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A mucoadhesive chitosan polymer-based nanoplatform has been increasingly recognized as an effective mucosal vaccine delivery system for fish. The present study aimed to investigate the effectiveness of immersion vaccination with a chitosan polymer-based nanovaccine to elicit an immune response in serum and mucus of red tilapia and evaluate its protective efficacy after immersion challenge with a heterogenous strain of Aeromonas veronii UDRT09. Six hundred red tilapia (22 ± 1.8 g) were randomly allocated into four experimental groups: control, empty-polymeric nanoparticle (PC), formalin-killed vaccine (FKV), and chitosan polymer-based nanovaccine (CS-NV) in triplicate. The specific IgM antibody levels and their bactericidal activity were assessed in serum and mucus for 28 days after immersion vaccination and followed by immersion challenge with A. veronii. The immersion vaccine was found to be safe for red tilapia, with no mortalities occurring during the vaccination procedure. The specific IgM antibody levels and bactericidal activity against A. veronii in both serum and mucus were significantly higher in red tilapia vaccinated with CS-NV compared to the FKV and control groups at all time points. Furthermore, the serum lysozyme activity, ACH 50 , and total Ig levels demonstrated a significant elevation in the groups vaccinated with CS-NV compared to the FKV and control groups. Importantly, the Relative Percentage Survival (RPS) value of the CS-NV group (71 %) was significantly higher than that of the FKV (15.12 %) and PC (2.33 %) groups, respectively. This indicates that the chitosan polymer-based nanovaccine platform is an effective delivery system for the immersion vaccination of tilapia., (Copyright © 2024. Published by Elsevier Ltd.)

Tilapia is the world's most extensively farmed species after carp. It is an attractive species for aquaculture as it grows quickly, reaching harvest size within six to seven months of production, and provides an important source of food and revenue for many low-income families, especially in low- to middle-income countries. The expansion of tilapia aquaculture has resulted in an intensification of farming systems, and this has been associated with increased disease outbreaks caused by various pathogens, mostly bacterial and viral agents. Vaccination is routinely used to control disease in higher-value finfish species, such as Atlantic salmon. At the same time, many tilapia farmers are often unwilling to vaccinate their fish by injection once the fish have been moved to their grow-out site. Alternative vaccination strategies are needed to help tilapia farmers accept and use vaccines. There is increasing interest in nanoparticle-based vaccines as alternative methods for delivering vaccines to fish, especially for oral and immersion administration. They can potentially improve vaccine efficacy through the controlled release of antigens, protecting antigens from premature proteolytic degradation in the gastric tract, and facilitating antigen uptake and processing by antigen-presenting cells. They can also allow targeted delivery of the vaccine at mucosal sites. This review provides a brief overview of the bacterial and viral diseases affecting tilapia aquaculture and vaccine strategies for farmed tilapia. It focuses on the use of nanovaccines to improve the acceptance and uptake of vaccines by tilapia farmers.

Streptococcus agalactiae is one of Thailand's most important pathogens in tilapia aquaculture. Vaccination is a very effective method for protecting fish against disease in aquaculture. Oral vaccination is an interesting route for vaccine delivery as it mimics the pathogenesis of S. agalactiae and provides convenient administration for mass vaccination of fish. Moreover, gut mucosal immunity is associated with a mucus layer on the gastrointestinal tract. Therefore, this study aimed to develop a novel cationic-based nanoemulsion vaccine containing bile salts (NEB) coated by chitosan (CS) and determined its physicochemical characterization, morphology, in vitro mucoadhesive property, permeability, and acid-base tolerance. In addition, the efficacy of NEB-CS as an oral vaccination for Nile tilapia was evaluated in order to investigate the innate immune response and protection against S. agalactiae. The groups of fish consisted of: (1) deionized water as a non-vaccinated control (Control); (2) an inactivated vaccine formulated from formalin-killed bacteria (IB); and (3) a novel cationic-based nanoemulsion vaccine containing bile salts (NEB) coated by chitosan (CS). The control, IB, and NEB-CS were incorporated into commercial feed pellets and fed to Nile tilapia. In addition, we evaluated the serum bactericidal activity (SBA) for 14 days post-vaccination (dpv) and protective efficacy for 10 days post-challenge, respectively. The mucoadhesiveness, permeability, and absorption within the tilapia intestine were also assessed in vivo. The NEB-CS vaccine appeared spherical, with the nanoparticles having a size of 454.37 nm and a positive charge (+47.6 mV). The NEB-CS vaccine had higher levels of mucoadhesiveness and permeability than the NEB (p < 0.05). The relative percent survival (RPS) of IB and NEB-CS, when administered orally to fish, was 48% and 96%, respectively. Enhanced SBA was noted in the NEB-CS and IB vaccine groups compared to the control group. The results demonstrate that a feed-based NEB-CS can improve the mucoadhesiveness, permeability, and protective efficacy of the vaccine, and appear to be a promising approach to protecting tilapia in aquaculture against streptococcosis., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The occurrence of francisellosis caused by Francisella orientalis sp. nov. (Fo) and columnaris disease caused by Flavobacterium oreochromis (For) is negatively impacting Nile tilapia (Oreochromis niloticus) production, especially when high stocking densities are used. A new and innovative bivalent mucoadhesive nanovaccine was developed in this study for immersion vaccination of tilapia against francisellosis and columnaris disease. It was shown to have the potential to improve both innate and adaptive immunity in vaccinated Nile tilapia. It increased innate immune parameters, such as lysozyme activity, bactericidal activity, phagocytosis, phagocytic index, and total serum IgM antibody levels. Additionally, the vaccine was effective in elevating specific adaptive immune responses, including IgM antibody levels against Fo and For vaccine antigens and upregulating immune-related genes IgM, IgT, CD4 + , MHCIIα, and TCRβ in the head kidney, spleen, peripheral blood leukocytes, and gills of vaccinated fish. Furthermore, fish vaccinated with the mucoadhesive nanovaccine showed higher survival rates and relative percent survival after being challenged with either single or combined infections of Fo and For. This vaccine is anticipated to be beneficial for large-scale immersion vaccination of tilapia and may be a strategy for shortening vaccination times and increasing immune protection against francisellosis and columnaris diseases in tilapia aquaculture., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The aim of the present study was to optimize a masculinization platform for the production of all-male red tilapia fry by oral administration of 30 and 60 ppm of MT and alkyl polyglucoside nanostructured lipid carriers (APG-NLC) loaded with MT, respectively, for 14 and 21 days. The characterization, encapsulation efficiency and release kinetics of MT in lipid-based nanoparticles were assessed in vitro. The results showed that the MT-loaded nanoparticles were spherical, ranging from 80 to 125 nm in size, and had a negative charge with a narrow particle distribution. The APG-NLC loaded with MT provided higher physical stability and encapsulation efficacy than the NLC. The release rate constants of MT from MT-NLC and MT-APG-NLC were higher than those of free MT, which is insoluble in aqueous media. There was no significant difference in survival between the fish administered MT or the those fed orally with MT-APG-NLC fish. According to the logistic regression analysis, the sex reversal efficacy of MT-APG-NLC (30 ppm) and MT (60 ppm), resulted in significantly higher numbers of males after 21 days of treatment compared with the controls. The production cost of MT-APG-NLC (30 ppm) after 21 days of treatment was reduced by 32.9% compared with the conventional MT treatment group (60 ppm). In all the treatments, the length-weight relationship (LWR) showed negatively allomeric growth behavior ( b < 3), with a relative condition factor (K n ) of more than 1. Therefore, MT-APG-NLC (30 ppm) would seem to be a promising, cost-effective way to reduce the dose of MT used for the masculinization of farmed red tilapia.

Tilapia lake virus (TiLV), an enveloped negative-sense single-stranded RNA virus, causes tilapia lake virus disease (TiLVD), which is associated with mass mortality and severe economic impacts in wild and farmed tilapia industries worldwide. In this study, we developed a chitosan nanoparticle TiLV immersion vaccine and assessed the efficacy of the vaccine in laboratory and field trials. Transmission electron microscopy showed that the inactivated vaccine had a particle size of 210.3 nm, while the nano inactivated vaccine had a spherical shape with a diameter of 120.4 nm. Further analysis using fluorescent staining and immunohistochemistry analysis revealed the mucoadhesive properties of the nanovaccine (CN-KV) through fish gills. We assessed the efficacy of an immersion-based TiLV nanovaccine using a cohabitation challenge model. The fish that received the nanovaccine showed better relative percent survival (RPS) at 68.17% compared with the RPS of the inactivated virus vaccine (KV) group at 25.01%. The CN-KV group also showed a higher TiLV-specific antibody response than the control and KV groups (p < 0.05). Importantly, under field conditions, the fish receiving the CN-KV nanovaccine had better RPS at 52.2% than the nonvaccinated control group. Taken together, the CN-KV nanovaccinated fish showed better survival and antibody response than the control and KV groups both under laboratory control challenge conditions and field trials. The newly developed immersion-based nanovaccine is easy to administer in small fish, is less labor-intensive, and allows for mass vaccination to protect fish from TiLV infection., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Whiteleg shrimp ( Penaeus vannamei ) have been vulnerable to the stress induced by different aquaculture operations such as capture, handling, and transportation. In this study, we developed a novel clove oil-nanostructured lipid carrier (CO-NLC) to enhance the water-soluble capability and improve its anesthetic potential in whiteleg shrimp. The physicochemical characteristics, stability, and drug release capacity were assessed in vitro. The anesthetic effect and biodistribution were fully investigated in the shrimp body as well as the acute multiple-dose toxicity study. The average particle size, polydispersity index, and zeta potential value of the CO-NLCs were 175 nm, 0.12, and -48.37 mV, respectively, with a spherical shape that was stable for up to 3 months of storage. The average encapsulation efficiency of the CO-NLCs was 88.55%. In addition, the CO-NLCs were able to release 20% of eugenol after 2 h, which was lower than the standard (STD)-CO. The CO-NLC at 50 ppm observed the lowest anesthesia (2.2 min), the fastest recovery time (3.3 min), and the most rapid clearance (30 min) in shrimp body biodistribution. The results suggest that the CO-NLC could be a potent alternative nanodelivery platform for increasing the anesthetic activity of clove oil in whiteleg shrimp ( P. vannamei ).

Red tilapia (Oreochromis sp.), one of the important freshwater fish species in fish farming in Thailand, has for long been suffering from a serious bacterial disease named epizootic ulcerative syndrome and hemorrhagic septicemia. The disease is mainly caused by Aeromonas veronii. Vaccine is proposed to be a major impact tool for sustainable control and prevention strategies. Vaccination by immersion has many benefits over injection. However, the conventional immersion method suffers from a low potency due to the inefficient uptake of antigens across mucosal tissue. Here, we developed a chitosan-polymer based nanovaccine together with an efficient delivery vehicle to enhance the immunogenicity of immersion vaccination, increasing bioavailability and inducing local immune responses during transit to mucosal inductive immune sites. The physiochemical properties of nanovaccine, which was modified on surface particle by using a mucoadhesive polymer, were assessed for size, zeta potential, and particle distribution. Our study demonstrated by SEM image and microscopic fluorescence image that nanovaccine greatly increased the binding and penetrating ability into gills when compared with formalin killed vaccine. The nano-sized particles were well dispersed in water and trapped in core nanoparticle as confirmed by TEM image. The efficacy of vaccine was performed by immersion challenge with virulent A.veronii after 30 days post vaccination in tilapia. The result revealed a high level of mortality in the control, empty-polymeric nanovaccine and formalin killed bacterin vaccine groups. A high relative percentage survival (RPS) of vaccinated fish was noted with chitosan-polymer based nanovaccine. Our studies indicated that this chitosan-polymer based nanovaccine derived from cell fragments and supernatant was the improved version of the conventional formalin killed vaccine. The chitosan polymer based particle could increase the efficacy of nanovaccine toward the target mucosal membrane and enhance protection against A. veronii infection in red tilapia., Competing Interests: Declaration of competing interest The authors declare that there are no conflicts of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Columnaris is a bacterial disease, found in freshwater fish, caused by Flavobacterium oreochromis. The disease has a devastating impact on a range of cultured and wild freshwater fish species e.g. Lates calcarifer (Asian sea bass), which is a serious economic losses to the freshwater aquaculture in Thailand. The disease can be prevented by an efficacious vaccine, however, no licensed effective vaccine is available to date. Current study was based on the development of a novel mucoadhesive nano-encapsulated vaccine (EncapFlavoNP ++ ), where, cationic lipid-based nanoparticles were combined with an antigen obtained from F. oreochromis. Various parameters including transmission electron microscopy (TEM), physiochemical properties; zeta potential, and polydispersity index were determined. The TEM results depicted well-formed circular-shaped nano-encapsulates complexed with cationic lipid surfactants. The average diameter of the molecules was 200 nm, having a zeta potential of 31.82 mV, while, the polydispersity index (PDI) was 0.31. The in vivo study lasted for 8 weeks, the immunologic and protective potentials of the prepared molecules were determined by challenging the fish for 8 weeks. The most effective dilutions of EncapFlavoNP ++ solution were 1:100 and 1:200, which significantly improved the efficacy of the immunity by increasing the level of antibody specific to F. oreochromis. A trend of upregulation was found in the immune-related genes including immunoglobulin M heavy chain (IgM), major histocompatibility complex class IIα molecules (MHC-IIα), and dendritic cell specific transcript (DCs) in gills, skin, liver, peripheral blood lymphocytes (PBLs), head kidneys, and spleen as compared to the control group (P < 0.05 and P < 0.01). Upon immunization with EncapFlavoNP ++ solution at the dilution of 1:100 and 1:200, the significant increase in survival rate (SR) and relative percent survival (RPS) were found in fish challenged with virulent F. oreochromis bacterium (SR 72.50% and RPS 62.07) and (SR 65.83% and RPS 52.87), respectively as compared to the control group (P < 0.05). It can be concluded that immunization with EncapFlavoNP ++ solution has significant immunologic and protective effects against Columnaris disease. Furthermore, the prepared vaccine candidate has more potential as compared to whole-cell immersion vaccination (FK-WC). It can be used on a large scale in the freshwater aquaculture industry to boost immunity against Columnaris disease., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Francisella noatunensis subsp. orientalis (Fno) is one of the infectious diseases that causes economic losses associated with tilapia mortality. Even though direct immersion administration of vaccines is more practicable for small fish and fry compared with oral and injection vaccination in the fields, the efficacy is still insufficient due to lower potency of antigen uptake. Herein, we accomplished the development of a mucoadhesive nanovaccine platform using cetyltrimethylammonium bromide (CTAB), a cationic surfactant, to improve the efficiency of immersion vaccination against Fno in tilapia. Cationic Fno nanovaccine (CAT-Fno-NV) was prepared though emulsification using an ultrasonic method. In our investigation, the CAT-Fno-NV increased the opportunity of Fno vaccine uptake by extending the contact time between vaccine and mucosal surface of fish gills and enhancing the protective efficacy against Fno infection. Fish were vaccinated with the CAT-Fno-NV by a direct immersion protocol. The challenge trial by Fno injection revealed that CAT-Fno-NV at the concentration 1:100 ratio (approximately 1 × 10 6  cfu/mL) had the highest efficacy to protect fish from Fno infection at day 30 after post challenge period according to the total number of Fno detected in head kidney, spleen and liver. A significant upregulation of IgM gene was observed in gills, skin, head kidney, serum and peripheral blood lymphocytes (PBLs) and spleen tissues treated with WC and CAT-Fno-NV (1:100) vaccines, while IgT gene was highly expressed in only gills and skin tissues for treated WC and CAT-Fno-NV (1:100) groups. We anticipate that the cationic surfactant-based nanovaccine developed in this study could become an efficient alternative for direct immersion vaccination to induce humoral immune responses against Fno in vaccinated tilapia., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Aeromonas schubertii is a Gram-negative, rod-shaped bacterium. It is a rare species that has been reported in humans and aquatic animals. Here, we report the genome sequences of A. schubertii strains isolated from two mass mortality events in central Thailand that were associated with aquaculture of Asian seabass.

Immersion vaccination with a biomimetic mucoadhesive nanovaccine has been shown to induce a strong mucosal immune response against columnaris disease, a serious bacterial disease in farmed red tilapia caused by Flavobacterium columnare . However, the induction of a systemic immune response by the vaccine is yet to be investigated. Here, we examine if a specific humoral immune response is stimulated in tilapia by a biomimetic-mucoadhesive nanovaccine against Flavobacterium columnare using an indirect-enzyme-linked immunosorbent assay (ELISA), serum bactericidal activity (SBA) and the expression of immune-related genes within the head-kidney and spleen, together with assessing the relative percent survival of vaccinated fish after experimentally infecting them with F. columnare . The anti-IgM antibody titer of fish at 14 and 21 days post-vaccination was significantly higher in chitosan complex nanoemulsion (CS-NE) vaccinated fish compared to fish vaccinated with the formalin-killed vaccine or control fish, supporting the serum bactericidal activity results at these time points. The cumulative mortality of the unvaccinated control fish was 87% after challenging fish with the pathogen, while the cumulative mortality of the CS-NE vaccinated group was 24%, which was significantly lower than the formalin-killed vaccinated and control fish. There was a significant upregulation of IgM , IgT , TNF α , and IL1-β genes in the spleen and kidney of vaccinated fish. Significant upregulation of IgM and IgT genes was observed in the spleen of CS-NE vaccinated fish. The study confirmed the charged-chitosan-based mucoadhesive nanovaccine to be an effective platform for immersion vaccination of tilapia, with fish generating a humoral systemic immune response against columnaris disease in vaccinated fish.

Columnaris, a highly contagious bacterial disease caused by Flavobacterium columnare, is recognized as one of the most important infectious diseases in farmed tilapia, especially during the fry and fingerling stages of production. The disease is associated with characteristic lesions in the mucosa of affected fish, particularly their skin and gills. Vaccines delivered via the mucosa are therefore of great interest to scientists developing vaccines for this disease. In the present study, we characterized field isolates of F. columnare obtained from clinical columnaris outbreaks in red tilapia to select an isolate to use as a candidate for our vaccine study. This included characterizing its colony morphology, genotype and virulence status. The isolate was incorporated into a mucoadhesive polymer chitosan-complexed nanovaccine (CS-NE), the efficacy of which was determined by experimentally infecting red tilapia that had been vaccinated with the nanoparticles by immersion. The experimental infection was performed 30-days post-vaccination (dpv), which resulted in 89% of the unvaccinated control fish dying, while the relative percentage survival (RPS) of the CS-NE vaccinated group was 78%. Histology of the mucosal associated lymphoid tissue (MALT) showed a significantly higher presence of leucocytes and a greater antigen uptake by the mucosal epithelium in CS-NE vaccinated fish compared to control fish and whole cell vaccinated fish, respectively, and there was statistically significant up-regulation of IgT, IgM, TNF α, IL1-β and MHC-1 genes in the gill of the CS-NE vaccinated group. Overall, the results of our study confirmed that the CS-NE particles achieved better adsorption onto the mucosal surfaces of the fish, elicited great vaccine efficacy and modulated the MALT immune response better than the conventional whole cell-killed vaccine, demonstrating the feasibility of the mucoadhesive nano-immersion vaccine as an effective delivery system for the induction of a mucosal immune response against columnaris disease in tilapia., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Red tilapia (Oreochromis sp.) has become one of the most important fish in aquaculture. Bacterial infection caused by Flavobacterium columnare, the causative agent of columnaris disease, has been now identified as one of the most serious infectious diseases in farmed red tilapia and cause major financial damage to the producers. Among the effective prevention and control strategies, vaccination is one of the most effective approach. As the surface of living fish is covered by mucus and directly associated with the mucosal immunity, we therefore hypothesized that better adsorption on mucosal surfaces and more efficient vaccine efficacy could be enhanced biomimetic nanoparticles mimicking the mucoadhesive characteristic of live F. columnare. In this work, we describe an effective approach to targeted antigen delivery by coating the surface of nanoparticles with mucoadhesive chitosan biopolymer to provide "pathogen-like" properties that ensure nanoparticles binding on fish mucosal membrane. The physiochemical properties of nanovaccines were analyzed, and their mucoadhesive characteristics and immune response against pathogens were also evaluated. The prepared vaccines were nano-sized and spherical as confirmed by scanning electron microscope (SEM). The analysis of hydrodynamic diameter and zeta-potential also suggested the successful modification of nanovaccines by chitosan as indicated by positively charged and the overall increased diameter of chitosan-modified nanovaccines. In vivo mucoadhesive study demonstrated the excellent affinity of the chitosan-modified nanovaccines toward fish gills as confirmed by bioluminescence imaging, fluorescent microscopy, and spectrophotometric quantitative measurement. Following vaccination with the prepared nanovaccines by immersion 30 min, the challenge test was then carried out 30 and 60 days post-vaccination and resulted in high mortalities in the control. The relative percent survival (RPS) of vaccinated fish was greater than 60% for mucoadhesive nanovaccine. Our results also suggested that whole-cell vaccines failed to protect fish from columnaris infection, which is consistent with the mucoadhesive assays showing that whole-cell bacteria were unable to bind to mucosal surfaces. In conclusion, we could use this system to deliver antigen preparation to the mucosal membrane of tilapia and obtained a significant increase in survival compared to controls, suggesting that targeting mucoadhesive nanovaccines to the mucosal surface could be exploited as an effective method for immersion vaccination., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Vaccination is the most effective approach for prevention of infectious diseases in aquaculture. Although immersion vaccination is more applicable compared to in-feed/oral administration and injection, this method suffers from low potency as the efficiency of uptake of antigens through mucosal membranes is limited. In this study, we have successfully developed a mucoadhesive vaccine delivery system to enhance the efficacy of direct immersion vaccination against Flavobacterium columnare, the causative agent of columnaris disease in red tilapia. A formalin-killed negatively charged, bacterial cell suspension was used to prepare a mucoadhesive vaccine by electrostatic coating with positively charged chitosan. Our results demonstrate that the chitosan-complexed vaccine greatly increases its mucoadhesiveness, thus increasing the chances of vaccine uptake by the gill mucosa and improving the protection obtained against columnaris infection. The surface charge of the chitosan-complexed vaccine was altered from anionic to cationic after chitosan modification. Tilapia were vaccinated with the prepared chitosan-complexed vaccine by immersion. The challenge test was then carried out 30 and 60 days post vaccination, which resulted in a high level of mortalities in the non-vaccinated and uncomplexed vaccine groups. A high relative percentage survival (RPS) of vaccinated fish was noted with the mucoadhesive vaccine. Our results indicated that the naked vaccine failed to protect the fish from columnaris infection, which is consistent with the mucoadhesive assays performed during the study showing that the naked vaccine was unable to bind to mucosal surfaces. This system is therefore an effective method for immersion vaccination in order to deliver the antigen preparation to the mucosal surface membrane of the fish., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Magnesium sulfate is most effective for prevention and treatment of convulsions among preeclampsia women. The therapeutic level of magnesium at 4.8 to 8.4 mg/dL and the overdose of magnesium may be fatal. In Maharat Nakhon Ratchasima Hospital, intravenous magnesium sulfate is used with the starting dose of 4 grams followed by 1 gram per hour for symptom control. However, between 2012 and 2013, in Maharat Nakhon Ratchasima Hospital, 14 cases of eclampsia developed convulsions during magnesium sulfate therapy. Additionally, all of them had serum magnesium lower than the therapeutic level and 85.7 % of them had a body weight more than the standard (Body mass index (BMI) ≥25 kg/m(2))., Objective: To compare the success rates of yielding the standard therapeutic level of magnesium among overweight mothers with preeclampsia after receiving 1 gram and 2 gram per hour of magnesium sulfate maintenance infusion., Material and Method: This study was a randomized controlled trial study. The 38 overweight mothers (BMI ≥25 kg/m(2)) who were diagnosed as having preeclampsia and administered magnesium sulfate for prevention of convulsion were recruited. The patients who had kidney impairment or were under conservative treatment were excluded. The sample size was calculated to be 19 for each group from the pilot, with five cases per group, led to type I and type II errors, 0.05 and 0.20, respectively. They were allocated with simple randomization into an experimental group that would be treated with magnesium sulfate at 2 grams per hour and a control group treated with 1 gram per hour infusion. At the fourth hour of infusion before delivery and every four hours after delivery, the magnesium levels from both groups were compared and analyzed using Chi-square., Results: The body mass index of the experimental and the control groups were 33.5±6.84 and 33.7±6.09 kg/m(2), respectively. No difference in the basic characteristics between the two groups was observed. The rate of achievement of the therapeutic level of magnesium in the experimental group was higher than that of the control group both before delivery (52.6% vs. 15.8%, respectively, RR 3.3 (95% CI 1.08-10.24)) and after delivery (84.2 % vs. 42.1%, respectively, RR 2.0, 95% CI: (1.14-3.51)). Neither the overdose of magnesium nor convulsions were found in either group. The dose of magnesium in the control group was raised to 1.5 gram per hour in four patients and 2 grams per hour in seven patients to achieve the therapeutic level after delivery., Conclusion: The therapeutic level of magnesium in overweight mothers with preeclampsia could be more frequently accessed before and after delivery with the dose of 2 grams per hour of magnesium sulfate infusion. No overdose of magnesium was observed. This fact would be used to improve the guideline of preeclampsia patient care.

Objective: To compare-the adequacy of endometrium and the post-procedural pain between the manual vacuum aspiration (MVA) and metal curettage method., Material and Method: The present research was a clinical experiment. A randomized controlled trial study was done with older than 35-year oldfemales with abnormal intrauterine bleeding who attended the out-patient gynecology department of Maharat Nakhon Ratchasima Hospital between December 1, 2013 and April 30, 2014. Patients were allocated with simple randomization technique into two groups, the experimental group was using MVA and the control group was using conventional metal uterine curettage. Pain levels were assessed according to the visual analogue scale. All tissue samples were examined by pathologists. Statistics used were percentage and Chi-square., Results: Percentages of tissue adequacy for pathological examination of control and experiment groups were 87.88 and 90.91, respectively. There was no significant difference between the two methods (p-value = 0.572). The patients with severe pain in the experiment group were less than that of the control group. The relative risk is 0.47 (95% CI = 0.30-0.72)., Conclusion: MVA caused less pain than the metal curette method, while both provided the same rate of adequacy of endometrial tissue sampling for pathological diagnosis. The MVA offered more humanized health care for gynecological patients who required such procedure. Further researches focusing on the cost-effectiveness or medical complications could benefit a practice guideline and the health care system for this patient group.

Background: Adolescent pregnancy is risky with multiple complications during pregnancy and the delivery period. Adolescent pregnancy among students is more risky because the mothers did not intend to get pregnant, have poor relationship with the husband and do not take care of their child themselves as in other occupations., Objective: The decisions of adolescent mothers towards antenatal care (ANC) attendance and their postpartum adaptation; comparing students with other occupations, Material and Method: This retrospective hospital-based study used data from the records of 777 adolescent mothers who attended the adolescent postpartum clinic at Maharat Nakhon Ratchasima Hospital from January 2012 to December 2013. The data were classified into students and other occupation groups. Their decisions for ANC attendance, spousal relationship, pregnancy intentions, family acceptance and postpartum adaptation (contraceptive decision, decision for taking care of baby and returning to study) from both groups were compared and analyzed., Results: The prevalence of student mothers was 63.3% of all adolescent pregnancies. The following factors were more common in student mothers with statistical significance, odd ratio (95% confidence interval): unintended pregnancy 3.66 (2.45-5.47), family non-acceptance 1.71 (1.03-2.93), poor ANC (no ANC and ANC after 12 weeks) 22.82 (14.33-37.34). Other factors including no ANC attendance, decision for taking care of the baby, contraceptive decision (before and after deliveries), and the contraceptive method was no different between the groups. After delivery, adolescents decided to return to their studies; 58.7% for students and 33.3% for other occupation groups., Conclusion: Students account for 63.3% of all adolescent pregnancies. None of them was married so the majority did not intend to be pregnant and not be accepted by their families, leading to poor ANC attendance. Half of them decided to return to their studies. Further studies should be prospectively performed at schools to see the true prevalence of pregnancy and the related factors such as pregnancy termination, withdrawal from school and the continuation of their studies.

A total of 83 Vibrio isolates from farmed marine shrimps (Penaeus monodon) were tested for the presence of class 1, 2 and 3 integrons, SXT constin and tetracycline resistance-encoding genes. Mutations in the quinolone resistance-determining regions (QRDRs) of the gyrA and parC genes were determined in fluoroquinolone-resistant Vibrio strains (n=17). Five isolates were found to carry class 1 integrons, of which only one contained the partial rumA gene in the variable region. All the Vibrio strains were devoid of class 2 and 3 integrons. Seven isolates harbored SXT constin. None of the Vibrio isolates were positive to the tet(K), tet(L), tet(M), tet(O) and tet(S) genes. Ten fluoroquinolone-resistant Vibrio strains carried a point mutation G-248-T in the gyrA QRDR, leading to a Ser-83-Ile substitution in GyrA, but none of these strains had mutations in the QRDR of the parC gene.