Khoa Y, Đại học Quốc gia Thành phố Hồ Chí Minh

Background: Monochorionic twins are a high risk pregnancy and are associated with special complications that are unique to sharing a placenta and because of the hemodynamic imbalance caused by placental vascular anastomoses. Therefore, the outcome of monochorionic twins is still being researched and reported to looking for the best evidence to perform the optimal interventions. Objectives: To describe the outcome of monochorionic twins to determine the proportion of special complications. Moreover, exploring the rate of fetal death in uterus, premature delivery, the successful vaginal birth in complicated monochorionic twins after bipolar cord coagulation. Materials and Methods: Case series report of monochorionic twins which was managed pregnancy and delivered at Tu Du hospital between January 2018 and January 2019, comprised 166 cases with 81 complicated monochorionic twin pregnancies. Results: The series comprised 85 uncomplicated monochorionic twins (51.2%) and 81 complicated cases (48.8%) with 15% twin-twin transfusion syndrome (TTTS) and 28.3% selective intrauterine growth restriction (sIUGR). Nineteen cases of bipolar cord coagulation perfomed included seven TTTS, eight sIUGR, three cases with serious malformation, and one twin reversed arterial perfusion sequence (TRAP). Conclusions: TTTS and sIUGR are complications unique to monochorionic twins and diagnosed in the early stage after 23 week’s gestation. Bipolar cord coagulation is an effective procedure in complicated monochorionic pregnancies to improve pregnancy outcome.

Thai ngoài tử cung đoạn kẽ là một bệnh lý hiếm gặp nhưng nguy hiểm, ảnh hưởng đến tính mạng và tương lai sản khoa của người bệnh. Can thiệp phẫu thuật là một chọn lựa điều trị quan trọng, đôi khi là chỉ định tuyệt đối trong một số trường hợp. Hiện chưa có những đồng thuận về việc quản lý thai kỳ tiếp theo sau phẫu thuật điều trị thai ngoài tử cung đoạn kẽ, trong thực hành lâm sàng việc cung cấp thông tin chính xác cho người bệnh về những nguy cơ tiềm ẩn trong lần mang thai tiếp theo vẫn là một thách thức. Bài tổng quan nhằm mục đích đề cập đến những nguy cơ đáng ngại và đề xuất kế hoạch quản lý thai kỳ phù hợp sau phẫu thuật điều trị thai ngoài tử cung đoạn kẽ dựa trên những bằng chứng y học hiện tại.

Objective: To describe the presentation, diagnosis, and treatment children with endoscpically confirmed laryngomalacia in hospitalized at the respiratory department of children’s hospital 1. Methods: Prospective case series children with endoscpically confirmed laryngomalacia dunring 1-year period 05/2020 to 05/2021. We included all 34 children under 2 years old with endoscpically confirmed laryngomalacia without prior documentation of the diagnosis. Results: 34 children had a confirmed diagnosis of laryngomalacia and were thus included (1.8:1 male to female sex ratio; mean age, 3 months, age range, 0-6 months). Twenty- three children (67,6%) presented with stridor, 34 (100%) with pulmonary rales, 33 (97,1%) with using accessory respiratory muscles. Type 1 laryngomalacia was the most commoly encountered (29,4%). Most with severe laryngomalacia (52,9%) needed medical treatments in our study. GERD and pneumonia are theo two common comorbidities in our study. Medical comorbidites were associated with severe laryngomalacia. Conclusions: Early diagnosis of laryngomalacia by typical clinical presentations and flexible fiberoptic laryngoscopy may improve the disease severity and outcomes of laryngomalacia patients. Besides, evaluating and treating the comorbidities are also important.

Presently, shortening the time-to-result of antimicrobial susceptibility test (AST) is of the utmost importance for sepsis management in an effort to reduce mortality and antibiotic resistance rate. HB&L ((Human Biological Liquid Culture), a product of the Alifax company (Italy), can detect replicating microorganisms and their antibiotic resistance in a few hours with high sensitivity and specificity by using light scattering technique. This study aims to evaluate the correlation between rapid antibiogram using the HB&L system and the routine methods on positive blood cultures at the Hospital for Tropical Diseases in Ho Chi Minh City from March 2020 to April 2021. Gram-positive bacteria blood samples were tested against Cefoxitin, Vancomycin while Gram-negative bacteria samples were trialed with Ceftriaxone, Levofloxacin, Piperacillin-Tazobactam and Meropenem. The concordance of the two methods was defined by the categorical agreement (CA), very major errors (VME), major errors (ME) and minor errors (mE) in Cumitech 31A. Of the 81 blood culture samples containing Gram-negative bacteria, the CA of Ceftriaxone, Meropenem, Levofloxacin and Piperacillin-Tazobactam were 90%, 100%, 67% and 88%. The maximum VME was 22% for Levofloxacin. On the other hand, of the 32 Gram-positive samples, CA and VME of Cefoxitin were 53% and 65% respectively while CA of Vancomycin was 100%. The median time to receive rapid AST results of the HB&L system is 4.43 hours faster than the standard that.

Background: Assessment of the level of Activities of Daily Living (ADL) in heart failure elderly inpatients is important factors in comprehensive geriatric caring. Objectives: Investigating the level of activities of daily living in elderly inpatients at Department of Cardiology of Thong Nhat Hospital and age, gender and heart failure (HF) by Katz index. Method: A cross-sectional study on 202 elderly inpatients (≥60 years old) treated at Department of Cardiology of Thong Nhat Hospital was assessed ADL by Katz index from 05/2020 to 05/2021. Results: In general population, the proportions of independence, partial dependence, and complete dependence are 64.4%, 16.8%, and 18.8%, respectively. The dependency proportions (complete and partial) in 60-69 group, 70-79 group, ≥80 were 30.2%, 48.1% và 32.3% (p=0.003), correspondingly. Female patients had a higher rate than male patients (45.5% compared to 28.0%) (p=0.035). Patients with HF had a dependency rate of 55.1%, 27.8% higher than the group without HF (p=0.001). Conclusions: The in dependence of ADL rate in elderly inpatients at Department of Cardiology, Thong Nhat Hospital is high. Patients in age group 70-79, female, with heart failure have a higher decline in ADL than the other group.

Objective: The research was conducted with the purpose of estimating the prevalence of Anxiety Disorder and associated factors among students of School of Medicine – Vietnam National University Ho Chi Minh City. Methods: A cross-sectional study was carried out on 906 students of the School of Medicine - Vietnam National University Ho Chi Minh City from 9th to 30th September 2021. Full sampling technique, collecting the data by using self-completed questionnaires through Google Form. This study used the Zung Self-Rating Anxiety Scale (SAS) to assess anxiety disorders. Results: The study showed that the prevalence of anxiety disorder among students of School of Medicine - Vietnam National University Ho Chi Minh City was 36.2%. In which, the level of anxiety from mild to moderate, severe anxiety and extreme anxiety respectively: 27.92%; 7.4%; 0.88%. Factors associated with anxiety include: gender, having someone to share with, pressure on academic performance, pressure on family and social relationships, pressure from COVID-19, financial pressure, pressure on appearance and social networks time use. Conclusion: The prevalence of anxiety disorders among students of School of Medicine - Vietnam National University Ho Chi Minh City is alarming. Finding out the associated factors helps to identify groups of students that need to be prioritized in detecting mental health problems and taking appropriate measures to improve their mental health.

Background: Breast cancer often metastasizes to the bone that is the big reservoir of available tissue contained within the human skeleton and the environmental conditions surrounding it. Once cancer cells have metastasized to bone, they are generally incurable and have devastating effects on patients. However, the underlying molecular mechanisms of cancer metastasis to bone are poorly understood. It is still not clear why some patients metastasize, others do not, and not all metastatic patients progress bone metastasis. So, there is a clinical need to investigate the biomarkers that could accurately identify early prognostic prediction for patients with bone metastasis. Methods: Clinical information and gene expression profiles from breast cancer patients were retrieved from GEO, including GSE2034 (n=286) and GSE2603 (n=82). Chi-square, Kaplan-Meier curves, and log-rank tests were performed in the R environment to evaluate the prognostic value of DIMT1. All statistical analyses were considered significant if a value of less than 0.05. Results: We found that breast cancer patients with high expression levels of DIMT1 had poor bone metastasis-free survival outcomes and suggested DIMT1 as an independent predictor of bone metastasis. Moreover, DIMT1 also helps to obtain greater insights into the heterogeneity of breast cancer patients with triple-negative. Conclusion: DIMT1 is a potential predictor in gaining insights into the heterogeneous landscape of bone metastatic. Moreover, by integrating into the molecular subtypes, DIMT1 can further subclassify patients into two risk groups, thereby enabling more informed therapeutic decisions and improved prognostics for breast cancer. Together, these findings indicate the general utility of DIMT1 as a biomarker in the age of personalized and precision medicine.

Coronavirus disease 2019 (COVID-19) has been a great global public health issue for two years. In November 2021, a new variant, B.1.1.529, of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in South Africa and caused a rapid rise in COVID-19 cases. On 26 November 2021, the World Health Organization (WHO) named this variant Omicron and classified it as a variant of concern (VoC). The spike protein of this variant contains a high number of mutations, raising concerns about viral transmissibility, pathogenicity, immune evasion, and neutralization by antibodies. When the early Omicron surge occurred, preliminary data showed that the transmission of this variant was extremely fast, but the number of patients with severe symptoms was low. This review will describe the characteristics of the Omicron variant and compare the mutations of the spike in the five VoCs. We also look over research and opinions on the Omicron variant and evaluate epidemiological data from the Omicron wave and the Delta wave. In the review discussion, we will discuss Omicron whether it is a challenge for global vaccine campaigns, whether it is a sign of a waning pandemic, and how we acknowledge the new variant and future of the COVID-19 pandemic.

Several metals in soil affect the production of secondary metabolites in medicinal plants. In this study, we have determined concentrations of K, Mn, Fe, Zn, Cu in soils collected at Tinh Bien, Tri Ton, Thoai Son, and Cam Mountain areas in An Giang province by X-Ray Fluorescence Spectroscopy (XRF). We simultaneously evaluated the total phenolic and flavonoid content of methanol extracts from Solanum torvum (Sw.) leaves and Zingiber zerumbet (L.) rhizomes harvested in Tinh Bien and Cam Mountain. The results showed that the concentrations of metals reached the highest values at the soil particle size 0.25 mm among three sizes: 0.25 mm, 1 mm, and 2 mm. Whereas, the metal contents at two sampling depths 0-15 cm and 15-30 cm were similar. The concentrations of K and Cu in the soil in Tinh Bien are higher than Cam Mountain at 1.18 times and 1.70 times; however, the Fe, Zn, Mn content in Tinh Bien is lower at 2.16 times, 1.64 times, and 1.43 times. Thereby, it can be seen that the higher concentration of K and Cu may contribute to increasing the total phenolic content about 1.8 times with the Zingiber zerumbet (L.) rhizomes sample, and the flavonoid content by 2.5 times for the Solanum torvum (Sw.) leaves sample in Tinh Bien compared to Cam Mountain. Meanwhile, the concentrations of Fe, Zn, and Mn did not affect the flavonoid and phenolic content in these two plants

Introduction: Fish mint (Houttuynia cordata Thunb.) has been widely used in both traditional and modern medicine for a long time. Its flavonoid component has a variety of pharmacological effects that have been demonstrated in previous studies. In this research, we optimized the ultrasoundassisted extraction (UAE) of flavonoid-rich content from Houttuynia cordata Thunb. using response surface methodology - central composite design (RSM-CCD). Methods: Based on the results of single-factor test , central composite design (CCD) approach-based response surface methodology (RSM) analysis was utilized to evaluate the effects of ethanol concentration, solid-liquid ratio, extraction time, and temperature on the total flavonoid content expressed as rutin equivalents. Flavonoid component from the extract under optimum conditions was then identified by using UPLC-ESI-MS. Results: The optimum conditions for obtaining the maximum TFC (53.6321 +/- 0.9474 mg RE/g) were found at 80% ethanol concentration, 1/60 g/mL solid-liquid ratio for 38 min at 60 oC. Using UPLC-ESI-MS, we determined six major flavonoid compounds in the extract: rutin, hyperin, isoquercitrin, quercitrin, afzelin, and quercetin. Conclusion: From these results, this study showed that UAE is a fast and efficient technique for flavonoids extraction from the fish mint.