PROVISION CAPACITY OF SERVICE DELIVERY FACILITIES FOR CHILDREN WITH HEARING LOSS IN HAI PHONG, VIETNAM

Objective: Hearing loss is a commonly occurring disability that affects 466 million people worldwide. This study aimed at determining the actual situations of early intervention delivery facilities for children with hearing loss. Out of this affected population, 7% are children (34 million) who, along with their families, grapple with the serious lifelong problems that accompany the disease. Methods: This descriptive cross-sectional study was conducted with facilities investigated consisting of a school for the deaf, hospitals, an audiology center, and a social agency in Hai Phong province from January 2013 to December 2014. A sample composed of 353 children was also recruited. Results: The examined facilities suffer from shortcomings in provision capacity, which manifest in deficient materials, supplies and equipment, and human resources; the lack of interdisciplinary coordination of activities; inadequate community awareness; and the unaddressed need for early detection and intervention. The conditions of most of the children (98%) were detected by their families, and among those who were clinically diagnosed, the majority (76.8%) received such diagnosis at central hospitals. Hearing impairment among the children were detected, diagnosed, and subjected to intervention at a very late stage (on average, at ages 22.3, 34, and 32.5 months, respectively), thereby compelling up to 63.6% of the families to struggle with their children’s hearing loss. Conclusion: Solutions to current interventions are needed to enhance service delivery systems and guarantee early detection as well as timely and appropriate treatment

Purification and characterization of novel fibrinolytic proteases as potential antithrombotic agents from earthworm Perionyx excavatus

Six protease fractions, namely FI, FII, FIII-1, FIII-2, FIII-3 and FIV, were isolated from Perionyx excavatus earthworm biomass by acetone precipitation, followed by serial chromatography using anion exchange, hydrophobic interaction and size exclusion chromatography. All fractions exhibited strong hydrolytic activity towards casein. The activity of six fractions towards fibrin, determined by fibrin plate assay, ranged from 44 to 831 plasmin unit.mg-1 and ranked as FIII-3 > FIII-2 > FI > FIII-1 > FIV > FII. Casein degradation was optimal at pH 7 and 11, and at 45-60°C. All fractions were considerably stable at high temperature and wide pH range. They were completely inhibited by phenylmethylsulfonyl fluoride (PMSF). The molecular weights (MW) and isoelectric points (pI) determined by 2D-electrophoresis were 27.5-34.5 kDa, and 4.3-5.2, respectively. Tandem mass spectrometry (MS) analysis was used to deduce the amino acid sequences of some peptides from FIII-1 and FIII-2. The sequences shared 16.9% and 13.2% similarity, respectively, with the fibrinolytic enzymes from two related earthworm species, Lumbricus rubellus and Eisenia fetida. The P. excavatus proteases were classified as serine proteases. They could perform rapid hydrolysis on both coagulated fibrous fibrin and soluble fibrinogen monomers without the presence of activators such as tPA or urokinase

Lovastatin for the Treatment of Adult Patients With Dengue: A Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: Dengue endangers billions of people in the tropical world, yet no therapeutic is currently available. In part, the severe manifestations of dengue reflect inflammatory processes affecting the vascular endothelium. In addition to lipid lowering, statins have pleiotropic effects that improve endothelial function, and epidemiological studies suggest that outcomes from a range of acute inflammatory syndromes are improved in patients already on statin therapy. METHODS: Following satisfactory review of a short pilot phase (40 mg lovastatin vs placebo in 30 cases), we performed a randomized, double-blind, placebo-controlled trial of 5 days of 80 mg lovastatin vs placebo in 300 Vietnamese adults with a positive dengue NS1 rapid test presenting within 72 hours of fever onset. The primary outcome was safety. Secondary outcomes included comparisons of disease progression rates, fever clearance times, and measures of plasma viremia and quality of life between the treatment arms. RESULTS: Adverse events occurred with similar frequency in both groups (97/151 [64%] placebo vs 82/149 [55%] lovastatin; P = .13), and were in keeping with the characteristic clinical and laboratory features of acute dengue. We also observed no difference in serious adverse events or any of the secondary outcome measures. CONCLUSIONS: We found lovastatin to be safe and well tolerated in adults with dengue. However, although the study was not powered to address efficacy, we found no evidence of a beneficial effect on any of the clinical manifestations or on dengue viremia. Continuing established statin therapy in patients who develop dengue is safe.Chinese Clinical Trials Registration. ISRCTN03147572

PHÁT HIỆN MỘT SỐ THUỐC HẠ GLUCOSE MÁU TRỘN LẪN TRONG CHẾ PHẨM DƯỢC LIỆU BẰNG PHƯƠNG PHÁP SẮC KÝ LỎNG HIỆU NĂNG CAO (HPLC)

Circular No. 10/2021/TT-BYT stipulated that several hypoglycemic drugs, such as metformin hydrochloride, are prohibited from adulterating medicinal herbal preparations. Therefore, this study aims to develop a procedure to detect five hypoglycemic drugs, including metformin hydrochloride, glibenclamide, gliclazide, glimepiride, and glipizide, adulterated in herbal preparations by using the high-performance liquid chromatography (HPLC) method. The chromatographic program includes the methanol:phosphate buffer pH 3 mobile phase 70/30 (v/v), chromatographic column C18 (250 × 4.6 mm, 5 μm), and analysis time of 25 minutes. The procedure has high specificity, accuracy and precision, according to AOAC. We detected six herbal products reacting positively with glibenclamide and one with both metformin hydrochloride and glibenclamide.Thông tư số 10/2021/TT-BYT quy định một số thuốc hạ glucose máu, như metformin hydroclorid, là các chất cấm trộn lẫn trong chế phẩm có nguồn gốc từ dược liệu. Do đó, mục tiêu nghiên cứu này là xây dựng quy trình phát hiện năm loại hoạt chất hạ glucose máu, gồm metformin hydroclorid, glibenclamid, gliclazid, glimepirid và glipizid, trộn lẫn trong chế phẩm có nguồn gốc dược liệu bằng phương pháp sắc ký lỏng hiệu năng cao (HPLC). Chúng tôi đã xây dựng được chương trình sắc ký gồm hệ pha động methanol:đệm phosphat pH 3 với tỷ lệ 30/70 (v/v), cột sắc ký C18 (250 × 4,6 mm, 5 μm), và thời gian phân tích 25 phút. Phương pháp thẩm định có tính đặc hiệu cao, độ đúng, độ lặp lại và độ tái lặp cao, đạt yêu cầu theo AOAC. Chúng tôi đã phát hiện bảy mẫu chế phẩm dược liệu dương tính trong đó sáu mẫu dương tính với glibenclamid và một mẫu dương tính đồng thời với metformin và glibenclamid

EFFECTIVENESS OF INITIAL SOLUTIONS INCORPORATED INTO EARLY INTERVENTION DELIVERY SYSTEMS FOR CHILDREN WITH HEARING LOSS: EVIDENCE FROM HAI PHONG, VIETNAM

Objective: Hearing loss is a serious disease that needs attention from society because of its considerable effects on the normal development of children. This study incorporated systematic solutions into early intervention delivery systems for children with hearing loss in Hai Phong, Vietnam, and evaluated the effectiveness of the strategies. Methods: This community intervention study, which was carried out from 2013 to 2014, involved a comparison of the early intervention delivery systems before and after the implementation of the proposed solutions. Results: Two years after the solutions were applied, the following results were derived: The availability of resources and the quality of service provision improved and access to and the use of services by families whose children suffer from hearing loss increased. The solutions also facilitated the creation of an early communal intervention program and significantly enhanced the situations of children with hearing loss as regards the average ages at which disease onset was suspected, the disease was definitively identified, hearing aid fitting was initiated, and language intervention was implemented (15.5, 21, 23.7, and 26.5 months, respectively). Finally, the solutions enabled detection, diagnosis, and early intervention at <12 and 24 months of age (p<0.001). Conclusion: The strategy of reinforcing intervention programs with general and comprehensive solutions can be expanded to other Vietnamese provinces grappling with similar problems

Genome-wide association study identifies susceptibility loci for dengue shock syndrome at MICB and PLCE1.

Hypovolemic shock (dengue shock syndrome (DSS)) is the most common life-threatening complication of dengue. We conducted a genome-wide association study of 2,008 pediatric cases treated for DSS and 2,018 controls from Vietnam. Replication of the most significantly associated markers was carried out in an independent Vietnamese sample of 1,737 cases and 2,934 controls. SNPs at two loci showed genome-wide significant association with DSS. We identified a susceptibility locus at MICB (major histocompatibility complex (MHC) class I polypeptide-related sequence B), which was within the broad MHC region on chromosome 6 but outside the class I and class II HLA loci (rs3132468, P(meta) = 4.41 × 10(-11), per-allele odds ratio (OR) = 1.34 (95% confidence interval: 1.23-1.46)). We identified associated variants within PLCE1 (phospholipase C, epsilon 1) on chromosome 10 (rs3765524, P(meta) = 3.08 × 10(-10), per-allele OR = 0.80 (95% confidence interval: 0.75-0.86)). We identify two loci associated with susceptibility to DSS in people with dengue, suggesting possible mechanisms for this severe complication of dengue

Sensitivity and specificity of a novel classifier for the early diagnosis of dengue.

BACKGROUND:Dengue is the commonest arboviral disease of humans. An early and accurate diagnosis of dengue can support clinical management, surveillance and disease control and is central to achieving the World Health Organisation target of a 50% reduction in dengue case mortality by 2020. METHODS:5729 children with fever of <72 hrs duration were enrolled into this multicenter prospective study in southern Vietnam between 2010-2012. A composite of gold standard diagnostic tests identified 1692 dengue cases. Using statistical methods, a novel Early Dengue Classifier (EDC) was developed that used patient age, white blood cell count and platelet count to discriminate dengue cases from non-dengue cases. RESULTS:The EDC had a sensitivity of 74.8% (95%CI: 73.0-76.8%) and specificity of 76.3% (95%CI: 75.2-77.6%) for the diagnosis of dengue. As an adjunctive test alongside NS1 rapid testing, sensitivity of the composite test was 91.6% (95%CI: 90.4-92.9%). CONCLUSIONS:We demonstrate that the early diagnosis of dengue can be enhanced beyond the current standard of care using a simple evidence-based algorithm. The results should support patient management and clinical trials of specific therapies

Univariate and multivariate analysis of candidate predictors of laboratory-confirmed dengue.

<p>BMI: body mass index; WBC: white blood cell count; PLT: platelet count; HCT: hematocrit; ALB: albumin; AST: aspartate aminotransferase; CK: creatine kinase</p><p>Univariate and multivariate analysis of candidate predictors of laboratory-confirmed dengue.</p