Concordance of Clinical, Histologic and Direct Immunofluorescence Findings in Patients with Autoimmune Bullous Dermatoses in Vietnam.

Introduction: Autoimmune bullous dermatoses (ABD) represent a heterogeneous group of blistering disorders that may be debilitating with high morbidity. Clinical, histological, and direct immunofluorescence (DIF) studies are essential in establishing an accurate diagnosis of ABD, which is essential for its clinical management. Our study objective was to perform a systematic evaluation of ABD cases in a patient population at an academic medical center in Ho Chi Minh City, Vietnam, and determine the degree of concordance of clinical, histological, and DIF findings in ABD. Methodology: A systematic retrospective cross-sectional study was performed on 92 patients diagnosed with ABD by clinical, histological, and DIF studies at the University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam, between September 2019 and September 2021. The clinical histories, H and E stained tissue sections, and DIF stains were evaluated by pathologists at the University of Medicine and Pharmacy. Results: ABD was evaluated as a whole and subdivided into an intraepidermal blister subgroup and a subepidermal blister subgroup. The analysis of paired diagnostic methods (clinical, histological, and DIF) for concordance with the final diagnosis was performed and showed that there were no statistically significant differences between the paired methods (McNemar's test, p > 0.05). There was moderate concordance between the clinical, histological, and DIF diagnoses among all ABD cases (Brennan-Prediger coefficient Kappa test, κBP = 0.522, CI = 0.95). In the intraepidermal blister subgroup, the diagnostic accuracies of the histology and DIF stains were comparable to each other, and both were more accurate than a clinical diagnosis alone. In the subepidermal blister subgroup, there was no statistically significant difference in each pair of the three diagnostic methods (clinical, histological, and DIF) (McNemar's test, p > 0.05). The concordance between the clinical, histological, and DIF diagnoses was high for the intraepidermal blister subgroup (Kappa test, κBP = 0.758, CI = 0.95). However, the concordance between the clinical, histological, and DIF diagnoses was slight for the subepidermal blister subgroup (Kappa test, κBP = 0.171, CI = 0.95). Conclusion: Histological evaluation is highly accurate in the diagnosis of the intraepidermal blister subgroup, but it is not as accurate in the diagnosis of the subepidermal blister subgroup in the Vietnamese patient cohort in which clinical, histological, and DIF studies were performed. DIF stains are a crucial diagnostic tool for ABD in this patient population.

Study on effects of traditional processing methods on chemical composition and biological activity of Drynaria bonii Rhizome

Study on ‘Cot toai bo’ (Drynaria bonii Rhizome) product was processed from fresh stem and root of Drynaria bonii Christ., collected at Lang Son from July 2003 to September 2003. Results: chemical analysis showed that Cot toai bo contains flavonoids, steroid saponins, sterols, tannins, deoxidized sugar. Total flavonoid in stem and root accounted for 0.60±0.03% and total saponin was 3.71±0.06%. After processing by traditional method, total flavonoids and saponins in processed materials reduced in comparison with raw material. Compare 2 processing methods: in rice alcohol processed material, whose chemical constituents were reduced very little but in fried material, whose chemical constituents were reduced more than raw material. Rice alcohol processed Cot toai bo had analgesic and anti-inflammatory effects better than raw material and this processing was a more appropriate method than fried method

Study on acute and subchronic toxicity of CP preparation (extracted from Cu Binh Voi)

Study on acute and subchronic toxicity of CP preparation (extracted from Cu Binh Voi) finding using CP preparation with 1000mg/kg mouse of dose, follow in 72 hours, not any mice died. With 30mg/kg mouse uninterrupted take in 30 days, CP preparation didn’t effect to making blood function (but reduced number of leukocyte). It exchanged effect of eliminate urea thourgh renal. It not exchanged tranxaminaza level in serum but slightly effect to sterilize function of rabit

Preliminary assessment of pain relief and antiinflammatory effects of day dau xuong

The effect of analgetic and anti inflammatory of Tinospora Sinensis Men were studies in the form liquid glue on experimental mice. These mice were divided into 4 groups: group 1 takes NaCl 0,9%; group 2 takes Aspegic; group 3 takes liquid glue with dose 4g/kg; group 4 takes liquid glue with dose 8g/kg. The results were: after 5 min causing pain, aspegin and Tinospora Sinensis Men relieves pain clearly. After 15 min, these two drugs also has effect vigorous (58.88 – 88.5%) compared to control group with P<0.001. Dose 4g/kg of Tinospora Sinensis Men had not effected yet acute anti inflammatory clearly. Dose higher 8g/kg can inhibit inflammatory reaction on leg of mice with 10,16% (P<0.005), less than aspegic 0.05g/kg. The conclusion: Tinospora Sinensis Men has effect relieving pain by peripheral machanism, anti inflammatory acute and relievring oedematose reaction local with dose 8g/kg

Study on the anti inflammatory effect of cot toai bo in experimental animals

The anti-flammatory effect of Drynaria fortunei was studied on rat’s hind paw edema induced by carrageenin. Results showed that its aqueous extract in the dose of 4g/kg body weight exerts anti-inflammatory effect. Acute effect of Drynaria fortunei is exhibited through the decreased quantity of exudation and the number of leucocyte in the exudation.

Study on effects of processing methods to acute toxicity and painkiller, anaesthesia effects of Cot khi cu

Cot khi cu was studied on experiment animals. Pain relief effect was evaluated with 1% extract, sedative and hypnotic effect was compared with hexobarbital and acute toxicity was assessed by Lichfield Wilcozon Method. Results showed that raw and processed Cot khi cu did not cause acute toxicity, with a dose of 200 folds of clinical dose. In raw and processed Cot khi cu, there is no defference in pain relief effect. Roast Cot khi cu gave a better sedative effect than the raw Cot khi cu

Preliminary assessment of pharmacological effect of the Formula D1

On experimental rats, the effect of pain relieve, of neuroleptic and acute toxicity of Formula D1 was studies. The formula composes of 9 componants (Bach truat, Hoang ky, Chi thuc, Moc huong, Nghe, Cam thao, Lac tien, Bach thuoc, Huong phu). It manifests an effects of analgesic on white mouse, experimented with the method of heat plate and Koster. The formula inhibits Central nervous system, it has not acute toxicity when administered orally in dose of 73 folds of therapeutic dose

The anti- inflammation and pain relief effects of " Cau tich" in experiment

Cau tich fluid extract was studied on white mice. The dose of 4 g/kg of body weigh exerts against acute inflammation and relief the pain 2 hours, 4 hours, and 6 hours after the onset of inflammation. On the experimental granuloma, Cau tich has a moderate effect on chronical inflammation. In experimental model of “hot plate” Cau tich manifests a pain relief effect centrally and peripherally

Acute toxicity and some pharmacological effects of "c?t khí c?", a traditional pharmaceutical material

The study was carried out with healthy white mice of the strain of Swiss, weighed 202 g, fed properly in good supply of water and food. Results a pain relief and narcotic effects of the material. An intensive dose 200 times higher than usual clinical dose did not manifest toxicity in the animal