TTU Journal of Biomedical Sciences

Preliminary Results of a Study Using Dynamic Angiography in Predicting Progression or Regression of Moderate Severity Lesions

Thach Nguyen — 2024-04-29

Background: Many patients with stable angina (SA) having moderate 50% lesions could deteriorate or stay stable for a long time. No present techniques nor test could accurately predict the progression to acute coronary syndrome (ACS) or stabilization of these moderate lesions. Based on the fluid dynamic methodology research, could turbulent flow further damage the plaque and rupture its cap? In contrast, could laminar flow delay the progression of the plaque and keep patients stable for a long period of time?

Methods: Patients with stable angina (SA) were admitted to the intermediate care unit and underwent coronary angiography. Patients were selected if they had a single 50% coronary lesion. The baseline angiographic factors included the flow characteristics: laminar or turbulent, anterograde or retrograde direction, and duration of the turbulent flow across the lesion. The patients were followed up for 2 years. The main clinical endpoints included (A) the development of acute coronary syndrome (ACS), (B) the need for percutaneous coronary interventions (PCI), or (C) persistent stable angina without new clinical or interventional events.

Results: 20 patients with moderate lesions were enrolled and followed up for 2 years. The majority of the lesions (18/20= 90%) were located at the mid-segment of the right coronary artery (RCA) or left anterior descending artery. There were six patients with turbulent flow seen at the lesion. 83% of these patients (5/6) developed ACS regardless of the blood pressure or low-density-lipoprotein (LDL) level. If the patients had laminar flow, with well-controlled HTN (SBP< 130mmHg) and LDL cholesterol (<75mg%), these patients had NO clinical ACS and event (= 93% 13/14 patients).

Conclusions: The preliminary results of a pilot study with only 20 patients showed that patients with turbulent flow at the location of a moderate lesion progressed to ACS and PCI. The patients with laminar flow across the lesion remained stable without the need for PCI. Larger randomized studies are needed to confirm the above findings.

A meta-analysis preliminary result: Effectiveness and Safety of Oral Semaglutide vs. Injectable Semaglutide in Weight Loss in General Population Indifferent of Diabetic Status

Khoa Tran — 2024-04-29

Background: Semaglutide, a well-known medication used in treating type 2 Diabetes Mellitus, has gained attention for its beneficial effects on weight loss, leading to its investigation for use in obesity management. The US Food and Drug Administration recently approved a glucagon-like peptide-1 receptor agonist for chronic weight management. Semaglutide is the only drug among GLP-1RAs available in injectable and oral forms for treating diabetes. However, its approval for obesity treatment is limited to subcutaneous injection.

Methods: This study aims to conduct a meta-analysis comparing the efficacy and safety of oral and injectable forms of Semaglutide in overweight patients. PubMed, Medline, Web of Science, the Cochrane Library, Embase, Google Scholar, and CINAHL databases were systematically searched. Comprehensive Meta-Analysis version 3 was utilized for statistical analysis.

Results: A total of 20 eligible articles published between 2015 and 2023 were included, comprising 7,852 participants (4,525 in the Semaglutide group and 3,327 in the placebo group). Seventeen studies utilized subcutaneous Semaglutide, while five studies evaluated the oral form. Analysis was conducted on the overall efficacy of Semaglutide, with subsequent sub-analysis comparing oral versus injectable forms, high-dose versus low-dose, diabetic versus non-diabetic patients, and the general population versus specific comorbidities. Additionally, side effects of oral versus injectable forms were assessed.

Conclusion: Overall, our findings contribute to the understanding of Semaglutide’s effectiveness and safety profile in managing obesity, providing insights into potential differences between oral and injectable formulations.

The Rate of Ectopic Pregnancy Among Adolescent Girls at Tu Du Hospital in 2022

Duyen Nguyen — 2024-04-29

Objective: To assess the percentage of ectopic pregnancy (EP) among adolescent girls at Tu Du Hospital in 2022 in Vietnam.

Method: A retrospective cross-sectional study based on medical records of 59 cases at Tu Du Hospital in 2022 with a structured questionnaire and analyzed data using Excel and SPSS 18.0. We recorded data related to the rate of EP in adolescent patients at Tu Du Hospital in 2022, including demographic characteristics, medical history, initial assessment at the time of admission, clinical and para-clinical symptoms, treatment, and hospital stay.

Result: The rate of EP in adolescent girls was 1.31% (late adolescent accounted for 91.5%). The group of workers had the highest rate (30.5%), followed by students (25.4%). Most of the patients admitted to hospital with abdominal pain (42.4%). The proportion of para-uterine mass on vaginal examination and ruptured EP were 62.7% and 23.7%, respectively. There was 1 case of shock at the time of admission (1.7%).

Conclusion: This study will provide an overview of love, the sex of adolescence, and accompanying consequences. It is necessary to strengthen communication and health education on safe sex and sexually transmitted diseases, as well as enhance the role of parents towards adolescent girls.

IG# & IG% in Upper Urinary Tract Infection with Sirs Syndrome Diagnosis, a Retrospective Research at Binh Dan Hospital

Lien Tran — 2024-04-29

Introduction: There have been studies examining the application of immature granulocyte counts (IG#) and immature granulocyte percentage (IG%) indexes, especially in the setting of sepsis originating from various sources. However, to the extent of our knowledge, there are no studies on applying these new indices in sepsis originating from the upper urinary tract. Thus, we conduct this research to evaluate the application IG# & IG% in diagnosing sepsis originating from the upper urinary tract at Binh Dan Hospital.

Purposes: To investigate the role IG# and IG% in diagnosing sepsis in patients with upper urinary tract infection.

Research Methods: A cross-sectional retrospective research of patients diagnosed with sepsis/septic shock caused by upper urinary tract infection, admitted to Binh Dan Hospital from January 1, 2020, to the end of December 31, 2022. Sepsis 2 (1992) was used to classify those patients into two groups: one with systemic inflammatory response syndrome (SIRS) syndrome and the other with SIRS negative.

Results: 464 cases met the inclusion criteria. 219 patients had SIRS, of which 19 had positive blood cultures and 226 UTIs without SIRS. Results show that IG# and IG% are valuable tools for the initial screening of sepsis originating from upper urinary tract infections. The sensitivity of IG# was 59.7%, and the specificity was 74.3% at the cut-off point of 0.075 x 103/µL. The sensitivity of IG% was 69.3%, and the specificity was 61.9% at the recommended cut-off point of 0.55. When raising the cut-off point of IG% to 1.95, the specificity was 93%. IG#’s AUC is 0.734, IG%’s AUC is 0.692.

Conclusion: Although IG# & IG% cannot be used as a sole biomarker in diagnosing sepsis originating from the upper urinary tract, IG# & IG% are convenient, earliest markers that can help clinicians distinguish between infectious and non-infectious diseases at the time of admission point.

Annotated Bibliography on the Mechanism Starting and Sustaining Atherosclerosis

Thach Nguyen — 2024-04-29

Background: In the past 30 years, there has been a significant rise in coronary artery disease (CAD) and atherosclerosis, primarily attributed to dietary changes toward cholesterol-rich fast foods. Traditional research methodologies focusing on molecular biology have been insufficient in fully understanding the initiation mechanisms of these conditions. This paper reviews the literature and defines the knowledge gap for the need for a new dynamic coronary angiographic technique.

Methods: Our approach involved a comprehensive review of fluid mechanics literature to identify gaps in current CAD research. This included analyzing major works from standard physiology textbooks, fluid mechanics reviews, and bioengineering journals. The study also introduced a new technique, "Dynamic Coronary Angiography," aimed at identifying and analyzing blood flow characteristics in coronary arteries using the principles and practices of fluid dynamics.

Results: The literature review highlighted the pulsatile nature of coronary blood flow and the importance of wall shear stress (WSS) in the development of atherosclerosis. However, existing research showed limitations such as reduced applicability of animal model data to human pathophysiology and simplistic experimental designs. The new angiographic technique revealed various flow patterns in cardiac cycle phases, including laminar, turbulent, and retrograde flows, and their possible impacts on the arterial wall.

Conclusions: Our findings suggest that turbulent flow may be critical in initiating atherosclerosis by damaging endothelial cells. This new perspective on the role of blood flow dynamics in CAD provides a promising avenue for understanding plaque formation and growth, potentially leading to significant advancements in cardiovascular medicine.

Global Healthcare Financing, Current Trends, and Their Implications for Vietnam

Tung Mai — 2024-04-29

Healthcare models play a crucial role in healthcare delivery. It determines the accessibility and quality of healthcare services. This paper reviews the evolution of healthcare models and analyzes the current global healthcare trends and their implications for improving healthcare outcomes in Vietnam. The paper aims to spark interest among healthcare professionals in the business side of medicine in Vietnam. Also, it offers insights for healthcare leaders in Vietnam to make policies and procedures that will provide high-value care for the people.

Letter from the Editor-In-Chief

Thach Nguyen — 2024-04-29

This is the third time in two years since 2023, the Tan Tao University (TTU) research office
publishes the TTU Journal of Biomedical Sciences (TTU JBMS). In this third issue, there are seven
manuscripts with three original research papers analyzing the data from 2 major teaching hospitals,
Binh Dan and Tu Du in Ho Chi Minh city, Vietnam and from Methodist Hospital, Merrillville IN,
USA. The three other US papers discuss the methodology of a big data analysis study, healthcare
financing, and the annotated bibliography of atherosclerosis. A new feature of the journal is to
showcase the current and future research and publication activities by faculty and students from the
TTU School of Medicine. Once these papers are published on line, the TTU research office will
submit these articles to be uploaded on the Digital Access to Scholarship at Harvard (DASH), the
research repository of Harvard University Library. DASH Home (harvard.edu).