Patient Self-testing (PST) could be an option for present anticoagulation therapy monitoring, but current evidence on its cost-effectiveness is limited. This study aims to estimate the cost-effectiveness of PST to other different care approaches for anticoagulation therapy in Thailand, a low-to-middle income country (LMIC). A Markov model was used to compare lifetime costs and quality-adjusted life years (QALYs) accrued to patients receiving warfarin through PST or either anticoagulation clinic (AC) or usual care (UC). The model was populated with relevant information from literature, network meta-analysis, and database analyses. Incremental cost-effectiveness ratios (ICERs) were presented as the year 2015 values. A base-case analysis was performed for patients at age 45-year-old. Sensitivity analyses including one-way and probabilistic sensitivity analyses (PSA) were constructed to determine the robustness of the findings. From societal perspective, PST increased QALY by 0.87 and costs by 112,461 THB compared with UC. Compared with AC, PST increased QALY by 0.161 and costs by 21,019 THB. The ICER with PST was 128,697 (3625 USD) and 130,493 THB (3676 USD) per QALY gained compared with UC and AC, respectively. The probability of PST being cost-effective is 74.1% and 51.9%, compared to UC and AC, respectively, in Thai context. Results were sensitive to the efficacy of PST, age and frequency of hospital visit or self-testing. This analysis suggested that PST is highly cost-effective compared with usual care and less cost-effective against anticoagulation clinic. Patient self-testing strategy appears to be economically valuable to include into healthcare system within the LMIC context.
It has been reported that oestrogen receptor alpha (ER-α) polymorphisms are associated with knee osteoarthritis (OA). In this study, we assessed whether there was any association between the codon 594 (G>A) polymorphism in ER-α and radiographic features of OA or patient function. Radiographs, WOMAC score and patient reported time of symptom onset were assessed in 194 patients presenting for total knee replacement at Ramathibodi hospital over a one year period. ESR-1 genotyping was assessed. There were 107 (55.15%) patients with common homozygote (GG), 78 (40.20%) patients with heterozygote (GA) and nine (4.65%) patients with rare homozygote (AA). There was poor correlation (r = <0.2) between group difference in the radiographic parameters, time of onset of symptom , or in WOMAC scores. This polymorphism is not associated with the clinical features of knee osteoarthritis. The role of this polymorphism is unlikely then to be used as a biological marker predicting the progression of knee OA.
The intercountry border areas of Thailand have high malaria receptivity and vulnerability that present numerous problems in the control of malaria transmission. This study focused on the 30 provinces of Thailand situated next to neighboring countries, which can be divided into 4 groups: the Thai-Myanmar border (10 provinces), the Thai-Cambodia border (6 provinces), the Thai-Lao border (10 provinces) and the Thai-Malaysia border (4 provinces). The purpose of the present study was to describe the pattern and trend of malaria incidence in the highly endemic provinces along the Thai borders for the 11 years from 1991 to 2001. Analysis of trends showed the distribution of malaria parasites to have shifted from a preponderance of Plasmodium falciparum to Plasmodium vivax along the western border with Myanmar, the northern border with Lao PDR and along the eastern border with Cambodia whereas the southern border with Malaysia the pattern changed from a preponderance of P. vivax to P. falciparum, since 1997. There was a significant difference in annual parasite incidence between borders and non-border districts, especially along the Thai-Myanmar and Thai-Cambodia borders. It is thus evident that all border districts should pay more attention to control of malaria transmission and the activities of the malaria surveillance system, and that monitoring and evaluation of the Thai Malaria Control Program needs to be performed consistently, including some areas where a few malaria cases were found as well as in malaria free areas.
Clinical smoking cessation interventions have been found typically to be highly cost-effective in many high-income countries. There is a need to extend this to low- and middle-income countries and undertake comparative analyses. This study aimed to estimate the incremental cost-effectiveness ratio of a range of clinical smoking cessation interventions available in Thailand.
Kesatuan Ekonomi ASEAN (AEC) merupakan realisasi matlamat akhir integrasi ekonomi yang diasaskan pada pemusatan keinginan negaranegara ASEAN untuk meluaskan intergrasi ekonomi melalui inisiatif baru dan sedia ada dalam kerangka masa yang telah ditetapkan. Dalam merealisasikan salah satu tindakan AEC yang telah dikenal pasti iaitu memperkasakan perlindungan pengguna ASEAN, pengharmonian undang-undang kontrak pengguna dilihat sebagai salah satu agenda penting ASEAN. Dengan berobjektifkan pengharmonian undang-undang kontrak ASEAN yang mengkhusus kepada penggunaan terma tidak adil dalam pasaran pengguna seterusnya mencadangkan ASEAN Model Law on Unfair Terms in Consumer Contracts, makalah ini mengadoptasi metodologi analisis kandungan berteraskan literatur undang-undang primer dan sekunder. Mengguna pakai undang-undang kes dan perundangan di enam negara ASEAN terpilih iaitu Malaysia, Singapura, Indonesia, Thailand, Filipina dan Brunei, penyelidikan ini mendapati wujud persamaan dalam mekanisme yang digunakan di negara-negara ASEAN ini dalam menangani permasalahan penggunaan terma tidak adil dalam kontrak pengguna. Namun walaupun perundangan dilihat sebagai mekanisme yang mampu menangani permasalahan ini, wujud perbezaan pendekatan dalam perundangan yang diadaptasi oleh negara-negara ASEAN tersebut. Penggunaan perundangan berorientasikan perlindungan pengguna bagi mengawal penggunaan terma tidak adil dalam kontrak pengguna jelas kelihatan di Malaysia, Singapura, Indonesia, Thailand dan Filipina. Penggunaan perundangan kontrak yang mengkhusus kepada terma tidak adil sebagai instrumen kawalan pula kelihatan di Singapura, Thailand dan Brunei. Dalam aspek ini, keunikan Singapura dan Thailand yang menangani permasalahan terma tidak adil dalam kontrak pengguna dengan mengadakan perlindungan melalui dua jenis perundangan yang berbeza menampakkan korpus perlindungan pengguna yang lebih mapan. Pendekatan yang berbeza yang diamalkan di beberapa negara ASEAN terpilih ini memperlihatkan satu korpus perlindungan pengguna yang unik dalam aspek kontrak pengguna tidak adil.
The sarawakensis species group of the termitophilous carabid genus Orthogonius MacLeay, 1825 is defined and reviewed. Members of this species group are distributed in Southeast Asia and represented by four species, including two new species: Orthogonius sabahicus sp. n. (Sabah, northern Borneo, Malaysia) and Orthogonius morvanianus sp. n. (southern Thailand). A key to all species of the species group is also provided.
An overview of the Oriental species of Cleruchus Enock (Hymenoptera: Mymaridae) is given, and its five newly described species as well as one undescribed species from Malaysia are keyed. The described new taxa are C. funiculatus Manickavasagam Palanivel sp. n., C. indicus Manickavasagam Palanivel sp. n. and C. orientalis Manickavasagam Palanivel sp. n., all from India, C. blimp Triapitsyn sp. n. from Brunei, and C. pmilb Triapitsyn sp. n. from Thailand. Anaphes quinquearticulatus Huber Triapitsyn is newly reported from India.
Pseudopsyra is a genus of Phaneropterinae katydid (Orthoptera: Tettigoniidae), currently comprising of four species - two species each from southern China and Peninsular Malaysia (Hebard, 1922; Liu & Kang, 2006; Tan & Kamaruddin, 2013, 2014). The revision of Pseudopsyra by Liu & Kang (2006) provided a redescription of the genus, a new diagnosis and a key to known species. Subsequently, more surveys were conducted in Peninsular Malaysia and yield another species, representing the lowest latitudinal limits of this genus thus far (Tan & Kamaruddin, 2013). Continued surveys between the upper and lower latitudinal limits of the genus yield a new species: Pseudopsyra taksini sp. nov. from the Sakaerat Biosphere Reserve, Thailand. The orthopteran diversity at Sakaerat Biosphere Reserve remains understudied with numerous new species described recently, including other genus of Phaneropterinae (Tan & Artchawakom, 2014; Tan et al., 2015). With emphasis of using sexual parts for evidence of reproductive isolation in species delimitation, the discovery of a new species of Pseudopsyra also represents the first record of the genus from Thailand. It is not surprising that more undescribed species of Pseudopsyra can be found across the Indo-China region.