Etiology and epidemiology of diarrhea in children in Hanoi, Vietnam

SummaryObjectivesThis paper provides a preliminary picture of diarrhea with regards to etiology, clinical symptoms, and some related epidemiologic factors in children less than five years of age living in Hanoi, Vietnam.MethodsThe study population included 587 children with diarrhea and 249 age-matched healthy controls. The identification of pathogens was carried out by the conventional methods in combination with ELISA, immunoseparation, and PCR. The antibiotic susceptibility was determined by MIC following the NCCLS recommendations.ResultsOf those with diarrhea, 40.9% were less than one year old and 71.0% were less than two years old. A potential pathogen was identified in 67.3% of children with diarrhea. They were group A rotavirus, diarrheagenic Escherichia coli, Shigella spp, and enterotoxigenic Bacteroides fragilis, with prevalences of 46.7%, 22.5%, 4.7%, and 7.3%, respectively. No Salmonella spp or Vibrio cholerae were isolated. Rotavirus and diarrheagenic E. coli were predominant in children less than two years of age, while Shigella spp, and enterotoxigenic B. fragilis were mostly seen in the older children. Diarrheagenic E. coli and Shigella spp showed high prevalence of resistance to ampicillin, chloramphenicol, and to trimethoprim/sulfamethoxazole. Children attending the hospitals had fever (43.6%), vomiting (53.8%), and dehydration (82.6%). Watery stool was predominant with a prevalence of 66.4%, followed by mucous stool (21.0%). The mean episodes of stools per day was seven, ranging from two to 23 episodes. Before attending hospitals, 162/587 (27.6%) children had been given antibiotics. Overall, more children got diarrhea in (i) poor families; (ii) families where piped water and a latrine were lacking; (iii) families where mothers washed their hands less often before feeding the children; (iv) families where mothers had a low level of education; (v) families where information on health and sanitation less often reached their households.ConclusionsGroup A rotavirus, diarrheagenic Escherichia coli, Shigella spp, and enterotoxigenic Bacteroides fragilis play an important role in causing diarrhea in children in Hanoi, Vietnam. Epidemiological factors such as lack of fresh water supply, unhygienic septic tank, low family income, lack of health information, and low educational level of parents could contribute to the morbidity of diarrhea in children

Study of Using Cassava Pulp to Produce Livestock Feed Pellet

In Vietnam, the cassava production capacity is about 10 million tons annually. Indeed, it eliminates approximate 4 million tons of cassava pulp from the cassava starch factories. This amount of cassava is usually dried to feed cattle or fertilizer. However, drying of cassava pulp has its disadvantages such as air pollution, difficult storage and transportation. This study has proposed and successfully tested a line of equipment used to produce pellets from the utilization of fresh cassava pulp bringing from cassava starch processing plants. The processing includes a mixing of fresh cassava pulp with dried cassava starch, pressing and drying of pellets. The experiment results show that when the mixing ratio between cassava starch and cassava residue is 1:10 – 1:5, the cassava pulp pellets after drying achieved the required technical specifications. Hence, it has high volume density, the dried specific weight of the pellets is about 700 kg / m3, the breaking strength of the pellets is greater than 2 kG, the tanning time of the pellets is greater than 116 minutes in water, the moisture content of the pellets is remained in 13% after drying in 5-5.5 hours

Extract and fraction of cashew nut testa ameliorate the hyperglycemic mice induced by Streptozotocin and high-fat diet

Drug strategy is a standard method for treating type 2 diabetes mellitus (T2D), a non-communicable disease with increasing prevalence, which may cause side effects. Therefore, natural compounds with limited adverse effects have come back into vogue for treating T2D. This study aims to evaluate the effects on rehabilitating hyperglycemic mice of cashew nut testa (husk) extract and fraction known as potential bio-substances for improvement in T2D. First, the hyperglycemic mice were induced with a high-fat diet (HFD) for 4 weeks and then were injected with streptozotocin (STZ, dozen for injection was 40 mg/kg/week) for 2 weeks. Next, the confirmed hyperglycemic mice were treated with pioglitazone (HG+PG group), total extract (HG+TE group), and saponin-rich fraction (HG+SRF group) for 3 weeks. Then, the evaluation was based on body mass; blood glucose (BG) level; BG tolerance, lipid profile, pancreatic histology and the expression IRS-1 in the pancreas. The results showed that body mass and BG level significantly increased in hyperglycemic mice. After substance treatment, there was no change in body mass in TE and SRF groups. However, BG level of HG+TE group mice significantly decreased compared to hyperglycemic mice and only BG tolerance of HG+SRF group was improved. Besides, HG+TE and HG+SRF groups modulated the triglyceride, HDL and LDL close to those expressed in normal mice. In addition, histological images of the pancreas revealed the restoration in both HG+TE and HG+SRF groups. Simultaneously, the IRS-1 expression in HG+TE group pancreas was restored to its expression in normal mice. These results demonstrate that the TE and SRF of cashew nut testa could ameliorate BG, lipid profile and pancreatic IRS-1 expression and restore the damaged pancreas and islets in hyperglycemic mice

Dexamethasone and long-term outcome of tuberculous meningitis in Vietnamese adults and adolescents.

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654

The Effect of Awareness on the Behavior of Advertisement on Social Network Basis for Cosmetic Products Line

The study examines the factors affecting the perception and interaction behavior with advertising cosmetic products. The authors used SPSS and Smart PLS software to conduct statistics and analyze survey results. The results of data analysis show that there are 5 factors that directly affect the perception of avoidance: Health concerns; Doubts about advertising intermediaries; Privacy concerns; Information value; Obstructing cognitive goals. The factor that directly affects Avoidant Behavior is Perception of avoidance, there are 5 factors that indirectly affect Avoidant Behavior: Health concerns; Doubts about advertising intermediaries; Privacy concerns; Information value; Obstructing cognitive goals. At the same time, the research also shows that negative experiences do not affect the impact process from Avoidant Perception to Avoidant Behavior. This study has important practical elements for businesses, managers and even social network users in reducing users' awareness and avoidance of advertising

A preliminary study to establish the transfected CHO cell lines which highly express Trastuzumab - A biosimilar product of Herceptin

Human epidermal growth factor receptor 2 (HER2) has been identified as a molecular target for breast cancer therapy, such as Trastuzumab (Herceptin®). This has been shown to improve patient survival substantially. The current study is aiming to locally produce an anti-HER2 monoclonal antibody (named Trastuzumab) which has an equivalent biological properties in comparison with the original version, Herceptin®). In silico design and construction of recombinant vectors, as well as the establishment of transfected cell lines with high expression of Trastuzumab were performed. Based on the protein sequences obtained from the Drugbank, the DNA sequences encoding for the light chain (Tras-Lc) and heavy chain (Tras-Hc) of Trastuzumab were optimized and integrated into pNanogen-Hygro and pNanogen-Puro vectors, respectively. The Neon Transfection System was used to co-transfect the pNanogen-Tras-Lc-Hygro and pNanogen-Tras-Hc-Puro constructs into CHO cells. Different co-transfected single-cell-colonies selected on media supplemented with hygromycin and puromycin were used for ELISA and SDS-PAGE assays to identify the CHO cell lines which highly express Trastuzumab. Based on the present results, 30μg of both constructs were suitable for DNA co-transfection. After 07 days of culture, the highest amount of Trastuzumab (561 µg/ml) was obtained from the H06LD68 cell line

Dexamethasone and Long-Term Outcome of Tuberculous Meningitis in Vietnamese Adults and Adolescents

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654

ADAPTAÇÃO CULTURAL E VALIDAÇÃO PSICOMÉTRICA DO QUESTIONÁRIO SELF EFFICIENCY AND PERFORMANCE IN SELF-MANAGEMENT SUPPORT (SEPSS) EM ESTUDANTES DE GRADUAÇÃO EM ENFERMAGEM E MEDICINA DE BANGLADESH

In an aging society, healthcare professionals and students face increasing demands to actively involve patients in the decision-making process regarding their health conditions and lifestyles. Self-management support is considered a best practice that aligns with the patient-centered care paradigm in Bangladesh. However, there is currently no instrument available to assess healthcare professionals’ competencies in this field, particularly during their early education and training period. The aim of this study was to translate the Self Efficiency and Performance in Self-management Support (SEPSS) instrument into Bangla and validate its psychometric properties in a sample of undergraduate healthcare students in Bangladeshi higher education institutions. A cross-sectional study was conducted to assess the reliability, validity, and cultural appropriateness of the Bangla version of SEPSS-36 among 486 nursing and medical students. Confirmatory factor analysis was carried out using the chi-square model fit index (CMIN), comparative fit index (CFI), and Root Mean Square Error of Approximation (RMSEA) as fit indices. The internal consistency was estimated by the Cronbach alpha coefficient. The results indicate that the CMIN (2.658) and RMSEA (.058) values suggest that the sample data and hypothetical model are an acceptable fit in the analysis, with satisfactory CFI values (.895). The reliability for all SEPSS dimensions was acceptable. The Bangla version of the SEPSS questionnaire is a valid and reliable instrument that can assist healthcare educators and researchers in determining students’ competencies within this domain.Numa sociedade envelhecida, os profissionais de saúde e os estudantes enfrentam exigências cada vez maiores para envolver ativamente os pacientes no processo de tomada de decisão em relação às suas condições de saúde e estilos de vida. O apoio à autogestão é considerado uma prática recomendada que está alinhada com o paradigma de cuidados centrados no paciente em Bangladesh. No entanto, atualmente não existe um instrumento disponível para avaliar as competências dos profissionais de saúde nesse campo, especialmente durante o período inicial de educação e formação. O objetivo deste estudo foi traduzir o instrumento Self Efficiency and Performance in Self-management Support (SEPSS) para o bengali e validar as suas propriedades psicométricas numa amostra de estudantes de saúde de graduação em instituições de ensino superior de Bangladesh. Foi realizado um estudo transversal para avaliar a confiabilidade, validade e adequação cultural da versão em bengali do SEPSS-36 entre 486 estudantes de enfermagem e medicina. A análise fatorial confirmatória foi conduzida utilizando o índice de ajustamento do modelo qui-quadrado (CMIN), o índice de ajustamento comparativo (CFI) e o erro quadrado médio de aproximação (RMSEA) como índices de ajustamento. A consistência interna foi estimada pelo coeficiente alfa de Cronbach. Os resultados indicam que os valores de CMIN (2,658) e RMSEA (0,058) sugerem que os dados da amostra e o modelo hipotético têm um ajustamento aceitável na análise, com valores de CFI satisfatórios (0,895). A confiabilidade de todas as dimensões do SEPSS foi aceitável. A versão em bengali do questionário SEPSS é um instrumento válido e fiável que pode ajudar os educadores e investigadores em saúde a determinar as competências dos estudantes nesta área

Experiência de aprendizagem de estudantes de enfermagem na prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IACS) em países asiáticos: um estudo qualitativo exploratório

Background: Healthcare-associated infection prevention and control (HAI-PC) education programs in Asian countries seem limited and require improvement and support. Objective: This study explored students’ learning experiences with HAI-PC education programs in Asian countries (two Vietnamese and two Cambodian universities) to support a pedagogical model in HAI-PC. Method: A qualitative exploratory study design was employed, and inductive content analysis was conducted. Students were selected to participate in the focus group to investigate their experiences with HAI-PC using five structured questions. There were 48 nursing students in total from four universities, 28 from 2 universities in Cambodia, and 20 from two universities in Vietnam. Results: The summary results gained from the four universities were synthesized by grouping them into sub-categories and four primary categories, which were students’ HAI-PC competence, students’ current learning methods in HAI-PC Education, the HAI-PC teaching and learning environment, students’ capacity, and entrepreneurial skills in HAI-PC development. Conclusion: This study revealed evidence to improve nursing education in HAI-PC in Asian countries. The new learning method of the simulation scenario and the model fascinated the students; they were happy and more confident about their future careers in practicing HAI-PC skills in their clinical practicum and hospital practice. The current HAI-PC education faces issues related to education and healthcare systems in Asian countries, highlighting the need for improvement.Enquadramento: Os programas de educação em prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IAS) em países asiáticos parecem ser limitados e necessitam de melhorias e apoio. Objetivo: Este estudo explorou as experiências de aprendizagem dos estudantes com programas de educação em PC-IAS em países asiáticos (duas universidades vietnamitas e duas universidades cambojanas) para apoiar um modelo pedagógico em PC-IAS. Método: Foi utilizado um desenho de estudo exploratório qualitativo, e foi realizada uma análise de conteúdo indutiva. Os estudantes foram selecionados para participar no grupo focal para investigar as suas experiências com PC-IAS usando cinco perguntas estruturadas. No total, participaram 48 estudantes de enfermagem de quatro universidades, sendo 28 de duas universidades no Camboja e 20 de duas universidades no Vietname. Resultados: Os resultados resumidos das quatro universidades foram sintetizados agrupando-os em subcategorias e quatro categorias principais, que eram competência dos estudantes em PC-IAS, métodos de aprendizagem atuais dos estudantes em Educação em PC-IAS, ambiente de ensino e aprendizagem em PC-IAS, capacidade dos estudantes e habilidades empreendedoras no desenvolvimento de PC-IAS. Conclusão: Este estudo revelou evidências para melhorar a educação em enfermagem em PC-IAS em países asiáticos. O novo método de aprendizagem do cenário de simulação e o modelo cativaram os estudantes; eles ficaram felizes e mais confiantes em relação às suas futuras carreiras na prática de habilidades em PC-IAS no estágio clínico e na prática hospitalar. A educação atual em PC-IAS enfrenta questões relacionadas aos sistemas de educação e saúde em países asiáticos, destacando a necessidade de melhorias