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Acute prosthetic heart valve thrombosis (PHVT) is a severe complication affecting patients who have undergone heart valve replacement surgery. We present a case of acute recurrent PHVT associated with parasite-induced eosinophilia. A man in his early 50s with rheumatic heart disease underwent mechanical mitral valve replacement 5 years ago and received well-managed anticoagulation with regular follow-up visits. The patient developed a sudden onset of dyspnoea and was diagnosed with mechanical valve thrombosis, which was managed with thrombolysis. However, the valve became stuck again just a week after the initial episode while the patient was still in the hospital and was receiving anticoagulation within the target range. Concurrently, he experienced skin rashes and itching, prompting an investigation that revealed hypereosinophilia secondary to parasite infestation. The patient’s valve functions well after thrombolysis and parasite infection treatment. The eosinophil counts were monitored to remain within the normal range.

ObjectivesThis study aimed to determine doctors’ level of adherence to the natriuretic peptide testing guideline and to identify the factors influencing their adherence.DesignCross-sectional study.SettingWeb-based survey.ParticipantsFull-time doctors involved in heart failure (HF) treatment in Vietnam.Primary and secondary outcome measuresDoctors using natriuretic peptide testing for diagnosis, differential diagnosis, treatment assessment and prognosis of patients with HF were classified as adhering to the guidelines. We assessed the practice of natriuretic peptide testing and stratified the doctors based on their professional qualifications. Univariate and multivariate logistic regression analyses were used to estimate the Odds Ratio (ORs) and 95% CIs for associations between guideline adherence and selected covariates.ResultsOver half of the participants adhered to the natriuretic peptide testing guidelines (57.4%). Cardiologists adhered more closely to the guidelines than other professionals; they had approximately four times higher odds of adherence than other doctors (univariate model, OR: 3.88, 95% CI: 2.56 to 5.89, p<0.001; multivariate model, OR: 4.24, 95% CI: 2.64 to 6.82, p<0.001). Cardiologists also had significantly higher rates of using natriuretic peptide testing for diagnosis (93.8% vs 84.1%, p<0.002), differential diagnosis (71.4% vs 53.5%, p<0.001), treatment assessment (87% vs 64.2%, p<0.001) and prognosis (68.2% vs 50.4%, p<0.001) than other professionals. More years of professional experience correlated with higher guideline adherence (<2 years was used as a reference point; >5 to <10 years, OR: 2.59, 95% CI: 1.45 to 4.60, p<0.001; ≥10 years, OR: 2.30, 95% CI: 1.30 to 4.09, p<0.004).ConclusionThe level of adherence to natriuretic peptide testing guidelines among doctors treating patients with HF varies across Vietnam. Targeted interventions are needed to enhance understanding and proficiency, especially among non-cardiologists and those with limited experience. A dedicated fact sheet focusing on natriuretic peptide testing in HF management, separate from the existing guidelines, could bridge this gap.

From 2004 to 2006, the Ministry of Health (MoH), in collaboration with WHO, organized five Public Health and Emergency Management in Asia and the Pacific (PHEMAP) courses. These were attended by healthcare personnel and staff directly responsible for activities for preparedness and response to disasters and health emergencies in localities. There is currently no data on the impact of the PHEMAP courses on the work and attitudes of healthcare personnel who have attended. This study aims to address the above issues as well as give recommendations for upcoming PHEMAP courses. It focuses on describing changes in work and attitudes of participants toward PHEMAP courses as well as examines the need for training. We concluded that 1) There are many changes with participants after attending the national PHEMAP courses; 2) sending updated information to and following-up participants are important to encourage them to apply the knowledge and skills gained from the PHEMAP course; 3) the national PHEMAP courses should be continuously provided to participants at provincial and district levels; 4) material of the PHEMAP should be improved to suit different contexts; and 5) Participants should also be from sectors other than the health sector.

Dengue encephalitis is considered as a severe but unusual clinical presentation of dengue infection. Limited molecular information is available on the neurotropism of dengue virus (DENV), highlighting the need for further research. During a dengue outbreak in Vietnam in 2013, two DENV-3 strains were isolated, in which one was isolated from cerebrospinal fluid (CSF) samples from a dengue encephalitis patient and another strain was isolated from a patient with classical dengue fever in Hai Phong, Vietnam. DENV serotype-3 (DENV-3) isolated from these samples belonged to genotype III, marking the first report of this genotype in the country at that time. Genetic variation between both strains was elucidated by using a full genome sequencing by next-generation sequencing (NGS). The infectivity of the isolated DENV-3 strains was further characterized using human and mouse neuronal cell lines. Phylogenetic analysis of the isolates demonstrated high homogeneity between the CSF-derived and serum-derived DENV-3, in which the full genome sequences of the CSF-derived DENV-3 presented a Thr-1339-Ile mutation in the nonstructural 2A (NS2A) protein. The CSF-derived DENV-3 isolate grew preferentially in human neuronal cells, with a significant proportion of cells that were positive for nonstructural 1 (NS1), nonstructural 4B (NS4B), and nonstructural 5 (NS5) antigens. These results suggest that NS2A may be a crucial region in the neuropathogenesis of DENV-3 and its growth in human neuronal cells. Taken together, our results demonstrate that a CSF-derived DENV-3 has unique infectivity characteristics for human neuronal cells, which might play a crucial role in the neuropathogenesis of DENV infection.

In order to develop an in vitro propagation process for production and conservation, in this study, we investigated the influence of disinfectants and plants growth regulators (PGR) on the infection rate of explants, the ability of callus formation, and the regeneration of shoot and root from Asparagus officinalis L. trunk segments. We obtained the best results when disinfecting trunk segments explants combined with alcohol 70° in 5 minutes and NaClO in 5 minutes with the lowest contamination rate of 3.7%. Callus was formed well in MS medium supplemented with 3% sucrose; 0.7% agar, pH= 5.8; 1.0 mg/l BAP and combined with 0.5 mg/l NAA, 1.5 mg/l BAP and 0.75 mg/l NAA. The highest rate of shoot formation was 87.2% when the callus continued to grow in the environment supplemented with 2.0 mg/l BAP and 1.0 mg/l NAA. Roots were formed after 4 weeks of shoot cultivation in MS medium supplemented with 0.5 mg/l NAA with the highest rooting rate of 74.59%.

Background Between 2016 and 2019, 265 cases of Zika virus (ZIKV) infection were reported in Vietnam, predominantly in southern Vietnam. In 2016, a case of ZIKV-associated microcephaly was confirmed in the Central Highlands, and several members of the infant’s family were confirmed to be infected with ZIKV. The study aims to determine the level of immunity to ZIKV in the general population of the ZIKV epidemic region. Methods A total of 879 serum samples were collected from 801 participants between January 2017 and July 2018, during and after the ZIKV epidemic in Vietnam. The samples were tested for anti-ZIKV immunoglobulin M (IgM) and immunoglobulin G (IgG), and anti-dengue virus (DENV) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Plaque-reduction neutralization test (PRNT) for ZIKV was performed on all samples, and for DENV on the samples that ZIKV neutralizing antibody positive. Results A total of 83 (10.3%) participants had anti-ZIKV IgM. Of the 83, 6 were confirmed to be ZIKV antibodies positive using PRNT and anti-ZIKV IgG ELISA. Of the 718 participants who were anti-ZIKV IgM negative, a further 3 cases were confirmed as positive for antibodies against ZIKV. Of the 9 participants with ZIKV infection, 5 lived in the same village as the infant with ZIKV-associated microcephaly and the other 4 lived in 2 neighboring communes. Repeat samples were collected from the 83 ZIKV IgM positive participants 1.5 years after the first collection. No new cases of ZIKV infection were detected. In addition, 2 of 3 participants with anti-ZIKV NS1 IgG demonstrated a 4- to 8-fold increase in ZIKV neutralizing antibody titer. Conclusions ZIKV was present in the area around Krong Buk, with the rate of ZIKV-specific antibodies was 1.1% in the community since at least 2016. While the low levels of circulation together with low seroprevalence suggests a limited outbreak in the region, the results also reflect on low levels of protective immunity to Zika within the population. These results provide a better understanding of the current ZIKV epidemic status in the region and demonstrate a need for implementation of more effective ZIKV infection control measures.

A total of 221 isolates of M. tuberculosis were sampled from hospitals and the general population in the northern plain of Vietnam, one of the most populated region of the country. Genotypic composition and diversity were characterized, and we investigated how they are affected by sampling (hospital vs. general population), correcting for potential confounding effects (location, age and gender of the patients). Spoligotyping and 12 MIRU-VNTR typing were used as first line. Then 15 MIRU-VNTR standard set was used, making 21 MIRU-VNTR typing for the clustered isolates. Result showed that 8 lineages and 13 sub-lineages were circulating in the region. The most predominant lineages were Beijing (38.5%) and EAI (38.5%). Others appeared with small proportions H (1.4%), LAM (1.8%), T (8.1%), X (0.9%), MANU (2.3%), and Zero (0.4%). Higher clustering rate was found in the hospital samples (17.9% in urban and 19.2% in rural areas) compared to the population ones (0%). The typical Vietnamese EAI4-VNM sub-lineage of EAI lineage accounted for 67% of EAI strains and was associated with older ages. Beijing genotypes were associated with younger, urban population and were characterized by high clustering rates. These characteristics strongly suggest that Beijing strains are invading the population, replacing the local EAI-VNM4, thus predicting a more serious tuberculosis situation in the future in the absence of more effective control strategies.

Physiological disorders (PDs) in durian lead to reduced commodity prices; therefore, reducing the PD rate in durian enhances the fruit’s value and farmers’ profits. Nutrient and soil management may affect the PD rate during fruit development. Herein, we used amendments such as organic manure (OM) and foliar fertilization (FF) applications to reduce the PD rate and improve the soil health and fruit yield of durian. This study was conducted in three durian orchards in the Vietnamese Mekong Delta from 2022 to 2024. The treatments were as follows: (i) control (unamended), (ii) OM, (iii) FF, and (iv) OM + FF. N−P−K fertilizers (0.45 kg of N, 0.45 kg of P, and 0.45 kg of K per tree) were uniformly applied to all durian trees. We measured the characteristics of the soil, such as the soil pH, soil organic carbon (SOC), available phosphorus (AP), and exchangeable cations (K+ and Ca2+). The leaf nutrient (K and Ca) content, fruit yield (kg tree−1), and fruit quality (PD rate, total soluble solids (TSS), and aril color characteristics) were also recorded. Our study indicates that OM + FF increased soil pH and SOC, AP, and exchangeable cations (K+ and Ca2+). In addition, the K and Ca concentrations in durian leaves increased by approximately 4% using OM + FF. Combining OM and FF decreased the PD rate of durian fruit (>85%) compared with the control. This practice increased the fruit quality TSS (13%), color, proportion of arils, and fruit yield (~10%) compared with conventional practice (control). Overall, using OM and FF contributed to improving durian production and values. Therefore, we recommend that farmers who cultivate durian apply OM + FF to their orchards to enhance soil health, fruit quality, and yield.

Transurethral resection of the prostate (TURP) syndrome is a complication of transurethral resection of the prostate procedure. The incidence of TURP syndrome ranges from 0.78% to 1.4%. This syndrome is caused by excessive absorption of electrolyte-free and hypotonic washing solution. The fluids absorb into the circulation, which leads to heart failure, hyponatremia, and a decrease in serum osmolality. Cerebral edema, coma, pulmonary edema, cardiovascular collapse, and even death are common complications. We report a patient who suffered severe TURP syndrome after transurethral resection of the prostate procedure. Clinical manifestations were pulmonary edema and respiratory failure. The concentration of Na was 112.6 mmol/l, which was severe hyponatremia. The serum osmolality pressure was 234mOsmol/kg, pH was 7.23, pO was 45mmHg and pCO was 44mmHg. The patient had successfully recovered after being used CPAP-PSV Pro breathing through a mask with + 5cmH O of PEEP, 8cmH O of supporting pressure, 70-100% of FiO , 20mg furosemide of intravenously, 150 mL of 3% NaCl, and 100mL natribicarbonate 8.4%. TURP syndrome is a life-threatening complication of transurethral resection of the prostate procedure, which is caused by excessive absorption of electrolyte-free and hypotonic washing solution. Therefore, the patient should be monitored seriously, diagnosed early, and treated promptly.