Nguyen Dang Duc

Background: Bupropion is a common cause of drug-induced seizures, but evidence guiding prophylactic therapy is limited. No prospective head-to-head comparison of phenobarbital and benzodiazepines for symptomatic bupropion overdose has been reported. Methods: We performed a 6-month prospective observational cohort study of patients with symptomatic bupropion overdose. Patients were grouped by receipt of seizure prophylaxis versus no prophylaxis, with agent-specific exploratory analyses for phenobarbital and lorazepam. Baseline characteristics and clinical outcomes were summarized using descriptive statistics. Continuous variables were assessed for normality using Shapiro-Wilk testing and summarized as median and interquartile range (IQR) when non-normally distributed. Categorical outcomes were compared using two-tailed Fisher exact tests with statistical significance defined as p < 0.05. Exploratory logistic regression evaluated seizure odds by prophylaxis group with and without adjustment for initial heart rate. Results: Fifty-five patients were enrolled: 39 received prophylaxis and 16 who did not receive recommended prophylaxis and served as controls. The prophylaxis agents used were phenobarbital in 20 patients, lorazepam in 12, other benzodiazepines in 6, and combined phenobarbital plus lorazepam in 1. Initial heart rate was 114 bpm (IQR 97–133.5) in the prophylaxis group versus 109 bpm (IQR 103.5–117.8) in controls. Reported ingestion dose was 2.70 g (IQR 1.39–5.18) versus 1.80 g (IQR 0.98–7.13), respectively. Three patients had a documented seizure history and were in the prophylaxis group, none of which experienced a seizure. Overall seizure incidence was lower with prophylaxis but did not reach statistical significance (1/39 [2.6%] vs 3/16 [18.8%]; p = 0.069). Proconvulsant co-ingestions were similar between groups (12/39 [30.8%] vs 7/16 [43.8%]; p = 0.370). Among patients with known ingestion ≥3 g, seizures occurred in 0/10 phenobarbital-treated patients, 1/4 lorazepam-treated patients, and 3/5 controls; phenobarbital differed from control (p = 0.022), whereas lorazepam did not (p = 0.524), and phenobarbital did not differ significantly from lorazepam (p = 0.286). Among patients with initial heart rate ≥120 bpm, seizures occurred in 0/7 phenobarbital-treated patients, 1/6 lorazepam-treated patients, and 3/4 controls; phenobarbital differed from control (p = 0.024), whereas lorazepam did not (p = 0.190) and phenobarbital did not differ significantly from lorazepam (p = 0.462). Exploratory logistic regression adjusted for initial heart rate found higher seizure odds in controls than in prophylaxis patients (OR 26.86, 95% CI 1.21–598.08; p = 0.038); initial heart rate showed a nonsignificant trend (OR 1.08 per bpm; p = 0.070). Conclusions: In this interim cohort, phenobarbital was associated with fewer seizures than no prophylaxis in higher-risk subgroups. However, direct phenobarbital-lorazepam comparisons were not statistically different. Findings remain hypothesis-generating given the small sample, observational design, statistical fragility, sparse seizure events, wide regression confidence intervals, and potential reporting bias. Background: Bromadiolone is a long-acting anticoagulant rodenticide that can cause severe and prolonged coagulopathy in humans, while clinical data from low- and middle-income countries remain limited. This study aimed to describe the clinical characteristics, laboratory findings, management strategies, and outcomes of patients with bromadiolone poisoning treated at an emergency center in Vietnam, and to identify factors associated with severe outcomes. We conducted a retrospective observational study of adult patients with confirmed bromadiolone poisoning admitted to the Emergency Center of Thai Nguyen Medical University Hospital, Vietnam, between February 2021 and August 2024. Demographic data, exposure characteristics, clinical manifestations, laboratory parameters, treatment details, and outcomes were extracted from medical records. Severe outcome was defined as major bleeding, international normalized ratio (INR) ≥ 5, requirement for blood product transfusion, or death. A total of 33 patients were included, with a median age of 46 years; 60.6% were male, and suicidal ingestion accounted for 66.7% of cases. Severe outcomes occurred in 7 patients (21.2%). Patients with severe outcomes presented significantly later after exposure (median 48 vs. 5.5 h, p = 0.001) and had markedly higher admission INR values. Bleeding manifestations and blood product transfusion were observed exclusively in the severe outcome group, and no in-hospital deaths occurred. In conclusion, bromadiolone poisoning is associated with substantial morbidity due to prolonged coagulopathy. Delayed hospital presentation and severe coagulopathy at admission are strongly associated with adverse outcomes, highlighting the importance of early recognition and appropriate vitamin K therapy in resource-limited settings. Methods: This retrospective observational study was conducted at the Emergency Center of Thai Nguyen Medical University Hospital, Thai Nguyen, Vietnam. Study population: All consecutive adult patients diagnosed with bromadiolone poisoning and admitted between February 2021 and August 2024 were eligible. Inclusion criteria: Exclusion criteria: Data collection Data extracted from medical records included: Results: Baseline characteristics: Thirty-three patients with bromadiolone poisoning were included. The median age was 46 years (IQR 27), and 20 patients (60.6%) were male. Suicidal ingestion was the most common exposure intent, accounting for 22 cases (66.7%). The median time from exposure to hospital presentation was 7 h (IQR 20), and the median estimated ingestion dose was 1 mg (IQR 4). Conclusions: Bromadiolone poisoning is a serious clinical condition associated with prolonged coagulopathy and a substantial risk of severe bleeding. Delayed hospital presentation and severe coagulopathy at admission are strongly associated with adverse outcomes. Early diagnosis, close monitoring of coagulation parameters, and appropriate vitamin K therapy are essential to improve outcomes, particularly in low- and middle-income countries. Background: Amiodarone is an antiarrhythmic drug used to treat life-threatening cardiac dysrhythmias, but its use is limited by multiorgan toxicity. Large-scale age-stratified data on clinical outcomes remain limited. The National Poison Data System (NPDS) is a national database of over 81 million de-identified case records from all 53 U.S. poison centers. The objective of this study was to describe amiodarone exposures reported to U.S. poison centers.

Parvovirus B19 is a non-enveloped DNA virus of the Parvoviridae family, which usually causes erythema infectiosum in children. Although rare in adults, thi

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Glufosinate ammonium (GLA) is a nonselective herbicide of the phosphinic acid group, which is widely used in agriculture. Dermatologic toxicity has been rarely reported, especially in the elderly. We present the case of a 94-year-old female patient who developed irritant contact dermatitis and paresthesia after using her feet to stir 20 vials of Glufosinate ammonium herbicide in water. The patient presented with pruritus, numbness of the extremities, and a very high immunoglobulin E (IgE) elevation (855.5 IU/mL), which gradually decreased over time. This is the first report in Vietnam describing a delayed systemic IgE elevation due to dermal exposure to Glufosinate ammonium in a very elderly person.

This study aimed to examine caregivers’ perceptions, practices, and challenges regarding rehabilitation services for people with disabilities, with a focus on identifying factors influencing their decisions to bring care recipients for formal rehabilitation. A cross-sectional study was conducted in rural Thai Nguyen Province, Vietnam. Data were collected from 214 primary caregivers using a structured questionnaire covering demographics, caregiving roles, and rehabilitation-related perceptions. A pilot study was conducted to refine the tool, and data were collected via face-to-face interviews by a trained team. Statistical analyses included descriptive statistics, chi-square tests, and stepwise logistic regression to identify key predictors of care-seeking behaviors. Results showed that 92% of caregivers perceived rehabilitation as necessary or very necessary. Female caregivers were more likely to provide care at home (95.3%), while male caregivers were more likely to utilize hospital-based services (73.5%) and to bring care recipients for rehabilitation overall (79.4% vs. 67.1%). Logistic regression revealed that female caregivers were significantly less likely than males to bring people with disabilities in for care (OR = 0.34, p = 0.02). Longer caregiving duration was associated with a reduced likelihood of seeking care (OR = 0.96 per year, p < 0.001), whereas caregivers of individuals with mobility needs (OR = 3.15, p < 0.001) and social integration needs (OR = 2.12, p = 0.05) were significantly more likely to seek care. These findings highlight gender-based differences and caregiving dynamics that influence access to rehabilitation. To enhance rehabilitation outcomes and support caregiver engagement, targeted policies are needed to address gender roles, caregiving fatigue, and the specific needs of care recipients.

The escalating presence of antibiotic-resistant bacteria (ARB) in food systems presents a pressing challenge, particularly in preventing contamination and ensuring food safety. Traditional sanitation methods, such as cooking and chemical disinfectants, provide effective means to reduce ARB, yet there is a growing need for additional preventive measures directly on food surfaces. This review explores the potential of chitosan–phytochemical composites (CPCs) as surface coatings to prevent the initial contamination of food by ARB, thereby offering a novel complementary approach to conventional food safety practices. Chitosan, combined with active plant-derived metabolites (phytochemicals), forms composites with notable antibacterial and antioxidant properties that enhance its protective effects. We examine CPC synthesis methodologies, including chemical modifications, free radical-induced grafting, and enzyme-mediated techniques, which enhance the stability and activity of CPCs against ARB. Highlighting recent findings on CPCs’ antibacterial efficacy through minimum inhibitory concentrations (MIC) and zones of inhibition, this review underscores its potential to reduce ARB contamination risks on food surfaces, particularly in seafood, meat, and postharvest products. The insights provided here aim to encourage future strategies leveraging CPCs as a preventative surface treatment to mitigate ARB in food production and processing environments.

Cyanide poisoning is one of the most dangerous poisonings, it can be absorbed into the body through the mouth, inhalation and through the skin. A 32-year-old female patient was admitted to our poison control center because of high fever, severe vomiting, and seizures. Physical examination found that the patient was drowsy, had a high fever of 40 degrees Celsius, pulse of 140 beats/minute, and increased tendon and bone reflexes. Exploiting the patient's information, it was discovered that the patient bought Cyanide to drink with the intention of committing suicide. The patient was quickly treated with gastric lavage and activated charcoal. Echocardiography recorded EF: 35%, reduced movement of the entire myocardium. CK blood test: 4562 U/L. The patient's condition rapidly deteriorated and the patient was made ECMO, IHD and CVVHDF. After 3 days of treatment, the patient's condition did not improve, so the family asked for the patient to go home. This article aims to describe the rapidly progressing and severe damage to the heart and muscles of patients with cyanide poisoning.