Transformation Chlorophyll a of Spirulina platensis to Chlorin e6 Derivatives and Several Applications

BACKGROUND: Spirulina platensis contains a large amount of chlorophylls, chlorophyll a, that are starting materials to synthesize functionalized chlorins. Chlorin e6 (Ce6) as well as its derivatives are second generation sensitizers using in photodynamic therapy (PDT) of various cancers. In this study, we transfer chlorophyll a of S. platensis to Ce6derivatives and determine their several applications. AIM: to evaluate the effects of Ce6 derivatives to treat cancer cells. METHODS: Ce6 trimethylester was created from methyl pheophorbide a2 in S. platensis provided by the Hidumi Company, Nghe An province, Viet Nam. Hela cells were incubated with Ce6 trimethylester and the irradiated with the diode laser dose of 1.2 J/cm2/min through the system of filters £ 650 nm. MTT assay and clonogenic assay were used to determine survival rate and cloning efficiency of cells. Antimicrobial effect of Ce6 trimethylester with halogen light were studied with Propionibacterium acnes VTCC 0218 and Staphylococcus aureus VTCC 0173. RESULTS: From dry biomass (700 g) of S. platensis, after extracting chlorophyll a and methanolysis, 4.2 g of methyl pheophorbide a was obtained. The reaction to give Ce6 trimethylester with 82% yield was performed with potassium hydroxide (KOH) in MeOH/THF/CHCl3. After irradiation with a 650 nm laser at 1.2 J, the cell viability in all samples decreased with Ce6 trimethylester treatment, the survival declining trend of Hela cells treated with Ce6 trimethylester were proportional when concentration of Ce6 trimethylester increased. The rate of colony formation was declined as the concentration of Ce6 trimethylester treated was increased. The growth of both S. aureus and P. acnes can be inactivated by Ce6 trimethylester PDT. The MIC99 value against P. acnes VTCC 0218 and S. aureus VTCC 0173 of Ce6 trimethylester with halogen light was 1.25 μg/ml. CONCLUSION: The Ce6 trimethylester from S. platensis cultivated in Viet Nam could be used as a potential photosentizer for photodynamic therapy for treatment of cancer and acne

Anatomical Characteristics and Variants of Prostatic Artery in Patients of Benign Hyperplasia Prostate by Digital Subtraction Angiography

AIM: This work is aimed to describe anatomical features and variants of the prostatic artery (PA) using digital subtraction angiography (DSA). METHODS: This is a descriptive statistic study. We reviewed the DSA of 348 patients, who had a PA embolisation to reduce the benign prostatic hyperplasia (BPH) symptoms at Radiology Department of Bach Mai Hospital from Oct – 2014 to Oct – 2018. RESULTS: PA was found at 660 pelvic halves, of which 30 pelvic halves (4.5%) had two PAs, 630 pelvic halves had one PA. In terms of the origin of PA, in total 690 PAs, the percentage of type 1, 2, 3, 4 and 5 was successively 33.9%, 13.9%, 18.3%, 23.9% and 10.4%, respectively. Atherosclerosis of PA observed in 20.9%. The ‘corkscrew’ pattern was found in 30.4%. The average diameter of PA was 1.5 ± 0.34mm. The anastomosis of PA with surrounding arteries was common. PA may supply rectum (6.1%), seminal vesical (9.6%), bladder (5.2%), contralateral prostatic parenchyma (13.0%), surrounding soft-tissues (3.5%). CONCLUSION: The common trunk with SVA superior vesical artery was the most common origin of PA. Anastomoses of PA with surrounding tissues were complex

Dry Eyes Status on Des Scale and Related Factors in Outpatients at Vietnam National Institute of Ophthalmology

BACKGROUND: Dry eye (DE) can effect on quality of life by pain, inability to perform certain activities that require prolonged attention (driving, reading,…) and productivity at work and finally effect to Q0L associated with DE. OSDI is scale questionnaire is created team to measure the quality of life related to ocular surface disease. AIM: To describe the dry eye disease according to OSDI scale and related factors of this disease. METHODS: A cross-sectional descriptive study was carried out on outpatients (≥ 16-year-old) who were examined and diagnosed with dry eyes at Vietnam National Institute Of Ophthalmology from April to July 2018. Data was collected using the OSDI questionnaire. RESULTS: The average age of participants was 44.6 years; 80.9% of patients were female; 39.9% were identified having mild dry eye. The related factors have been identified that associated with severe dry eye, including age OR = 1.03 (95%CI: 1.01-1.05, p = 0.005), binocular good vision OR = 0.11 (95%CI: 0.05-0.23; p < 0.0001), medical history OR = 17.09 (95%CI: 2.24-130.25; p < 0.0001), chronic conjunctivitis OR = 0.36 (95%CI: 0.14-0.91; p = 0.027), refractive errors OR = 0.14 (95%CI: 0.04-0.48; p < 0.0001), Sjogren's syndrome OR = 31.13 (95%CI: 7.08-136.76; p < 0.0001). CONCLUSION: Several related factors have been identified associated with severe dry eye, including: age, binocular good vision, medical history, chronic conjunctivitis, refractive errors, Sjogren's syndrome

Preimplantation Genetic Testing of Aneuploidy by Next Generation Sequencing: Association of Maternal Age and Chromosomal Abnormalities of Blastocyst

BACKGROUND: Aneuploidy is a major cause of miscarriages and implantation failure. Preimplantation genetic testing for aneuploidy (PGT-A) by Next Generation Sequencing (NGS) is able to detect of the numeral and structural chromosomal abnormalities of embryos in vitro fertilization (IVF). AIM: This study was aimed to assess the relationship between maternal age and chromosomal abnormalities NGS technology. METHODS: 603 human trophectoderm (TE) biopsied samples were tested by Veriseq kit of Illumina. The relation of marternal age and chromosomal abnormality of blastocyst embryo was evaluated. RESULTS: Among the 603 TE samples, 247 samples (42.73%) presented as chromosomal abnormalities. The abnormalities occurred to almost chromosomes, and the most popular aneuploidy observed is 22. Aneuploidy rate from 0.87% in chromosome 11 to 6.06% in chromosome 22. The rate of abnormal chromosome increased dramatically in group of mother's ages over 37 (54.17%) comparing to group of mother's ages less than 37 (38.05%) (p < 0.000). The Abnormal chromosome and maternal age has a positive correlation with r = 0.4783 (p<0.0001). CONCLUSION: These results showed high rate abnormal chromosome and correlated with advanced maternal age of blastocyst embryos

Point-of-care C-reactive protein testing to reduce inappropriate use of antibiotics for non-severe acute respiratory infections in Vietnamese primary health care: a randomised controlled trial

Background Inappropriate antibiotic use for acute respiratory tract infections is common in primary health care, but distinguishing serious from self-limiting infections is diffi cult, particularly in low-resource settings. We assessed whether C-reactive protein point-of-care testing can safely reduce antibiotic use in patients with non-severe acute respiratory tract infections in Vietnam. Method We did a multicentre open-label randomised controlled trial in ten primary health-care centres in northern Vietnam. Patients aged 1–65 years with at least one focal and one systemic symptom of acute respiratory tract infection were assigned 1:1 to receive either C-reactive protein point-of-care testing or routine care, following which antibiotic prescribing decisions were made. Patients with severe acute respiratory tract infection were excluded. Enrolled patients were reassessed on day 3, 4, or 5, and on day 14 a structured telephone interview was done blind to the intervention. Randomised assignments were concealed from prescribers and patients but not masked as the test result was used to assist treatment decisions. The primary outcome was antibiotic use within 14 days of follow-up. All analyses were prespecifi ed in the protocol and the statistical analysis plan. All analyses were done on the intention-totreat population and the analysis of the primary endpoint was repeated in the per-protocol population. This trial is registered under number NCT01918579. Findings Between March 17, 2014, and July 3, 2015, 2037 patients (1028 children and 1009 adults) were enrolled and randomised. One adult patient withdrew immediately after randomisation. 1017 patients were assigned to receive C-reactive protein point-of-care testing, and 1019 patients were assigned to receive routine care. 115 patients in the C-reactive protein point-of-care group and 72 patients in the routine care group were excluded in the intention-to-treat analysis due to missing primary endpoint. The number of patients who used antibiotics within 14 days was 581 (64%) of 902 patients in the C-reactive protein group versus 738 (78%) of 947 patients in the control group (odds ratio [OR] 0·49, 95% CI 0·40–0·61; p<0·0001). Highly signifi cant diff erences were seen in both children and adults, with substantial heterogeneity of the intervention eff ect across the 10 sites (I²=84%, 95% CI 66–96). 140 patients in the C-reactive protein group and 137 patients in the routine care group missed the urine test on day 3, 4, or 5. Antibiotic activity in urine on day 3, 4, or 5 was found in 267 (30%) of 877 patients in the C-reactive protein group versus 314 (36%) of 882 patients in the routine treatment group (OR 0·78, 95% CI 0·63–0·95; p=0·015). Time to resolution of symptoms was similar in both groups. Adverse events were rare, with no deaths and a total of 14 hospital admissions (six in the C-reactive protein group and eight in the control group). Interpretation C-reactive protein point-of-care testing reduced antibiotic use for non-severe acute respiratory tract infection without compromising patients’ recovery in primary health care in Vietnam. Health-care providers might have become familiar with the clinical picture of low C-reactive protein, leading to reduction in antibiotic prescribing in both groups, but this would have led to a reduction in observed eff ect, rather than overestimation. Qualitative analysis is needed to address diff erences in context in order to implement this strategy to improve rational antibiotic use for patients with acute respiratory infection in low-income and middle-income countries

The Role of Serial NT-ProBNP Level in Prognosis and Follow-Up Treatment of Acute Heart Failure after Coronary Artery Bypass Graft Surgery

BACKGROUND: After coronary artery bypass graft (CABG) surgery, heart failure is still major problem. The valuable marker for it is needed. AIM: Evaluating the role of serial NT-proBNP level in prognosis and follow-up treatment of acute heart failure after CABG surgery. METHODS: The prospective, analytic study evaluated 107 patients undergoing CABG surgery at Ho Chi Minh Heart Institute from October 2012 to June 2014. Collecting data was done at pre- and post-operative days with measuring NT-proBNP levels on the day before operation, 2 hours after surgery, every next 24 h until the 5th day, and in case of acute heart failure occurred after surgery. RESULTS: On the first postoperative day (POD1), the NT-proBNP level demonstrated significant value for AHF with the cut-off point = 817.8 pg/mL and AUC = 0.806. On the second and third postoperative day, the AUC value of NT- was 0.753 and 0.751. It was statistically significant in acute heart failure group almost at POD 1 and POD 2 when analyzed by the doses of dobutamine, noradrenaline, and adrenaline (both low doses and normal doses). CONCLUSION: Serial measurement of NT-proBNP level provides useful prognostic and follow-up treatment information in acute heart failure after CABG surgery

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security