Characteristics and Related Factors of Bacterial Infection Among Patients With Cirrhosis.

Background: Infection causes cirrhosis to decompensate, affecting liver function and resulting in several complications, including esophageal variceal hemorrhage, hepatic encephalopathy, and hepatorenal syndrome. Objective: This study aimed to identify the prevalence, essential features, and related factors of bacterial infection among patients with cirrhosis in Vietnam. Methods: This retrospective study included 317 patients diagnosed with cirrhosis, who were divided into two groups: group 1 including 125 patients with bacterial infection and group 2 including 192 patients without bacterial infection. Infection was diagnosed on the basis of its localization. Results: Spontaneous bacterial peritonitis (SBP; 31.2%) and pneumonia (28.8%) were the most common infections identified. The procalcitonin (PCT) level had a strong diagnostic value with an area under the curve value of 0.868. The most common type of gram-negative bacteria was Escherichia coli, while the gram-positive bacteria seen were Staphylococcus, Enterococcus, and Streptococcus among the patients with infection. In the logistic regression analysis, Child-Pugh class B and C (p<0.001, OR=4.14, CI=1.90-9.03; OR=4.76, CI=2.03-11.16, respectively) and the presence of acute kidney injury (p=0.009, OR=2.57, CI=1.27-5.22) and gastrointestinal hemorrhage (p=0.035, OR=0.39, CI=0.16-0.94) significantly differed between the groups. Conclusion: The most prevalent type of bacterial infection in patients with cirrhosis is SBP, with gram-negative bacteria being the most common cause. The PCT level is useful in identifying infection in patients with cirrhosis. Decompensated cirrhosis is linked to a higher risk of infection.

A rare case of duodenal adenocarcinoma.

Duodenal adenocarcinoma is very rare. Its clinical picture is nonspecific and the diagnosis is often accidental. The factors that affect survival are difficult to determine because the number of patients is not high. The common site of duodenal tumors and surgical removal are also debatable. The treatment guidelines published so far have mostly been evaluated in retrospective studies conducted over a 20-year period with relatively small sample sizes. The author presents a case of duodenal adenocarcinoma in a 62-year-old male patient with a clinical manifestation of melena. Duodeno-cephalo-pancreatectomy was the surgical option.

A rare case of perineal synovial sarcoma.

Synovial sarcoma is a malignant mesenchymal neoplasm that is frequently misdiagnosed due to its slow growth and small size. This tumor presents as a nonspecific heterogeneous mass on cross-sectional imaging. Biopsy and histopathological assessments are required to differentiate synovial sarcoma from other sarcoma subtypes and to define the tumor grade. This article presents the case of a 17-year-old male patient with perineal synovial sarcoma.

A rare case of Ladd's band causing duodenal occlusion in an adult with intestinal malrotation.

A congenital defect of the fetal intestinal rotation, known as malrotation of the gut, is most often identified as an acute intestinal occlusion in early infancy. Adults with this disease tend to be asymptomatic and extremely rare. We present a case of a 47-year-old woman with duodenal obstruction due to Ladd's band admitted with acute abdominal pain and vomiting.

A case report of segmental hypoganlionosis of the ileum in an adult.

Intestinal hypoganglionosis in adults is quite uncommon, and hypoganglionosis of the ileum has not been documented to date. The majority of studies on this disorder are single case reports and brief case series. We describe a 30-year-old male patient with bowel obstruction and intestinal hypoganglionosis of the ileum and we review the literature on the disorder.

A rare case of hepatic epitheliod hemangioendothelioma.

Hepatic epithelioid hemangioendothelioma (HEHE) is an extremely uncommon tumor of the liver. It typically lacks recognizable clinical signs and is diagnosed with the aid of imaging and histopathology combined with immunohistochemical analysis. We discuss the case of a 40-year-old woman with HEHE. The aim of this case report and literature review is to increase doctors' knowledge of HEHE and reduce the incidence of missed clinical diagnoses.

Acute hemorrhage from a retroperitoneal liposarcoma treated by embolization.

Liposarcomas are rare retroperitoneal mesenchymal tumors that present at an advanced stage and often have poor prognoses. These malignant tumors create a diagnostic conundrum and pose several treatment difficulties due to their rarity and anatomic placement. Retroperitoneal liposarcomas often present as asymptomatic abdominal tumors and rarely cause acute bleeding. Surgery is typically required in cases with acute malignant bleeding and hemodynamic instability. Angioembolization and other bleed-control methods should be researched where available. This case report describes the case of a 17-year-old male patient whose tumor had an acute abdominal hemorrhage treated by embolization.

An extremely rare case of intrahepatic sarcomatoid cholangiocarcinoma.

One uncommon histological subtype of intrahepatic cholangiocarcinoma is sarcomatoid intrahepatic cholangiocarcinoma. Histopathological and immunohistochemical tests are used to diagnose sarcomatoid intrahepatic cholangiocarcinoma, which frequently has a worse prognosis than regular intrahepatic cholangiocarcinoma. The example of a 65-year-old female with sarcomatoid intrahepatic cholangiocarcinoma, who presented with sporadic right upper abdomen discomfort, is discussed in this paper. This case study and literature analysis aims to improve physicians' comprehension of sarcomatoid intrahepatic cholangiocarcinoma and lower the frequency of missed clinical diagnoses.

The Combined Use of Metformin and Methotrexate in Psoriasis Patients with Metabolic Syndrome.

Objective: To evaluate the efficacy and safety of the combination of metformin and methotrexate (MTX) versus MTX monotherapy in treating psoriasis in patients with metabolic syndrome. Materials and Methods: A prospective clinical trial was conducted using metformin and MTX to treat psoriasis patients with metabolic syndrome. A treatment group of 35 psoriasis patients with metabolic syndrome was treated with MTX and metformin. A control group of 31 psoriasis patients with metabolic syndrome was treated with MTX only. Results: Patients treated with the combined regimen showed measured improvement in disease status compared to those treated with MTX monotherapy. The Psoriasis Area and Severity Index (PASI) scores of psoriasis patients with metabolic syndrome using the metformin and MTX combination were significantly lower than those treated with MTX only (p < 0.05). The combination treatment group also showed a significant decrease in blood sugar and triglyceride levels after 3 months (p < 0.05). However, there were no significant differences in subclinical indexes between the treatment and control groups. Conclusion: In this treatment sample, a combination of metformin and MTX in psoriasis patients with metabolic syndrome showed positive responses and no serious side effects.

Adverse effects of dioxins on cognitive ability and motor performance of 5-year-old children residing in a hotspot of dioxin contamination originating from Agent Orange in Vietnam: A prospective cohort study.

Bien Hoa airbase is the most dioxin-polluted hotspot in Vietnam. In 2012, a birth cohort living around Bien Hoa airbase was recruited for assessment of physical and neurological development. In the present study, neurodevelopment scores at 5 years of age were assessed by the Kaufman Assessment Battery for Children, Second Edition and the Movement Assessment Battery for Children, Second Edition for 185 children in Bien Hoa and 104 children in Ha Dong (unexposed control group) to clarify the effects of dioxin. 2,3,7,8-tetrachlorodibenzo-p-dioxin concentrations in breast milk of women in Bien Hoa were approximately three times higher than those of women in Ha Dong (2.33 vs. 0.69 pg/g fat, p < 0.001). In general, neurodevelopment scores were lower in Bien Hoa children than in Ha Dong children. In boys, scores differed for number recall (12.6 vs. 14.0, p = 0.036), triangles (10.7 vs. 12.4, p = 0.005), manual dexterity (8.3 vs. 9.7, p = 0.037), balance (7.4 vs. 10.3, p < 0.001), and total movement scores (8.0 vs. 10.1, p = 0.003). After adjusting for covariates, linear regression analysis indicated that the scores of the triangles, balance, and total movement tests were inversely associated with levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin and of toxic equivalency of polychlorinated dibenzodioxins and polychlorinated dibenzofurans. In girls, scores differed for the triangles test (11.0 vs. 12.6, p = 0.005), hand movement test (9.6 vs. 11.3, p = 0.003), and balance test (9.1 vs. 10.7, p = 0.050); toxic equivalency of polychlorinated dibenzofurans was inversely associated with hand movement and balance scores. Overall, perinatal dioxin exposure appears to have a long-term impact on neurodevelopment.

Anatomical Characteristics of Facial Nerve Trunk in Vietnamese Adult Cadavers.

BACKGROUND: In medical literature, there are few studies provided a precise and detailed description of the facial nerve rami and its branches. AIM: Identify several practical anatomic landmarks related to the facial nerve main trunk and its rami. METHODS: A descriptive study, 30 cadavers in the anatomy department of UPNT from October 2012 to April 2015. RESULTS: The average distance from the mandibular angle to the division of the facial nerve is 40.8 mm, and is 86.6% from range 36 - 50 mm. There is 86.7% case in which the facial nerve is in the lateral of the retromandibular vein, and there is a significant difference about both sides. Eighty percent of the case has the superior and inferior ramus in the lateral to the retromandibular vein. There are 2 cases in which the superior ramus makes the circle of the vein. Eighty percent of the facial nerve is in the lateral to the external carotid artery. CONCLUSION: The distance from the mandibular to the division of the facial nerve is longer. The relationship between the superior/inferior ramus and the retromandibular vein maybe not the same in both sides. In some cases, it makes the circle of the vein to cause some complication in the parotid gland surgery.

Short Tandem Repeats Used in Preimplantation Genetic Testing of Β-Thalassemia: Genetic Polymorphisms For 15 Linked Loci in the Vietnamese Population.

BACKGROUND: ß-thalassemia is one of the most common monogenic diseases worldwide. Preimplantation genetic testing (PGT) of ß-thalassemia is performed to avoid affected pregnancies has become increasingly popular worldwide. In which, the indirect analysis using short tandem repeat (STRs) linking with HBB gene to detect different ß-globin (HBB) gene mutation is a simple, accurate, economical and also provides additional control of contamination and allele-drop-out ADO. AIM: This study established microsatellite markers for PGT of Vietnamese ß-thalassemia patient. METHODS: Fifteen (15) STRs gathered from 5 populations were identified by in silico tools within 1 Mb flanking the HBB gene. The multiplex PCR reaction was optimized and performed on 106 DNA samples from at-risk families. RESULTS: After estimating, PIC values were ≥ 0.7 for all markers, with expected heterozygosity and observed heterozygosity values ranged from 0.81 to 0.92 and 0.53 to 0.86, respectively. One hundred percent of individuals had at least seven heterozygous markers and were found to be heterozygous for at least two markers on either side of the HBB gene. CONCLUSION: In general, a pentadecaplex marker (all < 1 Mb from the HBB gene) assay was constituted for ß-thalassemia PGT on Vietnamese population.