Isolation and identification of triterpenoid compounds from Couroupita guianensis Aubl.

In this report, the extracts from the fruit and leaves of Couroupita guianensis were isolated using chromatographic methods and investigated for chemical composition. Four triterpenoid compounds were isolated and identified as betulinic acid, oleanolic acid, β-amyrin and friedelin. Their chemical structures were interpreted based on modern spectra such as MS, NMR and compared with previously published spectral data

The Relationship between HLA-B27, HLA-Cw06, HLA-DR7 and Psoriatic Arthritis in Vietnamese Patients: Disease Progression and Therapeutic Burden

We conducted a prospective, cross-sectional study at Ho Chi Minh City Hospital of Dermato Venereology from January 2016 to March 2017 in 40 psoriatic arthritis (PsA) patients to evaluate the disease progression and therapeutic burden about the HLA patterns. Based upon our results, PsA with HLA-B27 (+) had a threat of severe arthritis. PsA with HLA-Cw06 (+) had a higher risk of earlier onset and shorter duration for plaque psoriasis to transform into PsA. HLA-DR7 (+) in PsA delayed the time for conversion from plaque psoriasis into PsA. These findings are quite similar to other studies in the literature

Barriers and enablers to blood culture sampling in Indonesia, Thailand and Viet Nam: a Theoretical Domains Framework-based survey

Objective Blood culture (BC) sampling is recommended for all suspected sepsis patients prior to antibiotic administration. We examine barriers and enablers to BC sampling in three Southeast Asian countries. Design A Theoretical Domains Framework (TDF)-based survey, comprising a case scenario of a patient presenting with community-acquired sepsis and all 14 TDF domains of barriers/enablers to BC sampling. Setting Hospitals in Indonesia, Thailand and Viet Nam, December 2021 to 30 April 2022. Participants 1070 medical doctors and 238 final-year medical students were participated in this study. Half of the respondents were women (n=680, 52%) and most worked in governmental hospitals (n=980, 75.4%). Outcome measures Barriers and enablers to BC sampling. Results The proportion of respondents who answered that they would definitely take BC in the case scenario was highest at 89.8% (273/304) in Thailand, followed by 50.5% (252/499) in Viet Nam and 31.3% (157/501) in Indonesia (p<0.001). Barriers/enablers in nine TDF domains were considered key in influencing BC sampling, including ‘priority of BC (TDF-goals)’, ‘perception about their role to order or initiate an order for BC (TDF-social professional role and identity)’, ‘perception that BC is helpful (TDF-beliefs about consequences)’, ‘intention to follow guidelines (TDF-intention)’, ‘awareness of guidelines (TDF-knowledge)’, ‘norms of BC sampling (TDF-social influence)’, ‘consequences that discourage BC sampling (TDF-reinforcement)’, ‘perceived cost-effectiveness of BC (TDF-environmental context and resources)’ and ‘regulation on cost reimbursement (TDF-behavioural regulation)’. There was substantial heterogeneity between the countries. In most domains, the lower (higher) proportion of Thai respondents experienced the barriers (enablers) compared with that of Indonesian and Vietnamese respondents. A range of suggested intervention types and policy options was identified. Conclusions Barriers and enablers to BC sampling are varied and heterogenous. Cost-related barriers are more common in more resource-limited countries, while many barriers are not directly related to cost. Context-specific multifaceted interventions at both hospital and policy levels are required to improve diagnostic stewardship practices

Successful Psoriasis Treatment Using NB-UVB with Methotrexate: The Vietnamese Experience

AIM: To compare the effectiveness of narrowband ultraviolet B (NBUVB) and oral methotrexate (MTX) to oral MTX alone in Vietnamese psoriasis patients, from May 2016 to May 2018. METHODS: We conducted a non-randomized trial on 70 patients with plaque-type psoriasis of moderate to severe. Thirty-five patients apply NBUVB once/day in 5 days/week for 4 weeks plus oral MTX 7.5 mg/week and 35 patients oral MTX 7.5 mg/week and both two groups treatment for 3 months. The extent of the lesion was assessed by the Psoriasis Area and Severity Index (PASI). RESULTS: The proportion of decreasing PASI was comparable (68.49% in NBUVB and MTX versus 57.62% in MTX alone); p &lt; 0.05. Inside, good 28.58%, moderate 68.57% and poor 2.85% in NBUVB and MTX better than good 2.85%, moderate 71.4% and poor 25.72% in MTX alone; p &lt; 0.05. The recurrence rate after 24 months of the NBUVB and MTX group (42.9%) was lower than the MTX alone group (71.4%); p &lt; 0.05. CONCLUSION: NBUVB and oral MTX have affected treatment with chronic plaque psoriasis better than oral MTX alone

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

Identifying Live Bird Markets with the Potential to Act as Reservoirs of Avian Influenza A (H5N1) Virus: A Survey in Northern Viet Nam and Cambodia

Wet markets are common in many parts of the world and may promote the emergence, spread and maintenance of livestock pathogens, including zoonoses. A survey was conducted in order to assess the potential of Vietnamese and Cambodian live bird markets (LBMs) to sustain circulation of highly pathogenic avian influenza virus subtype H5N1 (HPAIV H5N1). Thirty Vietnamese and 8 Cambodian LBMs were visited, and structured interviews were conducted with the market managers and 561 Vietnamese and 84 Cambodian traders. Multivariate and cluster analysis were used to construct a typology of traders based on their poultry management practices. As a result of those practices and large poultry surplus (unsold poultry reoffered for sale the following day), some poultry traders were shown to promote conditions favorable for perpetuating HPAIV H5N1 in LBMs. More than 80% of these traders operated in LBMs located in the most densely populated areas, Ha Noi and Phnom Penh. The profiles of sellers operating at a given LBM could be reliably predicted using basic information about the location and type of market. Consequently, LBMs with the largest combination of risk factors for becoming virus reservoirs could be easily identified, potentially allowing control strategies to be appropriately targeted. These findings are of particular relevance to resource-scarce settings with extensively developed LBM systems, commonly found in South-East Asia

Simulação como método de ensino na formação em enfermagem na prevenção e controlo de infeções associadas aos cuidados de saúde em países asiáticos: um estudo qualitativo

Background: Applying simulation for nursing education, especially in healthcare-associated infection prevention and control (HAI-PC) in developing countries has limited evidence. The study was conducted to explore educators’ perceptions of simulation as a teaching method for nursing education in HAI-PC in two Vietnamese and two Cambodian universities. Methods: An exploratory qualitative design was applied. A focus group of 37 educators from four universities was conducted for data collection. Inductive and deductive qualitative content analysis was applied in analysing the data. Results: The core category was constructed to reflect educators’ perception of scenario-based simulation (SBS) as a teaching method for nursing education in HAI prevention and control. This main category included three subcategories: (i) enhancing nursing competence; (ii) preparing students for simulation; and [1] promoting simulation pedagogy competence. Conclusions: The findings identified the importance and benefits of applying simulation as a teaching method in nursing education. Additionally, it emphasized the necessity of enhancing knowledge associated with HAIs and providing additional training on simulation for educators to improve the quality of conducting simulations.Enquadramento: A aplicação da simulação no ensino de enfermagem, especialmente na prevenção e controlo de infeções associadas aos cuidados de saúde (IACS), em países em desenvolvimento, tem evidências limitadas. O estudo foi conduzido para explorar as perceções dos educadores sobre a simulação como método de ensino para a formação em enfermagem na prevenção e controlo de IACS em duas universidades vietnamitas e duas universidades cambojanas. Métodos: Foi aplicado um desenho qualitativo exploratório. Um grupo de discussão com 37 educadores de quatro universidades foi conduzido para a recolha de dados. A análise qualitativa de conteúdo indutiva e dedutiva foi aplicada na análise dos dados. Resultados: A categoria central foi construída para refletir a perceção dos educadores sobre a simulação baseada em cenários (SBC) como método de ensino para a formação em enfermagem na prevenção e controlo de IACS. Esta categoria principal incluiu três subcategorias: (i) aprimoramento da competência em enfermagem; (ii) preparação dos estudantes para a simulação; e [1] promoção da competência em pedagogia de simulação. Conclusões: Os resultados identificaram a importância e benefícios da aplicação da simulação como método de ensino na formação em enfermagem. Além disso, enfatizou a necessidade de aprimorar o conhecimento associado às ICACS e fornecer treinamento adicional sobre simulação para educadores, visando melhorar a qualidade da condução das simulações

Experiências do estudante de enfermagem na aprendizagem da prevenção e controlo de IACS em países asiáticos através do uso de simulação baseada em cenários: um estudo qualitativo exploratório

Background: Healthcare-associated infections (HAIs) have posed a major threat to both patients and to the safety healthcare personnel worldwide. According to the World Health Organization, 10% of hospitalized patients are affected by HAIs worldwide. Objective: The objective of this study was to explore the experiences of nursing students in learning HAIs prevention and control by the application of the scenario-based simulation pedagogy now in use in two Vietnamese and two Cambodian universities. Methods: A qualitative study was conducted among 160 nursing students from 2 Cambodian universities and 2 Vietnamese universities, and by using the purposive-sampling method. The data were collected through a focus group discussion and analyzed by the Graneheim and Lundman method (Graneheim &amp; Lundman, 2004). Results: Two themes and six categories were generated. 1) First theme: factors for enhancing student learning on the prevention and control of HAIs by use of scenario-based simulation; and 2) Second theme: factors hindering students learning on HAI prevention and control by use of scenario-based simulation. Conclusion: The findings showed that SBS is an effective learning method for nursing students that can be applied to enhance the quality of nursing education in the Asian countries as SBS not only improves the clinical skills, but also the soft skills of nursing students. However, the effective outcomes and impacts can only be achieved in the context with the appropriate learning materials and equipment, simulation facilities and the instructors with pedagogical skills.Enquadramento: As infeções associadas a cuidados de saúde (IACS) têm representado uma grande ameaça tanto para os pacientes quanto para a segurança dos profissionais de saúde em todo o mundo. De acordo com a Organização Mundial da Saúde, 10% dos pacientes hospitalizados são afetados por IACS em todo o mundo. Objetivo: O objetivo deste estudo foi explorar as experiências dos estudantes de enfermagem na aprendizagem da prevenção e controlo de IACS através da aplicação da pedagogia de simulação baseada em cenários, atualmente em uso em duas universidades vietnamitas e duas universidades cambojanas. Métodos: Um estudo qualitativo foi conduzido entre 160 estudantes de enfermagem de duas universidades cambojanas e duas universidades vietnamitas, utilizando o método de amostragem propositada. Os dados foram recolhidos através de uma discussão em grupo focal e analisados pelo método de Graneheim e Lundman (Graneheim &amp; Lundman, 2004). Resultados: Dois temas e seis categorias foram gerados. 1) Primeiro tema: fatores que contribuem para a aprendizagem dos estudantes na prevenção e controlo de IACS pelo uso de simulação baseada em cenários; e 2) Segundo tema: fatores que impedem a aprendizagem dos estudantes na prevenção e controlo de IACS pelo uso de simulação baseada em cenários (SBC). Conclusão: Os resultados demonstraram que a SBC é um método de aprendizagem eficaz para estudantes de enfermagem que pode ser aplicado para melhorar a qualidade da educação em enfermagem nos países asiáticos, uma vez que a SBC não só melhora as habilidades clínicas, mas também as habilidades interpessoais dos estudantes de enfermagem. No entanto, os resultados e impactos efetivos só podem ser alcançados no contexto com os materiais e equipamentos de aprendizagem apropriados, instalações de simulação e instrutores com habilidades pedagógicas

Validation and utilization of an internally controlled multiplex Real-time RT-PCR assay for simultaneous detection of enteroviruses and enterovirus A71 associated with hand foot and mouth disease

BACKGROUND: Hand foot and mouth disease (HFMD) is a disease of public health importance across the Asia-Pacific region. The disease is caused by enteroviruses (EVs), in particular enterovirus A71 (EV-A71). In EV-A71-associated HFMD, the infection is sometimes associated with severe manifestations including neurological involvement and fatal outcome. The availability of a robust diagnostic assay to distinguish EV-A71 from other EVs is important for patient management and outbreak response. METHODS: We developed and validated an internally controlled one-step single-tube real-time RT-PCR in terms of sensitivity, linearity, precision, and specificity for simultaneous detection of EVs and EV-A71. Subsequently, the assay was then applied on throat and rectal swabs sampled from 434 HFMD patients. RESULTS: The assay was evaluated using both plasmid DNA and viral RNA and has shown to be reproducible with a maximum assay variation of 4.41 % and sensitive with a limit of detection less than 10 copies of target template per reaction, while cross-reactivity with other EV serotypes was not observed. When compared against a published VP1 nested RT-PCR using 112 diagnostic throat and rectal swabs from 112 children with a clinical diagnosis of HFMD during 2014, the multiplex assay had a higher sensitivity and 100 % concordance with sequencing results which showed EVs in 77/112 (68.8 %) and EV-A71 in 7/112 (6.3 %). When applied to clinical diagnostics for 322 children, the assay detected EVs in throat swabs of 257/322 (79.8 %) of which EV-A71 was detected in 36/322 (11.2 %) children. The detection rate increased to 93.5 % (301/322) and 13.4 % (43/322) for EVs and EV-A71, respectively, when rectal swabs from 65 throat-negative children were further analyzed. CONCLUSION: We have successfully developed and validated a sensitive internally controlled multiplex assay for rapid detection of EVs and EV-A71, which is useful for clinical management and outbreak control of HFMD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12985-015-0316-2) contains supplementary material, which is available to authorized users

SIMULATION AS A TEACHING METHOD FOR NURSING EDUCATION IN HEALTHCARE-ASSOCIATED INFECTION PREVENTION AND CONTROL IN ASIAN COUNTRIES: A QUALITATIVE STUDY

BACKGROUND: Applying simulation for nursing education, especially in healthcare-associated infection prevention and control (HAI-PC) in developing countries has limited evidence. The study was conducted to explore educators’ perceptions of simulation as a teaching method for nursing education in HAI-PC in two Vietnamese and two Cambodian universities. METHODS: An exploratory qualitative design was applied. A focus group of 37 educators from four universities was conducted for data collection. Inductive and deductive qualitative content analysis was applied in analysing the data. RESULTS: The core category was constructed to reflect educators’ perception of scenario-based simulation (SBS) as a teaching method for nursing education in HAI prevention and control. This main category included three subcategories: (i) enhancing nursing competence; (ii) preparing students for simulation; and [1] promoting simulation pedagogy competence. CONCLUSIONS: The findings identified the importance and benefits of applying simulation as a teaching method in nursing education. Additionally, it emphasized the necessity of enhancing knowledge associated with HAIs and providing additional training on simulation for educators to improve the quality of conducting simulations