Electroacupuncture at Trigger point gains better pain relief effectiveness than Electroacupuncture at Meridian point: A non-blind randomized trial of chronic neck pain treatment among patients at Traditional Medicine Hospital

Original Research

Abstract

Introduction: Neck pain is one of the leading causes of disabilities and increasing economic and social burden. Methods affecting the trigger point (TrP) have initially shown good pain relief effectiveness and decreased degree of invasion in patients. The research is conducted to evaluate the effectiveness of Electroacupuncture (EA) at TrP in chronic neck pain (CNP) treatment.

Methods: A non-blind randomized study on 125 patients with CNP at Traditional Medicine Hospital in Ho Chi Minh City from September 2020 to June 2021. Patients will be randomly classified into EA at the TrP group or EA at the meridian points group.

Results: There were 62 patients in the TrP group and 63 patients in the other group. After 4 weeks, in the TrP group, the Questionnaire Douleur Saint-Antoine (QDSA) score of 38.2 ± 2.6 decreased to 9.3 ± 5.7, compared with the meridian points group’s QDSA score of 37.8 ± 2.3 decreased to 12.3 ± 7.1. The percentage of patients to reach good pain relief effectiveness of EA at TrP measured by QDSA is 71.0%, statistically significantly higher than 47.6% of the other group. The decrease in the number of TrPs of EA at TrP is higher and has statistical value compared with EA at meridian points.

Conclusions: EA at TrP showed better pain relief effectiveness, has a higher percentage of patients reaching good pain relief effectiveness measured by QDSA, and decreases the number of TrPs more than EA at meridian points does on patients with CNP.

Graphical abstract

Developing diagnostic criteria of illness of traditional medicine on patients with carpal tunnel syndrome by a descriptive cross-sectional survey

Original Research

Abstract

Background and Objective: Carpal tunnel syndrome (CTS) is one of the most common neurodegenerative conditions. However, studies on the classifications and symptoms of CTS from the perspective of traditional medicine are still limited. Our study aims to identify traditional medicine disease nomenclature and symptoms of CTS by the survey form.

Methods: A descriptive cross-sectional study was conducted at The 3rd branch of University Medical Center HCMC, Thong Nhat Hospital from March 2021 to June 2021. We conducted a study survey on patients diagnosed with primary CTS and agreed to participate in the study with survey questionnaires, data were processed by using Excel 2016 and Lantern 5.0 software.

Results: 48 symptoms collected from 94 patients with CTS based on questionnaires were included in the Latent Tree Model. Compared with the medical literature review, there were 40/48 symptoms and 5 patterns appearing in the collected sample. These 5 main patterns: Blood stasis has 4 symptoms, yin deficiency has 6 symptoms, damp heat has 3 symptoms, blood deficiency has 3 symptoms and invasion of meridians of wind cold has 3 symptoms to diagnose. The results of the study have shown that the results of the algorithms are statistically significant when comparing clusters of latent variables with traditional medicine descriptions. Therefore, the use of the results of the machine has a scientific basis in terms of statistics.

Conclusion: After analyzing clinical data from 94 patients with Latent Tree Model, it was found that 5 disease patterns appeared with symptoms helping diagnose those disease patterns.

Graphical abstract

A 63–year–old female with bilateral renal artery stenosis – highlights on diagnosis and optimal medical treatment

Case Study

Abstract

Renal artery stenosis is responsible for approximately 75% of secondary hypertensive cases. A 63-year-old female patient with uncontrolled hypertension and other comorbidities including type 2 diabetes mellitus and knee osteoarthritis presented with drastically raised systolic blood pressure in this case report (220 mmHg). Bilateral abdominal bruits were detected upon of physical examination. Imaging investigation showed significant bilateral atherosclerotic renal artery stenosis. An optimal combination of antihypertensive agents mainly with an angiotensin converting enzyme inhibitor, other than interventional revascularization, was applied and resulted in controlled blood pressure. 

Graphical abstract

Development and validation of simultaneous assay of simvastatin, beta-hydroxy simvastatin as metabolite in human plasma using liquid chromatography-tandem mass spectrometry

Original Research

Abstract

Introduction: Several generic products containing simvastatin are circulating on the Vietnamese market at a more inexpensive price than that of a brand-name one. These formulations, however, have not been assessed for in vivo bioequivalence to the reference product. After oral administration, simvastatin (SIM) is extensively converted into an active metabolite, beta-hydroxy simvastatin acid (SIM-A) and a very low concentration of simvastatin can be found in plasma. Therefore, a method for quantification of simvastatin and its metabolite needs to be developed with a high specificity and sensitivity to detect these analytes in human plasma at such low concentrations. Our purpose was to develop a reliable LC-MS/MS (liquid chromatography-tandem mass spectrometry) method for simultaneous determination of simvastatin and metabolite of simvastatin, beta-hydroxy simvastatin acid, in human plasma and to apply this method to evaluate the bioequivalence of a test product in comparison with the reference product.

Methods: Mass spectrometry, internal standard (IS), and chromatographic conditions were investigated to find out the suitable IS and conditions. Human plasma samples were treated by liquid-liquid extraction (LLE). The assay was validated in compliance with US-FDA (United States-Food and Drug Administration), and EMA (European Medicines Agency) guidelines.

Results: LC-MS/MS with electrospray ionization interface in positive (for SIM and lovastatin as IS) and negative (for SIM-A) ionization mode performed under the multiple reaction monitoring mode was used for detection of the analytes. The transition of m/z is 436.00 → 285.15, 435.10 → 319.15, and 404.95 → 199.10 for SIM, SIM-A, and IS, respectively. Tert-buthyl methyl ether was used for extraction of analytes from human plasma by a simple LLE followed by addition of an ammonium acetate buffer. The developed method was fully validated with acceptable selectivity, linearity and linear range, matrix effect, lower limit of quantitation (LLOQ), carryover, dilution integrity, and intra- and inter-day accuracy and precision, free-thaw stability.

Conclusions: The method can be applied for quantification of these compounds in human plasma for in vivo bioavailability and bioequivalence studies. 

Graphical abstract

Effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration in preterm infants using non-invasive ventilation

Original Research

Abstract

Background: The use of non-invasive ventilation (NIV) in preterm infants is becoming increasingly common. The use of cannula in NIV can cause ulceration of the nasal bridge with the current practices using the thin foam patches. This study aims to evaluate the effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration comparing to that of the thin foam patches.

Methods: A prospective cohort study using hydrocolloid dressing pads (1 November to 30 April 2020) was compared to that of a historical control group using thin foam dressing (1 April to 15 October 2019) to evaluate the effectiveness of hydrocolloid dressing pads. All participants were preterm infants (less than 37 weeks of gestational age) and used nasal cannula NIV at the Department of Neonatal Intensive Care (NICU), Children's Hospital 1.

Results: 71 infants used hydrocolloid dressing pads, and 42 used ordinary thin foam nasal dressings. In the hydrocolloid dressings group, two infants (2.8%) had nasal ulcers; among them, one was mild, and the other was moderate. In comparison, ten infants (23.8%) using thin foam dressings developed ulcers, of which seven were mild, two were moderate, and one was severe. Using hydrocolloid nasal dressings significantly reduced nasal ulceration compared to thin foam dressings (OR = 0.09, 95%CI = 0.02 – 0.45).

Conclusion: Using hydrocolloid nasal dressings for preterm infants on nasal cannula NIV significantly reduced nasal ulceration compared to ordinary thin foam dressings.

Graphical abstract

Quality of Life in Patients Receiving Percutaneous Coronary Intervention and Optimal Medical Therapy in Ho Chi Minh City, Vietnam

Original Research

Abstract

Introduction: This study assessed Health-Related Quality of Life (HRQOL) of patients with Acute Coronary Syndrome (ACS) 6 to 12 months after receiving Percutaneous Coronary Intervention (PCI) and/or Optimal Medical Therapy (OMT) at a hospital in Ho Chi Minh City, Vietnam.

Methods: A cross-sectional study was conducted on 113 patients. Data on demographic, lifestyle behaviours, and HRQOL were collected using a structured questionnaire through face-to-face interviews. HRQOL was measured using EQ-5D-5L and EQ-VAS. Data on co-morbidity and other clinical characteristics were extracted from hospital records. Bivariate and multivariable linear regression models were run to test the differences in EQ-5D-5L utility index and EQ-VAS scores between PCI/OMT and OMT alone groups.

Results: EQ-5D-5L utility index and EQ-VAS scores were lower in PCI/OMT compared to OMT groups, although the differences were not clinically meaningful. Weight status, smoking, and physical activity were associated with EQ-5D-5L utility index score, whereas only physical activity was associated with EQ-VAS score.

Conclusion: The findings suggested that improving sufficient physical activity levels and stopping smoking after PCI or/and OMT may help increase HRQOL among ACS patients.

Graphical abstract

A case report of hepatic perivascular epithelioid cell tumours (pecomas) and literature review

Case Study

Abstract

Perivascular epithelioid cell tumours (PEComas) belongs to the family of mesenchymal neoplasms that can occur in many organs, but rarely found in liver. Preoperative diagnosis could be challenging due to unspecific and variable radiologic patterns, which can be clinically misdiagnosed with hepatocellular carcinoma and other benign tumors. This report aims to announce a case of hepatic PEComa with extramedullary hematopoiesis. A 44- year- old woman accidentally presented a nodular mass in the left hepatic segment on ultrasonography with normal liver function result. Abdominal enhanced CT Scan showed hypervascular lesion. Morphology exibits classical characteristics of PEComa with mature fat tissue predominance, thick-wall vessel; somewhat amount of extramedullary hematopoiesis was also recognized. Tumor cells are diffusely immunoreactive with HMB45. PEComa is a rare disease in liver, pathologists need to recognize three components of this tumor to avoid misdiagnosing with malignant conditions.

Graphical abstract

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