Comparison of effects of medicinal cannabis or standard palliative care on quality of life of patients with cholangiocarcinoma in Northeast Thailand

Background: Cholangiocarcinoma (CCA) has a poor prognosis and is a major cause of mortality and suffering in Thailand’s Northeastern (Isaan) Region. Methods: This prospective cohort study aimed to compare the health-related quality of life (HRQoL) among 72 newly diagnosed CCA patients; 42 patients who received cannabis treatment (CT) and 30 patients who received a standard palliative care treatment (ST). The study was carried out between 1st September 2019 to 31st October 2020. Data were collected from patients from oncology clinics of six hospitals in five provinces of northeast Thailand. The HRQoL was measured at baseline, and at 2 and 4 months after diagnosis by the European Organisation for Research and Treatment of Cancer (EORTC) Core Quality of Life questionnaires QLQ-C30, and QLQ-BIL21. The Mann-Whitney U-test was performed to compare quality of life scores between the two patient groups and Wilcoxon signed rank test was performed to compare within groups QoL scores at pre-treatment, and 2 and 4 month follow-ups. Results: Global health status and functional scales, for both groups were high at pre-treatment. At 2 and 4 month follow-up, CT group patients had consistent statistically significantly better Palliative Performance Scale (PPS), and QoL scores, and many symptom scores than the ST group. Conclusions: Medicinal cannabis may increase QoL for advanced CCA patients. Our findings support the importance of early access to palliative cannabis care clinic before the terminal and acceleration phase close to death.

Effects of Environmental Factors and Infecting Trematodes on the Size and Inorganic Elements of Bithynia siamensis goniomphalos Snails in Northeast Thailand

Infection with the foodborne trematode, Opisthorchis viverrini, is a major public health issue in southeast Asia. The freshwater snail, Bithynia siamensis goniomphalos, is an intermediate host of O. viverrini and other trematode species. Understanding the effects of environmental conditions and infecting trematodes on B.s. goniomphalos snails is thus crucial for the potential influences on trematode transmission. This study measured environmental variables of water and soil properties, and analyzed B.s. goniomphalos snails for their trematode infection, snail shell length, and inorganic elemental concentration, from 30 localities in northeast Thailand. The results showed that prevalence of trematode infection in B.s. goniomphalos was 3.82%. Nine types of trematode cercariae were identified, with virgulate type 1 as the most common (1.23%). Opisthorchis viverrini-infected snails were mostly found in low-humic gley soils in Sakon Nakhon Province, and were associated with water dissolved oxygen and soil pH. Compared with uninfected snails, larger sizes were observed in virgulate type 1 and pleurolophocerca-infected snails, whereas hypercalcification was noticed in virgulate type 1, virgulate type 3, and pleurolophocerca-infected snails. Infected snails were more sensitive toward environmental conditions, possibly because of the dynamic parasitic processes between trematodes and hosts. Among the environmental factors, soil texture (i.e., sand, silt, and clay compositions) exhibited more significant correlations with B.s. goniomphalos shell characteristics regardless of the trematode infection types. The findings of this study underscore the need to consider the effects of environmental conditions and trematode species-specific pathogenic processes for a more effective and sustainable parasitic control and prevention effort.

Chronology of the Occupation Pattern Distribution: A Case Study At The Mun River Valley Prehistoric Settlement Site, Northeast Thailand

Chronological framework can be used to identify the distribution of occupation patterns. This study was based on fourteen radiocarbon samples from the eight excavation pits at Ban Non Wat and Nong Hua Raet archaeological sites. The chronology of the cultural layers was developed using AMS radiocarbon dating to supplement existing data, specifically to examine the dating of the end of the Iron Age occupation. The objective of this study was to continue testing the premise that the end of the Iron Age on the Mun river floodplain in Northeast Thailand that is better defined as either a singular more or less contemporaneous de-population event characterized by widespread abandonment of settlements or a gradual transition from dispersing a rural settlement to more concentrated urban style of settlement. The results support the existing chronological framework of the study area and suggest that the end of the Iron Age in the Mun River valley is better defined as a gradual transition from dispersed rural settlements to a more concentrated urban style settlement. Occupation commenced at the center of the mound of Ban Non Wat during the Neolithic period, and gradually spread radially to the margin by the Iron Age. Occupation at the neighboring site of Nong Hua Raet commenced during the Iron Age period, parallel to that at Ban Non Wat.

MARKETING, HEALTH LITERACY, AND THE USE OF MELASMA AND FRECKLE PREVENTION AND TREATMENT PRODUCTS

The research goals of this study were to identify the association between marketing and health literacy and the use of products to prevent and treat melasma and freckles among working-age women in northeast Thailand. One thousand one hundred forty-three working-age women were randomly selected using multistage sampling from 4 provinces in northeast Thailand to participate in a self-administered structured questionnaire. A generalized linear mixed model (GLMM) evaluated the associations between product use and the studied factors. The majority of respondents (59.49%; 95% CI = 50.09 – 62.33) were current users of these products. Factors associated with product use were adequate to excellent health literacy (adj OR = 2.88, 95% CI = 2.51-3.42, p < 0.001), product marketing (adj OR = 2.20, 95% CI = 1.59-2.84, p < 0.001), presence of freckles (adj OR = 2.17, 95% CI = 1.53-2.79, p < 0.001), and melasma (adj OR = 2.05: 95%CI = 1.52-2.67, p < 0.001). The other significant covariates were age 30-44 years (adj OR = 2.40, 95% CI = 1.78-2.81, p < 0.001), having a bachelor’s degree or higher (adj. OR = 2.03, 95%CI = 1.61-2.11, p 0.005), and average monthly income > 15,000 THB (adj. OR = 2.08, 95% CI = 1.60-2.91, p < 0.001). About sixty percent of working-age women were current users of melasma and freckle prevention/treatment products. Health literacy and product marketing were positively associated with product use. Other associated factors were facial skin conditions, age, education level, and income. The study findings provide pertinent information to policymakers and the community about implementing educational health literacy programs.

Use of Organic Materials to Maintain Soil Quality by Thai-Lao Rice Farmers in Northeast Thailand

Maintaining soil quality is a major problem for traditional farmers in the tropics. Many rely on organic amendments to enhance the productivity of their fields. However, indigenous knowledge about soil organic matter (SOM) and its management has received relatively little attention from researchers. This paper describes the use of organic materials to maintain soil quality by Thai-Lao farmers in a rice-growing village in Northeast Thailand. In-depth semi-structured interviews were conducted with twelve farmers to: 1) identify the indicators of soil fertility they employed; 2) inventory the organic materials they used; 3) determine changes in the use of amendments over time; and 4) understand their concept of SOM. They used many physical and biological indicators of soil quality. They used nine different organic materials: rice straw and stubble, cattle, buffalo and pig manure, rice husks, sunn hemp plants as green manure, charcoal, commercial compost, homemade compost, and tree leaf litter. Recently, use of livestock manure, rice husks, charcoal, and leaf litter has declined because of supply shortages. They do not appear to have a general concept of organic matter nor is there a commonly used word for “organic” in their language. Most of the farmers would use larger quantities of organic amendments but are constrained by their scarcity and high cost. Ways to increase local supplies of organic materials must be found if the government’s efforts to encourage the adoption of organic agriculture are to be successful.