Asian Medical Journal and Alternative Medicine

An Update in Adult Intraosseous Infusion

Wirot Sombatthavoankun — Tue, 30 Apr 2024 00:00:00 +0700

The Intraosseous (IO) needle was developed in 1920s to access the vascular system via the bone marrow cavity. Around the 2010s, there was widespread interest in IO after the American Heart Association (AHA) recommended that intraosseous access is an optional route when intravenous (IV) access cannot be obtained quickly. IO had a higher success rate (99.6%), was faster to perform (15-24 seconds), had a nearly equal flow rate (1-5L/hr), and had almost equal drug bioavailability to IV. The complication of IO becoming dislodged was 10-16%, needle dislocation was 0.8%, needle bending was 0.4% and parafusion (defined as fluid leakage at the insertion site causing tissue edema surrounding the leakage point) was 0.4%. Most retrospective trials and meta-analysis studies found that hospital discharge, return of spontaneous circulation (ROSC), and favorable neurological outcome was higher with IV than with the IO group. In conclusion, IO is still beneficial for immediate vascular access and should be placed after and/or simultaneously to IV insertion.

Objectives: to update content of adult intraosseous infusion in critical situations.

Role of Digital Health in FGIDs, A Mini Review

Navapan Issariyakulkarn — Tue, 30 Apr 2024 00:00:00 +0700

Treating functional GI disorders (FGIDs) caused by abnormal gut-brain interactions requires an understanding of individual GI pathophysiology as well as the patient’s behaviors. Many physicians frequently struggle to manage these patients due to a lack of knowledge regarding the patient’s pathophysiology and behaviors. Many digital tools for collecting and recording patients’ health information, which also include patient communication, are available to assist the physician in better understanding the patient. The purpose of this review is to assess how digital health can help FGIDs treatment and the interpretation of GI physiology testing.

Disseminated Nocardiosis with Intracranial Mycotic Aneurysm in A Patient with Autoimmune Hepatitis: A Case Report and Review of The Literature

Tue, 30 Apr 2024 00:00:00 +0700

We are reporting a case of disseminated Nocardia otitidiscaviarum infection, manifesting as a ruptured intracranial aneurysm in an immunocompromised patient. The patient succumbed despite treatment with trimethoprim-sulfamethoxazole, amikacin, and levofloxacin along with surgical repairment. Nocardiosis should be one of the differential diagnoses for intracranial mycotic aneurysm among immunocompromised individuals.

Running title: Nocardia intracranial aneurysm

Assessment of in vitro Antioxidant Activities and Quantification of Total Phenolic and Flavonoid Contents in Extracts from The Thai Traditional Remedy “Ruean-Khi-Nok” and its Plant Constituents

Tue, 30 Apr 2024 00:00:00 +0700

Introduction: Psoriasis is an immune-mediated inflammatory skin disease. The pathogenesis of psoriasis has been associated with an increase of oxidative stress. Therefore, natural antioxidant compounds (e.g., phenolics and flavonoids) might be beneficially used as an adjuvant. Ruean-Khi-Nok (RKN) remedy is a Thai traditional preparation used to treat psoriatic skin, consisting of nine plants in an equal proportion.
Objectives: To investigate the antioxidant capability of the RKN remedy and its components using three chemical-based assays, as well as to determine phenolic and flavonoid contents.
Methods: The 95% and 40% ethanolic extracts of RKN remedy and its plant components were investigated for in vitro antioxidant activities using DPPH and ABTS radical scavenging assay, as well as FRAP assay. The total phenolic and flavonoid contents in extracts were quantified using the Folin-Ciocalteu’s method and the aluminum chloride colorimetric method, respectively.
Results: The results exhibited potential antioxidant activity of the 95% ethanolic extract of RNK remedy in the DPPH, ABTS and FRAP assay. In addition, it also contained high phenolic and flavonoid contents. Among individual plants, Piper wallichii extracts displayed outstanding antioxidant capability compared to the others.
Conclusions: The RKN remedy is therefore highly promising antioxidant and might support the traditional use of RKN remedy for treatment of psoriatic skin. However, RKN should be investigated further for psoriasis treatment.

Exploring Antioxidant and Anti-diabetic Activities, and Chemical Contents of Extracts from Thai Traditional Medicine (Pra-Sa-Ka-Phrao Remedies) and Its Plant Ingredients

Tue, 30 Apr 2024 00:00:00 +0700

Introduction: Pra-Sa-Ka-Phrao complete (PSKPC) remedy is a Thai traditional medicine published in the Thailand National List of Essential Medicines (NLEM). In this research, we have developed a modified version of the remedy, named as Pra-Sa-Ka-Phrao incomplete (PSKPIC), following the FDA Thailand’s guidelines for using it as a food supplement. Notably, there is a lack of studies concerning biological activities and chemical constituents of both remedies.
Objectives: This study aimed to investigate and compare the antioxidant and anti-diabetic activities, and chemical contents derived from both remedies and its plant ingredient extracts.
Methods: Extraction was performed by maceration in 95% ethanol and decoction. The antioxidant activity was investigated using a DPPH, ABTS, FRAP, and TBARS assays, while the anti-diabetic (α-amylase, α-glucosidase inhibitory activities) were also evaluated, along with the determination of total phenolic (TPC) and total flavonoid (TFC) contents.
Results: The ethanolic extract of Zingiber officinale (ZOE) and water extract of Ocimum sanctum (OSW) exhibited the highest antioxidant activity, TPC, and TFC contents. The antioxidant results revealed that the PSKPIC water extract (PSKPICW) showed greater potency than PSKPC water extract in all assays. Additionally, the PSKPICW demonstrated higher TPC and TFC levels compared to the PSKPC remedy. Glycyrrhiza glabra (GGE) presented the strongest α-glucosidase inhibitory activity. However, all remedy extracts did not significantly affect anti-diabetic activity.
Conclusions: These results show the efficacy of the PSKPICW remedy, used as food ingredients or food supplements extract, and selected active extracts, such as ZOE and OSW, which supports their use in antioxidant products.

Field Expansion for Homonymous Hemianopia by Mobile Application with Virtual Reality Glasses

Tue, 30 Apr 2024 00:00:00 +0700

Introduction: Homonymous hemianopia interferes with the daily living activities of patients.
Objectives: To present a mobile application using the camera function in combination with three-dimensional virtual reality (VR) glasses to expand the visual field by transferring imagestoward the residual field.
Methods: The authors included patients with homonymous hemianopia who could provide consent and communicate during examinations. The authors prospectively tested patients using an iOS-mobile application with a mobile camera and VR headsets to compare the binocular visual field before and after the test.
Results: Six patients were included in the study. The mean age was 50 (43-57 years). We found that the patients had a range in field expansion from 0 to 39.9 degrees (average of 21.28 degrees). Five patients were satisfied with the expanded visual field in adaptive confrontation testing.
Conclusions: This study has shown some effectiveness, we demonstrated a positive result of field expansion and patient satisfaction.

Prediction of COVID-19 with Statistical Data on Chest Radiography using Artificial Intelligence

Tue, 30 Apr 2024 00:00:00 +0700

Introduction: COVID-19 is rapidly spreading around the world and has a high mortality rate. Artificial intelligence (AI) technology is a method that can be used to diagnose the presence of COVID-19 via chest radiographic apparatus. AI can be found to provide accurate results and increased diagnostic efficiency.
Objectives: To evaluate the efficacy of artificial intelligence for COVID-19 diagnosis using statistical data from radiographic chest images.
Methods: The research population sample consisted of 10,000 normal heathy individuals and 10,000 COVID-19 chest radiographs of patients were used for training (70.0%), validating (20.0%), and testing (10.0%). The images were segmented into the left and right lung regions by using the U-net architecture and then statistical data was calculated, including integrated density, mean, standard deviation, skewness, and kurtosis. Three artificial intelligence methods (support vector machine, K-mean clustering, and restricted Boltzmann machine) were compared the models’ predictions. The performance of three methods were analyzed for accuracy, sensitivity, specificity, precision, and F1-score.
Results: The accuracy of the support vector machine, K-mean clustering, and restricted Boltzmann machine were 70.5%, 62.5%, and 63.2%, respectively. The trend of the sensitivity, specificity, precision, and F1-score were similar in terms of accuracy, sensitivity, specificity, precision, and F1-score of the support vector machine, which were 64.2%, 73.5%, 68.2%, and 68.5%, respectively.
Conclusions: The most successful technique for diagnosing COVID-19 from chest radiographs was the support vector machine. It outperformed the restricted Boltzmann machine, which was followed by K-mean clustering

Quality Control of Raw Plant Materials and Stability Testing under Accelerated Storage Conditions of Kheaw-Hom Remedy Extract

Tue, 30 Apr 2024 00:00:00 +0700

Introduction: Kheaw-Hom remedy (KH), a Thai traditional antipyretic medicine, is included in the National List of Essential Medicine. Currently, there is no scientific report on its standard requirements for quality control and stability testing.
Objectives: To determine the quality control and stability testing of KH on anti-inflammatory activity and its bioactive marker
Methods: Quality control methods (loss on drying, total ash, acid-insoluble ash, extractive values, and heavy metals) of KH and raw plant materials were performed according to Thai Herbal Pharmacopoeia (THP). The stability testing of the ethanolic extract of KH (KHE) was stored under 40 ± 2 ºC and 75 ± 5% relative humidity for 180 days. Anti-inflammatory activity on LPS-induced nitric oxide (NO) production in RAW264.7 macrophage cells were evaluated. Ethyl p-methoxycinnamate (EPMC), a bioactive marker, was analyzed using high performance liquid chromatography (HPLC).
Results: KH showed loss on drying, total ash, acid-insoluble ash, ethanol soluble extractive and water-soluble extractive values of 8.66 ± 0.47%, 6.17 ± 0.06%, 1.14 ± 0.07%, 10.62 ± 0.12%, and 13.78 ± 0.54%, respectively. Eighteen plant materials met the requirements of THP. The anti-inflammatory activity on nitric oxide inhibition and EPMC content of KHE on day 180 exhibited no significant difference when compared with day 0.
Conclusions: This study is the first report on quality control and stability testing of KH. All KH and its plant components conformed to the standard requirements of THP. KHE could be stored at room temperature for two years.

Diabetes Mellitus in Thai Traditional Medical Theory

Pannawat Chaiyawatthanananthn — Tue, 30 Apr 2024 00:00:00 +0700