Bach Mai Hospital is a multi-field medical facility in Hanoi and is considered one of the largest in Vietnam. The hospital was established in 1911 during the French colonial rule. It has played an important role in the health system of Vietnam and is one of three high specialized medical centers, specializing in internal medicine. It is a big center of cadres training and scientific research in the country. The hospital has 3,500 beds and 4,300 staff.During Nixon's Christmas Bombing, Operation Linebacker II, on December 22, 1972 American bombs struck the hospital, obliterating the building and killing 28 hospital staff members and an unconfirmed number of patients.A special rehabilitation unit was opened in 1998 for treating adults and children with disabling conditions (stroke and cerebral palsy). The unit sponsored by Veterans For America has seen more than 1,700 patients and has fitted more than 2,100 plastic braces since its establishment.In 2000, Bach Mai Hospital was partly reconstructed and supplied with up-to-date facilities and equipment under a grant aid project of the Government of Japan.When SARS broke out in Vietnam in 2003, Bach Mai Hospital substantially contributed to putting it under control by providing strict nosocomial infection control, which was implemented by Japanese experts.There is a small speech therapy unit at the Hospital headed by Dr. Vu Thi Bich Hanh.The new spinal unit with 25 patient's beds established with help of Handicap International was opened in May, 2008..
Access to trustworthy artificial intelligence (AI) for clinical applications is uneven, especially in low-resource settings with limited and inconsistent data. Models from high-resource settings often fail to generalize. Transfer learning (TL) can adapt established models to new settings. Using neurological outcome prediction for out-of-hospital cardiac arrest (OHCA) as a proof of concept, we adapted a model trained on a large cohort to Vietnam (243 patients) and Singapore (15,916 patients) using the Pan-Asian Resuscitation Outcomes Study registry. The external model performed poorly on the Vietnam cohort, with an area under the receiver operating characteristic curve (AUROC) of 0.467 (95
BACKGROUND:People living with HIV are two to three times more likely to smoke than the general population, resulting in higher risk for tobacco-related morbidity and mortality. Despite this growing burden of disease, there is little evidence for the long-term effectiveness of tobacco cessation interventions among people living with HIV, particularly in low-income and middle-income countries. We aimed to compare the effectiveness of three tobacco cessation interventions among people living with HIV. METHODS:We conducted an open-label, three-arm pragmatic randomised controlled trial in 13 outpatient HIV clinics (OPCs) in Hanoi, Viet Nam. Adults who smoked at least one cigarette a day, lived in Hanoi, had a clinic visit in the past 12 months, and had daily access to a mobile telephone that could receive text messages were allocated (1:1:1) to either: proactive referral to Viet Nam's national smokers' Quitline counselling programme (Quitline group); six-session tailored counselling delivered by trained OPC nurses plus text messages (Counselling + SMS group); or Counselling + SMS plus 6 weeks of nicotine replacement therapy (ie, 2 mg nicotine gum; Counselling + SMS+ gum group). Randomisation was by stratified permuted block randomisation with block sizes of three and six. Neither study participants, OPC health-care workers, nor study staff were masked to group assignment. All patients received advice to quit and brief cessation counselling during their physician visit. The primary outcome was 7-day point-prevalence smoking abstinence confirmed at 6 months by exhaled carbon monoxide concentration of less than 8 ppm, assessed with an intention-to-treat analysis. The trial was registered on Dec 17, 2021, at ClinicalTrials.gov (NCT05162911). FINDINGS:Between Nov 30, 2021 and Sept 27, 2023, 672 patients were randomly allocated to the three test groups (221 to the Quitline group, 225 to the Counselling + SMS group, and 226 to the Counselling + SMS + gum group). 338 (50%) patients reported dual waterpipe and cigarette use. At 6 months, 109 (16%) patients had confirmed abstinence (28 [13%] for Quitline, 40 [18%] for Counselling + SMS, and 41 [18%] for Counselling + SMS + gum). There were no significant differences between intervention groups: Counselling + SMS versus Quitline (odds ratio 1·48, 95% CI 0·78-2·81; p=0·33), Counselling + SMS+ gum versus Quitline (1·64, 0·86-3·11; p=0·17), and Counselling + SMS + gum versus Counselling +SMS (1·11, 0·61-2·00; p=0·91). There were no serious adverse events linked to the study interventions throughout the trial duration. INTERPRETATION:Integrating nurse-delivered cessation treatment and proactive referral to a national Quitline was feasible within the context of HIV care. In the absence of evidence that tailored interventions provide additional benefit, our findings suggest that national Quitlines, available in 42 low-income and middle-income countries, might serve as a resource for integrating tobacco treatment into HIV care systems. FUNDING:US National Cancer Institute.
Parvovirus B19 is a non-enveloped DNA virus of the Parvoviridae family, which usually causes erythema infectiosum in children. Although rare in adults, this virus can cause severe complications, including encephalitis. We report a case of a 50-year-old male patient, previously healthy, who was admitted to the hospital with high fever, headache, nausea, vomiting, and rapidly progressing to impaired consciousness. The patient was intubated and placed on mechanical ventilation. A lumbar puncture was performed, which showed mild leukocytosis with normal protein and glucose levels, and negative cultures. Tests to exclude common causes of encephalitis such as HSV, Influenza, Dengue, and HIV were all negative. Brain magnetic resonance imaging revealed corpus callosum lesions, while electroencephalography showed diffuse theta slow waves. Multiplex Polymerase chain reaction (PCR) of the cerebrospinal fluid confirmed the diagnosis of Parvovirus B19 infection. The patient was treated empirically with empirical broad-spectrum antibiotics (meropenem and vancomycin) and supportive intensive care. After seven days, the patient made a complete recovery without neurological sequelae and was discharged in a stable condition. This report emphasizes that Parvovirus B19, although generally considered a benign agent in children, can cause encephalitis in healthy adults and should be considered in the differential diagnosis of encephalitis of unknown etiology.
Lơ-xê-mi kinh dòng lympho (chronic lymphocytic leukemia, CLL) được chẩn đoán dựa trên sự kết hợp giữa hình thái học tế bào, số lượng tế bào B đơn dòng và kiểu hình miễn dịch đặc trưng. Kiểu hình điển hình bao gồm đồng biểu hiện CD19, CD5 và CD23, kèm theo biểu hiện yếu của CD20, CD79b và globulin miễn dịch bề mặt (surface immunoglobulin, sIg). Do nhiều bệnh lý tăng sinh lympho B trưởng thành có hình thái tương tự nhau, dấu ấn miễn dịch giữ vai trò trung tâm trong chẩn đoán và chẩn đoán phân biệt CLL. Tuy nhiên, các dấu ấn điển hình có thể giảm hoặc mất biểu hiện, tạo nên những trường hợp CLL không điển hình (atypical CLL, aCLL) và gây khó khăn trong thực hành lâm sàng, đặc biệt tại các cơ sở còn hạn chế về xét nghiệm chuyên sâu. Bài viết tổng hợp các đặc điểm kiểu hình miễn dịch của CLL, tiêu chuẩn chẩn đoán theo iwCLL, một số hệ thống tính điểm miễn dịch và vai trò của các xét nghiệm bổ sung trong phân biệt aCLL với u lympho tế bào áo nang và các bệnh tăng sinh lympho B khác. Một trường hợp lâm sàng được trình bày nhằm minh họa nguy cơ chẩn đoán nhầm aCLL với u lympho tế bào áo nang.
