Background: Anemia in patients with liver cirrhosis can be due to either iron deficiency as the result of gastroesophageal bleeding or vitamin B12 and folic acid deficiency in patients with alcohol - induced liver cirrhosis. Nevertheless excessive iron level in liver can induce damages to hepatic cells and further advance the cirrhosis process. Objective: To investigate the function of iron in the treatment of anemia in liver cirrhosis patients, collecting data on plasma iron and ferritin concentrations. Subjects and method: Research on 100 patients with liver cirrhosis has been conducted at Department of Gastroenterology, Bach Mai Hospital. Results: 59% patients had low plasma iron level and 9% had high level whereas 13% and 61 % patients had low and high plasma ferritin levels respectively. Plasma iron levels reduced significantly at patients with liver cirrhosis at advanced stage (p < 0.01) and at patients with gastroesophageal (GE) haemorrhage (p < 0.05). Plasma ferritin levels reduced in patients with gastroesophageal bleeding (p < 0.05) but increased in patients with liver cirrhosis at advanced stage (p <0.01) and at alcohol - induced liver cirrhosis patients (p < 0.05). Conclusions: For patients having chronic anemia, plasma levels of iron and ferritin should be determined before a decision of prescribing iron being made.
Fibrosis ; Iron ; iron-binding seminal plasma antigen

Background: pH monitoring 24h is used to diagnose atypical gastroesophageal reflux disease or can be applied to consider surgery for cases poorly respond with medical treatment. Objective: To study clinical signs, gastroscopic and oesophageal histopathologic features, pH monitoring 24h in the patients with gastroesophageal reflux disease (GERD). Subjects and method: The descriptive, cross-sectional study was conducted in patients with gastroesophageal reflux disease treated at Bach Mai Hospital from November 2005 to October 2006. 73 patients with GERD diagnosed according to Romell criteria were underwent gastroscopy and biopsy. 15 patients having extraesophageal manifestations of gastroesophageal reflux disease were underwent gastroesophageal reflux monitoring pH. Results: 31 (42.4%) patients had oesophagitis in which 67.7% grade A, 6.5% grade D and C, 2.7% Barret, and 53.4% having gastritis associated. 61 % oesophagitis and 13.9% Barret were seen on the biopsy. 40% (6/15) patients had abnormal pH monitoring but there was no statistically significant difference in pH monitoring between the group having oesophagitis from those without oesophagitis (p > 0.05). Conclusions: Among 15 patients underwent Ph monitoring, the rate of patients with abnormal pH monitoring was 40%. There was no statistically significant difference of pH monitoring result between patients with or without esophagus lesion.
Gastroesophageal Reflux/pathology ; etiology

Background: Peritoneal tuberculosis (PT) and peritoneal malignancy (PM) are the most frequent causes of exsudate ascitic fluid but the different diagnosis between the former and the latter is also difficult and elusive. Objective: To study the difference of clinical and laparoscopic features between PT and PM. Subjects and method: 76 patients with PT and 50 with PM were diagnosed by laparoscopy and peritoneal biopsy. Ascitic mycobacterium tuberculosis was detected by PCR analysis. Exsudate ascites was confirmed according to criteria of Light. Results and Conclusions: Average age of PT was younger than of PM (p < 0.001). The frequency of fever, pleural effusion in the patients with PT was higher than those in PM (p < 0.001 and 0.05). The anemia and abdominal tumefaction in those of PM was more frequent than in those of PT (p < 0.05 and 0.001). High protein ascitic fluid and numerous lymphocytes in the patients with PT was frequent than in those with PM (p < 0.05). Laparoscopic features: In those patients with PT the white "miliary nodules" or adhesions between abdominal wall was more frequent than in those with PM (p < 0,05) and in patients with PM omental thickening, tumor formation was more than in those with PT.
Peritonitis ; Tuberculous/pathology ; diagnosis ; Laparoscopy

Background: Spontaneous bacterial peritonitis (SBP) is severe complication of the patients with liver cirrhosis, can also develop renal hepatic syndrome or hepatic encephalopathy. Objective: To study clinical signs and the frequency of SBP according to the severity of liver disease and the change of biochemical parameters, characteristics of ascitic fluid. Subjects and method: 37 patients with liver cirrhosis having SBP diagnosed or by an ascitic fluid polymorphonuclear neutrophil (PMN) leukocyte count of > 250 cells per mm3 and/ or microbial positive culture ascites. The conventional method of culture ascites by plating out a loop of fluid on agar plates in the microbiology laboratory. All patients were treated at Bach Mai Hospital. Results:78.4% SBP in patients with Child - Pugh C 64.9% in patients having abundant ascites fluid, 72.9% having ascitic protein < 10g/l, the very low frequency of culture - positive ascitic fluid (5.4%). The frequency clinical signs were abdominal pain (67.6%) and diarrhea (73.0%). Conclusions: Considering the SBP preventive treatment for patients with liver cirrhosis having low - protein ascites < 10g/l) and setting up ascitic fluid culture with a larger volume of ascites into aerobic and anaerobic blood culture bottles at the beside improves the sensitivity of detection of an organism.
Fibrosis ; Peritonitis/ diagnosis

Background: Streptococcus pneumonia (S.pneumoniae) is the main cause of acquired pneumonia in the community along with otitis media, sinusitis, septicemia and meningitis. Objectives: The study determined antimicrobial resistance and serotype distribution of Streptococcus pneumonia isolates from hospitalized children at Hai Phong Children's Hospital, Vietnam. Subjects and method: From June 2006 to September 2007, 80 pneumococccal isolates were tested for susceptibility to the 13 antibiotics and 84 pneumococcal isolates were serotyped. Results:Seventy-five percent of strains showed multi-drug resistance. Ninety percent of strains showed resistance to penicillin (48% intermediate and 42% fully resistant). In addition, 100% of isolates were resistant to cotrimoxazole, 74% of isolates were resistant to cephalexin; 71 % of isolates were resistant to erythroomycin and 58% were resistant to cefuroxxime. Almost all the isolates were susceptible to amoxicillin, cefotaxime, ceftriaxone, ceefepime, ofloxacin and 100% of isolates were susceptible to vancomycin. Among the 84 serotypes, 82% were included in the 23 valent pneumococcal polysaccharide vaccine including: 19F (30%), 23F (21 %), 14 (13%) and 6B (13%). Six other serotypes (13, 15C, 18, 11A, 15B and 6A) accounted for 12% of strains and 9 (11%) strains were untypeable. Conclusion: Pneumococcal antibiotics is spreading most rapidly among children in Vietnam, especially strains typs 19F and 23 F. Concerted efforts are necessary to prevent it spreading.\r\n", u'\r\n', u'
Antimicrobial resistance ; streptococcus pneumonia