Diabetic fetopathy associated with bilateral adrenal hyperplasia and ambiguous genitalia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Many fetal malformations can occur because of maternal diabetes. However, ambiguous genital organs have never been reported as an associated finding in the literature. This is the first report of associated ambiguous genital organ and bilateral adrenal hyperplasia in a case of diabetic fetopathy.</p> <p>Case presentation</p> <p>A 19-year-old Thai primigravida with familial history of diabetes mellitus (DM) was diagnosed as having gestational DM type 2, based on 100 g oral glucose tolerance test, and was poorly controlled with insulin injections. Delayed targeted ultrasonography at 28 weeks gestation revealed multiple fetal anomalies. The woman underwent low transverse cesarean section at 30 weeks gestation due to preterm labor and transverse lie. The newborn with ambiguous genitalia was delivered but expired after birth. Autopsy findings revealed alobar holoprosencephaly, a prominent forehead, hypotelorism, an absent nose, absent bilateral ears, median cleft lip and palate, preaxial polydactyly of the right hand, accessory spleens, single umbilical artery, markedly enlarged adrenal glands and ambiguous external genitalia The subsequent fetal chromosomal study revealed 46,XX.</p> <p>Conclusion</p> <p>We describe a case of diabetic fetopathy with classic facial malformation and preaxial hallucal polydactyly which has been proposed as a marker of diabetic embryopathy. Bilateral adrenal hyperplasia with ambiguous genitalia, an uncommon associated anomaly, was also identified. It is controversial whether adrenal hyperplasia can be a novel feature of diabetic fetopathy or just a coincidental finding. Further observation and adequate investigation are needed in such cases.</p

Constructions of náksèuk-săa : tracing contested imaginings of the Thai university student

Higher education (HE) has been identified as a key priority for Thai policymakers across historical periods and is often understood to be an important investment that will enhance both social development and economic prosperity. Given the prominence of HE in Thai government policy and the significant government revenues that flow into HE, the Thai university student or náksèuk-săa is often a figure under intense national scrutiny. Despite this significant interest, the ways in which náksèuk-săa are conceptualised has been under-considered in scholarly accounts. This chapter responds to these gaps, taking náksèuk-săa seriously as an important educational subject worthy of detailed attention. Following analysis of a corpus of HE policy texts spanning three decades, we discern four key imaginings of náksèuk-săa: future worker, preserver of culture, customer and the ‘new gen’ student. These imaginings have arisen in response to the changing economic and political circumstances of the nation. However, through our analysis we characterise náksèuk-săa as a complex figure where multiple constructions are both coexisting and in conflict. Our chapter makes a contribution to studies of Thai HE by connecting together a highly dispersed literature, and by inviting greater reflection about which ideas of the student might be carried forward, and which ought to be contested. By focusing on Thai HE, we also offer a new perspective on global conversations about the idea of the university student

Teaching democracy while students leave their shoes at the door : attending to mundane practices of power inequality in Thai schools

Thailand experienced a democratic revolution in 1932, and for over 80 years has identified as a constitutional monarchy. Despite being recognised then as relatively progressive within Southeast Asia, over the past decade Thailand’s democracy has been in oscillation, if not regress. Some public support for coups d’état remains, elections have been popularly opposed or stalled, and ‘special mechanisms’ have been normalised into the country’s political culture. At the same time, the notion of individual rights often remains a foreign concept in practice. Such phenomena are in contrast to attempts at integrating democratic and civic education in schools, the purpose of which have been to foster democratic values towards the political development of the nation. Focusing on the mundane occurrences that have been overlooked in previous attempts at educational reform, this chapter seeks to uncover and problematise quotidian schooling practices in Thailand. We contend that ordinary school routines work to reproduce underlying misconceptions about democracy that remain prevalent across Thai society. Practices common across public schools that we critique include: students being the only group required to take off their shoes before entering classrooms, the differences between teachers’ and students’ meals, and the norm of classroom interruptions by school administration. We argue that such subtle practices may influence students’ beliefs, behaviours and learning about democracy in spite of the intentions of the formal curriculum. Educating students about democracy, therefore, requires attention to the hidden curriculum of habits and values embedded within ordinary school practices

Narratives of ‘stuckness’ among North–South academic migrants in Thailand : interrogating normative logics and global power asymmetries of transnational academic migration

Higher education (HE) researchers have become increasingly interested in transnational academic mobility as a field of inquiry. A phenomenon frequently associated with ‘progress’ and ‘development’, research accounts are written about academic migrants who harness career momentum and experience upward social mobility resulting from their travels. In contrast to scholarly accounts which link mobility with progress of many kinds, this article foregrounds under-considered accounts of migrant academics who describe themselves as moving ‘backwards’ and feeling ‘stuck’. Drawing on an empirical study with 25 migrant academics employed in Thailand, we investigate ‘stuckness’ via two narratives of Global North academics. These narrative portraits reveal how migration may be prompted by career immobilities and that migrant academics in Thailand may perceive that they lack opportunities for career progression. We also examine how Thailand is configured as a ‘weird’ mobility destination, one that may struggle for recognition as a site for international academic career progress. The key contribution we make to critical academic mobilities scholarship is to weave in decolonial analyses of the geopolitics of knowledge production, examining ‘South’ and ‘stuckness’ as potentially linked categories for North-to-South academic migrants. We argue that narratives of stuckness among Northern academic migrants in Thailand are deeply interwoven with assumptions made about desirable directions of global travel, assumptions which are born from the profound inequalities which characterise global HE’s core/periphery structure

Analysing the national and institutional policy landscape for foreign academics in Thailand : opportunity, ambivalence and threat

While academic expatriation is a longstanding global phenomenon, Thailand has emerged in recent years as an increasingly popular destination for internationally mobile academics. The objective of this article is to identify current policy dispositions towards foreign academics at the national and institutional levels in Thailand. The article finds that within Thai higher education policy discourse, foreign academics are framed in three primary ways: as opportunities, as absent or unimportant, and as threats to Thailand. While foreign academics are often cast as experts who might accelerate the economic development of the nation and enhance the competitiveness of the Thai higher education sector, they may also be presented as threats to Thai culture, values and security. However, the most prevalent disposition found in this study was one of absence and marginality, suggesting a high degree of ambivalence toward foreign academics. The article concludes with implications for future researchers and policymakers to consider