Photocurable acrylate epoxy/ZnO-Ag nanocomposite coating: fabrication, mechanical and antibacterial properties.

In this study, a UV-curable acrylate epoxy nanocomposite coating has been prepared by incorporation of ZnO-Ag hybrid nanoparticles. For this purpose, firstly ZnO-Ag hybrid nanoparticles were fabricated by a seed-mediated growth method. Then, these ZnO-Ag hybrid nanoparticles (2 wt%) were added into the UV-curable acrylate resin matrices. The photocuring process of nanocomposite was evaluated by various factors, such as the conversion of acrylate double bonds, pendulum hardness and gel fraction. Under the 4.8 s UV-exposure time for full crosslinking, the obtained data indicated that incorporation of ZnO-Ag nanohybrids into the coating matrix changed the crosslinking process of coating significantly. A mechanical teat indicated that the presence of nanohybrids in photocurable coating matrix enhanced its abrasion resistance from 98.7 to 131.6 L per mil (33.3%). The antibacterial test against E. coli over 7 h indicated that E. coli bacteria were killed totally by nanocomposite coating, whereas it was 2.6 × 104 CFU mL-1 for the neat coating without nanoparticles.

Adult-Onset Primary Intestinal Lymphangiectasia With Liver Enzymes Elevation.

Primary intestinal lymphangiectasia is a rare disorder that may result in protein-losing enteropathy. We report a 21-year-old man with malabsorption syndrome, an unintentional weight loss of 30 kg over 10 months, lymphocytopenia, and hepatic aminotransferase elevation. His diagnosis was established by a combination of enteroscopy, histopathology, and secondary etiology exclusion. Institution of parenteral nutrition, followed by a low-fat diet, medium-chain triglycerides, and octreotide, resulted in the resolution of his symptoms and laboratory abnormalities and led to weight gain. Aminotransferase abnormalities are an atypical finding in primary intestinal lymphangiectasia and were most likely due to nonalcohol steatohepatitis after rapid weight loss. Primary intestinal lymphangiectasia should be considered in patients with protein-losing enteropathy and lymphocytopenia.

Successful Treatment of Facial Atrophic Acne Scars by Fractional Radiofrequency Microneedle in Vietnamese Patients.

AIM: This study aimed to evaluate the effect of the fractional Radiofrequency microneedle treatment for facial atrophic acne scars. METHODS: A group of 52 patients were recruited for the study. Goodman & Baron's acne scar grading system was used for assessment at their first visit and the end of 3 months after the last treatment session. RESULTS: The results displayed that 73.1% of patients have the improvement of the Goodman scar level after four times of treatment. The Goodman and Baron scar point mean was reduced from 16 ± 7.6 to 5.6 ± 5.0 (p < 0.01). Post-inflammatory hyperpigmentation was experienced in 5 patients (9.6%). CONCLUSION: The microneedle fractional Radiofrequency is an effective treatment method of facial atrophic acne scars, with minor side effects and a short downtime.

Improving Treatment Outcome of Pemphigus Vulgaris on Vietnamese Patients by Using Desmoglein Elisa Test.

BACKGROUND: Pemphigus Vulgaris (PV) is a chronic disease, is characterized by the presence of flacid bullous in skin and mucosa. There are 2 main autoantibodies against desmoglein3 (Dsg3) and desmoglein1 (Dsg1). AIM: The aims of this study were to evaluate the before and after treatment outcome with corticosteroid, using Desmoglein ELISA test. METHOD: Forty patients with Pemphigus include 36 PV and 4 PF (28 women, 12 women) were enrolled. The titers of Dsg in pemphigus patients by using ELISA test were done before and 1-month treatment. RESULTS: Both anti-Dsg1 and anti-Dsg3 levels were significantly reduced after treatment (P < 0.05). The severity of skin lesions was correlated with anti-Dsg1 antibody level and the severity of oral lesions was significantly correlated with anti-Dsg 3 antibody levels (p < 0.05). CONCLUSION: It is recommended that we can predict and improve the outcome of treatment by using Desmoglein ELISA test.

The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience.

BACKGROUND: Chronic urticaria, a mast cell-driven condition, is common, debilitating and hard to treat. H1-antihistamines are the first line treatment of chronic urticaria, but often patients do not get satisfactory relief with the recommended dose. European guidelines recommend increased antihistamine doses up to four-fold. AIM: We conducted this study to evaluate the efficacy of increased H1-antihistamine doses up to two-fold in Vietnamese chronic urticaria patients. METHODS: One hundred and two patients with chronic urticaria were recruited for treatment with levocetirizine (n = 52) or fexofenadine (n = 50). Treatment started at the conventional daily dose of 5 mg levocetirizine or 180 mg fexofenadine for 2 weeks and then increased to 10 mg levocetirizine or 360 mg fexofenadine for 2 weeks if patients did not have an improvement in symptoms. At week 0, week 2 and week 4 wheal, pruritus, size of the wheal, total symptom scores, and associated side-effects were assessed. RESULTS: With the conventional dose, the total symptom scores after week 2 decreased significantly in both groups compared to baseline figures, i.e. 7.4 vs 2.3 for levocetirizine group and 8.0 vs 2.6 for fexofenadine group (p < 0.05). However, there were still 26 patients in each group who did not have improvements. Of these 26 patients, after having a two-fold increase of the conventional dose, 11.5% and 38.5% became symptom-free at week 4 in levocetirizine group and fexofenadine group, respectively. At week 4 in both groups, the total symptom scores had significantly decreased when compared with those at week 2 (2.8 ± 1.5 versus 4.7 ± 1.6 in levocetirizine group; 2.1 ± 1.9 versus 5.1 ± 1.4 in fexofenadine group). In both groups, there was no difference in the rate of negative side effects between the conventional dose and the double dose. CONCLUSION: This study showed that increasing the dosages of levocetirizine and fexofenadine by two-fold improved chronic urticaria symptoms without increasing the rate of negative side effects.

Efficacy of 10% Potassium Hydroxide Solution Versus 10% Salicylic Acid Ointment in Treatment of Molluscum Contagiosum - the Low - Cost Dermatologic Therapy in Vietnam.

BACKGROUND: Molluscum contagiosum is a common viral disease primarily affecting children. AIM: The objective is to compare the efficacy of 10% potassium hydroxide (KOH) solution versus 10% salicylic pomade in the treatment of molluscum contagiosum. METHODS: Clinical trials on 70 patients were randomised into 2 groups: 39 patients treated with 10% KOH solution and 31 patients treated with 10% salicylic pomade. The evaluation was based on the complete clearance of lesions, side effects and complications of the drug. RESULTS: The clearance of all lesions after 2, 4, 6, 8 weeks of treatment in both groups were 7.7%; 23.1%; 53.8%; 79.5% and 0%; 3.2%, 9.7% 22.6%, respectively (p < 0.05). Side effects were seen in both groups include burning (76.9% versus 19.4%; p < 0.05); redness (59% versus 14%; p < 0.01); desquamation (12.8% versus 19.3%; p < 0.05). CONCLUSION: The efficacy of KOH solution in the treatment of MC was better than that of salicylic pomade and both products are safe, effective, and easy to apply at home.

Quality of Life in Psoriasis Vietnamese Patients Treated with Metformin in Combination with Methotrexate.

A cross-sectional study was performed on 48 psoriasis Vietnamese patients treated with metformin as an add-on for methotrexate and 48 psoriasis patients treated methotrexate alone. The mean PASI scores were 5.25 ± 5.72. Total QOL scores had a slight difference between patients treated metformin combined with methotrexate and methotrexate alone (62.32 ± 18.1 vs 60.91 ± 19.63). Combined therapy with metformin and methotrexate contributes to significantly improve the quality of life for patients with psoriasis.

Antibiotic prescribing and dispensing for acute respiratory infections in children: effectiveness of a multi-faceted intervention for health-care providers in Vietnam.

BACKGROUND: Appropriate antibiotic use is vital to effectively contain antibiotic resistance and improve global health. Acute respiratory infections (ARIs) remain the leading cause of disease and death in children under five in low-income countries. OBJECTIVE: To evaluate a multi-faceted intervention targeting health-care-providers' (HCPs) knowledge, practical competences and practices regarding antibiotic use for ARIs. METHODS: A multi-faceted educational intervention with a two-armed randomised controlled design targeting HCPs treating ARIs in children was conducted in Bavi district, a rural district in Northern Vietnam in 2010-2011. Thirty-two communes of the district were randomized into two arms, with 144 HCPs in the intervention arm and 160 in the control arm. The intervention, conducted over seven months, comprised: (i) education regarding appropriate-antibiotic use, (ii) case scenario discussion and (iii) poster distribution. Questionnaires to assess knowledge and dispensing/prescribing forms to assess practice were completed before-and after interventions. The main outcome measures were differences in improvement in knowledge and practice in the intervention and control group, respectively. RESULTS: Knowledge improved in the intervention group for ARI aetiology by 28% (ΔDecrement control arm 10%), antibiotic use for mild ARIs by 15% (ΔDecrement control arm 13%) and for severe ARIs by 14% (ΔImprovement control arm 29%). Practical competence for a mild ARI case scenario improved in the intervention and control groups by 20% and 11%, respectively. Total knowledge score increased statistically in the intervention group (Δmean improvement 1.17); less so in the control group (Δmean improvement 0.48). Practice regarding antibiotics for mild ARIs improved by 28% in the intervention group (ΔDecrement control arm 3%). CONCLUSIONS: The intervention significantly improved HCPs' knowledge of ARIs and practice of antibiotic use in treatment of ARIs. We suggest mixed method assessment and long-term follow-up of these interventions to enable better appreciation of the effects and effect sizes of our interventions.

'Women think pregnancy management means obstetric ultrasound': Vietnamese obstetricians' views on the use of ultrasound during pregnancy.

OBJECTIVE: To explore Vietnamese obstetricians' experiences and views on the role of obstetric ultrasound in clinical management of complicated pregnancy and in situations where maternal and fetal health interests conflict. DESIGN: Seventeen obstetricians in northern Vietnam were interviewed as part of the CROss-Country Ultrasound Study (CROCUS) project in 2013. Data were analysed using qualitative content analysis. RESULTS: The participants described ultrasound as a central tool in prenatal care, although they called for increased training and resources to prevent inappropriate management. A prevailing overuse driven by women's request and increased commercialisation was described. Other clinical examinations were seen as being disregarded by women in favour of ultrasound, resulting in missed opportunities for identifying potential pregnancy complications. The use of ultrasound for sex selection purposes raised concern among participants. Visualisation of human features or heartbeat during ultrasound was commonly described as the point where the fetus became regarded as a 'person'. Women were said to prioritise fetal health interests over their own health, particularly if a woman had difficulties becoming pregnant or had undergone assisted fertilisation. The woman's husband and his family were described as having an important role in decision-making in situations of maternal and fetal health conflicts. CONCLUSIONS: This study provides insight into issues surrounding ultrasound use in contemporary Vietnam, some of which may be specific to this low-income context. It is clear that ultrasound has become a central tool in prenatal care in Vietnam and that it has also been embraced by women. However, there seems to be a need to balance women's demands for obstetric ultrasound with better recognition of the valuable contribution to be made by the full range of clinical examinations in pregnancy, along with a more strategic allocation of resources, that is, use of obstetric ultrasound based on clinical indications. Better regulation of private obstetric practice also appears to be needed. While the root causes of sex selection need to be addressed at societal level, efforts are also required more immediately to find ways to combat the inappropriate use of ultrasound for the purpose of sex selection.