Routine Medical Check-Up and Self-Treatment Practices among Community-Dwelling Living in a Mountainous Area of Northern Vietnam.

This study was conducted to evaluate the routine medical check-up and self-treatment behaviors of people living in a remote and mountainous setting in Northern Vietnam and identify their associations. A cross-sectional study was conducted on 175 people in August 2018 in Cao Son commune, Da Bac district, Hoa Binh. Information regarding routine medical check-ups and self-treatment behaviors was collected by using a structured questionnaire. Multivariate logistic regression was used to examine the associations. Results show that 24% of the mountainous people had routine medical check-ups in the last 12 months. The rate of self-treatment in the past three months was 33.7%. The number of chronic diseases (OR = 1.5, 95% CI = 1.0-2.3), health information sources from radio/television (OR = 3.3, 95% CI = 1.2-9.5), or social media (OR = 24.8, 95% CI = 1.2-512.4) was related to routine medical check-up. People who did not have routine medical check-up were more likely to have self-treatment practice (OR = 6.3, 95% CI = 1.9-21.1) than those who had a regular health check. Promoting health education and communication through mass media to raise people's awareness about regular health check-ups is a promising way to improve people's self-treatment status.

Diagnostic values of different cytokines in identifying tuberculous pleural effusion.

Interleukin (IL)-1 beta (IL-1ß), IL-2, Interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α) in the pleural fluid are valuable biomarkers in early diagnosis of Tuberculous Pleural Effusion (TPE). This study aimed to analyze the diagnostic values of some cytokines (IFN-γ, TNF-α, IL-1ß, and IL-2) in pleural fluid for identifying TPE in Vietnam. We performed a cross-sectional study on tuberculosis (TB) patients with pleural effusion. Pleural IFN-γ, TNF-α, IL-1ß, IL-2 were measured by ELISA® Kit (Abcam, USA) on Biotek system. Receiver operating characteristic curves (ROC), an area under the curve (AUC), sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of IFN-γ, TNF-α, IL-1ß, IL-2 in identifying TBE were assessed. Among 386 patients, 234 (60,6%) had TPE, and 152 (39,4%) did not have TPE. The median of IL-2, TNF-α, and IFN-γ levels were significantly higher in TPE compared to the non-TPE group (p<0.05). AUC for IL-1ß, IL-2, TNF-α, and IFN-γ were 0.54, 0.57, 0.62. 0.84 (p<0.05), respectively. The sensitivity of IL-1ß, IL-2, TNF-α, and IFN-γ in the diagnosis of TPE were 82.1, 53.4, 77.8, and 80.3, while the specificity was 28,4, 69.7, 47.4, and 80.9, respectively. IFN-γ and TNF-α are potential biomarkers in diagnosing TPE.

Diagnostic values of different cytokines in identifying tuberculous pleural effusion

@# Interleukin (IL)-1 beta (IL-1β), IL-2, Interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α) in the pleural fluid are valuable biomarkers in early diagnosis of Tuberculous Pleural Effusion (TPE). This study aimed to analyze the diagnostic values of some cytokines (IFN-γ, TNF-α, IL-1β, and IL-2) in pleural fluid for identifying TPE in Vietnam. We performed a cross-sectional study on tuberculosis (TB) patients with pleural effusion. Pleural IFN-γ, TNF-α, IL-1β, IL-2 were measured by ELISA® Kit (Abcam, USA) on Biotek system. Receiver operating characteristic curves (ROC), an area under the curve (AUC), sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of IFN-γ, TNF-α, IL-1β, IL-2 in identifying TBE were assessed. Among 386 patients, 234 (60,6%) had TPE, and 152 (39,4%) did not have TPE. The median of IL-2, TNF-α, and IFN-γ levels were significantly higher in TPE compared to the non-TPE group (p<0.05). AUC for IL-1β, IL-2, TNF-α, and IFN-γ were 0.54, 0.57, 0.62. 0.84 (p<0.05), respectively. The sensitivity of IL-1β, IL-2, TNF-α, and IFN-γ in the diagnosis of TPE were 82.1, 53.4, 77.8, and 80.3, while the specificity was 28,4, 69.7, 47.4, and 80.9, respectively. IFN-γ and TNF-α are potential biomarkers in diagnosing TPE.

Chondrocyte damage following osteochondral grafting using metal and plastic punches: comparative study in an animal model.

PURPOSE: Osteochondral impaction grafting to manage isolated chondral defects in femoral condyles usually uses a metal punch to impact the grafts into predrilled cavities. Damage to the chondrocytes during impaction is a concern, however, and new methods are being sought to minimise the damage. We studied if impaction with a plastic punch instead of a metal punch reduces the extent of chondrocyte damage in an animal model. METHODS: 32 osteochondral plugs were prepared from knees of 10 freshly slaughtered sheep knees; the contralateral condyles were then prepared to receive the osteochondral grafts. 20 plugs were impacted into predrilled holes: 10 using a metal punch and 10 using a plastic punch. The 12 remaining plugs were used as controls. The plugs were recovered, incubated for 24 hours in calf serum, and stained with 3-[4,5-dimethylthiazol]-2,5-diphenyltetrazolium to measure the content of viable cells. Digital photographs of the stained cartilage were then analysed on a 0-to-255 grey-scale. RESULTS: We found no significant difference in the extent of chondrocyte damage caused by impaction using metal and plastic punches. The content of viable cells in plugs impacted by metal and plastic punches, however, was significantly lower than that in the control plugs, as reflected by higher means of light intensity of 52.9 (p<0.001) and 32.4 (p=0.005), respectively. CONCLUSION: Impaction grafting clearly damages chondrocytes of the osteochondral plug. The use of a plastic punch does not reduce the extent of chondrocyte damage during the impaction grafting procedure.

Utility of B-type natriuretic peptide in the diagnosis of congestive heart failure in an urgent-care setting.

OBJECTIVES: The goal of this study was to evaluate the utility of a rapid "bedside" technique for measurement of B-type natriuretic peptide (BNP) in the diagnosis of congestive heart failure (CHF) in an urgent-care setting. BACKGROUND: B-type natriuretic peptide is a protein secreted from the cardiac ventricles in response to pressure overload. One potential application of measurements of BNP in blood is distinguishing dyspnea due to CHF from other causes. METHODS: B-type natriuretic peptide concentrations were measured in a convenience sample of 250 predominantly male (94%) patients presenting to urgent-care and emergency departments of an academic Veteran's Affairs hospital with dyspnea. Results were withheld from clinicians. Two cardiologists retrospectively reviewed clinical data (blinded to BNP measurements) and reached a consensus opinion on the cause of the patient's symptoms. This gold standard was used to evaluate the diagnostic performance of the BNP test. RESULTS: The mean BNP concentration in the blood of patients with CHF (n = 97) was higher than it was in patients without (1,076 +/- 138 pg/ml vs. 38 +/- 4 pg/ml, p < 0.001). At a blood concentration of 80 pg/ml, BNP was an accurate predictor of the presence of CHF (95%); measurements less than this had a high negative predictive value (98%). The overall C-statistic was 0.97. In multivariate analysis, BNP measurements added significant, independent explanatory power to other clinical variables in models predicting which patients had CHF. The availability of BNP measurements could have potentially corrected 29 of the 30 diagnoses missed by urgent-care physicians. CONCLUSIONS: B-type natriuretic peptide blood concentration measurement appears to be a sensitive and specific test to diagnose CHF in urgent-care settings.

[Observation on efficacy of artemether compound against vivax malaria].

AIM: To observe the efficacy of artemether compound against vivax malaria. METHODS: Each artemether compound tablet contains 120 mg benflumetolum and 20 mg artemether. 132 patients with vivax malaria were divided into 3 groups. Group A, 36 patients received 8 tablets as an initial dose, followed by 4 tablets daily for 2 days; group B, 41 patients received 8 tablets as an initial dose, followed by 3 tablets daily for 4 days; group C, 55 patients receiving chloroguine-primaquine served as control. Two patients of group A were voluntarily to be bitten by Anopheles dirus before and after medication to observe the influence of artemether compound on the sporogony. RESULTS: The average defervescence times for groups A, B and C were 22.3 h, 23.2 h and 25.0 h (P > 0.05), respectively, the average parasite clearance times were 33.5 h, 30.5 h and 44.9 h, respectively, the average parasite clearance times of groups A and B were all significantly shorter than that of group C (P < 0.01). The replase rates of groups A, B and C were 84.9%, 78.8% and 22.9%, respectively, followed-up at nine months, the relapse rates of groups A and B were higher than that of group C(P < 0.01). CONCLUSION: Two regimens of artemether compound have the advantage of high efficacy against vivax malaria.

A clinical trial of antioxidant supplements in the treatment of oral leukoplakia.

Seventy-nine patients with oral leukoplakia that was histologically verified as either hyperkeratosis or epithelial dysplasia with hyperkeratosis were enrolled in an antioxidant supplementation program for the treatment of the oral lesions. The patients received 30 mg of beta-carotene, 1000 mg of ascorbic acid, and 800 IU of alpha-tocopherol per day for 9 months. Clinical improvement of the oral lesion was noted in 55.7% of the patients and was more likely to occur in patients who reduced their use of alcohol or tobacco (p = 0.0056). Although risk-factor reduction was important, approximately half of the patients who did not alter their exposure to either alcohol or tobacco showed clinical improvement. The antioxidant supplementation significantly increased serum and tissue levels of beta-carotene, ascorbic acid, and alpha-tocopherol, but these changes did not correlate strongly with clinical improvement.

Evaluation of serum and tissue levels of beta-carotene.

Interest in beta-carotene (BC) has increased as studies show that low dietary or serum BC is associated with increased risk of cancer. Patients with oral epithelial dysplasia had serum and oral mucosa punch biopsy samples taken before supplementation of 30 mg/day of beta-carotene and after 6 and 9 months of supplementation. BC was analyzed for 28 patients by high-performance liquid chromatography. At baseline, serum BC and gender accounted for 48% of tissue BC variance: Tissue BC = -0.13 + 0.08(Serum BC) + 1.21(Sex) with sex as male = 0 or female = 1. Following supplementation, serum BC had an exponential relationship to tissue BC which accounted for 52% of tissue variance: Tissue BC = 1.15 + 5.7 x 10(-5)(Serum BC)2 + 3.91(Sex). Women had higher mean concentrations of serum and oral mucosal BC before and during supplementation. The need for oral mucosal sampling may be eliminated by the correlation between serum and tissue BC.

Free gracilis transfer in the treatment of gluteus medius paralysis after poliomyelitis.

Paralysis of the gluteus medius after poliomyelitis often gives rise to secondary spinal deformity and inclination of the pelvis; the patient presents with a typical waddling gait. The paralysis is usually associated also with varying degrees of involvement and deformity of the extremities. Current treatment for paralysis of the gluteus medius has not been totally satisfactory. With the development of micro-neurovascular procedures, transfer of free muscle grafts for paralyzed or functionless muscles can be performed with functional recovery. The authors present a series of 12 cases, of which 10 were followed-up from 12 to 35 months. All of them had good cosmetic and functional results, with increased hip stability and stable gait. The operative technique, as well as the surgical anatomy, are described.