Tạp chí của Trường Đại học Y Dược Thành phố Hồ Chí Minh
Fever with vesiculopapular eruptions mimicking varicella: an atypical presentation of measles in an unvaccinated adult
We describe a case involving a 30-year-old man with a previous history of varicella, who developed an acute febrile episode associated with a progressively spreading skin rash. At onset, the skin eruption presented as maculopapular lesions, later transforming into vesiculopapular eruptions with hemorrhagic characteristics. Typical Koplik spots were also observed on illness day 7, which was day 5 of the rash. The diagnosis was confirmed via positive measles-specific IgM serology. Fulltext link
Diagnosis of endometrioid adenocarcinoma of the fallopian tube misinterpreted as ovarian cancer: a case report
Primary fallopian tube cancer is a rare gynecologic malignancy, often misdiagnosed as ovarian cancer due to overlapping clinical and radiologic features. We report a case of a 49-year-old woman presenting with abnormal uterine bleeding and lower abdominal pain. Imaging revealed bilateral adnexal masses and elevated CA 125, HE4, and Risk of Ovarian Malignancy Algorithm (ROMA) index. Surgical exploration identified a left fallopian tube tumor and omental involvement. Histopathology confirmed high-grade endometrioid adenocarcinoma of the left fallopian tube with metastatic deposits. The patient underwent total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and adjuvant chemotherapy with Paclitaxel and Carboplatin. This case underscores the diagnostic challenge and clinical significance of recognizing fallopian tube carcinoma in patients with adnexal masses and elevated tumor markers. Fulltext link
Preliminary assessment of content validity and internal consistency of the N-CT-4 students questionnaire in the master’s students in nursing
Introduction: Critical thinking (CT) is a core competency in nursing, essential for clinical judgment, safe practice, and professional development. However, valid and context-specific tools to assess CT in nursing education remain limited in Vietnam. This study is the first to translate, content validate, and reliability test the N-CT-4 Students questionnaire into Vietnamese and to employ it in the survey on Master’s students in Nursing (MSNs), marking the initial use of this tool among graduate-level nursing students. Methods: The Vietnamese version of the N-CT-4 Students questionnaire used in this study was translated through a forward–backward translation process. Content validity was assessed through evaluations by six experts, using the item-level and scale-level content validity indices (I-CVI, S-CVI). Internal consistency reliability, measured by Cronbach’s Alpha, was determined through an online survey involving 100 MSNs at the University of Medicine and Pharmacy at Ho Chi Minh City (UMP). Results: The Vietnamese version of the N-CT-4 Students questionnaire preserved the meaning of the original English version, which was clear and easy to comprehend. The I-CVI for the N-CT-4 Students components ranged from 0.8 to 1.0. The S-CVI/AVE and S-CVI/UA were 0.99 and 0.95, respectively. The internal consistency reliability of MSNs was 0.982. Conclusions: The Vietnamese version of the N-CT-4 Students questionnaire demonstrates strong content validity and high internal reliability, making it a suitable tool for assessing CT among MSNs in Vietnam. Its availability can support nursing educators in evaluating this competency and developing strategies to enhance CT in clinical settings. Fulltext link
Prevalence of mental disorders and personality traits among public health students: a cross-sectional study
Introduction: Mental disorders are common among health students. Personality traits have been identified as potential predictors of mental health. This study aimed to assess the prevalence of mental disorders and examine their association with personality traits among students at the Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City. Methods: A cross-sectional study was conducted using a self-administered questionnaire consisting of the Self-Reporting Questionnaire (SRQ-20) to assess mental disorders and the Big Five Inventory Short Form (BFI-S) to evaluate personality traits. In this study, “mental disorders” refer to probable cases identified through the SRQ-20 screening tool, which does not provide a clinical diagnosis. Data were analyzed using multivariable Poisson regression models to ascertain the relationship between mental disorders and personality traits. Results: Among the 427 students participating in the study, the prevalence of mental disorders was found to be 49.9%. Of those experiencing mental disorders, 39.9% reported mild disorder, 35.7% moderate disorder, and 24.4% severe disorder. Prominent personality traits among students included agreeableness, openness to experience, and conscientiousness. Multivariable regression analysis revealed that mental disorders were associated with neuroticism and extraversion. Specifically, high neuroticism was a strong predictor of mental disorders, while extraversion acted as a protective factor, helping to reduce mental disorders. Conclusions: Students with high neuroticism are at increased risk for mental disorders. Conversely, personality traits such as extraversion, openness to experience, agreeableness, and conscientiousness contribute to lower risks of mental disorders. Effective intervention programs are needed to alleviate mental disorders among students. Fulltext link
Phenotyping cough in lung cancer: a focus on productive cough and its link to chronic obstructive pulmonary disease (COPD) in a Vietnamese cohort
Introduction: Cough is a primary symptom in lung cancer that severely diminishes patient quality of life. However, specific clinical data for Vietnamese patients remain limited, hindering targeted treatment. This study sought to characterize cough and identify its key drivers within this specific demographic. Methods: A cross-sectional study was performed from January 2025 to May 2025 at the Ho Chi Minh City Oncology Hospital, enrolling 392 patients aged 18 years and older exhibiting cough symptoms. A survey collected data on cough duration, characteristics, intensity (visual analogue scale for cough, VAS-C), and epidemiological factors, including chronic obstructive pulmonary disease (COPD), smoking status, and treatment. Chi-square and Fisher’s exact tests, together with multivariable logistic regression, were employed for analysis. Results: Among 392 patients, productive cough was present in 61.2%. The logistic regression model determined that concomitant COPD is the most significant independent risk factor for productive cough (adjusted odds ratios ([aOR]=52.46; 95% confidence interval [CI]: 10.57–260.45; p<0.001). Each year of increased age also raised the odds by 5% (aOR=1.05; p=0.001), while smoking cessation for ≥6 months significantly reduced the risk compared to current smokers (aOR=0.06; p=0.009) Conclusions: In our Vietnamese lung cancer cohort, productive cough is the dominant presentation. The occurrence is strongly associated with underlying COPD and older age, whereas quitting smoking offers significant protection. These results emphasize the necessity of integrating COPD management and robust smoking cessation support into oncological care to mitigate cough burden and enhance patient quality of life. Fulltext link
Effectiveness of cupping therapy in managing neck pain and improving cervical mobility in cervical spondylosis patients: a randomized clinical trial
Introduction: Cervical spondylosis is one of the common causes of chronic neck pain. This study aimed to evaluate the comparative effectiveness of fire cupping (FC) therapy versus electroacupuncture (EA) on reducing pain and improving cervical spine range of motion (ROM) in patients with neck pain due to cervical spondylosis. Methods: Eighty-two participants with neck pain caused by cervical spondylosis were randomly allocated in 1:1 ratio to either the FC or EA group. Both groups received treatment at EX-B2, A-shi, and Gall Bladder (GB21) acupuncture points. The two-week study assessed pain levels using the visual analog scale (VAS) at 2 points in time post-intervention and evaluated adverse effects weekly. Results: After 2 weeks of intervention, VAS scores significantly decreased in both the FC group (from 6 [6–7] to 3 [2–3]) and the EA group (from 6 [6–7] to 2 [1–3]) (p<0.001). However, inter-group pain relief was not statistically significant (p=0.5794, Cohen’s d=0.12; 95% CI [–0.31–0.6]). Both groups showed statistically significant ROM improvement (p<0.001), though the EA group demonstrated better improvement in flexion, extension, and left/right lateral flexion (p<0.05). No adverse effects of FC were reported. Conclusions: FC appears to be an effective and safe therapy for neck pain due to cervical spondylosis, showing similar pain relief efficacy with no statistically significant difference compared to EA despite a lower treatment dosage. However, due to methodological limitations, these findings should be interpreted with caution and warrant further validation in rigorously designed studies. Fulltext link
Comparison of continuous norepinephrine and phenylephrine infusion for preventing hypotension during low-dose spinal anesthesia in cesarean delivery: a randomized controlled trial
Introduction: Hypotension is a frequent complication of spinal anesthesia (SA) for cesarean delivery (CD). Phenylephrine is recommended for prophylaxis but may cause reflex bradycardia. Norepinephrine, with mild β-adrenergic activity, may reduce both hypotension and bradycardia. This study compared the efficacy of continuous norepinephrine versus phenylephrine infusion in preventing hypotension during low-dose SA in CD. Methods: In this randomized, controlled, single-blind trial, ninety-four term parturients undergoing elective CD under low-dose SA were randomly assigned to receive norepinephrine (0.05 mcg/kg/min) or phenylephrine (0.25 mcg/kg/min) infusion. The primary outcome was the incidence of hypotension. Secondary outcomes included bradycardia, severe hypotension, hypertension, escalation to rescue vasopressors or rescue atropine for bradycardia, nausea and vomiting, and neonatal Apgar scores. Results: The norepinephrine group had a lower incidence of hypotension (14.9% vs. 42.6%, p=0.003; RR=0.35; 95% CI: 0.16–0.75), fewer recurrent episodes, and reduced rescue vasopressor needs (p<0.05). Area under the curve (AUC)/time analysis showed that norepinephrine provided more stable blood pressure and heart rate profiles throughout the study. Bradycardia was less frequent with norepinephrine (14.9% vs. 25.5%, p=0.2; RR=0.58; 95% CI: 0.25–1.35). Two patients in the phenylephrine group required atropine. Apgar scores and other adverse events were comparable between groups. Conclusions: Norepinephrine infusion at 0.05 mcg/kg/min is more effective than phenylephrine at 0.25 mcg/kg/min in preventing hypotension during low-dose SA for CD, providing better hemodynamic stability and fewer episodes of bradycardia. Fulltext link
Application of computed tomography in evaluating imaging features of intraductal papillary mucinous neoplasms
Introduction: Intraductal papillary mucinous neoplasms (IPMNs) are increasingly detected owing to high-resolution imaging. IPMNs have malignant potential, ranging from low-grade dysplasia to invasive carcinoma. However, data from Vietnam are limited. This study aimed to describe computed tomography (CT) features of IPMNs and evaluate their diagnostic value. Methods: We performed a retrospective case series of patients with histopathologically confirmed IPMNs between January 2016 and December 2024. Thirty-two patients who underwent preoperative CT scans and met inclusion criteria were analyzed. CT features were assessed for their association with malignancy. Results: The cohort comprised 32 patients from 17 malignant and 15 benign cases. The mean age was 64.5±10.2 years of 19 men, 13 women. CT features significantly associated with malignancy were enhancing mural nodules (p<0.001), main pancreatic duct diameter (p=0.047), cyst size (p=0.047), thickened enhancing cyst walls (p=0.031), abrupt ductal caliber change with distal atrophy (p=0.026), and lymphadenopathy (p=0.019). Mural nodules≥5 mm demonstrated high sensitivity and specificity (82.4% and 80%). When patients had ≥4 worrisome features, the corresponding sensitivity (82.4%), specificity (80%), and accuracy (81.3%) in this small surgical series should be interpreted as descriptive, hypothesis-generating estimates rather than as definitive values or as directly comparable to those of high-risk stigmata. Conclusions: CT provides valuable information for not only diagnosing IPMNs but also predicting malignant potential. Mural nodules ≥5 mm and accumulation of worrisome features can help identify patients who may benefit from surgical intervention. Fulltext link
Molecular characterization and antimicrobial resistance of carbapenem-resistant Klebsiella pneumoniae and Escherichia coli at Cho Ray Hospital, Vietnam
Introduction: Due to limited treatment options, the infection of carbapenem-resistant Enterobacterales (CRE), particularly Escherichia coli and Klebsiella pneumoniae, emerges as a critically imminent global health threat. This study aimed to investigate the prevalence and molecular characteristics of carbapenemase genes in CRE isolated from Cho Ray Hospital, and to assess their associated antimicrobial resistance profiles. Methods: A cross-sectional study was conducted on 160 non-duplicate CRE isolates collected from various clinical specimens at Cho Ray Hospital. Carbapenemase production was detected phenotypically using the modified carbapenem inactivation method and genotypically confirmed by multiplex real-time PCR targeting blaOXA, blaNDM, blaKPC, blaVIM, and blaIMP. Results: K. pneumoniae accounted for 80.6% of isolates, while E. coli comprised 19.4%. The co-occurrence of blaOXA and blaNDM was the most common pattern (46.5% in K. pneumoniae). Notably, blaKPC was found in 17.8% of K. pneumoniae but not in E. coli. Colistin resistance was significantly higher in blaKPC isolates (30.4%) than blaNDM isolates (3.2%). Conclusions: The study highlights the high prevalence of dual carbapenemase gene carriage and the emergence of blaKPC at Cho Ray Hospital. These findings emphasize the importance of localized molecular surveillance and targeted infection control strategies in Vietnamese tertiary care settings. Fulltext link
Factors associated with pain management for trauma patients in pre-hospital emergency care in Ho Chi Minh City
Introduction: Trauma represents a significant proportion of prehospital emergency cases and ranks among the leading contributors to Disability-Adjusted Life Years (DALYs). Implementing pain relief interventions enhances patient survival rates, reduces disability prevalence, and ultimately improves overall quality of life. This study aims to explore the characteristics of prehospital trauma cases and factors associated with pain management in Ho Chi Minh City from 2022 to 2024. Methods: All trauma patients managed by prehospital emergency teams in Ho Chi Minh City between 2022 and 2024 were retrospectively enrolled in this descriptive study. Results: From 2022 to 2024, a total of 10,038 cases were included in the study, accounting for 20% of all emergencies handled by the prehospital emergency system. Males accounted for 61.7% of the cases, with the mean age of all trauma patients being 48 years (SD 22.3). Common injuries included limb lesion (36.3%), head injury (33.3%), and multiple trauma (9.0%). Doctors led 49% of emergency teams, and medical technicians led 20%. After excluding pre-arrival deaths or cardiac arrest cases (187 cases), 9,851 patients were included in the analysis of pain management. Pain relief was provided in 18.3% of cases, primarily NSAIDs (13.8%), paracetamol (5.5%), and opioids (1.2%). Poisson regression analysis, with a significance level of 0.05, showed higher likelihood of analgesic use among doctors as emergency team leader (adjusted prevalence ratios [aPR]=1.79; 95% CI: 1.59–2.01); for female patients (aPR=1.17; 95% CI: 1.08–1.26); limb injury presented (aPR=1.98; 95% CI: 1.80–2.17); multiple trauma presented (aPR=1.30; 95% CI: 1.14–1.49); chest injury presented (aPR=1.52; 95% CI: 1.28–1.79); and for occupational accident cases (aPR=1.18; 95% CI: 1.06–1.31), compared to other respective groups. Conversely, the rate of analgesic use was lower among patients with head injuries (aPR=0.64; 95% CI: 0.57–0.71). Conclusions: Effective pain management in patients is essential and should be promoted through appropriate interventions. Emphasis should be placed on patients with head injuries, ensuring equitable pain management across all patient groups. Fulltext link
Prevalence, colonoscopic features, and risk factors of colonic diverticulosis in Vietnamese adults undergoing colonoscopy: a cross-sectional study
Introduction: Colonic diverticulosis is common in gastrointestinal disease with a rising prevalence in Asia. Regional differences exist in prevalence, distribution, and risk factors of diverticulosis; however, data from Vietnam are still lacking. The purpose of our study was to ascertain the prevalence, colonoscopic features, and risk factors of colonic diverticulosis among Vietnamese adults undergoing colonoscopy. Methods: A descriptive cross-sectional study was performed prospectively on patients undergoing colonoscopy at the Gastrointestinal Endoscopy Department of the University Medical Center-Ho Chi Minh City. Metabolic syndrome was established on the Adult Treatment Panel III guidelines. Univariate and multivariate analyses were conducted to identify risk factors. Results: There were 480 participants, with a mean age of 53.2±12.7 years. The male-to-female ratio was 0.8. The prevalence of diverticulosis was 29.6%. Right-sided diverticulosis was observed in 69% of cases. Multiple diverticula were present in 68.4% of cases. Multivariate analysis identified advanced age (odds ratio [OR]=2.38, 95% confidence interval (CI): 1.41–4.05, p=0.001), male sex (OR=1.78, 95% CI: 1.05–3.02, p=0.033), central obesity (OR=1.61, 95% CI: 1.03–2.50, p=0.037), metabolic syndrome (OR=1.91, 95% CI: 1.12–3.27, p=0.021), and heavy alcohol consumption (OR=2.23, 95% CI: 1.03–4.84, p=0.042) as independent risk factors of diverticulosis. Conclusions: Diverticulosis was prevalent in Vietnamese, with a right-sided predominance of the colon and multiple diverticula. Advanced age, male sex, central obesity, metabolic syndrome, and heavy alcohol consumption were risk factors. Fulltext link
A review of the role of gastric ultrasound in anaesthesia planning for emergency surgery patients
Pulmonary aspiration is a life-threatening complication in emergency surgery, with a mortality rate of 6.6%. The incidence is 1 in 2,000–3,000 cases, and it occurs 4.5 times more frequently than in elective procedures. Although Rapid Sequence Induction (RSI) helps reduce the risk of aspiration, it can also increase the risk of adverse events, such as an undetected difficult airway, hypotension, and hypoxemia during induction. Identifying risk factors related to the patient’s condition, surgical impact, and effects of the anesthesia technique is crucial in planning optimal perioperative management for each patient. Gastric ultrasound is an effective tool for anesthesia planning in emergency surgery. It helps assess stomach contents, which in turn minimizes the risk of aspiration and the need for unnecessary RSI. With 95% sensitivity and 88%-95% specificity, it allows for precise risk stratification. A practical flowchart guides decisions on surgical timing and anesthesia techniques, ultimately reducing complications like aspiration and improving patient safety by tailoring care to the patient’s gastric status. Fulltext link
Cost-effectiveness analysis of the fixed-dose combination of Dorzolamide+Timolol versus Brinzolamide+Timolol in the treatment of ocular hypertension and primary open-angle glaucoma in Vietnam
Introduction: This pharmacoeconomic assessment aimed to explore the cost-effectiveness of the fixed-dose combination of Dorzolamide+Timolol (DTFC) in ocular hypertension and primary open-angle glaucoma (OH/POAG) in Vietnam. Methods: A cost-effectiveness analysis from third-party health payer perspective was designed with mixed modelling technique to simulate the long-term care for OH/POAG patients in Vietnam. With fixed-dose combination of Brinzolamide+Timolol (BTFC) as comparator, the treatment process was simulated by the decision-tree model for initial therapy and continued with the Markov model for maintenance therapy. Model parameters were derived from multiple sources, including real-world data, literature reviews and clinician consultations. Sensitivity analysis, including deterministic and probabilistic analyses, was conducted to explore the uncertainty of model outcomes. Results: Base case analysis showed that the cost of treatment for each patient by DTFC was 42,906,600 VND, and by BTFC was 43,864,938 VND, while the comparative effectiveness was not different. Costs for healthcare services and medications were the most influential factors to model outcomes. DTFC demonstrated a 51.53% probability of being cost-effective compared to BTFC at the standard willingness-to-pay threshold. Conclusion: From third-party health payer perspective, DTFC was the more cost-saving option while maintaining treatment benefits, compared to BTFC. Full text link
A case report of difficult airway management in patients with severe spinal deformity
Airway management in patients with ankylosing spondylitis (AS) poses significant anesthetic challenges, especially in advanced stages characterized by severe spinal deformities, reduced cervical mobility, and fixed flexion contractures. These anatomical limitations complicate tracheal intubation and elevate the risk of airway-related complications. We report a case of a 63-year-old male diagnosed with advanced-stage ankylosing spondylitis (AS), exhibiting a 60-degree fixed thoracolumbar kyphosis and cervical spine ankylosis. The patient who had cervical rigidity with impaired extension, underwent awake nasal intubation using flexible fiberoptic bronchoscopy. The procedure was well-tolerated, and spinal tumor resection proceeded uneventfully under intraoperative neurophysiological monitoring. This case highlights the importance of comprehensive preoperative airway evaluation and individualized planning in patients with advanced AS. Awake fiberoptic-guided intubation can offer a safe and effective approach to securing the airway in anatomically challenging cases. Full text link
A case report of pseudohypoaldosteronism type 1 initially misdiagnosed as congenital adrenal hyperplasia in a 3-month-old infant
Pseudohypoaldosteronism type 1 (PHA1) is a rare and serious disorder caused by aldosterone resistance, leading to significant disturbances in electrolyte balance. Due to overlapping clinical manifestations, it is frequently misidentified as congenital adrenal hyperplasia (CAH), resulting in unnecessary corticosteroid therapy. We reported on the case of a 3-month-old infant who had been initially diagnosed and treated for CAH due to severe salt-wasting symptoms. Further biochemical evaluation and genetic analysis later confirmed PHA1. The patient achieved clinical stabilization with fludrocortisone and sodium supplementation. This case underscored the necessity of differentiating PHA1 from CAH through repeated biochemical assessments and genetic testing to ensure an accurate diagnosis and appropriate treatment strategy. Full text link
Listening to auscultation manikins: efficacy of a single simulation training in a resource-limited setting
Introduction: Auscultation proficiency remains suboptimal among healthcare professionals, particularly in resource-limited countries. Simulation-based training is a promising measure to address this gap by offering a safe and controlled environment. This quasi-experimental study aimed to assess the efficacy of Student Auscultation Manikin II® (SAM II®)-based training and to determine the influential factors in our academic setting. Methods: A total of 370 third-year medical students (MSs) received a single 4-hour SAM II®-based training commenced with clinical rotations. To evaluate student’s performance, a test comprising 16 sounds and diagnoses was conducted at three points in time: prior to, at the end of, and at a short interval after the training. Multivariable linear regression models with intervention as a dummy variable were used to examine whether faculty qualifications and prior clinical exposure were associated with outcomes. Results: SAM II®-based training immediately improved student’s heart and lung auscultation performance with statistical significance (Median [IQR]: 5 vs. 4, p<0.001; 5 vs. 3, p<0.001, respectively). Retention rates were 96.8% for cardiac and 88.1% for respiratory auscultation, with no significant difference (p=0.109). Furthermore, our analysis revealed no correlation between their post-training competence, and educators’ qualifications or students’ prior exposure to clinical conditions. Conclusions: Our findings demonstrated the immediate efficacy of part-task trainers in enhancing and maintaining auscultation skills over short periods. Clinical faculties with adequate simulation training can instruct MS-3s as effectively as simulation experts. Nevertheless, it is imperative to conduct a comprehensive evaluation of simulator quality to ensure alignment with the learning objectives. Full text link
Discovery of potent inhibitors of NS4B protein of dengue virus type 2 from natural compounds: an in silico approach
Introduction: Dengue fever is an annual infectious epidemic disease caused by the Dengue virus, mainly found in tropical and subtropical regions. Of which, Dengue virus type 2 (DENV2) has been a major cause of severe cases globally. Currently, NS4B is one of the promising targets of dengue drug discovery, as it is crucial for the virus life cycle and highly conserved among different dengue strains. However, up till now, no potent synthetic DENV2 NS4B inhibitors have entered clinical research due to toxicity profiles. Therefore, this study aimed to search for new DENV2 NS4B inhibitors from in-house phytochemical compound database based on integration of in silico approaches. Methods: Initially, due to the lack of crystal structure of DENV2 NS4B protein, the 3D structure and binding site of this protein were predicted. Subsequently, virtual screening process was conducted through molecular docking and the most potential compounds in terms of binding affinity were selected for molecular dynamics simulations (MDs) and binding free energy calculation. Results: The flavonoid compound D155, derived from Valeriana hardwickii, and the saponin compound D170, extracted from Glinus oppositifolius, exhibited good binding affinities and bound well in the binding site of DENV2 NS4B protein. Notably, MDs study revealed that these two compounds formed stable interactions with NS4B protein during 200 ns of simulation and had a binding free energy <–20 kcal/mol. Conclusions: The findings suggested that D155 and D170 can be potential inhibitors targeting NS4B protein of DENV2. Further in vitro and in vivo studies are required to confirm their inhibitory activities. Full text link
Effectiveness of clinical pharmacist interventions on improving the appropriateness of prescription and treatment outcomes for acute myocardial infarction patients: a before-after study at a Vietnamese hospital
Introduction: Acute myocardial infarction (AMI) is a leading cause of global morbidity and mortality. Clinical pharmacist intervention offers a promising approach to improve prescription appropriateness and treatment outcomes. This study evaluated the impact of this intervention in treatment for AMI patients. Methods: A retrospective before-and-after study was conducted on all AMI patients at the Department of Interventional Cardiology, comparing two phases. The pre phase was designed without clinical pharmacist intervention (August 1, 2019, to December 31, 2019) and the post phase with the participation of clinical pharmacists in the prescription process (August 1, 2022, to December 31, 2022); with 6-month post-AMI follow-up periods in each phase. The impact of interventions was evaluated by comparing appropriateness of prescription, treatment outcomes, and adverse drug events (ADEs) between the two phases. Results: The study included 183 and 211 patients in the pre and post phases, respectively. The overall rates of prescription appropriateness were significantly higher in the post phase (85.8% vs. 48.6%, p<0.001). The mortality rates within 6 months of AMI discharge in the two phases were 18.6% and 16.5%, respectively (p=0.604). The proportions of patients who experienced ADEs were 57.4% and 56.4%, respectively (p=0.845). Clinical pharmacist interventions were associated with a higher rate of overall prescription appropriateness (OR: 6.734; 95% CI: 4.098–11.065; p<0.001). Conclusions: Clinical pharmacist interventions significantly improved the appropriateness of prescription for AMI treatment but did not reduce occurrence of mortality or ADE. Full text link
Validation of a consumer-grade wearable activity tracker for sleep measurement in Vietnamese patients
Introduction: The increasing use of wearable activity trackers (WAT) for home-based sleep assessment has raised necessity to clarify their accuracy, particularly in resource-limited settings. This study aimed to validate WAT by polysomnography (PSG) for measuring key sleep parameters—including total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), sleep onset latency (SOL), and sleep stage distribution—in a Vietnamese clinical population, with implications for primary care applications. Methods: This cross-sectional study was conducted at the University Medical Center-Ho Chi Minh City, Vietnam, from December 2023 to July 2024. Sleep data were collected from 47 patients undergoing overnight PSG while simultaneously wearing a WAT. Sensitivity, specificity, and accuracy in detecting sleep versus wakefulness were assessed using epoch-by-epoch comparisons. Bland-Altman analysis was used to evaluate the agreement between WAT and PSG measurements, with mean differences and limits of agreement calculated for each sleep parameter. Results: The WAT demonstrated high sensitivity (93%) but low specificity (44%) and an accuracy of 79% in identifying sleep versus wakefulness when compared to PSG. No significant differences were found between the two devices in measuring TST , SE, SOL, and sleep stages. However, the WAT significantly underestimated WASO compared to PSG (p=0.011). Conclusions: The results are promising, but further confirmation in larger studies is required to confirm the utility of WAT in primary care settings in Vietnam. Full text link
Carbapenem resistance and carbapenemase classification of Enterobacteriaceae in intensive care unit: a cross-sectional study
Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) poses a significant challenge in treating infections, leading to increased mortality and healthcare burden. Early and accurate identification of CRE is crucial for appropriate antibiotic selection. This study aimed to evaluate the prevalence of CRE isolated from ICU patients and carbapenemase gene profiles among Klebsiella pneumoniae isolates. Methods: A cross-sectional study was conducted on Enterobacteriaceae isolates from 53 ICU patients from March to May 2023. Among 125 initial isolates, 89 non-duplicated Enterobacteriaceae strains were included. Carbapenem resistance was determined from Kirby-Bauer disk diffusion susceptibility testing results. Carbapenemase-producing phenotype and carbapenemase classification were classified from BD Phoenix M50 results using the NMIC-500 CPO panel. Carbapenemase-encoding gene were identified from amplification results of carbapenemase-encoding genes in K. pneumoniae strains using multiplex real-time PCR. Results: Of 89 isolates, 51 (57.3%) were carbapenem-resistant, predominantly K. pneumoniae (34/48, 70.8%) and Serratia marcescens (12/13, 92.3%). All isolates were carbapenem-resistant due to carbapenemase production. Class D carbapenemase was the most prevalent (39/51, 76.5%). Among K. pneumoniae isolates, 12/34 harboured single carbapenemase genes: blaOXA-48-like (17.7%), blaKPC (14.7%), and blaNDM-1 (2.9%); Sixteen isolates carried two genes: blaNDM-1 +blaOXA-48-like and blaKPC+blaOXA-48-like; Three isolates possessed three genes: blaKPC+blaNDM-1+blaOXA-48-like. Multiple gene carriage was significantly associated with increased antibiotic resistance (p<0.01). Conclusions: This study revealed a high prevalence of carbapenemase-producing, CRE. This significantly increased the risk of spreading multidrug-resistant pathogens. Therefore, stronger infection control measures are in demand. Additionally, automated susceptibility testing and carbapenemase class identification are crucial for guiding treatment decisions. Full text link
Prevalence of hypertension and its related factors among K’Ho ethnic group from 25 to 64 years old at Lien Dam Commune, Di Linh District, Lam Dong Province: a cross-sectional study
Introduction: Hypertension is a major global health concern and a leading cause of preventable mortality. In Vietnam, ethnic minority groups such as the K’Ho may face elevated hypertension risks due to unique cultural practices and socioeconomic disparities. However, little is known about the burden and determinants of hypertension in this population. This study aimed to determine the prevalence of hypertension and examine associated factors among the K’Ho ethnic group in Lien Dam commune, Lam Dong Province. Methods: A cross-sectional study was conducted among K’Ho adults aged 25–64 using a multistage cluster sampling method. Data were collected through structured interviews and physical examinations. Hypertension was defined according to the 2022 Vietnam National Heart Association recommendations. Multivariable logistic regression was performed to identify factors associated with hypertension. Model diagnostics, including multicollinearity, Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), and Area under the ROC curve (AUC), were used to evaluate model performance. Results: Among 328 participants, the prevalence of hypertension was 31.7%, higher than the national average. The final multivariable model retained seven predictors, showed good model fit and discriminative performance. Significant risk factors included increasing age, overweight/obesity, high sodium intake, binge drinking, and family history of hypertension. Notably, individuals affiliated with Protestantism had significantly higher prevalence of hypertension compared to Catholics. Conclusions: Hypertension is highly prevalent among the K’Ho ethnic minority, underscoring the need for targeted public health interventions. Prevention strategies should focus on promoting healthy lifestyles, reducing alcohol and sodium intake, encouraging weight control, and prioritizing early detection, especially among those with a family history of hypertension. The potential influence of religious affiliation on health behaviours warrants further culturally sensitive investigation. Full text link
Source-specific PM2.5 pollution and respiratory health impacts in an urban Asian district: a real-time monitoring study in Ho Chi Minh City, Vietnam
Introduction: Fine particulate matter (PM2.5) is a pressing public health challenge in rapidly urbanizing Asian cities. In District 5 of Ho Chi Minh City, Vietnam, localized PM2.5 pollution arises from diverse sources such as stationary street food vendors, religious temples, traffic congestion, and fuel stations. Understanding the relative contribution of these sources is critical for designing effective interventions. This study aims to identify and quantify the contributions of specific local PM2.5 sources to respiratory health outcomes among residents in District 5, Ho Chi Minh City. Methods: We conducted a source-specific assessment of PM2.5 exposure and its association with respiratory health outcomes using a real-time sensor network (Airbeam3) deployed at seven sites representative of key emission sources. A total of 184 participants were recruited for the study, including residents living near various PM2.5 sources. Respiratory symptoms were evaluated through a locally adapted American Thoracic Society questionnaire (ATS-DLD-78). Multivariable regression models were used to quantify the impact of specific sources on reported symptoms. Results: Stationary street-food vendors and traffic congestion were identified as dominant contributors to PM2.5 pollution. Residents living near continuous traffic and stationary street vendor areas experienced significantly higher rates of sputum production. Stationary street-food vendors exhibited the strongest association with adverse outcomes (β=0.47, p<0.001). Conclusions: Our findings highlighted the urgent need for targeted air pollution control strategies in complex urban environments. Interventions such as cleaner cooking technologies and improved traffic management may significantly reduce PM2.5 exposure and its health burden. This study demonstrates the utility of low-cost, real-time monitoring for guiding public health policies in rapidly developing megacities. Full text link
Lynch syndrome in Vietnamese patients with colorectal cancer: prevalence and clinicopathologic characteristics from a single-center study
Introduction: Lynch syndrome (LS) is the most common hereditary cause of colorectal cancer (CRC), but the prevalence and clinical characteristics of this disorder among Vietnamese patients remain underreported. This study estimated the prevalence and described the clinical characteristics of LS in a hospital-based population in Vietnam. Methods: A cross-sectional study on prospective data was conducted at the University Medical Center, Ho Chi Minh City (2022–2024), including 190 CRC participants underwent panel genetic testing for LS-associated genes (MLH1, MSH2, MSH6, PMS2, EPCAM). Results: LS was diagnosed in 12/190 patients (6.3%); the prevalence for MLH1, MSH2, MSH6 mutations was 3.7%. The most frequent mutations were in MSH2 (25%) and PMS2 (33.3%). LS patients were significantly younger (49.7±14.5 vs. 60.3±12.1 years, p=0.004), with 50% diagnosed before 50-year-old. Right-sided tumours were more common (58.3%). Most LS cases were in stage 3 (50%), and 58.3% had no family history of CRC. Conclusions: The LS prevalence in Vietnamese CRC patients was higher than expected, particularly for PMS2 mutations. 58.3% of LS patients had no family history, and 50% wer xe aged ≥50 years, suggesting potential false negatives according to traditional screening criteria. Expanding genetic testing to older patients and those without a family history could improve LS detection and management. Full text link
Parotitis overview: an integrated approach from classification to treatment strategies
Parotitis is the inflammation of the largest salivary gland, with diverse aetiologies including infections, autoimmune disorders, and mechanical obstructions. The lack of a standardised classification system, along with varied clinical manifestations, poses significant challenges in diagnosis and management. This review aimed to provide a comprehensive overview of the classification, diagnostic methods, and treatment strategies for parotitis, focusing on both acute and chronic forms. A literature review was conducted using PubMed and Google Scholar up to January 2025. Inclusion criteria were English-written studies on human subjects related to parotitis, covering classification, diagnostic methods and treatment strategies. Data were extracted and synthesized to highlight current practices. Parotitis features 5 subtypes, namely: (1) acute viral, (2) acute suppurative, (3) sialolithiasis-associated, (4) chronic non-neoplastic, and (5) chronic neoplastic. Diagnostic tools include clinical evaluation, imaging (ultrasound, computed tomography, magnetic resonance imaging, sialography), and sialendoscopy. Treatment ranges from conservative management to minimally invasive procedures, with surgery reserved for severe cases. Accurate classification and diagnosis are key to the effective management of parotitis. Advances in imaging techniques and sialendoscopy have significantly improved diagnostic accuracy and treatment outcomes. Implementing a standardised approach can optimize patient care, reduce recurrence rates, and prevent complications. Full text link
Assessment of outcomes of emergent stenting in vertebrobasilar occlusion stroke: a single experience in a comprehensive stroke centre
Introduction: In acute posterior circulation strokes, vertebrobasilar occlusions are typically associated with poorer outcomes than anterior circulation strokes. Previous trials had an overall mortality rate of 37%. However, few studies have addressed the benefit and safety of the emergent stenting in the successful recanalization at these complex occlusions. We studied whether clinical outcomes improved three months after the procedure. Methods: A retrospective analysis of acute vertebrobasilar occlusions patients who received emergent stenting was performed at our hospital. The vertebrobasilar occlusions comprised of tandem occlusions (defined as severe stenosis or occlusion of the vertebral artery ostium concomitant with the basilar artery occlusion) and isolated occlusions. Clinical and functional features and complication rates were recorded. The primary objective was the variation in clinical outcomes as measured by modified Rankin Scale (mRS) score at 3 months. Results: We conducted a retrospective study of a prospectively maintained database with 56 patients, however only 38 patients were eligible with major vessel occlusion in posterior circulation who underwent mechanical thrombectomy between December 2020 and November 2023. Although all patients had successful recanalization (modified treatment in cerebral infarction [mTICI]≥2b), there was only one (2.6%) patient experienced symptomatic intracranial hemorrhage. At three months following emergent stenting in vertebrobasilar occlusion stroke, 25 (65.8%) patients had a favorable outcome (mRS≤3). 22 (57.9%) patients had good outcomes (mRS≤2), with 5 (13.2%) tandem and 17 (44.7%) isolated lesions. Conclusions: While this study provides preliminary insights into the role of emergent stenting in the vertebrobasilar occlusions stroke, its retrospective approach, small sample size, lack of a control group, and potential selection bias limit the generalizability of findings. Full text link
Episiotomy incidence and decision-making factors: a prospective descriptive study at a maternity hospital in Vietnam
Introduction: Episiotomy, a perineal incision performed to expand the birth canal and expedite labor, is typically done based on the birth attendant’s assessment. This study aimed to investigate the incidence of episiotomy in vaginal deliveries and to explore the factors that influence clinical decision-making at Hung Vuong Hospital. Methods: This prospective descriptive study included 384 vaginal delivery cases from labor onset to hospital discharge between March and May 2023. Data on medical history, pregnancy, labor, postpartum details, and neonatal outcomes were collected. Birth attendants were surveyed post-delivery regarding their decision-making. Descriptive statistics summarized participant characteristics. Univariate and multivariate logistic regression models were used to identify factors associated with episiotomy. Statistical analyses were performed using Stata 14, with significance set at p<0.05. Results: Episiotomy was performed in 208 cases (54.2%). The most common reasons for conducting or avoiding episiotomy were perineal elasticity, parity, fetal condition, labor progression, and instrumental vaginal delivery. Episiotomy was strongly associated with a history of vaginal delivery (aOR 0.06; 95% confidence interval [CI] 0.03–0.10), full-term pregnancy (aOR 3.59; 95% CI 1.43–9.03), and deliveries attended by private doctors (aOR 2.38; 95% CI 1.23–4.60). No cases of obstetric anal sphincter injury (OASIS) were recorded. Maternal outcomes included a higher degree of perineal tear (aOR 219.61; 95% CI 81.03–595.20), while neonatal outcomes showed no significant differences (p>0.05). Conclusions: The incidence of episiotomy (54.2%) remained greater than the WHO-recommended rate of 10%. This study outlined the important factors driving episiotomy decisions, emphasizing the need for evidence-based, individualized practice. Full text link
Factors associated with self-care practices in postoperative colorectal cancer patients undergoing chemotherapy
Introduction: Self-care practices are essential for helping patients undergoing adjuvant chemotherapy after colorectal cancer surgery in managing and coping with the common side effects of treatment. However, these practices can be influenced by various factors. Identifying these factors is crucial, as it enables healthcare providers, particularly nurses, to design and implement interventions that can improve patients’ self-care abilities and overall quality of life. Methods: A descriptive analytical cross-sectional study was conducted on 200 postoperative colorectal cancer patients receiving adjuvant chemotherapy at Cho Ray Hospital, who were interviewed directly using a structured questionnaire between April and August 2023. Participants who met the inclusion criteria and provided consent were included in the study. Results: The mean age of the patients was 57.8±11.4 years, with 65% being male, and 64% had been undergoing chemotherapy for less than six months. The proportion of patients practicing good self-care was 24%, indicating that the rate of effective self-care practices remained low. Multivariable logistic regression analysis revealed independent associations, showing that employed patients and those with higher education levels were more likely to engage in good self-care practices (Employment: OR=4.05, 95%CI: 1.82–10.1, p=0.045; High school: OR=9.72, 95%CI: 3.62–9.62, p=0.001; University: OR=5.38, 95%CI: 3.46-35.3, p=0.008). Additionally, patients with better knowledge and the ability to meet their basic needs were more likely to practice good self-care (Chemotherapy and self-care knowledge: OR=3.01, 95%CI: 1.80–5.04, p<0.001; Ability to meet basic needs: OR=5.31, 95%CI: 1.71–16.5, p=0.004). Conclusions: The rate of effective self-care practices among patients remained low. Interventions to improve self-care should consider factors such as employment status, level of education, family history of cancer, duration of chemotherapy-related side effects, knowledge of chemotherapy and self-care, and the capacity to meet basic needs to effectively enhance self-care behaviors. Full text link
Fabricating a low-cost 3D printed transparent temporal bone model for anatomy teaching in medical education
Introduction: The intricate anatomy of the human temporal bone poses challenges for medical students in achieving a comprehensive understanding. Additionally, the avaibility of temporal bones from cadavers is limited, and specimen processing is costly. Therefore, we aimed to describe the process of 3D reconstruction and the manufacturing of an assemblable temporal bone model from computed tomography scan images for anatomical study using cost-effective 3D printing techniques. Methods: The three-part 3D model of the right healthy temporal bone of an anonymous patient was segmented and edited using 3D Slicer and Meshmixer software. The facial nerve, vestibulocochlear nerve, and labyrinth were hollowed out. Vat photopolymerization-based 3D printing technology, utilizing transparent liquid resin, was employed to print the model at 200 percent of its actual scale. The model then underwent post-processing with ultraviolet (UV) light and the attachment of magnets. The hollowed structures were injected with dye to improve visualization. Finally, two layers of glossy paint were applied to the model’s surface to enhance transparency. Results: The finished model featured three transparent, assemblable parts that facilitated the detailed observation of internal structures. The model clearly demonstrated the anatomical relationships between the ossicles, labyrinth, three segments of the facial nerve, internal carotid artery, and mastoid air cells, each in distinct colors. Conclusions: We successfully created a physical temporal bone model employing low-cost resources that are easily accessible in low- and middle-income countries. It can supplement other teaching modalities in the study of temporal bone anatomy. Full text link
Apoptosis induction of the rosmarinic acid-loaded mesoporous organosilica nanoparticles on gastric cancer cells
Introduction: Rosmarinic acid has anticancer properties because it inhibits cell growth and induces apoptosis. However, its stability is significantly diminished in the acidic environment of digestive system. Although encapsulation of rosmarinic acid with nanoscale materials is required to increase its bioavailability, the anticancer activity must be maintained. We have previously synthesized a new form of organosilica nanoparticle that could efficiently load rosmarinic acid in its pores, called as RA@SiNPs. These compounds were hazardous to some cancer cells, but the exact mechanism of cell death remained unclear. This study sought to determine the ability of RA@SiNPs to cause apoptosis in the AGS human gastric cancer cells. Methods: Cells were incubated with various concentrations of nanoparticles for 24 hours. Cells were analyzed after another 48 hours. Cytotoxicity was assessed using Cell Counting Kit-8 test. Cell apoptosis was determined by flow cytometry, intracellular Caspase-3 activity and DNA apoptosis ladder analyses. Abnormal cell morphologies were stained and visualized using optical microscopes. Results: Approximately 54.31±9.16% of AGS cells survived after incubation with 240 μg/mL of RA@SiNPs. The cell ratios in the early and late stages of apoptosis were 10.50±2.83% and 32.50±2.40%, respectively. The necrosis ratio was relatively low. RA@SiNPs-treated cells exhibited Caspase-3 activity, DNA damage and apoptotic cell morphological abnormalities. Conclusions: This study determined that the RA@SiNPs nanomaterial significantly reduced the viability of gastric AGS cells via apoptosis. Using safe drug delivery materials like RA@SiNPs can ensure the therapeutic effect of the drug in patients without causing inflammation. Full text link
A retrospective study of the risk factors for linezolid-induced thrombocytopenia in hospitalized patients
Introduction: Linezolid is widely used to treat multidrug-resistant Gram-positive infections, often at set doses independent of renal impairment. However, a clear exposure-response association has been established for linezolid-induced thrombocytopenia in patients with renal impairment. The purpose of this study is to assess the prevalence of thrombocytopenia and identify the risk factors for linezolid-induced thrombocytopenia in this population. Methods: A retrospective study was conducted in who had taken standard-dose linezolid for at least 7 days. Patients with apparent thrombocytopenia, abnormal baseline laboratory results, an intensive care unit stay, an estimated glomerular filtration rate (eGFR) variation of >50%, or who received blood or blood products were excluded. Thrombocytopenia was deﬁned as a 25% reduction from the baseline value. To evaluate risk factors, time-to-event analysis with Kaplan-Meier curves and Cox proportional hazards modeling were used. Results: Of the 170 patients enrolled (median age of 69.5 years), 37.1% had an eGFR of <60 mL/min/1.73 m2. Thrombocytopenia developed in 35.3% of patients, occurring at a median of 14 days after linezolid initiation. The proportion of thrombocytopenia was significantly higher in eGFR<60 mL/min/1.73 m2 group compared to eGFR≥60 mL/min/1.73 m2 group (47.6% vs. 28.0%, p<0.001). Cox modeling identified eGFR<60 mL/min/1.73 m2 (adjusted hazard ratio [aHR]=2.287, 95% confidence interval [CI] 1.328–3.907, p=0.0028) and linezolid duration (aHR=0.972, 95% CI 0.946–0.999, p=0.040) as significant risk factors for thrombocytopenia. Conclusions: Thrombocytopenia is more likely in patients with renal impairment who are taking long-term linezolid therapy. Optimizing empirical dosing and adopting therapeutic drug monitoring should be addressed to ensure efficacy and reduce this adverse event in high-risk patients. Full text link