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Background and Purpose: Cerebral venous thrombosis (CVT) is a rare cause of cerebral infarction with diverse clinical presentations and outcomes. Novel oral anticoagulants (NOACs) provide an alternative option of systemic anticoagulation in various thromboembolic conditions, but uncertainty exists over the use of NOACs among patients with CVT. We present our initial experience with the use of NOACs for CVT in Vietnam. Methods: We included consecutive patients diagnosed with CVT presenting to 115 People’s Hospital in Vietnam between May 2016 and July 2017 and who were treated with NOACs. Data on patient demographics, vascular risk factors, clinical presentations, and outcomes at 180 days follow-up were obtained and analyzed. Modified Rankin scale (mRS) scores on admission, at discharge, and 180 days were assessed. Recanalization was assessed using magnetic resonance venography at 180 days follow-up. Venous thrombo-embolism events were defined as primary outcome, while bleeding complications were defined as safety outcome. Results: Among 32 patients with CVT (72% females; mean age: 40 ± 9.7 years), 15 were treated with rivaroxaban and 17 with dabigatran. A common risk factor was the usage of oral contraception (70%) on presentation. The mean mRS score on admission was 3.1 points (± 1.4). At FUP (median 8.5 months, IQR 5.5-9.5), clinical outcome (mRS ≤ 1) was excellent in most patients. All patients had at least partial recanalization and half of them achieved complete recanalization at 180 days follow-up. There were no bleeding complications. Conclusion: NOACs may offer clinical benefits with minimal complications in the treatment of CVT. Further prospective assessment with randomized controlled studies is warranted.

Two new polyisoprenylated benzophenones, planchoniones A (1) and B (2), together with two known benzophenones (3, 4) and six known xanthones (5-10), were isolated from an ethyl acetate extract of t...

A significant proportion of patients with large-vessel occlusion (LVO) initially present to the hospital with transient ischemic attack (TIA) and mild clinical manifestations such as low National Institutes of Health Stroke Scale (NIHSS) scores (≤5). However, due to the natural course of the disease, the individuals may subsequently develop worsening symptoms. To date, there is lack of evidence-based guidelines on mechanical thrombectomy (MT) among those patients. Therefore, the predicting factors associated with better or worse outcomes for acute stroke patients receiving MT compared to those not receiving the treatment are unknown. We describe a TIA case with LVO who was treated with MT; we used perfusion imaging as a decision aid. A 55-year-old male patient with a past medical history of TIA, hypertension, and hyperlipidemia was admitted to our hospital for evaluation of transient mild right hemiparesis and dysarthria lasting for 5 min 3 h before admission. He reported that he had experienced the same condition 1 day before. On admission, neurological examination showed normal function with an NIHSS score of 0. Computed tomography angiography revealed left proximal M1 occlusion. In addition, perfusion magnetic resonance imaging maps calculated by the RAPID software showed acute small lesions on the left hemisphere with core volume (0 mL) and a large ischemic penumbra (70 mL). Immediate endovascular thrombectomy was performed 5 h following symptom onset with complete recanalization and clinical recovery. The case suggests that MT in LVO patients with low NIHSS scores, even a score of 0, on presentation is potentially a safe and effective treatment. The use of perfusion imaging in the acute phase of stroke should be encouraged for the decision-making process.

The efficacy of intravenous thrombolysis and endovascular therapy and their favorable treatment outcomes have been established in clinical trials irrespective of age. Current guidelines do not recommend an age limit in selecting eligible patients for reperfusion treatment as long as other criteria are satisfied. A 103-year-old woman was admitted at our hospital within 1 h of stroke onset secondary to a left internal carotid artery terminus occlusion. On admission, her National Institutes of Health Stroke Scale (NIHSS) score was 30, with a small left thalamic diffusion restriction lesion on MRI. Her medical history included paroxysmal atrial fibrillation, prior myocardial infarction, hypertension, chronic kidney disease, and diabetes mellitus. Her pre-stroke modified Rankin Scale score was 0, and she was fully independent before stroke. Once intravenous thrombolysis was started, the patient successfully underwent mechanical thrombectomy, and thrombolysis in cerebral infarction-3 recanalization was achieved 225 min after symptom onset. She showed dramatic recovery (NIHSS score of 5 after 48 h) and was discharged on day 7 with a modified Rankin Score of 1. To our knowledge, our patient is the second oldest documented patient who successfully underwent bridging therapy for stroke.

Acute basilar artery occlusion (BAO) is a neurological emergency that has a high rate of mortality and poor functional outcome. Endovascular therapy (ET) is the gold standard therapy for large vessel occlusion stroke of the anterior circulation. Whether ET can also be effectively and safely performed in early recurrent large vessel occlusion, especially in BAO, is unclear. We describe a case of successful recanalization and independent functional outcome of a BAO patient treated with intravenous thrombolysis combined with repeated ET. The patients was a 32-year-old man with a history of heavy smoking and drinking who presented to the Emergency Department with dizziness and hypertension, and progressed over the next 13 h to left hemiparesis and mild dysarthria with an NIHSS score of 7. CT angiography demonstrated occlusion of the proximal basilar artery (BA). Intravenous alteplase was given followed by ET. The first intervention failed and over the next 8 h, the patient’s NIHSS score increased to 12. A second attempt with balloon angioplasty managed to reconstitute arterial blood flow with a severe residual stenosis of the proximal BA. Subsequently, the patient progressed into deep coma with reocclusion of the BA demonstrated on transcranial Doppler. A third intervention with emergent stenting resulted in complete recanalization of the BA and excellent neurological recovery. This patient received three endovascular treatments within 24 h due to reocclusion of the BA and achieved good outcomes. In conclusion, repeated ET for early recurrent BAO is feasible in carefully selected patients.

Background: It remains controversial if intravenous thrombolysis (IVT) prior to mechanical thrombectomy (MTE) is superior to MTE alone in patients with acute ischemic stroke caused by large vessel occlusion. We aim to compare functional outcomes, mortality, reperfusion, and intracranial hemorrhage rates in bridging therapy (IVT prior thrombectomy) and MTE alone groups within 6 h from symptom onset. Materials and Methods: Consecutive hospitalized patients (September 2017 and July 2018) with acute large artery occlusion within the anterior cerebral circulation eligible for MTE with or without prior IVT were included. A modified Rankin Scale score of 0 to 2 was considered as good functional outcome at 90 days. Successful reperfusion was defined as a Thrombolysis in Cerebral Infarction scale of 2b to 3. Results: Of the 124 patients included, 56 (45.2%) received bridging therapy and 68 (54.8%) received MTE alone. Patients receiving bridging therapy were younger (median, 56 vs 63, P = .045) and had shorter onset-to-groin time (median, 270 vs 370 min, P < .001) than those receiving MTE alone. Successful reperfusion rate was significantly greater in the bridging therapy group (87.5% vs 72.1%, P = 0.03). There were no statistically significant differences between the 2 groups in functional independence (bridging 58.9% vs 75.0%, P = 0.07), mortality at 90 days (bridging 14.3% vs 7.4%, P = 0.22), parenchymal hematoma type 2 (bridging 3.6% vs 2.9%, P > .99), and any hemorrhage (bridging 42.3% vs 26.5%, P = 0.07). Conclusion: Compared to MTE alone, bridging therapy with IVT improved the reperfusion rate but not other outcomes. Further clinical trials are needed to confirm our findings.

In this study, partial mitochondrial DNA (mtDNA) D-loop sequences of three Vietnamese indigenous chicken varieties, including Mong Tien Phong, To, and Sau Ngon, were analyzed to access genetic diversity and the maternal lineages of origin. A 525 bp fragment of the mtDNA D-loop region was sequenced from a total of 61 chickens of the three varieties. A neighbor-joining phylogenetic tree was assembled from the haplotypes obtained and reference sequences of mtDNA D-loop sequences of Red Junglefowl and domestic chickens from National Center for Biotechnology Information database. Genetic diversity indices and analysis of molecular variance were performed. Evaluation of genetic relationships between the three varieties was carried out with pairwise fixation index (FST). In total, 16 haplotypes were identified in the chickens studied. These haplotypes were classified in three haplogroups (A, B, and E) with the majority grouped in haplogroup B and haplogroup E. All three chicken varieties studied were distributed into 2–3 haplogroups and all three haplogroups found in this study are also represented by Red Junglefowl. In conclusion, all three Vietnamese indigenous chicken varieties have likely originated from multiple maternal lineages and potentially descended from the Red Junglefowl.

Background: An essential strategy to reduce mortality and disability after stroke is to ensure access to evidence-based care. In developed countries, it has been shown that if hospitals improve the quality of care, the impact of stroke is attenuated. However, in developing countries, data on the processes of care and associated patient outcomes are scarce. We examined the care processes and outcomes among patients with acute stroke from a stroke unit in a major public hospital in Vietnam whereby there are approximately 15,000 hospital admissions for stroke per year. Methods: We included first-ever strokes admitted to the 115 People’s Hospital (June 2017-March 2018). Data were collected in the Registry of Stroke Care Quality which is used in >50 countries. Baseline characteristics, stroke-related factors (e.g., type and severity), processes of care (e.g., thrombolysis), and outcomes at discharge were examined including mortality and functional outcome, assessed as the walking ability without assistance. Results: Data were available for 6601 patients with first-ever stroke (44% women, 80% ischemic stroke [IS], median age: 62 years, interquartile range [IQR]: 53-72) who received stroke unit care. The median time from stroke onset to hospital arrival was 15.7 hours (IQR: 5.6-37.5). At admission, the median National Institute of Health Stroke Scale score indicating stroke severity was 7 (IQR: 4-12). Among those with IS, 9% received intravenous thrombolysis. Over 90% of the participants received recommended process of care including dysphasia screening (99%), antihypertensive agents (92%), cholesterol-lowering medication (IS = 99%), and antithrombotic medication (IS = 98%). At discharge (median length of stay: 4 days, IQR: 3-6), 3% of all cases died and 46% were able to walk independently. Advanced age, stroke severity, and not receiving antihypertensive agent(s) were contributing factors to mortality and poorer functional outcome. Conclusion: There was a considerable delay in the time from stroke onset to hospital arrival. Evidence-based care at the stroke unit was consistently provided. It remains unclear whether other hospitals in Vietnam and other developing countries perform as well. Greater public awareness of stroke to reduce onset to arrival times and more stroke units are warranted to achieve the excellent outcomes in the major public hospital.

The objectives of this study were to investigate the morphological characteristics, grain yield, and anthocyanin content of 36 black rice accessions that were collected from different locations in Vietnam. The results showed that the black rice accessions varied in growth duration (130 to 150 days), plant height (91.5 to 143.6 cm), morphological characteristics, and yield components. Grain yield of the black rice accessions ranged from 2.8 to 8.7 tons ha-1. The black rice accessions were classified into four groups based on their anthocyanin content: group I > 0.1% anthocyanin, group II 0.05%-0.1%, group III 0.001%-0.05%, and group IV < 0.001%. BR7 had the highest anthocyanin content (0.1438%), followed by BR5 (0.1317%). Anthocyanins with the strongest antioxidant activities were extracted from BR8, BR35, BR6, BR27, BR30, BR32, BR18, BR17, BR19, and BR1 with IC50 values less than 2 µg mL-1. Seven promising black rice accessions, namely BR1, BR14, BR17, BR25, BR30, BR34, and BR35, were selected for further research based on their high anthocyanin contents, and good grain yield and yield components.

'Sugars Will Eventually be Exported Transporters' (SWEETs) are a group of sugar transporters that play crucial roles in various biological processes, particularly plant stress responses. However, no information is available yet for the CaSWEET family in chickpea. Here, we identified all putative CaSWEET members in chickpea, and obtained their major characteristics, including physicochemical patterns, chromosomal distribution, subcellular localization, gene organization, conserved motifs and three-dimensional protein structures. Subsequently, we explored available transcriptome data to compare spatiotemporal transcript abundance of CaSWEET genes in various major organs. Finally, we studied the changes in their transcript levels in leaves and/or roots following dehydration and exogenous abscisic acid treatments using RT-qPCR to obtain valuable information underlying their potential roles in chickpea responses to water-stress conditions. Our results provide the first insights into the characteristics of the CaSWEET family members and a foundation for further functional characterizations of selected candidate genes for genetic engineering of chickpea.

Subarachnoid hemorrhage (SAH) due to a solitary spinal aneurysm is extremely rare. Early diagnosis of spinal SAH is challenging, particularly when the spinal cord has not been compressed. We report a case of a 45-year-old male who presented with sudden onset of abdominal pain, followed by severe headache, vomiting, and generalized seizure. Three days after admission to the hospital, he developed progressive paraparesis. Magnetic resonance imaging (MRI) revealed spinal SAH with hematoma resulting in cord compression at the level of T9. Diagnostic spinal angiography identified a ruptured aneurysm of a radiculomedullary artery. In conclusion, rupture of a spinal aneurysm should be considered a possible cause of SAH in appropriate clinical settings, and clinicians must be aware of the possibility of cord compression.