An extremely rare case of ovarian abscess in third trimester of pregnancy managed by successful vaginal birth and review of literature

Ovarian abscess (OA) in pregnancy is actually rare occurrence, almost unheard, which associated with poor prognosis for mother and fetus. This diagnostic dilemma is often difficult to be elucidated because of anatomical changes in pregnancy. It was established incidentally by obstetric ultrasound or during cesarean section performed for an obstetric indication. Specially, the presentation of adnexal abscess is very hard to distinguish from appendical abscess. In this report, we presented a 20-year-old woman (G0P0) at 33-34 weeks of gestation was admitted to the clinic of our hospital with a pelvic abnormal tumour accompanied by fetal growth restriction. The patient was indicated for serial laboratory examination, which showed a right abnormal adnexal mass. At hospitalization, the patient was mostly asymptomatic so she was followed by medical treatment and by an expectant management. The surveillance was strictly controlled without complications, except intrauterine growth restriction associated with pregnancy. The patient received a conservative management and gave a well-being infant at 36-37 weeks of gestation by vaginal delivery. Twelfth days after delivery, she underwent a laparoscopic operation to remove the abscess mass. Preventive treatment is also a major importance. This report describes the clinical features and results of the case with an ovarian abscess detected in the 3rd trimester without adverse sequelae and compared to the recurrent knowledge based on the literature regarding the advanced management of OA involved in pregnancy. Through this report, we aim to carry out a literature review in order to discuss these clinical manifestations of OA, optimize the importance in definitive diagnosis and underline the appropriate treatment of an individual case

Neonatal Outcomes in the Surgical Management of Placenta Accreta Spectrum Disorders: A Retrospective Single-Center Observational Study From 468 Vietnamese Pregnancies Beyond 28 Weeks of Gestation

BACKGROUND: Placenta accreta spectrum disorders (PASDs) increase the mortality rate for mothers and newborns over a decade. Thus, the purpose of the study is to evaluate the neonatal outcomes in emergency cesarean section (CS) and planned surgery as well as in Cesarean hysterectomy and the modified one-step conservative uterine surgery (MOSCUS). The secondary aim is to reveal the factors relating to poor neonatal outcomes. METHODS: This was a single-center retrospective study conducted between 2019 and 2020 at Tu Du Hospital, in the southern region of Vietnam. A total of 497 pregnant women involved in PASDs beyond 28 weeks of gestation were enrolled. The clinical outcomes concerning gestational age, birth weight, APGAR score, neonatal intervention, neonatal intensive care unit (NICU) admission, and NICU length of stay (LOS) were compared between emergency and planned surgery, between the Cesarean hysterectomy and the MOSCUS. The univariate and multivariable logistic regression were used to assess the adverse neonatal outcomes. RESULTS: Among 468 intraoperatively diagnosed PASD cases who underwent CS under general anesthesia, neonatal outcomes in the emergency CS (n = 65) were significantly poorer than in planned delivery (n = 403). Emergency CS increased the odds ratio (OR) for earlier gestational age, lower birthweight, lower APGAR score at 5 min, higher rate of neonatal intervention, NICU admission, and longer NICU LOS ≥ 7 days with OR, 95% confidence interval (CI) were 10.743 (5.675-20.338), 3.823 (2.197-6.651), 5.215 (2.277-11.942), 2.256 (1.318-3.861), 2.177 (1.262-3.756), 3.613 (2.052-6.363), and 2.298 (1.140-4.630), respectively, p \u3c 0.05. Conversely, there was no statistically significant difference between the neonatal outcomes in Cesarean hysterectomy (n = 79) and the MOSCUS method (n = 217). Using the multivariable logistic regression, factors independently associated with the 5-min-APGAR score of less than 7 points were time duration from the skin incision to fetal delivery (min) and gestational age (week). One minute-decreased time duration from skin incision to fetal delivery contributed to reduce the risk of adverse neonatal outcome by 2.2% with adjusted OR, 95% CI: 0.978 (0.962-0.993), p = 0.006. Meanwhile, one week-decreased gestational age increased approximately two fold odds of the adverse neonatal outcome with adjusted OR, 95% CI: 1.983 (1.600-2.456), p \u3c 0.0001. CONCLUSIONS: Among pregnancies with PASDs, the neonatal outcomes are worse in the emergency group compared to planned group of cesarean section. Additionally, the neonatal comorbidities in the conservative surgery using the MOSCUS method are similar to Cesarean hysterectomy. Time duration from the skin incision to fetal delivery and gestational age may be considered in PASD surgery. Further data is required to strengthen these findings

Prospects for Food Fermentation in South-East Asia, Topics From the Tropical Fermentation and Biotechnology Network at the End of the AsiFood Erasmus+Project

Fermentation has been used for centuries to produce food in South-East Asia and some foods of this region are famous in the whole world. However, in the twenty first century, issues like food safety and quality must be addressed in a world changing from local business to globalization. In Western countries, the answer to these questions has been made through hygienisation, generalization of the use of starters, specialization of agriculture and use of long-distance transportation. This may have resulted in a loss in the taste and typicity of the products, in an extensive use of antibiotics and other chemicals and eventually, in a loss in the confidence of consumers to the products. The challenges awaiting fermentation in South-East Asia are thus to improve safety and quality in a sustainable system producing tasty and typical fermented products and valorising by-products. At the end of the “AsiFood Erasmus+ project” (www.asifood.org), the goal of this paper is to present and discuss these challenges as addressed by the Tropical Fermentation Network, a group of researchers from universities, research centers and companies in Asia and Europe. This paper presents current actions and prospects on hygienic, environmental, sensorial and nutritional qualities of traditional fermented food including screening of functional bacteria and starters, food safety strategies, research for new antimicrobial compounds, development of more sustainable fermentations and valorisation of by-products. A specificity of this network is also the multidisciplinary approach dealing with microbiology, food, chemical, sensorial, and genetic analyses, biotechnology, food supply chain, consumers and ethnology

Spatiotemporal evolution of SARS-CoV-2 Alpha and Delta variants during large nationwide outbreak of COVID-19, Vietnam, 2021

We analyzed 1,303 SARS-CoV-2 whole-genome sequences from Vietnam, and found the Alpha and Delta variants were responsible for a large nationwide outbreak of COVID-19 in 2021. The Delta variant was confined to the AY.57 lineage and caused >1.7 million infections and >32,000 deaths. Viral transmission was strongly affected by nonpharmaceutical interventions

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

Spontaneous hemoperitoneum in the second and third trimester of pregnancy: two uncommon case reports at Tu Du Hospital, in Vietnam and a literature review

Abstract Background Spontaneous hemoperitoneum in pregnancy (SHiP) refers to fluid collection in the abdominal cavity with a vague presentation of clinical symptoms. Particularly, SHiP causes a life-threatening condition with the coexistence of intrauterine pregnancy, since this dangerous complication significantly increases the maternal and fetal mortality. Herein, we present two cases of nontraumatic SHiP in the second and third trimester of pregnancy, respectively. Case presentation The pregnant woman in case 1 was admitted to our hospital owing to severe paroxysmal shoulder pain along with abdominal pain. Her medical history was remarkably recorded with endometriosis and adenomyosis. At the emergency room, an ultrasound scan revealed a live fetus corresponding to 21 weeks and 3 days and free fluid in the abdominal cavity. She was subsequently diagnosed with SHiP and underwent immediate laparotomy for hemostatic procedures. During the postpartum course, the patient was uneventfully monitored. Unfortunately, the patient delivered on the 4th postoperative day in spite of the initial administration of tocolytic agents and close monitoring. The primigravid woman in case 2 complained of lower abdominal pain and vaginal bleeding. The patient’s history was noted with ovarian tumor removal. At admission, the sonography scan revealed free fluid in the abdominal cavity, a fetus at 34 weeks and 3 days gestational age with bradycardia of 70 bpm, and a laboratory test showed a low hemoglobin level. Thus, exploratory laparotomy and hysterotomy were performed at the same time due to fetal distress. The postpartum course was uneventful. The patient was discharged 5 days later. Conclusions In pregnant women with a history of endometriosis, adenomyosis, or ovarian tumor removal, acute abdominal pain combined with the presence of free fluid collection in the intraperitoneal cavity, and a decreased hemoglobin levels should be first assessed as SHiP originating from the spontaneous rupture of abnormal vascular proliferation. Proper management is strongly indicated for an emergent laparotomy to control the active bleeding point, thus increasing the survival rate for both mother and neonate

Prospects for food fermentation in South-East Asia, topics from the tropical fermentation and biotechnology network at the end o the AsiFood Erasmus plus project

Fermentation has been used for centuries to produce food in South-East Asia and some foods of this region are famous in the whole world. However, in the twenty first century, issues like food safety and quality must be addressed in a world changing from local business to globalization. In Western countries, the answer to these questions has been made through hygienisation, generalization of the use of starters, specialization of agriculture and use of long-distance transportation. This may have resulted in a loss in the taste and typicity of the products, in an extensive use of antibiotics and other chemicals and eventually, in a loss in the confidence of consumers to the products. The challenges awaiting fermentation in South-East Asia are thus to improve safety and quality in a sustainable system producing tasty and typical fermented products and valorising by-products. At the end of the "AsiFood Erasmus+ project" (www.asifood.org ), the goal of this paper is to present and discuss these challenges as addressed by the Tropical Fermentation Network, a group of researchers from universities, research centers and companies in Asia and Europe. This paper presents current actions and prospects on hygienic, environmental, sensorial and nutritional qualities of traditional fermented food including screening of functional bacteria and starters, food safety strategies, research for new antimicrobial compounds, development of more sustainable fermentations and valorisation of by-products. A specificity of this network is also the multidisciplinary approach dealing with microbiology, food, chemical, sensorial, and genetic analyses, biotechnology, food supply chain, consumers and ethnology