The Efficacy of a Two-Fold Increase of H1-Antihistamine in the Treatment of Chronic Urticaria - the Vietnamese Experience

BACKGROUND: Chronic urticaria, a mast cell-driven condition, is common, debilitating and hard to treat. H1-antihistamines are the first line treatment of chronic urticaria, but often patients do not get satisfactory relief with the recommended dose. European guidelines recommend increased antihistamine doses up to four-fold. AIM: We conducted this study to evaluate the efficacy of increased H1-antihistamine doses up to two-fold in Vietnamese chronic urticaria patients. METHODS: One hundred and two patients with chronic urticaria were recruited for treatment with levocetirizine (n = 52) or fexofenadine (n = 50). Treatment started at the conventional daily dose of 5 mg levocetirizine or 180 mg fexofenadine for 2 weeks and then increased to 10 mg levocetirizine or 360 mg fexofenadine for 2 weeks if patients did not have an improvement in symptoms. At week 0, week 2 and week 4 wheal, pruritus, size of the wheal, total symptom scores, and associated side-effects were assessed. RESULTS: With the conventional dose, the total symptom scores after week 2 decreased significantly in both groups compared to baseline figures, i.e. 7.4 vs 2.3 for levocetirizine group and 8.0 vs 2.6 for fexofenadine group (p < 0.05). However, there were still 26 patients in each group who did not have improvements. Of these 26 patients, after having a two-fold increase of the conventional dose, 11.5% and 38.5% became symptom-free at week 4 in levocetirizine group and fexofenadine group, respectively. At week 4 in both groups, the total symptom scores had significantly decreased when compared with those at week 2 (2.8 ± 1.5 versus 4.7 ± 1.6 in levocetirizine group; 2.1 ± 1.9 versus 5.1 ± 1.4 in fexofenadine group). In both groups, there was no difference in the rate of negative side effects between the conventional dose and the double dose. CONCLUSION: This study showed that increasing the dosages of levocetirizine and fexofenadine by two-fold improved chronic urticaria symptoms without increasing the rate of negative side effects

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

Earnings Quality and Corporate Social Disclosure: The Moderating Role of State and Foreign Ownership in Vietnamese Listed Firms

By investigating the effect of earnings quality (EQ) on corporate social disclosure (CSD) in the context of Vietnam, this study tests whether firms uphold managerial opportunism based on the agency theory or social responsibility based on stakeholder theory. It also tests the moderating effect of state and foreign ownership on the relationship between EQ and CSD. This study finds that the long-term perspective argument dominates in the relationship between EQ and CSD, indicating that EQ is positively and significantly associated with CSD. The study also finds that the increasing proportion of shares held by the government in firms weakens the relationship between EQ and CSD

sj-docx-1-ras-10.1177_00208523241230439 - Supplemental material for Transformational leadership and public employee performance: The mediating roles of employee participation and public service motivation

Supplemental material, sj-docx-1-ras-10.1177_00208523241230439 for Transformational leadership and public employee performance: The mediating roles of employee participation and public service motivation by Yen Thi Tran and Trang Cam Hoang in International Review of Administrative Sciences</p

Community-based rehabilitation workers in Vietnam need assistance to support communication and swallowing: Sustainable Development Goals 3, 4, 8, 10, 17

Purpose: Communication and swallowing disabilities (CSwD) impact health and well-being (Sustainable Development Goal SDG 3), educational attainment (SDG 4) and employment (SDG 8) and contribute to poverty (SDG 1). In Vietnam, community-based rehabilitation (CBR) workers are often the first point of contact for people with CSwD. This commentary reports research exploring the knowledge, experiences and training needs of CBR workers and their preparedness to provide services to people with CSwD and their families living in a province of Vietnam. Method: Two hundred and five CBR workers completed a written survey and eight participated in a semi-structured interview. Quantitative survey data were analysed using descriptive statistics and content analysis was used to analyse the qualitative data. Result: Most participants were female, aged over 30 and worked in a variety of health settings. Multiple challenges to the delivery of services to people with CSwD were described, including lack of training and limited understanding of CSwD by CBR workers, communities and their leaders. Conclusion: Limited knowledge and preparedness of CBR workers is threatening the achievement of the SDGs for people with CSwD in Vietnam. There is a need for comprehensive education, training and the raising of awareness of the cause and impact of CSwD, and for this to be in partnership with people who experience CSwD and their families, local speech-language pathologists, and international collaborators. Future research exploring the needs of people with CSwD in Vietnam is critical to guiding the development of contextually relevant services and support. This commentary focuses on good health and well-being (SDG 3), quality education (SDG 4), decent work and economic growth (SDG 8), reduced inequalities (SDG 10) and partnerships for the goals (SDG 17), and indirectly addresses no poverty (SDG 1)

New QuEChERS method for quantification of Physalin B and D in Physalis angulata L. in Vietnam

In Vietnam, Physalis angulata L. has been widely used as a traditional medicine to treat fever, anti-inflammatory, and expectorant. Currently, there have been studies on the content of chemical composition especially physalin with anti-diabetic, anti-inflammatory, antibacterial, prevent cancer. This study developed a reliable and sensitive method to determine and validate simultaneous Physalin B and Physalin D in Physalis angulata L.. The QuEChERS method was used for sample preparation from leaf matrices and quantified by using High-performance liquid chromatography coupled with a diode-array detector. The method of research was validated under AOAC and ICH guidance. Chromatography conditions include Agilent C18 column (250mm × 4,6mm; 5µm) with a gradient mode using acetonitrile – methanol-water as mobile phase. The recovery of the method ranged from 94.21 – 105.93% and RSD was from 1.20 – 2.31%, the LOD, and LOQ were 0.4 mg/kg – 2.4 mg/kg, respectively. The results of the study showed that the proposed the new QuEChERS method for quantification of Physalin B and D in Physalis angulata L. in Vietnam