Purpose: This study aimed to explore the prevalence of and possible risk factors for hand eczema with respect to the dissemination of information about new hand hygiene habits to protect against ongoing COVID-19 cross-transmission. The authors conducted a survey among health care workers (HCWs) and non-HCW populations in Khon Kaen, Thailand. Results: A total of 805 participants participated. The prevalence of hand eczema in the study population was 20.87%. There were several risk factors, including working as a HCW, having a history of previous hand eczema, having underlying atopic dermatitis, wearing gloves in everyday life, and washing hands frequently (more than 10 times/day). Hand hygiene with alcohol-based products was shown to be a risk factor for hand eczema, (OR (95% CI) 1.86 (1.03-3.35), P = .04). Conclusion: In terms of hand eczema prevention, we suggest that the use of alcohol-based products should be discontinued if other handwashing methods are available. The following factors increase the risk of hand eczema: being a HCW, having previous hand eczema, and having underlying atopic dermatitis. Proper strategies in terms of hand eczema prevention should be addressed, especially in this group, since we need to continue performing hand hygiene during the ongoing COVID-19 pandemic.

Backgound: The high incidence of thiopurine-induced myelosuppression in Asians is known to be attributable to genetic variation in thiopurine metabolism. A quantitative synthesis to summarize the genetic association with thiopurine-induced myelosuppression in Asians was therefore conducted.Methods: A Literature search was performed from January 2016 to May 2021 in the following databases: PubMed, Web of Science, and Embase and addition search included the studies from Zhang et al. Two reviewers independently extracted the following data: the author’s name, year of publication, ethnicity, drugs, diseases, genetic polymorphisms, onset, type of myelosuppression and results of Hardy-Weinberg equilibrium. The Newcastle-Ottawa Scale was used to assess the quality of the studies. The pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated to evaluate the associations of NUDT15 and the risk of thiopurine-induced myelosuppression stratified by onset and type of myelosuppressive. Subgroup analysis by NUDT15 genetic polymorphisms was performed.Results: A total of 30 studies was included in this meta-analysis. The overall OR for the relationship between NUDT15 genetic polymorphisms and thiopurine-induced early onset of leukopenia and neutropenia in Asian populations were 11.43 (95% CI 7.11–18.35) and 16.35 (95% CI 10.20–26.22). Among NUDT15 polymorphisms, NUDT15*3 showed a significantly increased risk of early leukopenia (OR 15.31; 95% CI 9.65–24.27) and early neutropenia (OR 15.85; 95% CI 8.80–28.53). A significantly higher thiopurine-induced early neutropenic risk was also found for NUDT15*2 (OR 37.51; 95% CI 1.99–708.69). Whereas, NUDT15*5 and NUDT15*6 variants showed a lower risk of leukopenia.Conclusion: This study suggests that NUDT15*3 and NUDT15*2 are important genetic markers of thiopurine-induced early onset of myelotoxicity in Asians, therefore, early detection of these variants before initiating thiopurine therapy is necessary.

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Background: Low bone mineral density (BMD) is prevalent in individuals with β-thalassemia which might be related to increased circulating dickkopf-1 (Dkk-1). These data are limited in α-thalassemia. Objectives: To evaluate the prevalence of low BMD in adolescents with non-deletional hemoglobin (Hb) H disease. Additionally, we aimed to examine the association between serum Dkk-1 concentration and BMD. Methods: Participant medical records were reviewed. The lumbar spine (LS) and total body (TB) BMD were measured and converted into height-adjusted z-scores. Serum Dkk-1, osteocalcin and C-telopeptide of type-I collagen (CTX) concentrations were also analyzed. Results: Thirty-seven participants (59% female, 86% Tanner stage ≥2, 95% regularly transfused) had mean age 14.6 ± 3.2 years, and average pretransfusion Hb and ferritin concentrations of 8.8 ± 1.0 g/dL and 958 ± 513 ng/mL, respectively. No participants had experienced fracture. The prevalence of low LSBMD and TBBMD was 42% and 17%, respectively. LSBMD z-score was lower in males vs. females (p-value = 0.029). LSBMD and TBBMD z-scores were correlated positively with BA, Tanner stage, and BMI, and negatively with Dkk-1 (p-values <0.05). Dkk-1 was correlated positively with history of delayed puberty, and negatively with transfusion interval (p-values = 0.038). Osteocalcin and CTX did not correlate with BMD or Dkk-1. Multiple regression analysis showed Dkk-1 inversely associated with TBBMD z-score adjusting for confounders (p-value = 0.009). Conclusions: We demonstrated a high prevalence of low BMD in adolescents with non-deletional Hb H disease. Moreover, Dkk-1 inversely associated with TBBMD suggesting it may serve as bone biomarker in thalassemia.

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Background: Low bone mineral density (BMD) is prevalent in individuals with β-thalassemia which might be related to increased circulating dickkopf-1 (Dkk-1). These data are limited in α-thalassemia. Objectives: To evaluate the prevalence of low BMD in adolescents with non-deletional hemoglobin (Hb) H disease. Additionally, we aimed to examine the association between serum Dkk-1 concentration and BMD. Methods: Participant medical records were reviewed. The lumbar spine (LS) and total body (TB) BMD were measured and converted into height-adjusted z-scores. Serum Dkk-1, osteocalcin and C-telopeptide of type-I collagen (CTX) concentrations were also analyzed. Results: Thirty-seven participants (59% female, 86% Tanner stage ≥2, 95% regularly transfused) had mean age 14.6 ± 3.2 years, and average pretransfusion Hb and ferritin concentrations of 8.8 ± 1.0 g/dL and 958 ± 513 ng/mL, respectively. No participants had experienced fracture. The prevalence of low LSBMD and TBBMD was 42% and 17%, respectively. LSBMD z-score was lower in males vs. females (p-value = 0.029). LSBMD and TBBMD z-scores were correlated positively with BA, Tanner stage, and BMI, and negatively with Dkk-1 (p-values <0.05). Dkk-1 was correlated positively with history of delayed puberty, and negatively with transfusion interval (p-values = 0.038). Osteocalcin and CTX did not correlate with BMD or Dkk-1. Multiple regression analysis showed Dkk-1 inversely associated with TBBMD z-score adjusting for confounders (p-value = 0.009). Conclusions: We demonstrated a high prevalence of low BMD in adolescents with non-deletional Hb H disease. Moreover, Dkk-1 inversely associated with TBBMD suggesting it may serve as bone biomarker in thalassemia.

Background: The incidence of acute diarrhea in Thai children under five years of age has increased over the last three decades. Even though mortality has significantly declined, the burden and cost of medical treatment are still high. Our objectives are to describe the burden and pattern of acute diarrhea cases that required admissions by Thai children under five years of age from 2015 to 2019.Methods: Data regarding the admission of acute diarrhea cases of Thai children with Thailand National Health Coverage (NHC) under five years of age from 2015 to 2019, recorded as International Statistical Classification of Diseases and Related Health Problems, tenth Revision, Thai Modification (ICD-10-TM), were analyzed.Results: The incidence trend of yearly acute diarrhea in children 0-5 years of age slightly decreased over approximately the last decade (124,403 cases in 2010 to 102,941 cases from 2015 to 2019), along with the high cost of performing the medical treatment of approximately three billion baths per year. Diarrhea-related mortality had a low, constant rate of 0.95 per 100,000 population per year (range: 0.81-1.14 per 100,000 population per year). Three-fourths of the mortality rate was observed in children under 2 years of age and a regional distribution of the causative agent was also observed in Cholera, Typhoid, and Amoebiasis cases. Seasonal variations demonstrated consistency with similar patterns during the cold and rainy seasons throughout the 5-year period. A08 and A09 were the two most common causes of diarrheal diseases.Conclusions: The burden, incidence and mortality rate of acute diarrhea in Thai children under five years of age were lower than those in the past decades. A similar seasonal outbreak of acute diarrhea was seen during each examined year. The causative agent was not significant and was mainly unspecific.Trial registration: number TCTR20220117002, date of registration 17/01/2022

Background: Two types of rotavirus vaccines (RVs), Rotarix (RV1) and RotaTeq (RV5), were licensed as optional vaccines in 2012 and became part of the National Immunization Program (NIP) in 2020 in Thailand. The main objective was to evaluate the impact of rotavirus vaccines on the burden of acute diarrheal severity ranging from mild (outpatient department, OPD) to moderately severe as diarrheal-related admission or deaths in pre- and post-NIP periods. The minor objectives were assessed on the monthly admission rate, rotavirus vaccine coverage rate and rotavirus vaccine completed dose (RotaC). Methods: Data regarding OPD, admission, and death cases under the Thailand National Health Coverage (NHC) between 2015-2019 (pre-NIP period) and in 2020 as the post-NPI year, which were recorded as International Classification of Diseases and Related Health Problem 10th (ICD-10), were analyzed. Results: The burden of diarrheal-related disease was diminished after the rotavirus vaccine was introduced. The OPD visit rate decreased from 10.1 to 8.3 visits per 100 person-years pre- and post-NIP, respectively (P<0.001). The admission rate significantly declined from 31.4 to 30.5 cases per 1,000 person-years pre- and post-NIP, respectively (P<0.001). The diarrheal-related mortality rate also subsided from 10.2 to 8.1 cases per 100,000 person-years pre- and post-NIP, respectively (P 0.3). The major population in both admission and deaths was infants under 1 year of age (P<0.001). Seasonality was seen as a constant bimodal pattern for cool and rainy reasons. RotaC was as high as 37.4%, even in the first year of the NIP. Conclusions: The rotavirus vaccine had a great impact on the diarrheal disease burden of all outpatient visits, hospitalization, and mortality, especially in infants under one year of age. Seasonality outbreaks of acute diarrhea were observed in each examination year. The RotaC was high even in the first year of the NIP of the rotavirus vaccine. of rotavirus vaccine quality should be warranted. Trial registration: number TCTR20220120003, date of registration: 20/01/2022, site: Thai Clinical Trials Registry, URL https://www.thaiclinicaltrials.org/show/TCTR20220120003