Population Pharmacokinetics and Loading Dose Optimization of Intravenous Valproic Acid in Hospitalized Thai Patients.

Our goal is to create a population pharmacokinetic (PK) model and identify the best loading dose (LD) of intravenous valproic acid for hospitalized Thai patients. Data from patients who received intravenous valproic acid and underwent measurement of serum valproic acid concentrations during hospitalization were collected retrospectively. A nonlinear mixed-effects modeling approach was conducted to estimate the PK parameters of valproic acid.

Factors associated with venous collaterals in patients with cerebral venous thrombosis.

Objectives: To identify the factors associated with venous collaterals in Thai patients with cerebral venous thrombosis.

Materials And Methods: This retrospective 20-year cohort study enrolled patients diagnosed with cerebral venous thrombosis between January 2002 and December 2022. Data was collected from the electronic medical record, and venous collaterals were independently reviewed by two neuroradiologists using the Qureshi classification.

Association between Bell's Palsy and Cardiometabolic Risks: An Age- and Sex-Matched Case-Control Study.

Background: Bell's palsy is possibly an ischemic cranial neuropathy, although reactivation of herpes virus infection has been proposed.

Methods: This was an age-and sex-matched and 1:2 case-control study enrolling Bell's palsy patients during 2011-2021 in a university hospital to investigate the significant associations of cardiometabolic risks (CMRs) with Bell's palsy. We analyzed the differences in waist circumference (WC), body mass index (BMI), systolic and diastolic blood pressures (SBP and DBP), fasting blood sugar (FBS), and lipid levels at 12 weeks post-Bell's palsy with those of the controls by descriptive statistics ( < 0.

Factors associated with the initial intracranial hemorrhage occurrence in patients with cerebral venous thrombosis.

Objectives: Studies focusing on intracranial hemorrhage (ICH) in patients with cerebral venous thrombosis (CVT) are limited; thus, we aimed to identify factors associated with the occurrence of ICH in Thai patients with CVT.

Methods: This retrospective cohort study recruited patients with CVT admitted to a tertiary university-based hospital between 2002 and 2022. The baseline characteristics, clinical presentations, radiographic findings, and etiologies were compared between the ICH and non-ICH groups.

Health-related quality of life of daily-life-affected benign essential blepharospasm: Multi-center observational study.

Purpose: To compare Thais' health-related quality of life (HRQOL) and severity grading, efficacy and safety in daily-life-affected benign essential blepharospasm (BEB) patients at baseline and after Botulinum toxin type A (BTX-A) treatment.

Design: Prospective-observational study.

Participants: BEB patients with Jankovic rating scale (JRS) at least 3 in both severity and frequency graded from 14 institutes nationwide were included from August 2020 to June 2021.

Comparison of Short-Term Post-Thymectomy Outcomes by Time-Weighted Dosages of Drug Requirements between Thymoma and Non-Thymoma Myasthenia Gravis Patients.

(1) Background: Early thymectomy is suggested in all clinically indicated myasthenia gravis (MG) patients. However, short-term clinical response after thymectomy in MG patients has been limitedly described in the literature. This study aimed to compare the 5-year post-thymectomy outcomes between thymoma (Th) and non-thymoma (non-Th) MG patients.

Factors associated with acute symptomatic seizure occurrence among patients with posterior reversible encephalopathy syndrome.

Objectives: We aimed to define the factors associated with acute symptomatic seizure occurrence in posterior reversible encephalopathy syndrome (PRES) in the Thai-Asian population.

Materials And Methods: We conducted a retrospective cohort study enrolling patients with PRES admitted to the hospital between 2006 and 2019. In addition to seizure characteristics, baseline characteristics, clinical presentations, precipitating factors, neuroimaging characteristics, hospital complications, and hospital outcomes were compared between the seizure and non-seizure groups.

Predictors of Hospital Outcomes Among Patients with Posterior Reversible Encephalopathy Syndrome.

Objectives: We aimed to identify independent predictors of the clinical outcomes of posterior reversible encephalopathy syndrome (PRES) in the Thai-Asian population.

Materials And Methods: This retrospective cohort study recruited PRES patients admitted in the hospital between 2006 and 2019. The baseline characteristics, clinical presentations, precipitating factors, neuroimaging characteristics, hospital complications, and hospital outcomes were compared between the groups with favourable (modified Rankin scale [mRS] score, 0-2) and unfavourable (mRS score, 3-6) clinical outcomes.

Validation of the Thai Version of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale.

Objective: This study aims to validate the Thai translation of the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS).

Methods: The English version was translated into Thai and then back-translated into English. The translated version underwent 2 rounds of cognitive pretesting to assess the ease of comprehension, ease of use and comfort with the scale.

Peripheral facial paralysis associated with HIV infection: A case series and literature review.

Objective: The association between peripheral facial paralysis (PFP) and HIV infection has been scarcely explained. The authors aimed to describe the association between PFP and HIV infection status, along with the related co-morbidities and the outcomes of PFP, as well as the literature review on this topic.

Patients And Methods: All HIV-infected patients who experienced PFP, both before and after a positive HIV serology test, between January 2002 and June 2015 were retrospectively reviewed.

Clinical presentations as predictors of prolonged mechanical ventilation in Guillain-Barré syndrome in an institution with limited medical resources.

Introduction: Severe Guillain-Barré syndrome (GBS) causes ventilatory insufficiency and the need for prolonged artificial ventilation. Under circumstances where medical care for patients with severe GBS is required in a resource-limited institution, identifying initial clinical presentations in GBS patients that can predict respiratory insufficiency and the need for prolonged mechanical ventilation (> 15 days) may be helpful for advanced care planning.

Methods: The medical records of patients diagnosed with GBS in a tertiary care and medical teaching hospital from January 2001 to December 2010 were retrospectively reviewed.

Excessive daytime sleepiness and nighttime sleep quality in Thai patients with Parkinson's disease.

Objective: To study the prevalence ofexcessive daytime sleepiness (EDS) and nighttime sleep quality (NSQ) in Thai patients with Parkinson's disease (PD) and compare their sleep characteristics with controls.

Material And Method: The Epworth Sleep Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI) and questions about sudden onset of sleep (SOS) were applied in a study of 73 PD patients without dementia to that of healthy controls.

Results: There were 36 females and 37 males with a mean (SD) age of 65.

The impact of the nocturnal disabilities of Parkinson's disease on caregivers' burden: implications for interventions.

Parkinson's disease (PD) imposes a burden on those who care for the person afflicted. The objective of this study was to assess and analyze the main determinants of caregivers' burden, especially the nocturnal manifestations of PD. This multi-center, national, cross-sectional study included 89 patient-caregiver pairs.

Nocturnal journey of body and mind in Parkinson's disease: the manifestations, risk factors and their relationship to daytime symptoms. Evidence from the NIGHT-PD study.

Nocturnal manifestations of Parkinson's disease (PD) are myriad, have diverse etiologies and include motor, sleep, urinary, and neuropsychiatric symptoms which are often associated with daytime somnolence. While most patients perceive these symptoms as troublesome, the recognition of nocturnal problems related to PD is still low in clinical practice. We conducted a survey using semi-structured interviews and self-rated questionnaires of 215 consecutive patients with PD enrolled in three centers in Thailand to determine the prevalence and risk factors of nocturnal disabilities and their relationship to daytime symptoms.

Thunderclap headache as a presentation of spontaneous spinal epidural hematoma with spontaneous recovery.

Background: Spontaneous spinal epidural hematoma (SSEH) is a rare spinal cord compression disorder. Thunderclap headache mimicking subarachnoid hemorrhage as an initial manifestation of this disorder has been scarcely reported. Moreover, the neurological outcome of conservative treatment is satisfactory only in some clinical settings.

Adult tonic-clonic convulsive status epilepticus over the last 11 years in a resource-poor country: a tertiary referral centre study from southern Thailand.

Status epilepticus is a common condition in patients admitted to hospital in resource-poor countries and reports indicate that aetiology, factors of poor outcome, and treatment strategies are variable. To date, there is no report of a prospective study in Thai adults. Herein, we investigated the aetiology, clinical features, factors of predicted poor outcome, and treatment strategies in Thai adult patients who presented with convulsive status epilepticus.

The association between CYP 2C9 polymorphism and bone health.

Purpose: There is a strong scientific rationale to support the view that cytochrome P450 (CYP P450) enzyme-inducing AEDs induce bone loss in patients with epilepsy. However, no study has investigated the association between CYP 2C9 polymorphism and bone mineral density (BMD), 25-hydroxyvitamin D or parathyroid hormone levels in patients with epilepsy. This study sought to determine the association between BMD and CYP 2C9 polymorphism.

Risk factors of recurrent seizure, co-morbidities, and mortality in new onset seizure in elderly.

Objective: To determine the risk factors of seizure recurrence and the most common comorbidities in elderly patients with epilepsy.

Method: We did a retrospective study of 278 patients older than 65 years with first seizure. We evaluated electrolytes, blood glucose, urea and creatinine levels, and performed electrocardiography (ECG), and routine electroencephalogram (EEG) on all patients.

Effect of switching hepatic enzyme-inducer antiepileptic drug to levetiracetam on bone mineral density, 25 hydroxyvitamin D, and parathyroid hormone in young adult patients with epilepsy.

We sought to determine the effect of changing phenytoin therapy on bone mineral density (BMD) and 25-hydroxyvitamin D in patients with epilepsy. Of the 90 patients, 54 patients had switched to levetiracetam, 19 patients had stopped, and 17 patients continued taking phenytoin. We proposed a 2-year period to examine 25-hydroxyvitamin D, parathyroid hormone, and BMD.

Rivastigmine patch for treatment of Alzheimer's disease in clinical practice in Thailand.

Background: Rivastigmine is a cholinesterase inhibitor for treatment of mild to moderate Alzheimer's disease (AD) and dementia associated with Parkinson's disease. The new patch formulation was recently made available. We assessed the safety, tolerability, and cognitive outcome of rivastigmine patch in treatment of mild to moderate AD in clinical practice in Thailand.

The association between BsmI polymorphism and bone mineral density in young patients with epilepsy who are taking phenytoin.

Purpose: This study sought to determine the association between BsmI polymorphism and bone mineral density, 25-hydroxyvitamin D, and parathyroid hormone levels in patients with epilepsy.

Methods: We recruited ambulatory young adults with epilepsy who were taking phenytoin. Data regarding demographics, basic laboratory studies, history of clinical epilepsy, parathyroid hormone, and vitamin D levels, as well as BsmI polymorphism of the vitamin D receptor (VDR) gene, were obtained.

Role of CYP2C9 polymorphism in phenytoin-related metabolic abnormalities and subclinical atherosclerosis in young adult epileptic patients.

Purpose: We investigated the influence of the CYP2C9 polymorphism on the lipid profile, insulin resistance, and subclinical atherosclerosis in young epileptic patients.

Methods: We performed a cross-sectional study to evaluate the association between CYP2C9 polymorphism and lipid profile, glucose homeostasis, and subclinical atherosclerosis in young epileptic patients via the ankle brachial index.

Results: The frequencies of CYP2C9*1 (CYP2C9 wild type gene) and CYP2C9*3 (CYP2C9 polymorphism gene) were 75% and 25%, respectively.

An uncommon cause of compressive myelopathy misdiagnosed as transverse myelitis.

Though spontaneous spinal epidural hematoma is a very uncommon cause of spinal cord compression, early correct diagnosis is crucial for final clinical outcome. A case of spontaneous spinal epidural hematoma with similar clinical presentation to transverse myelitis was reported. Careful clinical correlation and multiple sequences of spinal magnetic resonance images are critical factors for early diagnosis.

Clinical characteristics, etiology and long-term outcome of epilepsia partialis continua in adult patients in Thailand.

Objective: Epilepsia partialis continua (EPC) is clinically defined as a syndrome of continuous focal jerking of a body part. EPC has various etiologies and outcomes depending on its cause. Most studies on EPC have been conducted in Western countries and no study on the long-term outcome in adult onset epilepsia partialis continua has been reported.

Short questionnaire for Parkinson's disease as a screening instrument.

Objective: To validate and simplify a screening questionnaire for the determination of PD.

Methods: The screening questionnaire for PD was developed with the permission of the author. Reliability of the questionnaire was tested.