Prognostic Factors of Adult Hemophagocytic Lymphohistiocytosis and Clinical Utility of HLH-2004 Diagnostic Criteria and HScore: A Real-World Multicenter Study from Thailand.

Introduction: Adult hemophagocytic lymphohistiocytosis (HLH) is a rare disease with a dismal prognosis. Early diagnosis and prompt management are necessary for improved outcomes.

Methods: This multicenter retrospective study investigated the etiologies, survival, and prognostic factors of HLH, including the utility of HLH-2004 criteria and HScore in real-life clinical practice.

Therapeutic drug monitoring of mycophenolic acid and clinical outcomes of lupus nephritis: a systematic review and meta-analysis.

Introduction: Mycophenolic acid (MPA) is a primary immunosuppressive agent used in the treatment of lupus nephritis (LN). While therapeutic drug monitoring (TDM) of MPA is well established in organ transplantation, its role in LN treatment remains uncertain. Our objective was to review and summarise current knowledge on TDM of MPA in the LN treatment.

Topical and subconjunctival anesthesia versus topical anesthesia alone in patients with senile cataracts undergoing phacoemulsification: a double-blind randomized controlled trial.

Background: This study compared topical anesthesia to a combination of topical anesthesia and subconjunctival anesthesia for phacoemulsification.

Methods: This double-blinded parallel placebo-controlled randomized trial involved senile cataract patients scheduled for phacoemulsification between May and December 2022. Patients were randomly assigned to receive either topical anesthesia with 0.

Pediatric drug reaction with eosinophilia and systemic symptoms: A 12-year retrospective study in a tertiary center.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe adverse drug reaction involving multiple organs. Data on DRESS syndrome among children are currently limited. The purpose of this study was to determine the clinical features, causative drugs, systemic organ involvement, laboratory findings, disease severity score, and treatment outcomes in pediatric DRESS patients.

Mental Health of Transmasculine Adults Receiving Gender-Affirming Hormone Therapy in Thailand.

Purpose: Many studies have shown conflicting results regarding mental health among transmasculine adults or transgender men (TM). This study aimed to identify the prevalence of depression among Thai TM receiving gender-affirming hormone therapy (GAHT).

Methods: All TM, over 18 years of age, who received GAHT for at least three consecutive months were invited to complete a self-report questionnaire that covered participants' demographic and clinical data.

Minimally Invasive Harvesting of Triple-Fold Superficial Layer Quadriceps Autograft for Knee Ligament Reconstruction.

Graft selection plays a critical role in anterior cruciate ligament reconstruction. Autograft options, including hamstrings, bone-patellar tendon-bone, and quadriceps, offer distinct advantages and disadvantages. Soft tissue quadriceps tendon autografts are increasingly favored due to their strength, size compatibility, and potential for enhanced graft healing.

Old problems, new solutions: harnessing technology and innovation in Parkinson's disease-evidence and experiences from Thailand.

The prevalence of Parkinson's disease (PD) is increasing rapidly worldwide, but there are notable inequalities in its distribution and in the availability of healthcare resources across different world regions. Low- and middle-income countries (LMICs), including Thailand, bear the highest burden of PD so there is an urgent need to develop effective solutions that can overcome the many regional challenges associated with delivering high-quality, and equitable care to a diverse population with limited resources. This article describes the evolution of healthcare delivery for PD in Thailand, as a case example of a LMIC.

Long-term continuations rate of ring pessary use for symptomatic pelvic organ prolapse.

Purpose: To evaluate long-term continuation rates, adverse events of ring pessary use at a minimum of 5 years follow-up, and factors associated with discontinuation in symptomatic pelvic organ prolapse (POP).

Methods: Women with symptomatic POP who were treated with vaginal ring pessary and had successful fittings were included. Adverse events and reasons for discontinuation of pessary use were recorded.

An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4-5: A Magnetic Resonance Imaging Study.

Objective: We introduced a new preoperative method, the "expanded surgical corridor," to evaluate the actual safety corridor, which may expand the possibility of performing oblique lateral interbody fusion (OLIF).

Methods: Axial T2-weighted magnetic resonance images at the L4-5 disc level of 511 lumbar degenerative disease patients was evaluated. The distance between the medial edge of the left-sided psoas muscle and the major artery was measured as the conventional surgical corridor (CSc).

Traditional suture tape versus multiple high-strength sutures for augmentation of anterior cruciate ligament primary repair: A time-zero biomechanical study.

Background/objective: During the initial stages of rehabilitation after anterior cruciate ligament (ACL) surgery, a pivotal role is played in ensuring effective recuperation and averting complications. An often-employed strategy to tackle ACL laxity during this period involves the incorporation of synthetic materials for reinforcement. The objective of this study is to compare the effectiveness of conventional suture tape and multiple high-strength sutures as augmentation techniques for ACL repair.

Report on hematopoietic cell transplantations performed in 2018/2019 focusing on the trends of selection of stem cell sources in the Asia-Pacific region: APBMT Activity Survey.

The number of hematopoietic stem cell transplantations (HCTs) is increasing annually worldwide, and the Asia-Pacific (AP) region is no exception. We report on the absolute number of HCTs in 2018 and 2019 and the trends in graft selection and disease indication in the past few decades. In 2018, 24,292 HCTs were performed in the AP region, of which 8,754 (36.

Personalized Care in Eye Health: Exploring Opportunities, Challenges, and the Road Ahead for Chatbots.

In modern eye care, the adoption of ophthalmology chatbots stands out as a pivotal technological progression. These digital assistants present numerous benefits, such as better access to vital information, heightened patient interaction, and streamlined triaging. Recent evaluations have highlighted their performance in both the triage of ophthalmology conditions and ophthalmology knowledge assessment, underscoring their potential and areas for improvement.

Clinical utility of procalcitonin in implementation of procalcitonin-guided antibiotic stewardship in the South-East Asia and India: evidence and consensus-based recommendations.

Introduction: The South-East Asian (SEA) region and India are highly susceptible to antibiotic resistance, which is caused due to lack of antimicrobial stewardship (AMS) knowledge, uncontrolled use of antibiotics, and poor infection control. Nonadherence to national/local guidelines, developed to combat antimicrobial resistance, is a major concern. A virtual advisory board was conducted to understand the current AMS standards and challenges in its implementation in these regions.

Systematic Review of Clinical Outcomes After Proximal Tibia Anterior Closing-Wedge Osteotomy With ACL Reconstruction.

Background: While increased posterior tibial slope (PTS) is an important risk factor for failure after anterior cruciate ligament (ACL) reconstruction, controversy exists regarding indications and outcomes of proximal tibia anterior closing-wedge osteotomy (ACWO) with concomitant ACL reconstruction in patients with ACL tears.

Purpose: To assess clinical outcomes after combined ACL reconstruction and proximal tibia ACWO.

Study Design: Systematic review; Level of evidence, 4.

Novel Therapeutic Approaches in Treatment of Acute-on-Chronic Liver Failure.

Acute-on-chronic liver failure (ACLF), a clinical syndrome that can develop at any stage in the progression of cirrhotic liver disease, is characterized by an acute decompensation in liver function with associated multiorgan failure and high short-term mortality. Current evidence points to ACLF being reversible, particularly in those at the lower end of the severity spectrum. However, there are no specific treatments for ACLF, and overall outcomes remain poor.

Attitudes towards LGBTQ+ individuals among Thai medical students.

Background: The global population of individuals with gender diversity or LGBTQ+ people is on the rise. However, negative attitudes towards LGBTQ+ individuals persist, even among healthcare professionals, creating barriers to healthcare access. These attitudes are influenced by cultural variations worldwide and necessitate investigation across diverse cultures and settings.

Does needle size matter? Effects of micro-hypodermic needle injections of botulinum toxin type A in patients with hemifacial spasm.

Introduction: Botulinum toxin type A (BoNT/A) injections are the first-line treatment for primary hemifacial spasms (HFS), but require frequent painful injections. Although micro-hypodermic needles are commonly used for aesthetic BoNT/A injections to lessen pain and bruising, their benefits in HFS remain unclear.

Objective: To compare side effects of BoNT/A injection, specifically pain and bruising, between primary HFS patients who received injections using micro-hypodermic needles (34-G) and those using standard needles (30-G).

The dos, don'ts, and nuances of thrombophilia testing.

Considerable progress has been made in elucidating genetic and biologic risk factors for venous thromboembolism (VTE). Despite being able to identify heritable defects in a substantial proportion of patients with VTE, testing has not, in general, proven useful in management. Despite efforts to reduce inappropriate testing, it often falls to the hematologist to consult on patients having undergone thrombophilia testing.

The Efficacy of Metoclopramide for Gastric Visualization by Endoscopy in Patients With Active Upper Gastrointestinal Bleeding: Double-Blind Randomized Controlled Trial.

Introduction: The 2021 American College of Gastroenterology Guidelines suggested using of intravenous erythromycin before endoscopy in patients with upper gastrointestinal bleeding (UGIB) to enhance endoscopic view and reduce the need for repeat endoscopy. Evidence on intravenous metoclopramide, which is more accessible, is scant, especially in patients with active UGIB. This study aimed to evaluate the efficacy of metoclopramide for gastric visualization in patients with active UGIB.

Genetic variations of type 2 and type 3 von Willebrand diseases in Thailand.

Aims: Von Willebrand disease (VWD) is an inherited haemostatic disorder with a wide range of bleeding phenotypes based on von Willebrand factor (VWF) levels. Multiple assays including gene analysis are employed to correctly diagnose VWD and its subtypes. However, data on mutations among Southeast Asian populations are lacking.