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Background: Heavy metal contamination and related risks for the environment and human health are matters of increasing concern. Methods: The levels of 4 heavy metals (Cr, Cd, Pb, and As) were evaluated in 2 water types (surface and well), 4 types of seafood (tiger shrimp, stuffed snail, snake-head fish, and catfish), and 27 types of vegetables (12 leafy vegetables, 4 pea plants, 4 tuber vegetables, and 7 herbs) that are commonly consumed in northern coastal communes located in Vietnam. Atomic absorption spectrometry was employed for quantification. Results: The mean concentrations of heavy metals detected in water, seafood, and vegetable samples exceeded the national permitted standards and World Health Organization (WHO) recommendation values by at least 2-fold, 2.5-fold, and 5-fold for surface water, vegetables, and well water, respectively. The concentrations of all 4 heavy metals detected in seafood samples were higher than the standards. The levels of heavy metals decreased with increasing distance between the sample collection point and the pollution source. Conclusions: This is the first report of heavy metal contamination of common sources of food and water in the northern coastal area of Vietnam. Significantly, the concentrations of heavy metals detected in study samples exceeded the regulatory limits. These results underscore the importance of continued monitoring and the development of intervention measures to ensure that the quality of food and water meets established standards and protects the health of the local population.

Abstract Background Vietnam began providing methadone maintenance therapy (MMT) in 2008; as of June 2016, 44,479 persons who inject drugs (PWID) were in treatment in 57 provinces. However, 10–23% of patients were estimated to have dropped out of treatment during the first 2 years. We evaluated dropout and factors associated with quitting treatment. Methods We followed clients ≥ 18 years old enrolled in five MMT clinics in Haiphong for 3 years. Persons who missed a consecutive month of methadone treatment were considered to have dropped out and were not allowed to return; those who missed greater than five consecutive doses were considered to be non-compliant but were allowed to restart treatment at their initial dose. Clients who dropped out or who were non-compliant during their third year of MMT (cases) were traced and matched with two clients who remained in treatment (controls) by gender, age, and length of time in the program. Cases and controls were interviewed. Additional data on levels of yearly retention were abstracted from clinic records. Results Among the 1055 patients initially enrolled in MMT, dropout and non-compliance combined was 13.6% during the first year, 16.5% during the second year, and 22.3% during the third year. By 36 months, 33.3% of clients had dropped out, of whom 10.6% had died and 24% had been arrested. We traced and interviewed 81 clients who dropped out or who were non-compliant during year 3 as well as 161 controls. The primary reasons for dropping out included claiming no dependence on heroin (22.2%), conflict with work (21.0%), health problems (16.0%), and inability to afford the methadone co-payment of approximately 0.5 USD/day (14.8%). Independent factors associated with non-compliance included continuing to use heroin (aOR = 12.4, 95% CI 4.2–36.8) and missing greater than three doses during the previous 3 months (aOR = 18.5, 95% CI 7.4–47.1); receiving a daily dose of > 120 mg of methadone was associated with a lower odds ratio of dropping out (aOR = 0.3, 95% CI 0.1–0.9). Conclusion By 3 years, one third of all patients in treatment had permanently dropped out. Ensuring that methadone dosing is adequate and reducing or eliminating the co-payment fee for those who cannot afford it could improve retention.

Intestinal obstruction due to ligament (fibrous band) arising from the top of Meckel's diverticulum is a rare cause. To date, in the world, only a few cases have been reported and there are not enough statistics on the incidence of this disease. This case presentation will help doctors working in the field of pediatric surgery or of pediatric imaging diagnosis have more experiences on diagnosis and treatment, and enrich the medical literature on this rare disease. We report a case of an 8‐year‐old boy with intestinal obstruction due to ligament arising from Meckel's diverticulum with complete data set such as clinical manifestations, imaging diagnosis (ultrasound, unprepared abdominal x‐ray, computerized tomography scanner with contrast injection), surgical information, and histopathological findings. Intestinal obstruction due to the ligament arising from the apex of Meckel's diverticulum is an extremely rare disease and has asymptomatic imaging features so the preoperative diagnosis is only based on the indirect findings of computerized tomography scanner. The early diagnosis of an intestinal obstruction due to fibrous band can be made by using imaging methods such as ultrasound, unprepared abdominal x‐ray, computerized tomography scanner with contrast injection, contributing to the prompt diagnosis in order to avoid serious complications including bowel necrosis, intestinal perforation, and perforated diverticulum. [ABSTRACT FROM AUTHOR]

Physical and psychological symptoms among people living with HIV (PLWH) adversely affect quality of life and treatment adherence. Study objectives were: (i) to determine validity and reliability of a Vietnamese translation of the Memorial Symptom Assessment Scale–Short Form (MSAS-SF) among PLWH in Vietnam; (ii) to measure prevalence and burden of physical and psychological symptoms using the MSAS-SF including the Global Distress Index (GDI), Physical Distress subscale (PHYS), and Psychological Distress subscale (PSY); (iii) to identify symptom burden risk factors. We recruited 567 patients. Cronbach's alpha scores were: total MSAS-SF 0.91, GDI 0.83, PHYS 0.85, PSYCH 0.81. The scale showed good discriminant validity (low vs high function) (p < 0.001). The mean number of symptoms was 7.66, and the most prevalent were "worrying" (41.6%), "lack of energy" (40.6%), "feeling irritable" (40.4%), and "feeling sad" (39.2%). Monthly income below the poverty line was independently associated with increased: GDI,, PHYS, and PSY and a greater number of symptoms. The Vietnamese version of the MSAS-SF is valid to measure symptom prevalence and burden in HIV-positive populations. Here is a high symptom prevalence and burden among PLWH in Vietnam, especially those living in poverty, and a great need for palliative care integrated with HIV treatment. [ABSTRACT FROM AUTHOR]

AbstractWe evaluated the prevalence and profile of antiretroviral treatment (ART)-associated resistance mutations among HIV-1 strains in northern Vietnam by genotypically analyzing strains isolated from ART-naive individuals in Hai Phong, a city in which HIV-1 is highly prevalent. Plasma samples were collected from injecting drug users (IDU, n= 760), female sex workers (FSW, n= 91), seafarers (n= 94), pregnant women (n= 200), and blood donors (n= 210), and screened for HIV-1 antibodies. Plasma viral RNA was extracted from HIV-1-positive samples, amplified by reverse transcriptase (RT)-PCR of protease and RT genes, and analyzed for genotypes and ART-associated resistance mutations. HIV-1 prevalence among IDU, FSW, seafarers, pregnant women, and blood donors was 35.9%, 23.1%, 0%, 0.5%, and 2.9%, respectively. Phylogenetic analyses revealed that the most prevalent HIV-1 subtype was CRF01_AE (98.3%), similar to strains prevalent in southern China. Four (1.4%) subtype B strains and one (0.3%) unique recombinant between subtypes B and C were also identified. We found protease inhibitor-associated major resistance mutations in one of the 294 cases analyzed (0.3%; mutation M46I). We found RT inhibitor-associated major resistance mutations in 7/273 cases (2.6%; one occurrence each of L74I, M184I, and K219E; three cases of K103N; and two cases of G190E). One CRF01_AE strain harboring a protease codon 35 insertion was first identified in Vietnam. Thus, monitoring of drug-resistant HIV-1 and establishment of a database are required for the proper selection of ART in Vietnam. [ABSTRACT FROM AUTHOR]

To identify hepatitis C virus (HCV) transmission routes among injection drug users in Northern Vietnam, plasma samples were collected from 486 drug users in Hai Phong. Plasma viral RNA was extracted from 323 (66.5%) samples that were positive for anti-HCV antibodies. Portions of the HCV 5'-untranslated (5'UTR)-Core and NS5B genes were amplified by reverse-transcriptase polymerase chain reaction, sequenced directly, and genotyped in 194 and 195 specimens, respectively. Both regions were genotyped in 137 specimens. In the 5'UTR-Core region, genotype 6a was predominant (32.5%), followed by genotype 1a (23.7%), genotype 1b (20.6%), and genotype 6e (14.4%). In the NS5B region, genotype 1a was predominant (42.6%), followed by genotype 1b (24.1%), genotype 6a (14.4%), genotype 3b (7.2%), and genotype 6e (5.1%). Of the 137 specimens with both regions genotyped, 23 (16.8%) showed discordant genotyping results between the two regions, suggesting possible recombination and/or dual infection. Phylogenetic analysis revealed close associations between Hai Phong strains and strains from Southern China: the Yunnan province for genotype 3b; the Guangxi province for genotype 6e; the USA for genotype 1a; and Southern Vietnam for genotypes 1a and 6e. The human immunodeficiency virus (HIV) infection rate among HCV-infected injection drug users was 52.6-55.4% and did not differ significantly by HCV genotype. Most drug users infected with HIV-1 [98.8% (171/173)] were co-infected with HCV. These results suggest multiple routes of HCV transmission among injection drug users in Northern Vietnam that may also be HIV transmission routes., ((c) 2010 Wiley-Liss, Inc.)