Medication underuse in real-life practice: the impact of galcanezumab towards achieving very low frequency episodic migraine in a southeast Asian middle-income nation.

Background: Migraine progression, particularly from episodic to chronic migraine (CM), increases disease burden and healthcare costs. Understanding the new concept of "Medication Underuse Headache" should encourage the health care provider to consider early intervention with calcitonin gene-related peptide (CGRP) monoclonal antibodies. Galcanezumab given early in the course of the disease, may prevent migraine chronification and have a robust response, moreso than when initiated in later stages of migraine.

Detecting freezing of gait: A comprehensive toolkit for enhanced Parkinson's assessment.

Introduction: Detecting Freezing of Gait (FOG) poses challenges, with the subjective 6-item FOG Questionnaire relying solely on patient perception. We aim to create a holistic FOG Detection Toolkit combining subjective and objective elements (descriptions, images, and videos) to improve FOG detection precision.

Methods: Development of the FOG Detection Toolkit involved a detailed cover sheet on FOG and its triggers, along with video exemplars and a 4-item FOG-specific self-assessment questionnaire, all rigorously validated.

Prediction of axillary nodal burden using preoperative magnetic resonance imaging scoring in patients with clinically node-negative breast cancer: a retrospective cohort study.

Background: Axillary lymph node metastasis (ALNM) is a significant predictor of overall patient survival; thus, precise evaluation of ALNM is essential for staging breast cancer, informing multimodal treatment strategies, and ensuring optimal patient care. This study aimed to establish a magnetic resonance imaging (MRI) scoring system for predicting extensive axillary nodal metastasis in patients with clinically node-negative breast cancer derived from preoperative breast and axillary MRI.

Methods: This study included 226 patients with clinically node-negative breast cancer who underwent preoperative breast and axillary MRI between January 1, 2010 and December 31, 2020 at King Chulalongkorn Memorial Hospital.

Eligibility Criteria of Randomized Clinical Trials in Critical Care Medicine.

Importance: Eligibility criteria for randomized clinical trials (RCTs) are designed to select clinically relevant patient populations. However, not all eligibility criteria are strongly justified, potentially excluding marginalized groups, and limiting the generalizability of trial findings.

Objective: To summarize and evaluate the justification of exclusion criteria in published RCTs in critical care medicine.

Decoding the blueprint of receptor binding by filoviruses through large-scale binding assays and machine learning.

Evidence suggests that bats are important hosts of filoviruses, yet the specific species involved remain largely unidentified. Niemann-Pick C1 (NPC1) is an essential entry receptor, with amino acid variations influencing viral susceptibility and species-specific tropism. Herein, we conducted combinatorial binding studies with seven filovirus glycoproteins (GPs) and NPC1 orthologs from 81 bat species.

Parent-focused online video intervention for promoting parenting sense of competence: a randomized controlled trial.

Background: Apart from child behavioral problems which were ameliorated by increasing parenting skills, parental well-being is one of the important components for development of parenting sense of competence (PSOC), which subsequently affects parenting style and child outcomes. This randomized controlled trial study aims to determine whether a brief asynchronous parent-focused online video intervention (POVI) that was easily accessible would be effective in increasing PSOC and parental well-being.

Methods: One hundred and twenty parents, with a poor Thai Mental Health Indicators-15 score or mild-moderate depression/anxiety, of children aged 3-10 years, were randomized into two parallel groups, intervention and control groups (1:1).

Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study.

Prostate cancer (PCa) is one of the most common cancers among men worldwide, and robot-assisted radical prostatectomy (RARP) is a widely used treatment for localized PCa. Achieving pentafecta outcomes, which include continence, potency, cancer control, free surgical margins, and no major complications, is a critical measure of surgical success and long-term prognosis. However, predicting these outcomes remains challenging.

Unusual presentation of brisk active small bowel bleeding from jejunal GIST.

This case emphasises the difficulties in diagnosing a patient with brisk active small bowel bleeding and the differential diagnostic process of identifying tumour types preoperatively using imaging information. This case also underscores the importance of the surgical approach in different scenarios. Despite advancements in small bowel imaging, identifying the source and causes of small bowel bleeding remains challenging, particularly in life-threatening situations.

Anti-inflammatory effects of moxifloxacin and levofloxacin on cadmium-activated human astrocytes: Inhibition of proinflammatory cytokine release, TLR4/STAT3, and ERK/NF-κB signaling pathway.

Cadmium is a non-essential element and neurotoxin that causes neuroinflammation, which leads to neurodegenerative diseases and brain cancer. To date, there are no specific or effective therapeutic agents to control inflammation and alleviate cadmium-induced progressive destruction of brain cells. Fluoroquinolones (FQs), widely used antimicrobials with effective blood-brain barrier penetration, show promise in being repurposed as anti-inflammatory drugs.

Factors Associated With "Sterile Cystic Formation" Following the Application of BioGlue® in Brain Surgery and Review of Literature.

Introduction BioGlue® (CryoLife, Inc, Kennesaw, GA), despite being claimed to be a safe and harmless sealant, reportedly has several adverse effects including surgical wound dehiscence. This study aimed to examine the factors that may contribute to this unfavorable outcome in cranial surgery. Methods A retrospective cross-sectional analysis was conducted on patients who underwent brain surgery with the use of BioGlue® between January 2015 and December 2022.

Author Response: Continuous Infusion of Propofol or Dexmedetomidine should not be the First Choice to Prevent Postoperative Delirium in Patients after Hip Fracture.

Ekkapat G, Chokengarmwong N. Author Response: Continuous Infusion of Propofol or Dexmedetomidine should not be the First Choice to Prevent Postoperative Delirium in Patients after Hip Fracture. Indian J Crit Care Med 2025;29(1):88-89.

A prospective comparative trial to determine the optimal number of EUS-guided fineneedle passes for successful organoid creation in pancreatic ductal adenocarcinoma.

Introduction: EUS-guided fine-needle organoid creation (EUS-FNO) from pancreatic cancer (PC) has been increasingly important for precision medicine. The cost for pancreatic organoid creation is substantial and close to 2000 USD/specimen in our institution, and the specimen has to be processed immediately after tissue acquisition so the more passes and specimens, the higher cost of organoid creation will incur. To date, no prospective comparison trial has answered how many needle passes of EUS-FNO needed for a successful organoid creation.

A Convolutional Neural Network Using Anterior Segment Photos for Infectious Keratitis Identification.

Purpose: To develop a comprehensively deep learning algorithm to differentiate between bacterial keratitis, fungal keratitis, non-infectious corneal lesions, and normal corneas.

Methods: This retrospective study collected slit-lamp photos of patients with bacterial keratitis, fungal keratitis, non-infectious corneal lesions, and normal cornea. Causative organisms of infectious keratitis were identified by either positive culture or clinical response to single treatment.

Demographic Profile and Clinical Characteristics of Fuchs Endothelial Corneal Dystrophy in Thai Patients: A Retrospective Cohort in a Tertiary Referral Center.

Purpose: To describe the demographic profile, clinical characteristics, and treatment trends of Fuchs endothelial corneal dystrophy (FECD) in Thai patients, reflecting the evolving landscape of corneal transplantation in this region.

Patients And Methods: This retrospective cohort study included 900 patients (1,743 eyes) diagnosed with FECD at a tertiary referral center in Thailand between January 2017 and June 2023. Demographic, clinical, and surgical data were analyzed, focusing on best-corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell density (ECD), surgical interventions, and graft survival rate.

Overweight, obesity, and cardiovascular disease in heterozygous familial hypercholesterolaemia: the EAS FH Studies Collaboration registry.

Background And Aims: Overweight and obesity are modifiable risk factors for atherosclerotic cardiovascular disease (ASCVD) in the general population, but their prevalence in individuals with heterozygous familial hypercholesterolaemia (HeFH) and whether they confer additional risk of ASCVD independent of LDL cholesterol (LDL-C) remains unclear.

Methods: Cross-sectional analysis was conducted in 35 540 patients with HeFH across 50 countries, in the EAS FH Studies Collaboration registry. Prevalence of World Health Organization-defined body mass index categories was investigated in adults (n = 29 265) and children/adolescents (n = 6275); and their association with prevalent ASCVD.

Advocacy in Action: International Patient Group Improves Hereditary Angioedema Diagnosis and Care Across the Asia-Pacific.

This study demonstrates that patient advocacy groups significantly enhance medication availability and improve diagnosis of hereditary angioedema (HAE), particularly in emerging economies within the Asia-Pacific region. This study supports integrating patient advocacy group involvement into management guidelines, emphasising their role in improving access to diagnostics and treatment for HAE.

Artificial Intelligence for Cervical Spine Fracture Detection: A Systematic Review of Diagnostic Performance and Clinical Potential.

Study Design: Systematic review.

Objective: Artificial intelligence (AI) and deep learning (DL) models have recently emerged as tools to improve fracture detection, mainly through imaging modalities such as computed tomography (CT) and radiographs. This systematic review evaluates the diagnostic performance of AI and DL models in detecting cervical spine fractures and assesses their potential role in clinical practice.

Mental health professionals' perspectives and suggestions on religious and superstitious activities engagement of patients with serious mental illness: A national survey in Thailand.

Background: Patients with serious mental illness (SMI) often engage in religious and superstitious activities. The implications of such engagements remain unclear, with no established guidelines for mental health professionals.

Aims: This study aimed to survey perspectives and gather suggestions from various disciplines within mental healthcare regarding the engagement in religious/superstitious activities of SMI patients: schizophrenia spectrum disorders, bipolar disorder, major depressive disorder.

MicroRNA biomarkers and host response pathways in severe pulmonary hemorrhagic syndrome due to leptospirosis: A multi-omics study.

Background: Severe pulmonary hemorrhagic syndrome (SPHS) remains a fatal complication of leptospirosis with poorly understood mechanisms and an urgent need for effective biomarkers.

Methods: A nested case-control analysis was conducted using blood specimens from two previous Thai leptospirosis cohorts. Candidate microRNAs were initially discovered through a global profiling of 798 serum microRNAs in five SPHS and seven non-SPHS patients, and then validated using real-time polymerase chain reactions in 168 patients.

Increased atherogenicity in mood disorders: a systematic review, meta-analysis and meta-regression.

Background: Major depressive disorder (MDD) and bipolar disorder (BD) often coexist with metabolic syndrome. Both are linked to increased atherogenicity and a higher risk of cardiovascular diseases. Nevertheless, a comprehensive analysis of key atherogenic biomarkers in MDD/BD is still lacking.

Transforming Non-Digital, Clinical Workflows to Detect and Track Vision-Threatening Diabetic Retinopathy via a Digital Platform Integrating Artificial Intelligence: Implementation Research.

Introduction: Screening diabetic retinopathy (DR) for timely management can reduce global blindness. Many existing DR screening programs worldwide are non-digital, standalone, and deployed with grading retinal photographs by trained personnel. To integrate the screening programs, with or without artificial intelligence (AI), into hospital information systems to improve their effectiveness, the non-digital workflow must be transformed into digital.

Neutralization of omicron subvariants and antigenic cartography following multiple COVID 19 vaccinations and repeated omicron non JN.1 or JN.1 infections.

The ongoing emergence of SARS-CoV-2 variants, combined with antigen exposures from different waves and vaccinations, poses challenges in updating COVID-19 vaccine antigens. We collected 206 sera from individuals with vaccination-only, hybrid immunity, and single or repeated omicron post-vaccination infections (PVIs), including non-JN.1 and JN.

The effects of mandibular setback surgery on the upper airway and sleep quality in skeletal Class III patients and comparison with control subjects: a pilot study.

The aim of this study was to determine the effects of mandibular setback surgery exceeding 5 mm on upper airway and sleep quality in skeletal Class III patients, with comparisons to Class I controls. Sixteen individuals per group were selected based on their ANB angle and surgical need. 2D and 3D airway analyses were conducted.

Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis.

Background:  Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year.

Methods:  This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital.