Adsorption characteristics of S-Metolachlor onto the sawdust biochar derived from Acacia auriculiformis

The adsorption mechanism of S-Metolachlor in an aqueous solution by sawdust biochar derived from Acacia auriculiformis (SAB) was studied. SAB was manufactured at 500 °C for 4 h under oxygen-limited conditions and characterized for SEM, EDS, pHpzc, BET, and FTIR. The adsorption kinetics, isotherm, and diffusion studies of S-Metolachlor and SAB were further explored. Moreover, the effects of the solution pH were examined on the adsorption of S-Metolachlor by SAB. The BET analysis of SAB was achieved at 106.74 m2.g-1 and the solution pH did not significantly influence the S-Metolachlor adsorption. The adsorption data were fitted into a Langmuir isotherm and the PSO model. The film diffusion coefficient Df (4.93 × 10-11 to 8.17 × 10-11 m2.s-1) and the particle diffusion coefficient Dp (1.68 × 10-11 to 2.65 × 10-11 m2.s-1) were determined and the rate-limiting step of S-Metolachlor adsorption and SAB was governed by liquid film diffusion. The S-Metolachlor adsorption process onto SAB was controlled by multiple mechanisms, including pore filling, H-bonding, hydrophobic interaction, and π-π EDA interactions. H-bonding is the main interaction for the adsorption of S-Metolachlor and SAB. Conclusively, the study illustrates that biochar produced from Acacia auriculiformis sawdust possessed effective adsorption properties for S-Metolachlor herbicide.

Correction: Job Satisfaction of Hospital Pharmacists in a representative province in Mekong Delta, Vietnam

[This corrects the article DOI: 10.1371/journal.pone.0291201.].

Silk nanoparticles for the protection and delivery of guava leaf (Psidium guajava L.) extract for cosmetic industry, a new approach for an old herb

Guava (Psidium guajava L.) is a well-known plant containing high levels of natural antioxidants, the phenolic compounds, which have been employed in numerous cosmetic products. However, these molecules are unstable to oxidants, light, temperature, pH, water, and enzymatic activities. Therefore, to enhance their stability and preserve their antioxidant activity, this study investigated the silk fibroin nanoparticles (SFNs) ability to encapsulate, deliver, and heat-protect the phenolic compounds of the guava leaves ethanolic extract. Firstly, the guava ethanolic extract was produced by maceration, which possessed a total phenolic content of 312.6 mg GAE/g DPW and a high antioxidant activity (IC₅₀ = 5.397 ± 0.618 µg/mL). Then, the extract loaded SFNs were manufactured by desolvation method, and the particles demonstrated appropriate sizes of 200-700 nm with narrow size distribution, spherical shape, silk-II crystalline structure, high drug entrapment efficiency of > 70% (dependent on the fibroin content), and a two-phase sustained drug release for at least 210 min. Using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, the antioxidant activity of the guava extract was well-preserved in the extract loaded SFNs. Finally, after being treated with high temperature of 70 °C for 24 h, the guava extract almost loses all of its antioxidant property (5 times decrement), whereas the extract loaded SFNs could retain the extract activity. Conclusively, the SFNs proved much potential to deliver and heat-protect the guava extract phenolic compounds, and preserve their antioxidant activity. Confirmed by this case, SFNs could be further explored in protecting other natural compounds from environmental factors.

Job satisfaction of hospital pharmacists in a representative province in Mekong Delta, Vietnam

BACKGROUND

Job satisfaction is an important factor affecting job performance and turnover of healthcare workers, especially hospital pharmacists. Nevertheless, limited studies have reported this issue in the context of Vietnam.

OBJECTIVES

To help maintain the quality and size of the limited hospital pharmacy workforce in Vietnam, especially in the Mekong Delta area, this study investigated the job satisfaction of hospital pharmacists, and the associated factors, in Vinh Long province, a representative province in the central Mekong Delta.

METHODS

A cross-sectional survey was conducted, recruiting hospital pharmacists working in all 17 province/district-affiliated healthcare facilities across Vinh Long province, Vietnam, between August and September 2022.

RESULTS

Among the 235 survey participants (representing a response rate of 97.1%), 189 pharmacists (80.4%) reported that they were satisfied with their job. Working conditions, leadership styles, and benefits were factors found to significantly influence job satisfaction. Pharmacists who had worked in the field for 3-5 years (OR = 3.752, 95% CI = 1.036-13.595), more than 5 years (OR = 6.361, 95% CI = 2.264-17.875), did not have additional duties besides their primary responsibilities (OR = 2.046, 95% CI = 1.005-4.163), and worked in a private healthcare facility (OR = 12.021, 95% CI = 1.470-98.316), were significantly more likely to be satisfied with their job.

CONCLUSIONS

Most hospital pharmacists were satisfied with their current job. To further improve job satisfaction in this population, further improvements to working conditions are necessary.

Identification of potential inhibitors against Alzheimer-related proteins in Cordyceps militaris ethanol extract: experimental evidence and computational analyses

Laboratory experiments were carried out to identify the chemical composition of Cordyceps militaris and reveal the first evidence of their Alzheimer-related potential. Liquid chromatography-mass spectrometry analysis identified 21 bioactive compounds in the ethanol extract (1-21). High-performance liquid chromatography quantified the content of cordycepin (0.32%). Bioassays revealed the overall anti-Alzheimer potential of the extract against acetylcholinesterase (IC50 = 115.9 ± 11.16 µg mL-1). Multi-platform computations were utilized to predict the biological inhibitory effects of its phytochemical components against Alzheimer-related protein structures: acetylcholinesterase (PDB-4EY7) and β-amyloid protein (PDB-2LMN). In particular, 7 is considered as a most effective inhibitor predicted by its chemical stability in dipole-based environments (ground state - 467.26302 a.u.; dipole moment 11.598 Debye), inhibitory effectiveness (DS ¯ - 13.6 kcal mol-1), polarized compatibility (polarizability 25.8 Å3; logP - 1.01), and brain penetrability (logBB - 0.244; logPS - 3.047). Besides, 3 is promising as a brain-penetrating agent (logBB - 0.257; logPS - 2.400). The results preliminarily suggest further experimental attempts to verify the pro-cognitive effects of l(-)-carnitine (7).

Supplementary Information

The online version contains supplementary material available at 10.1007/s13205-023-03714-9.

Onto the differences in formulating micro-/nanoparticulate drug delivery system from Thai silk and Vietnamese silk: A critical comparison

Silk fibroin is a natural polymer with physicochemical properties heavily dependent on its silkworm sources and cultivation conditions. Hence, this study critically compared the characteristics and capacity to generate micro-/nanoparticles of fibroin extracted from the Thai silk and Vietnamese silk. Both Thai fibroin (SFT) and Vietnamese fibroin (SFV) were extracted and fabricated into micro-/nanoparticles using the same methods of desalination and condensation, respectively. Firstly, the amino acid compositions of SFT and SFV were determined and found to be similar, suggesting that the different cultivation conditions did not alter the fibroin chemical contents. Secondly, utilizing various analytical techniques, the SFT structure revealed less heavy chains, more light chains and P-25 glycoproteins, and lower crystallinity than those of SFV. Accordingly, compared to the particles formed by SFT, the SFV-based particles were significantly bigger (∼1700 nm vs. ∼150 nm), and possessed less drug (Amphotericin B) entrapment efficiency (64.3 ± 4.4% vs. 79.3 ± 5.1%), higher hemototoxicity, and less biostability in the blood. Conclusively, these differences add more insights for the appropriate applications of each fibroin kind to best promote its qualities and effectiveness.

Preparations and characterizations of effervescent granules containing azithromycin solid dispersion for children and elder: Solubility enhancement, taste-masking, and digestive acidic protection

Azithromycin, a macrolide antibiotics, is one of the frequently used drugs in the children and elder. However, due to these population difficulty in swallowing and inefficient absorption, and azithromycin inherent poor solubility, bitter taste, and instability in the stomach acidic condition, it is a challenge to reach high oral bioavailability of this drug. To overcome these issues, we developed and characterized the effervescent granules containing azithromycin solid dispersion. Firstly, the solid dispersion was prepared, employing both wet grinding and solvent evaporation methods, with different types/amounts of polymers. The optimal solid dispersion with β-cyclodextrin at a drug:polymer ratio of 1:2 (w/w), prepared by the solvent evaporation method, significantly enhanced the azithromycin solubility 4-fold compared to the free drug, improved its bitterness from "bitter" to "normal", possessed intermolecular bonding between the drug and polymer, and transformed the azithromycin molecules from crystalline to amorphous state. Secondly, the effervescent granules incorporating the solid dispersion were formulated with varied excipients of sweeteners, gas-generators, pH modulators, and glidants/lubricants. The optimal formula satisfied all the properties stated in the Vietnamese Pharmacopoeia. In summary, the final effervescent granules product could be further investigated in in-vivo and in clinical settings to become a potential azithromycin delivery system with high bioavailability for the children and elder.

COVID-19 vaccination: public preference and intention in Vietnam

Backgrounds

Understanding public opinion in relation to vaccination is critical, as there are several COVID-19 vaccines approved for use in Vietnam. This study aimed to assess public COVID-19 vaccine preferences and intention in Can Tho, Vietnam.

Methods

An analytical cross-sectional study was performed between September 20 and October 20, 2021. in people aged 18 and over living in Can Tho, Vietnam, A questionnaire captured demographic information, vaccination intention, preference for vaccine selection, and barriers and motivations related to COVID-19 vaccination. Predictors for vaccination willingness among unvaccinated people were determined using multivariable logistic regression.

Results

Out of the proposed vaccines that have been approved by the Vietnam Ministry of Health, AstraZeneca (31.4%), Pfizer (23.5%), and Moderna (14.7%) were the most preferred by participants. Out of 1,470 respondents, 35.8% have received at least one vaccine dose, and of these, 76.9% intended to continue to receive vaccinations. Among the unvaccinated, 74.8% reported that they would be willing to complete the vaccination. Most participants stated that they would receive a COVID-19 vaccine if provided with adequate information on effectiveness and safety (92.7%). The possibility of side effects after vaccination (75.4%) was the most important barrier to vaccination. Education, health status, and prior flu-vaccination were associated with the intention to receive a COVID-19 vaccination among those who had not previously received one.

Conclusions

Many unvaccinated adults were willing to receive a COVID-19 vaccination, with AstraZeneca being the preferred choice. These findings could help in the planning of vaccination campaigns to increase vaccination uptake in Vietnam.

Facilitators and barriers to telepharmacy use among community pharmacists in the Mekong Delta, Vietnam

Objectives

Recent years have seen the development and advancement of pharmaceutical care services using telecommunications, termed telepharmacy, in a variety of countries and settings. This study investigated the motivations/facilitators and barriers to pharmacists implementing telepharmacy at pharmacies/drugstores in the Mekong Delta region, Vietnam.

Methods

A descriptive cross-sectional online survey was conducted from March to May 2022, on 747 pharmacists, at pharmacies in all 13 cities/provinces in the Mekong Delta area, Vietnam.

Key findings

Of the 747 respondents, 74% participants had experience of using telepharmacy. Having a university degree in pharmacy (aOR = 1.86; 95% CI = 1.11–3.12; P = 0.018) and a monthly income >8.4 million VND (~357 USD) (aOR = 2.00; 95%CI = 1.16–3.42; P = 0.012) were factors positively associated with telepharmacy use. The factor reported as most greatly motivating telepharmacy use was its ability to provide healthcare services to people in remote/rural areas and those unable to travel (82.3%). The main barrier to telepharmacy use was cited as a lack of policies and regulations on the implementation, application and support of telepharmacy practice (76.8%). More than 75% of those without telepharmacy experience reported that they would like to use it in the future.

Conclusions

Telepharmacy use in Vietnam is familiar with the community pharmacists, although the use of telecommunications in pharmacy was only recently adopted in this country. Vietnamese government bodies and policy-makers must issue detailed regulations and instructions governing telepharmacy practice to support these advancements to the healthcare system in Vietnam.

Optimising remanufacturing decision-making using the bees algorithm in product digital twins

Remanufacturing is widely recognised as a key contributor to the circular economy (CE) as it extends the in-use life of products, but its synergy with Industry 4.0 (I4.0) has received little attention when compared to manufacturing. An agglomeration of I4.0 technologies and methodologies is reflected in the emerging digital twin (DT) concept, which has been identified as a life-extending enabler. This article captures the design and demonstration of a DT model that optimises remanufacturing planning using data from different instances in a product's life cycle. The model uses a neural network for remaining useful life predictions and the Bees Algorithm for decision making within a DT. The model is validated using a real case study. The findings support the idea that intelligent tools within a DT can enhance decision-making if they have visibility and access to the product's current status and reliable remanufacturing process information.

Controlled-Release Wedelia trilobata L. Flower Extract Loaded Fibroin Microparticles as Potential Anti-Aging Preparations for Cosmetic Trade Commercialization

Background

Wedelia trilobata L. (WT), a common herbal plant in Vietnam, is popularly used as a strong antioxidant in Vietnamese folk medicine. However, limited studies have reported the application of WT flower in cosmeceutical area.

Purpose

This study explored the potentials of WT loaded fibroin microparticles (FMPs-WT) as a novel anti-aging cosmeceutical product.

Methods

The WT flower was firstly extracted by maceration with methanol, ethanol 60%, and ethanol 96%, and its chemical compositions and total polyphenol content were investigated. Then, the FMPs-WT were developed by desolvation method and physicochemically characterized. Finally, the product antioxidant activities were in-vitro determined using DPPH assay.

Results

The optimal WT extract was the ethanol 60% extract, which contains polyphenols, alkaloids, flavonoids, saponins, glycosides, and organic acids; with a total polyphenol content of 46.47 ± 2.32 mg GAE/g plant powder. The FMPs-WT were successfully formulated, with a distinct silk-II polymorph; varied sizes of 0.592 to 9.820 µm, depending on the fibroin concentrations and the WT extraction solvent; high entrapment efficiencies of >65%; and sustained-release patterns of polyphenol in pH 7.4 for >6 h. Regarding the antioxidant activity, the pure WT flower extracts possessed high scavenging actions with IC₅₀ of 7.98 ± 0.40 µg/mL, comparable with the standard ascorbic acid (IC₅₀ = 4.23 ± 0.21 µg/mL). Moreover, the FMPs-WT could retain the extract antioxidant capacity, and exert the effects in a timely manner, corresponding to its release profile.

Conclusion

The FMPs-WT could be further investigated to become a potential anti-aging cosmeceutical product in the market.

Physician's Perspectives on Factors Influencing Antibiotic Resistance: A Qualitative Study in Vietnam

(1) Background: The antibiotic resistance (ABR) rates are escalating to seriously high levels worldwide. This study was conducted to determine physicians' perspectives on factors influencing ABR in Vietnam. (2) Methods: Focus group discussion (FGD) was conducted through in-depth interviews on ABR perspectives with 5-6 physicians from different geographical locations and hospitals in Vietnam between March and June 2020. The research questions were focused on three main themes of (a) knowledge deficiency on ABR and hospital-acquired infection, (b) antibiotic prescribing practice among clinicians in the healthcare setting, and (c) regulations and hospital policies on antibiotic use. The descriptive analysis was performed using QRS NVivo software. (3) Results: A total of six FGDs were conducted among 34 physicians (18 males, 16 females) aged 26-53 years old from six public and six private hospitals in Vietnam. Most of the participants were attending physicians (85.3%) and had 5-10 years of experience in surgical wards (55.9%). For theme (a), a majority of participants agreed that they had adequate information updates on how ABR develops in their clinical setting; and were well aware of hospital-acquired infections. For theme (b), the participants agreed that WHO guidelines and Vietnam national guidelines were two important reference documents in guiding physicians in antibiotic use. For theme (c), the FGD study revealed awareness of ABR, hospital antibiotic policies, and procedures for administrators on antibiotic use that were updated and complied with. (4) Conclusions: While different levels of control measures against ABR are ongoing in Vietnam, several weaknesses in the current antibiotic prescribing strategies in the hospital and clinical setting management policies have been identified in the healthcare system. The research findings will be helpful for policymakers to have better plans of action against ABR in Vietnam.

Cytotoxic Activities and Fingerprint Analysis of Triterpenes by HPTLC Technique for Distinguishing Ganoderma Species from Vietnam and other Asian Countries

Ganoderma lucidum (Fr.) P. Karst. (Ganodermataceae), commonly called Linhzhi, is traditionally employed in the treatment of human diseases, including hepatitis, liver disorders, hypercholesterolemia, arthritis, bronchitis, and tumorigenic diseases. In this study, the fingerprint profiles of five different strains of G. lucidum originated from Japan, Korea, China, and Vietnam, five samples of G. lucidum growing on Erythrophloeum fordii Oliv. in Vietnam, and five related Linhzhi species (Ganoderma applanatum, Ganoderma australe, Ganoderma clossum, Ganoderma subresinosu, and Ganoderma sp.) were investigated for triterpene derivatives using high-pressure, thin-layer chromatography (HPTLC). The HPTLC fingerprint profiles demonstrated significant differences between G. lucidum and other related Linhzhi species in the presence of triterpene derivatives. Evaluation for the cytotoxicity of these samples against four cancer cell lines, including A549, MCF7, PC3, and HepG2, displayed various levels of cytotoxic effects, with IC₅₀ values of: 15.6-46.3 µg/mL on the A549 cancer cell line, of 18.4-43.6 µg/mL on the MCF7 cancer cell line, of 10.0-32.1 µg/mL on the PC3 cancer cell line, and of 10.6-27.6 µg/mL on the HepG2 cancer cell line. Conclusively, these data contributed to the literature on the cytotoxic activities and fingerprint analysis of triterpenes by the HPTLC technique for distinguishing Ganoderma species from Vietnam and other Asian countries.

Determination of Antioxidant, Cytotoxicity, and Acetylcholinesterase Inhibitory Activities of Alkaloids Isolated from Sophora flavescens Ait. Grown in Dak Nong, Vietnam

Traditional/herbal medicine has gained increasing interests recently, especially in Asian countries such as Vietnam, due to its diverse therapeutic actions. In the treasure of Vietnamese medicinal plants, one of the potential herbs is the roots of Sophora flavescens Ait. (SF, "Kho sam" in Vietnamese). However, limited information has been reported on the Vietnamese SF compositions and their respective alkaloids' anti-acetylcholinesterase action. Thus, this study investigated the extractions, isolations, identifications, and in-vitro antioxidant, cytotoxicity, and acetylcholinesterase inhibitory activities, of the SF root extracts and their purified alkaloid compounds. To this end, four pure compounds were successfully isolated, purity-tested by HPLC, and structurally identified by spectroscopic techniques of FTIR, MS, and NMR. These compounds, confirmed to be oxysophocarpine, oxymatrine, matrine, and sophoridine, were then determined their therapeutic actions. The SF extracts and the compounds did not possess significant antioxidant activity using the DPPH and MDA assays, and cytotoxicity action using the MTT assay on the MDA-MB-231 breast cancer cell line. On the other hand, the SF total extract yielded a moderate acetylcholinesterase inhibition effect, with an IC50 of 0.1077 ± 0.0023 mg/mL. In summary, the SF extract demonstrated potential effects as an anti-acetylcholinesterase agent and could be further researched to become a pharmaceutical product for diseases related to acetylcholine deficiency, such as dementia.

Perspectives on COVID-19 prevention and treatment using herbal medicine in Vietnam: A cross-sectional study

INTRODUCTION

The significance of herbal medicine (HM) during the COVID-19 pandemic has been confirmed. Nevertheless, limited studies have included the people perspectives on COVID-19 prevention/treatment using herbal medicine in Vietnam. Thus, this study tackled the aforementioned issue.

METHODS

Online-based cross-sectional study was conducted in Vietnamese adults between February-April 2021. Descriptive analysis, regression and Chi-squared tests were implemented for the statistical purposes.

RESULTS

total of 787 respondents attended the study, 368 (46.8%) confirmed that they use herbal medicine/nutritional supplements for COVID-19 prevention/treatment. Over 50% of the respondents possessed positive perspective on vitamin C ingestion. Using herbal medicine for external use as a disinfectant was mostly preferred. Respondents who had a 'very good' health self-perception or who lived in rural areas, were more likely to have a positive opinion in the COVID-19 prevention/treatment using herbal medicine. The main barrier for herbal medicine utilization was the deficiency of personal experience or expert advice.

CONCLUSION

The Vietnamese people commonly utilize herbal medicine for the COVID-19 prevention/treatment. These data might help policy-makers in managing the public knowledge and practice on herbal medicine use in Vietnam.

Prevalence and eradication efficacy of Helicobacter pylori infection in children in the Mekong delta, Vietnam: a cross-sectional study

Background: Worldwide, Helicobacter pylori (HP) infection in children with peptic ulcer and/or gastritis (PUG) is increasingly common. In Vietnam, clinical symptoms of HP infection in PUG children are often non-specific, and treatment regimens currently have a low success rate.

Objective: This study determined the HP infection prevalence, its clinical and endoscopic findings, and its associated factors. Additionally, the efficiencies of HP treatment regimens in PUG children were also evaluated.

Design and setting: A cross-sectional descriptive study was conducted on 140 pediatric patients diagnosed with PUG at Can Tho Children’s Hospital from 2017–2019.

Results: The prevalence of HP infection in PUG children was 46.4%. A significant association was found between HP infection and patient possessing a family history of HP infection (aOR: 2.35 (1.1–4.76). Symptoms of abdominal pain accounted for the highest rate of 88.6%, followed by vomiting, heartburn, epigastric burning, and gastric bleeding (57.9%, 36.4%, 22.9%, and 13.6%, respectively). Endoscopic findings denoted that inflammatory lesions accounted for 85% and ulcers accounted for 15%. The successful HP eradication rate using the PAM regimen (Proton pump inhibitor/amoxicillin/metronidazole) was 51.8%, with 13.6% of PUG children encountering side effects.

Conclusion: PUG children have a high rate of HP infection. Clinical symptoms are often non-specific, in which abdominal pain is the most common symptom. The success of HP eradication by the standard guideline of the Vietnam Ministry of Health is quite low. Thus, critical adjustments in the regimens are necessary.

Involvement of pharmacy students in scientific research activities in Vietnam

INTRODUCTION

Scientific research is a crucial section of health-related student education to ensure the competence of graduates. This study is the first to explore attitudes on research, willingness and motivation to conduct research, and barriers preventing this amid pharmacy students in Can Tho, Vietnam.

METHODS

A cross-sectional online survey was performed on undergraduate pharmacy students (years four and five) from three public and private universities in Can Tho, Vietnam between April and May 2021.

RESULTS

Of the 576 respondents, the majority accredited the significance of conducting research to the field of pharmacy (85.9%) with the motivation of improving the profession (81.6%). Public university respondents were more than twice as likely to have a positive attitude toward research (odds ratio [OR] = 2.88, 95% CI = 1.32-6.27) and be willing to conduct research (OR = 5.73, 95%CI = 3.5-9.37) than their private university counterparts. Very good or excellent academic performance was associated with a positive attitude (OR = 3.09, 95% CI = 1.46-6.53), willingness (OR = 3.2, 95%CI = 1.7-6.03), and increased motivation (OR = 2.42, 95% CI = 1.26-4.64) toward conducting research compared to respondents with average or lower academic performance. A lack of experience (63.5%), knowledge and skills (46%), and research training (51.7%) were the most common personal and systemic barriers to conducting research.

CONCLUSIONS

Most students reported having a positive attitude and strong motivation toward research. These findings revealed an opportunity for pharmacy policymakers and educators to utilize national strategy to improve pharmacy education and the profession.

Silk fibroin hydrogel containing Sesbania sesban L. extract for rheumatoid arthritis treatment

Purpose

Rheumatoid arthritis, a chronic and progressive inflammation condition in the joints, has significantly reduced the patient quality of life and life expectancy. Crucially, there is no complete therapy for this disease, and the current treatments possess numerous side effects. Thus, novel therapeutic approach is necessary. To that end, this study developed novel silk fibroin in-situ hydrogel containing Sesbania sesban L. extract, a plant with high anti-inflammatory actions that are beneficial for rheumatoid arthritis treatments.

Methods

The hydrogels were manufactured using simple method of spontaneous gelation at different temperature. The gel properties of morphology, gelation time, viscosity, gel strength, stability, drug loading capacity, drug release rate, and in-vitro anti-inflammatory activity were investigated with appropriate methods.

Results

The optimal formulation had highly porous structure, with a gelation time of 0.5 h at room temperature and bodily temperature of 37 °C, a viscosity of 2530 ± 50 cP, a gel strength of 1880.14 ± 35.10 g, and a physical stability of >6 months. Moreover, the hydrogel contained the Sesbania sesban L. leaf extract with a total phenolic content of 92.8 ± 8.30 mg GAE/g, and sustained the release rate for >20 dạys, followed the Higuchi model. Regarding the in-vitro activities, all formulations were nontoxic to the RAW 264.7 cell line and demonstrated comparable anti-inflammatory activity to the free extract, in terms of the NO reduction levels.

Conclusion

Conclusively, the systems possessed potential properties to be further investigated to become a prospective rheumatoid arthritis treatment.

Willingness of Healthcare Students in Vietnam to Volunteer During the COVID-19 Pandemic

Healthcare students play an important role in volunteering activity, often addressing staff shortages. However, during the COVID-19 pandemic, the willingness of students to volunteer in contribution to the pandemic response, especially in Vietnam, has not been thoroughly investigated. This study aimed to determine the prevalence of and factors associated with the willingness of healthcare students to volunteer during the COVID-19 pandemic in Vietnam. For this, an online cross-sectional survey was conducted, between June 7th and July 6th, 2021, among healthcare students from 10 fields of study at the largest public university of medicine and pharmacy in the Mekong Delta, Vietnam. Of 2032 respondents, 1473 (72.5%) reported that they would be willing to volunteer during the COVID-19 pandemic. More than half of the students reported having a desire to volunteer in non-patient contact activities such as data entry (65.9%) and logistics (57.7%). Whereas less than 50% of the participants were willing to volunteer with activities involving patients. Year of education, study field, educational format, living arrangements, health status self-perception, chronic illness possession, COVID-19 fear level, past volunteering experience in non-healthcare sectors, and COVID-19 prevention and control training course attendance were all associated with a willingness to volunteer. The strongest barriers preventing volunteering included fear for the health of their family and lack of training/knowledge. Conclusively, healthcare students reported a high level of willingness, indicating a positive attitude toward responding to the COVID-19 pandemic. Adequate training should be employed to increase the willingness among healthcare students in Vietnam.

Synthesis of cuprous oxide nanocubes combined with chitosan nanoparticles and its application to p-nitrophenol degradation

For the first time, cuprous oxide nanocubes (Cu2O NCBs) were successfully combined with chitosan nanoparticles (CS NPs) to generate Cu2O NCBs/CS NPs composites material with highly optical property and photocatalytic activity using a simple and eco-friendly synthetic approach at room temperature for 30 min. The synthesized Cu2O NCBs NPs/CS NPs were determined characterizations by Ultraviolet-visible spectroscopy (UV-vis), Fourier transform infrared spectroscopy (FTIR), X – ray Diffraction (XRD),  Transmission Electron Microscope (TEM) and Energy-dispersive X-ray spectroscopy (EDX). Results show that the Cu2O NCBs/CS NPs composites have an average particle size of ~3-5 nm; in which, Cu2O has the form of nanocubes (Cu2O NCBs) with size ~3-4 nm and chitosan nanoparticles with spherical shape (CS NPs) with size ~4-5 nm. In addition, the percent (%) composition of elements present in Cu2O NCBs/CS NPs composites material have been obtained respective: Cu (23.99%), O (38.18%), and C (33.61%). Moreover, Cu2O NCBs/CS NPs composites material was also investigated for photocatalytic activity applied in p-nitrophenol degradation. The obtained results showed that the catalytic capability of Cu2O NCBs/CS NPs for p-nitrophenol reduction reached the highest efficiency >55% in the treatment time of 25 min, and this efficiency was higher than that result of using ZnO@chitosan nanoparticles (ZnO@CS NPs) catalyst under the same conditions for comparison.

Development of Metronidazole-loaded In situ Thermosensitive Hydrogel for Periodontitis Treatment

Objectives

Periodontal treatment focuses on the thorough removal of specific periodontal pathogens, mainly anaerobic Gram-negative bacteria, by mechanical scaling and root planning. In case the periodontal abscess is detected after treatment, a high dose of antimicrobial agents is commonly applied via oral administration. However, this approach increases the risk of antibiotic resistance and systemic side effects and decreases efficacy. To overcome the aforementioned issues, this study focused on the development of thermosensitive hydrogel to deliver the antibiotic drug metronidazole (MTZ) directly and locally to the oral infection site.

Materials and Methods

The thermosensitive hydrogels were prepared by blending 28% w/v Pluronic F127 with various concentrations of methylcellulose (MC) and silk fibroin (SF). The gel properties, such as sol-gel transition time, viscosity, and gel strength, were investigated. The drug dissolution profiles, together with their theoretical models and gel dissolution characteristics, were also determined.

Results

All hydrogel formulations exhibited sol-gel transitions at 37°C within 1 min. An increase in MC content proportionally increased the viscosity but decreased the gel strength of the hydrogel. By contrast, the SF content did not significantly affect the viscosity but increased the gel strength of the hydrogel. The thermosensitive hydrogels also showed prolonged MTZ release characteristics for 10 days in phosphate-buffered saline (PBS) at pH 6.6, which followed the Higuchi diffusion model. Moreover, MTZ-thermosensitive hydrogel exhibited delayed dissolution in PBS at 37°C for more than 9 days.

Conclusion

MTZ-thermosensitive hydrogels could be considered a prospective local oral drug delivery system to achieve efficient sustained release and improve the drug pharmacological properties in periodontitis treatment.

Heart transplantation outcomes in cardiac sarcoidosis

BACKGROUND

Cardiac sarcoidosis (CS) is a progressive inflammatory cardiomyopathy that can lead to heart failure, arrhythmia, and death. There is limited data on Orthotopic Heart Transplantation (OHT) outcomes in patients with CS. Here we examine outcomes in patients with CS who have undergone OHT at centers throughout the United States from 1987 to 2019.

METHODS

This was an analysis of 63,947 adult patients undergoing OHT captured in the United Network for Organ Sharing (UNOS) registry. Patients were characterized as cardiac sarcoidosis (CS) or Non-CS. Baseline characteristics were compared using chi-square and Kruskal-Wallis Tests. Outcomes of interest included primary graft failure, patient survival, treated graft rejection, hospitalization for infection, and post-transplant malignancy.

RESULTS

During the study period 227 patients with CS underwent OHT. Patients with CS were younger, had higher proportion of non-white patients, and received transplants at more urgent statuses. After multivariable modeling there was no difference in survival (HR 0.86, CI 0.59-1.3, p = 0.446) or graft failure (HR 0.849, CI 0.58-1.23, p = 0.394) between patients with CS and Non-CS. Patients with CS had lower odds of rejection (OR 0.558, CI 0.315- 0.985, p = 0.0444). Patients with CS had similar odds of hospitalization for infection and post-transplant malignancy, as Non-CS patients.

CONCLUSIONS

Patients with CS and Non-CS had similar post OHT survival, odds of graft failure, hospitalizations for infection, and post-transplant malignancy. Results of this study confirm the role of heart transplantation as a viable option for patients with CS.

Antibiotic usage and resistance in animal production in Vietnam: a review of existing literature

Inappropriate use of antibiotics in animal production system is one of the major factors leading to the antibiotic resistance (ABR) development. In Vietnam, the ABR situation is crucial as antibiotics have been used indiscriminately for disease prevention and as growth promoters in animals. Thus, a thorough understanding on the ABR in veterinary settings would be beneficial to the Vietnam public health authority in formulating timely interventions. This review aimed to provide information on the current status of antibiotic usage in animal husbandry in Vietnam, identified gaps in research, and suggested possible solutions to tackle ABR. To this end, data on ABR in animals were extracted from 3 major electronic databases (PubMed, Web of Science, and ScienceDirect) in the period of January 2013-December 2020. The review findings were reported according to PRISMA, which highlighted the emergence and persistence of ABR in bacterial isolates, including Escherichia coli, Enterococcus spp., and Salmonella species, obtained from pigs and poultry. The lack of awareness of Vietnamese farmers on the antibiotic utilization guidelines was one of the main causes driving the animal ABR. Hence, this paper calls for interventions to restrict antibiotics use in food-producing animals by national action plan and antibiotics control programs. Additionally, studies to evaluate knowledge, attitude, and practice (KAP) of the community are required to promote rational use of antibiotics in all sectors.

Use of and attitudes towards herbal medicine during the COVID-19 pandemic: A cross-sectional study in Vietnam

Introduction

Herbal medicine has a long and rich history of practice in Vietnam. The use and attitudes towards herbal medicine, during the COVID-19 pandemic was explored in this study. The aims were to examine (1) the prevalence and indications for herbal medicine use, (2) the factors associated with herbal medicine use, and (3) Vietnamese peoples' attitudes towards herbal medicine.

Methods

A cross-sectional online survey was conducted in Vietnamese adults aged 18 years and older, distributed equally across the Northern, Central, and Southern regions of Vietnam, between September and October 2020. Descriptive statistics, chi-square tests, and univariate and multivariate logistic regression analyses were performed to achieve the study objectives.

Results

Nearly half of the respondents reported using herbal medicine for common illnesses during the COVID-19 pandemic. The prevalence was strongly associated with marital status, urbanicity, monthly income, and health status perception. Ginger (Zingiber officinale Rosc.), honey (Mel), garlic (Allium sativum L.), and perilla (Perilla frutescens (L.) Britt.) were the most commonly used herbal medicines, mainly for the treatment of sore throat, cough, nasal congestion, and fever. Nearly 70% of the participants believed herbal medicines to be safe, to have less side effects than conventional medicines, and to be effective for minor health conditions.

Conclusion

The use of herbal medicine during the COVID-19 pandemic was a common practice among Vietnamese people. These findings may have implications for future medical research in Vietnam, and for policy-makers and those in the pharmaceutical industry with regard to future regulations and product development.

Medical staff perspective on factors influencing their prescribing decisions: a cross-sectional study in Mekong Delta, Vietnam

Objectives

Understanding medical staff’s prescription behaviors helps improve the quality of prescriptions and the rationality of medication use. Although factors affecting the prescribing decisions were discussed in various studies worldwide, limited knowledge of these issues has been reported in Vietnam. This paper aims to examine factors that influence prescribing behavior concerning medical staff’s demographics and characteristic differences.

Methods

Quantitative descriptive cross-sectional study, using adapted questionnaire consisting of 27 factors divided into 9 factor categories, was conducted with medical staff in Mekong Delta during June–July, 2019. Rasch analysis was performed to assess the questionnaire psychometric properties. Descriptive analysis, parametric tests and non-parametric tests were utilized to address the study objectives.

Key findings

A total of 201 participants completed the questionnaire. A majority of participants (>90%) agreed that their own decision to prescribe a drug was influenced by several factors such as drug safety and efficacy (92.5%), patient history (92.0%), patient income (92.0%) and patient disease status (91.0%). There were significant age differences in influences on prescribing decision. Medical staff aged under 30 appreciated the role of pharmacists higher than whose aged 31–40 (P-value = 0.010) and over 40 (P-value = 0.013). Additionally, they were more concerned with ‘patient characteristics’ including patient request, expectations, and disease status when making prescribing decisions compared with whose aged over 40 (P-value = 0.005).

Conclusions

The study revealed various factors influencing medical staff prescription decision-making processes. These findings could be useful for pharmaceutical companies in Vietnam in developing marketing strategies, and for policy-makers in timely improvement of prescription quality.

Fibroin nanoparticles: a promising drug delivery system

Fibroin is a dominant silk protein that possesses ideal properties as a biomaterial for drug delivery. Recently, the development of fibroin nanoparticles (FNPs) for various biomedical applications has been extensively studied. Due to their versatility and chemical modifiability, FNPs can encapsulate different types of therapeutic compounds, including small and big molecules, proteins, enzymes, vaccines, and genetic materials. Moreover, FNPs are able to be administered both parenterally and non-parenterally. This review summaries basic information on the silk and fibroin origin and characteristics, followed by the up-to-date data on the FNPs preparation and characterization methods. In addition, their medical applications as a drug delivery system are in-depth explored based on several administrative routes of parenteral, oral, transdermal, ocular, orthopedic, and respiratory. Finally, the challenges and suggested solutions, as well as the future outlooks of these systems are discussed.

History of cigarette smoking and heart transplant outcomes

Background: Active cigarette smoking (CS) is a contraindication for Orthotopic Heart Transplantation (OHT) with a recommendation that HT candidates be free from CS for at minimum 6 months prior to HT. Animal studies have shown that a history of CS is associated with increased risk of allograft rejection, but few studies have examined the association of past CS and HT outcomes. Methods: Data were analyzed from HT recipients captured in the United Network for Organ Sharing (UNOS) transplant registry. Adults aged 18–79 who underwent HT from 1987 to 2018 and with data for all covariates (N = 32,260) were included in this study. The cohort was categorized by past smoking history (CS vs non-CS). Post-transplant outcomes of interest included survival, graft failure, treated rejection, malignancy and hospitalization for infection. Baseline characteristics were compared between the two groups using the chi-squared analysis. Unadjusted associations between CS and patient survival were determined using the Kaplan-Meier estimations and confounding was addressed using multivariable Cox proportional hazards models. Results: HT recipients with a history of CS were older (55 vs 50, p = <0.0001), more likely to be Caucasian (75.7 vs 62.3, p = <0.0001), male (81.7 vs 68.2, p =< 0.0001), and diabetic (27.4 vs 24.4, p =< 0.0001). CS was associated with significantly worse survival (HR: 1.23, p < 0.0001). A history of CS was also associated with increased risk of acute rejection (OR: 1.20, p < 0.0001), hospitalization for infection (OR:1.24, p < 0.0001), graft failure (OR:1.23, p < 0.0001) and post-transplant malignancy (OR:1.43, p < 0.0001). Conclusion: A history of CS is associated with increased risk of adverse events post OHT.

Crosslinked Fibroin Nanoparticles: Investigations on Biostability, Cytotoxicity, and Cellular Internalization

Recently, crosslinked fibroin nanoparticles (FNP) using the crosslinker 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) or the polymer poly(ethylenimine) (PEI) have been developed and showed potentials as novel drug delivery systems. Thus, this study further investigated the biological properties of these crosslinked FNP by labeling them with fluorescein isothiocyanate (FITC) for in vitro studies. All formulations possessed a mean particle size of approximately 300 nm and a tunable zeta potential (-20 to + 30 mV) dependent on the amount/type of crosslinkers. The FITC-bound FNP showed no significant difference in physical properties compared to the blank FNP. They possessed a binding efficacy of 3.3% w/w, and no FITC was released in sink condition up to 8 h. All formulations were colloidal stable in the sheep whole blood. The degradation rate of these FNP in blood could be controlled depending on their crosslink degree. Moreover, no potential toxicity in erythrocytes, Caco-2, HepG2, and 9L cells was noted for all formulations at particle concentrations of < 1 mg/mL. Finally, all FNP were internalized into the Caco-2 cells after 3 h incubation. The uptake rate of the positively charged particles was significantly higher than the negatively charged ones. In summary, the crosslinked FNP were safe and showed high potentials as versatile systems for biomedical applications.

Alpha mangostin loaded crosslinked silk fibroin-based nanoparticles for cancer chemotherapy

Silk fibroin has been utilized extensively for biomedical purposes, especially the drug delivery systems. This study introduced and characterized three novel α-mangostin loaded crosslinked fibroin nanoparticles (FNPs), using EDC or PEI as a crosslinker, for cancer treatment. All three formulas were spherical particles with a mean size of approximately 300 nm. By varying the type and/or amount of the crosslinkers, particle surface charge was controllable from -15 to +30 mV. Crosslinked FNPs exhibited higher drug entrapment efficiency (70%) and drug loading (7%) than non-crosslinked FNP. FT-IR, XRD, and DSC analytical methods confirmed that α-mangostin was entrapped in FNPs in molecular dispersion form. Compared to the free α-mangostin, the crosslinked FNPs increased the drug's solubility up to threefold. They also showed sustained release characteristics of more than 3 days, and reduced free α-mangostin hematotoxicity by 90%. The α-mangostin loaded FNPs were physicochemically stable for up to 24 h when dispersed in intravenous diluent and for at least 6 months when preserved as lyophilized powder at 4 °C. In terms of anticancer efficacy, on both Caco-2 colorectal and MCF-7 breast adenocarcinoma cell lines, all formulas maintain α-mangostin's apoptotic effect while exhibit greater cytotoxicity than the free drug. In conclusion, α-mangostin loaded crosslinked FNPs show high potential for cancer chemotherapy.

Antimicrobial activity of some novel 2-(2-iodophenylimino)-5-arylidenethiazolidin-4-one derivatives

Background

Infectious diseases, especially those caused by multidrug-resistant bacteria, are becoming a serious problem worldwide because of the lack of effective therapeutic agents. Moreover, most antifungal drugs exhibit low efficacy and high toxicity because of the similarity between fungal and human cells. These issues warrant the search for potential new agents.

Objectives

To synthesize potent 2-(2-iodophenylimino)-5-arylidenethiazolidin-4-one derivatives, improve the synthetic process, elucidate their structures, and determine their antimicrobial activity.

Methods

2-Iodoaniline was used as an initial reactant in a 3-step process for the synthesis of 2-(2-iodophenylimino)-5-arylidenethiazolidin-4-one derivatives, including an acylation reaction, a cyclization reaction, and aldol condensation reactions. The structures of the obtained derivatives were investigated and elucidated using spectral methods. Antimicrobial activity toward 5 bacterial strains and 2 fungal strains was determined using Kirby–Bauer and agar dilution methods.

Results

We successfully synthesized 12 novel compounds and elucidated their structures. The derivatives had no antifungal activities. By contrast, they showed remarkable antibacterial activities. Some of them with minimum inhibitory concentrations (MICs) ≤8 μg/mL in both Staphylococcus aureus and methicillin-resistant S. aureus.

Conclusions

A simple and flexible way to synthesize new compounds with a thiazolidin-4-one ring was determined. Some of these new compounds have outstanding effects with low MICs for bacteria. Their further investigation as therapeutic agents is warranted.

Corifollitropin alfa vs recombinant FSH for controlled ovarian stimulation in women aged 35-42 years with a body weight ≥50 kg: a randomized controlled trial

STUDY QUESTION

Is corifollitropin alfa 150 μg equivalent to follitropin beta 300 IU/day for controlled ovarian hyperstimulation (COS) in older women weighing ≥50 kg undergoing IVF and/or ICSI in Vietnam?

SUMMARY ANSWER

Corifollitropin alfa 150 μg was equivalent to follitropin beta 300 IU/day with respect to the number of oocytes retrieved, the ongoing, cumulative and live birth rates and obstetric outcomes.

WHAT IS KNOWN ALREADY

Corifollitropin alfa is a recombinant FSH (rFSH) preparation with slow absorption and a long half-life allowing administration of a single dose for COS lasting 7 days. Several randomized, controlled clinical trials have reported that COS with corifollitropin alfa is associated with similar outcomes compared with COS using daily rFSH. However, limited data are available in Asian patients.

STUDY DESIGN, SIZE, DURATION

This randomized controlled trial was conducted at a single large IVF centre in Vietnam from June 2015 to August 2016. A total of 400 patients were included, 200 in each treatment group. The primary outcome measure was the number of oocytes retrieved. Patients were followed for 1 year after randomization.

PARTICIPANTS /MATERIALS, SETTING, METHODS

Participants aged 35–42 years with a body weight ≥50 kg who were undergoing an IVF cycle were randomized to undergo COS with a single dose of corifollitropin alfa 150 μg on Day 2 or 3 of the menstrual cycle, or follitropin beta 300 IU/day for 7 days starting on Day 2 or 3 of the menstrual cycle. All underwent ICSI according to standard institutional protocols. A beta hCG test was performed 17 days after ovum pick-up, and positive tests were confirmed on vaginal and/or abdominal ultrasound at 5–6 weeks after embryo transfer (clinical pregnancy) and at ≥10 weeks (ongoing pregnancy). Rates of ovarian hyperstimulation syndrome, and maternal and foetal outcomes after one cycle of ICSI were monitored over 12 months.

MAIN RESULTS AND THE ROLE OF CHANCE

Patients in the corifollitropin alfa and follitropin beta groups were well matched at baseline (mean age 37.5 ± 1.9 vs 37.7 ± 2.0 years, mean body weight 53.7 ± 5.4 vs 52.5 ± 4.8 kg). There was no significant difference between the corifollitropin alfa and follitropin beta groups in the number of oocytes retrieved (11.4 ± 5.9 vs 10.8 ± 5.8; P = 0.338). The ongoing pregnancy rate (31.5 vs 32.0%; P = 0.99) and live birth rate (30.5 vs 32.0%; P = 0.83) (both per initiated cycle at 12 months after randomization) were also similar in the two treatment groups. Complication rates were low and similar in the corifollitropin alfa and follitropin beta groups, and there were no significant between-group differences in obstetric outcomes.

LIMITATIONS, REASONS FOR CAUTION

This study had an open-label design, and therefore, the potential for bias cannot be excluded. The findings are only applicable to patient populations with similar characteristics to those enroled in the study.

WIDER IMPLICATIONS OF THE FINDINGS

This study adds to the body of evidence supporting the equivalence of corifollitropin alfa and follitropin beta for COS in a variety of patients undergoing IVF and/or ICSI. The ability to provide COS with corifollitropin alfa has the potential to reduce the burden of treatment for patients.

STUDY FUNDING/COMPETING INTERESTS

This study was supported by Merck Sharp and Dohme. The authors state that they have no financial or commercial conflicts of interest.

TRIAL REGISTRATION NUMBER

The trial was registered with clinicaltrials.gov (NCT02466204).

TRIAL REGISTRATION DATE

2 June 2015.

DATE OF FIRST PATIENT’S ENROLMENT

19 June 2015.

[Follow-up of postoperative endophthalmitis after cataract surgery and intravitreal injection of drugs - an analysis since 2009]

BACKGROUND

The frequency of intravitreal injection of drugs (IVI) has significantly increased recently and it is performed like cataract surgery as an outpatient procedure. The occurrence of postoperative endophthalmitis is rare, only few data of multicentre studies are available.

METHODS

We analysed the data of 30 consecutive patients with endophthalmitis following cataract surgery (group 1, n = 20) and IVI (group 2, n = 10) requiring therapy in a referral eye clinic from January 2009 to December 2013. All patients received topical and systemic anti-inflammatory and anti-infective therapy. Due to vitreous opacification and severe loss of vision 83 % of the eyes underwent immediately pars plana vitrectomy with diagnostic microbiological probe and intravitreal application of vancomycin and gentamicin.

RESULTS

Endophthalmitis occurred independently in both groups 1 to 10 days, on average 4 days, postoperatively. Group 1 showed conjunctival infection in 80 % (n = 16), group 2 in 20 % (n = 2). Hypopyon was found in group 1 in 65 % (n = 13), in group 2 in 40 % (n = 4). Group 1 presented retinal haemorrhages and epiretinal fibrin membranes in 15 % (n = 3), group 2 in 70 % (n = 7). Vitreous cultures were positive in 80 % (vancomycin-sensitive staphylococci). Staphylococcus was the most frequent bacteria, resistant to ceftazidime. In group 1 visual acuity was initially in 65 % (n = 13) of the eyes < 20/400 or worse, in group 2 90 % (n = 9) of the eyes had hand motions and in 10 % (n = 1) worse than 20/400. Visual outcome was 20/30 on average for group 1, PVR retinal detachment occurred once. In group 2 no patient achieved better visual outcome than < 20/400, 40 % of the eyes required permanent silicon oil tamponade because of PVR retinal detachment. The major pathogens were staphylococci resistant to ceftazidim.

CONCLUSION

Endophthalmitis following IVI had poor visual outcome compared to endophthalmitis following cataract surgery and showed less anterior segment symptoms.

[Effect of ocular compression on anterior chamber dimensions in cataract surgery using topical anaesthesia]

PURPOSE

Ocular compression is part of the preparation before cataract surgery to reduce the incidence of a positive intraoperative pressure. The purpose of this clinical study was to assess the influence of ocular compression on the anterior chamber dimensions and biometric parameters before cataract surgery using topical anaesthesia.

METHODS

In a prospective, comparative observational study the biometric parameters were assessed with slitlamp-adapted anterior segment OCT (SL-OCT, Heidelberg Engineering) and ultrasound biometry (A-Scan+, Sonomed) in 51 consecutive patients (51 eyes) with a mean axial eye length of 22.90 ± 1.05 mm before cataract surgery. The measurements were performed in all patients before and immediately after ocular compression (Oculopressor G-15392, Geuder). In 32 patients the measurements were repeated 10 minutes after ocular compression.

RESULTS

The optical and acoustic values of the anterior chamber depth did not change significantly after ocular compression (p > 0.05). Digital gonioscopy with OCT revealed a mean increase of the anterior chamber angle of 2.37° (p < 0.001) from 45.75 ± 7.28° to 48.12 ± 7.28°, and the angle opening distance of 37 µm (p = 0.017) from 627 ± 184 µm to 664 ± 162 µm. Also the average acoustic axial vitreous distance decreased significantly from 15.22 ± 0.98 to 15.18 ± 0.96 mm (p = 0.034) with a posterior shift in the relative lens position (p = 0.018).

CONCLUSIONS

In this clinical study, only slight anterior chamber and biometric changes were observed after ocular compression before cataract surgery using topical anaesthesia. There was a significant increase of the anterior chamber angle and angle opening distance with a concomitant decrease of the vitreous distance and shifting of the iris lens diaphragm.

[Individualised correction of presbyopia by the use of phacoemulsification: monovision and multifocal lenses]

The cataract operation has transformed from a procedure for correcting spherical and astigmatic errors to one for correcting even presbyopia. Higher demands by the patients and more and more complex and individual lifestyle options need customised concepts of presbyopic correction, taking also into account comorbidities and neuroadaption. One concept for achieving this goal is multifocal lenses, undergoing a renaissance these days. Monovision using monofocal lenses is a cost neutral alternative with very few side effects, if well performed. It is defined by the far focus of one eye and the near focus of the other. Binocularity of human vision enables multiple options by combining different means of presbyopia correction. But it also complicates making the right choice. This underlines the importance of an accurate patient selection and the precise definition of what to achieve for each individual patient.