Greater Mekong Sub-region Medical Journal (GMS Medicine Journal)

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

2026-01-26T10:39:44Z

Lipoprotein(a) and Cardiovascular Disease: A Review of Current Evidence and Future Directions Phitsanu Boonprasert; Chuthamat Kitisri 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. บทความ (Article)

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

2026-01-26T10:32:25Z

Severe Limbs Ischemia with Retiform Purpura: Serious Manifestations in Acute Meningococcemia Thanetphon Nanthiphatthanachai; Supapat Laodheerasiri 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. บทความ (Article)

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

2026-01-26T10:25:36Z

Antimicrobial Activity of Scutellaria Baicalensis Extract with Different Solvents against Escherichia coli Chin Jia Wei; Thidarat Duangyod; Aunyachuree Ganogpichayagrai; Raksuda Taniguchi; Pawat Thanavachirasin 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. บทความ (Article)

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

2026-01-26T10:15:58Z

Knowledge, Awareness and Attitude about Human Papilloma Virus (HPV) Infection and HPV Vaccination among Adolescents in Chiang Rai, Thailand Wisaka Wanichapichat; Natpailin Lerttrongjitr; Pariyakorn Thossapoldet; Salisa Sommart; Panita Sengpanich; Siracha Sujitkiddee; Paween Tangchitphisut 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. บทความ (Article)