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Biomedical subjects

V Poshyachinda

Publications and source records attributed to V Poshyachinda.

At least 19 recordsLinked to original sources

Evaluation of a targeted HIV prevention programme among female commercial sex workers in the south of Thailand.

OBJECTIVE: To evaluate a targeted HIV prevention programme among female commercial sex workers (CSWs) in the south of Thailand. SUBJECTS AND METHODS: A pretest-post-test comparison group study was carried out in Sungai Kolok and Betong between June and December 1994. In June 408 CSWs were entered in Sungai Kolok (the intervention area) and 343 CSWs were enrolled in Betong (the comparison area). In December 1994, 416 women were enrolled in Sungai Kolok and 342 in Betong. Of these women 37% (n = 283) also participated in the June survey. All women completed an oral interview and blood samples were collected for HIV serology. The intervention programme consisted of an informational and educational campaign and peer educator training. RESULTS: Increase in knowledge and perceived vulnerability was more pronounced in the intervention area but did not translate into a greater increase in condom use. Refusal of customers unwilling to use a condom and manager support in doing so were the only factors independently related to positive changes in condom use. HIV prevalence (approximately 20%) and incidence (approximately 4.2 per 100 women years) were the same in both study locations. Women in the intervention area reported significantly fewer customers and income from sex work, possibly as a result of a coincidental police campaign to suppress (child) prostitution. CONCLUSIONS: HIV incidence among CSWs in the south of Thailand is still high. Prevention programmes should focus on improvement of negotiation and refusal skills and manager support in using condoms.

Adult↗

Bias.

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Bias↗

Drugs and AIDS in Southeast-Asia.

Opium dependence was indigenous to countries in the Golden Triangle area in south-east Asia (SA). Heroin epidemics developed in most SA countries in the 1960s and early 1970s and remained a significant problem particularly in Myanmar, Thailand and Malaysia until now. In contrast, the island countries in SA seemed quite free from opiate abuse. Intravenous injection (IV) of drugs appeared after the heroin epidemic and currently prevails in countries with a significant opiate abuse problem. IV of opium was particularly common in the highly urbanized cities in Vietnam. Most SA countries started HIV seroscreening in IV drug users (IVDU) around the middle of the 1980s. Rapid epidemic spread of HIV infection was observed in 1988-89 in Thailand and Myanmar. The Highest prevalence of more than 80% was reported from a study of IVDUs in Yangon, Myanmar, followed by Thailand at about 40%. Although HIV infected IVDUs were identified at the same time in Malaysia and later in Singapore and the Philippines, there was no evidence of such a rapid and severe epidemic.

Adult↗

Drug injecting and HIV infection among the population of drug abusers in Asia.

Opium has been produced and consumed since the nineteenth century in the areas of Asia currently referred to as the Golden Crescent and the Golden Triangle. In the 1970s and 1980s, most countries from Afghanistan to Japan experienced a heroin epidemic of varying degrees of severity. Opium and heroin abuse appeared to be more severe in countries and areas where those drugs were produced, an exception being Hong Kong, which has had a large population of heroin abusers for more than two decades. Drug injecting was far more common in countries of the Golden Triangle than in those of the Golden Crescent. In Myanmar and Thailand, for example, up to 90 per cent of chronic heroin abusers practised intravenous injection, which appeared to spread to heroin abusers in nearby territories such as the State of Manipur in India. Yunnan province in China, as well as Malaysia and Viet Nam. Amphetamine abuse was more frequent in Japan and the Republic of Korea for a number of years, while illicit production and consumption in the Philippines have recently shown significant increases. The injection of amphetamines was common only in the Republic of Korea. The prevalence of injecting among institutionalized methamphetamine abusers was reported at about 90 per cent. Most countries in Asia first reported cases of infection with the human immunodeficiency virus (HIV) in the mid-1980s. An extremely rapid spead of the epidemic and high prevalence, at rates of from 30 to 90 per cent, of HIV infection among the sample of intravenous heroin abusers were observed in a few countries with a high prevalence of intravenous injecting, such as India (in the State of Manipur), Myanmar and Thailand. The rest had either few reported cases or none at all, even though needle-sharing was found to be common. Great caution should be exercised in interpreting prevalence because of vast differences in methods of assessment. Given the vulnerability of intravenous drug abusers to rapid transmission of HIV infection, the prevention of drug injecting is of paramount importance in arresting the spread of the epidemic. Efforts to contain drug abuse, though difficult, are a principal means of achieving that end.

Asia↗

Renal function in obstructive jaundice in man: cholangiocarcinoma model.

Renal function with respect to water clearance and renal hemodynamics was studied in 15 patients with obstructive jaundice due to cholangiocarcinoma. The results were compared with those of the control normal subjects. There was no change in renal function in the patients with mild to moderate jaundice, with total serum bilirubin from 8.0 to 15.1 mg/dl. Increased urinary sodium excretion and decreased free water and negative water clearances were observed in the patients with severe jaundice with total serum bilirubin from 27.0 to 40.4 mg/dl and normal serum albumin. Renal blood flow was normal, but creatinine clearance was decreased. In severely jaundiced patients with serum bilirubin from 30.5 to 40.1 mg/dl and hypoalbuminemia urinary sodium excretion, free water clearance, negative water clearance, renal blood flow and creatinine clearance were decreased. There was salt and water retention in this group. The findings suggest that in severe jaundice there is inhibition of sodium chloride reabsorption in the thick ascending limb of Henle's loop. ADH and increased hydraulic conductivity of the collecting tubules possibly contribute to decreased free water clearance. In severely jaundiced patients with hypoalbuminemia this salt losing effect is converted to salt retention by increased proximal tubular reabsorption of sodium.

Adenoma, Bile Duct↗

Renal failure in malaria: a pathophysiologic study.

A pathophysiologic study was made in 15 patients with acute renal failure due to falciparum malaria. Marked increase in plasma fibrinogen and elevation of serum fibrin degradation products were observed in all cases. The other coagulation parameters including prothrombin time, partial thromboplastin time, factor V and factor VIII were within the normal limits. Plasma hemoglobin was minimal. The blood viscosity was significantly increased. Blood volume study in 5 patients showed initial hypovolemia followed by hypervolemia and normovolemia. Decreased cortical renal blood flow was noted in renal hemodynamic study using 133Xe. Plasma renin activity was increased. Intravenous pyelography during the oliguric phase of renal failure revealed a poor nephrogram which increased in density at 24 and 48 h after the injection of the contrast material. The findings suggest the significance of reduction of renal blood flow in the pathogenesis of renal failure in human malaria. The roles of blood hyperviscosity and hypovolemia are emphasized.

Acute Kidney Injury↗

The effect of D-norgestrel, 30 micrograms, on the oral glucose tolerance test, including insulin levels, in Thai women.

The effect of D-norgestrel, 30 mug, on the oral glucose tolerance test was studied in 49 Thai women. There was a significant elevation of the blood glucose level at 60 minutes during the test in women who had taken D-norgestrel for 6 and 12 months. Insulin levels in the blood were significantly elevated over control levels in both groups of women at 90, 120, 150, and 180 minutes during the test. There was no difference in the results obtained at 6 months and 12 months. There was also no significant difference in the fasting blood glucose or insulin levels in the three groups of women. The results indicate that D-norestrel at a daily dose of 30 mug has an effect on carbohydrate metabolism in Thai women.

Administration, Oral↗

A study of the use of intermittent serum luteinizing hormone, progesterone and oestradiol measurements for the detection of ovulation.

The value of luteinizing hormone (LH), progesterone (P) and oestradiol (E2) in serum as an index of ovulation and corpus luteum function was studied in blood samples collected at infrequent intervals during the menstrual cycle from 19 healthy Thai women. A serum P level of more than 3 ng/ml was detectable in 70 to 80 per cent samples obtained between days 20 and 25 and a P peak and/or E2 peak (greater than 150 pg/ml) were found at this time in 85 to 94 per cent of the cycles. In not more than 26 per cent of the cycles was an LH peak (greater than 150 ng/ml-LER-907) detected when all results were considered. A significant P and/or E2 peak on day 22 or 23 occurred in more than 78 per cent of 25 to 33 day cycles, whereas, the P and/or E2 peak was detectable in only 50 per cent of the cycles lasting less than 25 or more than 33 days. The postovulatory serum P levels were the ones most consistently raised in patients studied over several consecutive cycles.

Adolescent↗

Postoperative thrombosis in Thai women.

The 125-I-labelled fibrinogen infusion test and phlebography were used to detect evidence of the postoperative development of deep-vein thrombosis (D.V.T) in the legs of 117 Thai women who had abdominal hysterectomy for benign conditions and of 52 who had major pelvic surgery for malignant disease of the ovary, uterus, and cervix. D.V.T. was demonstrated in 1.7% and 3.8%, respectively. Comparison of these results with an almost identical study in Oxford showed that D.V.T. was significantly more common in women in England - i.e., 12% and 35% in those with benign or malignant diseases, respectively.

Adult↗