterior stabilized (PS) TKA. The objective of this study was to compare perioperative blood loss and recovery among patients who underwent CR and PS BTKA. Methods: A cohort of 46 CR BTKA and 80 PS BTKA performed by a single surgeon were retrospectively evaluated. Identical surgical techniques and perioperative care were provided to all patients. Propensity score matching was utilized to compare blood loss, a visual analog scale (VAS) for postoperative pain level, morphine consumption, knee flexion arc, and length of stay (LOS). Results: Comparing CR BTKA and PS BTKA, drain output was 206.44 mL vs. 194.89 mL (p = 0.47), calculated blood loss was 886.23 mL vs. 724.89 mL (p = 0.05), and blood transfusion rate was 18% vs. 17% (p = 1.00). Additionally, CR BTKA had higher VAS than PS BTKA, at 6 h: 5.74 vs. 3.78 (p

Introduction The coronavirus disease (COVID-19) pandemic has challenged health systems worldwide. In Thailand, the pandemic has gradually affected the health-care provision for other diseases than COVID-19, including peritoneal dialysis for [...], Problem The coronavirus disease 2019 (COVID-19) pandemic could affect health service provision of less urgent interventions, such as peritoneal dialysis for chronic kidney disease patients. Approach To assess how peritoneal dialysis centres in Thailand adapted their provision of care, we invited medical directors and peritoneal dialysis managers to respond to an online survey on 1 July 2021. We asked whether they had modified or deferred their training, catheter insertion or removal, intravenous supplements, follow-up and home visits, and workload. Local setting Patients needing dialysis receive peritoneal dialysis free of charge in Thailand. As of 31 December 2020, 240 peritoneal dialysis centres in Thailand have provided care to 32 284 patients. Relevant changes At 24.6% (29/118) of centres, educational sessions for patients were modified. Catheter insertion continued at 71.9% (82/114) of centres. Few facilities (19.7%; 23/117) continued to perform peritoneal equilibration tests as usual. On-site intravenous injections were mostly transferred to health centres close to the patients' homes. Most centres reduced their outpatient follow-up visits (51.7%; 61/118) and stopped visiting patients at home (66.9%; 79/118). Peritoneal dialysis nurses reported an increased workload at 62.7% (74/118) of centres, and in many instances (66.1%; 78/118) were providing nursing care to COVID-19 patients and administering COVID-19 vaccines. Lessons learnt Health-care providers altered clinical care activities to protect their patients from COVID-19. However, further evidence is needed on the consequences of such alteration in care. To prepare for future pandemics, actors need to explore nonconventional peritoneal dialysis care as well as financial and nonfinancial incentive mechanisms for such care. Probleme La pandemie de maladie a coronavirus 2019 (COVID-19) est susceptible d'affecter la realisation, par les services de sante, d'interventions moins urgentes, telles que les dialyses peritoneales pour les patients atteints de maladies renales chroniques. Approche Afin d'evaluer comment les centres medicaux procedant a des dialyses peritoneales en Thailande ont adapte leur prestation de soins, nous avons invite des directeurs medicaux et des personnes effectuant des dialyses peritoneales a repondre a une enquete en ligne le 1er juillet 2021. Nous leur avons demande s'ils avaient modifie ou reporte leur formation, l'insertion ou le retrait de catheters, des supplements intraveineux, des visites de suivi ou a domicile et leur charge de travail. Environnement local En Thailande, les patients necessitant une dialyse beneficient gratuitement d'une dialyse peritoneale. Au 31 decembre 2020, 240 centres thailandais realisant des dialyses peritoneales ont fourni des prestations a 32 284 patients. Changements significatifs Dans 24,6% (29/118) des centres, les seances educatives destinees aux patients ont ete modifiees. L'insertion de catheters s'est poursuivie dans 71,9% (82/114) des centres. Peu de centres (19,7%; 23/117) ont continue a effectuer le test d'equilibrage peritoneal comme a leur accoutumee. Les injections intraveineuses sur place ont ete transferees pour la plupart dans des centres de sante proches du domicile des patients. La plupart des centres ont reduit leurs visites de suivi ambulatoire (51,7%; 61/118) et ont cesse de rendre visite aux patients a leur domicile (66,9%; 79/118). Le personnel infirmier charge de realiser des dialyses peritoneales a signale une augmentation de sa charge de travail dans 62,7% (74/118) des centres et, dans de nombreux cas (66,1%; 78/118), il fournissait des soins infirmiers aux patients atteints de la COVID-19 et vaccinait contre la COVID-19. Lecons tirees Les prestataires de soins de sante ont modifie leurs activites cliniques pour proteger leurs patients contre la COVID-19. Cependant, des preuves supplementaires sont necessaires sur les consequences d'une telle modification du schema de soins. Pour se preparer aux futures pandemies, les acteurs de la sante doivent envisager des interventions de dialyse peritoneale non conventionnelles ainsi que des mecanismes d'incitation financiere et non financiere pour ces soins. Situacion La pandemia de la coronavirosis de 2019 (COVID-19) podria afectar a la prestacion de los servicios sanitarios de intervenciones menos urgentes, como la dialisis peritoneal para pacientes con enfermedades renales cronicas. Enfoque Para evaluar como los centros de dialisis peritoneal de Tailandia adaptaron su prestacion de cuidados, se invito a los directores medicos y a los gestores de dialisis peritoneal a responder a una encuesta en linea el 1. de julio de 2021. Se les pregunto si habian modificado o aplazado su formacion, la insercion o retirada de cateteres, los suplementos por via intravenosa, las visitas de revision y a domicilio y la carga de trabajo. Marco regional Los pacientes que necesitan dialisis reciben dialisis peritoneal de forma gratuita en Tailandia. A 31 de diciembre de 2020, 240 centros de dialisis peritoneal en Tailandia atendieron a 32 284 pacientes. Cambios importantes Se modificaron las sesiones educativas para los pacientes en el 24,6 % (29/118) de los centros. La insercion de cateteres continuo en el 71,9 % (82/114) de los centros. En pocos centros (19,7 %; 23/117) se siguio realizando la prueba de equilibrio peritoneal de forma habitual. Las inyecciones por via intravenosa in situ se transfirieron en su mayoria a los centros sanitarios cercanos a los domicilios de los pacientes. La mayoria de los centros disminuyeron sus visitas de revision ambulatoria (51,7 %; 61/118) y dejaron de visitar a los pacientes en sus domicilios (66,9 %; 79/118). Las enfermeras dedicadas a la dialisis peritoneal informaron de un incremento de la carga de trabajo en el 62,7 % (74/118) de los centros, y en muchos casos (66,1 %; 78/118) estaban proporcionando cuidados de enfermeria a los pacientes de la COVID-19 y administrando las vacunas contra la COVID-19. Lecciones aprendidas Los proveedores de servicios sanitarios modificaron las actividades de atencion clinica para proteger a sus pacientes de la COVID-19. No obstante, se necesitan mas evidencias sobre las consecuencias de esta modificacion de la atencion. Para prepararse para futuras pandemias, los agentes sanitarios deben explorar los cuidados de dialisis peritoneal no convencionales, asi como los mecanismos de incentivos financieros y no financieros para estos cuidados.

Background:Aspergillus tracheobronchitis (AT) is an uncommon yet severe form of invasive pulmonary aspergillosis, with a notably low incidence among individuals living with HIV infection—accounting for merely 4.5% (7 out of 156 cases) in recent reviews. The advent of modern antiretroviral therapy (ART) has significantly altered the landscape of opportunistic infections in HIV, rendering conditions like AT rare in well‐controlled cases. Case Presentation: We present the case of a woman in her mid‐20s with well‐managed HIV infection who experienced a 4‐week history of fever and dyspnea. Diagnostic procedures, including bronchoscopy, revealed granulation tissue obstructing her right main bronchus. Cultures confirmed infection with Aspergillus fumigatus, leading to a diagnosis of AT. Despite initial positive response to voriconazole treatment, the patient developed severe hemoptysis and unfortunately succumbed to the complication. Conclusion: This case underscores the critical need for healthcare providers to consider AT in the differential diagnosis of respiratory symptoms in HIV‐positive patients, even when HIV is well‐controlled with ART. Early recognition and prompt antifungal therapy are essential for improving outcomes. Clinicians should remain vigilant for severe complications like hemoptysis, which can occur despite appropriate therapy. This report highlights the ongoing necessity for vigilance and proactive intervention in the care of individuals living with HIV. [ABSTRACT FROM AUTHOR]

Background: The relationship between consuming Thai desserts—predominantly composed of carbohydrates—and gut microbiome profiles remains unclear. This study aimed to evaluate the effects of consuming various Thai desserts with different GI values on the gut microbiomes of healthy volunteers. Methods: This open-label, parallel randomized clinical trial involved 30 healthy individuals aged 18 to 45 years. Participants were randomly assigned to one of three groups: Phetchaburi's Custard Cake (192 g, low-GI group, n = 10), Saraburi's Curry Puff (98 g, medium-GI group, n = 10), and Lampang's Crispy Rice Cracker (68 g, high-GI group, n = 10), each consumed alongside their standard breakfast. Fecal samples were collected at baseline and 24 h post-intervention for metagenomic analysis of gut microbiome profiles using 16S rRNA gene sequencing. Results: After 24 h, distinct trends in the relative abundance of various gut microbiota were observed among the dessert groups. In the high-GI dessert group, the abundance of Collinsella and Bifidobacterium decreased compared to the low- and medium-GI groups, while Roseburia and Ruminococcus showed slight increases. Correlation analysis revealed a significant negative relationship between sugar intake and Lactobacillus abundance in the medium- and high-GI groups, but not in the low-GI group. Additionally, a moderately negative association was observed between Akkermansia abundance and sugar intake in the high-GI group. These bacteria are implicated in energy metabolism and insulin regulation. LEfSe analysis identified Porphyromonadaceae and Porphyromonas as core microbiota in the low-GI group, whereas Klebsiella was enriched in the high-GI group, with no predominant bacteria identified in the medium-GI group. Conclusions: The findings suggest that Thai desserts with varying GI levels can influence specific gut bacteria, though these effects may be temporary. [ABSTRACT FROM AUTHOR]

During January 2020, persons in Thailand were tested for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection if they had a combination of fever or respiratory illness [...]