Biomedical Sciences and Clinical Medicine

Clinical and Imaging Features of Melioidosis: A Study at Maharaj Nakorn Chiang Mai Hospital

Mon, 25 May 2026 00:00:00 +0700

Objective Melioidosis is a life-threatening infectious disease caused by Burkholderia pseudomallei. The clinical presentations are diverse with high mortality. The disease requires timely and appropriate antibiotics. Imaging studies play an important role in the diagnosis. This study evaluated clinical manifestations, risk factors, and imaging patterns of melioidosis.

Methods This retrospective study reviewed medical records and imaging studies of patients with melioidosis conclusively identified by cultures at Maharaj Nakorn Chiang Mai Hospital during 2017–2023.

Results Of 33 melioidosis patients, most were male (75.76%) and the mean age was 57. Fever (66.67%) and localized pain (48.48%) were the common symptoms, while septicemia occurred in 33.33% of cases. Diabetes mellitus (48.48%) was the predominant risk factor. Imaging studies, including chest radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography, detected infections in 90.90% of the patients, with lung involvement being the most frequent (39.39%). CT was particularly effective in identifying pulmonary and visceral abscesses,
while MRI aided in diagnosing osteoarticular infections. Imaging successfully guided specimen collection in 78.57% of hemoculture-negative cases.

Conclusions This study underscores the importance of imaging in diagnosing melioidosis, particularly in patients with risk factors, and highlights the need for tailored imaging strategies based on clinical features.

Efficacy of Task-Oriented Mirror Therapy on Enhancing Functional Recovery for Unilateral Neglect Post Stroke

Mon, 25 May 2026 00:00:00 +0700

Objective Stroke is a neurological condition with multiple complications, one of the most common being Unilateral Spatial Neglect (USN), where patients lose awareness of one side of their body. Both task-oriented
mirror therapy and task-oriented therapy can aid in improving functional performance. The objective of the study was to compare the efficacy of task-oriented mirror therapy with task-oriented therapy in improving functional recovery among patients with USN.

Methods This was a comparative study of 30 individuals. Using the sealed envelope method, participants were randomly assigned into group A or group B with 15 individuals in each group as per the inclusion and exclusion criteria. Group A was administered task-oriented mirror therapy and group B was administered task-oriented therapy. The therapy sessions were conducted for 45 minutes daily, 5 times a week, over a span of 4 weeks. The outcome measures were evaluated using the Catherine Bergego Scale (CBS) and the Line Bisection Test.

Results Task-oriented mirror therapy had a greater impact on unilateral spatial neglect compared to task-oriented therapy without a mirror. A notable difference was found in the post-test mean and standard deviation values for CBS in group A [8.20 ± 2.624] and Group B [15.07 ± 3.105], as well as for line bisection test in group A [7.27 ± 1.534] and Group B [14.53 ± 2.973], both with a p < 0.001.

Conclusion Task-oriented mirror therapy showed better improvement in functional outcomes for patients with unilateral spatial neglect compared to task-oriented therapy.

Comparative Assessment of Serum Vitamin D and Calcium Levels in Hypothyroid Patients in Albayda, Libya

Nusieba A. Mohammed Ibrahim, Yahya Saber E. Mansour — Mon, 25 May 2026 00:00:00 +0700

Objective Vitamin D is essential for the proper functioning of numerous organs, including the thyroid gland. For that reason, a deficiency in vitamin D is considered a potential risk factor for developing various thyroid disorders, particularly hypothyroidism. The present study aimed to evaluate the serum concentrations of vitamin D and calcium in individuals who have been diagnosed with primary hypothyroidism.

Methods The research was conducted on a cohort of 100 hypothyroid patients at the Department of Internal Medicine, Albayda Medical Center, in Albayda, Libya. Serum levels of vitamin D, calcium, and thyroid profiles (thyroid stimulating hormone (TSH), T3, and T4) were measured in all participants. A control group consisting of 100 healthy individuals was used for comparison. Statistical analysis was performed using SPSS software version 20.0 with independent t-tests and Pearson correlation analysis.

Results Our findings indicate that the serum levels of vitamin D and calcium were significantly lower among the hypothyroid group compared to the control group (12.21 ± 2.02 ng/mL and 4.40 ± 1.24 mg/dL vs 45.53 ± 10.51 ng/mL and 10.88 ± 1.45 mg/dL, p = 0.008 and 0.006, respectively). However, we noticed non-significant differences in changes in the serum levels of vitamin D and calcium between males and females in the hypothyroid group (p = 0.578 and 0.410, respectively). Pearson correlation analysis indicated that the TSH levels of the hypothyroid group had statistically significant negative correlations with the serum vitamin D and calcium levels (r = −0.144, p = 0.030 and r = −0.145, p = 0.029, respectively).

Conclusions Based on these results, it is strongly advised that individuals with hypothyroidism be screened for vitamin D and calcium deficiencies and, if necessary, receive appropriate supplementation.

Prevalence of Neurological Abnormalities from Neuroimaging in Acute Acquired Comitant Esotropia

Mon, 25 May 2026 00:00:00 +0700

Objective This study aimed to determine the prevalence and characteristics of patients with acute acquired comitant esotropia (AACE) who had abnormal findings on neuroimaging.

Methods A retrospective review of data from patients diagnosed with AACE who had an onset age of greater than six months, cycloplegic refraction of less than +3.00 spherical diopters, and had undergone neuroimaging between 2014 and 2024 was conducted.

Results A total of 45 patients, 28 males (62.2%) were included in the study. The overall mean age was 10.2 years, and the mean angle of deviation was 36.11 prism diopters (PD) for distance and 36.1 PD for near. Of the 45 patients, 43 (95.6%) had normal neuroimaging and 2 (4.4%) had abnormal neuroimaging. Abnormal findings consisted of a small vascular anomaly in one patient and an arachnoid cyst in another. The mean age at onset was 5.5 years in the abnormal neuroimaging group and 8.8 years in the normal neuroimaging group (p = 0.46). The mean near angle of deviation was 27.5 PD versus 36.8 PD (p = 0.21) in patients with abnormal and normal neuroimaging, respectively. The mean distance deviation was 25 PD and 36.9 PD (p = 0.19) in the abnormal and the normal neuroimaging group, respectively. No patients demonstrated associated abnormal neurological symptoms or signs.

Conclusions No predictive factors associated with abnormal neurological findings were identified as statistically significant. Despite the infrequency of abnormal neuroimaging findings in AACE and the absence of identified predictive factors, clinicians should remain aware of the possibility of underlying brain abnormalities.

Gout Through the Ages: Past, Present, and Future

Worawit Louthrenoo — Mon, 25 May 2026 00:00:00 +0700

Gout is a disease unique to humans, resulting from the evolutionary loss of functional uricase, the enzyme that converts uric acid to the more soluble allantoin. This loss causes elevation of serum uric acid (SUA). With sustained hyperuricemia, deposition of monosodium urate (MSU) crystals in and around joints and extra-articular tissues occurs. Clinically, gout manifests as recurrent episodes of acute inflammatory arthritis and, when untreated or undertreated, may progress to more frequent flares, tophus formation, and structural joint damage. Persistent hyperuricemia is also linked to nephrolithiasis, chronic kidney disease progression, and increased cardiometabolic burden. This review summarizes gout across the past, the present, and the future. Historical perspectives span early descriptions dating to the Egyptian period and extend through the period just prior to the discovery of light microscopy that led to enabling identification of MSU crystals. The modern era is reviewed through the development of classification criteria; mechanisms of MSU crystal-induced inflammation; genetic determinants of urate homeostasis; and the roles of renal and intestinal urate transport in hyperuricemia. Metabolomic signatures and gut microbiota are discussed alongside current approaches to urate- lowering therapy (ULT) and flare prevention. Future directions include precision, individualized medicine integrating clinical features with molecular and imaging data to improve risk stratification and guide therapy. They also include targeted anti-inflammatory strategies, newer ULT and uricosuric agents, and the application of metabolomics and microbiome science. Finally, the long-term possibility of uricase gene restoration as a transformative approach to reconstitute urate metabolism and potentially modify disease course is discussed.