This first Vietnamese population-based study has highlighted original characteristics and signals of drug-induced SJS/TEN, which are relatively consistent with other worldwide data and typical for a developing country.

Drug safety issues in developing countries are complex and sensitive, and health authorities cannot always simply implement decisions from developed countries because the health system, disease patterns, and lists of marketed drugs all differ. A system for proactive and effective surveillance of drugs in each nation is needed to identify and manage the exact drug-related problems faced by patients in these countries. Vietnam launched its university-based National Drug Information and Adverse Drug Reaction Monitoring Centre (NDIADRMC) in 2009, a significant step towards catching up with international trends. Although the center is still in its infancy and has limited resources, it has attained some achievements and largely met the minimum World Health Organization requirements for a functional pharmacovigilance center. The number of reports has increased rapidly, with some important signals generated from the national database leading to regulatory actions at a national level. In addition, this system can help detect drug-quality problems that are less common in developed countries. The success of the quantity and quality of reporting, risk assessment, and communication is still limited compared with more developed systems. A number of opportunities remain to enhance the system, particularly in risk communication and evaluation of the impact of pharmacovigilance, and to apply reporting outcomes to reduce drug-related risks throughout the country. More internal and external support is needed to develop a stronger and more comprehensive pharmacovigilance system.

Drug-induced bone loss remains the major cause of vertebral and hip fractures and significantly associated to morbidity and mortality. This article will review the common drugs identified as the causes of bone loss and the risk factors and management in European countries. Areas covered: Beyond glucorticoid - the most cause of osteoporosis, many different drugs could cause harmful skeletal disorders. The antiepileptics, hormonal therapy, GnRH antagonists, aromatase inhibitors are well-known cause of bone loss. Osteoporosis and fractures risk also increased with calcineurin inhibitors, antiretroviral drugs, selective inhibitors of serotonin reuptake, loop diuretics, heparins, oral anticoagulants, high doses of thyroxine and proton pump inhibitors. Expert opinion: Drugs are an important secondary cause of osteoporosis. Healthcare professionals should reassess the requirement for drugs and use the lowest dosage and shortest duration. Lifestyle changes, adequate calcium, vitamin D supplement, appropriate monitoring of bone status and initiating osteoporosis treatment if indicated are recommended when drugs having potential deleterious effects on bone are used, particularly in high risk patients. The update and further studies would provide concluded evidences of controversial drugs induced bone loss and determine the best prevention and treatment strategies.

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Background: Data about the risk factors and pancreatic cancer in developing countries remain limited. We investigated for the first time the role of a number of risk factors (family cancer history, smoking, alcohol consumption, diabetes, inflammation disease, HBV infection) associated with pancreatic cancer among Vietnamese patients. Methods: We included all patients hospitalized at 4 Northern Vietnamese hospitals (Vietnam National Cancer Hospital, Bach Mai, Viet Duc, Thai Nguyen) and diagnosed with pancreatic cancer during the period from 2017 to 2019. Risk factors of eligible patients were collected and assessed the associations using a matched control study and logistic regression model analysis. Results: We identified 196 patients with diagnosis of pancreatic cancer of which 114 males and 82 females. The average age of the patient at the time of diagnosis was 58.28 years (standard deviation of 12.94, ranging from 25 to 87). Most of patients were diagnosed at advanced stage (85%). Smoking, diabetes, inflammation disease significantly increased the cancer risks (OR and 95% CI were 2.42 (1.38-4.37), 3.09 (1.54-6.68), 2.21 (1.42-3.45), respectively). HBV infection demonstrated a significant link with pancreatic cancer in univariate model (OR = 2.94 (1.08-9.36)), but not in multivariate model. However, cancer family history and alcohol drinkers did not show any significantly increased risk related to pancreatic cancer. Conclusions: Our finding showed smoking, diabetes, inflammation disease significantly increased the risk of pancreatic cancer in Vietnam.

What is known and objective There is limited data on the specific risks of anaphylaxis induced by beta‐lactam drugs. The aim of this study was to compare the risks of reporting beta‐lactam‐induced anaphylaxis using the national pharmacovigilance database of Vietnam (NPDV). Methods The multivariate generalised linear regression model was applied for signal generation and comparison of beta‐lactams. Results Between 2010 and 2016, there were 2,921 reports of anaphylaxis (19.93%) from 14,655 spontaneous reports of beta‐lactam use in the NDPV. Anaphylaxis signal generation was also found for the subgroup J01D (cephalosporins and carbapenems) (ROR = 1.27 [1.16‐1.39]) and beta‐lactamase‐sensitive penicillins (ROR = 1.74 [1.27‐2.35]). In the third generation cephalosporin subgroup, different risks were identified for the following combinations of beta‐lactams: 1) cefotaxime with cefoperazone+sulbactam; 2) cefixime/cefpodoxime/cefdinir with cefoperazone+sulbactam or ceftizoxime/cefoperazone/ceftazidime/ceftriaxone/cefotaxime. For the second generation cephalosporin subgroup, different risks were found for cefotiam compared to cefmetazole, cefaclor, cefamandole and cefuroxime. What is new and conclusion These findings identified and highlighted the different anaphylactic risks caused by various beta‐lactams in the main subgroups.

This study was employed with two objectives: 1/To describe the current situation of health workers and 2/To explore the factors influencing attraction and retention of health workers in Cu Kuin district hospital in period 2016 - 2018. A mixed - methods approach was applied, with a combination of using secondary data and qualitative research. The secondary data was collected from the hospital statistics and reports during the period of 2016 - 2018. The qualitative research was organized in-depth interviews with the directors, official managers and health staffs in the hospital. The main findings showed that during the time of 2016 - 2018, the quantative of health workers in Cu Kuin hospital decresed gradually and was slightly lacking when compared to Circular 08. The recruitment was still insufficient compared to the recruitment plan. There was still lacking of professional healthcare staffs, especially doctors and pharmacists. The allocation of healthcare staffs by clinical, admistrative sectors was not balanced in hospital. The number of training and re-training among health workers accounted for 48.9%. The attraction and retention for healthcare staffs in hospital did not work effectively. Therefore, to develop the human resources for hospital meed the needs and demands of the hospital activities, the leaders of the hospital should develop the human resource stratergy in accordance with the actual situation; Conduct training and re-training for health staffs regularly. For the department of health, it is necessary to supplement healthcare workers in accordance with Circular 08 and support training for healthcare workers to enhance the knowledge and update information. Keywords. Human resource for health, attraction and retention, factors influencing, healthcare staff, health workers.

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