Takhian Luean

Atrial fibrillation (AF) is a common heart rhythm disorder that can lead to serious complications like stroke and bleeding. Asian patients with AF tend to have higher rates of major bleeding, including bleeding in the brain, compared to non-Asian patients. This research focuses on understanding the use of blood-thinning medications called anticoagulants, especially newer drugs known as non-vitamin K antagonist oral anticoagulants (NOACs), which are considered safer than warfarin but are less commonly used in Asian countries due to cost concerns. The study aims to track changes in how these medications are used and how they affect health outcomes over time. The study is a large, prospective observational registry conducted across 33 centers in Thailand, enrolling 3680 patients with non-valvular AF over two years. There is no intervention or treatment assigned by the study; instead, researchers observe patients' current treatments and outcomes. Participants will be followed every six months for a total of three years to monitor their use of warfarin and NOACs and record any serious events such as stroke, systemic embolism, major bleeding, heart attacks, heart failure, and overall quality of life. Throughout the study, patients will undergo regular assessments including clinical evaluations and monitoring of their medication use. The main outcomes measured over the three years include rates of using warfarin and NOACs, occurrence of ischemic stroke or transient ischemic attack, systemic embolism, intracranial hemorrhage, and major bleeding events. This long-term follow-up aims to provide valuable information on treatment patterns and safety in Asian patients with atrial fibrillation.

This research aims to measure and compare the carbon footprint produced by upper gastrointestinal (GI) endoscopy procedures used for diagnosis in patients with dyspepsia and for treatment in patients with non-variceal upper GI bleeding. Upper GI endoscopy is a common hospital procedure that contributes significantly to healthcare-related greenhouse gas emissions. The study focuses on the direct carbon emissions generated during these procedures, which have not been previously compared in detail. Patients undergoing diagnostic upper GI endoscopy for dyspepsia or therapeutic upper GI endoscopy for peptic ulcer bleeding will be observed without changes to their standard care. Therapeutic treatments may include the use of a bipolar hemostasis probe, hemostasis clips, argon plasma coagulation, or epinephrine injection. The study will record data from the start to the end of the endoscopy visit, including equipment, medication, energy use, and reprocessing activities responsible for carbon emissions. Participants will have their age, body measurements, medical history, and procedure details recorded. Follow-ups at 72 hours and 30 days will track treatment success and complications in bleeding patients. Researchers will analyze these data to calculate the carbon footprint of each procedure type, aiming to better understand the environmental impact of diagnostic versus therapeutic endoscopy. The enrollment period for this study is two months, including patients aged 20 to 80 years.