Late-Onset Melorheostosis: A Case Report.

Melorheostosis is a rare benign bone pathology involving bone dysplasia and hyperostosis. The disease can be recognized with a characteristic radiographic feature of radiopaque lesions dripping along a long bone's diaphysis. The aberrant bone formation and development manifests mainly as pain, edema, and paresthesia of the affected limb. Severe cases may report limb deformity as well as limited range of motion. Until now, there have been approximately 300 cases reported about melorheostosis worldwide and its diverse clinical picture and age distribution. In Vietnam, there is only one known case of melorheostosis discovered incidentally via radiography. The scarcity of cases presents a challenge within the medical community in recognizing and diagnosing the condition, and a delayed diagnosis can lead to severe contracture and compromised limb motility. In this article, we reported an 82-year-old case of polyostotic melorheostosis with late onset and predominant edema, affecting the sternum, the ribs, and multiple bones of the right extremities and presented our clinical approach for a geriatric patient with chronic limb edema. Our case is distinctive in terms of anatomical location as well as the predominant 20-year non-pitting edema. A prompt diagnosis was made upon the classic dripping candle wax radiographic features emphasizing the role of plain X-ray in establishing the diagnosis without extraneous utilization of other modalities and invasive procedures. Exclusion of other causes of chronic edema such as lymphadenopathy, malignancy as well as parasitic infection is of clinical importance.

Knowledge, attitude, and clinical practice of dentists toward obstructive sleep apnea: A literature review.

OBJECTIVE: To review the knowledge, attitude, and clinical practice of dentists and dental specialists toward obstructive sleep apnea (OSA). METHODS: A literature search was performed on PubMed and ScienceDirect databases. Peer-reviewed English publications were reviewed. No time limit was applied. RESULTS: Four articles were included for the review. Years in the profession, specialist training, and gender were associated with the level of knowledge about OSA. Weight control was the most recognizable treatment for patients with OSA. Dentists agreed that OSA is a life-threatening disease, and they could be involved in detecting and treating OSA. Most dentists had no clinical experience of managing patients with OSA. CONCLUSION: Dentists had a certain level of knowledge about OSA and were willing to deal with OSA. However, they lacked clinical experience. They were also enthusiastic about further education on OSA.

Rickettsia felis and species of fleas parasitizing on household dogs in the Central Highlands of Vietnam.

Rickettsia felis is an obligate intracellular gra m-negative bacterium that belongs to the family of Rickettsiaceae. Ctenocephalides felis, cat flea, is the primary vector of the bacteria. The flea is the most common ectoparasite in dogs and associated with flea-borne spotted fever in humans. Information on R. felis and flea species parasitizing on dogs in Vietnam is limited. This study aimed to identify the species of fleas collected from dogs in the Central Highlands of Vietnam and detected the existence of R. felis in these fleas utilizing molecular tools. Morphological identification of 1618 fleas and molecular confirmation revealed the predominance of C. felis orientis parasitizing on dogs in the Central Highlands of Vietnam. Sixty-eight out of 100 fleas collected from household dogs were positive for spotted fever group rickettsiae; whilst R. felis was detected in 97.06 % (66/68) of C. felis orientis and C. felis felis. The results of this study indicate the potentially high risk of R. felis infection to humans and animals.

SERUM BIOCHEMISTRY AND SELECT MINERAL PARAMETERS OF PRE-RELEASE SUNDA PANGOLINS (MANIS JAVANICA) FOLLOWING REHABILITATION IN VIETNAM.

Native to Southeast Asia, the Sunda pangolin (Manis javanica) is critically endangered largely because of poorly regulated wildlife trade, consumptive practices, and use in traditional Chinese medicine. Efforts to rescue and rehabilitate animals confiscated from the illegal trade are complicated by a general lack of knowledge surrounding the normal health and disease processes unique to the species. To provide clinical reference intervals for normal health states of Sunda pangolins, biochemical parameters were determined from rescued individuals in Vietnam that had undergone a 14-day observation period and met a set of criteria for release back into the wild. Blood samples were collected from 42 apparently healthy Sunda pangolins while anesthetized or awake. Packed cell volume (PCV) and total solids (TS) were determined manually, and serum biochemistry values were determined in-house with a benchtop analyzer. Additional biochemical and mineral parameters not included in the primary panel were determined from a subset of 10 pangolins through an external diagnostic laboratory. Overall reference intervals were calculated for PCV and TS (n = 29) and for standard serum biochemistry parameters (n = 42). Females and males demonstrated significant variation with respect to body mass, potassium (K+), and phosphorus, whereas age was a significant source of variation in alkaline phosphatase. Seasonal variation in glucose (GLU), creatinine (CRE), total proteins, sodium, calcium, and K+ was also observed. Comparisons between anesthetized and awake pangolins demonstrated significant variation in GLU, CRE, and K+. The parameters determined in this study can serve as a clinical reference for ex situ Sunda pangolin conservation efforts. In the context of wildlife rehabilitation, serial bloodwork allows for continued monitoring of patient health and should inform decision making regarding release readiness and timing.

Nasalance scores for Vietnamese-speaking children with oral clefts.

OBJECTIVE: The study aimed to obtain nasalance scores for Vietnamese-speaking patients with repaired cleft palate with or without cleft lip. METHODS: A total of 29 children with cleft palate with or without cleft lip (4-18 years old, mean age 7.9±3.5 years old) were included in this study. Speech material was designed specifically for the Vietnamese language. The speech material consisted of oral stimuli (19 oral words and 18 oral sentences), oro-nasal stimuli (eight sentences), and nasal stimuli (seven sentences). The patients repeated the stimuli after the examiner. The Nasometer II (model 6450) was used to compute nasalance scores. RESULTS: The mean nasalance scores were 27.1% for oral stimuli, 40.2% for oro-nasal stimuli, and 57.5% for nasal stimuli. Hypernasality was detected in 41.4% of the patients. CONCLUSION: Vietnamese-speaking patients with repaired cleft palate with or without cleft lip who did not undergo speech therapy had poor speech outcomes.

Oral Health Status of Patients with Repaired Cleft Lip and Palate in Central Vietnam.

PURPOSE: To determine the oral hygiene habits, levels of dental caries, and periodontal condition of patients with repaired cleft lip and/or palate (CL/P) in Central Vietnam. MATERIALS AND METHODS: A total of 78 patients (1-54 years old; median: 6 years) with CL/P were examined for dental caries, gingivitis and periodontitis using the decayed, missing, and filled teeth (dmft/DMFT) index, gingival bleeding on probing and periodontal pocket depth. Data about dental visits, brushing habits and socioeconomic status were collected. RESULTS: A majority of patients brushed their teeth at least once a day with fluoride dentifrice but did not floss. The caries prevalence was 87.2%. The dmft of patients aged ≤ 5 years and 6-12 years were 7.4 and 9.0. The DMFT of patients aged 6-12 years, and ≥ 13 years were 1.6, and 6.7; the difference was statistically significant (p < 0.05). The percentages of patients who had bleeding on probing and had periodontal pocket depth 3.5-5.5 mm were 57.7% and 5.3%, respectively. CONCLUSIONS: Patients with repaired CL/P in Central Vietnam had a very high level of caries and had signs of gingivitis but not periodontitis. It is recommended to implement dental care in the treatment protocol for patients with CL/P.

Normative nasalance scores for Vietnamese-speaking children.

OBJECTIVE: The Nasometer is increasingly being used to complement auditory perceptual assessment of nasality. Nasalance scores which are obtained from the Nasometer vary across languages. Normative nasalance scores have been established for many languages but not for the Vietnamese language. The objective of this study was to obtain the normative nasalance scores for Vietnamese-speaking children. PARTICIPANTS: In this study, 102 healthy Vietnamese children speaking in the central regional dialect aged from 7 to 9 years (45 boys, 57 girls; mean age = 7.5 years) at a primary school in Hue, Vietnam participated. PROCEDURES: Three speech stimuli, which were specific for the Vietnamese language, were designed: oral stimuli (19 words and 18 sentences), oro-nasal stimuli (eight sentences) and nasal stimuli (seven sentences). The children were asked to repeat these stimuli after the examiner. The Nasometer II (model 6450) was used to obtain the nasalance scores. The procedure took about 10 minutes for each child. RESULTS: The mean nasalance scores and the standard deviation of each stimulus were: 13.1 ± 5.8 (oral stimuli), 30.7 ± 6.6 (oro-nasal stimuli) and 56.9 ± 9.2 (nasal stimuli). No significant differences between the genders were found. CONCLUSIONS: The normative nasalance scores provide essential reference information for clinicians who deal with nasalance disorders, especially patients with cleft palate. The nasalance scores in this study were established for Vietnamese children speaking in the central regional dialect and can be applied to both genders.

Application of a new patient-reported outcome measure in orofacial clefts: An exploratory study in two countries.

Patients with repaired cleft lip and/or palate may vary in satisfaction with their treatment. The exploratory study investigated the satisfaction of patients with orofacial clefts, and their parents with cleft treatment outcomes using the Cleft Hearing, Appearance and Speech Questionnaire (CHASQ). The study included 29 Vietnamese and 27 Estonian patients aged ≥ 7 years with repaired cleft lip and/or palate. The CHASQ was translated into Vietnamese and Estonian. The questionnaire was completed independently by patients and their parents. There were nine items in the CHASQ associated with the cleft (Factor 1) and six items less associated with the cleft (Factor 2). Significant moderate positive correlations were related to Factor 1. Vietnamese patients self-rated lower than Estonian patients in most of the items except speech. The agreement between patients and parents varied from low to moderate positive correlations in the features associated with the cleft, and mainly in the Vietnam sample. Vietnamese patients were less satisfied than Estonian patients. CHASQ is an easy tool to evaluate patients' satisfaction with hearing, appearance, and speech.

Nasolabial aesthetics of patients with repaired unilateral cleft lip and palate: A comparison of three rating methods in two countries.

OBJECTIVES: The study aimed to compare nasolabial aesthetics of patients with unilateral cleft lip and palate (UCLP) treated in Vietnam and Estonia using three rating methods: five-point aesthetic index, a visual analogue scale (VAS), and reference scores method. METHODS: A total of 56 patients with repaired UCLP (23 from Vietnam and 33 from Estonia) were included in this cross-sectional study. Patients' facial and profile photographs were cropped to reveal the nasolabial region and coded. Five examiners rated nasolabial aesthetics of the patients using three methods: five-point aesthetic index, 100 mm VAS, and reference scores method. Intraclass correlation coefficients were used to evaluate intrarater and interrater reliabilities. RESULTS: The five-point aesthetic index had a higher reliability than VAS and reference scores method. The least aesthetic feature among Vietnamese and Estonian patients was nasal symmetry and nasolabial profile respectively. No differences in nasolabial aesthetics were found between Vietnamese and Estonian patients regardless of the rating methods (p > 0.05) except for nasal symmetry. CONCLUSIONS: The five-point aesthetic index seems to produce more reproducible results. There were no significant differences in nasolabial aesthetics between the two countries. Overall average nasolabial appearance results were obtained using different treatment protocols in the two countries.