Background/Aims: Ineffective esophageal motility (IEM) is the most frequently encountered esophageal manometric abnormality. Nonobstructive dysphagia is frequently associated with severe esophageal peristaltic dysfunction. This study aims to evaluate the presenting symptoms and association between dysphagia and specific manometric findings in patients with IEM. Methods: We retrospectively reviewed 228 IEM patients diagnosed on high-resolution manometry at an academic institution (2010-2013). We collected data regarding the main presenting symptoms and manometric findings: bolus transit, distal esophageal pressure amplitude, and lower esophageal sphincter (LES) resting and relaxation pressure. Results: Dysphagia was the main presenting symptom (25%) in IEM patients. Bolus transit was incomplete in either liquid or viscous swallows (30%) and incomplete in both liquid and viscous swallows (59%) in IEM patients. The LES resting pressure and LES relaxation pressure were elevated (9% and 36%, respectively) in IEM patients. There was no significant difference between dysphagia and either poorly relaxing LES (P = 0.725) or defective bolus transit (DBT) to liquid and viscous swallows (P = 0.372) compared to the rest of the IEM patients. However, there was a significant association between dysphagia and the combination of poorly relaxing LES and DBT in liquid and viscous swallows (P = 0.006). Subgroup analysis comparing dysphagia with heartburn/regurgitation demonstrated a similar significant association between dysphagia and the combination of poorly relaxing LES and DBT during viscous and liquid swallows (P = 0.016). Conclusions Dysphagia is a variable symptom associated with complex esophageal motility abnormalities. IEM patients with a combination of poorly relaxing LES and DBT are more likely to have dysphagia.

The Taiwan Initiative for Geriatric Epidemiological Research (TIGER) was founded in 2011 to elucidate the interrelationships among various predictors of global and domain-specific cognitive impairment, with the aim of identifying older adults with an increased risk of dementia in the preclinical phase. TIGER, a population-based prospective cohort, recruited 605 and 629 (total of 1,234) older adults (aged 65 and above) at baseline (2011-2013 and 2019-2022) of phase I and II, respectively. Participants have undergone structured questionnaires, global and domain-specific cognitive assessments, physical exams, and biological specimen collections at baseline and biennial follow-ups to date. By 2022, TIGER I has included 4 biennial follow-ups, with the participants comprising 53.9% female and having a mean age of 73.2 years at baseline. After an 8-year follow-up, the annual attrition rate was 6.1%, reflecting a combination of 9.9% of participants who passed away and 36.2% who dropped out. TIGER has published novel and multidisciplinary research on cognitive-related outcomes in older adults, including environmental exposures (indoor and ambient air pollution), multimorbidity, sarcopenia, frailty, biomarkers (brain and retinal images, renal and inflammatory markers), and diet. TIGER’s meticulous design, multidisciplinary data, and novel findings elucidate the complex etiology of cognitive impairment and frailty, offering valuable insights into factors that can be used to predict and prevent dementia in the preclinical phase.

Rare Occurrence of Paratesticular Rhabdomyosarcoma in Adulthood: A Case Report Paratesticular rhabdomyosarcoma is an extremely rare malignant tumour that primarily affects pediatric patients but is uncommon in adults. Prompt diagnosis and treatment are essential to prevent metastasis and improve prognosis. A 28-year-old male was presented with a painless right scrotal swelling. Physical examination revealed a palpable mass in the right scrotal region, raising suspicion of a malignant tumour. Ultrasonography showed a hypoechoic mass originating from the right epididymis. The patient underwent a high inguinal orchidectomy, and histopathological examination confirmed the diagnosis of paratesticular rhabdomyosarcoma. Staging computed tomography revealed no evidence of metastasis. The patient received chemotherapy based on risk stratification. Paratesticular rhabdomyosarcoma carries a poor prognosis in advanced stages, highlighting the importance of early diagnosis. Surgery remains the mainstay of treatment and the role of adjuvant therapy in adults is not well established. Understanding the clinical manifestations, diagnosis and treatment of this rare malignancy can aid in improved management and outcomes

The liver plays a central role in the pharmacokinetics of drugs through drug metabolizing enzymes and transporters. Non-alcoholic steatohepatitis (NASH) causes disease-specific alterations to the absorption, distribution, metabolism, and excretion (ADME) processes, including a decrease in protein expression of basolateral uptake transporters, an increase in efflux transporters, and modifications to enzyme activity. This can result in increased drug exposure and adverse drug reactions (ADRs). Our goal was to predict drugs that pose increased risks for ADRs in NASH patients. Bibliographic research identified 71 drugs with reported ADRs in patients with liver disease, mainly non-alcoholic fatty liver disease (NAFLD), 54 of which are known substrates of transporters and/or metabolizing enzymes. Since NASH is the progressive form of NAFLD but is most frequently undiagnosed, we identified other drugs at risk based on NASH-specific alterations to ADME processes. Here, we present another list of 71 drugs at risk of pharmacokinetic disruption in NASH, based on their transport and/or metabolism processes. It encompasses drugs from various pharmacological classes for which ADRs may occur when used in NASH patients, especially when eliminated through multiple pathways altered by the disease. Therefore, these results may inform clinicians regarding the selection of drugs for use in NASH patients.

Child ; Critical Illness ; Hospital Mortality ; Humans ; Virus Diseases/epidemiology*

Aims: To isolate and characterize the lactic acid bacteria (LAB) strains from the “mam chua ca ro” (sour fermented fish) in the South of Vietnam and investigate their potential anti-bacterial properties. Methodology and results: Four LAB strains (MCR1, MCR2, MCR3 and MCR4) were isolated from the "mam chua ca ro" product and their anti-bacterial activity was determined using the spot assay and the paper disc diffusion method. The isolated LABs can inhibit Escherichia coli ATCC 25922, Staphyloccocus aureus ATCC 25923 and Vibrio parahaemolyticus BV016 and produce bacteriocin to control the growth of E. coli ATCC 25922 and S. aureus ATCC 25923, except V. parahaemolyticus. MCR2 was chosen to sequence 16S rRNA of Pediococcus acidilactic. Conclusion, significance and impact of study On the basis of their prominent anti-pathogenic bacteria activity, LAB strains isolated from Vietnamese sour-fermented fish products were verified as prospective probiotics.
Lactobacillales--isolation & ; purification ; Pediococcus acidilactici

OBJECTIVE: To study the effects of total ginsenosides (TG) extract from Panax ginseng on neural stem cell (NSC) proliferation and differentiation and their underlying mechanisms. METHODS: The migration of NSCs after treatment with various concentrations of TG extract (50, 100, or 200 µ g/mL) were monitored. The proliferation of NSCs was examined by a combination of cell counting kit-8 and neurosphere assays. NSC differentiation mediated by TG extract was evaluated by Western blotting and immunofluorescence staining to monitor the expression of nestin and microtubule associated protein 2 (MAP2). The GSK-3β/β-catenin pathway in TG-treated NSCs was examined by Western blot assay. The NSCs with constitutively active GSK-3β mutant were made by adenovirus-mediated gene transfection, then the proliferation and differentiation of NSCs mediated by TG were further verified. RESULTS: TG treatment significantly enhanced NSC migration (P<0.01 or P<0.05) and increased the proliferation of NSCs (P<0.01 or P<0.05). TG mediation also significantly upregulated MAP2 expression but downregulated nestin expression (P<0.01 or P<0.05). TG extract also significantly induced GSK-3β phosphorylation at Ser9, leading to GSK-3β inactivation and, consequently, the activation of the GSK-3β/β-catenin pathway (P<0.01 or P<0.05). In addition, constitutive activation of GSK-3β in NSCs by the transfection of GSK-3β S9A mutant was found to significantly suppress TG-mediated NSC proliferation and differentiation (P<0.01 or P<0.05). CONCLUSION TG promoted NSC proliferation and neuronal differentiation by inactivating GSK-3β.
Animals ; Cell Differentiation ; Cell Proliferation ; Ginsenosides/pharmacology* ; Glycogen Synthase Kinase 3 beta/metabolism* ; Neural Stem Cells/metabolism* ; Panax ; Plant Extracts/pharmacology* ; Rats ; beta Catenin/metabolism*

Objectives.: There is no existing Vietnamese diabetes knowledge questionnaire. This impedes assessment of patient knowledge that will be helpful in providing effective diabetes intervention. We aimed to validate the Vietnamese Translated Diabetes Knowledge Questionnaire (DKQ). Methodology: Translation and adaptation strictly followed the guidelines of Beaton et al. Internal consistency was assessed by Cronbach’s alpha coefficient, test-retest reliability was assessed by Fleiss’ Kappa coefficient, and validity value was determined among type 2 diabetes patients in a general hospital. Results: The Vietnamese version of the DKQ had good internal consistency (Cronbach’s alpha for all items = 0.898) and stability (Kappa coefficient >0.600). The average score for all equivalence criteria was 1.00, demonstrating good equivalence to the original. The significant difference between knowledge score and education level (p <0.001) confirmed construct validity. Conclusion Our study provided a reliable Vietnamese version of the DKQ. Future studies may apply the version in different regions in Vietnam to determine external validity.
Southeast Asian People

Objective: Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infections and cervical cancer due to their high number of sexual partners. The objectives of this study were to determine the prevalence of HPV and identify risk factors for high-risk HPV infection among FSWs in Hanoi and Ho Chi Minh City (HCMC), Viet Nam. Methods: A cross-sectional study was conducted in Hanoi and HCMC between December 2017 and May 2018. We surveyed and screened 699 FSWs aged ≥18 years for HPV infection and abnormal cytology. A multivariable modified Cox regression model was used to determine risk factors for high-risk HPV infection. Results The overall prevalence of any HPV, high-risk HPV and HPV-16/18 infection in the 699 FSWs was 26.3%, 17.6% and 4.0%, respectively, and were similar in both cities. Multiple infections were identified in 127 participants (69.0%).HPV-52 was the most prevalent (7%), followed by HPV-58 (6%). Abnormal cytology was detected in 91 participants (13.0%). FSWs who are divorced (adjusted prevalence ratio [aPR]: 1.96, 95% confidence interval [CI]: 1.01–3.81), widowed (aPR: 3.26, 95% CI: 1.49–7.12) or living alone (aPR: 1.85, 95% CI: 1.01–3.39) were associated with a higher prevalence of high-risk HPV infection.