Mahidol University's Institutional Repository
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Recent Submissions
Bioprosthetic Aortic Valve Thrombosis Presenting as Recurrent Inferior Wall STEMI
(2026-03-11) Kittiboonya T.; Leelasithorn S.; Chandavimol M.; Sasiprapha T.; Kongrat S.; Methachittiphan N.; Kittiboonya T.; Mahidol University
Background: Prosthetic aortic valve thrombosis is an extremely rare cause of ST-segment elevation myocardial infarction (STEMI). This case highlights the diagnostic challenge of this clinical entity. Case Summary: A 71-year-old man with bioprosthetic aortic and mitral valve replacement 15 years prior presented with recurrent inferior wall STEMI. Coronary angiography showed no significant stenosis, consistent with myocardial infarction with nonobstructive coronary arteries (MINOCA). Transesophageal echocardiogram revealed a 2-cm mobile thrombus on the right coronary cusp of the prosthetic aortic valve, intermittently occluding the right coronary artery ostium. Discussion: Bioprosthetic valve thrombosis typically occurs early postimplantation; this case is notable for its 15-year latency. It underscores the need to consider valve thrombosis in patients with bioprosthetic valves presenting with embolic phenomena or MINOCA, even long after surgery. Take-Home Messages: Clinicians should maintain a high suspicion for prosthetic valve thrombosis as a cause of MINOCA. Early diagnosis using comprehensive imaging, particularly transesophageal echocardiography, is critical to prevent complications.
Intraureteric Indocyanine Green in Laparoscopic Endometriosis Surgery 10 Steps
(2026-01-01) Panichyawat N.; Duchon M.; Chauvet P.; Bourdel N.; Panichyawat N.; Mahidol University
Objective: To demonstrate a step-by-step technique of intraoperative intraureteric indocyanine green (ICG) administration under cystoscopic guidance to localize intraoperative ureters under near-infrared fluorescence imaging during laparoscopic deep endometriosis surgery. The standardization and description of the surgery in 10 steps are the main objective of this video (Supplemental Video 1). Setting: A university tertiary care hospital. Participant: Patient who was diagnosed with deep endometriosis underwent laparoscopic surgery treatment. The local institutional review board ruled that approval was not required for this video article because the video describes a technique and does not report a clinical case. Intervention: Ten main steps of cystoscopy with intraureteral ICG administration to allow real-time visualization of intraoperative ureters during adhesiolysis and endometriosis resection were described in detail: Step 1: preparing ICG; step 2: preparing ureteric catheter; step 3: preparing instruments for cystoscopy; step 4: cystoscopy; step 5: identifying the ureteric orifices; step 6: inserting ureteric catheter through ureteric orifices; step 7: injecting ICG; step 8: laparoscopic surgery; step 9: intraoperative visualization of ureters; and step 10: deep endometriosis surgery. Conclusion: The use of cystoscopy-guided intraureteric ICG dye instillation and intraoperative ureteric near-infrared fluorescence imaging is a safe and effective tool for visualization of the ureteric position precisely and in real time, making the procedure faster and easier and reducing the intraoperative ureteric complication during laparoscopic deep endometriosis surgery [1-5].
Training peer supporters in a single-centre medical school: a mixed-methods evaluation using Kirkpatrick’s Four-Level model
(2026-12-01) Bovornchutichai P.; Rojsirikulchai N.; Puapornpong P.; Pasuntaviroj N.; Piyawutthiseth P.; Thebraksa S.; Puranitee P.; Awirutworakul T.; Bovornchutichai P.; Mahidol University
Background: Medical students face high levels of psychological distress but often hesitate to seek formal support. Peer support programmes offer a student-centred approach to fostering well-being and resilience. This study examines the educational impact of the Ramathibodi Peer Support Programme (Rama PSP), a student-led initiative in Thailand, with a focus on the development of peer supporters. Method: Thirty-seven medical students across all six years participated in a 10-week training programme. A mixed-methods design was employed, guided by Kirkpatrick’s Four-Level Model of Training Evaluation. Quantitative data were collected using the mid- and end-course assessments, Rama PSP aptitude assessment, PHQ-9 and GAD-7. Qualitative data were obtained through post-training interviews and analysed using content analysis. Results: Peer supporters demonstrated self-reported significant improvements in key competencies, including clarifying questions, referrals and boundary-setting. No significant changes were observed in PHQ-9 and GAD-7 levels, consistent with the programme’s educational–not therapeutic–focus. Qualitative findings revealed substantial growth in self-awareness (96.2%), self-esteem, self-management and social awareness. Peer supporters reported applying their skills in both formal and informal peer interactions. Conclusions: Rama PSP suggests that structured peer support training may be associated with perceived improvements in interpersonal competencies and developmental outcomes among medical students. By focusing on peer supporters, the programme may support professional identity formation and complement traditional curricula. Integrating such training could help foster empathy, resilience and a supportive learning environment; however, further research using objective measures is needed.
Parasitological efficacy of seasonal malaria chemoprevention in Nampula, northern Mozambique
(2026-03-01) Bonnington C.; Sitoe M.; Pulido Tarquino I.A.; Enosse S.M.; Sararat C.; Suwannasin K.; Proux S.; Koesukwiwat U.; Tarning J.; Imwong M.; Theiss-Nyland K.; Nosten F.H.; White N.J.; Bonnington C.; Mahidol University
Background Deployment of seasonal malaria chemoprevention (SMC) for young children using monthly sulphadoxine-pyrimethamine-amodiaquine (SPAQ) has recently been extended to Central and East Africa. Methods A pilot pharmacometric assessment was nested within a larger deployment of SMC in a high malaria transmission area in northern Mozambique. SPAQ was given to 460 healthy children in two large villages. Simultaneous filter-paper blood spot malaria quantitative PCRs, blood slide microscopy and antimalarial drug measurements were taken before, then 7 and 28 d after first SPAQ administration. Results After SPAQ, parasitaemia prevalence decreased from 68% to 41%. Among children followed successfully for 28 d, malaria parasitaemia prevalence declined from 71% to 44%. Preventive efficacy was 97% for Plasmodium ovale and 42% for Plasmodium falciparum. Reinfections (N=50 with sufficient DNA for genotyping) and recrudescences (N=3) often grew through high concentrations of desethylamodiaquine, yet all 250 P. falciparum isolates genotyped were Pfcrt 76K, a molecular marker of 4-aminoquinoline susceptibility. One-third (21/64) of microscopy-detectable breakthrough P. falciparum infections had patent gametocytaemia. There was a clear chemoprevention exposure–response relationship evident for desethylamodiaquine, but not for sulphadoxine or pyrimethamine. Conclusions In Nampula, northern Mozambique, amodiaquine had low parasitological efficacy and sulphadoxine and pyrimethamine did not contribute significantly to chemoprevention.
Standardized Omics at a Global Scale: A Perspective on Barriers, Opportunities, and Lessons Learned
(2026-03-03) Odenkirk M.T.; Amponsah E.A.; Anim A.; Chaura J.; Read M.L.; Shah S.; Koroijiuta J.; Chimasangkanan J.; de la Parra J.; Ahmed S.; Prenni J.E.; Odenkirk M.T.; Mahidol University
Omics science has expanded rapidly with innovations in analytical chemistry and data science, yet equitable global participation remains limited by uneven access to infrastructure, training, and additional complex barriers. Recognition of the value and necessity of large, comparable datasets has motivated community-wide efforts to build consensus, develop open-source resources, and promote methodological standardization. One such initiative, The Periodic Table of Food Initiative (PTFI), recently distributed standardized workflows for food analysis to 19 international partner laboratories. Here, we share stories and lessons learned from the initial dissemination of these methods, highlighting obstacles encountered across global laboratories. Specifically, we document widespread logistical challenges, ranging from instrument procurement to routine operation, faced by low- and middle-income countries (LMICs). These barriers highlight stark contrasts in scientific infrastructure. For example, common reagent shipments averaged 4.25 days in high-income countries (HICs, four responses) compared to 65.6 days in LMICs (six responses), a staggering 1444% increase. Equally important, our findings reveal key drivers of laboratory adoption of standardized omics, which directly influence the long-term viability of global omics initiatives. As omics science continues to evolve, the community faces both opportunities and responsibilities to develop globally accessible, end-to-end workflows that support the generation of harmonious data. By sharing these stories, we aim to raise awareness of the challenges and opportunities inherent in global standardization efforts, emphasizing that democratizing omics and sustaining such initiatives will require collective commitment from the international scientific community.