ABSTRACT
Objectives@#Tuberculosis (TB) and drug-resistant TB (DR-TB) are national health burdens in Vietnam. In this study, we investigated the prevalence of rifampicin (RIF) and/or isoniazid (isonicotinic acid hydrazide, INH) resistance in patients with suspected TB, and applied appropriate techniques to help rapidly target DR-TB. @*Methods@#In total, 1,547 clinical specimens were collected and cultured using the BACTEC MGIT system (Becton Dickinson and Co.). A resazurin microtiter assay (REMA) was used to determine the proportions of RIF and/or INH resistance. A real-time polymerase chain reaction panel with TaqMan probes was employed to identify the mutations of rpoB and katG associated with DR-TB in clinical isolates. Genotyping of the identified mutations was also performed. @*Results@#A total of 468 Mycobacterium tuberculosis isolates were identified using the REMA. Of these isolates, 106 (22.6%) were found to be resistant to 1 or both antibiotics. Of the resistant isolates, 74 isolates (69.8%) were resistant to isoniazid (INH) only, while 1 isolate (0.94%) was resistant to RIF only. Notably, 31 isolates (29.24%) were resistant to both antibiotics. Of the 41 phenotypically INH-resistant isolates, 19 (46.3%) had the Ser315Thr mutation. There were 8 different rpoB mutations in 22 (68.8%) of the RIF-resistant isolates. The most frequently detected mutations were at codons 531 (37.5%), 526 (18.8%), and 516 (6.3%). @*Conclusion@#To help prevent new cases of DR-TB in Vietnam, it is crucial to gain a comprehensive understanding of the genotypic DR-TB isolates.
ABSTRACT
Even though the combined use of ultrasound (US) and alpha-fetoprotein (AFP) is recommended for the surveillance of hepatocellular carcinoma (HCC), the utilization of AFP has its challenges, including accuracy dependent on its cut-off levels, degree of liver necroinflammation, and etiology of liver disease. Though various studies have demonstrated the utility of protein induced by vitamin K absence II (PIVKA-II) in surveillance, treatment monitoring, and predicting recurrence, it is still not recommended as a routine biomarker test. A panel of 17 experts from Asia-Pacific, gathered to discuss and reach a consensus on the clinical usefulness and value of PIVKA-II for the surveillance and treatment monitoring of HCC, based on six predetermined statements. The experts agreed that PIVKA-II was valuable in the detection of HCC in AFP-negative patients, and could potentially benefit detection of early HCC in combination with AFP. PIVKA-II is clinically useful for monitoring curative and intra-arterial locoregional treatments, outcomes, and recurrence, and could potentially predict microvascular invasion risk and facilitate patient selection for liver transplant. However, combining PIVKA-II with US and AFP for HCC surveillance, including small HCC, still requires more evidence, whilst its role in detecting AFP-negative HCC will potentially increase as more patients are treated for hepatitis-related HCC. PIVKA-II in combination with AFP and US has a clinical role in the Asia-Pacific region for surveillance. However, implementation of PIVKA-II in the region will have some challenges, such as requiring standardization of cut-off values, its cost-effectiveness and improving awareness among healthcare providers.
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Objective: The aim of the study was to assess the effectiveness of educational interventions on the knowledge andcounseling practice of community pharmacists in Hue, Vietnam with respect to common cold management.Method: Thirty-eight pharmacists were invited to participate in educational initiatives, including in-class training andreference to a printed pocket handbook. The knowledge was measured before and after the interventions via a paperbased test, and actual practice was evaluated via a pseudo customer experiment a week later.Results: The interventions significantly improved pharmacists’ knowledge (p = 0.001). In the pre-test, only 37.4%of the participants provided correct answers, but this increased to 83.9% in the post-test. In the pseudo customerexperiment, pharmacists asked about patient identification, age, and symptoms (93.3%, 80.0%, and 80.0%,respectively) but not about medical and medication histories or allergies (less than 20%). All pharmacists offeredadvice as regards dosage, but only half of them shared information on drug names and indications. A third providedguidance on drug interactions. Practices related to inappropriate drug dispensing included the issuance of incorrectmedications or the sale of prescription-only drugs to customers with no prescriptions.Conclusion: Although educational interventions effectively enhance the knowledge and counseling practice ofpharmacists, a huge gap continues to exist between these variables.
ABSTRACT
Space exploration is one of the dreams of humankind. However, the intriguing environment was a challenge for the human body, where we must counter with many extreme conditions such as thermal support, radiation, microgravity. Life, as well as the human body, developed and evolved in the continuous presence of gravity, especially when living creatures transfer from the ocean to the land. Once this gravitational force doesn't impact on the body, the drastic changes occur. Some of these changes were observed immediately, while others progress only slowly. Since the first orbital flight was performed, several hazards for the organs of the human body were identified [1]. These changes in human physiology can reverse when astronauts return to Earth. This article will review the published findings of the effects of microgravity exposure on the human body.
ABSTRACT
The objective of this study was to develop and validate a new simple tool for identifying Thai women who are at high risk of having osteoporosis. A total of 322 women, aged > or = 45 years, were randomly divided into two cohorts: a development (n = 130) and a validation cohort (n = 192). Femoral neck and lumbar spine BMD were measured by LUNAR DPX-IQ densitometer. The prevalence of osteoporosis (defined by BMD T-scores < or = -2.5) was 33 per cent by either femoral neck or lumbar spine BMD. Khon Kaen Osteoporosis Study (KKOS), scoring based on age and weight was calculated and applied to the development cohort. Individuals with KKOS score < or = -1 were defined as "high risk"; otherwise a "low risk" was defined. In the validation cohort, the sensitivity and specificity of KKOS was 70 and 73 per cent, respectively. Furthermore, if the high risk individuals identified by KKOS are to be treated, and if the treatment reduces fracture incidence by 50 per cent and assuming that treatment cost is 10 bahts per day, then the cost to prevent one fracture is estimated to be 466,695 bahts per year. These data suggest that although age and body weight can be used to identify Thai women who are at high risk of having osteoporosis, its application to the general population requires further research to arrive at the optimal cost-benefit for the community.