Greater Mekong Subregion Medical Journal

Severe Limbs Ischemia with Retiform Purpura: Serious Manifestations in Acute Meningococcemia

2025-04-24T14:28:28+07:00

Acute meningococcemia often presents with severe skin manifestations, such as limb ischemia and purpura fulminans. Prompt diagnosis and timely treatment are critical to avoid serious complications, including permanent limb loss. We report the case of a 22-year-old man living in a military camp, referred from a community hospital, who developed acute high-grade fever, altered consciousness, and retiform purpura that evolved into purpura fulminans alongside septic shock. His condition rapidly worsened, complicated by bilateral limb ischemia and necrotizing fasciitis, eventually requiring bilateral below knee amputations. This case highlights the importance of early recognition and aggressive management of meningococcemia to improve patient outcomes and prevent irreversible damage.

Antimicrobial Activity of Scutellaria Baicalensis Extract with Different Solvents against Escherichia coli

2025-05-09T15:07:40+07:00

Background: Huang Qin (Scutellaria baicalensis, S. baicalensis) has been used to treat various diseases such as fever, diarrhea, and dysentery. Escherichia coli (E. coli) is a standard part of intestinal microbiota and the common cause of several diseases that come with diarrhea, stomach cramps, and fever.

Objectives: This paper aimed to determine the antimicrobial activity of S. baicalensis extract with different solvents (water, ethanol, and ethyl acetate) against E. coli.

Materials and Method: S. baicalensis is ground into powder and macerated in solvents until exhausted and extracted via evaporation under vacuum. The water extract S. baicalensis (WHQ), ethanol extract S. baicalensis (EtOHHQ), and Ethyl Acetate extract S. baicalensis (EtOAcHQ) dissolved in dimethyl sulfoxide (DMSO). The agar wall diffusion method was used to test antimicrobial activity. The microdilution method determined the minimum inhibitory concentration (MIC) of the extractions. The extractions' minimum bactericidal concentration (MBC) was evaluated from the agar plate, and no microbial growth area was
observed.

Results: The average inhibition zone in MIC of EtOHHQ was 7.33 ± 0.58 mm, EtOAcHQ was 7.67 ± 0.58 mm, Baicalein was 7.67 ± 0.58 mm, while Gentamicin showed 16.33 ± 0.58 mm. MIC of EtOHHQ, EtOAcHQ, and Baicalein were > 2,000 μg/ml, while MIC of Gentamicin was 6.25 μg/ml. MBC of EtOHHQ, EtOAcHQ, and Baicalein were > 2,000 μg/ml, while MBC of Gentamicin was 6.25 μg/ml. WHQ and Baicalin did not show antimicrobial activity against E. coli.

Lipoprotein(a) and Cardiovascular Disease: A Review of Current Evidence and Future Directions

2025-10-20T11:28:50+07:00

Lipoprotein(a), Lp(a), is a type of low-density lipoprotein (LDL) that is now widely understood to be an independent and direct risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis (CAVS). Plasma Lp(a) levels are predominantly (over 90%) genetically determined, making them relatively stable throughout life and unresponsive to lifestyle modifications or most currently available lipid-lowering therapies. The pathophysiology of Lp(a) is complex, involving pro-atherogenic, pro-inflammatory, and pro-thrombotic mechanisms, primarily driven by its unique protein component, apolipoprotein (a) (apo(a)), and its role as the primary carrier of oxidized phospholipids (OxPL). Despite challenges in measurement standardization, a global clinical consensus is emerging, recommending at least a one-time screening for Lp(a) in all adults. The field is on the cusp of a major therapeutic breakthrough with the development of specific Lp(a)-lowering RNA-based therapies, such as pelacarsen and olpasiran, as well as a novel oral agent, muvalaplin, which are in late-stage trials and promise to address this long-recognized risk factor for the first time.

Knowledge, Awareness and Attitude about Human Papilloma Virus (HPV) Infection and HPV Vaccination among Adolescents in Chiang Rai, Thailand

2025-10-09T18:19:42+07:00

Background: Human Papilloma Virus (HPV) is a significant cause of cervical cancer and other HPV-related diseases. The HPV vaccine is an effective method for preventing these conditions, particularly when administered during adolescence.

Objectives: To evaluate the knowledge, awareness, and attitudes of adolescents in Chiang Rai, Thailand, with the aim of identifying key factors that influence the need for HPV vaccination.

Materials and Method: A total of 426 participants were recruited from the secondary schools in Chiang Rai, Thailand. Data were collected through online questionnaires, which included sections on baseline characteristics, knowledge, awareness, attitudes
toward HPV infection and vaccination, and the perceived need for HPV vaccination.

Results: The proportions of participants with high levels of knowledge, awareness, and attitudes about HPV were 72.30%, 14.31%, and 62.68%, respectively. Additionally, 64.08% expressed the need for HPV vaccination. Being female (OR=2.20, p < 0.001), having a high level of awareness (OR=2.96, p=0.007) and attitude toward HPV infection and vaccination (OR=3.35, p = 0.038) were significantly associated with the perceived need for HPV vaccination.

Conclusion: Health promotion about HPV is vital for adolescents, with an emphasis on both females and males. Initiatives to improve awareness and attitude of HPV infection should be implemented to increase vaccination rates and reduce the prevalence of HPV.

Exploring Potential of Phytochemicals from Houttuynia cordata Thunb. as Angiogenesis Inhibitors in Melanoma Treatment: A Molecular Docking Study

2025-03-01T21:04:04+07:00

Background: Houttuynia cordata Thunb. extract has shown programmed cell death induction in melanoma. Antagonism of the VEGF receptors (VEGFR) has been suggested as a potential mechanism of action due to its role in the progression of melanoma. Given the downsides of the current anti-VEGFR drugs, including lack of selectivity and unwanted side effects, the phytochemical constituents of Houttuynia cordata Thunb. were investigated for their inhibition of VEGFR using molecular docking simulations.

Objective: To investigate and identify the efficacy of potential orally-compatible phytochemical constituents that bind and inhibit the ATP binding sites of VEGFR1 and VEGFR2 using molecular docking simulations.

Materials and Method: The X-ray crystal structures of VEGFR1 and VEGFR2 were downloaded and prepared. A total of 74 phytochemical compounds in Houttuynia cordata Thunb. were constructed and energy minimized in 3D format and docked to the ATP binding sites of VEGFR1 and VEGFR2. Drug-like properties were calculated. This is followed by analysis of the binding modes, calculated docking scores and oral pharmacokinetics of potential candidates.

Results: Five compounds, luteolin, quercetin, isorhamnetin, apigenin, and kaempferol, were identified to have acceptable oral pharmacokinetics and docking scores, and were predicted in silico to have adequate VEGFR inhibition. Notably, apigenin and quercetin were predicted to have the best inhibitory action against VEGFR1 and VEGFR2, respectively, i.e., apigenin scored -9.148 kcal/mol against VEGFR1, and quercetin scored -9.945 kcal/mol against VEGFR2.

Conclusion: Luteolin, quercetin, isorhamnetin, apigenin, and kaempferol could serve as potential candidates for effective inhibition of the ATP binding site of VEGFR. In this light, these phytochemical constituents of Houttuynia cordata Thunb. are suggested as potential therapeutics for the treatment of melanoma through direct inhibition of VEGFR at the ATP
binding site. Specifically, apigenin and quercetin were predicted to be the strongest VEGFR1 and VEGFR2 inhibitors and are suggested for in vitro and in vivo drug tests.

Body Mass Index Has Significant Moderate Positive Correlation with High Sensitivity C-Reactive Protein in Overweight and Obese Thai Adults

2025-03-08T20:23:15+07:00

Background: Thailand's population is becoming more sedentary, while obesity, another major health issue, is rising worldwide. This trend increases non-communicable disease risk, especially cardiovascular disease. Chronic low-grade systemic inflammation caused by adipose tissue inflammation can be recognized by a rise in hs-CRP, a biomarker of cardiovascular disease risk. According to earlier studies, hs-CRP is significantly greater in obese people and related to lesser physical activity, but obesity may influence the results.

Objectives: This study aimed to study the association between total physical activity, screen time, and hs-CRP in overweight and obese adults. This study also examines screen time, a sedentary behavior indicator.

Materials and Method: This study was a cross-sectional study conducted in 21 healthy, normal-weight, overweight, and obese Thai adults aged between 20 and 40 years old. Subjects’ body weight and height were measured, and they were interviewed to answer the GPAQ questionnaire and screen time questionnaire.

Results: Using the Pearson correlation coefficient, total physical activity and screen time had no significant correlation with hs-CRP (p > 0.05), while there was a significant, moderate positive correlation between BMI and hs-CRP (r = 0.462, p = 0.035).

Conclusion: Total physical activity and screen time had no significant correlation with hs-CRP in overweight and obese adults. However, BMI had a significant moderate positive correlation with hs-CRP.