Background: Although angiotensin-converting enzyme (ACE) inhibitors are among the most-prescribed medications in the world, the extent to which they increase the risk of adverse effects remains uncertain. This study aimed to systematically determine the adverse effects of ACE inhibitors versus placebo across a wide range of therapeutic settings. Methods: Systematic searches were conducted on PubMed, Web of Science, and Cochrane Library databases. Randomized controlled trials (RCTs) comparing an ACE inhibitor to a placebo were retrieved. The relative risk (RR) and its 95% confidence interval (95% CI) were utilized as a summary effect measure. A random-effects model was used to calculate pooled-effect estimates. Results: A total of 378 RCTs fulfilled the eligibility criteria, with 257 RCTs included in the meta-analysis. Compared with a placebo, ACE inhibitors were associated with an significantly increased risk of dry cough (RR = 2.66, 95% CI = 2.20 to 3.20, p < 0.001), hypotension (RR = 1.98, 95% CI = 1.66 to 2.35, p < 0.001), dizziness (RR = 1.46, 95% CI = 1.26 to 1.70, p < 0.001), and hyperkalemia (RR = 1.24, 95% CI = 1.01 to 1.52, p = 0.037). The risk difference was quantified to be 0.037, 0.030, 0.017, and 0.009, respectively. Conclusions: We quantified the relative risk of numerous adverse events associated with the use of ACE inhibitors in a variety of demographics. This information can help healthcare providers be fully informed about any potential adverse consequences and make appropriate suggestions for their patients requiring ACE inhibitor therapy.

Parietal emissary foramina (PEF) are an important structure which the parietal emissary vein passes through. Aims of this study were to study morphometry of the PEF and its clinical implications. The present study examined in 800 parietal bones (400 Thai skulls; 200 males and 200 females). A total of 587 emissary foramina were found in 344 skulls. The PEF were found on the right side (298), left side (256). One hundred fifty-five unilateral, 189 bilateral, and 33 center of PEF were found in our study. The average of foramina to sagittal suture were 5.67 ± 2.73 mm on the right and 5.91 ± 2.37 mm on the left in male, while in female it was 5.28 ± 2.61 mm on the right and 5.48 ± 2.54 mm on the left. The shape was mostly circular with mean diameter of 1.27 ± 0.56 mm on the right, 1.23 ± 0.52 on the left and 1.11 ± 0.49 mm at the center in male. In female, the mean diameter of 1.19 ± 0.42 mm on the right, 1.12 ± 0.41 mm on the left and 1.60 ± 0.92 mm at the center. The ratio of distance from the external occipital protuberance (EOP)to PEF and to glabella in males on the right side is 0.342 cm. (3/8) and 0.349 cm. (3/8) on the left side. While the ratio of females is 0.367 cm. (3/8) and 0.388 cm. (3/8), respectively. Our finding obtained in this study scientists can be essentially benefited for anatomists, radiologists, neurosurgeons, and forensic to aware this anatomical structure.

The dorsalis pedis artery (DPA) is a vital artery that supplies the foot and ankle area which is clinically important for palpating when taking the pulse. This research was performed on fresh cadaveric dissection of 40 legs by injecting paint into popliteal artery for tracking the dorsalis pedis artery and its branches. The present research revealed that the Thai population has an anatomical variation and different location of the DPA and exact location of DPA for estimating the location of the DPA and may have clinical implications. The statistically descriptive analysis elucidated the distances of the DPA to the lateral malleolus and medial malleolus which were 51.48 ± 7.27 mm and 42.62 ± 11.40 mm, respectively. The distance of the extensor hallucis longus (EHL) to the DPA was 14.29 ± 4.11 mm. The length of the dorsalis pedis artery which measured from artery on intermalleolar line to its dipping in 1st intermetatarsal space to be 122.03 ± 21.07 mm. The arcuate loop which is anastomosis U-loop of lateral tarsal arteries of the DPA was found 55 % in Thais population. There were no statistically significant differences of all parameters between the side and sex in DPA consideration. An understanding of the variations of the anatomical vasculature of DPA is essential for precise clinical assessment because exact anatomical knowledge and location can contribute to the pulse taking and be applied in surgical procedure.

Age at death estimation has always been a crucial yet challenging part of identification process in forensic field. The use of human skeletons have long been explored using the principle of macro and micro-architecture change in correlation with increasing age. The clavicle is recommended as the best candidate for accurate age estimation because of its accessibility, time to maturation and minimal effect from weight. Our study applies pre-trained convolutional neural network in order to achieve the most accurate and cost effective age estimation model using clavicular bone. The total of 988 clavicles of Thai population with known age and sex were radiographed using Kodak 9000 Extra-oral Imaging System. The radiographs then went through preprocessing protocol which include region of interest selection and quality assessment. Additional samples were generated using generative adversarial network. The total clavicular images used in this study were 3,999 which were then separated into training and test set, and the test set were subsequently categorized into 7 age groups. GoogLeNet was modified at two layers and fine tuned the parameters. The highest validation accuracy was 89.02% but the test set achieved only 30% accuracy. Our results show that the use of medial clavicular radiographs has a potential in the field of age at death estimation, thus, further study is recommended.

Motorcycle food delivery riders (MFDR) are more susceptible to traffic collisions when compared to regular motorcyclists. Their safety is a major concern in many developing countries, especially Thailand, which has the highest rate of motorcyclist fatalities in the world. This cross-sectional study aimed to identify the prevalence of accidents, hospitalization, involvement in risky behaviors, and concerning problems among MFDR and determine factors associated with accidents. The data were collected from 709 MFDR in Chiang Mai, Thailand. The prevalence of any accidents among MFDR in the past six months was 18.9% which can be categorized into 4.9% minor injuries, 2.4% hospitalized major injuries, and 11.6% non-hospitalized major injuries. 84.3% of them engaged in at least one risky behavior and 5.8% of them engaged in ten or more risky behaviors. The most frequent risky behavior was using the mobile phone while riding (78.8%), While the least frequent risky behavior not wearing a helment (9.3%). Multivariable logistic regression analysis indicates that the factors associated with the major accidents were running a red light (aOR 2.78, 95%CI 1.07 to 7.21) and having concerns for customer behavior (aOR 2.66, 95%CI 1.26 to 5.62). The factors associated with any accidents (both major and minor accidents) were sleeping < 6 hours/day (aOR 2.13, 95%CI 1.41 to 3.21) and working ≥ 48 hours/week (aOR 1.72, 95%CI 1.04 to 2.83) To reduce the rate and severity of traffic accidents, the government and the delivery firms should provide effective strategies and targeted interventions focusing on the reduction of risky behaviors and other modifiable risk factors.