Triple burden of malnutrition among Vietnamese 0·5-11-year-old children in 2020-2021: results of SEANUTS II Vietnam.

OBJECTIVE: SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old. DESIGN: Cross-sectional survey. SETTING: A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. PARTICIPANTS: 4001 children between 6 months and 11.9 years of age. RESULTS: Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI. CONCLUSIONS: SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.

Clinical outcomes of current medical approaches for Middle East respiratory syndrome: A systematic review and meta-analysis.

Middle East respiratory syndrome (MERS) is a respiratory disease caused by MERS coronavirus. Because of lack of vaccination, various studies investigated the therapeutic efficacy of antiviral drugs and supportive remedies. A systematic literature search from 10 databases was conducted and screened for relevant articles. Studies reporting information about the treatment of MERS coronavirus infection were extracted and analyzed. Despite receiving treatment with ribavirin plus IFN, the case fatality rate was as high as 71% in the IFN-treatment group and exactly the same in patients who received supportive treatment only. Having chronic renal disease, diabetes mellitus and hypertension increased the risk of mortality (P < .05), and chronic renal disease is the best parameter to predict the mortality. The mean of survival days from onset of illness to death was 46.6 (95% CI, 30.5-62.6) for the IFN group compared with 18.8 (95% CI, 10.3-27.4) for the supportive-only group (P = .001). Delay in starting treatment, older age group, and preexisting comorbidities are associated with worse outcomes. In conclusion, there is no difference between IFN treatment and supportive treatment for MERS patients in terms of mortality. However, ribavirin and IFN combination might have efficacious effects with timely administration and monitoring of adverse events. Large-scale prospective randomized studies are required to assess the role of antiviral drugs for the treatment of this high mortality infection.

Spinal cord ischemia after transcatheter artery chemoembolization for hepatocellular carcinoma: A case-report.

INTRODUCTION: Transarterial hepatic chemoembolization (TACE) has been used to treat unresectable hepatocellular carcinoma and has gained widespread acceptance as a treatment for both primary and secondary hepatic malignancies. CASE REPORT: We report a case of 78-year-old male patient with chronic hepatitis B, diagnosed with HCC. He underwent the second TACE, and right after the procedure, the patient abruptly developed bilateral lower extremities motor weakness and sensory impairment below the T10 dermatome. Spinal magnetic resonance imaging showed T2-weighted scans showed increased intramedullary signal strength at the T1-T12 level. The patient received supportive care, ongoing rehabilitation, and steroid pulse therapy. The motor strength remained unchanged, but the sensory deficiencies practically disappeared. CLINICAL DISCUSSION: The hepatic artery injury or decreased flow at the prior TACE site, which causes collateral recruitment, can explain why spinal cord injury following TACE typically happens after the second or third session. It can occasionally result from accidental embolized spinal branches originating from intercostal or lumbar collateral arteries. In our case, we hypothesize the embolism caused the infarction to the spinal cord travel through the connection between the lateral branches of the right inferior phrenic artery and the intercostal arteries, which supply the spinal cord through the anterior spinal artery. CONCLUSIONS: TACE in rare case can have severe complications. A tailored therapeutic strategy, including consideration of a shunt and selection of the vessels utilized for the Lipiodol infusion prior to TACE, is crucial to achieving an optimal end outcome to avert these significant consequences.

Laparoscopic pancreatic duct exploration, electrohydraulic shock wave lithotripsy combined with internal drainage for pancreatic duct stones: A case report.

INTRODUCTION: Chronic pancreatitis is characterized by irreversible structural damage, including fibrosis and compression of the pancreatic ducts, often leading to stones forming in the pancreatic duct and parenchyma. Surgery is indicated when severe obstruction with chronic pain is presented and conventionally drained by pancreatojejunostomy. CASE REPORT: A 56-year-old female patient with epigastric pain for many years. Computed tomography revealed an atrophic pancreas with a dilated pancreatic duct (18 mm) obstructed by a stone sized 1.3 cm. The patient underwent laparoscopic pancreatic duct exploration, used electrohydraulic lithotripsy for pancreatic duct stones, and then placed pancreaticoduodenal internal drainage with primary closure of the pancreatic duct. The operative time was 185 min, and the total blood loss was around 50 ml without intraoperative complication. The patient was discharged from the hospital on postoperative day 5 uneventfully. The epigastric pain symptoms dramatically decreased in the follow-up visit after one month. CLINICAL DISCUSSION: We combined several minimally invasive techniques to treat a chronic pancreatitis patient with a stone forming in the main duct in this patient. We used lithotripsy and internal drainage without the need for anastomosis. To our knowledge, this is the first report on this technique in literature. We found this technique is safe and applicable in selected patients to treat pancreatic stones with the dilated pancreatic duct. CONCLUSIONS: In this case, we demonstrate a novel surgical treatment option for chronic pancreatitis with a simple and effective technique to manage pancreatic stones in chronic pancreatitis patients.

Efficacy of Oral Low-Dose Isotretinoin in the Treatment of Acne Vulgaris in Vietnam.

BACKGROUND: Oral isotretinoin is an effective therapy for acne. However, isotretinoin can induce hyperhomocysteinemia and decreased serum folic acid level, which may be a risk for cardiovascular disease and thrombosis, as well as psychoses. Besides, many recent types of research emphasise the safety and effects of the low dose isotretinoin therapy. AIM: The aim of our study was to evaluate the effect of the low-dose isotretinoin on the plasma homocysteine and serum folic acid level in the Vietnamese population. METHODS: We conducted a longitudinal study to evaluate the effectiveness of the low-dose therapy on the plasma homocysteine and serum folic acid level of 52 acne patients after 6-8-week treatment at University Medical Center Ho Chi Minh City, Viet Nam. Patients had moderate-severe acne with the prolonged course, and most of them had a scar. RESULTS: With a low dose of oral isotretinoin (0.37 ± 0.11 mg/kg/day), after 6-8-week treatment, patients dropped the severity of disease, increased the plasma homocysteine level and decreased the serum folic acid level with significant differences in comparison to those before treatment. However, these changes do not exceed the normal range. CONCLUSION: In overall, low dose isotretinoin treatment had effectiveness in decrease the severity of disease and no increasing the plasma homocysteine level as well as the serum folic acid level.

Relationship at work as a cause of occupational stress: the case of academic women in Vietnam.

BACKGROUND: The present research paper aims to bring deeper understanding and insight to perceptions and experiences of occupational stress from relationships at work in the cultural context of Vietnam. The paper also examines differences in perceptions, experiences of occupational stress from this problem and makes a comparison with perspectives in other cultures. METHODS: Grounded theory approach is used to study occupational stress by collecting data from in-depth interviews with 42 academic women employed at Vietnamese higher education institutions to understand the meaning, the nature and source of the occupational stress from relationships at work they experience and the impact of occupational stress on their lives. RESULTS: Cultural factors play an important role in occupational stress. Cultural factors such as power distance and hierarchy influence perception, experiences of occupational stress and the ways occupational stress is responded to. The Vietnamese context differs from other cultural contexts in the range of factors perceived as stressors for Vietnamese women. CONCLUSION: This paper is the first grounded theory study of occupational stress among women academics in Vietnam that determines that the natural of the relationship at work play an important role in how women understand and respond to occupational stress and supports the growing evidence that occupational stress is common, global but different in other cultures.

Randomized trial assessing home use of two pregnancy tests for determining early medical abortion outcomes at 3, 7 and 14days after mifepristone.

OBJECTIVE: To evaluate the accuracy, feasibility and acceptability of two urine pregnancy tests in assessing abortion outcomes at three time points after mifepristone administration. STUDY DESIGN: This randomized trial enrolled women seeking early medical abortion at two hospitals in Vietnam. Investigators randomly allocated participants to at-home administration of a multilevel urine pregnancy test (MLPT) or a high sensitivity urine pregnancy test (HSPT) to assess their abortion outcomes. A baseline test was administered on the same day as mifepristone. Participants performed and interpreted results of pregnancy tests taken 3, 7 and 14days after mifepristone. Ultrasound exam determined continuing pregnancy. RESULTS: Six hundred women enrolled, and 300 received each test. A percentage of 97.4 (584) had follow-up, of whom 13 women had continuing pregnancies. The specificity of MLPT at detecting absence of continuing pregnancy was 63.9%, 90.4% and 97.1% at study day 3, 7 and 14. The specificity of HSPT was 6.0%, 19.8% and 62.2%, respectively. The positive predictive value (PPV) of MLPT at detecting continuing pregnancy was 6.4% at day 3 and rose to 46.7% at day 14. In contrast, the PPV for HSPT was 2.2% at day 3 and rose to 6.5% at day 14. At all three time points, the sensitivity and negative predictive values for both tests were 100.0%. Most women found their assigned tests easy to use and would prefer future home follow-up with a pregnancy test. CONCLUSIONS: The MLPT enables women to assess their abortion outcomes more reliably than with HSPT. With MLPT, women can know their outcomes as early as 3 days after mifepristone. IMPLICATIONS: Medical abortion service delivery with an MLPT to obtain a baseline (preabortion) human chorionic gonadotropin (hCG) estimate and a second follow-up MLPT 1 to 2 weeks later can establish whether there has been a drop in hCG, signifying absence of a continuing pregnancy. Used this way, MLPTs can enable women to assess their abortion status outside of a clinic setting and without serum hCG testing and/or ultrasound.