Background: In cirrhotic patients, variceal bleeding remains a major cause of death. After a variceal bleeding episode, mortality and rebleeding rates spike for the first 6 weeks before levelling off. We aimed to evaluate the performance of AIMS65 score in comparison with Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease (MELD) score in predicting 6-week mortality and rebleeding in cirrhotic patients with variceal bleeding.

Method: Data were collected prospectively from patients with cirrhosis and variceal bleeding at Gastroenterology and Hepatology Department of Cho Ray hospital from September 2016 to April 2017. The primary endpoint was 6-week mortality and rebleeding. The prognostic value of AIMS65, CTP, and MELD scoring systems for 6-week mortality and rebleeding was compared by receiver operating characteristics curves (ROC) and the area under the curve (AUC).

Results: Among 80 patients, 15% rebled and 25% died during 6-week follow-up. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week rebleeding were 0.68, 0.54, and 0.48, respectively. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week mortality were 0.80, 0.74, and 0.64, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of AIMS65 score at the cutoff point of 2 were 95%, 55%, 41.3%, and 97%, respectively.

Conclusion: AIMS65 score is a simple yet applicable tool for risk stratification in cirrhotic patients with variceal bleeding. We recommend using AIMS65 score with a cut-off point of 2 to identify patients at increased risk for 6-week mortality after variceal bleeding.

Methotrexate (MTX) is a chemotherapy and immunosuppressive agent widely used to treat cancer, autoimmune diseases in children and adult patients, and ectopic pregnancy. However, MTX is highly toxic to the liver, kidney, and nervous system. This study aimed to quantify the concentration of MTX in human plasma using high-performance liquid chromatography (HPLC). MTX and its internal standard (para aminoacetophenone-PAPA) in plasma samples were extracted simultaneously with methanol. Sample purity was performed using the 1 cc OASIS HLB cartridges. Sample injection volume of 10 µL was analyzed on a Lichrocart Supersil 125-4 column C18 maintained at 40 °C on a Waters 2695 XE equipped with a PDA detector set at 303 nm. The mobile phase contained phosphate buffer (pH 6.0) and methanol at a ratio of 80:20 (v/v) and was maintained at a flow rate of 1 ml/min. The results showed that the total time of chromatographic analysis was 15 min. MTX and PAAP were found in the chromatograms at retention times of 2.3 and 5.2 min, respectively. The linear range of the MTX from 0.5 to 25 µg/mL. Intra-day and inter-day imprecision for MTX ranged from 3.42 to 8.128%. LLOQ of MTX was 0.5 µg/mL and the extraction effects were above 77%. In conclusion, we developed and validated a simple HPLC method to determine the MTX concentrations in human plasma.
 

Introduction: In the last few decades, pyrazoline-based substances have emerged as potential antimicrobial and anticancer candidates. In concern with antimicrobial activity, this study aims to build a docking model to predict the structure of potential 2-pyrazoline derivatives. The cytotoxicity of some compounds was also evaluated to get insight into the structure–anticancer activity relationship of the 2-pyrazoline derivatives.

Methods: Docking models were built on virtual FabH enzymes using FlexX platform with 2-pyrazoline derivatives served as test sets. Afterward, derivatives with high docking scores were chemically synthesized and evaluated for antibacterial activity using the agar dilution method. Furthermore, MTT assay was used to assess the cytotoxicity of these compounds.

Results: The docking score and the in vitro minimum inhibitory concentration (MIC) value on Staphylococcus aureus (S. aureus) bacteria strongly correlate with an R-square value of 0.6751 (p < 0.0001). Four 2 pyrazoline derivatives were synthesized and evaluated for antimicrobial activity. Their MIC values on S. aureus range between 4 and 16 μg/mL, consistent with ones predicted by the docking model. Apropos cytotoxic properties, a series of 2-pyrazolines exhibit a moderate activity on HepG2, RD, and MDA-MB-231. The most active compound, HP10, has the IC50 values on these cell lines. which are 26.62 μM, 17.74 μM, 14.47 μM, respectively.

Conclusion: Our research built a docking model on the virtual S. aureus FabH enzyme with high potential in predicting antibacterial activities of different 2-pyrazoline derivatives. Moreover, our cytotoxicity results provided data for further studies on the anticancer activity of these promising derivatives.
 

Introduction: Tumor and pseudotumor (TP) at the proximal femur (PF) can seriously affect mortality, extremity function, and body integrity. However, reports often focused on a specific tumor, not regional lesions. This study focuses on clinical findings, imaging, micro-pathology, and the treatment of all TP at the site.

Methods: The study involved all patients who had a confirmed tumor or pseudotumor diagnosis at the PF. The clinical findings, X-ray, and biopsy were recorded and analyzed. Treatment was optional depending on the patient's situation and available condition of the hospital. The functional outcome, bone healing were defined at the last examination or two years of follow-up.

Results: Fifty patients were involved in the study. Twenty-four patients had apparent tumors. TP at the PF, neck-trochanter, trochanters, and neck were 21 (42%), 16 (32%), 9 (18%), and 4 (8%) cases, respectively. There were 29 (58%) pathologic fractures. Biopsy was made for all patients. Twenty-three cases (46%) were malignant, and 8 (16%) cases were giant cell tumors. Thirtythree patients suffered from an operation. Ennerking's functional score was excellent, good, fair, and poor in 24 (48%), 5 (10%), 1 (2%), and 20 (40%) patients, respectively. For the last outcomes of 33 operated patients, 17 healed, three unchanged, one worse, and two dead.

Conclusions: For the PF TP, the rate of malignant and pathological fracture was high. The giant cell tumor was not rare. The resection of the TP combined with grafts using ordinary fixation devices was satisfactory.

Introduction: The pattern of drug use in Vietnam has changed rapidly over the past decade, and a large number of people who have a history of heroin injection reportedly use methamphetamine. This paper describes factors associated with methamphetamine use among people who inject heroin in Hanoi, the capital of Vietnam.

Methods: This is a cross-sectional survey among 521 heroin injectors who were recruited through chain referral and outreach at community and clinic settings. Eligibility criteria included: (1) male aged 18 or older; (2) reported heroin injecting during the 12 months before the survey; (3) agreed for a urine test to detect methamphetamine and opiate metabolites. The primary outcome, methamphetamine use, was defined as selfreported methamphetamine use during the 30 days before the survey and/or having a urine test positive for methamphetamine. Structural Equation Model was used to evaluate associated factors for methamphetamine use.

Results: One third of participants qualified as methamphetamine users as defined in this study. A longer history of heroin use (β=0.126, p<0.001), using MDMA and/or cannabis (β=0.28, p<0.001) and not using condom during sex (β=0.139, p<0.001) were positively associated with methamphetamine use. Family functioning (β=-0.141; p<0.001) was protective. The goodness-of-fit of Structural Equation Model was excellent (CFI=0.934; TLI=0.912; RMSEA=0.033; WRMR=0.98).

Conclusions: Methamphetamine use among people who inject heroin is a substantial issue in Hanoi. Family functioning has made a critical contribution on reducing methamphetamine use. Future studies should pay attention to address the role of factors at the family level in addition to individual-level factors towards the pattern of drug use.

Spontaneous hemopneumothorax is a rare condition and may be a life-threatening condition that needs prompt diagnosis and urgent intervention. In this study, we reported three male cases of spontaneous hemopneumothorax, two cases presented with chest pain and one with epigastric pain. All cases were successfully treated by early surgical intervention. Total blood drainage was ranged from 1400 to 2000 mL. Video-assisted thoracoscopic surgery was performed successfully in two cases, however, one case was transferred to urgent thoracotomy due to excessive blood clotting in the pleura cavity and continuous bleeding. Leukocytosis was observed in two cases, mostly due to pneumonia or sepsis. The bleeding point was identified in all cases, however, the air leak area could not be identified in two cases. Length of hospital stay after admission was ranged from five to seven days. We recommend that video-assisted thoracoscopic surgery should be considered as a first choice due to its effectiveness in reducing postoperative complications and facilitating rapid recovery.

Background: Many clinical and paraclinical studies related to coronary artery disease have been done in Vietnam in recent years. However, there have been no studies on nurses’ knowledge and practice regarding patient care after coronary angiography (CAG) or percutaneous coronary intervention (PCI). This study was conducted to assess nurses' knowledge and practice on patient’s safety after CAG or PCI and its associated factors.

Methods: A descriptive cross-sectional study was conducted from December 2019 to June 2020 at the Department of Internal Cardiology, Interventional Cardiology, Intravascular Intervention, and Intensive care unit/Coronary care unit in three general and specialist hospitals in Ho Chi Minh city, Vietnam. 167 nurses who have taken care of patients after CAG or PCI were included in the study through using convenient sampling technique. A translated self-administered questionnaire was utilised. This self-reported survey achieved 100% response rate. Statistical analysis was performed by the Chi-square test (X2). Statistical significance level was at p<0.05 to determine factors related to nurses’ knowledge and practice. Prevalence ratio (PR) with 95% confidence interval (95% CI) were also used to measure the association.

Results: The study findings revealed that only 36% of the study sample had a good knowledge while 78% of them had a good practice on patient’s safety after CAG or PCI. There were association between educational level, working place with the knowledge (PR=1.87-1.92, p<0.01) and practice (PR=1.18-1.35, p<0.05) on patient’s safety after CAG or PCI among Vietnamese nurses. Besides those factors, the number of years working in cardiac specialty were also found to have an association with the practice. A moderately positive correlation between the knowledge and the practice towards patient‘s safety after CAG or PCI has been identified in this study (PR=1.27, 95% CI [1.09 – 1.47], p=0.005).

Conclusions: More than a half of the study sample had poor knowledge but performed good practice in some items of care for patients after CAG or PCI. There was positive association between the knowledge and practice about patient’s safety after CAG or PCI among Vietnamese registered nurses. Educational training programs for staffs working in coronary angiography or percutaneous coronary intervention is recommended to develop.