1.Resources and organization of Neurology care in South East Asia.
Neurology Asia 2007;12(1):41-46
ASEAN Neurology Association (ASNA) consists of 9 member countries, Brunei, Indonesia, Lao, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam. Among them 2 countries are considered lower middle income, 4 as upper middle income, and 3 as high income by World Bank criteria. The life expectancy is above 75 years in Brunei and Singapore, below 60 years in Lao and Myanmar. There are a total of 1,871 neurologists in ASNA member countries which has a total of 540 million populations. This constitutes 2.2% of the world neurologists, although ASNA member countries accounts for 8.3% of the world population. Myanmar and Lao in particular, has lowest ratio of neurologist, with one neurologist serving 5 million populations in Myanmar, and 2 million populations in Lao.
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2.Clinical profile, risk factors and aetiology of young ischaemic stroke patients in Asia: A prospective, multicentre, observational, hospital-based study in eight cities
Kay Sin Tan ; Jose C Navarro ; Ka Sing Wong ; Yi Ning Huang ; Hou Chang Chiu ; Niphon Poungvarin ; Shan Jin Ryu ; Ester Bitanga ; Nijasri Suwanwela ; Sardar Mohd Alam ; Woo Yoon
Neurology Asia 2014;19(2):117-127
Background and Objective: There is a lack of international collaborative studies on young adults with ischaemic stroke in Asia. The aim of this study was to investigate risk factors, aetiology and outcome at hospital discharge of these patients across 8 participating countries in Asia. Methods: This was a prospective, observational, multicentre, hospital based cohort study. Consecutive young stroke patients with confirmed cerebral infarction between the ages of 18-49 were recruited from December 2011 to May 2012. Data was collected for patient demography, risk factors, investigations, clinical profile and TOAST classification. Outcome measures were death and independence (modified Rankin score≤ 2) at hospital discharge. Results: Two hundred and eighteen patients with the mean age was 40.8±6.7 years were recruited. There was a larger proportion of male patients with a ratio of 1.9:1. Traditional risk factors observed were hypertension (n=103; 47.3%), dyslipidaemia (n=93; 42.4%), smoking (n=85; 38.8%), diabetes (n=53; 24.3%), alcohol use (n=33; 15.0%), a previous history of stroke and transient ischaemic attacks (6.4%), family history (n=12; 5.5%), migraine (n=6;2.8%), pregnancy related (n=5; 2.3%) and numerous cardiac risk factors (0.9-5.5%). The majority suffered arterial infarction; n=216 (99.4%) while n=2 (0.6%) had venous strokes. The predominant stroke subtypes were large artery atherosclerosis (LAA); 29.8% and small vessel occlusion (SVO); 20.2%. LAA and SVO accounted for 37.5% of all stroke subtypes in the ≤36 year age-group. Cardioembolism (15.1%) and stroke of determined aetiology (14.7%) contributed to the other categories of identified stroke subtypes. Mortality on hospital discharge was 3.1% while 65.1% of patients were independent on discharge. Conclusion: This study demonstrated the substantial presence of premature atherosclerosis and conventional risk factors in young ischaemic stroke patients from 8 Asian cities. Venous infarction from cerebral venous thrombosis was rare in this study. Outcome on hospital discharge was poorer compared to Western studies. Detection of vascular risk factors and primary prevention measures should be initiated during late adolescence or early adulthood in urban Asia.
3.Complication of acute stroke: A study in ten Asian countries
Jose C Navarro ; Ester Bitanga ; Nijasri Suwanwela ; Hui Meng Chang ; Shan Jin Ryu ; Yi Ning Huang ; Lawrence Wong ; Deepak Arjundas ; Bhim Sen Singhal ; Sang Bok Lee ; Byung Woo Yoon ; N Venketasubramanian ; Hou Chang Chiu ; Niphon Poungvarin ; Kay Sin Tan ; Sardar Mohd Alam ; Duc Hinh Le
Neurology Asia 2008;13(1):33-39
Background and Objective: There is a paucity of studies looking into the frequency of complications
after stroke among Asians. We sought to determine the frequency and rate of complications among
Asians after acute stroke. Methods: Consecutive patients with acute stroke among 10 participating Asian
countries were included in the study. The frequency and timing of pre-determined complications, and
their relation to area of admission were noted. Results: Of the 1,153 patients included in the study, 423
(41.9%) developed complications within the first 2 weeks of stroke. Recurrent stroke, chest infections
and urinary tract infections were most commonly encountered, and were most frequent within the
first week of stroke onset. A lower rate of complications was noted among patients admitted at an
organized stroke unit.
Conclusion: There is a similar rate of frequency and timing of complications after acute stroke among
Asians as compared with other populations.
4.Telomere length in Thai Buddhist monks and Thai males aged 40 years and above
Pakamas Winson ; Preeya Leelahagul ; Aruchalean Taweewongsounton ; Wutarak Puenputtho ; Somchai Bovornkitti ; Niphon Poungvarin
Malaysian Journal of Nutrition 2022;28(No.3):383-393
Introduction: The daily lifestyles of Thai Buddhist monks and Thai males differ due
to Buddhist practices, which potentially affect telomere length. Telomeres are DNA
compounds located at the ends of chromosomes that shorten with each cell division. This
study investigated the difference in telomere length between Thai Buddhist monks and
Thai males aged ≥40 years. Method: This was a cross-sectional study involving 100 Thai
Buddhist monks aged ≥40 years who had been ordained for more than five years and 100
Thai males aged ≥40 years. General information and health information were assessed
by questionnaire. Nutritional status was determined by body composition and blood
chemistry parameters. Telomere length was measured by Monochrome Multiplex RealTime Quantitative PCR and expressed as T/S ratio. Result: Mean telomere length of Thai
Buddhist monks was longer than that of Thai males (1.08±0.18 vs. 1.02±0.17; p<0.050).
In both groups, the mean telomere length in subjects aged ≥60 years was shorter than
that in subjects aged 40-59 years (p<0.010). Alcohol consumption, which affected Thai
males (p<0.050), but meditation tend to slow down the shortening of telomeres (r=0.167;
p<0.050) in both groups. Conclusion: Age was the parameter that affected telomere
length the most. Furthermore, various factors in the Buddhist monk group, such as a
peaceful lifestyle, meditation, non-alcohol consumption, and fewer underlying diseases,
could explain for the longer telomere lengths in this group.