Outcomes of Gamma Knife Radiosurgery for Drug-Resistant Primary Trigeminal Neuralgia.

Objective: To evaluate the result of gamma knife radiosurgery (GKRS) for drug-resistant primary trigeminal neuralgia (TN). Methods: Patients who were diagnosed with drug-resistant primary TN were treated with GKRS at the Nuclear Medicine and Oncology Center, Bach Mai Hospital from January 2015 to June 2020. Using the pain rating scale of the Barrow Neurological Institute (BNI), follow-ups and evaluations were conducted at 1 month, 3 months, 6 months, and 9 month, and 1, 2 years, 3 years, and 5 years after radiosurgery. Comparisons of pain levels was performed before and after radiosurgery according to the BNI scale. Results: From January 2015 to June 2020, 33 patients were treated with GKS. There were 23 female patients and 10 male patients; the average age was 61.9. The average onset time of disease was 4.42 years. Among all patients, 84.8% of patients were relieved from pain and 78.8% were pain-free without medication. The mean time for pain relief was 3 months and was not related to the dose of GKS (<80 Gy and ≥80 Gy). The efficacy of pain relief is not related to blood vessel contact with the trigeminal nerve, the dose of GKS, and the onset of disease. The rate of recurrence after the first pain relief was low (14.3%). Conclusions: Gamma knife is an effective method for the treatment of primary drug-resistant TN, especially in elderly patients with underlying medical conditions. The analgesic effect does not depend on the presence of nerve-vascular conflict.

Molecular Identification and Pathogenicity of Novel Duck-Origin Goose Parvovirus Isolated from Beak Atrophy and Dwarfism Syndrome of Waterfowls in the North of Vietnam.

The aim of this study is to identify and characterize virus isolates (which are named for Bacgiang Agriculture and Forestry University [BAFU]) from diseased Cherry Valley duck and mule duck flocks and investigate the damage caused by a novel parvovirus-related virus (DuPV) to tissues and organs, including the brain, cerebellum, kidney, liver, lung, spleen, and spinal cord. The results of phylogenetic analysis show that DuPV-BAFU evolved from a goose lineage and duck parvoviruses rather than from Muscovy duck parvoviruses. In the genetic lineages, DuPVs were identified from the DuPV samples analyzed, and DuPV-BAFU was found to be closely clustered with two known goose origin parvoviruses (GPVa2006 and GPV1995) and a duck GPVs. Finally, structural modeling revealed that DuPV-BAFU and the closely related viruses GPVa2006 and GPV1995 possessed identical clusters of receptor-interacting amino acid residues in the VP3 protein, a major determinant of viral receptor binding and host specificity. Significantly, these three viruses differed from DuPVs, Muscovy duck parvoviruses, and other goose parvoviruses at these positions. These results also demonstrated that DuPV-BAFU represents a new variant of goose-origin parvovirus that currently circulates in ducklings and causes beak atrophy and dwarfism syndrome, as noted in the previous reports in Europe, Taiwan, and China. This new finding highlights the need for future surveillance of DuPV-BAFU in waterfowl in order to gain a better understanding of both the evolution and the biology of this emerging parvovirus in waterfowl.

Identificación molecular y patogenicidad de un nuevo parvovirus de ganso de origen en pato aislado del síndrome de atrofia del pico y enanismo de las aves acuáticas en el norte de Vietnam. El objetivo de este estudio es identificar y caracterizar aislados de virus detectados en la Universidad de Agricultura y Silvicultura de Bacgiang (BAFU) de parvadas de patos enfermos Cherry Valley e híbridos y también investigar el daño causado por un nuevo virus relacionado con parvovirus del pato (DuPV) en tejidos y órganos, incluidos el cerebro, el cerebelo, los riñones, el hígado, los pulmones, el bazo y la médula espinal. Los resultados del análisis filogenético mostraron que el virus DuPV-BAFU evolucionó a partir de un linaje de parvovirus de patos y gansos en lugar del parvovirus de patos reales. En los linajes genéticos, se identificaron virus DuPV a partir de las muestras de DuPV analizadas, y se encontró que el DuPV-BAFU estaba estrechamente agrupado con dos parvovirus conocidos de origen de ganso (GPVa2006 y GPV1995) y con parvovirus de pato. Finalmente, el modelado estructural reveló que el virus DuPV-BAFU y los virus estrechamente relacionados GPVa2006 y GPV1995 poseían grupos idénticos de residuos de aminoácidos que interactúan con el receptor en la proteína VP3, que es un determinante importante de la unión al receptor viral y la especificidad del huésped. Significativamente, estos tres virus diferían de los DuPV, los parvovirus del pato real y de otros parvovirus del ganso en estas posiciones. Estos resultados también demostraron que el virus DuPV-BAFU representa una nueva variante del parvovirus de origen ganso que actualmente circula en patitos y causa atrofia del pico y síndrome de enanismo, como se señaló en reportes anteriores en Europa, Taiwán y China. Este nuevo hallazgo destaca la necesidad de una vigilancia futura para el virus DuPV-BAFU en las aves acuáticas para comprender mejor tanto la evolución como la biología de este parvovirus emergente en las aves acuáticas.

Data on cerebral palsy in Vietnam will inform clinical practice and policy in low and middle-income countries.

PURPOSE: To document known risk factors, clinical severity, associated impairments and rehabilitation status of children presenting with cerebral palsy (CP) to the National Children's Hospital (NCH) in Hanoi, Vietnam. MATERIALS AND METHODS: Active prospective ascertainment of cases of CP presenting between June and November 2017 to the NCH using surveillance modelled on the Paediatric Active Enhanced Disease Surveillance system in Australia. RESULTS: Data were collected on 765 children with CP (mean age: 2 years 7 months (SD 2 y 6 mo). Mean age at diagnosis was 1 year 8 months (SD 1 y 9 mo). Children predominantly had spastic CP (95.2%, n = 729), most were quadriplegic (69.6%, n = 532) and 60.3% (n = 454) were Gross Motor Functional Classification System level III-V. Of the children 76.2% (n = 583) had one/more associated impairments. 36.3% (n = 276) had presumed perinatal asphyxia, 26.5% (n = 202) were preterm. Physiotherapy (94.3%, n = 663) was the most common form of intervention used. Only 2.6% (n = 12) of the children who would have benefitted from assistive devices had wheelchairs. CONCLUSION: We established hospital-based surveillance of CP in Hanoi and confirmed a high burden and severity of CP with potentially preventable risk factors. These data will inform clinician training and health policy and identify need for evidence-based care and assistive devices.IMPLICATIONS FOR REHABILITATIONWe identified a high number of children with severe forms of cerebral palsy (CP) in Hanoi, Vietnam through hospital-based surveillance.There is an urgent need for clinician training and access to and use of evidence-based interventions including assistive technology.This study will inform local capacity building and health policy for improved diagnosis and care of children with CP in Vietnam and other low and middle-income countries.

Prevalence, Virulence Gene Distribution and Alarming the Multidrug Resistance of Aeromonas hydrophila Associated with Disease Outbreaks in Freshwater Aquaculture.

The study aims to evaluate the infection prevalence, virulence gene distribution and antimicrobial resistance of Aeromonas hydrophila associated in diseased outbreaks of cultured freshwater fish in Northern Vietnam. The confirmed A. hydrophila were screened for the presence of the five pitutative-virulence genes including aerolysin (aerA), hemolysin (hlyA), cytotonic enterotoxin (act), heat-labile cytotonic enterotoxin (alt), and heat-stable enterotoxin (ast), and examined the susceptibility to 16 antibiotics. A total of 236 A. hydrophila isolates were recovered and confirmed from 506 diseased fish by phenotypic tests, PCR assays, and gyrB, rpoB sequenced analyses, corresponding to the infection prevalence at 46.4%. A total of 88.9% of A. hydrophila isolates harbored at least one of the tested virulence genes. The genes aerA and act were most frequently found (80.5% and 80.1%, respectively) while the ast gene was absent in all isolates. The resistance to oxacillin, amoxicillin and vancomycin exhibited the highest frequencies (>70%), followed by erythromycin, oxytetracycline, florfenicol, and sulfamethoxazole/trimethoprim (9.3-47.2%). The multiple antibiotic resistance (MAR) index ranged between 0.13-0.88 with 74.7% of the isolates having MAR values higher than 0.2. The results present a warning for aquaculture farmers and managers in preventing the spread of A. hydrophila and minimizing antibiotic resistance of this pathogen in fish farming systems.