Amphoe Mueang

Atrial fibrillation AF is a major cause of heart-related illness and death, especially among Asian patients who face higher risks of serious bleeding such as brain hemorrhage compared to non-Asians. This research, called the COhort of antithrOmbotic use and cLinical outcomes in patients with Atrial Fibrillation COOL-AF Phase 2, aims to study how antithrombotic medication use changes over time and how these changes affect health outcomes in people with AF. The study is observational and conducted across multiple centers in Thailand. Participants in this study have known or newly diagnosed non-valvular AF and are followed without any intervention or treatment assigned by the study. The study plans to enroll about 3680 patients over two years from 33 centers. Participants will be monitored every 6 months for up to 3 years to observe patterns of medication use, particularly warfarin and non-vitamin K antagonist oral anticoagulants NOACs, and clinical events including stroke, systemic embolism, bleeding, heart attacks, and heart failure. Throughout the study, patients will have regular check-ins every six months to track their medication usage and health status. Researchers will collect data on important outcomes such as rates of stroke, bleeding events, and quality of life. The studys primary focus is on long-term safety and effectiveness of antithrombotic treatments in this population. The total participation duration can be up to 3 years, ensuring thorough observation of clinical outcomes and treatment patterns.

Researchers are evaluating the use of rapid bacterial identification and antibiotic resistance gene detection combined with targeted antibiotic treatment in patients with infections caused by Pseudomonas aeruginosa or carbapenemase producing Enterobacterales. This trial aims to reduce the time between infection onset and appropriate treatment in hospital-acquired bloodstream infections, hospital-acquired pneumonia, or ventilator-associated pneumonia. The study is an open-label, multinational, randomized trial comparing these rapid diagnostics and targeted therapy with standard antibiotic susceptibility testing. The goal is to see if this approach improves clinical outcomes compared to usual care. Participants are randomly assigned to either an intervention or control group. The intervention group will have specimens tested with the BioFire Blood Culture Identification 2 Panel for blood infections and the BioFire FilmArray Pneumonia or Pneumonia plus Panel for respiratory infections. Antibiotic guidelines will support treatment decisions and ceftazidime-avibactam will be available for targeted use when appropriate. The control group will receive standard microbiology testing and antibiotics as per usual hospital practice. The main population includes hospitalized patients with the specified infections, and a secondary group includes those with multidrug-resistant Gram-negative bacteria. Participants will be monitored for clinical and mortality outcomes up to 60 days after infection onset. Bacterial isolates will be collected for genetic analysis through whole genome sequencing. The primary outcome is a combination of all-cause mortality and lack of improvement in organ function score at 14 days post infection. Additional outcomes include clinical response, mortality at different time points, functional status, composite outcomes at 28 days, and health economic assessments. The study plans to enroll 1900 participants across 20 sites, with ongoing safety and clinical assessments throughout the trial.

Researchers are evaluating the epidemiological impact and cost-effectiveness of long-acting antiretrovirals for HIV prevention among Thai men who have sex with men MSM and transgender women TGW. The study includes discrete choice experiments DCEs to understand preferences for different pre-exposure prophylaxis PrEP options, as well as analysis of routine service data. The findings will guide mathematical modeling of long-acting PrEP uptake and its impact on HIV prevention. The study has three phases. Phase I involves in-depth interviews IDIs and focus group discussions FGDs with current, previous, or interested PrEP users to identify important attributes for PrEP choices. Phase II pilots the DCEs with convenience samples to refine the survey. Phase III launches two final surveys for MSM and TGW, collecting data on demographics, risk behavior, HIV and STI testing, PrEP knowledge, use, and preferences across attributes like product form, dosing frequency, provider type, and cost. Participants will take part in interviews, group discussions, and surveys conducted either in person or online. Data collected includes sociodemographic information, risk behaviors, PrEP attitudes, and preferences. Researchers will measure the projected uptake of long-acting PrEP, epidemiological impact, and cost-effectiveness over 12 to 18 months. The study includes ongoing monitoring of participant responses to optimize understanding of factors influencing PrEP use.