Gender Differences in HIV, HCV risk and Prevention Needs Among People who Inject drug in Vietnam.

We examined gender differences among people who inject drug (PWID) in Hai Phong, Vietnam in term of blood-borne infections, risk behaviors, and access to care. Using respondent-driven-sampling surveys, we recruited 3146 PWID from 2016 to 2018. Inclusion criteria included a positive urine test for heroin and recent injection marks. There were 155 female PWID (4,9%), including 82 at RDS-2016, 32 at RDS-2017 and 38 at RDS-2018. The age mean was 36.3 ± 7.2 years. The majority of female PWID had less than high school education (90.9%) and were unemployed (51.3%). There was no difference in the proportion of HIV and HCV positive by gender. However, women had several significant differences in risk behaviors than men in multivariable logistic regression. Being a woman was independently associated with being unemployed, being a sex worker, having unstable housing, having uses drugs for less than 5 years, more use of methamphetamine, having a partner who ever injected drugs, and less access to methadone treatment. Interventions targeting female PWID are needed, possibly through community organizations and peer educators.

The Multiple V-Y Advancement Modification for the Surgical Correction of Cryptotia.

Cryptotia is a rare congenital auricular deformity among Caucasians but more common in Asians. Various operative techniques have been described, such as skin graft, V-Y plasty, Z plasty, and islands skin flap. Among those techniques, V-Y plasty has many advantages and is indicated for severe cases. However, several problems remain when this method is adopted, such as conspicuous scars and lowered hairline. To overcome these problems, the authors have developed a new technique, multiple V-Y advancement modification, which stitches the skin flaps together to a tight, discrete central focal point. This technique has the advantage of hiding scars behind the earlobe, providing enough skin for the deformed areas, minimizing the condition of the hairline being lowered and auriculocephalic sulcus depth.

Applying Tumescent solution for preserving the facial nerve in parotidectomy.

BACKGROUND: Facial nerve palsy is one of the most common complications in parotid gland surgery. This report evaluates the effectiveness of applying Tumescent solution for preserving the facial nerve in parotidectomy. MATERIAL AND METHODS: Prospective and descriptive clinical study on 34 patients undergoing parotidectomy with facial nerve preservation. Before skin incision, 5-10 min, we injected 100-200 ml of the Tumescent solution into the surgical area. We recorded the surgical method, tumor size, length of surgery, pathological results and facial nerve dysfunction. All patients were followed for a period ranging from 6 to 24 months. RESULTS: There were 14 patients with malignant tumors and 20 patients with benign tumors. The length of surgery lasted from 90 to 180 min, with an average of 126.8 min. The number of patients having temporary facial paralysis was 22 cases (64.7%), recovery time ranged from 1 week to 6 months, and no permanent facial paralysis cases were recorded. The clinical occurrence of Frey's syndrome was five cases (14.7%). CONCLUSIONS: The application of Tumescent solution for preserving facial nerves in parotidectomy could minimize nerve injury and shorten the length of surgery.

Lipectomy for madelung disease using tumescent technique: a cross-sectional study.

Madelung's disease is a rare disfiguring disorder that affects both function and esthetic appearance in the head and/or shoulder, neck, and arms regions. Lipectomy is typically necessary but such treatment can encounter difficulties due to the large sizes of the tumors, interspersed with important organs in the surrounding region. In this report, the authors evaluate the effectiveness of using tumescent solution in lipectomy to provide a dual treatment of tissue removal for Madelung disease in the head-and-neck region. Methods: A prospective study and clinical descriptions were conducted on 17 patients undergoing 26 head-and-neck lipectomies. A tumescent solution was injected into the surgical region with a blunt-tip cannula 5-10 min before skin incision. The authors recorded systemic manifestations both during and after surgery; tumescent volume; surgical region; clarity of the operative field; weight of fat removed, and early complications. After surgery, the authors followed the patients from periods of 3 months to 4 years. Results: All 17 male patients had a history of alcoholism. In total, 12 lipectomies for the removal of anterior neck fatty masses and 14 lipectomies for the removal of posterior neck fatty masses were performed. The average amount of tumescent injected was 260.1 ml (range 140-550 ml). Surgery was reported as totally bloodless in 10 (38.5%) operative fields, with minimum bleeding in 12 (46.1%) operative fields, acceptable bleeding in four (15.4%) operative fields. The average surgical time was 175.6 min (range 135-250 min). The removed fatty masses weighed between 250 and 2150 g, with an average of 582.9 g. Early complications were seen in four patients, accounting for 15.4% (2 hematoma, 1 skin necrosis, and 1 seroma). Conclusions: Using tumescent solution in lipectomies to treat Madelung disease in the head and neck area is a simple, safe, and useful technique. The technique helps to create a clean operative field, reduces bleeding, and thereby assists surgeons during the operation.

An anatomic study of the perforators from the peroneal artery. A new method to locate the cutaneous perforator.

Background: The goal of this study was to investigate the anatomy of the perforators from the peroneal artery in Vietnamese patients. Methods: 30 cadaver's legs were dissected and investigated for the distribution, course, origin, number and types of perforators of the peroneal artery. The locations of the exit points on the skin of perforators were marked in relation to reference points and segments. Results: The total number of cutaneous perforating branches of the peroneal artery from 30 specimens was 149, which included 63 (42.2%) musculocutaneous perforators and 86 (57.8%) septocutaneous perforators. In most cases, the perforator branches were located in the range from 4 to 7 of the total fibula length (69.8%). The average number of perforating vessels in a leg was 4.9, ranging from 1 to 8 vessels. All the perforators were positioned behind the posterior border of the peroneal bone. In all the dissected samples presented, there was always one cutaneous perforator within a distance of 18 mm from the F point, which is the junction between the 6/10 and 7/10 segments at the posterior border of the fibular bone. Conclusion: The abundance of cutaneous perforators in Vietnamese patients can be used to plan various combined skin and bone flaps. A cutaneous perforator was consistently found near the F point, and this factor can be used in the planning of a bone flap with accompanying skin for monitoring survival of the underlying fibular bone flap.

Multiple Symmetric Lipomatosis: Lipectomy for Madelung Collar.

Multiple symmetric lipomatosis (MSL) is a rare disease associated with metabolic disorders and alcoholism. In this report, we describe the clinical outcome and surgical protocol for eight men with Madelung collar who underwent treatment in a craniofacial and plastic surgery facility in Hanoi, Vietnam, between May 2018 and December 2020. We discuss the patients' clinical symptoms, subclinical signs, epidemiology, magnetic resonance imaging, computerized tomography, surgical protocol, complications, and postoperative indicators that we collected and evaluated. Each patient underwent surgery in two stages (i.e., in supine and prone positions). We injected a tumescent solution 10 min before the incision. Two surgeons performed each operation simultaneously. After surgery, we followed the patients for 6-27 months. All of the patients had a history of long-time alcohol abuse and had associated comorbidities that included liver disease, blood disorders, restricted neck movement, and orthopnea. We did not have to open the trachea or transfuse blood during any of the surgical procedures. Postoperatively, all patients were satisfied with their functional results and aesthetic appearance. One patient experienced a recurrence of his MSL. We believe our surgical protocol provides optimal results for patients with MSL and Madelung collar.

A giant adenomatoid odontogenic tumor of the mandible: A case report and literature review.

INTRODUCTION AND IMPORTANCE: An adenomatoid odontogenic tumor is a rare medical condition. Large tumor (or several) often appears in the maxillae. In a minority of cases, the tumor(s) appear in the mandible. CASE PRESENTATION: We report on a case of a 24-year-old female diagnosed with a mandibular adenomatoid odontogenic tumor, a giant tumor measuring approximately 22 × 25 × 17 cm. The tumor was located on the side of the mandible, causing facial deformity, malnutrition, and hemorrhaging. We assessed the patient's overall condition, carried out a resection of the tumor and mandible from the right condyle to the left mandibular angle, and reconstructed the mandibular defect with a fibula free flap. After the treatment, the patient was followed up for 1 year, with no recurrence detected over this period. CLINICAL DISCUSSION: Because adenomatoid odontogenic tumors are benign odontogenic lesions, which are painless and slow-growing, most are surgically removed or treated conservatively. However, the above treatment measures cannot be applied in the case of a giant tumor that causes facial deformity, destroys the entire jawbone, and has complications such as hemorrhaging and malnutrition. After the tumor resection, the defect is still significant. Accordingly, reconstruction using a microsurgical bone flap is an effective method instead. CONCLUSION: Large adenomatoid odontogenic tumors in the mandible are rare, and treatment cannot follow conventional methods. Accordingly, defect reconstruction after tumor resection is essential.

"Maintaining HIV and HCV prevention and care for people who inject drugs despite COVID-19 in Hai Phong, Vietnam".

BACKGROUND: After the emergence of COVID-19, a one-month strict lockdown was imposed in April 2020 in Vietnam, followed by lighter social distancing restrictions over the year. We investigated whether those measures affected people who inject drugs (PWID) in terms of risk behaviors for HIV and HCV and access to prevention and care in the city of Haiphong, a historic hotspot for HIV and drug use. METHODOLOGY: We carried out a 'before-after' study from 2019 to 2020 using respondent-driven sampling method to enroll PWID. They were interviewed on their socioeconomic situation, drug use and sexual behaviors, relations to care services and tested for drugs and methadone in the urine, for HIV, HCV, and HIV plasma viral load when HIV-positive. Changes following the restrictions were assessed by comparing 'before' to 'after' data. RESULTS: 780 PWID were enrolled. Mean age was 44 years; 94% were male. All were actively injecting heroin 'before', versus 56% 'after'. Among those, frequency of consumption decreased from 24 to 17 days per month. No changes were observed in the frequency and practices of methamphetamine smoking. The proportion of PWID on MMT increased from 68.7% to 75.3%, and that of PWID engaging in risky behaviors related to drug injection decreased from 6.0% to 1.5%. No HIV seroconversions were observed; HCV incidence was 2.6/100 person-years (95% CI [0.7-6.7]). 9% of PWID reported a monthly income of less than 130USD 'before' versus 53% 'after'. CONCLUSION: The case of Hai Phong shows that it is possible, during times of COVID-19 pandemic, to maintain access to harm reduction and care and to prevent HIV and HCV transmission among PWID in a resource-limited setting where severe social distancing restrictions are implemented. Further research is needed to assess the consequences of long-term economic difficulties and the impact of actual spread of SARS-Cov2 that has since emerged in Haiphong.

Chromium, Cadmium, Lead, and Arsenic Concentrations in Water, Vegetables, and Seafood Consumed in a Coastal Area in Northern Vietnam.

BACKGROUND: Heavy metal contamination and related risks for the environment and human health are matters of increasing concern. METHODS: The levels of 4 heavy metals (Cr, Cd, Pb, and As) were evaluated in 2 water types (surface and well), 4 types of seafood (tiger shrimp, stuffed snail, snake-head fish, and catfish), and 27 types of vegetables (12 leafy vegetables, 4 pea plants, 4 tuber vegetables, and 7 herbs) that are commonly consumed in northern coastal communes located in Vietnam. Atomic absorption spectrometry was employed for quantification. RESULTS: The mean concentrations of heavy metals detected in water, seafood, and vegetable samples exceeded the national permitted standards and World Health Organization (WHO) recommendation values by at least 2-fold, 2.5-fold, and 5-fold for surface water, vegetables, and well water, respectively. The concentrations of all 4 heavy metals detected in seafood samples were higher than the standards. The levels of heavy metals decreased with increasing distance between the sample collection point and the pollution source. CONCLUSIONS: This is the first report of heavy metal contamination of common sources of food and water in the northern coastal area of Vietnam. Significantly, the concentrations of heavy metals detected in study samples exceeded the regulatory limits. These results underscore the importance of continued monitoring and the development of intervention measures to ensure that the quality of food and water meets established standards and protects the health of the local population.