Epidural injection-related pneumorrhachis: A case report with cauda equina syndrome.

Pneumorrhachis (PR) is an uncommon condition characterized by the accumulation of air within the spinal canal. This finding may occur due to various causes, mostly after trauma and medical procedures. It can manifest with various features depending on the underlying cause, the location, and the extent of the air trapped. Clinically, the symptoms in affected patients can span a spectrum, ranging from being asymptomatic to manifesting as radiculopathies resulting from compression. The pneumorrhachis-related cauda equina syndrome is incredibly rare and typically appears as a large volume of air causing compression or irritation of the nerve roots in the lower spinal cord. In this report, we present a female patient whose cauda equina syndrome developed as a result of accidental extradural pneumorrhachis after epidural injection in the lumbar spine.

Role of Calprotectin, IL-6, and CRP in Distinguishing Between Inflammatory Bowel Disease and Diarrhea Predominant Irritable Bowel Syndrome.

Background: The early establishment of prophylaxis and immediate administration of anticoagulant therapy upon the diagnosis of venous thromboembolism should be the treatment objectives in these patients. Objective: The study aimed to determine the optimal cut-off point of Calprotectin, IL-6 (interleukin-6), CRP (C reactive protein) to differentiate UC, IBS-D. Methods: A cross-sectional descriptive study of 335 individuals ≥15 years old was performed, including 31 healthy controls, 215 with IBS-D, 71 diagnosed with UC, and 18 diagnosed with CD. Receiver Operating Characteristics (ROC), sensitivity, specificity, and area under curve (AUC) were computed. Results: The results showed that the median value of calprotectin (IQR) in healthy participants was 20.0 (6.0 - 34.0) µg/g; 17,7 (8,7-38,9) µg/g in IBS-D group; 1710.0 (588 - 4260,0) µg/g in UC group; and 560.5 (177.8 - 1210.0) µg/g in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of CRP (range IQR) was 1,3 (0,9 - 2,3) mg/L in IBS-D group; 7.0 (2.4 -16.6) mg/L in UC group; and 10.1 (2.2 - 42.5) mg/L in CD group. CRP concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of IL-6 (range IQR) was 2.3 (1.6 - 5.7) pg/mL in IBS-D group; 16.8 (9.4 - 47.0) pg/mL in UC group; and 9.4 (7.9 - 11.0) pg/mL in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The optimal cut-off point of calprotectin that differentiated IBS-D from IBD was 110.5 µg/g, with sensitivity and specificity of 93.3% and 91.4%, respectively; of IL-6 was 7.2 pg/mL with sensitivity and specificity of 92.0% and 78.0%, respectively; of CRP of 2.4 mg/L had specific sensitivities of 83.3% and 86.0%, respectively. Conclusion: The Calprotectin immunoassay has the best value in discriminating between IBD and IBS-D.

Phytochemical constituents from the rhizomes of Kaempferia parviflora Wall. ex Baker and their acetylcholinesterase inhibitory activity.

Phytochemical study on the rhizomes of Kaempferia parviflora led to the isolation of twenty-three compounds including six phenolic glycosides (1-6), thirteen flavones (7-19), and five phenolic compounds (20-23). Of these, the new compounds were determined to be 2,4-dihydroxy-6-methoxyacetophenone-2-ß-D-apiofuranosyl-(1→6)-ß-D-glucopyranoside (1), 2-hydroxy-4-propionyl-phenyl O-ß-D-glucopyranoside (2), and 4-hydroxy-3,5-dimethoxyacetophenone 8-O-α-L-rhamnopyranosyl-(1→6)-ß-D-glucopyranoside (3) and named as kaempanosides A-C, respectively. Their chemical structures were established based on HR-ESI-MS, 1D and 2D NMR spectra. All compounds 1-23 exhibited acetylcholinesterase inhibitory activity with IC50 values ranging from 57.76 to 253.31 µM.

Calorie Restriction Impairs Anti-Tumor Immune Responses in an Immunogenic Preclinical Cancer Model.

(1) Background: Although the important role of dietary energy intake in regulating both cancer progression and host immunity has been widely recognized, it remains unclear whether dietary calorie restriction (CR) has any impact on anti-tumor immune responses. (2) Methods: Using an immunogenic B16 melanoma cell expressing ovalbumin (B16-OVA), we examined the effect of the CR diet on B16-OVA tumor growth and host immune responses. To further test whether the CR diet affects the efficacy of cancer immunotherapy, we examined the effect of CR against anti-PD-1 monoclonal antibody (anti-PD-1 Ab) treatment. (3) Results: The CR diet significantly slowed down the tumor growth of B16-OVA without affecting both CD4+ and CD8+ T cell infiltration into the tumor. Although in vivo depletion of CD8+ T cells facilitated B16-OVA tumor growth in the control diet group, there was no significant change in the tumor growth in the CR diet group with or without CD8+ T cell-depletion. Anti-PD-1 Ab treatment lost its efficacy to suppress tumor growth along with the activation and metabolic shift of CD8+ T cells under CR condition. (4) Conclusions: Our present results suggest that a physical condition restricted in energy intake in cancer patients may impair CD8+ T cell immune surveillance and the efficacy of immunotherapy.

Polycyclic Aromatic Hydrocarbons from Domestic Solid Waste Incinerators in Nam Dinh Province, Northern Area of Vietnam: A Comprehensive Assessment of Emission, Source Markers and Human Health Risk.

A comprehensive research of the polycyclic aromatic hydrocarbons (PAHs) emission from domestic waste incinerators in northern areas of Vietnam, were investigated. Sixty-four samples from two domestic waste incinerators were collected and analyzed for PAHs. The PAHs concentrations in the samples were determined using gas chromatography coupled with mass spectrometry. In April, June, September, and November 2021, Σ16PAHs mean concentrations in chimney air samples were 970.9 ± 57.4, 1061.9 ± 49.8, 1070.7 ± 41.3 and 1136.1 ± 136.5 µg m-3, respectively. The mean emission factors of Σ16PAHs were 7.5 mg/kg. The mean percentages of low molecular weight PAHs were predominant in the analyzed air samples. The toxic equivalent quotient of samples ranged from 30.7 to 41.7 mg/kg, whereas the incremental lifetime cancer risk exceeded 10- 3. This results implied a high level of concern with potentially negative health consequences. The four diagnostic ratios of PAHs were found and can be used for identification of sources markers from domestic waste incinerators.

Factors related to unfavorable outcome in minor ischemic stroke.

BACKGROUND: Stroke recurrence and disability are important challenges to overcome in patients with minor ischemic stroke. The aim of our study was to determine the factors associated with unfavorable outcomes in patients with minor ischemic stroke. METHODS: This was a prospective cohort study including patients with minor ischemic stroke with a National Institutes of Health Stroke Scale (NIHSS) score ≤ 4 who were treated at the Bach Mai Hospital stroke center from June 15, 2021, to September 15, 2022. Unfavorable outcome was defined as mRS 2-6 at 90 days. Multivariable logistic regression analysis was conducted to assess risk factors related to clinical outcomes. RESULTS: Of 678 patients presenting with minor ischemic stroke, there were 90 (13.3%, 90/678) patients with no intracranial artery imaging. Hence, 588 were patients analyzed, of whom 6.0% received thrombolytic therapy, 8.5% developed NIHSS > 4 in 24 hours, and 30.4% had intracranial stenosis > 50%. Compared with the group of unfavorable outcomes, the favorable outcome group had more NIHSS 0-1 (29.9% vs.8.7%, P<0.001), lower cardioembolic (3.2% vs.7.9%, P=0.021), low IV-tPA ratio (4.8% vs.10.3%, P=0.019), lower NIHSS progression > 4 in the first 24 hours (3.9% vs.25.4%, P<0.001), and lower ICAS rate (28.1% vs.38.9%, P=0.02). Multivariable regression analysis of factors affecting unfavorable outcomes included baseline NIHSS 2-4 (OR, 3.85; 95% CI, 1.97-7.52), NIHSS progression > 4 (OR, 7.57; 95% CI, 3.80-15.10), and ICAS (OR 1.68; 95%CI, 1.07-2.64). CONCLUSIONS: In patients with minor ischemic stroke, unfavorable outcomes were associated with baseline NIHSS 2-4, NIHSS progression > 4 points in 24 hours, and ICAS. These factors may identify a patient population in need of close monitoring and at higher risk of adverse outcomes.

Level of BTEX in the Areas of Domestic Waste Incinerators in Northern Vietnam: A Comprehensive Assessment of Contamination, Composition and Human Health Risk.

The trend of the treatment of solid domestic waste by the domestic waste incinerator system is an option to improve waste management and to reduce the negative impacts on the environment and human health. Benzene, toluene, ethylbenzene, and xylenes (o-, m- and p-) (BTEX) are toxic chemical environmental contaminants that are released from different sources such as the domestic waste incinerator system. To determine the concentration of BTEX in the ambient air from these incinerator areas, the research team conducted four sampling campaigns in April, June, September, and November 2021, with a total of 80 samples collected. Concentrations of benzene, toluene, (m,p)-xylenes, o- xylenes and ethylbenzene ranged from 4.53 to 36.75 µg/m3, from 16.29 µg/m3 to 125.36 µg/m3, from 2.82 µg/m3 to 31.45 µg/m3, from 1.42 µg/m3 to 25.61 µg/m3, from 1.32 µg/m3 to 10.79 µg/m3, respectively. As a result of the risk assessment, it was determined that the incinerator's exhaust gas caused secondary environmental damage, impacting the health of not only workers but also people living in nearby communities. On that basis, the article recommends applying a number of management measures to minimize the negative impacts of the operation of the solid waste incinerator on the environment and the health of the workers operating the incinerator.

Polypunctosides E-K: seven new steroidal saponins from Polygonatum punctatum Royle ex Kunth and their nitric oxide production inhibitory activities.

Polygonatum punctatum Royle ex Kunth is a high-value medicinal plant found in old natural forests. A phytochemical study on the roots of this plant led to the isolation of seven new steroidal saponins including four furostans (1-4) and three furospirostans (5-7). Their structures were elucidated as (25R)-26-O-(ß-D-glucopyranosyl)-furost-5-ene-3ß,17α,22α,26-tetraol 3-O-α-L-arabinopyranosyl-(1 → 2)-ß-D-glucopyranosyl-(1 → 4)-ß-D-galactopyranoside (1), (25R)-26-O-(ß-D-glucopyranosyl)-furost-5-ene-3ß,14α,17α,22α,26-pentaol 3-O-α-L-arabinopyranosyl-(1 → 2)-ß-D-glucopyranosyl-(1 → 4)-ß-D-galactopyranoside (2), (25R)-26-O-(ß-D-glucopyranosyl)-furost-5-ene-22α-methoxy-3ß,17α,26-triol 3-O-α-L-arabinopyranosyl-(1 → 2)-ß-D-glucopyranosyl-(1 → 4)-ß-D-galactopyranoside (3), (25R)-26-O-(ß-D-glucopyranosyl)-furost-5-ene-22α-methoxy-3ß,17α,26-triol 3-O-[α-L-arabinopyranosyl-(1 → 2)-ß-D-glucopyranosyl-(1 → 4)]-[acetoxy-(→ 6)]-ß-D-galactopyranoside (4), 26-O-(ß-D-glucopyranosyl)-14α,17α-dihydroxynuatigenin 3-O-α-L-arabinopyranosyl-(1 → 2)-ß-D-glucopyranosyl-(1 → 4)-ß-D-galactopyranoside (5), 26-O-(ß-D-glucopyranosyl)-17α-hydroxynuatigenin 3-O-α-L-arabinopyranosyl-(1 → 2)-ß-D-glucopyranosyl-(1 → 4)-ß-D-galactopyranoside (6), and 26-O-(ß-D-glucopyranosyl)-14α-hydroxynuatigenin 3-O-α-L-arabinopyranosyl-(1 → 2)-ß-D-glucopyranosyl-(1 → 4)-ß-D-galactopyranoside (7) by extensive spectroscopic analyses, including infrared, high-resolution electrospray ionization mass spectrometry, and one- and two-dimensional nuclear magnetic resonance spectroscopy. Compounds 1-7 inhibited nitric oxide production in lipopolysaccharide activated RAW264.7 cells with IC50 values ranging from 41.5 ± 3.2 to 62.2 ± 3.7 µM, compared to 33.8 ± 2.6 µM for the positive control compound L-NMMA.

Partial replacement of pelvis with the hip joint in osteosarcoma treatment: A case report.

INTRODUCTION: and importance: Pelvic osteosarcoma is quite rare and is a challenging task for orthopedic surgeons. This aim of this study is to present the first case report using customized 3D-printed prosthesis in Vietnam. CASE PRESENTATION: 57-year-old male was diagnosed with pelvic osteosarcoma. After neoadjuvant chemotherapy, we did limb-salvage surgery after partial pelvic resection. He had to undergo another surgery due to an infection complication that exposed part of the prosthesis. At 6 months follow-up, the patient's overall status was stable. VAS score when moving is 2/10. He can walk with one crutch. Patient is still being followed up and treated. CLININCAL DISCUSSION: Management of pelvic osteosarcoma remains a challenging task for orthopedic surgeons. Advancements in customized 3D-printed prosthesis have been applied in treatment of pelvic osteosarcoma. Despite the complications, the results are promising. We believe that this is a new and innovative route in surgery of pelvic osteosarcoma. CONCLUSION: Using customized 3D-printed prosthesis is a good way for management of pelvic osteosarcoma.

Performance evaluation of nanotubular halloysites from weathered pegmatites in removing heavy metals from water through novel artificial intelligence-based models and human-based optimization algorithm.

The efforts of this study aimed to evaluate the feasibility of the nanotubular halloysites in weathered pegmatites (NaHWP) for removing heavy metals (i.e., Cd2+, Pb2+) from water. Furthermore, two novel intelligent models, such as teaching-learning-based optimization (TLBO)-artificial neural network (ANN), and TLBO-support vector regression (SVR), named as TLBO-ANN and TLBO-SVR models, respectively, were proposed to predict the Cd2+ and Pb2+ absorption efficiencies from water using the NaHWP absorbent. Databases used, including 53 experiments for Pb2+ absorption and 56 experiments for Cd2+ absorption from water, under the catalysis of different conditions, such as initial concentration of Pb2+ and Cd2+, solution pH, adsorbent weight, and contact time. Subsequently, the TLBO-ANN and TLBO-SVR models were developed and applied to predict the efficiencies of Cd2+ and Pb2+ absorption from water, aiming to evaluate the role as well as the effects of different conditions on the absorption efficiencies using the NaHWP absorbent. The standalone ANN and SVM models were also taken into consideration and compared with the proposed hybrid models (i.e., TLBO-ANN and TLBO-SVR). The results showed that the NaHWP detected in a Kaolin mine (Vietnam) with 70% nanotubular halloysites is a potential adsorbent for water treatment to eliminate heavy metals from water. The two novel hybrid models proposed, i.e., TLBO-ANN and TLBO-SVR, also yielded the dominant performances and accuracies in predicting the Cd2+ and Pb2+ absorption efficiencies from water, i.e., RMSE = 1.190 and 1.102, R2 = 0.951 and 0.957, VAF = 94.436 and 95.028 for the TLBO-ANN and TLBO-SVR models, respectively, in predicting the Pb2+ absorption efficiency from water; RMSE = 3.084 and 3.442, R2 = 0.971 and 0.965, VAF = 96.499 and 96.415 for the TLBO-ANN and TLBO-SVR models, respectively, in predicting the Cd2+ absorption efficiency from water. Furthermore, the validation results also demonstrated these findings in practice through 23 experiments with the accuracies of 98.3% and 98.37% for the TLBO-ANN and TLBO-SVR models, respectively, in predicting the Pb2+ absorption efficiency from water; the accuracies of 98.3% and 97.46% for the TLBO-ANN and TLBO-SVR models, respectively, in predicting the Cd2+ absorption efficiency from water. Besides, solution pH was evaluated as the most critical parameter that can be adjusted to enhance the performance of the absorption of the heavy metals in this study. By using the NaHWP absorbent and the novel proposed intelligent models developed, heavy metals can be eliminated entirely from water, providing pure water/clean freshwater without any risk of adverse health effects for the short term or long term.

Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to investigate the efficacy of fluorescence-based methods, visual inspections, and photographic visual examinations in initial caries detection. A literature search was undertaken in the PubMed and Cochrane databases. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed, and eligible articles published from 1 January 2009 to 30 October 2019 were included if they met the following criteria: they (1) assessed the accuracy of methods of detecting initial tooth caries lesions on occlusal, proximal, or smooth surfaces in both primary and permanent teeth (in clinical); (2) used a reference standard; (3) reported data regarding the sample size, prevalence of initial tooth caries, and accuracy of the methods. Data collection and extraction, quality assessment, and data analysis were conducted according to Cochrane standards Quality Assessment of Diagnostic Accuracy Studies-2. Statistical analyses were performed using Review Manager 5.3 and STATA 14.0. A total of 12 eligible articles were included in the meta-analysis. The results showed that the sensitivity and specificity of fluorescence-based methods were 80% and 80%, respectively; visual inspection was measured at 80% and 75%, respectively; photographic visual examination was measured at 67% and 79%, respectively. We found that the visual method and the fluorescence method were reliable for laboratory use to detect early-stage caries with equivalent accuracy.

Synthesis and Cytotoxic Evaluation of Artemisinin-triazole Hybrids.

Dihydroartemisinin was converted to its corresponding alkyne-functionalized esters, which were subsequently deployed as substrates for a 'click' chemistry-mediated coupling-with 3'-azido-3'-deoxythydimine (AZT) to furnish novel triazole-artesunate-AZT hybrid compounds. Moreover, various substituted triazole-artemisinin :hybrids were synthesized based on 'click' chemistry between propargyl-substituted derivatives and artemisinin containing a 2-hydroxypropane unit. Fourteen new hybrids were thus successfully prepared and evaluated as cytotoxic agents, revealing an interesting anticancer activity of four triazole-artemisinin derivative hybrids in KB and HepG2 cancer cell lines.

A survey of membrane proteins in human serum.

Serum and membrane proteins are two of the most attractive targets for proteomic analysis. Previous membrane protein studies tend to focus on tissue sample, while membrane protein studies in serum are still limited. In this study, an analysis of membrane proteins in normal human serum was carried out. Nano-liquid chromatography-electrospray ionization mass spectrometry (NanoLC-ESI-MS/MS) and bioinformatics tools were used to identify membrane proteins. Two hundred and seventeen membrane proteins were detected in the human serum, of which 129 membrane proteins have at least one transmembrane domain (TMD). Further characterizations of identified membrane proteins including their subcellular distributions, molecular weights, post translational modifications, transmembrane domains and average of hydrophobicity, were also implemented. Our results showed the potential of membrane proteins in serum for diagnosis and treatment of diseases.

Virulence of H5N1 influenza virus in Cattle Egrets (Bubulcus ibis).

In Vietnam, Cattle Egrets (Bubulcus ibis) are common in a variety of habitats, such as freshwater marshes, beaches, and paddy fields. They are also found associated with cattle (Bos spp.) and occasionally with pigs (Sus scrofa), goats (Capra hircus), and horses (Equus caballus) and are kept for insect control in households. In this study, six Cattle Egrets were experimentally infected intranasally with highly pathogenic avian influenza (AI) A/duck/Vietnam/40D/04 (H5N1) to investigate a possible epidemiologic role for Cattle Egrets in outbreaks of H5N1 AI in Vietnam. The Cattle Egrets were highly susceptible to the infection and either died within a week or had to be euthanized. Five uninfected chickens housed with the inoculated Cattle Egrets from day 1 to day 8 postinfection showed no signs of disease or mortality. This observation was most probably due to the low-level virus shedding by the Cattle Egrets. We concluded that Cattle Egrets are not significant reservoir hosts for H5N1 AI virus.

Susceptibility of Muscovy (Cairina Moschata) and mallard ducks (Anas Platyrhynchos) to experimental infections by different genotypes of H5N1 avian influenza viruses.

It is a fact that in Viet Nam, Muscovy ducks are raised in large populations (approximately 8 million), usually kept in small flocks together with mallards and chickens. As a result, it is a great concern for epidemiologists to elucidate possible differences in relation to these species being exposed to infection with H5N1. To do this, an experimental study on infections with different genotypes of H5N1 in mallards and Muscovy ducks have been conducted, where it was found that the mortality of the inoculated Muscovy ducks was at least 80%, regardless of the virus strain employed. In contrast, the mortality of the mallards ranged from nil to 100%, which suggests that Muscovy ducks are more susceptible to HPAIV H5N1 infection in terms of disease development and mortality. It was also found that higher virus titers developed in vital organs of Muscovy ducks compared to mallards, particularly in the brain. Due to their high susceptibility, it is unlikely that Muscovy ducks act as a silent reservoir. The virus strains used in this study, to a certain degree, differed in their virulence properties to the bird species in question.

Multiple sublineages of influenza A virus (H5N1), Vietnam, 2005-2007.

Phylogenetic analysis of influenza subtype H5N1 viruses isolated from Vietnam during 2005-2007 shows that multiple sublineages are present in Vietnam. Clade 2.3.4 viruses have replaced clade 1 viruses in northern Vietnam, and clade 1 viruses have been detected in southern Vietnam. Reassortment between these 2 sublineages has also occurred.

Drug-resistant pneumococci in children with acute lower respiratory infections in Vietnam.

BACKGROUND: Acute lower respiratory infections (ALRI), primarily pneumonia, are the leading cause of death in children under 5 years of age. Most of these deaths occur in Africa and southeast Asia. Increasing rates of drug resistance in pneumococcal strains emphasize the necessity of prevention of pneumococcal vaccines. The aim of the present study was to determine the frequency of drug resistance and the distribution of serotype of pneumococcal strains isolated from pediatric patients with ALRI in Vietnam. METHODS: Two hundred and twenty pediatric patients with ALRI under 5 years of age were enrolled in Hanoi, Vietnam between 2001 and 2002. Bacterial pathogens with a heavy growth (10(6) c.f.u./mL) were isolated from nasopharyngeal secretions on quantitative culture. Fifty-three pneumococcal strains isolated from the nasopharynx of pediatric patients were examined for antibiotic susceptibility including drug-resistant genes and serotyping. RESULTS: A total of 73.6% of pneumococcal strains were genotypic penicillin-resistant Streptococcus pnemoniae (gPRSP), possessing altered penicillin-binding protein genes pbp 1a + 2x + 2b; 67.9% of these strains were gPRSP and simultaneously had the ermB gene, which is responsible for high resistance to erythromycin. The majority of gPRSP strains were serotype 19F or 23F. CONCLUSION: gPRSP strains with serotype 19F or 23F are highly prevalent among pediatric patients with ALRI under 5 years of age in Hanoi, Vietnam.

First aid and initial management for childhood burns in Vietnam--an appeal for public and continuing medical education.

A prospective study to investigate first aid and initial management for 247 paediatric burn patients from 1 June, 2004 to 31 June, 2006 at the Burn Intensive Care Unit, National Institute of Burns (NIB), Hanoi. Data were collected from documents from referring hospitals and direct interview of patients, relative and transport team as guided by the International Society for Burn Injury (ISBI) and the World Health Organization (WHO). Results showed that cooling the burn surface by cold water was applied in 27.17%. Among 132 patients transferred from other hospitals, fluid resuscitation was given in 102 patients (77.28%) before transferring and over a half of these patients were not given intravenous fluid during the time of transfer, especially for children under 1 year of age (p<0.05). Dressings were applied in 36.36% of transferred patients. Burn surface area was accurately diagnosed in only 21.90% of total cases. In conclusion, first aid and initial management in Vietnam are still far from ideal. Further public education and continuing medical education should be applied in Vietnam.