Severity and factors associated with depressive symptoms among type 2 diabetic patients in Vietnam / Journal of the ASEAN Federation of Endocrine Societies

Background@#Diabetes and psychiatric disorders often co-occur. The prevalence of depression in a person with diabetes is two times higher than that of the general population. During the last decade, the prevalence of diabetes in Vietnam has nearly doubled. However, there is little data regarding depressive symptoms among people with diabetes. Therefore, this study aims to explore the level of depressive symptoms and its associated factors among patients with type 2 diabetes mellitus in Hanoi, Vietnam.@*Methodology@#A cross-sectional study was conducted among 519 patients diagnosed with type 2 diabetes at the Agricultural General Hospital, one of the largest primary care hospitals for diabetes in Hanoi, Vietnam. Patient Health Questionnaire-9 (PHQ-9) was used to assess the severity of depressive symptoms. Multivariate Tobit and logistic regression models were applied to examine factors associated with the severity of depressive symptoms and medication adherence@*Results@#Approximately 45.2% of participants were identified as having depressive symptoms at different levels. The proportion of patients with mild, moderate, moderately severe, and severe depressive symptoms is 36.0%, 7.6%, 1.4%, and 0.2% respectively. Regarding the treatment process, patients being treated for their diabetes for a longer time were more likely to have depressive symptoms. DDepression was positively linked to currently drinking alcohol (Coef = 1.04; 95% CI = 0.30-1.78), having comorbidities (Coef = 1.08; 95% CI = 0.15; 2.01) and having irregular physical activities (Coef = -1.28; 95% CI = -2.18; -0.38). Patients with severe depressive symptoms (higher PHQ-9 score) were more likely to be non-adherent to their medications in the last month (AOR = 1.30; 95% CI = 1.17; 1.46).@*Conclusion@#Our study shows that a high percentage of patients with diabetes have depressive symptoms. There is a strong association between having depressive symptoms and non-adherence to medications in the last month. To reduce the risk of developing depressive symptoms, depression should be screened at the initial treatment process and patients should be advised to avoid alcohol and to engage in physical activities regularly.

Cisteína oral N-Acetyl versus indometacina retal para prevenção de pancreatite pós-CPRE: um ensaio controlado randomizado multinacional multicêntrico / Oral n-acetyl cysteine versus rectal indomethacin for prevention of post ercp pancreatitis: a multicenter multinational randomized controlled trial

ABSTRACT Background This multicenter multinational RCT designed to compare the efficacy of suppository indomethacin and NAC for prevention of PEP. Methods: During a 6-month period, all of the ERCP cases in seven referral centers were randomly assigned to receive either 1200 mg oral NAC, indomethacin suppository 100 mg, 1200 mg oral NAC plus indomethacin suppository 100 mg or placebo 2 hours before ERCP. The primary outcomes were the rate and severity of any PEP. Results: A total of 432 patients included (41.4% male). They were originally citizens of 6 countries (60.87% Caucasian). They were randomly allocated to receive either NAC (group A, 84 cases), rectal indomethacin (group B, 138 cases), NAC + rectal indomethacin (group C, 115 cases) or placebo (group D, 95 cases). The rate of PEP in groups A, B and C in comparison with placebo were 10.7%, 17.4%, 7.8% vs 20% (P=0.08, 0.614 & 0.01 respectively). The NNT for NAC, indomethacin and NAC + indomethacin was 11, 38 and 8 respectively. Conclusion: Oral NAC is more effective than rectal indomethacin when compared to placebo for prevention of PEP and the combination of NAC and Indomethacin had the lowest incidence of PEP and may have synergistic effect in preventing of PEP (IRCT20201222049798N1; 29/12/2020).

RESUMO Contexto: Este estudo randomizado, controlado multicêntrico e multinacional foi projetado para comparar a eficácia da indometacina supositório e N-acetil cisteína (NAC) para prevenção de pancreatite pós colangiografia endoscópica. Métodos: Durante um período de 6 meses, todos os pacientes submetidos à CPRE em sete centros de referência foram aleatoriamente atribuídos para receber 1200 mg de NAC oral, supositório de indometacina 100 mg, 1200 mg de NAC oral mais supositório de indometacina 100 mg ou placebo 2 horas antes do procedimento. Os resultados primários foram a taxa e a gravidade de qualquer pancreatite pós procedimento (PPP). Resultados: Um total de 432 pacientes foram incluídos (41,4% do sexo masculino). Eram originalmente cidadãos de seis países (60,87% caucasianos). Foram alocados aleatoriamente para receber NAC (grupo A, 84 casos), indometacina retal (grupo B, 138 casos), NAC + indometacina retal (grupo C, 115 casos) ou placebo (grupo D, 95 casos). A taxa de PPP nos grupos A, B e C em comparação com o placebo foi de 10,7%, 17,4%, 7,8% vs 20% (P=0,08, 0,614 e 0,01, respectivamente). Conclusão A NAC oral é mais eficaz do que a indometacina retal quando comparado ao placebo para prevenção de PPP e a combinação de NAC e indometacina teve a menor incidência de PPP e pode ter efeito sinérgico na sua prevenção de PPP. (IRCT20201222049798N1; 29/12/2020).

The first community outbreak of COVID-19 in Viet Nam: description and lessons learned

@#Objective: At the time of this study, the prevention of novel coronavirus disease 2019 (COVID-19) relied solely on nonpharmaceutical interventions. Implementation of these interventions is not always optimal and, consequently, several cases were imported into non-epidemic areas and led to large community outbreaks. This report describes the characteristics of the first community outbreak of COVID-19 in Viet Nam and the intensive preventive measures taken in response. Methods: Cases were detected and tested for SARS-CoV-2 by real-time reverse transcriptase polymerase chain reaction. Contact tracing and active surveillance were conducted to identify suspected cases and individuals at risk. Clinical symptoms were recorded using a standardized questionnaire. Results: In Vinh Phuc province from 20 January to 3 March 2020, there were 11 confirmed cases among 158 suspected cases and 663 contacts. Nine of the confirmed cases (81.8%) had mild symptoms at the time of detection and two (18.2%) were asymptomatic; none required admission to an intensive care unit. Five prevention and control measures were implemented, including quarantining a community of 10 645 individuals for 20 days. The outbreak was successfully contained as of 13 February 2020. Discussion: In the absence of specific interventions, the intensive use of combined preventive measures can mitigate the spread of COVID-19. The lessons learned may be useful for other communities.

Application of the artificial neural network to optimize the formulation of self-nanoemulsifying drug delivery system containing rosuvastatin

The objectives of this study were to optimize the formula of the self-nanoemulsifying drug delivery system (SNEDDS)containing rosuvastatin and to evaluate its physicochemical characteristics. The solubility and compatibility ofrosuvastatin in surfactants, cosurfactants, and oil excipients were evaluated. The D-optimal experimental design,created by JMP 15 software, was used for analyzing the effects of excipients on the physicochemical characteristicsof SNEDDS to optimize the rosuvastatin SNEDDS formula. The generated nanoemulsions from Ros SNEDDS werecharacterized for droplet size, polydispersity index, and entrapment efficiency. As a result, Cremophor RH40, Capryol90, and PEG 400 were selected to develop the pseudoternary phase diagram to identify the area capable of selfforming nanoemulsion. As the percentage of rosuvastatin calcium increased from 8% to 12%, the area for optimizingthe formula of Ros SNEDDS decreased. The Ros SNEDDS prepared according to predicted formulas possessed selfemulsification to form nanoemulsion with average droplet size less than 100 nm, polydispersity index less than 0.3,and rosuvastatin entrapment higher than 90%.

Enhancing surveillance for early detection of Zika virus infection: strategies for the countries of Eastern Mediterranean Region

Background: Zika virus infection (ZIKV) has caused major outbreaks in tropic and sub-tropic areas. No case from ZIKV has yet been reported in the countries of the Eastern Mediterranean Region (EMR) despite the presence of competent vector Aedes mosquitoes in many of these countries.

Aims: This study addresses appropriate surveillance strategies for early detection of ZIKV infection, which is important for EMR countries with established Aedes populations, but with no known or documented autochthonous transmission of ZIKV.

Methods: The WHO Regional Office for the Eastern Mediterranean developed a strategic framework for enhancing surveillance for ZIKV infection in EMR countries with established Aedes populations through a consultative process and review of available evidence.

Results: The framework calls for enhancing surveillance for early detection of ZIKV infection using a combination of both syndromic and event-based surveillance approaches.

Conclusions: Enhancing surveillance for ZIKAV would require no shift in the existing system. A number of considerations would be required to integrate this syndromic and event-based surveillance approaches within the existing system

Task sharing for family planning services, Burkina Faso

Problem: In Burkina Faso, the coverage of services for family planning is low due to shortage of qualified health staff and limited access to services.Approach:Following the launch of the Ouagadougou Partnership, an alliance to catalyse the expansion of family planning services, the health ministry created a consortium of family planning stakeholders in 2011. The consortium adopted a collaborative framework to implement a pilot project for task sharing in family planning at community and primary health-care centre levels in two rural districts. Stakeholders were responsible for their areas of expertise. These areas included advocacy; monitoring and evaluation; and capacity development of community health workers (CHWs) to offer oral and injectable contraceptives to new users and of auxiliary nurses and auxiliary midwives to provide implants and intrauterine devices. The health ministry implemented supportive supervision cascades involving relevant planning and service levels.Local setting In Burkina Faso, only 15% (2563/17 087) of married women used modern contraceptives in 2010.Relevant changes Adoption of new policies and clinical care standards expanded task sharing roles in family planning. The consortium trained a total of 79 CHWs and 124 auxiliary nurses and midwives. Between January 2017 and December 2018, CHWs provided injectables to 3698 new users, and auxiliary nurses or midwives provided 726 intrauterine devices and 2574 implants to new users. No safety issues were reported.Lessons learnt The pilot project was feasible and safe, however, financial constraints are hindering scale-up efforts. Supportive supervision cascades were critical in ensuring success

Morbidity and mortality of acute respiratory infections in Thai Binh province, Vietnam, 2002-2005

Background: Acute Respiratory Infection (ARI) is a common disease in developing countries. Morbidity and mortality of ARI are high, especially among children under 15 years old. Objectives: To describe socio-graphic factors, seasonal patterns, risky areas and determine the morbidity and mortality rates of acute respiratory infections in Thai Binh province. Subjects and method: This retrospective study reviewed the medical records of 4,585 hospital admitted patients who were diagnosed with ARI including upper and lower respiratory infections such as sore throat, pharyngitis, bronchitis, pneumonia and bronchitis-pneumonia at 8 district hospitals and 1 provincial hospital in Thai Binh province during 2002-2005. The selected medical records were based on the available check list and two standard screening tests. Results:Morbidity and mortality of ARI in Thai Binh province were 61.6 and 0.52, respectively. ARI mainly occurred among children under 5 years old, of which the highest mortality was among those under 12 months of age. Male children were at higher risk of acquiring ARI, but less prone to death than female. Occupation did not significantly associate with the risk of ARI. The morbidity increased sharply during inter-season, e.g. March and October. Thai Binh city, Kien Xuong and Tien Hai district were reported with the highest morbidity in accompany of the high mortality as consequences. Conclusion: The prevention and control methods were recommended to annually focus on the male children aged less than 5 years old during March and October in Thai Binh city, Kien Xuong and Tien Hai district.

Emerging a member of reoviridae family associated with acute encephalitis syndrome in Gia Lai province, 2005

Background: In recent years, some arbo viruses which causes acute encephalitis syndrome (AES) have been identified in serveral countries in the world such as Chandipura virus belonging to Rhabdoviridae family in India, Banna virus belonging to Reoviridae family in China. In Vietnam, apart from Japanese Encephalitis Virus which is considered as main cause of AES, there are a few intestinal viruses like Herpes symplex virus type 1 and 4 and Nam Dinh virus considering other causes of AES. Objective: To identify the hyppothesis that one virus strain parasitizing in mosquito in Gia Lai province causes AES in order to provide more information about virus strains which cause AES in Vietnam. Subjects and method: Aedes albopictus cell line clone C6/36 was used for the isolation of virus in 43 cerebrospinal fluid samples of patients who were treated in Gia Lai hospital, from January/2005 to July/2005. Result and Conclusion: One virus strain from a 3-year old girl in Gia Lai province was isolated in 2005. The virus coded 05VN225 has the morphology similar to other viruses belonging to Reoviridea family.The nucleic acid sequence of the virus was checked with specific primers of alphavirus and flavirus groups, Nam Dinh virus and Conti virus group B (reovirus) of the Reoviridae. The positive result was confirmed with reovirus primers. This member of the Reoviridae family was isolated from acute encephalitis syndrome in Vietnam in 2005. Further study on pathology of the virus is very necessary.

Expressions of type I and type III collagens and tenascin-C in rat bone mesenchymal stem cells co-cultured with ligament fibroblasts / 生物医学工程学杂志

Bone marrow mesenchymal stem cells (BMSCs) can be directed to differentiate into a variety of cell types depending on their micro-environment. In this study, rat BMSCs were co-cultured with rat ligament fibroblasts during different time courses. The mRNA expressions of type I, type III collagens and tenascin-C were measured by real time RT-PCR, and the corresponding protein levels of type I and type III collagens by radioimmunoassay. Results show that the mRNA expressions of type I and type III collagens in the BMSCs were 2 times up-regulated after a 6-day co-culture, and the relative mRNA expressions of type I and type III collagens were 3.9 +/- 0.2 and 1.9 +/- 0.2, while they were 1.9 +/- 0.3 and 0.8 +/- 0.1 in the control groups, respectively. The protein syntheses of these two collagens were also increased after a 12-day co-culture; the type I and type III collagens synthesis were 13.6 +/- 1.3 ng/microg and 5.9 +/- 0.5 ng/microg in co-culture groups and 12.4 +/- 0.8 ng/microg and 5.0 +/- 0.4 ng/microg in their control groups, respectively. Likewise, there was a 2 times enhancement in tenascin-C mRNA expression after the 12-day co-culture (0.07 +/- 0.02 by control group and 0.14 +/- 0.02 by co-culture group, P < 0. 05). These data suggest that the presence of the ligament fibroblast promotes the syntheses of type I and the III collagens and tenascin-C in the rat BMSC.

Detection of apoptotic frequency in Chinese hamster ovary (CHO-K1) cells after gamma-irradiation using both neutral Comet assay andterminal desoxynucleotidyl transferase (TdT) assay

<p><b>OBJECTIVES</b>Two assay methods, namely the neutral Comet assay andterminal desoxynucleotidyl transferase (TdT) assay, were carried out for comparison to investigate the capability of using the neutral Comet assay as an alternative for detection of apoptosis.</p><p><b>MATERIALS AND METHODS</b>Chinese hamster ovary-K1 (CHO-K1) cells were exposed to gamma-rays with different doses and then the frequencies of apoptotic cells were determined at given points of time using the neutral Comet assay andTdT assay.</p><p><b>RESULTS</b>Apoptotic frequency of CHO-K1 cells after gamma-irradiation is dependent on both time after irradiation and radiation dose using either the neutral Comet assay orTdT assay. There are differences between the data obtained using the neutral Comet assay andTdT assay (p<0.01, Student's t-test).</p><p><b>CONCLUSIONS</b>The neutral Comet assay appears to be an appropriate tool for detection of radiationinduced apoptosis at the early stage of the process. Compared to the other methods such as theTdT assay, the neutral Comet assay is a rapid, simple and economical method for detection of apoptosis.</p>

the typhoid and essential fever

A study aims to determine the etiological spectrum of the essential fever, the danger of typhoid in status of the long-lasting fever as well as the epidermiological and clinical features and tests which related with the experiences in diagnosis. The subjects included all adult patients admitted to the department of the essential fever in the Institute of the Clinical Medicine and Tropical disease in Ho Chi Minh city during 8/1995 12/1998. A retrospective and descriptive study has shown that there were 154 patients with ages of 36+/- 14; the average duration of fever before admitting to hospital was 48+/- 36 days; there were 92 patients were treated before admission.

The rate of intestinal helminthiasis in Thanh Luu (Ha Nam province) and results of mass treatment with mebendazole

The sample of faeces of 279 cases at Thanh Luu- Thanh Luong commune, Ha Nam province, especially the children under 15 years old, were collected, in order to identify the rate of intestinal helminthiasis and the effect of mebendazole from October 10-17, 1998. Results: the rate of helminthiasis was 85.3% and all participants were infected only Ascaris lumbricoides and trichirura. The rate of multiinfection was 52.1%. There was no difference of infection by age, sex. Single dose of mebendazole 400 mg eliminated 65% of cases of infection. Vomiting with worm occurred in 1.67% of cases.