Introduction: Auricular acupuncture (AA) is a method of Traditional Medicine that has been used for a long time to treat many diseases, including stroke. This study aimed to examine the effect of auricular acupuncture combined with electro-acupuncture and physiotherapy exercise in the motor rehabilitation of patients with ischemic stroke.

Methods: 128 patients after ischemic stroke participated in this RCT, then were randomly assigned to either the AA-study group (auricular acupuncture combined with electro-acupuncture and conventional therapy) or the CT - control group (sham auricular acupuncture combined with electro- acupuncture and conventional therapy). They were treated and monitored for six consecutive weeks. Clinical outcomes were measured using the Barthel Index (BI), Fugl Meyer Assessment (FMA), and Motricity Index (MI) scales at two-time points, including before and six weeks after initiation of the intervention.

Results: After six weeks, FMA, BI, and MI scores were significantly higher than before treatment (p < 0.05) in both groups. Specifically, the study group had a statistically significant improvement compared to the control group (p < 0.05).

Conclusions: This study shows that auricular acupuncture in combination with electro-acupuncture and physiotherapy exercise was more effective than electro-acupuncture and physiotherapy exercise in improving motor function in patients after ischemic stroke.

Introduction: Auricular Acupuncture (AA) is both a diagnostic method and a treatment used to relieve pain and alleviate addictions. The effects and biological mechanisms of AA on the human body have been increasingly observed in clinical and experimental studies based on the gate control theory and the endogenous opioids theory. The purpose of this study was to investigate changes in facial pain thresholds among healthy volunteers after applying AA to acupoints on both auricles.

Methods: This was a pilot study with a crossover randomized controlled trial design. 66 healthy volunteers with normal hemodynamic indexes were randomly assigned to one of two groups to receive AA treatment at the Shenmen point, Sympathetic point, Adrenal gland point, Jaw point, and Tooth point of either the left or right auricle (phase 1). 7 days later, participants received sham acupuncture at the same points (phase 2).

Results: In phase 1, the results showed that AA at these points in either auricle increased the pain threshold of the facial skin statistically significantly (p<0.05). No statistically significant difference was detected in the sham acupuncture phase.

Conclusions: This suggests that AA can be used as a non-pharmacological adjunct to facial pain relief.

Introduction: Measuring scales are an indispensable tool in rehabilitation interventions, especially when you want to intervene with Traditional medicine methods on post-stroke patients. Appropriate scales are a prerequisite to assessing treatment response, the degree of recovery, and the value of the intervention method. The Barthel Index (BI) is a common scale used to measure activity function (activities of daily living - ADL), while the Fugl Meyer Assessment (FMA) and Motricity Index (MI) are commonly used scales to measure motor function.

Methods: A descriptive cross-sectional study was conducted on 128 post-stroke patients with hemiplegia from March 2021 to November 2022. Spearman's test assessed the correlation of 3 scales: BI, FMA, and MI.

Results: FMA and MI significantly correlate with BI, with correlation coefficients of r = 0.659 and r = 0.748, respectively. The subdomains of FMA, including FMA-UE (upper extremity), FMA-LE (lower extremity), and MI, including MI-UE (upper extremity), MI-LE (lower extremity), TCT (Trunk Control Test), are also highly correlated with BI.

Conclusions: Research results show that scales such as FMA and MI strongly correlate with BI and can be a valuable tool to support the comprehensive assessment of motor and activity function in post-stroke patients.

Introduction: Removing the third molar is a common dental surgery that often results in swelling and discomfort, impacting the patient's wellbeing. Previous studies have shown that auricular acupuncture (AA) can effectively alleviate pain after surgery. This study aimed to assess the pain-relieving benefits of AA for patients undergoing third molar surgery.

Methods: A clinical trial using a split-mouth design and double-blind methodology was conducted at the Dental Clinic of the University of Medicine and Pharmacy at Ho Chi Minh city between March 2022 and March 2023. Participants had both sides of their third molars extracted, with one side receiving AA in combination with postoperative pain relief medication, and the other side receiving sham AA along with postoperative pain relief medication. Pain levels at 2, 24, 48, and 72 hours after surgery, and the amount of pain medication used was recorded. Additionally, any side effects resulting from the AA treatment were also evaluated.

Results: The pain levels measured by the Visual Analog Scale (VAS) decreased over time for both intervention periods after surgery, with statistically significant lower VAS scores observed in the AA time compared to the sham AA time. The amount of 500mg/tablet paracetamol used after the intervention also decreased over time for both periods. At all-time points, the amount of paracetamol used in the AA group was lower than the sham AA group. No adverse effects were reported in either group.

Conclusions: AA was effective for relieving pain after madibular third molar surgery and reducing amount of paracetamol tablets.

Introduction: Depression is a common mental disorder; however, no study has investigated adolescent and late-life depression in Vietnam, and little has been done to compare the clinical characteristics among age groups of patients with this condition in the literature. Therefore, the study aims to examine the differences in symptom presentation among adolescents, adults, and the elderly with major depressive disorder (MDD).

Methods: A total of 238 patients diagnosed with MDD according to the DSM-5, including 43 aged 10 to 17 years old, 74 aged 18 to 59 years old, and 121 aged 60 and older, were recruited in a cross-sectional study from March to August 2022 at three psychiatric clinics in Ho Chi Minh City. The eligible participant completed an epidemiological questionnaire.

Results: All participants exhibited depressed mood, and 58.8% admitted to having suicidal ideation, with an alarming rate among adolescents (72.1%). Adolescents were less likely to experience the symptoms of interest decrease, appetite problems, insomnia, fatigue, and anxious distress than these other groups (p < 0.05). The pattern of symptom profiles in depressed adults largely remained the same in the older patients, except for psychomotor retardation and concentration problems, in which the latter were less likely to exhibit these symptoms compared to the first one (p<0.001).

Conclusion: Adolescents appear to experience fewer depressive symptoms than adults and the elderly, while the two later groups show similar clinical presentations. Therefore, the differences in symptoms across age groups necessitate an individual approach and management by clinicians.

Hemoglobin A1c (HbA1c) levels in whole blood samples are commonly used to diagnose diabetes and monitor the effectiveness of glycemic control. However, there have not been many studies evaluating changes in HbA1c concentration under different storage conditions and analytical methods. The purpose of this study was to evaluate the stability of %HbA1c stored at different temperature conditions using immunoassays in order to improve the quality of HbA1c test. Whole blood samples collected from 10 healthy volunteers were anticoagulated with K2 EDTA and stored at the following temperatures: 20-25°C, 2-8°C, and -20°C. %HbA1c in human whole blood samples at each time point was determined simultaneously on Standard F Analyzer (%HbA1c-S) with reagent kit based on a reflectometry and immunoassay technology, and Erba XL640 system (%HbA1c-E) used immunoturbidimetric method, respectively. %HbA1c was assessed as stable when the difference in HbA1c level at the later time point was not statistically significant (p >0.05) compared with baseline (T0). Results showed that a positive correlation between %HbA1c-S and %HbA1c-E at T0 (r=0.9996) was observed at room temperature. %HbA1c-S was stabilized for 24 hours at 20-25°C, for 2 days at 2-8°C and for more than 1 month at -20°C. %HbA1c-E was stable for 12 hours at 20-25°C; less than 1 day at 2-8°C, and less than 1 month at -20°C. In conclusion, human whole blood samples for HbA1c determination can be stored for up to 1 month at -20°C.

Background and Aim: Carpal Tunnel Syndrome (CTS) is a common pathology that affects the quality of human life. It is essential to promote clinical intervention studies. Our initial step in this study focused on the cure for CTS and the safety of Laser Acupuncture (LA), which is a type of acupuncture uses low-level laser instead of metal acupuncture needles.

Method: This is a before-after interventional study based on a group of 38 CTS patients, ranging from mild to moderate. Intervention using LA 5 times per week for 4 weeks, using low-level laser with a continuous wavelength of 655 nm, wattage of 5 mW/point, dose of 6 J/point, and direction perpendicular to the skin surface, in 10 pressure points on the affected hand, including PC4, PC6, PC7, PC8, LI4, LI10, LI1, HT3, HT7, LU10. The change in the Symptom Severity Scale (SSS), Functional Status Scale (FSS) through the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and adverse events were monitored to assess the effectiveness and safety of LA.

Results: At the second and fourth weeks, respectively, the SSS score decreased from 28 (27-33) to 14 (14-21) and 12 (11-13); this difference was statistically significant (p<0001). Similarly, the FSS score decreased from 13 (13-15) to 8 (8-10), 8 (8-8), and the difference was statistically significant (p<0001). Following the intervention, 37% (CI 95%, 23-53%) of patients experienced complete symptom recovery and 100% experienced complete functional recovery. No side effects were noted during the treatment.

Conclusion: LA was initially shown to be safe and effective in the treatment of CTS by improving symptoms and rehabilitation.

Introduction: Hepatitis B infection has become a social burden in over the world due to its high prevalence, while the treatments still do not offer the desired effects. Literature showed that combining traditional medicine with modern drugs was able to inhibit the proliferation of the hepatitis B virus, thus making it an effective treatment. To compare the efficacy of Tenofovir monotherapy versus Tenofovir and Phyllanthus Amari combination therapy in chronic hepatitis B patients.

Materials and methods: Randomized controlled clinical trial on 200 chronic hepatitis B patients with HBeAg (+); divided into 2 groups: The combination therapy group used Phyllanthus Amari product and Tenofovir for treatment and the monotherapy group with Tenofovir.

Results: The serological, biological, and virological responses in the combination therapy group were earlier than those in the monotherapy group. Statistically significant differences in serological responses between the combination therapy versus monotherapy group were achieved from the 3rd (59% versus 33%, p=0.021) to the 18th month (99% versus 91%, p=0.029). Statistically significant differences in biochemical responses between the combination therapy versus monotherapy group were achieved from the 9th (12% versus 1%, p=0.003) to the 18th month (35% versus 21%, p=0.040). Statistically significant differences in virological response between the combination therapy versus monotherapy group were achieved from the 6th (23% versus 10%, p=0.021) to the 18th month (97% versus 88%, p=0.029).

Conclusion: The combination of Tenofovir and the Phyllanthus Amari product is more effective than using only Tenofovir for treatment in chronic hepatitis B patients with HBeAg-positive.

Introduction: To date no study has investigated speech-related social anxiety for Vietnamese adults who stutter. To carry out such a study, a culturally and linguistically relevant assessment tool is required but is not yet available. The objectives of this study were to translate and adapt the UTBAS-6 scale into Vietnamese and evaluate the validity and reliability of the Vietnamese version of the scale for use with Vietnamese adults who stutter.

Methods: The translation process included forward and backward translation, synthesis, and expert review. The final version was administered to 34 Vietnamese adults who stutter. Content validity was assessed by experts working in the field of speech and language therapy. Face validity was assessed by study participants. Convergent and divergent validities were used to determine the construct validity. Cronbach’s alpha was used to test the internal consistency and intraclass correlation coefficient to determine test-retest reliability.

Results: S-CVIs of “Relevance” and “Clarity” of the scale were in the range of 0.83-1.00, showing a high consensus of the expert panel. All participants stated that the Vietnamese version was related to stuttering and was easy to understand. The convergent validity was at 88.9% of the items, and the divergent validity was at 61.1% of the items. Alpha coefficients of three subscales and total scale were greater than 0.7. The test-retest reliability of the scales was moderate.

Conclusions: The results of the study provided preliminary information on the validity and reliability of the Vietnamese version of the UTBAS-6 scale. Further studies with a representative and larger sample size are needed to ensure the accuracy of the findings.

Introduction: Findings of experiences and impacts of stuttering on adult people who stutter (PWS) from previous qualitative studies may not be true for PWS in Vietnam, because of cultural, social, and environmental differences. Until now, there has been no study of stuttering in adult Vietnamese PWS, therefore, the aim of this study was to explore the experiences and impacts of stuttering in adult Vietnamese PWS across their lifespan and on different areas of their lives.

Methods: This is a qualitative descriptive study. Participants were recruited via the social networking site of the Vietnamese stuttering community (ECHO Vietnam). Each person was screened for developmental stuttering by an experienced and independent speech language therapist. Semi-structured interview was used for data collection. Thematic analysis was used to analyse the data.

Results: Fear of stuttering, being teased by friends, unfavorable family reactions made PWS less confident, self-isolated, thereby having negative impacts on studying, working, and social relations. Beside negative experiences, a few showed empathy and support from teachers, relatives, and friends. PWS had low access to stuttering treatment because of lacking of official information on stuttering treatment. Self-help groups have played an active role in the treatment and emotional support for PWS.

Conclusion: This study provided preliminary information about the experiences and impacts of stuttering in Vietnamese adult PWS. Further studies are needed to obtain deeper and more comprehensive information. It is necessary, through mass media, especially the internet, to provide information about treatment facilities, or organizations that PWS can join to get counseling about treatment.

Introduction: In Vietnam, gastric cancer (GC) ranks 4th in incidence and 3rd in mortality among all cancers. Most of the new GC cases in Vietnam were diagnosed at an advanced stage. Data on early gastric cancer (EGC) in Vietnam is very limited. This study aimed to evaluate the prevalence, endoscopic and histopathological characteristics of EGC among Vietnamese patients.

Methods: This is a retrospective study conducted at the University Medical Center of Ho Chi Minh City, Vietnam from January 2014 to December 2019.  Electronic medical records of patients with EGC were reviewed to collect data regarding age, gender, endoscopic findings of EGC lesions (including location, size, and their type according to the Japanese classification of gastric carcinoma), and histopathological characteristics of these lesions based on the resected gastric specimens.

Results: Among 1666 patients with GC, there were 67 EGC cases, accounting for 4.0%. All of the patients diagnosed with EGC were older than 40 years. The detection rate of EGCs gradually increased during the study period. The EGC lesions were mostly located in the antrum-incisura angularis (73.1%) with a median diameter of 1.0 cm. Regarding macroscopic types, a majority of these lesions were classified as type 0-IIc (31.3%) and type 0-IIa+0-IIc (29.9%). The most common histological type of EGC was adenocarcinoma (82.1%) and poorly differentiated type (40.3%).

Conclusions: EGCs are mainly detected in individuals aged over 40 years. EGC lesions are commonly located in the antrum-incisura angularis and have characteristic features including the macroscopic and histological types.

Introduction: Auricular acupuncture (AA) is a method for diagnosing and treating physical and psychosomatic dysfunctions by stimulating a specific point in the ear. Some studies prove that the acupoints on the pinna have a corresponding relationship to areas of the body. According to several studies, acupoints on the body may influence the temperature of the corresponding region. In our study, we surveyed the change in temperature of the skin surface at the mandibular area when using AA at the Jaw point on each side of the ear in healthy people.

Methods: A cross-over study with 35 healthy volunteers was conducted in the Acupuncture Experimental Research Lab, Faculty of Traditional Medicine, University of Medicine and Pharmacy at Ho Chi Minh City from November 2021 to May 2022. Temperatures of the mandibular area before and after using auricular acupuncture were recorded.

Results: After using AA at the Jaw point on the left, the temperature of the left mandibular area was increased statistically from that before (from 34.34 ± 0.69 to 34.76 ± 0.72). After using AA at the Jaw point on the right, the temperature of the right mandibular area was increased statistically from that before (from 34.50 ± 0.86 to 34.31 ± 0.68). No side effects were observed during the study.

Conclusions: When using AA at the Jaw point on the ear, the temperature of the mandibular area on the side of using auricular acupuncture increased statistically, showing the relationship of the Jaw point on the ear with the mandibular area.

Introduction: Covering of skin defects in the foot region endures a significant challenge because of the anatomical characteristics of soft tissue. This research estimated the initial results of reconstruction of foot skin defects using lateral supramalleolar flap.

Methods: This is a prospective observational study conducted from Dec 2017 to Dec 2021 at the Hospital for Traumatology and Orthopaedics, Ho Chi Minh City, Vietnam. Gathered information about demography, etiology, size of skin defect, size of flap, time of surgery, and post operation data. Using Stata 16.0 to analize data.

Results: Patients in this research included 21 males and 6 females. The mean age was 42 (ranging from 15 to 68) years. The range of size of skin defects was from 9 to 80 cm2. The success rate was 89%. Twenty-three cases had covered uneventful, and partial flap necrosis occurred in 4 cases (in which three patients were treated by skin graft later and one case got minor surgery suturing).

Conclusions: Foot skin defects can be covered with good results by using the lateral supramalleolar flap nourishing by the dorsal vessels anastomosis with the peroneal artery.

Introduction: Major depressive disorder (MDD) presents a diverse clinical picture, especially with somatic symptoms, which can lead to negative impacts on the course and prognosis of the illness. This study aimed to (1) assess the prevalence of various somatic symptoms in MDD patients and (2) assess their association with demographic factors.

Methods: A total of 345 outpatients diagnosed with MDD according to DSM-5 criteria were enrolled in this cross-sectional study over 6 months. Participants completed a questionnaire that included clinical and demographic information as well as the PHQ-9.

Results: There were 99.7% of patients who had at least one somatic symptom. The common somatic symptoms were fatigue (89.9%), insomnia (87.8%), palpitations (77.7%), headache (69.6%) and dizziness (61.4%). Total PHQ-9 scores and total number of somatic symptoms were found to have a regression relationship with a regression coefficient of 0.14 (t = 6.001, p < 0.001). In multiple logistic regression analysis, female gender was found to be associated with dizziness (odd ratios [OR] = 2.54, 95% confidence interval [CI] 1.53-4.21, p < 0.01), headaches (OR = 1.94, 95% CI 1.16-3.32, p < 0.05), and bowel problems (OR = 0.59, 95% CI 0.37-0.96, p < 0.05); while headaches (OR = 1.73, 95% CI 1.05-2.85, p < 0.05), and stomach problems (OR = 0.56, 95% CI 0.36-0.88, p < 0.05) were associated with age 40 and below.

Conclusions: The study findings provide a resource for clinicians in mental health settings as well as primary care clinics in detecting inexplicable somatic symptoms associated with MDD.

Introduction: Tenofovir alafenamide (TAF), a prodrug of tenofovir (TFV), is currently used for treatment of chronic hepatitis B as first line recommendation. The Vietnamese market is currently circulating a tenofovir alafenamide generic. This formulation has not been assessed for in vivo bioequivalence. This study has been performed with the aim of development, validation, and application of LC-MS/MS procedure for quantitation of TAF and TFV in human plasma.

Methods: Internal standard (IS), and analytical parameters were investigated to find out the suitable IS and conditions. Chromatographic conditions were optimized by considering the column type, mobile phase component, concentration of the buffer solutions and strength, oven temperature, flow rate, and injection volume. Human plasma samples were treated by protein precipitation with acetonitrile. The assay was validated in compliance with US-FDA and EMA guidelines. This assay was applied to evaluate the bioequivalence of the generic and reference products of 25 mg TAF in the healthy Vietnamese subjects under fed conditions.

Results: TAF, TFV, IS were ionized using ESI and detected by MRM mode to obtain molecular and fragment ions for quantification. The recovery of all analytes from human plasma was above 70%. The chromatographic conditions contained a C6-Phenyl column and mobile phase including acetonitrile and 0.5% formic acid. The specificity, precision, accuracy, matrix effect of all the analytes were in the acceptable range. Thirty six subjects finished the fed trial. The two products’ geometric mean ratios for AUC_0-t, AUC_0-∞, and C_max (80.00% to 125.00%) met the bioequivalence acceptance criteria.

Conclusions: A LC-MS/MS procedure for simultaneous quantitation of TAF and TFV in human plasma was developed, validated, applied.

A 25-year-old previously healthy female patient experienced new-onset psychosis and showed suicidal behavior after contracting COVID-19. Based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the diagnosis of an acute and transient psychotic disorder (ATPD) was appropriate. Due to poor insight into illness, the patient received an oral solution containing 2 mg/mL haloperidol and fully recovered after the first month of treatment. This is the first case of a COVID-19-associated psychotic episode showing full recovery with late intervention, which occurred nearly 45 days after exhibiting the first psychotic symptoms. Additionally, the patient would require long-term follow-up owing to an ultra-high risk of relapse.

Introduction: Neck pain is one of the leading causes of disabilities and increasing economic and social burden. Methods affecting the trigger point (TrP) have initially shown good pain relief effectiveness and decreased degree of invasion in patients. The research is conducted to evaluate the effectiveness of Electroacupuncture (EA) at TrP in chronic neck pain (CNP) treatment.

Methods: A non-blind randomized study on 125 patients with CNP at Traditional Medicine Hospital in Ho Chi Minh City from September 2020 to June 2021. Patients will be randomly classified into EA at the TrP group or EA at the meridian points group.

Results: There were 62 patients in the TrP group and 63 patients in the other group. After 4 weeks, in the TrP group, the Questionnaire Douleur Saint-Antoine (QDSA) score of 38.2 ± 2.6 decreased to 9.3 ± 5.7, compared with the meridian points group’s QDSA score of 37.8 ± 2.3 decreased to 12.3 ± 7.1. The percentage of patients to reach good pain relief effectiveness of EA at TrP measured by QDSA is 71.0%, statistically significantly higher than 47.6% of the other group. The decrease in the number of TrPs of EA at TrP is higher and has statistical value compared with EA at meridian points.

Conclusions: EA at TrP showed better pain relief effectiveness, has a higher percentage of patients reaching good pain relief effectiveness measured by QDSA, and decreases the number of TrPs more than EA at meridian points does on patients with CNP.

Introduction: Beauty need is a growing demand these days; thus, the search for non-invasive beautifying methods that effectively and safely reduce the wrinkles on the face is of great need. Thread embedding acupuncture (TEA) has been proven to be effective in rejuvenating the facial skin and consists of advantages such as little invasion, few side-effects.

Methods: The study was a single-arm pre-post study, 20 female volunteers, aged 35-60. TEA is conducted on Daying (ST5), Jiache (ST6), Dicang (ST4), Yingxiang (LI20), and Hegu (LI4) with mono-filament Polydioxanone (PDO). The participants were monitored and evaluated after 1, 2 and 3 months. The variables are Nasolabial fold (NF), Marionette line (ML), Alexiades-Armenakas laxity scale (AALS), Global aesthetic improvement scale (GAIS).

Results: Both sides NF, ML and AALS after 1 month TEA, 2 months TEA, 3 months TEA compared to pre-intervention showed decrease of statistical significance. NF, ML of both sides after 1 month TEA, 2 months TEA compared to the previous 1 month showed decrease of statistical significance. However, after 3 months, compared with 2-month threshold, difference has no statistical significance. AALS after 2 months and 3 months TEA, differences have no statistical significance. There were 17 persons “improved” (85%), 3 persons “unchanged” (15%) according to GAIS. No side effect of any kind was recorded.

Conclusions: This research proved TEA method is effective on the acupuncture points that the research used in facial wrinkle reduction treatment. However, a RCTs (Randomized Controlled Trial study) is needed to confirm effectiveness.

Background: CAFs (cancer-associated fibroblasts) and tumor-associated p-EMT (partial epithelial mesenchymal transition) cells coexist and contribute to the formation of epithelial tumors like OSCC (oral squamous cell carcinoma). In oral cancer, Wnt signaling pathway contributes to the tumor progression, invasion and metastasis. Here we deeply analyzed Wnt signaling pathway using our previous single-cell RNA-seq data of CAFs and p-EMT tumor cells in OSCC by computational methods.

Material and methods: Integrated single-cell RNA sequencing data of OSCC CAF and p-EMT clusters were obtained from our previous study. These cells were from samples being primary tumor, oral cavity location, metastasis information and then analyzed by R, Python to investigate the gene expression, cell-cell communication, gen set enrichment analysis (GSEA) and overall survival analysis across metastasis conditions regarding Wnt signaling pathway.

Results: Genes related to Wnt signaling pathway upregulated in CAFs and p-EMT cancer cells, especially under metastasis condition including WNT2, WNT5A, FZD1-4, ROR2 in CAFs, and WNT7B, FZD2/5/6 in p-EMT cells. Cell-cell interaction analysis and GSEA in CAFs and p-EMT tumor cells highlighted non-canonical Wnt signaling pathway in CAFs and canonical Wnt signaling pathway in p-EMT tumor cells. CTHRC1 and SFRP2 were suggested as biomarkers in Wnt signaling pathway of CAFs from the gene expression, GSEA and overall survival analysis.

Conclusion: Our study found CTHRC1 and SFRP2 as biomarkers for HSCC and OSCC prognosis belong to CAFs of TME. It might pave the way for targetable treatment based on WNT ligand-receptor interaction and Wnt signaling modulation in OSCC CAFs based on metastatic status.

Introduction: People with drug-resistant epilepsy (DRE) are at high risk of sudden unexpected deaths and lower quality of life. Experiments showed thread embedding acupuncture (TEA) has a seizure-reducing effect; however, data on DRE has been limited. This trial aimed to establish the efficacy and safety of TEA in people with DRE.

Method: This was a two-arm, randomized controlled trial conducted on 30 DRE outpatients, which was fulfilled drug-resistant International League Against Epilepsy. The study was conducted at the Epilepsy clinic, Nguyen Tri Phuong Hospital, Ho Chi Minh City, from December 2020 to March 2022. All procedures for TEA and sham TEA (STEA) groups were identical. Seizure frequency diaries at the baseline and monthly follow-up visits by the participants. The Quality of Life in Epilepsy Inventory (QOLIE-31) scores at the baseline and 16 weeks; the National Hospital Seizure Severity Scale (NHS3) scores at the baseline, 8 weeks, and 16 weeks and the adverse events at monthly follow-up visits by a researcher.

Results: A reduction in relative seizure frequency and the score change in QOLIE-31 and NHS3 in the TEA group were significantly different from the STEA group when analyzing each group separately (p<0.05). However, when comparing two groups, no significant difference was found in the change in seizure freedom and QOLIE-31 (p>0.05). Mild pain appeared in all participants after the intervention, but no serious adverse effects of TEA were observed.

Conclusion: TEA is a safe technique to use in people with DRE. However, the effectiveness of TEA needs further study. 

Introduction: Due to the surge of the post-COIVD-19 patients, numerous publications were recently presented, including applying Traditional Chinese medicine (TCM) in accelerating recovering pace. However, most TCM studies mainly focused on interventions and their effect on the patients. In the general characteristic of the post-COVID-19 syndrome in TCM, this study identified the relationship between post-COVID-19 syndrome and cold–heat patterns, one of the essential principles of the Eight Principles in TCM.

Method: We established a cross-sectional study on 384 participants at University Medical Centre HCMC - branch No.3 and the faculty of Traditional medicine, UMP, from January 2022 to April 2022 (including outpatients, inpatients, and students). A questionnaire was built to collect data on socio–demography, post-COVID-19 status, and cold-heat patterns. Cold-heat patterns were gathered based on the “Cold and heat patterns identification questionnaire” developed by Yeo M et al. (2016). All eligible participants were free to choose a suitable interview method, including by phone, by URL link, or by face-to-face interview.

Result: We enrolled 384 eligible patients, and 17 samples were removed due to missing. The median age was 33 (24 - 42) and the median BMI was 21.97 (19.78 – 23.88), and females took up to 62%. We found the relationship between gender and cold-heat pattern with post-COVID-19 status (p<0.05).

Conclusion: The relevance of post-COVID-19 status and cold–heat patterns took the first step in comprehensively observing general TCM characteristics of the post-COVID-19 syndrome. 

Introduction: Enteric duplication cysts found throughout the alimentary tract are rare congenital mass lesions, which usually share a common wall with the gastrointestinal tract. However, many cases of isolated enteric duplication (IED) cysts, reported in the literature, are without any attachment to the gastrointestinal tract. We report a case of an IED cyst located in the transverse mesocolon, which was successful treatment with laparoscopy, in Children’s Hospital #1, Ho Chi Minh City, Vietnam.

Case presentation: A girl turned 3 years old presented with dull abdominal pain and vomiting. Abdominopelvic computed tomography revealed a lesion located around duodenojejunal flexure with a thick wall. Laparoscopy detected a mobile cystic mass found on the mesentery of the transverse colon, which was not connection or attachment to any part of the adjacent intestine. Histopathology of the cyst wall was compatible with an EDC.

Conclusion: The IED cyst is an unusual phenomenon that confuse with other diagnosis in clinical. The definitive diagnosis of IED is based on histopathology. Laparoscopic resection of the cyst is the preferred treatment. 

This study was conducted to build an early forecast model for the dengue epidemic using an artificial neural network (ANN) in Vung Tau City in Ba Ria - Vung Tau province. Weather factors (temperature, precipitation, humidity, wind speed) were all correlated with the number of dengue cases (p<0.05) in the 1/2010 - 12/2020 period. The ANN is a simulated information processing model based on the activity of the organism's nervous system, consisting of a large number of neurons mounted to process information. Of all the models we built, the ANN 10-7-1 model gave the best results with a total squared error (SSE) and relative error (RE) during network training of SSE=25.23, respectively; RE=0,58; correlation coefficient R2 =29.1%. The model showed that the number of dengue cases have marked tendencies to increase to increase or to decrease, also the forecast data was almost accurate compared to the actual number of dengue cases. The ANN can be applied to predict future dengue outbreaks in Vung Tau City. To increase the accuracy of the ANN model, it needs to be combined with other factors such as housing index, mosquito density, population,... 

Introduction: Some previous studies have shown the effect of K2EDTA, heparin, citrate, kalioxalate on lipid test results [1,2,3], but no studies on sodium fluoride - potassium oxalate. Furthermore, it is also important to ensure sample stability during testing. We performed this study to evaluate the effect of NaF-KOx on lipid results and lipid stability when storing.

Methods: A cross-sectional study was conducted on the residual of 150 pairs of serum and NaF-KOx plasma samples from the patients at the University Medical Center 2. These patients participated voluntarily after signing the consent form. We divided the samples into groups: serum (group 1), unpreserved plasma (group 2); stored plasma for 24 hours at 2-8°C (group 3), and stored plasma for 48 hours at 2-8°C (group 4). All samples were analyzed on an AU480 system – Beckman Coulter. The data would be processed using Stata 10.0.

Results: The results difference between these groups: 2,3,4 compared to group 1 was statistically significant (p < 0.001). Total cholesterol, triglycerides, HDL-C, and LDL-C concentrations in group 2 decreased, respectively: 5.83%; 6.77%; 5.12%; 5.96%. We found the lipid test results of group 3 and group 4 also reduced compared to group 1: cholesterol decreased by 5.25%, 5.77%; triglycerides by 6.7%, 6.49%; HDL-C by 5.8, 7.22%; and LDL-C by 4.79%; 5.05%. After 48 hours, cholesterol, HDL-C, and LDL-C concentration continued to reduce, while the difference in triglycerides concentration was not statistically significant.

Conclusions: NaF-KOx anticoagulant reduces lipid test results. We should not use NaF-KOx plasma to measure lipid tests. 

Background: As we know, sleep is very important and necessary for every person. Especially, among patients undergoing surgery as an effective form of treatment, they also need a good quality of sleep to restore both physiological and psychological health. However, poor sleep quality is common in patients after surgery and produces harmful effects on postoperative recovery.

Objectives: This study was conducted to investigate the quality of sleep and identify related factors among postoperative patients at the Department of General Surgery, Tay Nguyen Regional General Hospital, Dak Lak Province.

Methods: A cross-sectional descriptive study was performed. 374 postoperative patients who meet the sampling criteria were recruited by simple random sampling between March and July 2021. General information data were collected through interviews with structured questionnaires, and the patient's sleep quality was assessed by using the Pittsburgh Sleep Quality Index (PSQI) Vietnamese version. Data analysis was performed via SPSS ver 20.0; p < 0.05 was statistically significant.

Results: The average mean of PSQI score was 10.3 ± 3.27 (range = 0 -21, SD = 3.27). The percentage of postoperative patients who had poor sleep quality was 78.1%. Factors associated with poor sleep quality include old age (p < 0.01), education level (p < 0.05), level of postoperative pain (p < 0.001).

Conclusions: The frequency of poor sleep quality among postoperative patients is high. The findings of this study also provide a better understanding of related factors that affect poor sleep quality. So, the nurses should develop an appropriate care plan to improve sleep quality in these patients by controlling the above factors. It will help these patients recover fastest and most comprehensively in the postoperative period, enhancing the quality of care. 

Background: Internet addiction and poor sleep quality are two types of common mental health disorders among high school students. This study was conducted to determine the prevalence of poor sleep quality and its association with internet addiction in high school students.

Methods: A cross-sectional study was conducted on 820 high school students in Dong Hoa town, Phu Yen province in April 2021. The students were requested to fill out a structured questionnaire. internet addiction was evaluated by the short version Internet Addiction Test (s-IAT). The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.

Results: The prevalence of poor sleep quality was 33.5% among high school students. The proportion of students with internet addiction evaluated by the s-IAT was 21%. The association between internet addiction and poor sleep quality remained statistically significant with p<0,001 (OR=2.98, 95% CI: 2.05-4.34) after adjusting for potential confounding variables.

Conclusion: The proportions of internet addiction and poor sleep quality were high and there was an association between them. Students should not use the internet after 9 pm and should spend at least 8 hours each night on sleep. 

Background: A mental disorder is a state of mental health deviance in a period and leads to the disruption of a body’s self-balance. Adolescence is a period of many psychophysiological changes, and several factors which are related to personal characteristic, family and school could adversely affect a child's mental well-being. The objectives of the study were to determine the prevalence of mental disorders and ascertain some associated factors in middle school students (ages 12-15) in Tuy Hoa city, Phu Yen province, Viet Nam 2021.

Materials and methods: A cross-sectional study was conducted from March to April on 539 students and parents at middle schools in Tuy Hoa city, Viet Nam in 2021. Parents were requested to complete the Strengths and Difficulties Questionnaire (SDQ).

Results: The prevalence of having mental disorders in middle school students was 22.7%. The difference between the prevalences of having mental disorders in male and female students was statistically significant (p=0.014), grade lever (p=0.020), conduct (p=0.040), concern from parents (p=0.046), family conflicts (p=0.029), being scolded for making mistakes by parents (p=0.004) and being bullied by classmates (p=0.045).

Conclusion: Experiencing mental disorders was relatively prevalent among middle school students. Some factors which were related to family and school environments were found associated with psychiatric disorders. Therefore, interventions and cooperation from parents and school officers are essential to mitigate students' sufferings caused by mental health problems, promote psychological well-being, or preclude psychoses from occurring. 

Introduction: Despite many medical advances, acute lower gastrointestinal bleeding in Asia has been increasing gradually and has resulted in substantial mortality. The study aimed to describe the clinical characteristics, interventions, and outcomes of acute lower gastrointestinal bleeding in Vietnamese people.

Methods: A multicenter cohort study was prospectively and retrospectively conducted in patients presenting with acute lower gastrointestinal bleeding in Vietnam. Severe lower gastrointestinal bleeding was defined as persistent bleeding within the first 24 hours and/or recurrent bleeding after 24 hours of stability accompanied by a reduction in hematocrit of ≥ 20% and/or transfusion of ≥ 2 units of red blood cells. The clinical characteristics, interventions, and adverse outcomes were recorded.

Results: There were 811 patients with a male: female ratio of 1.07 and a mean age of 61 years. A total of 85.6% of patients presented with hematochezia. The common causes of acute lower gastrointestinal bleeding were hemorrhoids (28.6%), diverticulosis (9.7%), and unknown origin (16%). The rates of blood transfusion, endoscopic therapy, radiologic intervention, and surgery were 39.8%, 8.6%, 0.5%, and 7.3%, respectively. Severe lower gastrointestinal bleeding was observed in 222 (27.4%) patients. In-hospital deaths were recorded in 17 (2.1%) patients. The majority of in-hospital deaths were due to unstable comorbidities.

Conclusions: Hemorrhoids were the most common cause of acute lower gastrointestinal bleeding. The rates of blood transfusion, endoscopic hemostasis, interventional radiology, and surgery were 39.8%, 8.6%, 0.5%, and 7.3%, respectively. A total of 27.4% of cases progressed to severe bleeding. 

Background: Early diagnosis is key in testicular torsion. This study is to validate the diagnostic value of the “Testicular Workup for Ischemia and Suspected Torsion (TWIST)" score for evaluating acute scrotum in children.

Methods: Patients from 1 month old to 16 years old presented to Children’s hospital No.1 with acute scrotum between June 1 st, 2020, and May 31 st, 2021 were prospectively studied. General surgeons performed an examination and recorded signs and symptoms in the collection form. After that, all patients had Scrotal Doppler Ultrasound (DUS). We calculated the sensitivity, specificity, positive predictive, and negative predictive values of the TWIST score. The ROC curve was used to find out the optimal cut-off in diagnosing Testicular torsion (TT) in Children.

Results: Among 68 children with acute scrotum, 16 cases had TT (23.5%). The median age was 12.5 years in the TT group and 9 years in the non-TT group. None of 32 patients with the TWIST score ≤ 2 had TT and among 20 patients with a score of 3 – 4, only one had TT. More importantly, in the high-risk group with a score ≥ 5, 15 had TT (93.8%). ROC curve revealed an AUC of 0.987 (p<0,001) representing a high diagnostic value. The sensitivity and specificity for TT at 5-point cut-off were 93.7% and 98.1%, respectively.

Conclusions: The TWIST scoring system has high sensitivity and specificity values. Therefore, it should be used as a useful tool for the diagnosis of testicular torsion. The score ≥ 5 is an indicator of testicular torsion, hence emergency surgical intervention is required. 

Introduction: Pediatric gastric adenocarcinoma (GAC) is sporadic with limited relevant data, and gastric adenocarcinoma, which presents as submucosal, has seldom been reported. The clinical presentation and outcome have not yet been thoroughly understood.

Case presentation: Two boys (10 and 14-year-old) were admitted to the hospital with severe malnutrition. Abdominal CT demonstrated the tumor protruding into the stomach, irregular border, and peritoneal metastasis. Gastric biopsies showed pleomorphic cells, variable size, and increased N/C ratio. These cells were arranged into sheet growth patterns, clusters of cells or incomplete tubules with neutrophils infiltrating. The malignant cells showed strong expression of CK, negativity for CD99, NSE, myogenin, CD3, CD20, ALK, and CD30. Both cases were consistent with poorly differentiated gastric adenocarcinomas, diffuse type with lymphovascular invasion.

Discussion and Conclusion: Pediatric GAC presented with a more advanced stage and poor differentiation. However, the clinical presentation is similar to adult GAC. Because of data limitations, the diagnosis and treatment of pediatric GAC remain a significant challenge. GAC should be kept in mind, especially when a submucosal tumor-like lesion appears in the stomach. Additional molecular investigations, including E-cadherin or HER2 testing of the tumor samples, may offer more treatment choices for these patients. 

Introduction: Lactobacillus brevis NB10 isolated from human saliva, showed in vitro effect on inhibiting the growth and the biofilm formation of Streptococcus mutans - a major pathogen that initiates dental plaque and caries. Formulation of chewing gum containing L. brevis NB10 is the next step in using this probiotic for the prevention of dental diseases related to S. mutans.

Methods: Cryoprotectants such as sorbitol, mannitol, xylitol, lactose, maltodextrin, skim milk and potassium ascorbate were selected to formulate the freeze-dried powder containing L. brevis NB10. Next, the freeze-dried powder of L. brevis NB10 was used to make chewing gum by direct compression method using HIG-04 gum base (Heath in Gum ®). Other ingredients such as xylitol, strawberry flavor powder, glycerin, aerosil, talc, and magnesium stearate were selected to formulate chewing gum with suitable chewing feel, taste, and flavor.

Results: The freeze-dried powder showing the highest bacterial survival rate (75.5 ± 7.6%) consists of 6% maltodextrin, 6% skim milk, and 0.25% potassium ascorbate. The optimal formula of chewing gum tablet consists of 10% L. brevis NB10 freeze-dried powder, 10% xylitol, 2% strawberry powder, 1.5% glycerol, 1.5% magnesium stearate, 1.5% talc and 2.5% aerosil. The bacterial survival rate after tablet compression is 34.34 ± 0.55 %. The product is stable for at least 3 months at 5 ºC ± 3 ºC.

Conclusion: This study was successful in formulating chewing gum containing at least 107 CFU/tablet of L. brevis NB10. 

Background and Objective: Carpal tunnel syndrome (CTS) is one of the most common neurodegenerative conditions. However, studies on the classifications and symptoms of CTS from the perspective of traditional medicine are still limited. Our study aims to identify traditional medicine disease nomenclature and symptoms of CTS by the survey form.

Methods: A descriptive cross-sectional study was conducted at The 3rd branch of University Medical Center HCMC, Thong Nhat Hospital from March 2021 to June 2021. We conducted a study survey on patients diagnosed with primary CTS and agreed to participate in the study with survey questionnaires, data were processed by using Excel 2016 and Lantern 5.0 software.

Results: 48 symptoms collected from 94 patients with CTS based on questionnaires were included in the Latent Tree Model. Compared with the medical literature review, there were 40/48 symptoms and 5 patterns appearing in the collected sample. These 5 main patterns: Blood stasis has 4 symptoms, yin deficiency has 6 symptoms, damp heat has 3 symptoms, blood deficiency has 3 symptoms and invasion of meridians of wind cold has 3 symptoms to diagnose. The results of the study have shown that the results of the algorithms are statistically significant when comparing clusters of latent variables with traditional medicine descriptions. Therefore, the use of the results of the machine has a scientific basis in terms of statistics.

Conclusion: After analyzing clinical data from 94 patients with Latent Tree Model, it was found that 5 disease patterns appeared with symptoms helping diagnose those disease patterns.

Pyoderma gangrenosum is a rare inflammatory cutaneous condition characterized by the rapid progression of painful ulcers. Pyoderma gangrenosum is usually associated with a systemic disease. A 34-year-old female with a history of ulcerative colitis presented with hematochezia and multiple leg ulcers after stopping her medication for 3 months. A diagnosis of pyoderma gangrenosum with acute severe ulcerative colitis (ASUC) was made based on the clinical characteristics of the ulcers and their histopathologic features. The patient did not respond to intravenous corticosteroid. Therefore, oral cyclosporine was prescribed. Her bowel movements returned to normal after a week. Her ulcers healed after 2 months, leaving cribriform scars. Pyoderma gangrenosum should be considered in the differential diagnosis of skin ulcers, especially in patients with an underlying systemic disease such as inflammatory bowel disease. Oral cyclosporine may be considered for the management of patients with steroid-refractory pyoderma gangrenosum and ASUC. 

Transcatheter aortic valve replacement (TAVR) through the carotid artery in middle-aged patients with severe aortic stenosis and chronic hemodialysis has been a challenge in clinical practice because of the complex technique. A 60-year-old man was admitted to our hospital because of his symptomatic severe aortic stenosis. With the high risk of open surgery due to chronic hemodialysis, TAVR was selected after an in-depth discussion between the heart team and the patient. The transfemoral access route was not appropriate due to severe calcifications and tortuous iliofemoral arteries, therefore, the left carotid route was chosen. A 29-mm CoreValve Evolut R system was successfully implanted without any complications. His symptoms significantly improved at 12- month follow-up, without any major cardiovascular adverse events. TAVR via the carotid artery thus demonstrates the feasibility, safety, and effectiveness in such complex conditions. 

Introduction: Patients undergoing orthopedic surgery are at high risk of venous thromboembolism (VTE), but the prophylactic practices are suboptimal. We aim to investigate the risk of VTE, the appropriateness of VTE prophylaxis and its associated factors in patients undergoing lower limb orthopedic surgery.

Method: A cross-sectional study was conducted at Gia Dinh People’s Hospital. Data was collected from medical records of patients aged ≥18 years undergoing lower limb orthopedic surgery between March 1st 2020 and June 30th 2020. VTE risk was stratified using the Caprini Risk Assessment Model, contraindications to anticoagulation and the appropriateness of thromboprophylaxis were evaluated according to current guidelines. Multivariate logistic regression analysis was used to determine factors associated with the appropriateness of VTE prophylaxis.

Results: A total of 217 patients was included (median age 54, 57.6% male). There were 80.2% of patients at risk of VTE. Overall rate of appropriate VTE prophylaxis was 35.0%. Patients with age ≥41, BMI >25 kg/m2, surgical duration >45 minutes, plaster cast or screw splint were less likely to receive appropriate VTE prophylaxis; patients with hospital stay >4 days after surgery got more chances to have proper VTE prophylaxis (p <0.05).

Conclusions: The majority of patients undergoing lower limb orthopedic surgery were at risk of VTE, but the rate of appropriate VTE prophylaxis was low. Factors associated with the appropriateness of VTE prophylaxis were age, BMI, surgical duration, plaster cast or screw splint, and length of hospital stay after surgery. Interventions are needed to improve the appropriateness of VTE prophylaxis. 

COVID-19 vaccines available in Vietnam have different prices, efficacies, and side effects. We studied acceptance and willingness to pay (WTP) for COVID-19 vaccines in Vietnam, using a self-designed online questionnaire. Respondents were 2093 unvaccinated adults. Multiple regression analyses identified factors associated with vaccine acceptance and WTP. Acceptance of free vaccines was around 90% for the three available in Vietnam (Astra Zeneca, SPUTNIK V, and Pfizer-BioNTech). WTP for the same vaccines was about 70%. Vaccine acceptance was associated with being female and/or chronically ill or undergoing COVID-19-related job changes. WTP was associated variously with family economic status, occupational changes due to COVID-19, chronic disease, and perceived risk of infection. Most respondents were willing to be vaccinated and many were willing to pay for it, depending on personal and family circumstances. Vietnam should budget for free vaccines to support those unable to pay. 

Background and Objectives: Adult eczema (AE) has been reported to have a poor quality of life (qoL). Auricular acupuncture (AA) is a method that has been studied a lot recently. Our study is to determine the effects of combining AA and modern medication in the relief of symptoms and the improvement in qoL in AE.

Methods: A single-blind randomized study on 65 AE at the University Medical Center Ho Chi Minh City Branch 3; was randomized into an auricular acupuncture (AA) group and a Sham acupuncture (SA) group. All AA group patients will receive AA at Lung, Shenmen, Endocrine, and Adrenal points. The score of scoring atopic dermatitis (SCORAD) and the score of dermatology life quality index (DLQI) were compared in two groups before and after treatments.

Results: There were 33 patients in the AA group and 32 patients in the SA group. After 2 weeks, in the SA group, the SCORAD score of 46.4 ± 1.3 decreased to 28.2 ± 1.2, compared with the AA group’s SCORAD score of 47.5 ± 1.5 decreased to 24 ± 1.3; the DLQI score of 14.7 decreased to 7.6, compared with the intervention group DLQI score of 15, reduced to 5.7. The difference in improving the SCORAD score and the DLQI score between the two groups was statistically significant. No patient had any adverse events during the study.

Conclusions: Combining auricular acupuncture Lung, Shenmen, Endocrine, Adrenal points, and modern medication treatment may relieve effectively symptoms and improve the QoL in AE. 

Introduction: Gonadotropin-releasing hormone agonists (GnRHa) are generally indicated in central precocious puberty (CPP) patients. We aimed to analyze the auxological outcomes of GnRHa treatment on CPP children.

Methods: A cross-sectional study with observational data were collected from 143 CPP patients who finished GnRHa therapy in Children Hospital 2, Vietnam. Anthropometry and sexual maturity rating were assessed after 6 months and each year of the therapy. The Bayley-Pinneau method was used to estimate the predicted adult height (PAH).

Results: The mean calendar age and bone age at the start of the treatment were 8.0 ± 0.7 years and 10.5 ± 0.1 years, respectively. The mean treatment period was 2.4 ± 0.6 years. GnRHa led to the regression of pubertal symptoms after treatment. The pre-treatment PAH was 157.8 ± 0.6 cm (girls) and 172.3 ± 2.4 cm (boys). The PAH at treatment discontinuation (162.0 ± 0.5 cm in girls and 176.7 ± 2.3 cm in boys) was higher than the initial PAH (p<0.05). For girls with treatment before 6 years old, GnRHa results in a predicted average gain in adult height of 10.2 ± 3.2 cm, whereas the predicted height advancement in the 6-8 age group was 5.3 ± 0.7 cm. The predicted average height gain of girls aged over 8 years was 3.2 ± 0.6 cm.

Conclusion: GnRHa therapy was effective for CPP treatment with the improvement of predicted final height. Predicted height advancement was still documented in females who started the treatment after 8 years old. 

Introduction: Group B Streptococcus (GBS) is one of the common causes of neonatal sepsis spreading from mothers to newborns. A common method to isolate and identify GBS is using Blood agar which delivers results in at least 48 hours. Although chromogenic culture media including CHROMagarTM StrepB, can develop colored colonies for detecting pathogenic bacteria easily, there has not been approached GBS isolation in Vietnam. This study was conducted to find out the GBS infection ratio in pregnant women at the 35th – 37th week of gestation. Furthermore, this research evaluates the efficacy of CHROMagarTM StrepB media and Blood agar in GBS detection as well.

Method: In a cross-sectional survey, a total of 258 pregnant women at 35th to 37th of gestation screened for GBS at Thuan Kieu General Clinic from 04/2021 to 12/2021 were recruited. Rectovaginal swabs from these patients were cultured on Blood agar and CHROMagarTM StrepB. We performed data analysis using SPSS ver 20, p<0.05 was statistically significant.

Result: Overall, out of 258 participants, 52 (20.16%) were GBS carriers. CHROMagarTM StrepB has significantly higher sensitivity than blood agar if spending a similar time (1.52 fold, p-value < 0.001), or event training a shortened time (18 hours and 48 hours), CHROMagarTM StrepB media is still more sensitive than blood agar (1.16 fold, p-value 0.044).

Conclusion: In this study, the GBS infection ratio in pregnant women at 35-37 weeks of gestation at Thuan Kieu General Clinic is 20.16%. Culturing vaginal-rectal specimens on CHROMagarTM StrepB medium is higher sensitivity and rapidly than blood agar for GBS detection. CHROMagarTM StrepB should be used to get more effective in identifying GBS carriers in near-term pregnant women. 

Objectives: This study aims to narratively review the progression of ethical and legal issues related to transplant tourism.

Methods: PubMed search and Google search with keywords were used in March 2022 to identify relevant studies and law documentation.

Results: The progression of transplant tourism was classified into three main periods. Before 2000, the most popular destination country was India (1,308 cases), this period was characterized by the absence of laws and regulations worldwide. The period from 2000 to 2010 was the peak explosion of transplant tourism, China became the most popular destination of tourists (7,591 cases). This triggered alarms by World Health Organization (WHO) resolution in 2004 and Istanbul declaration in 2008 calling for regulations to prohibit transplant tourism. From 2010 till today, additional scientific publications reported several complications in overseas transplanted patients. Laws and regulations restricting transplant tourism were promulgated by many countries such as Israel, Taiwan, Spain and others.

Conclusions: Transplant tourism is considered as illegal worldwide. WHO and many developed countries announced laws and measures to prevent this activity. The incidence of transplant tourism is currently decreasing, continued efforts should persist to end this criminal act. 

Introduction: Vietnam’s health system increasingly recognizes the importance of interprofessional collaboration and education. Understanding stereotypes and interprofessional attitude could foster successful collaboration. This study aimed to assess stereotypes about nursing amongst healthcare students at University of Medicine and Pharmacy at Ho Chi Minh City.

Method: We invited nursing, medical, pharmacy and rehabilitation therapy students to complete an online survey before an interprofessional education course in September 2020. Student Stereotypes Rating Questionnaire was used to assess student stereotypes about nursing. Univariate regression was used to analyze the association between stereotypes score and other factors including interprofessional attitude as measured by Readiness for Interprofessional Learning Scale.

Results: With 102 students invited, 90 students completed the survey. Students were 20-21 years old, 57% were female, and 9% from minor ethnicity. The total attitude score was 80.2 ± 7.2, which meant favorable interprofessional learning. The total stereotype score was 37.1 ± 4.0, considered as high. Stereotype rated in descending order were: Practical skills (4.4), Interpersonal skills (4.3), Ability to be a team player (4.3), Professional competence (4.2), and Confidence (4.2), Ability to make decisions (3.9), Ability to work independently (3.8) and Leadership skills (3.5). There was an association between stereotype and interprofessional attitude total score (Coefficient 0.25, 95%CI: 0.15; 0.36, p-value < 0.01).

Conclusion: Vietnamese students highly regarded nursing profession, yet stereotypes about nursing existed and students viewed nurses as a capable team player, almost a follower. We need to study how interprofessional education courses could improve students’ attitude and stereotypes in future research. 

Eosinophilic gastrointestinal disorders are rare inflammatory conditions marked by eosinophilic infiltration of the gastrointestinal tract. Endoscopic manifestations vary from patient to patient. However, ulcerative lesion is a rare occurence. A 57-year-old patient presented with chronic diarrhea and significant peripheral blood eosinophilia. During endoscopy, multiple ulcers were discovered throughout the stomach, duodenum, and colon. Biopsies showed excess tissue eosinophilia suggestive of eosinophilic gastroenteritis and colitis. The patient responded dramatically with corticosteroid. However, he developed steroid dependency necessitating the use of azathioprine. In conclusion, a rare case of eosinophilic gastroenteritis and colitis presented with multiple ulcerative lesions was described. Physicians should be aware that eosinophilic gastroenteritis and colitis may be a cause of chronic diarrhea, particularly, in patients presented with peripheral blood eosinophilia. Corticosteroid is the mainstay of treatment. In steroid dependency case, azathioprine may be an option. 

Introduction: COVID-19 in children has a diverse clinical presentation, most of which is asymptomatic or mildly symptomatic. In addition, after 2-6 weeks of being infected with COVID-19, children may have the multisystem inflammatory syndrome in children (MIS-C), which is rare but serious condition, death has also been reported despite active treatment. We describe a severe clinical case of MIS-C treated at our hospital in the early stage of the 4th wave of COVID-19 in Vietnam.

Case report: A six-year-old boy admitted to Thu Duc City Hospital on August 27th, 2021. He had a history of COVID-19, which was diagnosed by a positive RT-PCR SARS CoV-2 test on July 24th, 2021. He had no symptoms and was concentrated quarantine with his family. He was discharged on August 12th, 2021. Four weeks after SARS-CoV-2 infection, he had symptoms such as sustained fever (5 days), stomachache (6 days), erythema multiform (8 days), eye and lip swelling (7 days), edema of hands and feet (10 days), dyspnea (5 days), hepatomegaly and shock. After then, he was diagnosed with MIS-C and treated with intravenous methylprednisolone 2 mg/kg/day (3 days), then tapered 1 mg/kg/day (5 days), maintained with prednisone 1 mg/kg/day for 14 days. The patient had no clinical symptoms, was discharged after 14 days of treatment, and continued treatment with aspirin 3 mg/kg/day and prednisolone 1 mg/kg/day.

Conclusion: The MIS-C manifestation following SARS-CoV2 infection needs prompt attention and treatment. Intravenous immunoglobulin plays an important role in treatment. However, when intravenous immunoglobulin is not available where limited resources, early appropriate use of methylprednisolone may be beneficial. 

Coronary arteries with anomalous origin are unusual but can be responsible for myocardial infarction. Acute occlusion of an anomalous coronary artery is not only easily missed on angiography but also technically challenging for percutaneous intervention. In this report, we present our experience in a patient with an anomalous circumflex being the culprit vessel in acute myocardial infarction. We report a case of a 74-year-old male patient presented with sudden chest pain. The diagnosis of occluded anomalous circumflex coronary artery was made by invasive coronary angiography shortly after admission. The patient was stented with a 2.5 x 18mm bare metal stent and was discharged with intensive medical treatment and regular follow-up. Interventional cardiologists should keep in mind there are several anomalous origin, the most frequent anomaly being a circumflex artery with origin from the right coronary artery or the right sinus of Valsalva. 

Renal artery stenosis is responsible for approximately 75% of secondary hypertensive cases. A 63-year-old female patient with uncontrolled hypertension and other comorbidities including type 2 diabetes mellitus and knee osteoarthritis presented with drastically raised systolic blood pressure in this case report (220 mmHg). Bilateral abdominal bruits were detected upon of physical examination. Imaging investigation showed significant bilateral atherosclerotic renal artery stenosis. An optimal combination of antihypertensive agents mainly with an angiotensin converting enzyme inhibitor, other than interventional revascularization, was applied and resulted in controlled blood pressure. 

Post-transplantation anemia is common among renal transplant recipients (RTR). The most frequent causes are erythropoietin deficiency, acute allograft rejection, iron deficiency, hemolytic anemia, adverse effects of immunosuppressive therapy, and virus infection. Human parvovirus B19 (HPV B19) can cause persistent viremia and erythropoietin-resistant erythroid aplasia in immunosuppressed patients. This case report describes two male renal transplant recipients who infected HPV B19 after kidney transplantation with severe anemia. Rapid and severe anemia that did not respond to blood transfusion. Adjustment of immunosuppressive drugs and intravenous immunoglobulin treatment resolved severe anemia after two months. In conclusion, when anemia develops rapidly and severely in renal transplant recipients in the absence of rejection and hemolysis, parvovirus B19 infection should be considered. 

A 33-year-old G2 P1001 female at 13 weeks of gestation presented with dyspnea, tachycardia, and hypotension. Initial assessment revealed cardiogenic shock and acute respiratory failure caused by extremely severe pulmonary artery hypertension (PAH). Multidisciplinary efforts led to the diagnosis of severe PAH as an initial manifestation of systemic lupus erythematosus (SLE). Team care included gestational termination via dilation and curettage (D&C), followed by corticosteroids and vasodilator therapy, with excellent clinical and hemodynamic outcomes. 

Bullous systemic lupus erythematosus is an uncommon autoimmune subepidermal vesiculobullous disease occurring in less than 5% of patients with systemic lupus erythematosus. The diagnosis of bullous systemic lupus erythematosus is based on clinical picture, histopathological findings, direct immunofluorescence and other immunologic tests. Importantly, establishing the diagnosis of bullous systemic lupus erythematosus requires the occurrence of systemic lupus erythematosus according to the American College of Rheumatology criteria. We report a case of bullous systemic lupus erythematosus in a 16-year-old Vietnamese girl, who demonstrated an acquired vesiculobullous eruption associated with nephrotic syndrome and fulfilled the European League Against Rheumatism/ American College of Rheumatology 2019 classification criteria of systemic lupus erythematosus. Clinical examination showed numerous tense, clear fluid-filled vesicles and bullae affecting the whole body with the predilection for the face, neck, chest, abdomen and bilateral inner thigh areas. Erosions were observed on the tongue and the buccal mucosa. Histopathologic examination showed subepidermal vesicle containing abundant neutrophils and perivascular mixed inflammatory cell infiltration. Microabscesses at tips of dermal papillae and the features of a leukocytoclastic vasculitis were not seen. Direct immunofluorescence of perilesional skin biopsies demonstrated linear deposition of IgG, IgA, IgM and C3 in the basement membrane zone. Linear immunoglobulin deposition displayed a u-serrated pattern with the predominant staining intensity of IgG. Serologic tests showed positive antinuclear antibody. Complement components assay revealed low levels of C3 (66.5 mg/dL) and C4 (3,9mg/dL). Proteinuria level was increased to 3.5g/24 hours. The final diagnosis of bullous systemic lupus erythematosus with nephrotic syndrome was made. The patient was treated with a high-dose oral glucocorticoid scheme and showed significant clinical improvement. 

Introduction: This study aimed to translate the 31-item Quality of Life in Epilepsy Inventory (QOLIE-31) into Vietnamese and validate the translation.

Methods: The inventory was translated through “forward – backward” translation, and culturally adapted for standardization. To ensure the reliability of the inventory, the internal consistency and the temporal consistency was determined. Clinical variables were tested for discriminant validity by comparing their scores.

Results: Cronbach’s alpha coefficient ranged from 0.91 to 0.57, with the lowest in the Overall quality of life subscale. Test-retest reliability showed high reproducibility with intra-class correlation coefficients ranging from 0.72 to 0.87 (p<0.001). The mean score of QOLIE-31 was 71.31. Further, the study used the statistical differences of QOLIE-31 scores in the drug-resistant group to show discriminant validity.

Conclusion: The Vietnamese QOLIE-31 is a reliable and valid instrument as proven by the statistical data and can be used to assess quality of life in people with epilepsy. 

Introduction: In some cases, gastroesophageal reflux (GER) may be accompanied by duodenogastric reflux, forming non-acid reflux, which has a certain influence on the clinical presentation and the response to anti-reflux therapy. The study aimed to determine the role of non-acid reflux in children with recurrent and chronic respiratory diseases (RCRD).

Methods: All children with RCRD, for unknown reason, poorly responding to respiratory-specific therapy, hospitalized for gastroesophageal reflux disease (GERD) screening, using dual pH-multichannel intraluminal impedance (pH-MII).

Results: The study was conducted in 42 children at the age Me – 2.75; IQR 1.08-9.42. The most common type of reflux was weakly acid reflux - 62.25 [36.425-121.225], then acid - 34.05 [12.875-71.65], alkaline - 1.75 [0 - 12.375] episodes per day (p <0.05). Non-acid reflux was more common in children with only respiratory symptoms - no esophageal manifestations of GERD. All types of refluxes were more often recorded in the upright compared to the supine position. In 70% patients, cough could be associated with reflux, while in 88% children reflux was non-acid (including 69% - weakly acid, 19% - alkaline), in 38% - acid.

Conclusions: Non-acid reflux is the main type of GER in children with RCRD refractory to standard therapy, which could be associated with cough in this patient population. 

Introduction: Venous thromboembolism (VTE), a highly prevalent complication in cancer patients, causes prolonged hospitalization and mortality. This study aimed to investigate the characteristics of VTE in older patients with cancer.

Methods: This was a retrospective study. Data were extracted from electronic medical records at the Geriatrics-Palliative Care Department of University Medical Center Ho Chi Minh City. Inclusion criteria included: aged ≥ 60 years, confirmed or newly diagnosed with cancer, and new VTE diagnosis. Exclusion criteria included lacking any information on demographics, laboratories, or treatments. Pulmonary embolism (PE) was confirmed using chest computerized tomography scans, while deep vein thrombosis (DVT), and other types of venous thrombosis were confirmed based on a doppler or abdominal ultrasound. Data were analyzed using Stata 15.0, with p <0.05 signifying statistical significance.

Results: Data of 151 patients were extracted from 1170 medical records (median age: 67, range 60 to 89 years). The three most frequent types of VTE were portal vein thrombosis (48.3%), PE (30.5%), and DVT (29.1%). Stage IV cancer was found in 74.2% of VTE patients. Leg pain was presented in 59.1% of the patients with DVT, and dyspnea was confirmed in 80.4% of the patients with PE. Anticoagulant therapy was the most common treatment for VTE (33.8%) and no major bleeding was recorded.

Conclusions: VTE was highly common among older patients with advanced cancer. Leg pain was an indicator of DVT and dyspnea was a warning sign of PE in older patients with cancer. No major bleeding was recorded in those receiving anticoagulants. 

Pseudomembranous colitis (PMC) is characterized by the presence of an inflammatory pseudomembrane overlying the colonic mucosa, and is primarily caused by Clostridium difficile infection (CDI). PMC is often associated with the use of broad-spectrum antibiotics. Common symptoms include watery diarrhea, mucus in stool, abdominal cramps, and fever. We report a case of a 52-year-old female presenting with new abdominal distention, frequent bloody, mucoid, jelly-like diarrhea, and abdominal pain. Peritoneal fluid analysis showed neutrocytic ascites with low serum-ascites albumin gradient (SAAG). A diagnosis of pseudomembranous colitis was confirmed by flexible sigmoidoscopy. However, polymerase chain reaction (PCR) test for Clostridium difficile was negative. The patient was treated with metronidazole (500 mg IV q8h) and vancomycin (250 mg PO QID). Her symptoms resolved after several days of treatment with no ascites found by ultrasound. Neutrocytic ascites can be a complication of PMC. Physicians should also be aware that empirical treatment of Clostridium difficile may cause false negative diagnostic test result. 

Background: COVID-19 is a rising health problem that affects not only the infected patients but also the non-COVID-19 group. There is a reduction of non-COVID-19 healthcare services during COVID-19 outbreaks which leads to subsequent increment of mortality. This study aims to investigate the impact of the fourth COVID-19 surge on the cardiology outpatient visits at Nhan dan Gia Dinh hospital.

Method: A retrospective observational study was conducted using extracted data from the healthcare informative system of Nhan dan Gia Dinh hospital. Monthly trends of cardiology outpatient visits between May 1st, 2021 to August 31st, 2021 were compared with those of the previous four months and the same period of the year 2020. The demographic characteristics, diagnoses, and prescription behavior were described.

Results: Non-COVID-19 cardiology outpatient visits showed a stable trend until the beginning of the fourth outbreak, in May 2021 when they dropped drastically by 50%. A reduction of 50% was observed in every diagnosis. There was a substantial decrease in visits from other provinces as well as in the concurrent diagnosis of cancer. No change in the rates of prescribed medications was observed besides the lengthening of the prescription time.

Conclusion: The fourth COVID-19 wave caused a serious impact on cardiology outpatient care which might lead to an adverse prognosis. Though there has been some adaptive modification in prescription, this phenomenon calls for more attention and adequate measurements in the non-COVID-19 population for the later outbreaks. 

Introduction: Obesity is acknowledged to be a significant risk factor for mortality in patients with COVID-19. At primary healthcare center, early stratification of high-risk patients is critical in order to provide effective management. There is limited research available in Vietnam concerning the relationship between obesity as defined by Asian- standards and pulmonary damage. Our goal was to find the correlation between the obesity status index by Asian-standardized BMI and the severity of lung injury on chest radiographs patients with COVID-19 in the Vietnamese field hospital.

Methods: A total of 279 confirmed COVID-19 patients (118 males and 161 females) patients were recruited in our study. Two internal medicine physicians independently evaluated chest X-rays using the Brixia score system to assess the severity of lung disease, then agreed. The probability of Brixia scores per chest X-ray film was modeled using Poisson regression with gender and Asian-standardized BMI as predictors.

Results: The study revealed that the median age of our study was 59 years, and the mean BMI was 24.6 ± 3.4 kg/m2. The Pearson correlation between the Brixia score and the BMI was 0.25 with a p-value < 0.05. Both men and women showed that the obese group had the highest Brixia scores. There was a statistically significant difference between Brixia scores of male patients between the normal and obese groups (p-value =0.0446). Poisson regression showed that as the BMI increased, the probability of a higher Brixia score also increased.

Conclusions: According to the findings, the higher the BMI value of a patient, the higher the Brixia score for chest X-rays. This result was recorded in both genders, but more significantly in men. 

Introduction: Streptococcus pneumoniae is the most common cause of community-acquired pneumonia (CAP) in children. Recently, the rapid emergence of antibiotic-resistant pneumococci has posed enormous challenges for CAP treatment and public health. This study aims to provide clinicians with updated data about the antimicrobial susceptibility of S. pneumoniae and improve the treatment guidelines in CAP in children.

Methods: This cross-sectional and in-vitro study was conducted at three hospitals in Quang Nam province and Da Nang city in Vietnam. Pneumococcal strains were isolated from nasopharyngeal aspirate samples of 360 CAP in-patients under five years of age. The susceptibility of clinically used antibiotics was investigated using the disk diffusion test and the E-test for identifying the MIC. Multi-drug resistant (MDR) S. pneumoniae isolates were also determined.

Results: 21.9% of CAP children patients were pneumococcal carriage. The susceptibility testing demonstrated that all 56 tested pneumococcal isolates were resistant to erythromycin and azithromycin, whereas none of the isolates developed the resistance to levofloxacin, vancomycin, and linezolid. The clindamycin- and cotrimoxazole-resistant pneumococci rates were 96.4% and 87.5%, respectively. For β-lactam antibiotics, the resistance proportions of pneumococcal isolates to penicillin G, co-amoxiclav, amoxicillin, cefotaxime, and ceftriaxone were 3.6%,1.8%, 1.8%, 1.8%, and 3.6%, respectively. 83.9% of the tested isolates were MDR S. pneumoniae.

Conclusion: Our data support using penicillin G, amoxicillin, co-amoxiclav, or cefotaxime as the first-line therapy for uncomplicated-pneumococci-induced CAP in Quang Nam – Da Nang, while vancomycin, linezolid, and levofloxacin should be used as alternatives or in MDR cases. 

Introduction: COPD affects the quality of a patient’s life and leads to death. Identifying TCM symptoms and clinical patterns proportions in the community will make diagnosis and treatment more effective. In Vietnam, there were no epidemiological documents about COPD in TCM. Therefore, this study wished to survey stable COPD patients to find out the proportions of symptoms and patterns in TCM to create a basis for further practice.

Methods: The survey was conducted as a descriptive cross-sectional study. Participants were stable COPD outpatients at the Clinic and respiratory function test of the University Medical Center HCMC from September to December 2018. According to the survey form based on the TCM diagnostic criteria, the proportions of symptoms and patterns were recorded.

Results: After three months, 116 patients were recruited. The proportions of 30 TCM symptoms and signs were recorded. The proportions of patients were as follows: 80.17% met Lung qi deficiency, 76.72% for Lung-kidney qi deficiency, 53.45% for Lung-kidney qi and yin deficiency, 47.41% for Lung-spleen qi deficiency, and 2.59% for not meeting any of the diagnostic criteria. Patterns were overlapping in the same patients.

Conclusions: All TCM symptoms and patterns in the diagnostic criteria appeared in COPD patients. The deficiency of the Lung and Kidney was the most common. Most patients were classified into many different patterns with multi organs damage. More multicenter studies with bigger participants numbers are suggested. 

Introduction: The increasing number of older people around the world has increased the demand for elderly care nursing services. Understanding nursing perceptions can identify willingness to work with older people.

Objective: This study aims to determine predictors for nursing students’ perception of working with older people.

Methods: A cross-sectional study was performed on 292 nursing students at the University of Medicine and Pharmacy. Stratified random sampling with an online self-reporting questionnaire was used to collect data from first- to fourth-year nursing students. Data analysis was performed using SPSS 20. Independent t-test, ANOVA and Pearson’s correlation were utilised to determine the correlation of demographic variables, knowledge and attitude with perception. Moreover, multiple linear regression was applied to determine predictors for the perception of working with older people.

Results: The mean score of perception of working with older people amongst undergraduate nursing students was 51.79±6.31. Factors related to perception include gender (p=0.004), geriatric nursing choice (p=0.007), knowledge about ageing (p=0.001) and attitude towards older people (p<0.001). Multiple linear regression analysis showed that gender (β=−0.149, p=0.005), geriatric nursing choice (β=0.154, p=0.003), knowledge about ageing (β=0.122, p=0.021) and attitude towards older people (β=0.367, p<0.001) are predictors for the perception of working with older people.

Conclusion: An in-depth understanding of ageing and attitude towards older people in the geriatric curriculum plays a vital role in promoting nursing students’ perception of working with older people. 

Introduction: The COVID-19 pandemic has spread around the world that severely affects people's life and the health system of countries. Enhancing the population’s awareness and prevention behaviors are crucial. This study aims to assess the knowledge, attitudes, and behaviors regarding COVID-19 prevention of outpatients and visitors at the University Medical Center in Ho Chi Minh City (UMC).

Methods: A cross-sectional study was conducted on 765 participants who were conveniently selected when they arrived at UMC between March 2021 and April 2021. A questionnaire was developed based on guidelines of Viet Nam Ministry of Health (Viet Nam MOH), World Health Organization (WHO), and other prior studies to evaluate the general knowledge regarding COVID-19 disease, disease prevention, attitude, and behaviors on prevention methods.

Results: The results showed low proportions of participants who had good knowledge of COVID-19 disease (29.15%) and prevention measures (38.17%) that were in contrast with a high percentage of positive attitudes (89.08%). There were 22.09% of participants were identified as good preventive behaviors based on seven surveyed measures. An association between prevention knowledge and prevention behaviors was observed when participants with good knowledge showed 2.15 times-higher odds of good behaviors (95%CI: 1.52, 3.04, p-value<0.001) compared to those with insufficient knowledge. Gender, occupation, accommodation, living with family or friends, comorbidities, and history of COVID-19 -related isolation were associated with good behaviors (adjusted p-value <0.05).

Conclusions: The percentage of knowledge and the compliance rate for COVID-19 prevention measures is low, and there is a positive association between prevention knowledge and good behaviors. Therefore, communication programs to improve the community's knowledge and to increase good practice rates are necessary and urgent. 

Background: The health status of ethnic minorities of all ages lags far behind that of the general population, particularly in the old. The old minor ethnic population is more likely to have chronic diseases but less likely to access health services. This study assesses the rate of health services use and associated factors in the old Khmer population.

Method: A cross-sectional study was conducted on 400 Khmer people aged 60+ year-old from March to May 2020. Eligible participants were randomly recruited from households of five clusters out of nine communes of Tri Ton District, An Giang province, Vietnam. A structured questionnaire was designed to collect data on socio-demography, health status, health service use and accessibility to health services and quality of life. Quality of life was measured using EQ-5D-5L. All eligible participants were face-to-face interviewed by a bilingual researcher.

Result: The rate of health services use was 63.3%. The EQ-5D-5L utility index mean score was 0.46 (SD=0.28) and EQ-VAS mean score was 49.01 (SD=16.19). The odds of using health services were higher in those reported to have problems in mobility (OR=2.56, 95%CI 1.43-4.61, p<0.01), self-care (OR=2.05, 95%CI 1.30-3.24, p<0.01), activity (OR=2.35, 95%CI 1.44-3.82, p<0.01), pain/discomfort (OR=2.63, 95%CI 1.22-5.67, p=0.01), and anxiety/depression (OR=2.07, 95%CI 1.00-4.29, p=0.05) in univariate but not in multivariable analysis. The multivariable logistic regression showed that the odds of using health services were lower in those who were currently working (aOR=0.48, 95%CI 0.30-0.79, p<0.01), accessible to health information (aOR=0.47, 95%CI 0.27-0.80, p<0.01), but higher in those using health insurance (aOR=5.09, 95%CI 3.19-8.14, p<0.01), and in health facilities used Khmer language (aOR=2.04, 95%CI 1.15-3.62, p=0.01).

Conclusion: This study suggested that Khmer people should be involved in all stages of planning and implementing health programs and services for Khmer communities to improve the accessibility and health equity. 

Introduction: Body constitution (BC) is widely applied in daily clinical practice by Traditional Chinese Medicine (TCM) practitioners. The BC is innate depending on the intrinsic properties of the human body and is influenced by the environment. The most common diagnostic tool of physiological BC types is the Constitution in Chinese Medicine Questionnaire (CCMQ). This study was conducted to determine the proportion of nine TCM constitution types and comorbidities observed in the community of District 4, Ho Chi Minh City.

Methods: A cross-sectional design was applied to collect data for this study. All the participants were classified as BC types by the CCMQ. The collected data were statistically analyzed with the SPSS 22.0 software.

Results: There were 436 participants aged from 18 (163 males; 273 females) enrolled in this study from 05/2021 – 06/2021 in District 4. Five comorbidities were observed including hypertension (23.6%), cardiovascular diseases (13.1%), diabetes (11.5%), hyperlipidemia (8.3%) and obesity (4.1%). In participants, the prevalence of nine BC types were Neutral (62.4%), Qi-deficiency (17.2%), Qi-depression (15.6%), Inherited-special (8.9%), Yang-deficiency (8.3%), Blood-stasis (8.0%), Yin-deficiency (7.6%), Phlegm-dampness (6.4%), and Dampness-heat (5.7%). The Qi-deficiency type was significantly associated with ages, genders, hypertension and cardiovascular diseases while the Dampness-heat one was related to gender.

Conclusions: Among the participants in District 4, Ho Chi Minh City, hypertension (23.6%) is the most common comorbidity. Neutral (62.4%) is the majority in BC types. The associations between BC types and ages, genders, jobs, five chronic diseases were different. 

Introduction: Indocyanine green (ICG) clearance and remnant liver volume (RLV) are the two important factors in predicting post-hepatectomy liver failure (PHLF) after major hepatectomy; however, the combination of these is still controversial. This study is to find a way to combine these to select candidates for safe major hepatectomy.

Methods: A prospective cohort study included 137 major hepatectomies. ICG clearance (through ICG remnant at 15 minutes: ICG-R15), liver function results and the ratio of remnant to standard liver volume (RLV/SLV) were analyzed to examine their relations to PHLF. These variables, gender and age were analyzed using multivariate logistic regression to establish a model to predict PHLF.

Results: PHLF rate after major hepatectomy was 16.8% with 5.8% for grade B-C. ICG-R15 and RLV/SLV were significantly associated with PHLF (p = 0.019 and 0.007 respectively). ICG-R15 was not significantly associated with the grade of PHLF while RLV/SLV was but the post-hoc analysis showed no significant difference. Group RLV/SLV < 40% tended to have higher rate and grade of PHLF than group RLV/SLV > 40% but the difference was not significant (p = 0.063 and 0.072 respectively). Based on gender, age, ICG-R15 and RLV/SLV, PHLF rate could be estimated with model performance of 77%.

Conclusion: ICG clearance and RLV were associated with PHLF after major hepatectomy. It was safe and feasible to perform major hepatectomy with RLV/SLV under 40% and good ICG-R15. It was possible to estimate PHLF rate based on the patients’ gender, age, ICG-R15 and RLV/SLV. 

Introduction: Ramipril, which is an angiotensin-converting enzyme (ACE) inhibitor, is prescribed to treat heart failure, diabetic kidney diseases and high blood pressure. The United States Pharmacopeia 43 (USP 43) and British Pharmacopoeia 2020 (BP 2020) require testing ramipril methyl ester (impurity A) in ramipril pharmaceutical substances as well as corresponding finished products. This study was conducted with the aim of synthesis and standardization of impurity A as related substance and using established reference impurity A in impurity test of ramipril pharmaceutical products.

Method: Impurity A was synthesized from ramipril by transesterification reaction with methanol and potassium hydroxide. The synthesized product chemical structure was elucidated from its spectroscopic data. High performance liquid chromatography (HPLC) method was utilized to determine its purity and establish it as reference standard. Finally, the assay of impurities in ramipril pharmaceuticals was determined by HPLC method, using the established impurity A standard.

Results: Ramipril methyl ester was successfully synthesized and purified with 39.2% yields (about 1.08 g). Impurity A purity determined was over 98% and conformed to establish reference standard. The assigned purity value of impurity A is 99.01%. Additionally, the assay of impurities in available ramipril pharmaceuticals by application of a HPLC method referred from USP 43 was conducted.

Conclusion: Impurity A was successfully synthesized and standardized as reference standard for impurities test of ramipril. 

In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic. In Vietnam, the incidence rate started climbing in May 2021, reaching an all-time high of 9,000 cases per day, and is projected to increase even further. Direct patient contact, as has always been the case in conventional medical practice, now constitutes significant transmission risk during the height of COVID-19. Healthcare workers, while accounting for a minor proportion of the population, are two to three times more likely to contract COVID-19, especially those who provide outpatient care or home-based service. The pandemic has led to a significant increase in the adoption of telemedicine, as hospitals are overwhelmed with critically ill patients, demand for healthcare soars, and transmission risk remains serious. With appropriate attention and further advancement of Vietnam's telehealth infrastructure, telemedicine will become an indispensable weapon to combat COVID-19 and an important modality of medical care during and after the pandemic. 

Introduction: Indocyanine green (ICG) clearance (through ICG retention rate at 15 minutes - ICG-R15) is proven to correlate with histological fibrosis stage. Child-Pugh score, although proven to have weaker correlation, is still one of pre-hepatectomy liver function assessments. This study is to compare ICG-R15 and Child-Pugh score in evaluation of histological fibrosis stage and predicting of post-hepatectomy liver failure (PHLF) and to create the model of staging estimation for fibrosis.

Methods: A prospective cohort study was conducted in 340 patients of hepatectomy. ICG-R15, Child-Pugh score and platelet count (PLT) were analyzed to examine their association with histological fibrosis stage and PHLF. Ordinal logistic regression was used to establish the model of staging estimation for fibrosis.

Results: Child-Pugh score showed no significant association with histological fibrosis stage (p = 0.257) while ICG-R15 had a weak correlation (r = 0.232, p < 0.001), INR had a weak correlation (r = 0.156, p = 0.004), PLT had a negative correlation (r = -0.378, p < 0.001). The histological fibrosis stage could be estimated based on gender, age, ICG-R15 and PLT with AUC of 0.68. ICG-R15 was shown to be related to PHLF (p = 0.039) in which non-PHLF group had 0.75 times lower ICG-R15 than PHLF group while Child-Pugh score was shown to be statistically insignificant.

Conclusion: ICG clearance test was better than Child-Pugh score in evaluation of pre-hepatectomy liver function and predicting of PHLF. It was possible to estimate the histological fibrosis stage based on gender, age, ICG-R15 and PLT. 

Objective: Dengue is an infectious disease that causes a worldwide health and economic burden despite the efforts to eradicate the disease. From 2013 to 2015, dengue epidemic significantly increased from 33,626 to 50,205 cases in Vietnam. This study aims to determine the genotype variations of dengue virus (DENV) circulating in Southern Vietnam during 2014-2015.

Methods: C6/36 cells were infected with twenty-four strains of dengue virus isolated in 2014-2015 and kept frozen. The complete nucleotide sequence of dengue virus genomes was obtained by polymerase chain reaction (PCR). The genome was sequenced in the MiSeq system and analyzed by the basic local alignment search tool (BLAST) program. Data from GeneBank was used to create the phylogenetic trees.

Results: Among the 17 analyzed strains from 8 southern provinces, four (23.53%) were DENV-1, three (17.65%) were DENV-2, five (29.41%) were DENV-3, and five (29.41%) DENV-4 were isolated. Four DENV-1 isolates belong to Asia genotype. Three DENV-2 strains were concentrated in a subgroup of Asian 1 genotype. Five DENV-3 isolates were identified as belonged to Asian 2 genotype and five DENV-4 isolates were found as belong to Asia 1 genotype. There were no amino acid mutations and the transition capacity between the nucleotide among four types of DENV serotypes suggested that the probability of conversion from C to T was the highest conversion rate.

Conclusions: These DENV isolates were genetically close to other previous strains isolated from Vietnam and its neighboring countries, including Thailand, China, Cambodia, and Singapore, Brazil, Sri Lanka due to dynamic transmission. 

Introduction: Antibiotic resistance has been determined as a global threat. Inappropriate use of antibiotics is a crucial driver of the evolution of resistance.

Methods: A cross-sectional study was conducted aiming to describe the antibiotic usage among the elderly (60 years old and above) in Tan Loi commune, Dong Hy district, Thai Nguyen province, Vietnam in 2020. The questionnaire survey was submitted to 370 participants.

Results: More than half of the participants were female. The proportion of the elderly who bought antibiotics using a prescription was 39.2%. The participants normally bought the medicines the same as the previous (53.0%), medicine seller’s advice (44.9%), and relatives/friends’ advice (15.4%). More than half of the participants bought antibiotics themselves (57.8%). Local private pharmacies and health centers/hospitals were common locations for buying antibiotics, 63.8%, and 34.1% respectively. The percentage of the participants who stopped taking antibiotics when the symptoms are gone was 54.1%. More than 50.0% of the participants would change to more expensive antibiotics in case of symptoms are not released after using antibiotics. Some factors significantly associated with prescription usage were education levels, ethnic, obtained information related to antibiotic uses, others helping to buy the antibiotics.

Conclusions: The proportion of the elderly using antibiotics with a prescription was low. Majority of the participants bought antibiotics from the local private pharmacies. The main source of information to buy antibiotics was as the last time and medicine sellers. Some factors significantly associated with prescription use were education level, ethnicity, obtained information related to antibiotic uses, individuals who buy the medicines. Interventions are needed to improve knowledge and practice in buying antibiotics not only for the elderly but also for health service providers, private pharmacies in particular. 

Previous studies have reported in vitro antioxidant and inhibitory activity on xanthine oxidase of Jasminum subtriplinerve Blume, Oleaceae, which suggested the potential prevention of gout and supplementary treatment. This study evaluated analgesic, anti-inflammatory, and hypouricemic effects of the 50% ethanolic extract of J. subtriplinerve (EEJS) at the oral doses of 800 and 1200 mg/kg in mice. For acute oral toxicity, after oral administration of single doses of EEJS; mortality and toxic signs in male and female mice were noticed within 72 hours and 14 days. The analgesic effect was observed in acid acetic induced writhing in mouse model within 40 minutes. The anti-inflammatory effect was determined in mice-induced edema by 1% carrageenan. The hypouricemic effect was evaluated in mice with the peritoneal injection of potassium oxonate inducing acute and chronic hyperuricemia. The results showed that there was not any toxic sign in mice given orally at the maximum dose (Dmax) of 20 g EEJS/kg. At the dose of 800 and 1200 mg/kg, EEJS did exhibit analgesic effect until 40th minute. EEJS 1200 mg/kg expressed acute anti-inflammatory effect. EEJS had no acute hypouricemic effect at the oral doses of 800 and 1200 mg/kg. When given to mice with chronic hyperuricemia, 800 mg/kg EEJS reduced 30-44% blood uric acid concentration compared to pathological group. In conclusion, EEJS did not cause any toxic sign in mice at the Dmax of 20 g/kg. This extract had analgesic and chronic hypouricemic effects at the oral dose of 800 mg/kg in mice. 

Background: The COVID-19 epidemic has spanned four waves in Vietnam, the most recent and also the most deadly of which began in April 2021.

Methods: We reported on a group of University Medical Center Ho Chi Minh City patients who were diagnosed with SARS-CoV-2 infection and were suitable for mini-pulse corticosteroid therapy with 125 mg of methylprednisolone twice daily for at least three days. Demographics, clinical, laboratory, and outcome data were gathered by electronic medical report. We also compared laboratory data before and after the start of mini-pulse corticosteroid therapy, as well as between the discharged and deceased groups.

Results: We gathered data on 25 patients. The average age was 61.5 ± 11.9 years, and 52% of them were male. Dyspnea was the most prevalent chief complaint. Almost all of them had at least one co-morbidity, with hypertension being the most common; all of them were put on oxygen supplementation, and 44% were started on mini-pulse corticosteroid while using a high-flow nasal cannula. Eighty-four (21%) reacted well and were discharged, whereas sixteen (4%) worsened and died. The deceased group was older than the discharged group (69.8 ± 3.1 vs. 59.9 ± 12.4, p =.005).

Conclusion: Our findings suggest that methylprednisolone at a mini-pulse dosage might be an effective and safe treatment option for COVID-19 inpatients in the inflammatory stage. 

The flowers of Hylocereus undatus (Haw.) Britton & Rose have been reported in vitro antioxidant and tyrosinase inhibitory activities. This study screened preliminarily the triterpenoid constituents and evaluated in vitro tyrosinase inhibitory activity of H. undatus flowers. H. undatus flowers were harvested from Binh Thuan Province, Vietnam at four different flowering stages, and their five separated parts (stamen, pistil, petals, ovary, and sepals) were extracted with ethanol. Triterpenoids were identified in the extracts by thin-layer chromatography and Liebermann - Burchard reaction. Tyrosinase inhibitory activity was evaluated using the dopachrome method with L-tyrosine substrate and kojic acid as the positive control. Results showed that at the different flowering periods, there was the formation of different parts of the flowers. The triterpenoid compounds are the main constituents in the H. undatus flower extracts. The 70% ethanol extract from H. undatus flower at the stage of 2 - 3 days before blooming exhibited the strongest tyrosinase inhibitory activity with IC50 value of 266.4 μg/mL compared to that of 7.60 μg/mL of kojic acid. In the case of separation of flower parts, 70% ethanol extracts of each part inhibited weakly the tyrosinase enzyme. In conclusion, the present study provided information about the morphological characteristics of H. undatus flower collected from Binh Thuan Province, Vietnam. Triterpenoid was found as the main constituents of the ethanolic extracts of H. undatus flower. The 70% ethanol extract from whole H. undatus flower at the stage of 2 - 3 days before blooming exhibited strong tyrosinase inhibitory activity. 

Introduction: Gastroesophageal reflux disease (GERD) is one of comorbid diseases, that worsen the course and outcomes of respiratory pathology. The study aimed to determine role of esophageal symptoms in the diagnosis of GERD in children with recurrent and chronic respiratory diseases (RCRD).

Methods: The study included 125 children (70 boys, 55 girls), median 3,75 years (interquartile range, IQR – 1,21-9,38 years), with RCRD, refractory to standard therapy. GERD was diagnosed on the basis of clinical and complex instrumental examination, including fluoroscopy esophagus with contrast, esophagogastroduodenoscopy (EGDS), 24-hour esophageal pH-monitoring, dual pH-multichannel intraluminal impedance (pH-MII).

Results: In children with RCRD, the frequency of GERD was 86,4%. Among children without esophageal manifestations of GERD, pathological reflux was confirmed by instrumental methods in 81% of patients; in children with esophageal manifestations - 92%, with no statistically significant differences (p = 0,0637). Nonacid reflux is more common in patients without esophageal manifestations of GERD.

Conclusions: The frequency of GERD in children with RCRD is very high. It is possible to screen GERD in children with RCRD, independent on the presence of clinical esophageal symptoms. 

Introduction: Several generic products containing simvastatin are circulating on the Vietnamese market at a more inexpensive price than that of a brand-name one. These formulations, however, have not been assessed for in vivo bioequivalence to the reference product. After oral administration, simvastatin (SIM) is extensively converted into an active metabolite, beta-hydroxy simvastatin acid (SIM-A) and a very low concentration of simvastatin can be found in plasma. Therefore, a method for quantification of simvastatin and its metabolite needs to be developed with a high specificity and sensitivity to detect these analytes in human plasma at such low concentrations. Our purpose was to develop a reliable LC-MS/MS (liquid chromatography-tandem mass spectrometry) method for simultaneous determination of simvastatin and metabolite of simvastatin, beta-hydroxy simvastatin acid, in human plasma and to apply this method to evaluate the bioequivalence of a test product in comparison with the reference product.

Methods: Mass spectrometry, internal standard (IS), and chromatographic conditions were investigated to find out the suitable IS and conditions. Human plasma samples were treated by liquid-liquid extraction (LLE). The assay was validated in compliance with US-FDA (United States-Food and Drug Administration), and EMA (European Medicines Agency) guidelines.

Results: LC-MS/MS with electrospray ionization interface in positive (for SIM and lovastatin as IS) and negative (for SIM-A) ionization mode performed under the multiple reaction monitoring mode was used for detection of the analytes. The transition of m/z is 436.00 → 285.15, 435.10 → 319.15, and 404.95 → 199.10 for SIM, SIM-A, and IS, respectively. Tert-buthyl methyl ether was used for extraction of analytes from human plasma by a simple LLE followed by addition of an ammonium acetate buffer. The developed method was fully validated with acceptable selectivity, linearity and linear range, matrix effect, lower limit of quantitation (LLOQ), carryover, dilution integrity, and intra- and inter-day accuracy and precision, free-thaw stability.

Conclusions: The method can be applied for quantification of these compounds in human plasma for in vivo bioavailability and bioequivalence studies. 

Introduction: Body constitution (BC) plays an important role in preserving health and reducing risk of diseases depending on each person’s physical characteristics. Classification of BC is almost based on the Constitution in Chinese Medicine Questionnaire (CCMQ). In Vietnam, there is still no questionnaire survey to assess the BC. Therefore, this study aims to adapte and validate the Vietnamese version of CCMQ.

Methods: 2 phases of the study: the first phase constituted the translation with cross-cultural adaptation of CCQM into Vietnamese according to Guillemin et al; the second phase assessed the reliability and validity of the Vietnamese CCMQ version based on a cross-sectional study.

Results: Phase 1 formed the final Vietnamese CCMQ version in which face validity and content validity are incorporated. Seven traditional medicine practitioners confirmed the content validity (CVI: 57%–100%). The face validity of the scale is qualified. In phase 2, 455 participants aged 18 years old or older were enrolled in this study from 01/2021 – 06/2021 in Ho Chi Minh City. Regarding the criterion validity, the correlation coefficient between Vietnamese CCMQ and SF-36 was 0.67 for the Neutral type and -0.31 to -0.57 for the rest. The internal consistency varied from 0.70 to 0.83 measured by Cronbach’s alpha. The test-retest reliability varied from 0.63 to 0.90 for each of the 9 sub-scales and from 0.40 to 0.68 for each of the 60 questions.

Conclusions: The Vietnamese version of CCMQ has good reliability and validity, which provides a strong basis for future researches on BC of Vietnamese Traditional Medicine. 

Background: In cirrhotic patients, variceal bleeding remains a major cause of death. After a variceal bleeding episode, mortality and rebleeding rates spike for the first 6 weeks before levelling off. We aimed to evaluate the performance of AIMS65 score in comparison with Child-Turcotte-Pugh (CTP) score and model for end-stage liver disease (MELD) score in predicting 6-week mortality and rebleeding in cirrhotic patients with variceal bleeding.

Method: Data were collected prospectively from patients with cirrhosis and variceal bleeding at Gastroenterology and Hepatology Department of Cho Ray hospital from September 2016 to April 2017. The primary endpoint was 6-week mortality and rebleeding. The prognostic value of AIMS65, CTP, and MELD scoring systems for 6-week mortality and rebleeding was compared by receiver operating characteristics curves (ROC) and the area under the curve (AUC).

Results: Among 80 patients, 15% rebled and 25% died during 6-week follow-up. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week rebleeding were 0.68, 0.54, and 0.48, respectively. AUCROC of AIMS65, CTP, and MELD scores in predicting 6-week mortality were 0.80, 0.74, and 0.64, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of AIMS65 score at the cutoff point of 2 were 95%, 55%, 41.3%, and 97%, respectively.

Conclusion: AIMS65 score is a simple yet applicable tool for risk stratification in cirrhotic patients with variceal bleeding. We recommend using AIMS65 score with a cut-off point of 2 to identify patients at increased risk for 6-week mortality after variceal bleeding.

Methotrexate (MTX) is a chemotherapy and immunosuppressive agent widely used to treat cancer, autoimmune diseases in children and adult patients, and ectopic pregnancy. However, MTX is highly toxic to the liver, kidney, and nervous system. This study aimed to quantify the concentration of MTX in human plasma using high-performance liquid chromatography (HPLC). MTX and its internal standard (para aminoacetophenone-PAPA) in plasma samples were extracted simultaneously with methanol. Sample purity was performed using the 1 cc OASIS HLB cartridges. Sample injection volume of 10 µL was analyzed on a Lichrocart Supersil 125-4 column C18 maintained at 40 °C on a Waters 2695 XE equipped with a PDA detector set at 303 nm. The mobile phase contained phosphate buffer (pH 6.0) and methanol at a ratio of 80:20 (v/v) and was maintained at a flow rate of 1 ml/min. The results showed that the total time of chromatographic analysis was 15 min. MTX and PAAP were found in the chromatograms at retention times of 2.3 and 5.2 min, respectively. The linear range of the MTX from 0.5 to 25 µg/mL. Intra-day and inter-day imprecision for MTX ranged from 3.42 to 8.128%. LLOQ of MTX was 0.5 µg/mL and the extraction effects were above 77%. In conclusion, we developed and validated a simple HPLC method to determine the MTX concentrations in human plasma.
 

Introduction: In the last few decades, pyrazoline-based substances have emerged as potential antimicrobial and anticancer candidates. In concern with antimicrobial activity, this study aims to build a docking model to predict the structure of potential 2-pyrazoline derivatives. The cytotoxicity of some compounds was also evaluated to get insight into the structure–anticancer activity relationship of the 2-pyrazoline derivatives.

Methods: Docking models were built on virtual FabH enzymes using FlexX platform with 2-pyrazoline derivatives served as test sets. Afterward, derivatives with high docking scores were chemically synthesized and evaluated for antibacterial activity using the agar dilution method. Furthermore, MTT assay was used to assess the cytotoxicity of these compounds.

Results: The docking score and the in vitro minimum inhibitory concentration (MIC) value on Staphylococcus aureus (S. aureus) bacteria strongly correlate with an R-square value of 0.6751 (p < 0.0001). Four 2 pyrazoline derivatives were synthesized and evaluated for antimicrobial activity. Their MIC values on S. aureus range between 4 and 16 μg/mL, consistent with ones predicted by the docking model. Apropos cytotoxic properties, a series of 2-pyrazolines exhibit a moderate activity on HepG2, RD, and MDA-MB-231. The most active compound, HP10, has the IC50 values on these cell lines. which are 26.62 μM, 17.74 μM, 14.47 μM, respectively.

Conclusion: Our research built a docking model on the virtual S. aureus FabH enzyme with high potential in predicting antibacterial activities of different 2-pyrazoline derivatives. Moreover, our cytotoxicity results provided data for further studies on the anticancer activity of these promising derivatives.
 

Introduction: Tumor and pseudotumor (TP) at the proximal femur (PF) can seriously affect mortality, extremity function, and body integrity. However, reports often focused on a specific tumor, not regional lesions. This study focuses on clinical findings, imaging, micro-pathology, and the treatment of all TP at the site.

Methods: The study involved all patients who had a confirmed tumor or pseudotumor diagnosis at the PF. The clinical findings, X-ray, and biopsy were recorded and analyzed. Treatment was optional depending on the patient's situation and available condition of the hospital. The functional outcome, bone healing were defined at the last examination or two years of follow-up.

Results: Fifty patients were involved in the study. Twenty-four patients had apparent tumors. TP at the PF, neck-trochanter, trochanters, and neck were 21 (42%), 16 (32%), 9 (18%), and 4 (8%) cases, respectively. There were 29 (58%) pathologic fractures. Biopsy was made for all patients. Twenty-three cases (46%) were malignant, and 8 (16%) cases were giant cell tumors. Thirtythree patients suffered from an operation. Ennerking's functional score was excellent, good, fair, and poor in 24 (48%), 5 (10%), 1 (2%), and 20 (40%) patients, respectively. For the last outcomes of 33 operated patients, 17 healed, three unchanged, one worse, and two dead.

Conclusions: For the PF TP, the rate of malignant and pathological fracture was high. The giant cell tumor was not rare. The resection of the TP combined with grafts using ordinary fixation devices was satisfactory.

Introduction: Well-timed contraception after delivery using effective methods protects women from unintended pregnancies and improves the quality of life of both women and their children. However, little attention has been paid on the issue in Vietnam. Therefore, this study aimed to determine the percentage of postpartum women from 0 to 6 months using contraceptive methods and associated factors in Trang Bom District, Dong Nai Province, Vietnam.

Methods: A cross-sectional study was adopted. A systematic random sampling method was used to select 355 postpartum women. Women were interviewed about sociodemographic characteristics, reproductive history, and contraceptive use after giving birth.

Results: Of the 355 women, 63.1% used at least one modern or traditional contraceptive method; 58.9% current use, 4.2% previous use, and 36.9% never use. The most selected methods were withdrawal (41.1%), male condom (28.2%), and calendar method (24.4%). Multivariable analysis showed that women who had their menstruation returned, long postpartum duration, high education level, many years of marriage, and previous caesarean section were more likely to use contraception after birth.

Conclusion: The family planning program in Vietnam should focus more on postpartum women. Postpartum contraception should be consulted at all obstetric health centers before and right after delivery. Emphasis should be placed on the initial times to adopt contraception soon and not waiting until the first menses. Women should be encouraged to use modern contraceptive methods instead of traditional ones.
 

Introduction: The pattern of drug use in Vietnam has changed rapidly over the past decade, and a large number of people who have a history of heroin injection reportedly use methamphetamine. This paper describes factors associated with methamphetamine use among people who inject heroin in Hanoi, the capital of Vietnam.

Methods: This is a cross-sectional survey among 521 heroin injectors who were recruited through chain referral and outreach at community and clinic settings. Eligibility criteria included: (1) male aged 18 or older; (2) reported heroin injecting during the 12 months before the survey; (3) agreed for a urine test to detect methamphetamine and opiate metabolites. The primary outcome, methamphetamine use, was defined as selfreported methamphetamine use during the 30 days before the survey and/or having a urine test positive for methamphetamine. Structural Equation Model was used to evaluate associated factors for methamphetamine use.

Results: One third of participants qualified as methamphetamine users as defined in this study. A longer history of heroin use (β=0.126, p<0.001), using MDMA and/or cannabis (β=0.28, p<0.001) and not using condom during sex (β=0.139, p<0.001) were positively associated with methamphetamine use. Family functioning (β=-0.141; p<0.001) was protective. The goodness-of-fit of Structural Equation Model was excellent (CFI=0.934; TLI=0.912; RMSEA=0.033; WRMR=0.98).

Conclusions: Methamphetamine use among people who inject heroin is a substantial issue in Hanoi. Family functioning has made a critical contribution on reducing methamphetamine use. Future studies should pay attention to address the role of factors at the family level in addition to individual-level factors towards the pattern of drug use.

Spontaneous hemopneumothorax is a rare condition and may be a life-threatening condition that needs prompt diagnosis and urgent intervention. In this study, we reported three male cases of spontaneous hemopneumothorax, two cases presented with chest pain and one with epigastric pain. All cases were successfully treated by early surgical intervention. Total blood drainage was ranged from 1400 to 2000 mL. Video-assisted thoracoscopic surgery was performed successfully in two cases, however, one case was transferred to urgent thoracotomy due to excessive blood clotting in the pleura cavity and continuous bleeding. Leukocytosis was observed in two cases, mostly due to pneumonia or sepsis. The bleeding point was identified in all cases, however, the air leak area could not be identified in two cases. Length of hospital stay after admission was ranged from five to seven days. We recommend that video-assisted thoracoscopic surgery should be considered as a first choice due to its effectiveness in reducing postoperative complications and facilitating rapid recovery.

Background: Many clinical and paraclinical studies related to coronary artery disease have been done in Vietnam in recent years. However, there have been no studies on nurses’ knowledge and practice regarding patient care after coronary angiography (CAG) or percutaneous coronary intervention (PCI). This study was conducted to assess nurses' knowledge and practice on patient’s safety after CAG or PCI and its associated factors.

Methods: A descriptive cross-sectional study was conducted from December 2019 to June 2020 at the Department of Internal Cardiology, Interventional Cardiology, Intravascular Intervention, and Intensive care unit/Coronary care unit in three general and specialist hospitals in Ho Chi Minh city, Vietnam. 167 nurses who have taken care of patients after CAG or PCI were included in the study through using convenient sampling technique. A translated self-administered questionnaire was utilised. This self-reported survey achieved 100% response rate. Statistical analysis was performed by the Chi-square test (X2). Statistical significance level was at p<0.05 to determine factors related to nurses’ knowledge and practice. Prevalence ratio (PR) with 95% confidence interval (95% CI) were also used to measure the association.

Results: The study findings revealed that only 36% of the study sample had a good knowledge while 78% of them had a good practice on patient’s safety after CAG or PCI. There were association between educational level, working place with the knowledge (PR=1.87-1.92, p<0.01) and practice (PR=1.18-1.35, p<0.05) on patient’s safety after CAG or PCI among Vietnamese nurses. Besides those factors, the number of years working in cardiac specialty were also found to have an association with the practice. A moderately positive correlation between the knowledge and the practice towards patient‘s safety after CAG or PCI has been identified in this study (PR=1.27, 95% CI [1.09 – 1.47], p=0.005).

Conclusions: More than a half of the study sample had poor knowledge but performed good practice in some items of care for patients after CAG or PCI. There was positive association between the knowledge and practice about patient’s safety after CAG or PCI among Vietnamese registered nurses. Educational training programs for staffs working in coronary angiography or percutaneous coronary intervention is recommended to develop.

Background: Nowadays, metabolic disorders such as dyslipidemia have become serious health problems in the modern world. PPARs are regulators of numberous metabolic pathways, hence there has been a huge increase in the development and use of the PPARs agonists, especially PPARα agonists as main therapeutic of dyslipidemia.

Objectives: The study aimed to explore potential plant-derived natural compounds as PPARα agonist agent for drug discovery of dyslipidemia. Methods: Structure-based virtual screening through molecular docking was conducted for 142 bioactive compounds from 29 medicinal plants on the main binding site of PPARα (PDB ID: 5HYK). Binding affinities and binding interactions between the ligands and PPARα were investigated.

Results: Screening results showed that 34 compounds had strong binding affinities into the PPARα (binding affinities of less than -8.0 kcal.mol-1), including 20 flavonoid, 4 terpenoid and 10 alkaloid compounds. Flavonoid was found as the best group which fitted well in the binding site of the PPARα. Top compounds were identified, including formononetin from Thermopsis alterniflora (-10.2 kcal.mol-1), diosmetin from Musa spp. (-10.1 kcal.mol-1), luteolin from Elsholtzia ciliate (-9.9 kcal.mol-1); steviol from Stevia rebaudiana (-9.4 kcal.mol-1); and tuberocrooline from Stemona tuberosa (-10.5 kcal.mol-1), respectively. These compounds showed the potential agonistic activities due to forming the hydrogen bonds as well as hydrophobic interactions with four key residues of the receptor such as Ser280, Tyr314, His440 and Tyr464.

Conclusions: These potential natural compounds may provide useful information in the drug design and discovery for anti-dyslipidemia agents.

Background: The use of non-invasive ventilation (NIV) in preterm infants is becoming increasingly common. The use of cannula in NIV can cause ulceration of the nasal bridge with the current practices using the thin foam patches. This study aims to evaluate the effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration comparing to that of the thin foam patches.

Methods: A prospective cohort study using hydrocolloid dressing pads (1 November to 30 April 2020) was compared to that of a historical control group using thin foam dressing (1 April to 15 October 2019) to evaluate the effectiveness of hydrocolloid dressing pads. All participants were preterm infants (less than 37 weeks of gestational age) and used nasal cannula NIV at the Department of Neonatal Intensive Care (NICU), Children's Hospital 1.

Results: 71 infants used hydrocolloid dressing pads, and 42 used ordinary thin foam nasal dressings. In the hydrocolloid dressings group, two infants (2.8%) had nasal ulcers; among them, one was mild, and the other was moderate. In comparison, ten infants (23.8%) using thin foam dressings developed ulcers, of which seven were mild, two were moderate, and one was severe. Using hydrocolloid nasal dressings significantly reduced nasal ulceration compared to thin foam dressings (OR = 0.09, 95%CI = 0.02 – 0.45).

Conclusion: Using hydrocolloid nasal dressings for preterm infants on nasal cannula NIV significantly reduced nasal ulceration compared to ordinary thin foam dressings.

Introduction: The rapid increase of infected cases and fatalities during the COVID-19 pandemic has created a huge health crisis to the world and Vietnam in particular. Health professionals were put under massive pressure in preventing pandemic. This study was conducted to assess the knowledge, attitude and practice (KAP) during the COVID-19 disease through an online survey as well as related infection control practices among pharmacy students in the University of Medicine and Pharmacy at Ho Chi Minh City (UMP).

Methods: The cross-sectional study was conducted based on the data obtained from an online questionnaire. Correlation analysis was performed using statistical tests and linear regression model for practice. The total study sample, chosen based on the inclusion and exclusion criteria was taken from pharmacy students in UMP during the study period.

Results: A scale of KAP towards COVID-19 was developed with 43 questions and received 1,089 responses. We acknowledged that the awareness and practice of these students were at a good level (with a mean score of 8.37±0.77 and 8.46±1.33, respectively) and the attitude was optimistic with a mean score of 6.22±0.68. Related factors to practice included gender (p=0.005), year of study (p=0.013); to knowledge included the time spent in university (p=0.040); to attitude included social distancing (p=0.024). Multivariable regression analysis showed that practice is related with male gender (β=-0.254; p=0.001), the first 3 school years (β = 0.173; p=0.020), knowledge score (β =0.154; p=0.003).

Conclusions: Based on a constructive scale, the study noted students' knowledge-attitude-practice towards COVID-19 at a good level. School year and knowledge scores positively affected practice scores, while male students had a negative effect.

Protein kinase C (PKC) family has been an alluring objective for new cancer drug discovery. It has been reported to regulate telomerase in several cancer types. Our team had previously used telomerase to elucidate alpha-fetoprotein (AFP) modulation in hepatocellular carcinoma (HCC). The aim of this study was to investigate the interrelationships among PKC isoforms, telomerase and AFP in HCC. PKCα and PKCδ were the most expressed isoforms in HepG2/C3A, PLC/PRF/5, SNU-387 and SKOV-3 cells. Following the upregulation of AFP using pCMV3-AFP and the human telomerase reverse transcriptase (hTERT) using a construct expressing a wild-type hTERT, and after their inhibition with all-trans retinoic acid and hTERT siRNA each respectively, we found that the expression of PKCα, PKCβI, PKCβII and PKCδ was affected by the variation of AFP and hTERT mRNA levels. An increase in AFP expression and secretion was observed after gene silencing of PKCα, PKCβ, PKCδ, and PKCε in HepG2/C3A. A similar pattern was observed in transfected PLC/PRF/5 cells, however PKCδ isoform silencing decreased AFP expression. Furthermore, telomerase activity was quantified using quantitative telomeric repeat amplification protocol. The variations in hTERT expression and telomerase activity were similar to those of AFP. Further investigation showed that PKC isoforms regulate AFP and hTERT expression levels through PI3K/AKT/mTOR pathway in HepG2/C3A and PLC/PRF/5 cells. Thus, these results show for the first time a possible interrelationship that links PKC isoforms to both AFP and hTERT via PI3K/AKT/mTOR pathway in HCC.

Introduction: Total anomalous pulmonary venous connection (TAPVC) is a rare condition. Mortality of TAPVC has improved dramatically in the present. Sutureless closure had initially used for congenital pulmonary venous stenosis (PVS) or post-repair PVS. Recently, it had been adopted for primary TAPVC to prevent postoperative pulmonary venous obstruction, a leading cause of death. This technique had gradually applied at our institute for primary TAPVC since 2018.

Methods: Prospective case series was conducted from mid-2019. Including criteria consists of patients with primary TAPVC. These are all supracardiac, infracardiac, mixed type and intracardiac TAPVC with pulmonary venous stenosis. Excluding measures are TAPVC with single ventricle, isomerism or heterotaxy. End-point outcomes were mortality and short-term PVS.

Results: Seventeen TAPVC cases were enrolled in this study from 06/2019-12/2020 at Children's Hospital 1. Male/female ratio was 12/5. Median age at admission was 44 (3-1010) days old. The median operative weight was 3.9 kg (2.4-11). Of those, fourteen (82.4%) cases were supracardiac TAPVC and 3 (17.6%) cases were infracardiac TAPVC. Nine (52.9%) cases were emergency operations. Median aortic clamp time was 66 (32-138) mins. Median bypass time was 112 (86-212) mins. There were 9 (52.9%) cases with arrhythmias, 2 (11.8%) cases with chylothorax. Mean ventilation time was 3.6±0.5 days; mean CICU time was 6.5 (1-20), median LOS was 14.5 (8-39). In-hospital mortality was 5.9% (1). Mean follow-up time was 12.3±6.4 months (range 4-24), there was no PVS with median pulmonary venous score of 0 (range 0-1).

Conclusions: Sutureless technique could be a safe option for primary TAPVC repair.

Purpose: To report a case of large intraorbital foreign body after a trauma.

Case report: A 38-year-old male patient admitted to hospital because of blurry vision and pain in left eye after being hit by a windscreen wiper on left eye (OS). Lid laceration was treated in a tertiary center before the patient was admitted to Ho Chi Minh City Eye Hospital with diagnosis orbital cellulitis and intraorbital foreign body of OS. High dose of antibiotics had been indicated before he underwent surgery to remove the foreign body. The foreign body was made of plastic, 7×10×35mm in size with many edges and adjacent to the orbital apex.

Conclusion: Taking history and trauma mechanism carefully may aid to early diagnosis and appropriate treatment to a patient with intraorbital foreign body. CT-scan images of the orbit, the globe, the sinuses and the cranial bones not only help locate the foreign body, but also aid to find out injuries of adjacent structures.

Introduction: Insomnia is a common disease in all societies and age groups. Among them, medical students are one of the population most susceptible to sleep problems. Studies from many countries have shown high prevalence of insomnia among medical students. Sleep diary is the gold standard for evaluating subjective insomnia and other sleep disorders. This research aims to study the prevalence of insomnia in Vietnamese medical students, associated factors, and their sleep patterns.

Method: In a cross-sectional survey using stratified random sampling, a total of 176 medical students was recruited, each completed a self-administered questionnaire and a 7-consecutive-day sleep diary. Demographic data and lifestyle factors were obtained from the questionnaire, while sleep patterns and quality were collected from the sleep diary. We performed data analysis using SPSS ver 22, p<0.05 was statistically significant.  

Results: Overall, out of 176 participants, 93 (52.8%) were affected by insomnia. On average, students acquired 6.2 hours of sleep each night. 70.94% of the recorded nights had total sleep time (TST) less than 7 hours. Associated factors of insomnia include sleep environment, sleep efficiency (SE), bedtime, falling asleep time, get up time, self-reported sleep quality.

Conclusion: The findings of our study revealed the high prevalence of insomnia among medical students. From recorded sleep data, we observed that sleep deprivation is also a common issue faced by the study participants. The valuable insights provided by sleep diary proved to be crucial in evaluating sleep patterns and quality.

Introduction: Endometrial cancer and endometrial atypical hyperplasia, futher referred to as endometrial (pre)malignancy in approximately 8.3-17.6% of cases depending on different studies. The incidence of abnormal endometrium increases during the postmenopausal period, especially endometrial (pre)malignancy. There are limited data regarding endometrial (pre)malignant disorders in patients with postmenopausal uterine bleeding.

Purpose: The aim of this study is to investigate the risk of endometrial cancer and atypical hyperplasia in the women who had postmenopausal uterine bleeding (PUB) and assess the risk factors associated with such cases.

Methods: A cross-sectional study was conducted on 164 women with PUB used vacuum aspirator with Karman canula to evaluate endometrial pathology, underwent treatment at deparment of Gynaegology, Tu Du hospital through a set of questionaires and case file reports completed from February to June of 2020.

Results: In Bayesian inference, the risk of endometrial (pre)malignancy was 17.5%, CI (credible interval) 95% of 14.1 to 21.1%. There was a significant association between the risk and the duration of bleeding (OR = 1.02, CI 95% 1.01 to 1.03, LR+ 1.96, LR- 0.37), number of live births (OR = 0.79, CI 95% 0.66 to 0.95, LR+ 2.41, LR- 0.76), endometrial thickness (OR = 1.08, CI 95% 1.01 to 1.16, LR+ 1.16, LR- 0.77) and the presence of abnormal intracavitary mass in transvaginal ultrasound (OR = 9.12, CI 95% 4.09 to 20.33, LR+ 3.65, LR- 0.4).

Conclusions: Using manual vacuum aspirator with Karman canula showed the risk of (pre)malignancy in women having PUB and this risk depends on the presence of the risk factors.

Introduction: This study assessed the validation of Body Mass Index (BMI) against Subjective Global Assessment (SGA), and identify the prevalence of malnutrition and its associated factors in Chronic Obstructive Pulmonary Disease (COPD) inpatients at Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam.

Methods: A cross-sectional study was conducted to consecutively select COPD inpatients based on medical records and consultancy with doctors. A structured questionnaire was designed to collect socio-demographic characteristics, health status and comorbidities, nutritional status, and handgrip strength. Nutritional status was assessed using SGA and BMI. Handgrip strength was measured using a hand dynamometer. Health status was collected from medical records.

Results: The mean age of 83 COPD inpatients recruited in this study was 67 (SD=10.4) years. Most of the sample population was ≥60 years old (75%), male (86%), Kinh ethnic (89%), married (72%), not currently working (70%), and less than junior high school (81%). Nearly 68% had at least one comorbidity and 27% were active smokers. The mean handgrip strength was 21.6 kg (SD=8.7), and mean weight was 53.9 kg (SD=10.0). The mean BMI was 20.4 kg/m² (SD=3.4) with 58% having BMI <21 kg/m². SGA provided the prevalence of malnutrition of 65%. Age-group, BMI and handgrip strength were associated with malnutrition. A BMI cut-off point of <21 kg/m² provided the highest ROC area of 84% (95%CI: 76%-92%).

Conclusion: Malnutrition is common in COPD inpatients. This study confirms findings of previous studies that a BMI cut-off point of <21 kg/m² was sensitive and specific for screening malnutritional risk at bedside.

Patients with Crohn’s disease may present with lesions in their oral cavity. Oral lesions may be associated with the disease itself representing an extraintestinal manifestation, with nutritional deficiencies or with complications from therapy including infections. Actinomycosis is a slowly progressive bacterial infection caused by Actinomyces spp., anaerobic Gram-positive bacteria. These organisms are normal inhabitants of mucous membranes, especially of the oropharynx, and cause opportunistic infections. We report a case of a 30-year-old male with Crohn’s disease presenting with painful oral aphthous ulcers and swelling of the upper lip. A diagnosis of oral actinomycosis was confirmed by histopathological examination. The patient was treated with infliximab and a regimen of amoxicillin 1 g three times a day. He had a marked response to the treatment after 2 weeks. The plan was to continue amoxicillin for at least 6 months with regular follow-up. Physicians should be aware that actinomycosis may be a cause of oral lesions in Crohn’s disease patient, particularly in immunosuppressed patient. Bacterial cultures and pathology are the cornerstones of diagnosis and should be performed in suspected cases to prevent misdiagnosis.

Background: The research aimed to increase certain HbA1c concentrations at medical decision levels for external quality control samples from healthy donor blood.

Methods: The in vitro study was performed from October 2019 to January 2021 at Quality Control Center for Medical Laboratory at University of Medicine and Pharmacy at Ho Chi Minh City. The study observed on the conditions including the optimal buffer solutions (BAGPM, BPS, Ringer, Saline), temperature (2ºC - 8ºC, 22ºC - 24ºC, 37ºC), and glucose concentration (100 mM, 305 mM, 500 mM) affecting the HbA1c concentration in vitro to make the external quality control samples fell in normal, prediabetes, and diabetes range. At every condition, the HbA1c concentration was measured by Tina Quant method to look for the optimal procedure to increase HbA1c concentration required of the external quality control protocol.

Results: The highest HbA1c concentration (11.57±0.2%) was found in BAGPM solution with 100 mM glucose after 15 days with the baseline HbA1c 5.43±0.13%; the HbA1c level increase dramatically at 37ºC in BAGPM 500 mM glucose solution in fifteen days (40.03±1.05%).

Conclusions: The appropriate conditions were identified to prepare HbA1c standards for prediabetic and diabetic levels. The standards for HbA1c concentrations were recommended to prepare by incubating RBCs from non-diabetic donor blood in BAGPM solution containing glucose at 37ºC for 24 hours. Glucose concentrations should be 100 mM and 500 mM, respectively, for prediabetic level (HbA1c ~ 6.0 ± 0.12%) and diabetic level (HbA1c ~ 9.6 ± 0.17%).

Skin aging is a natural phenomenon which is related to progressive loss of skin structural integrity and physiological function and affects aesthetics which has been of highly interest. Inhibition of matrix metalloproteinases (MMPs) such as MMP-1, MMP-3, MMP-9 is one of the potential approaches for anti-aging treatment as these targets are involved in molecular pathology to skin aging process from sunlight. The aim of the study was to investigate the binding affinity of 9 phytochemical compounds extracted from Morus alba Moraceae into the MMP enzymes leading to potential anti-aging activity by using in silico approaches including molecular docking and molecular dynamics simulations. All the compounds showed binding abilities into the targets. In particular, mulberrofuran H obtained the best docking results on the three MMPs. Molecular dynamics simulations of the complex of  mulberrofuran H and MMP-9 showed that this complex was stable. Combination of molecular docking and molecular dynamics simulations results, there was an important hydrophobic interaction between mulberrofuran H and His401 at the active site of the MMP-9, which determined the MMP-9 inhibitory potential of mulberrofuran H. The ligand mulberrofuran H was also stabilized into the MMP-9 protein by hydrogen bonds with Pro421 with the high occupancy of 77.67%. These results demonstrated the good binding of mulberrofuran H on the protein MMP-9 which highlighted its anti-aging potency.

The manuscript is withdrawn due to authors’ request.

Introduction: Herbal antidiabetic products are popular in Vietnam. Many cases have presented to hospitals with severe lactic acidosis, shock and were ultimately fatal. We reviewed the clinical findings of these patients for factors that contributed to their illness and death, and analyzed the ingredients contained in these herbal products sold for diabetic treatment.

Method: This was a single-center, retrospective, observational case series. Data were collected on all cases who presented with severe lactic acidosis after use of traditional herbal anti-diabetic pills, over the two-year time period 2018 – 2019. Past medical histories and clinical findings were reviewed. Samples of the herbal anti-diabetic products, and patient blood and urine were analyzed.

Results: A total of 18 cases of severe lactic acidosis associated with use of herbal anti-diabetic pills were reviewed. These patients had a diagnosis of diabetes for an average of 9 years (9.4 ± 4.6 years). The use of these herbals for blood glucose control ranged from one month to 8 years; approximately 50% of these patients consumed these products over a year’s time. Only two cases had combined herbal products and metformin 500 mg. A total mean of herbal pills consumed was 9 (SD ± 8); patients commonly took combinations of 2 different colored tablets. Major manifestations included gastrointestinal disorders, severe metabolic acidosis (pH = 6.85 ± 0.22, HCO3- = 4.4 ± 2.6), with multi-organ failure and shock on admission. Hyperlactatemia was present in all cases (195 ± 74 mg/dL). For lactate removal and acidosis correction, intermittent hemodialysis or continuous renal replacement therapy was performed, ranging from 2 hours to 72 hours depending on the severity of lactic acidosis and patient need. The mortality rate was 33.3% and all these patients became hypoglycemic, either at initial presentation or during treatment. 22 samples of herbal pills were available for testing that contained the biguanides metformin and phenformin, with a higher concentration of phenformin than metformin if both were present, Phenformin was presented in all samples. Arsenic was found in two samples.

Conclusion: Biguanides are an effective treatment for diabetes and were added to traditional herbal pills sold and used for blood glucose control. Many users of these products are doing so because of the cost and perception of the safety of natural remedies. Biguanide poisoning may still occur even in patients without renal impairment.

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR.

Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included.

Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia.

Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

Introduction: Germline mutations in predisposing genes have been found in 30-40% of pheochromocytoma/paraganglioma patients. Screening for inherited genetic mutations provide clinicians with mutation-positive patient management strategies in addition to identifying family members at risk of disease. However, genetic testing for pheochromocytoma has not been performed widely in Vietnam.

Methods: Seven patients diagnosed with pheochromocytoma in Vietnam underwent germline genetic testing in known pheochromocytoma-associated genes by direct sequencing. When a germline mutation was identified the first-degree relatives were counseled and offered genetic testing for the inherited mutation.

Results: Mutations were found in five of seven cases and all mutations were in RET proto-oncogene codon 634 indicating a high risk of developing aggressive medullary thyroid cancer and in some cases leading to prophylactic thyroidectomy as recommended.

Conclusions: Genetic testing plays an essential role in the clinical management of pheochromocytoma patients. Genetic results have significantly changed the clinical approach in these patients and identified ‘at risk’ family members.

Introduction: Mycophenolic acid (MPA) is an active metabolite of mycophenolate mofetil and mycophenolate sodium which are widely prescribed to prevent organ rejection after solid organ transplantations. However, MPA induced many side effects on gastrointestinal tract and haematological system.

Objectives: The purpose of this study is to establish a high-performance liquid chromatography (HPLC) method to determine the MPA concentration in plasma in order to optimize the treatment efficacy of MPA or apply to bioequivalence studies. MPA and visnadine (as an internal standard) were extracted from plasma samples with methanol by solid phase extraction using Osis HLB 1cc cartridge. 10 µL of sample extract was injected onto LiChroCART®125-4 (C18 reversed-phase column) at 43 ^°C on a Waters 2695 XE system. The signals were detected by PDA detector (photodiodes array) at 254 nm. The mobile phase was a mixture of acetonitrile and phosphate buffer (pH 3) with a flow rate of 1 mL/min. The validation criteria included: selectivity, linearity, accuracy, precision, recovery, lower limit of quantification.

Results: Total chromatographic runtime was 15 min. MPA and visnadine were found at 6.45 and 10.79 min, respectively. MPA concentrations were in the linear range from 0.25 to 50 µg/mL. The coefficient of variation (CV) of mean intra-day and inter-day precision levels for MPA was less than 7.5%. The lower limit of quantification was 0.25 µg/mL. No interference was found in the assay.

Conclusion: A simple and reliable HPLC method was developed to quantify the MPA concentration in plasma.

Actinomycosis is an underreported chronic invasive disease caused by Actinomyces spp. In that group of diseases, pelvic actinomycosis is very rare and most of the cases reported in the literature have shown unilateral psoas muscle involvement. We report a 35-year-old woman with a retroperitoneal mass located in the left psoas muscle that makes abdominal tenderness and difficulty in walking. She had a 7-year history of intrauterine device which had been removed one month just before this event. After undergoing two laparotomies to perform a biopsy with undetermined results, she developed a new mass in the right psoas muscle which was similar to the left one. On the third attempt, the histopathology revealed yellow sulfur granules of Actinomyces which reacted positively with periodic acid Schiff and Grocott’s dye. After three months of treatment with Amoxicillin plus Clavulanic acid, her abscesses were completely resolved. Actinomycosis should always be included in the diagnostic list in patients with a pelvic mass and a history of intrauterine device.

Background: The dengue infection cases are increasing in Ho Chi Minh city (HCMC), Vietnam. Previous studies have demonstrated the correlation between dengue cases and weather factors, which then are used to built prediction models for dengue outbreaks. However, the association between dengue and weather varies greatly between regions and locations. In HCMC, a tropical climate city in Vietnam, there is no such a weather-based prediction model for dengue outbreaks.

Objectives: This study aims to determine the correlation between weather factors and a weekly number of dengue cases and to develop a scoring scheme prediction model for dengue outbreaks using weather factors in HCMC, Vietnam. 

Methods: An ecological study was conducted on the evaluation of weekly time-series data from 1999 to 2017. A Poisson regression model coupled with Distributed Lag Non-Linear Model (DLNM) was constructed to evaluate the effects of weather factors (i.e., temperature, relative humidity, cumulative rainfall, wind speed) and the weekly dengue cases in HCMC with lag 1-12 weeks.

Results: The predictive model was based on the following weather factors: wind speed at lag 5-8 and 9-12 weeks; temperature amplitude and humidity at lag 5-8 weeks; rainfall at lag 1-4, 5-8, and 9-12 weeks. The predictive model using climate predictors explained about 80% of the variance in dengue cases with a small value of the mean absolute percentage error (MAPE= 0.17). The scoring scheme was then developed from the predictive model; it had a good prediction power – with the accuracy rate = 81%, sensitivity = 1, and specificity = 0.80. In summary, our study indicated that weather factors significantly influence and are predictors for the variation of dengue cases in Ho Chi Minh city, Vietnam. We recommend applying this model to improve the prevention of dengue outbreak.

Many plant parts have been widely used in the treatment of immune diseases in Vietnam, yet just few of them are known about their mechanism of action. The goal of this study was to investigate the in vitro inhibitory effects of in vitro inhibitory effect of crude ethanol extracts and fractions of thirteen medicinal plants on proliferation of human peripheral blood mononuclear cells (PBMCs), interleukin-2 secretion and antioxidant activity. PBMCs were extracted from the whole blood of healthy volunteers. The effects of thirteen crude extracts in ethanol and twenty four fractionated extracts in chloroform, ethyl acetate and water on in vitro proliferation of PBMCs were evaluated using MTT test. Interleukin - 2 (IL - 2) concentrations secreted by PBMC were determined by ELISA method. The antioxidant capacity of ethanol extracts and fractionated extracts were assessed using the DPPH method. The results showed that out of thirteen crude ethanol extracts, six extracts inhibited PBMC proliferation and two extracts stimulated PBMC proliferation and five extracts had no effect on PBMC proliferation. The inhibitory extracts reduced the amount of IL-2, while the stimulant extracts while the stimulant extracts had no effect on IL-2 secretion compared to the control. The chloroform extract of Wedelia chinesis showed the strongest inhibitory activity with an IC₅₀ concentration 16.1 µg/ml. The chloroform extract of Piper betle showed the strongest DPPH capture capacity with DPPH₅₀ 1.94 µg/ml and 2.1 times stronger than vitamin C. In conclusion, the chloroform extract of Wedelia chinensis may be considered for the treatment of autoimmune diseases.

Introduction: The production of carbapenem enzyme is one of the most frequent mechanisms reported in cabapenem resistant Pseudomonas aeruginosa. Besides, a growing number of mobile colistin resistance (MCR) genes are threatening the renewed interest of colistin as a "last-resort" against carbapenem-resistant pathogens. Therefore, the detection of carbapenem-resistant and colistin-resistant phenotypes as well as preventing transmission of multi-resistant P. aeruginosa strains with genes coding for carbapenemase is extremely necessary.

Material and methods: Among 159 P. aeruginosa strains were collected 46 isolates, which is resistant or intermediated to meropenem. Modified carbapenem inactivation (mCIM) and colistin broth disk elution (CBDE) methods were used to identify carbapenemase-producing strains and colistin resistance. In addition, a multiplex real-time PCR technique was applied to investigate the frequency of emergence of carbapenem resistance genes.

Results: The results revealed that 25 strains (54.3%) were positive with mCIM test and none of them resistant to colistin by CBDE method. Number of strains carrying a gene blaIMP: 4 strains (16%), blaNDM: 2 strains (8%). Strains are carrying two genes: blaIMP + blaNDM: 10 strains (40%), blaVIM + blaNDM: 1 strain (4%), blaNDM + blaOXA-48: 1 strain (4%) and are carrying three genes blaIMP + blaNDM + blaOXA-48: 6 strains (24%), blaKPC + blaIMP + blaNDM: 1 strain (4%).

Conclusions: All mCIM positive P. aeruginosa were contained carbapenemase genes. Colistin still reserved a good effect to combine with other antibiotics in multi-resistant treatment. Hence, the classification of genes can help clinicians selected appropriate antibiotics so that more effective treatment for patients.

A case of Rasmussen encephalitis in a 8 year old child is reported here who presented with recurrent focal seizures and progressive weakness of left half of body. EEG showed electrical features of epilepsy. MRI brain showed cortical atrophy of one brain hemisphere. On the basis of clinical and radiological evidence, diagnosis of Rasmussen encephalitis was made which is a rare neurological disorder of childhood.

Objectives: To analyze the budget impact of the HIV/AIDS treatment on a national scale, from the Vietnam Social Security (VSS) perspective.

Methods: A model with a 5-year time horizon was developed. The total first year direct medical cost (DMC) and its cost components were estimated for HIV-infected populations each year. Budget impact was described through the proportion of the DMC over the social health insurance (SHI) budget. A scenario analysis was conducted with four settings of different proportions of members and coverage levels of the SHI. All costs were converted to 2020 US dollars. 1-way sensitivity analyses were conducted with variations of mean values in a range of ±25%.

Results: The total DMC was estimated at $1.8M (10,000 cases) to treat all new infections and $27.7M (150,000 cases) to reach the treatment goal of the Ministry of Health (MOH) in 2020. The total DMC accounted for 0.6% of the SHI budget for the year 2020 to meet the treatment goal. The costs of CD4-count test and fully suppressive regimen containing Tenofovir Disoproxil Fumarate (TDF) were identified as key cost drivers. The proportion of the total DMC over the SHI budget among different scenarios did not vary significantly.

Conclusion: This is the first-ever study analyzing the budget impact of the HIV/AIDS treatment on a national scale, from the VSS perspective. The results showed that the cost of HIV/AIDS care was economical and the impact on the SHI budget was reasonable. Findings could be used to notify the MOH to allocate domestic resources and to optimize the current programs.

Introduction: The sex ratio at birth has dramatically increased since 1999 in Vietnam and stood at 112.7 boys per 100 girls in 2017. This figure alarms many female fetuses are aborted for sex-selection but the numerical evidence is unknown. To depict an accurate picture about the sex-selective abortion, we conducted a study to analyze the national data for sex-abortion in Vietnam.

Methods: To estimate the number of sex-selective abortions between 1999 and 2009, the 2009 Census and 1999 Life table of Vietnam were adopted. We calculated the actual number of female and male births for ten years using the reverse survival method. Then the number of sex-selective abortions was the gap between the expected and actual numbers of female births.

Results: There was 217,902 sex-selective abortions, which accounted for 11.8% of all causes of abortion in Vietnam from 1999 to 2009. The number of sex-selective abortions was nearly double from 74,179 in 1999-2004 to 143,723 in 2005-2009, even the national punishments on sex-selective abortion were launched since 2003.

Conclusions: Female fetuses are more likely aborted before birth for sex-selection in Vietnam because of the son preference. In the situation of Vietnam, changing the social norm regarding female values and roles in both family and society is the key solution to end this problem.

Background: Puberty is a milestone in child and adolescent development, yet a feasible tool to accurately assess pubertal stage in community context has not been validated in Vietnam.

Aim: This study was conducted to validate pubertal self-report among Ho Chi Minh City children and adolescents in comparison with paediatrician’s assessment.

Methods: 80 girls and 76 boys aged from 6 to 17 years old from 5 schools in Ho Chi Minh City were recruited. Self-administered questionnaires about sexual maturation were distributed to participants and results were compared with physician’s pubertal examination. Kappa statistic and Kendall’s τ b were used to evaluate validity of the questionnaire.

Results: Boys tended to overestimate their development stages while girls tended to underestimate. Fair to almost perfect agreement between students’ reports and paediatricians’ evaluation, along with high concordance was recorded, however younger boys (aged 6-11) showed limited evaluation of their own sexual maturation.

Conclusion: This method was inaccurate to evaluate younger boys’ sexual maturation; however, acceptable accuracy in sexual maturation estimation among younger girls and adolescents could allow it to serve as an effective screening tool in community context.

Objectives: We assessed the factors relating to the prevention of the Novel Coronavirus Disease (COVID-19) for students at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. 

Methods: A cross-sectional study was performed in February and March 2020. A 21 item self-administered questionnaire on the knowledge, attitude, and practices regarding COVID-19 was collected from students of the first to the sixth year using the strategy of simple random sampling. The aim was to establish factors that relate to practices using Odds ratio (OR) and 95% confidence interval (95% CI) which were estimated by the logistic regression model, p-value <0.05 shows a significant difference.

Results: Of the 551 students, 41.0% recorded responses indicating good practices toward prevention measures, while around half the students reported that they did not wash their hands for 20 full seconds (50.5%). The overall rate of good knowledge and positive attitude was 49.0% and 26.1%, respectively. When adjusted for all variables in the logistic regression model, a positive overall attitude was associated with good overall preventive practice; AOR = 1.72 (95% CI: 1.16 – 2.55). Furthermore, students mainly accessed information via social media and television (95.8% and 85.8%, respectively).

Conclusions: There were only 41.0% recorded responses indicating good practices toward prevention measures. Besides, knowledge and attitudes about COVID-19 among students were inadequate. Further health education interventions should be focused to change bad hand-washing habits via mass media messages.

Background: Recently, methods of quantifying total oxidant status (TOS) and total antioxidant capacity (TAOC) were developed to investigate periodontitis. This study was performed to evaluate the salivary TOS and TAOC levels of patients with chronic periodontitis (CP) and investigating the association between periodontal clinical parameters and these oxidative stress biomarkers.

Material and methods: 40 participants (23-65 years old) were classified into two groups of 20 each, namely the CP group (participants with CP) and the control group (periodontally healthy controls). Clinical periodontal parameters were monitored, and TOS and TAOC levels were measured using laboratory assays.

Results: TOS level increased in the saliva of patients with CP and the salivary TAOC in patients with CP was significantly lower than that of the control group. The TOS had a positive moderate correlation with the plaque index and clinical attachment loss (r=0.32 and 0.37, respectively) while TAOC was negatively and moderately correlated with clinical attachment loss (r=-0.35).

Conclusion: Salivary TOS and TAOC were distinguished in healthy and chronic PD patients. Further studies are required to comprehensively evaluate the potential role of these biomarkers in diagnosis and treatment evaluation of CP.

Central neurocytoma (CN) is an uncommon brain tumor arising primarily in the lateral ventricular near the foramen of Monro and approximately accounting for 0.1-0.5% of all primary tumors of the central nervous system. We report a case of neurocytoma located in the fourth ventricle and extended into the third ventricle. The tumor is composed of uniform round cells with immunohistochemical features of neuronal differentiation. CN is probably a differential diagnosis with oligodendrogliomas and ependymoma. Morphology and immunohistochemical findings associated with clinical and radiological characteristics may support CN diagnosis.

Type B Hepatic encephalopathy (HE) due to a congenital extra-hepatic porto-systemic shunt is an extremely rare condition. We report the case of a 57-year-old woman, with recurrent episodes of confusion and neuropsychiatric symptoms, who had an elevated serum ammonia level and a superior mesenteric-caval shunt documented on abdominal computed topography (CT) scan. There was no evidence of cirrhosis or portal hypertension. A diagnosis of non-cirrhotic, non-portal hypertension hepatic encephalopathy was made after excluding other causes of confusion and cognitive impairment. The patient was successfully treated by radiologically guided endovascular shunt closure and during 9 months follow up, her neuropsychiatric symptoms did not recur and repeated serum ammonia level results were normal.

Introduction: This study assessed Health-Related Quality of Life (HRQOL) of patients with Acute Coronary Syndrome (ACS) 6 to 12 months after receiving Percutaneous Coronary Intervention (PCI) and/or Optimal Medical Therapy (OMT) at a hospital in Ho Chi Minh City, Vietnam.

Methods: A cross-sectional study was conducted on 113 patients. Data on demographic, lifestyle behaviours, and HRQOL were collected using a structured questionnaire through face-to-face interviews. HRQOL was measured using EQ-5D-5L and EQ-VAS. Data on co-morbidity and other clinical characteristics were extracted from hospital records. Bivariate and multivariable linear regression models were run to test the differences in EQ-5D-5L utility index and EQ-VAS scores between PCI/OMT and OMT alone groups.

Results: EQ-5D-5L utility index and EQ-VAS scores were lower in PCI/OMT compared to OMT groups, although the differences were not clinically meaningful. Weight status, smoking, and physical activity were associated with EQ-5D-5L utility index score, whereas only physical activity was associated with EQ-VAS score.

Conclusion: The findings suggested that improving sufficient physical activity levels and stopping smoking after PCI or/and OMT may help increase HRQOL among ACS patients.

Background: This study translated and culturally adapted the Comfort Behavior Scale (Comfort-B) into Vietnamese using a standard protocol guided by the World Health Organization.

Methods: The Comfort-B was translated into Vietnamese and then English back-translated by independent translators. These versions were reviewed and assessed by a Vietnamese expert’s panel and an English expert’s panel. Thirty-four nurses of the Nhi Dong 1 Hospital were invited to use the Vietnamese Comfort-B to assess pain while watching five videos recorded before, during and after wound dressing replacement. The eight characteristics of the Vietnamese Comfort-B were assessed by 34 nurses. Fifteen nurses agreed to do the second assessment two weeks from the first assessment. The content validity index was used to assess the relevance and clarity of all items and the whole scale. Agreements between raters were explored using Kappa statistics. Intraclass correlation coefficients (ICC) were used to assess intra-rater and inter-rater reliability. Multi-level linear regression was used to assess changes in the Vietnamese Comfort-B before, during and after wound dressing replacement between two assessments.

Results: The Vietnamese Comfort-B was accredited by the Vietnamese expert’s panel. The English-back translated version was approved by the English expert’s panel. The nurses agreed that the Vietnamese Comfort-B can be used in clinical practice and research. Kappas of all items were ≥0.96 indicating excellent agreement between raters. Alpha coefficients of two assessments were ≥0.97 indicating excellent internal consistency. All ICCs ≥ 0.79 indicated good intra-rater and inter-rater reliability.

Conclusions: The study suggested that the Vietnamese Comfort-B can be used for future studies assessing children’s pain in the local hospital context.

The prevalence of asthma is sharply increasing in pediatric population and has become a global burden of medicine and economics. Nevertheless, evidence for the diagnostic criteria of this condition is still lacking. This condition leads to over-diagnosis of asthma in cases, especially younger children. Stridor and wheezing, pathologic signs of airway obstruction, are sometimes mistakenly identified. As a result, disorders of extra-thoracic airway obstruction may be misdiagnosed with intrathoracic diseases. An example of this confusion is that a 19-month girl admitted to our hospital with a diagnosis of uncontrolled asthma. Careful history taking, physical examinations and laboratory investigations revealed that the patient has laryngomalacia. We report this case in order to share with pediatric colleagues a valuable clinical experience in approaching children with noisy breathing.

It is well-known that hypothyroidism predisposes to weight gain and obesity, but in the synthesis process of the thyroid hormones there are several steps that can fail producing the same consequence. In this respect, almost all studies talk about the decrease in T3 levels in cases of hospitalization but none as the primary cause of obesity. Here we report a case of chronic obesity since childhood with persistent low T3 values, high deiodinase (DIO)-2 and normal reverse T3, thus proposing that low T3 syndrome is not only the result of a critical condition but could be previous to any acute disease leading to weight gain and obesity.

Objectives: Determined the effects of music on the result of non-stress test at 33 weeks of gestational ages for prenatal assessment.

Methods: The cohort design was conducted between 89 women who had regular NST (without music), and 88 women who do NST with music. These are women with a single pregnancy of 33 weeks or older who are not in the risk pregnancy group, with no signs of preterm labor.

Results: There were 178 pregnant women participating in the study. The median age of pregnant women in the study group who did not listen to music or listen to music was 30.0 ± 4.60 and 30.4 ± 4.00, respectively. The average gestational age in our study was 36.73 ± 1.64 and 36.07 ± 1.91, respectively, for with and without music group. Music increased the average number of fetal movements in the group of pregnant women listening to the music compared to the group that did not listen to music (11.13 ± 0.91 and 17.52 ± 1.63) during the NST. Music also increased the number of accelerations (5.54 ± 0.43 compared to 7.28 ± 0.47) and the resulting reactive NST in pregnant women.

Conclusion: Music increased the average number of fetal movements and the number of accelerations the group of pregnant women listening to the music compared to the group that did not listen to during the NST. Music also increased the resulting reactive NSTs in pregnant women. We can consider using music during NSTs.

Background and Objective: Chronic low back pain (CLBP) represents one of the major causes of increasing disability worldwide. Electroacupuncture with different frequencies at the Hua Tuo Jia Ji acupoints has been used to treat CLBP in patients with lumbar osteoarthritis. Basic studies demonstrate that 100 Hz or 2 Hz electroacupuncture has pain-relief effects on CLBP; however clinical evidence for choosing which frequency is still limited. Thus, our study aims to compare the effects of 100 Hz to 2 Hz electroacupuncture for CLBP on patients with lumbar osteoarthritis.

Methods: A randomized controlled trial of 124 patients with lumbar osteoarthritis at the Traditional Medicine Hospital at Ho Chi Minh City from September 2018 to July 2019. Patients were randomly allocated to either intervention group (n = 62) with 100 Hz electroacupuncture or control group (n = 62) with 2 Hz electroacupuncture at the L2-S1 Hua Tuo Jia Ji acupoints for 14 days. Du Huo Ji Sheng Tang decoction was also administered in both groups. Primary trial outcomes were QDSA score and the proportion of patients who achieved pain relief thresholds.

Results: After 14 days of treatment, QDSA score in intervention group decreased significantly compared to control group. 87% of patients in intervention group had pain relief of ≥70%, and only 45% patients in control group had such result. Lumbar flexion range of motion in 100 Hz group tended to be better than in 2 Hz group.

Conclusion: 100 Hz electroacupuncture had superior analgesic effects on lumbar osteoarthritis to 2 Hz electroacupuncture.

Vietnam has one of the highest multi drug resistance in Asia. Although, despite many efforts to implement the Antimicrobial Stewardship Programs (the ASP) since 2016, studies that on the implementation policy are very lacking of this program are limited. For that reason, we conducted this cross-sectional study to analyze the viewpoint of health workers (HWs) on the implementation of the ASP at some hospitals in Ho Chi Minh City (HCMC). An assessment of 234 HWs showed that the implementation of the ASP in HCMC hospitals was above average (62.7/100.0). A barrier to the implementation consisted of the deficiency in finances, guidelines for diagnosis, and specific interventions for some common infections, such as distributing current antibiogram and monitoring rate of Clostridioides difficile infections. These were the widely recognized problems in initially implementing the ASP. Although most HWs are aware of the importance of implementing the ASP (79.1%), the specific assessment has not been recorded clearly due to the numerous neutral responses. Despite the support of the leadership, the implementation still faces many difficulties and limitations, especially in 3^rd and 4^th class hospitals. Besides, there was a lack of wide dissemination of information on the ASP at each unit. To generalize the status of the ASP implementation, researchers should conduct qualitative and quantitative studies with a larger scale.

Introduction: Nursing handover is an important process in hospital care where information and responsibilities are transferred from one nurse to another to ensure continuity of care and safety of patients. However, evidence of the effectiveness of using standardized nursing handover approaches, particularly in resource-limited countries, is scarce. This study was conducted in order to evaluate the change in handover practice through the “I PASS the BATON” model in a university hospital in Vietnam and identify factors contributing to the effectiveness of this model.

Material and methods: We provided handover training for nurses in the Emergency Department using the “I PASS the BATON” model and evaluated their application right after the course and one month after the course.

Results: The consistency of the handover skill among participating nurses remained high one month after applying the model in the routine care at the hospital. Overall, the mean score achieved after training was high and remained unchanged after one month. However, significant and marginally significant improvement was found in some components one month after the course including the Action and Timing. In contrast, the Next component decreased over time. Evaluation of nurses’ perceptions about the model were assessed using the Health Belief Model which revealed that perceived susceptibility and seriousness were at the moderate level and significantly decreased after one month. In contrast, perceived benefits and barriers were at a high level and remained unchanged after one month.

Conclusions: The "I PASS the BATON" model was effective in improving nurses’ handover skills and practices.

Background and Objectives: Streptococcus mutans is a major pathogen that initiates dental plaque and dental caries due to its strong acid production and biofilm-forming ability. Recent studies showed that lactic acid bacteria (LAB), exert useful properties which make them become potential tools to fight against S. mutans and its relating diseases. The current study aimed to isolate and screen for LAB strains that could inhibit S. mutans growth as well as its biofilm production.

Methods and Results: Using the spread plate technique, fifty-one LAB strains were isolated from fermented vegetables and healthy human saliva. From that, fourteen isolates showed the inhibitory effect on S. mutans growth in well-diffusion assay. These strains were then screened on the ability in reducing S. mutans biofilm formation by colorimetric assay. Next, potential LAB was evaluated on some probiotic characteristics including saliva amylase tolerance, acid tolerance, bile tolerance as well as antibiotic susceptibility properties. As a result, four strains showed the most promising features were further tested for the ability to reduce Streptococcus mutans biofilm by scanning electron microscopy (SEM) observation and by expression analysis of biofilm-forming genes (gtfB and luxS) using RT-qPCR method. Finally, these four strains were identified to species level using API® 50 CHL kit and 16S rDNA sequencing method. The result showed that two strains belong to L. plantarums, one belongs to L. brevis and the other is Weisella confusa. 

Conclusion: This study was successful in isolating LAB that showed promising probiotic effects against S. mutans.

Introduction: Ureaplasma urealyticum and Mycoplasma genitalium are infectious pathogens resulting in non-gonococcal urethritis and complications such as pelvic inflammatory disease (PID) and infertility. This study aimed to determine the prevalence of U. urealyticum and M. genitalium in women with secondary infertility and the related factors to these infections.

Methods: This cross-sectional descriptive study was carried out from July 2017 to June 2018. Cervical specimens were collected from women with secondary infertility at the Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Vietnam. PCR was applied for detection of U. urealyticum and M. genitalium. Tubal patency was assessed by hysterosalpingography.

Results: Prevalence of U. urealyticum and M. genitalium were 37.9% and 2.1%, respectively. The association was not statistically significant among infection and the following factors like age, educational level, occupation, history of miscarriage, history of genital infection and abdominal surgery, or infertility duration (p > 0.05). There was a statistically significant correlation between U. urealyticum infection and tubal damage according to hysterosalpingography (p < 0.05).

Conclusion: In the case of women with secondary infertility, genital infection with M. genitalium was rare, whereas that with U. urealyticum infection was high and appeared to be associated with tubal damage.

Background: Childhood overweight and obesity are becoming more pronounced in Vietnam, so an assessment tool of high efficiency in the community is warranted. This study sought to validate skinfold thickness (SFT) equations for estimation of body fatness by Goran and Slaughter against DXA to aid in assessing obesity.

Method: A cross-sectional study was conducted on 144 healthy children (ages 6-17) who were conveniently sampled from schools within an urban district. Their anthropometric measurements (height, weight, and SFT) and DXA whole-body results were taken to record body fat percentage (BF%). Bland-Altman analysis and correlation between bias and body fat were employed to understand the agreement between results from each equation and DXA whole body.

Result: BF% was 32.2 ± 7.6% (mean ± SD). 52.8% of the children were overweight or obese. Bland-Altman plots showed that all four SFT equations had wide limits of agreement (LOAs) and largely underestimated the reference BF% by up to 8.90%. Goran equation predicted better when BF% decreased, whereas Slaughter equations produced less bias when there was more body fat.

Conclusion: The prevalence rate of overweight and obesity has become alarming. Besides, Goran and Slaughter equations cannot be used as alternatives for DXA scanning to measure body fat due to their underestimation.

Hospital-acquired infection (HAI) is a growing problem all around the world particularly for countries with aging and high-density population such as Vietnam. In this review, we summarized the current status of HAIs in Vietnam regarding types of infection, rates of infection, hospital-stay duration and cost of treatment, and provided an overview with suggestions on strategies in combating these infections especially in Vietnamese settings. From quite dispersed and varied data reported in English and Vietnamese, we have seen HAI rates of less than 10%. Over the years, the HAIs in Vietnam remained quite stable and even slightly decreased in recent years. Among all HAIs, respiratory tract infections are the most common, occurring in up to 80% of cases. Most Vietnamese statistical data on the etiology of HAIs focused on bacterial HAIs, mostly Candidiasis, whereas limited information was found on fungal infections, nosocomial viral and other parasitic infections. The most important HAI causative pathogens in Vietnamese hospitals include Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Candida species. There is absolutely few scientific data, but web-based information on HAIs treatment cost and measures to control the infections were found. Works are reported to be implemented to control HAIs in Vietnam at both national and hospital level. However, further improvement in controlling HAIs in Vietnam should be considered.

Background: In Vietnam, surgery or aspiration is preferred to treat thyroid cysts however each of them still have limitations. Purposes of this study were to evaluate the efficacy and safety of ethanol ablation in treating thyroid cysts and determine factors that predict the outcome of treatment.

Methods: This prospective study was approved by the Ethics Committee of the Institutional Review Board of Family hospital and written informed consent for procedures was obtained. From May 2018 to March 2019, 23 patients who underwent treatment for thyroid cysts by EA were enrolled in this study and were followed up for 1 month at Family hospital. The primary endpoint was efficient after one month as the volume reduction ratio was ≥ 50%. Secondary endpoints were improvements in symptoms, cosmetic scores, and safety. Multiple logistic regression analysis was used.

Results: In the finding, from May 2018 to March 2019, only 17 patients who matched inclusion criteria were included in the analyst, including 7 purely thyroid cysts, and 10 predominantly cystic nodules. Mean volume decreased significantly from 5.21 ± 3.37 ml to 2.35 ± 2.52 ml in corresponding to 52.87% of volume reduction with p < 0.05. Ethanol ablation (EA) success rate was 52.90% after 1 month. Symptoms and cosmetic scores were improved significantly. The thyroid function was constant. No adverse events occurred. Purely thyroid cyst was a predictive factor contributing to the success of EA.

Conclusion: EA seems likely to be a safe and an efficient therapy for patients who had purely or predominantly cystic thyroid nodules.

The benefits of non-Vitamin K oral antagonists in prevention or treatment of thrombosis have been studied in many randomized control trials. However, episodes of life-threatening bleeding caused by using novel oral anticoagulants have occurred in clinical practice and necessitate the development of aims for reversal of the anticoagulant effects. We report here three cases in which the use of idarucizumab, a humanized monoclonal antibody fragment, has successfully reversed the anticoagulation effects of dabigatran and produced favorable outcomes.

Introduction: Tracheomalacia can result from long-standing compression by a large goiter. The cartilaginous rings of the trachea may be weakened or destroyed by long-standing compression, causing loss of structural support. Tracheomalacia after resectioning of benign goiter compressing trachea was an important issue. It has extended the time of mechanical ventilation, increased the risk of failure extubating and mortality.

Materials and Methods: Descriptive and prospective study. From November 2014 to January 2017, we have collected 102 patients who had benign goiter compressing trachea and had thyroidectomy. Tracheomalacia was diagnosed and managed intra and postoperatively.

Results: Recognition of women accounted for the majority of 81.4%. The average age was 54.5 years old and the average duration of goiter was 5 years. The patients were hospitalized with the main symptom of dysphagia accounting for 21.6% and difficulty breathing when lying down was 16.7%. On CT scan, the average Goiter was 270g, the average narrow airway diameter was 8.4 mm, of which 12.7% of patients had narrow tracheal diameter <5mm. The rate of tracheomalacia was 4.9%. There were statistically significant differences between the 2 groups with and without tracheomalacia: elderly patients (p = 0.041); goiter long-standing time (p = 0.07); symptoms of positional dyspnea on lying (p = 0.003) and tracheal diameter compressed (p = 0.001).

Conclusion: Tracheomalacia should be noted in patients older than 65 years old, goiter exist longer than 5 years and goiter is over 200g.

Introduction: The tumor of pancreatic body and tail are relatively rare compared to those of head of pancreas.  Splenic preservation in pancreatic carcinoma’s surgery should be decided on every case. This study to determine the feasibility of distal pancreatectomy with splenic preservation, the rate of early complications of splenectomy surgery to preserve the spleen and the factors: tumor size, tumor location, tumor characteristic to help assess the possibility of preserving the splenic vessels in distal pancreatectomy with splenic preservation.

Methods: retrospective study, case series description for all patients aged 16 years and older with distal pancreatectomy and splenic preservation from 01/01/2012 to 31/12/2017.

Result: We had 47 case of distal pancreatectomy with splenic preservation. There were 26 cases of splenic preservation with preserving the splenic vessels (Kimura technique), 13 cases of splenectomy but not preserving the splenic vessels (Warshaw technique). There were 16 cases of laparoscopic surgery, 31 cases open surgery, general complication in surgery 11 cases. The mean age was 41.13 (17-76 years old). The mean hospital stay was 7.7 days (3 days - 21 days). General complication after surgery in 7 cases, pancreatic fistula in 5 cases, no cases need re-operation, no mortality.

Conclusion: The rate of intraopertative incidence was 23.4%; complications after surgery 14.9%. No case of re-operation or mortality in the study. Factors such as tumor size, tumor location, tumor characteristic did not help assess the possibility of preserving the splenic vessels in of distal pancreatectomy with splenic preservation.

The tubers of Hydnophytum formicarum Jack. have been used for the treatment of rheumatism, liver and intestinal diseases in the traditional medicine of Vietnam. The 50% ethanolic extract of H. formicarum (EEHF) has been proved anti-inflammatory and analgesic effects as well as hepatoprotective activity at the oral doses of 100 and 200 mg/kg in Swiss albino mice. The aim of this work was to study on the subacute oral toxicity of the EEHF at the doses of 100 and 200 mg/kg for 30 and 60 consecutive days in both sexes of mice. The observations were undertaken on the mortality, the body weights, the toxic signs, hematological and biochemical parameters. At the end of the experiment, the histopathology of liver and kidneys was studied. The results showed that the 100 mg/kg of EEHF did not cause any toxic signs in mice. There was no significant difference of hematological and biochemical parameters between the treated animals and the controls. Histopathological examinations of livers and kidneys showed no significant difference suggesting no morphological disturbances in treated mice. In conclusion, the results indicated that the EEHF did not cause any subacute toxicity in mice at the dose of 100 mg/kg, providing the evidence of the safety of health products from this medicinal plant.

Background: Phantom vibration (PV) is an illusionary perception in which people perceive their mobile phone vibrates while it actually does not. Recently, PV has attracted attention in psychology and medical field. There are several studies investigating the prevalence and risk factors associated with this phenomenon. However, the findings are inconsistent. The prevalence of PV fluctuates from 21% to 89% among different groups and its mechanism remains unclear. Further understanding is necessary to identify the settings in which PV may harm the population and warrant further exploration.

Objectives: This study aims to explore the prevalence of PV among medical students in Ho Chi Minh City and settings that PV can risk people’s health. Relationships between PV and phone usage habits as well as psychiatric disturbance also are investigated.

Methods: By using online questionnaire on 377 undergraduate medical students in Ho Chi Minh City, Vietnam, the cross-sectional study explored factors associated with PV, including demographic, behavioral phone usage, and mental/emotional factors using the Self Reporting Questionaire - 20 (SRQ-20). The descriptive and association analyses were employed using R software.

Results: The study found a significant association between mental/emotional factors (i.e. mental disturbance and phone attachment) and PV (OR=2.15, 95% CI=1.21-3.81, p value=0.009; OR=1.75, 95% CI=1.02-3.01, p value=0.043 respectively), which suggests an important role of mental/emotional factors in explaining the potential mechanism of PV. A high proportion of participants also experienced PV while driving (55.5%) within the last month. This implies the impact of PV possibly becomes significant, causing an increase in the risk of traffic accident due to distracted driving.

Introduction: Pancreaticoduodenectomy has been a radical treatment for periampullary carcinoma, which is a collection of malignant neoplasia of the periampullary region. Although the mortality has declined dramatically, the complications are still high. This study aims to determine the occurring rate of short-term complications after pancreaticoduodenectomy and to identify the risk factors related to those complications. Comprehension of these problems help increase the outcome.

Materials and Method: It is a cross-sectional study of the patients with periampullary cancer, who undergo pancreaticoduodenectomy at Cho Ray Hospital from January 2012 to October 2016.

Results: Overall complication rate was 25.65% from 230 patients. In which, pancreatic fistula and surgical site infection were the two most frequent complication (10.43% and 4.38% respectively). Pancreatic fistula was highly significantly associated with Wirsung’s duct diameter less than 3 mm (p = 0.015) and soften pancreatic parenchyma (p = 0.004). The soften pancreatic parenchyma also increased the risk of surgical site infection (OR 4.588), but it was not statistically significant (p = 0.056). Soften pancreatic parenchyma increased the haemorrhage complication significantly (p = 0.04) (OR: 10,668, 95% confidence).

Discussions: Pancreatic main duct’s diameter, pancreatic density and Hemoglobin may relate to the early postoperative complications following pancreaticoduodenectomy. Detailedly, in particular for pancreatic fistula, 2 risk factors recognized are Wirsung’s diameter less than 3mm and soft pancreatic density. Meanwhile low concentration of hemoglobin in blood may increase the risk of incisional infection. Pancreatic density related to the complication of haemorrhage.

Conclusions: Short-term complications’ rate following pancreatoduodenectomy remains high. Understanding the risk factors help us choose which case should be operated and do pre-operative preparation better.

Curcuma aromatica, the herbal medicine belongs to Zingiberaceae family, is well known for anti-tumor activity through multiple pathways and a potential candidate for complementary medicine in cancer treatment. The aims of this study were to distinguish between Curcuma species based on polymorphisms of the nucleotide sequence of chloroplast DNA (cpDNA) and preliminarily analyze their potential-anticancer compounds. Totally six samples supposed C. aromatica growing in An Giang province, Vietnam were collected. The contents of curcumin, curdione, and germacrone in the six samples were analyzed and compared by using the high-performance liquid chromatography (HPLC) method. All specimens were identified according to their trnSfMintergenic spacer sequences by Sanger sequencing. Among the six samples, three were determined as C. aromatica, two were C. longa, and one was C. zedoaria. Curcumin, curdione, and germacrone, known as anticancer compounds, were simultaneously found in sample NT3 that identified as C. aromatica by Sanger sequencing. The obtained results revealed a potential herbal candidate for complementary and alternative medicine.

Background: Acute myocardial infarction has become a serious financial burden for patients, healthcare system, and society. It is therefore necessary to assess treatment cost of myocardial infarction that had been conducted in many countries in the world and still not fully analysed in Vietnam. Thus, we sought to describe acute ST-elevation myocardial infarction treatment cost and analyse related factors to acute ST-elevation myocardial infarction treatment cost.

Methods and Materials: A retrospective cross-sectional study. Patients who was diagnosed by ST-elevation myocardial infarction at Cho Ray Hospital from June 2018 to February 2019, satisfied inclusion and exclusion criteria.

Results: We collected 130 patients with acute ST-elevation myocardial infarction with male: female ratio of 3:1, at average age of mean ± Standard deviation (SD) = 62.9 ± 12.6. The length of stay in hospital was mean ± SD = 7.1 ± 3.3 days and the median direct cost of MI was 68,902,500 VND (interquartile range (IQR): 5,737,200 – 104,266,000 VND). The average total cost of acute ST-elevation myocardial infarction in the percutaneous coronary intervention group was more than 16 times as the conservative group. The treatment strategies and hospital complications were major factors that affected treatment cost.

Conclusion: The median direct cost of acute ST-elevation myocardial infarction was accounted for 68,902,500 VND. Complications directly affected costs.

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam.

Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed.

Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens.

Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

Current pathophysiologic knowledge of achalasia suggests the important involvement of genetic predisposition. However, familial achalasia is very rare and most of the case reports in literature have shown an autosomal recessive pattern of inherence. We hereby report a case of familial achalasia with autosomal dominant pattern of inherence affecting ten members in three generations of a Vietnamese family.

Background and Objectives: Diarrhea is one of the first causes of morbidity and mortality among children, especially in poor and developing countries including Vietnam. For decades, although Vietnam has implemented different health interventions to suppress diarrhea spread, this disease has been continuously concerned as a national health problem. Hence, the aim of this study was to assess ethnic minority mothers’ knowledge, attitude and practice (KAP) associated with diarrhea in children under 5 years old; Then to find out the correlation among KAP, and discover some factors related to good knowledge, positive attitude, correct practice about diarrhea in under 5-year old children of the mothers in Pediatrics Department of Daklak General Hospital, 2014.

Method: A community based cross-sectional study was carried out from September 2013 to July 2014 in Pediatrics Department - Daklak General Hospital with the participation of 153 ethnic mothers who has children with diarrhea. The mothers were interviewed directly following the questionnaire, whose structure was adapted from the World Health Organization (WHO) and author Hau Van Pham. The collected data were checked for completeness, consistency and then entered into Epidata 3.1 and analyzed using SPSS 20.

Results: The data from 153 participants showed that the ethnic mothers had good knowledge accounted for 39.9%, whereas more than half of ethnic mothers (64.7%) had a positive attitude towards prevention of diarrhea among under-five children. However, the correct practice in taking care of children with diarrhea was not high (40.5%). As expected, there was statistically significant correlation between the mothers’ knowledge and their attitudes (p < 0.001), as well as their practice toward diarrhea treatment (p=0.005). Analyzed data exhibited that knowledge of the mothers about diarrhea was influenced by their differences in socio-demographic factors, including educational level (p<0.001), occupation (p=0.002) and an ability to access information related to diarrhea in children under 5 (p<0.001). Similarly, the socio-demographic factor (p=0.028) and access to information about diarrhea (p<0.001) have an effect the correct practice in the prevention of diarrhea. There was a statistically significant correlation between the good practice in preventing diarrhea and the socio-demographic factor, including the mothers’ educational level (p<0.001) and the occupation (p=0.021).

Background and Objectives: Exam anxiety is a commonly seen problem among medical students. Auricular acupuncture has been shown to have an anxiety-reducing effect, however, data on exam anxiety is limited. Research in dental and preoperative anxiety has indicated that anxiety level could be reduced by using ear acupoints on the non-dominant side. Therefore, this study aims to determine whether needling at acupoints on the non-dominant side can reduce exam anxiety in medical students.

Method: This is a prospective observational study on 32 students at The Faculty of Traditional Medicine, Ho Chi Minh City University of Medicine and Pharmacy. Eligible students received auricular acupuncture on the non-dominant side at the Master cerebral, Tranquilizer and Relaxation points. Levels of anxiety were measured using a visual analogue scale before and after the intervention as well as before the exam. The State-Trait Anxiety Inventory, heart rate, exam performance and adverse events occurring during the study were also collected.

Results: Exam anxiety level and heart rate decreased 30 minutes after auricular acupuncture (p<0.05). Before the exam, exam anxiety level and heart rate increased significantly compared to after the intervention but still lower than baseline (p<0.05). The exam anxiety level with heart rate at each time point did not differ significantly in gender and trait anxiety levels (p>0.05). No adverse events from auricular acupuncture were observed.

Conclusion: Auricular acupuncture at the Master cerebral, Tranquillizer and Relaxation points on the non-dominant side is effective in reducing exam anxiety in medical students.

In Vietnamese folk medicine, Bi ky nam (H. formicarum) tuber has been widely used to treat rheumatism, liver and intestinal diseases. This work aimed to study botanical, genetic characteristics and screening of the phytochemical constituents of wild H. formicarum of Phu Quoc Island, Vietnam. Anatomical characteristics of the plant material were described. Fresh leaves were used to analyze DNA barcodes based on rbcL region amplified by PCR. Sequences of DNA products were identified by Sanger method and BioEdit 7.0.5 software, then compared to the control rbcL sequences published in GenBank by BLAST. The tuber powder was studied for pharmacognostic parameters, preliminary phytochemical screening and total phenolic contents by Folin-Ciocalteu method. Results showed that the similarity between the rbcL sequences of H. formicarum leaves collected in Phu Quoc and the control one published in Genbank was 99%. Moisture content, total ash value and acid insoluble ash value of dried tuber powder were 11.06%, 9.60% and 0.70%, respectively. Raw material contained carotenoids, triterpenoids, flavonoids, phenolics, tannins, saponins, reducing substances and amino acids. Total phenolics content was about 58.847 mg pyrrogallol equivalent/g dried powder weight. Our results provided information about botanical, genetic and preliminary phytochemical characteristics of H. formicarum growing on Phu Quoc Island. This could be useful for the authentication of H. formicarum as a medicinal material.

Background: The study aimed to culturally adapt and validate Neonatal Infant Pain Scale (NIPS) for use in Vietnamese settings.

Methods: The original NIPS was translated into Vietnamese using a standard protocol. Registered nurses of Neonatal Intensive Care Unit (NICU), Tien Giang General Hospital, Vietnam used the Vietnamese NIPS for assessing neonatal pain and then provided feedback on acceptability of the scale. Five registered nurses of NICU were randomly selected and used NIPS for assessing neonatal pain while watching thirty videos at two times, two weeks apart from each other. Pulse rates per minute and oxygen saturation (SpO₂) were also recorded for validity evaluation. Intraclass correlation coefficients (ICC) with two-way random effects were applied to assess intra-rater and inter-rater reliability. Multilevel linear regression was applied to assess the association between NIPS score with pulse rates and SpO₂ adjusting for raters, three periods and two assessments.

Results: The Vietnamese NIPS was accepted and valued by nurses at the NICU. ICCs between the first and second assessments were from 0.53 to 1.00 for five raters before, during and after clinical procedures showing moderate to excellent intra-rater reliability. ICCs among five raters were moderate to good before and after, but poor (ICC<0.4) during clinical procedures. NIPS score was not associated with SpO₂, but with pulse rates per minute.

Conclusions: The preliminary results showed that the Vietnamese version of NIPS is reliable and should be used. However, it is recommended that further research should be conducted to confirm its reliability and validity.

It was previously thought that the establishment of the gut microbiota was completed within the first two years of life, and this community maintains fairly stable throughout the adult lifetime thereafter. However, recent evidence shows that the gut microbiota composition is constantly changing in the gut environment and is heavily influenced by diet. The individual differences responding to diets would root on the fluctuations of gut microbiota if dietary fluctuations affect the composition of gut microbiota so significantly.

Background and Objectives: Combining modern medicine and traditional medicine in the rehabilitation of post-stroke motor deficit has shown interesting results. Many studies on modified acupuncture, a combination of modern and traditional techniques, have proven its effectiveness in motor rehabilitation in post-stroke patients. Furthermore, the effectiveness of the motor relearning method in the treatment of post-stroke paralysis has been elucidated. Therefore, our study aims to determine whether the combination between modified acupuncture and motor relearning method can improve treatment outcomes.

Method: Multicenter randomized controlled trial (Traditional Medicine Hospital of Ho Chi Minh City, General Hospital of Soc Trang Province, and People Military Hospital of Soc Trang Province) from July 2014 to July 2015. 66 post-stroke patients were divided into two groups: The control group received modified acupuncture combined with Bobath method and the trial group received modified acupuncture combined with motor relearning method. After six weeks, patients were evaluated according to the Barthel score, the 10-hole test, and the ability to walk.

Results: The trial group showed better results than the control group. There was a significant difference between the two groups in the Barthel score and the ability to walk, excluding the 10-hole test. After treatment, 77.42% of patients in the trial group showed improvement compared to only 51.61% in the control group (P < 0.05).

Conclusion: The combination of modified acupuncture and motor relearning method is more effective than the combination of modified acupuncture and Bobath method in the rehabilitation of motor deficit after stroke.

Hydatidosis is a zoonotic disease caused by the tapeworm Echinococcus granulosus. It mostly involves liver and lungs whereas the unusual sites are spleen, kidney, peritoneal cavity, skin, muscles, heart, brain, vertebral column, ovaries, pancreas, gallbladder, thyroid gland, breast, and bones.  Herein, we describe a unique case of intrapleural hydatid cyst which was solely confined to the pleural space without involvement of lung parenchyma and other associated structures. Despite the fact that Pakistan is an endemic country for hydatid disease, we could not identify any single documented case of intrapleural hydatid disease from Pakistan. The purpose of our case report is to promote awareness among fellow healthcare professionals about this rare variant of hydatid disease and to prevent any missed diagnosis and life-threatening complications. Hence, once the diagnosis was established, we performed a right-sided thoracotomy. Intraoperatively, the lung was collapsed due to the pressure effects of hydatid cysts. The hydatid cysts were evacuated completely from the pleural cavity and postoperatively the patient had an uneventful recovery and remained asymptomatic during all the follow-up visits. Conclusively, the hydatid disease may involve unusual sites such as the pleural space. A strong clinical suspicion, supportive radiological findings, and positive serological evidence play a critical role in the establishment of the diagnosis.

Coronary artery disease was the cause of half of morbidity and mortality due to cardiovascular diseases in 2013. Myocardial infarction (MI) has been a common medical emergency with high mortality rate and complications unless it is early and appropriately treated. Health-related quality of life (HRQoL) has been popularly used in assessment of health state among coronary artery disease patients undergone both medical and surgical therapies. Bayesian model averaging approach statistically facilitated for identifying potential predictors of HRQoL among post-MI patients following up at University Medical Center, Ho Chi Minh City. The cross-sectional descriptive study was conducted on 146 participants diagnosed and treated with acute myocardial infarction from April 1^st 2017 to June 30^th 2017. The better HRQoL in physical component summary was associated with higher educational levels (coeff­icient=1.2) and weekly moderate – intensity physical activity (coeff­icient=0.002) but the contrast status for the female (coeff­icient =-3.7) in the fit model with R²= 0.24, BIC=-25.7 and posterior probability=11.7%. The good economic household (coeff­icient=9.8), more daily sitting time (coeff­icient =1.4) and weekly moderate – intensity physical activity (coeff­icient =0.004) predicted the increase of mental component summary score in the given model with R²= 0.08, BIC=-20.3 and posterior probability=25%. The post – MI patients experienced low physical health much more than mental health. The female and suitable physical activity should be concerned in the rehabilitation program as well as follow-up care during the discharge process.

Brachial plexus injury in neonates is a rare obstetrical complication, but it can cause huge anxiety to parents if occurring and sometimes leading to legal disputes in obstetrical practice. Trauma during birth delivery is mainly due to the over-stretch of fetal neck which is the main cause of brachial plexus injury in infants. However, those injuries are self-limited and most of them will self-recover. We conducted a retrospective analysis on ten cases diagnosed of post-delivery brachial plexus injury under monitoring at Tu Du Hospital from January to November 2018. Such factors as maternal obstetrical history, labor characteristics, mode of delivery, clinical symptoms and treatment approach of those cases were collected and analyzed. The risk factors of brachial plexus injury in our study included large fetus, interventional delivery, prolonged second stage of labor and shoulder dystocia. All the cases were treated with physiotherapy and recovered after 3 – 6 months. Family counseling and infants’ recovery played an important role in the management of those cases.

Aim: To clarify the meaning of commitment and to provide the empirical referents to measure the concept of commitment.

Method: By using the Walker and Avant (2011) methodology, data were analyzed with the focusing on critical attributes of concept, constructed cases, antecedents and consequences of the concept. Additionally, the empirical referents and implications for nursing knowledge are presented to further elucidate the concept of commitment.

Findings: The critical attributes of commitment derived from this analysis are 1) Promising to involve in an action; 2) Acceptance of responsibility for the action; and 3) Persistent involvement in an action. The process of analysis concept of commitment leads to a better understanding of the concept itself. Nurses can use the ideas of this analysis as conceptual tools to assess the level of commitment among patients/clients in their action toward the health promoting behavior.

Conclusion: This analysis proposes a definition with the critical attributes of the concept which can be considered to use in nursing practice. Nursing is a universal profession; hence, the definition was proposed from this concept analysis can be considered as a beginning point for the further study in nursing field of each country.

Polycystic ovary syndrome (PCOS) is a common endocrine metabolic disorder in women of reproductive age. PCOS is often associated with insulin resistance and carries an increased risk of gestational diabetes mellitus (GDM). The aim of this study was to evaluate the risk of GDM in women with a history of PCOS. This was a retrospective cohort study conducted at a single center in Vietnam between January 2014 and December 2017. A total of 400 women who conceived through assisted reproductive technology (ART) were included, 200 who had been diagnosed with PCOS, and 200 without a PCOS diagnosis as controls. Multivariable logistic regression models were used to examine the association between risk of GDM and PCOS after adjusting for confounders. GDM was present in 37% of those with PCOS, compared with 26.5% in those without PCOS (RR 1.4, 95% CI 1.04–1.87, p=0.02). The prevalence of GDM did not differ significantly between PCOS phenotype groups (p=0.28). Women with PCOS undergoing ART had a higher risk of GDM after adjusting for differences in age, pre-pregnancy body mass index, type of infertility, ART indications, and type of ART (adjusted OR 2.04, 95% CI 1.06–3.92). First-trimester fasting plasma glucose (FPG) was also an independent predictor for GDM (adjusted OR 1.54, 95% CI 1.01–2.34). This study suggests that PCOS and first-trimester FPG are independent risk factors for the development of GDM.

There are cases when symptoms are available but no abnormal stenosis is found in MRI and vice versa. Axial-loaded MRI has been shown that it can demonstrate more accurately the real status of spinal canal stenosis than conventional MRI. This is the first time we applied a new system that we have recreated from the original loading frame system in order to fit with the demands of Vietnamese people. Sixty-two patients were selected from Phu Tho Hospital in Phu Tho Province, Vietnam, who fulfilled the inclusion criteria. The Anterior-posterior diameter (APD), Dura Cross-sectional Area (DSCA) in conventional MRI and axial loaded MRI, and changes in APD and DCSA were determined at the single most constricted intervertebral level. The APD and DCSA in axial loaded MRI had very good significant correlations with VAS for back pain (rs=0.83, 0.79), leg pain (rs=0.69, 0.57) and JOA score (rs=0.70, 0.65). APD and DCSA in axial loaded MRI significantly correlated with the severity of symptoms. Our axial loading MRI provides more valuable information than the conventional MRI for assessing patients with LSCS.

Introduction: Continuing Medical Education (CME) significantly improves the competency of healthcare workers in Methadone Maintenance Treatment (MMT) clinics. However, CME courses are very costly, and a few participants fully attended a course. Online training is an alternative approach to efficiently improve training outcomes. The study assessed needs and possibility of online training courses of MMT clinics in southern Vietnam.

Methods: A google form was designed to collect characteristics, man-powers, facilities, online activities and training needs of MMT clinics. E-mails were sent to all MMT clinics in southern Vietnam to ask for their participants. A representative of MMT clinics who satisfied the inclusion invited to complete the form.

Result: 93 MMT clinics completed the survey. The response rate was 62% (93/150). One MMT clinic had 3 doctors/assistant doctors, 3 pharmacists/drug dispensers, 2 consultants and 3 other professionals on average. The number of clients visiting the clinic in the last month was 150. About 94% (93/95) of MMT clinics provide other additional services. On average, 385 clients came to MMT for other services. All clinics had adequate devices for online and blended training.

Conclusion: MMT clinics had high training needs and were willing to attend online and blended training courses. Online and blended training were possible in MMT clinics.

Reactive oxygen species (ROS) or oxidative stress has been reported with strongly involving to pathogenesis of many diseases in human. On the other hand, ROS play a critical regulation as secondary signal to maintain intracellular redox equilibrium. Basically, the antioxidant defense systems in the body counteract with overproduced ROS. However, when the redox balance is broken under severe oxidative stress conditions, it leads to tissue injuries and numerous disorders. In this review, we briefly introduce the systems of ROS and antioxidants systems in the body and discuss the opposite roles of ROS in normal physiological conditions and diseases. For ROS-related diseases, conventional and currently developed antioxidant therapies are also described in this review.

Introduction: Gastric cancer is one of the highly malignant gastrointestinal cancers and the third leading cause of cancer death. In the last decade, early gastric cancer (EGC) has been reported by using narrow-band imaging (NBI) magnifying endoscopy. Advances in endoscopic techniques, such as endoscopic submucosal dissection (ESD), have enabled the en bloc resection of these EGC. Although ESD is performed for early gastric cancer, there are still many difficult problems in technique of this procedure. The difficulty of gastric ESD depends on the size and location of a tumor, presence of severe submucosal fibrosis, presence of ulceration... We report a case of our successful ESD by using Clutch cutter and IT knife 2 in treatment of EGC with severe submucosal fibrosis.

Case presentation: A 62-year-old man felt an epigastric discomfort two months ago. The narrow-band imaging (NBI) magnifying endoscopy revealed a suspected early gastric cancer type 0 - IIa + IIc (Japanese classification of early gastrointestinal cancers) at the incisura angularis, the size of this lesion was 15 mm in diameter, and pathological result of endoscopic biopsy was a well-differentiated adenocarcinoma. ESD was performed and we found there was severe submucosal fibrosis which was dissected safer and faster by using Clutch cutter and IT knife 2. There were no complications such as severe bleeding and perforation. The size of resected specimen was 60 x 35 mm and the time of procedure was 150 minutes. After ESD, the pathological result was a well differentiated adenocarcinoma, pT1a, UL(-), LY(-), V(-), no cancer cell in vertical and horizontal margins. The healing time of ESD-induced ulcer was 5 weeks without local recurrence.

Conclusion: Through this case, we aim to emphasize the importance of using Clutch cutter and IT knife 2 as a modified technique which makes ESD a safe procedure in treatment of EGC with severe submucosal fibrosis.

Budd–Chiari syndrome (BCS), a rare and life-threatening disorder due to hepatic venous outflow obstruction, is occasionally associated with hypoproteinemia. We herein report the first case of BCS with segmental obstruction of the intrahepatic portion of inferior vena cava (IVC) and hepatic veins (HVs) successfully treated by endovascular stenting in Vietnam. A 32-year-old female patient presented with a 2-month history of massive ascites and leg swelling. She refused history of oral contraceptives use. Hepatosplenomegaly without tenderness was noted. Laboratory data showed polycythemia, mild hypoalbuminemia and hypoproteinemia, slightly high total bilirubin and normal transaminase level. The serum ascites albumin gradient was 1.9 g/dL and ascitic protein level was 1.1 g/dL. The other data were normal. BCS was suspected because of the discrepancy between mild liver failure and massive ascites; and the presence of hepatosplenomegaly and polycythemia. On abdominal magnetic resonance imaging, the segmental obstruction of three HVs and IVC was 2-3 cm long without thrombus. Cavogram revealed the severe segmental stenosis of intrahepatic portion of IVC with no visualized HV and extensive collateral veins. A Protégé stent was deployed to IVC. Leg swelling and ascites were completely resolved within 3 days after stenting. During 1-year follow-up, edema was not recurred and repeated laboratory results were all normal.

Objectives: to evaluate the fluid responsiveness according to fluid bolus triggers and their combination in severe sepsis and septic shock.

Design: observational study.

Patients and Methods: patients with severe sepsis and septic shock who already received fluid after rescue phase of resuscitation. Fluid bolus (FB) was prescribed upon perceived hypovolemic manifestations: low central venous pressure (CVP), low blood pressure, tachycardia, low urine output (UOP), hyperlactatemia. FB was performed by Ringer lactate 500 ml/30 min and responsiveness was defined by increasing in stroke volume (SV) ≥15%.

Results: 84 patients were enrolled, among them 30 responded to FB (35.7%). Demographic and hemodynamic profile before fluid bolus were similar between responders and non-responders, except CVP was lower in responders (7.3 ± 3.4 mmHg vs 9.2 ± 3.6 mmHg) (p 0.018). Fluid response in low CVP, low blood pressure, tachycardia, low UOP, hyperlactatemia were 48.6%, 47.4%, 38.5%, 37.0%, 36.8% making the odd ratio (OR) of these triggers were 2.81 (1.09-7.27), 1.60 (0.54-4.78), 1.89 (0.58-6.18), 1.15 (0.41-3.27) and 1.27 (0.46-3.53) respectively. Although CVP < 8 mmHg had a higher response rate, the association was not consistent at lower cut-offs. The combination of these triggers appeared to raise fluid response but did not reach statistical significance: 26.7% (1 trigger), 31.0% (2 triggers), 35.7% (3 triggers), 55.6% (4 triggers), 100% (5 triggers).

Conclusions: fluid responsiveness was low in optimization phase of resuscitation. No fluid bolus trigger was superior to the others in term of providing a higher responsiveness, their combination did not improve fluid responsiveness as well.

This study aimed to investigate the antitumor-promoting effects of total ethanolic extract from Perilla leaf (PLE) in a two-stage chemical carcinogenesis protocol in mice. Quantitative analysis active compounds in PLE were performed by thin layer chromatography with normal phase of silica gel F₂₅₄ and HPLC-PDA with reversed phase of C₁₈ column at UV 300 nm. The cutaneous tumors were initiated by a single application by 7,12-dimethylbenz[a]anthracene (DMBA) on the dorsal shaved skin, then promoted by repeated applications of croton oil during 20 weeks. PLE was topically applied daily until the end of the experiment. The results observed from thin layer chromatogram highlighted the presence of rosmarinic acid and luteolin in PLE. By means of HPLC-PDA analysis, the total content of rosmarinic acid and luteolin were found in amounts of 1.178 ± 0.011 % (w/w) and 0.105 ± 0.001 % (w/w), respectively. The PLE-treated group prolonged the latency period of tumor appearance up to 2 weeks and also significantly reduced tumor volume in dorsal skin of mice as compared to untreated group. In conclusion, the total ethanolic extract from leaves of Perilla frutescens demonstrated promising antitumor-promotion activity in mouse skin.

The issue of causation is one of the major challenges for epidemiologists who aim to understand the association between an exposure and an outcome to explain disease patterns and potentially provide a basis for intervention. Suitably designed experimental studies can offer robust evidence of the causal relationships. The experimental studies, however, are not popular, difficult or even unethical and impossible to conduct; it would be desirable if there is a methodology for reducing bias or strengthening the causal inferences drawn from observational studies. The traditional approach of estimating causal effects in such studies is to adjust for a set of variables judged to be confounders by including them in a multiple regression. However, which variables should be adjusted for as confounders in a regression model has long been a controversial issue in epidemiology. From my observation, the adjustments using only "statistical artifacts" methods such as the p-value<0.2 in univariate analysis, stepwise (forward/backward) are widely used in research and teaching in Epidemiology and Statistics but without appropriated notice on the biological or clinical relationships between exposure and outcome which may induce the bias in estimating causal effects. In this mini-review, we introduce an interesting method, namely Directed Acyclic Graphs (DAGs), which can be used to reduce the bias in estimating causal effects; it is also a good application for Epidemiology and Biostatistics teaching.

With our fast-pacing life, numerous learning and scientific sources and information are available and required for medical students to boost their skills since their early life to accommodate with the great knowledge they take. Medical students should re-elaborate what they studied and exploit knowledge clinically. A good doctor is a good observer, so eyes should be kept on while mentor managing patients in order to add more to our medical notions. A seed to become a great future doctor starts by searching for a specialty that fits your personality, to practice it as a volunteer, to gain its skills earlier. So when you graduate, you have more time to gain other learning experience. As long as you practice it, the more chance to become one of its experts. Managing your patient as a relative, not as a bag of money, is very important to be applied. Inability to diagnose a patient is not a shame, so never let a patient go home without referring him to another doctor who has more experience than you. Having a background in other medical specialties will help you recognize common signs of other related medical conditions that could lead you to refer him to right specialty doctor. Joining a research lab will keep you updated with new inventions, drugs, algorithms, and guidelines, which will help you become more acknowledged with medical problems that you were unaware of. Time management is the key to success as a researcher without affecting your daily life activities and study requirements.

Background: The Diabetes Distress Scale (DDS) is a valid instrument to measure diabetes distress included in American Diabetes Association and Canadian Diabetes Association guidelines but not available in Vietnamese. This study translated and culturally adapted the DDS to assess diabetes distress of Vietnamese type 2 diabetics and evaluated its internal consistency, face and content validity.

Methods: The translation process followed standard guidelines for adaptation of an instrument: forward translation, back translation, synthesis, evaluation by an expert panel and pretest. The expert panel included three English specialists as linguistic experts and six content experts in multidisciplinary areas relevant to the study. The pretest was conducted on a sample of 31 type 2 diabetics in the Endocrinology outpatient clinic at Trung Vuong hospital. Content validity was determined based on experts’ concurrence using content validity index for items (I-CVI). Face validity is assessed by participants in pretest. Internal consistency was measured using Cronbach’s alpha.

Results: Final version was equivalent with the original English version and easy to understand. I-CVI of 17 items were 1.00 in linguistic experts and greater than 0.83 in content experts. All 31 participants involved in the pretest commented that the items were very clear and acceptable regarding their socioeconomic background. Cronbach’s alpha coefficient was 0.76 – 0.93 for each subscale and 0.94 for the overall.

Conclusion: Vietnamese version of the DDS was reliable, face and content-valid to assess diabetes distress in type 2 diabetics among Vietnamese.

The paper aimed to present the introduction of the first official medical physics training program - a new health care profession in Vietnam. The detail studies and analyses of the current status of training in Medical Physics as well as the present and future demands of it were also reported. The main roles, responsibilities and the challenges of medical physicists in medicine were discussed and clarified as well.

Perivascular epithelioid cell tumours (PEComas) belongs to the family of mesenchymal neoplasms that can occur in many organs, but rarely found in liver. Preoperative diagnosis could be challenging due to unspecific and variable radiologic patterns, which can be clinically misdiagnosed with hepatocellular carcinoma and other benign tumors. This report aims to announce a case of hepatic PEComa with extramedullary hematopoiesis. A 44- year- old woman accidentally presented a nodular mass in the left hepatic segment on ultrasonography with normal liver function result. Abdominal enhanced CT Scan showed hypervascular lesion. Morphology exibits classical characteristics of PEComa with mature fat tissue predominance, thick-wall vessel; somewhat amount of extramedullary hematopoiesis was also recognized. Tumor cells are diffusely immunoreactive with HMB45. PEComa is a rare disease in liver, pathologists need to recognize three components of this tumor to avoid misdiagnosing with malignant conditions.

Healthcare professionals (HCPs) bear a huge responsibility of taking care of patients 24 hours a day and for the whole week. Although HCPs help patients get over their sufferings, these workers endanger their lives and cause themselves health problems including sleep disturbances. Since most of these disturbances are related to the timing or the schedules of these workers, the aim of this mini-review is to shed the light on how these shift schedules are different and how they can affect the sleepness and/or wakefulness of the workers in the health sector.

Research is the creative and systematic conversion of ideas into knowledge and the application of this knowledge in different life fields. The more you get involved in research, the more experiences and skills you can gain. The continuous decreasing number of medical students interested in research can affect the public health in future. Our aim is to encourage medical students to involve more in the research career and to highlight the importance and skills needed for being a successful researcher. Discipline, passion to gain the knowledge, the accuracy of data checking, team work and strict rules are the most important characteristics of a research team. A researcher should be passionate, hard-working, and patient. Teamwork is the golden key to doing research; you should be responsible for your team and develop their research skills along the study period. A researcher should be a self-learner to increase his skills to get an advanced level. From the most important skill that a researcher should gain it by time is the leadership. Being motivated along the study period is an obstacle that leaders always meet, so you should have solutions for it. Fairness is an important manner a leader should acquire. Contribution in a research lab from your youth to build your CV, personality and gain great publications by time.

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

Poor indoor air quality is one of the most important factor causing occupational health problems such as sick building syndrome (SBS). Most previous research on risk factors of SBS is evaluated in the office or school environments rather than in the hospital. The aim of this study is to investigate the prevalence of SBS and its related effect on hospital workers in poorly-ventilated and confined working environments through a set of the questionnaires completed from March to June of 2017. The relationship between SBS-Related symptoms, individual characteristics, work environment and conditions were analyzed using Poisson regression. The prevalence of sick building syndrome was 70.1%. The most common symptoms reported by hospital workers include fatigue, headache, and feeling heavy-headed. There was a significant relationship between the prevalence of syndrome and sex, overload of work, atopy as well as varying room temperature.

IVF carries a considerable physical, emotional and financial burden. Therefore, it would be useful to be able to predict the likelihood of success for each couple. The aim of this retrospective cohort study was to develop a prediction model to estimate the probability of a live birth at 12 months after one completed IVF cycle (all fresh and frozen embryo transfers from the same oocyte retrieval). We analyzed data collected from 2600 women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) at a single center in Vietnam between April 2014 and December 2015. All patients received gonadotropin-releasing hormone (GnRH) antagonist stimulation, followed by fresh and/or frozen embryo transfer (FET) on Day 3. Using Cox regression analysis, five predictive factors were identified: female age, total dose of recombinant follicle stimulating hormone used, type of trigger, fresh or FET during the first transfer, and number of subsequent FET after the first transfer. The area under the receiver operating characteristics curve for the final model was 0.63 (95% confidence interval [CI] 0.60‒0.65) and 0.60 (95% CI 0.57‒0.63) for the validation cohort. There was no significant difference between the predicted and observed probabilities of live birth (Hosmer-Lemeshow test, p > 0.05). The model developed had similar discrimination to existing models and could be implemented in clinical practice.

Evidence based medicine (EBM) education is a modern method for medical students in clinical training based on the reasonable use of the best evidence in making decisions about individual patient’s treatment. EBM education syllabus teaches medical student how to integrate the clinical experience and patient examination with the simplest out-there analysis data for increasing the utilization of top quality clinical analysis in clinical deciding, this methodology requires new literature looking out and proof evaluating skills. Thus, replacing the recently educated method by EBM has more challenges, the new program ought to analysis fastidiously for evaluating the behavior changes, the development of clinical skills and analysis the ultimate examination score for evaluating the effectiveness of EBM program. The result show that active teaching proves to be statistically completely different and has robust impact toward the ultimate outcome. EBM educated method might improve clinical knowledge and application of PBL/EBM brings concerning higher scores compared to recently educated method.

The secret of educational success and splendid future with prosperous career lies in the constant hard work performed in a smart way. By that way, the change or modification in study methods, exam strategies, and learning techniques is necessity. Deriving from our own experience as medical students from some developing countries from all over the world, authors support some tips and methods to approach the medical field more productive.

A POSCE was developed and administered in 2015 to assess six professional attributes for the Family Medicine (FM) residents, University of Medicine and Pharmacy (UMP), Vietnam. This study aims at exploring inter-rater reliability in FM POSCE developed in this context when analytic rubrics were applied.

Background: Past POSCEs showed raters’ variability on applying the global marking items and holistic rating. Using analytic rubrics, unlike holistic type, will provide more rationale for assigning a certain score might influence raters’ variability. Nonetheless, it is little known to what extent switching to this rubric type might influence the inter-rater reliability of POSCE.  

Methods:  Before the FM professionalism module (pretest) and after this module (posttest), 36 and 42 FM residents took the POSCE respectively. The raters in the pretest included 12 teachers of FM training center. Four faculty members from different faculties were belatedly added to the post-test together with the 12 former raters.  Raters’ training occurred in two different times, the former took place only for the 12 FM raters before the pretest and the latter was before the posttest for the 4 belatedly-recruited. During the POSCE, one pair of raters observed all performances per station. Inter-rater reliability was measured by the differences in total scores between raters per pair using paired t-test and Pearson correlation coefficient.  

Results: In POSCE pretest, no significant difference was found between raters’ scores in most pairs of raters, contrasting with that in the posttest. Most differences were noticed in the pairs of raters, in which one of the raters was the belatedly-recruited. In the pretest, moderate to strong positive correlation between raters’ mean scores were found (r=0.55-0.85), similar range was seen in the post-test (r=0.47-0.87), however, the correlation slightly weakened.   

Discussion and conclusion: The FM POSCE has high inter-rater reliability on the utilization of analytic grading rubrics. An analytic rubric might help minimize the discrepancies among raters. Moreover, training raters might have been an alternative influential factor on the raters’ consensus.

Assoc. Prof. Dr. Tran Diep Tuan

President of University of Medicine and Pharmacy at Ho Chi Minh City, Department of Pediatrics - UMP

We are delighted to introduce the Special Issue for the medical education derived from the 1st National Vietnam Medical Education Conference: “Preparing the 21^st Century Physician”. The First Annual National Vietnam Medical Education Conference was held on 2-3 December, 2017, by the Vietnam Ministry of Health, University of Medicine and Pharmacy in Ho Chi Minh City, and the Improving Access, Curriculum and Teaching in Medical Education and Emerging Diseases (IMPACT-MED) Alliance, which is supported by United States Agency for International Development (USAID) and implemented by Partnership for Health Advancement Vietnam, a collaboration between Harvard Medical School, the Brigham & Women’s Hospital and the Beth Israel Deaconess Medical Center. It has attracted approximately 300 leaders in the medical education, faculties and students from Vietnam and around the world.

This conference comes at an exciting time in the socio-economic development of Vietnam. The Vietnamese health sector has made enormous strides in the control of communicable diseases, increasing the life expectancy and increasing access to the health care for its population over the past 40 years since the reunification of the country. In July 2017, Vietnam became a middle-income country, and with this new status comes new health challenges, which if not addressed, will impede the continued development of the country.  Non-communicable diseases, a rapidly aging population, emerge threats of pandemics, environmental pollution, and climate change are all at our doorstep. Additionally, an increasingly connected society that demands a high-quality healthcare, the government’s plan for Universal Health Care, and the desire for regional and an international integration all represent the challenges and opportunities that we must tackle. Addressing these challenges and opportunities starts with transforming the health workforce. There is an urgent need to update the country’s system of health education including university curricula and transforming approaches to teaching and learning to train health professionals who can adapt and react to the health challenges and realize the opportunities that are presented.

A comprehensive curriculum reform is difficult.  However, we can build upon the experience of previous, smaller-scale reform projects, and capitalize on the investments and support from the highest level of government to transform our health education system. We have built strong partnerships among the network of universities and colleges in Vietnam to support each other, and we also have support from international partners. Education reform is a necessity for Vietnam. The conversations and discussions that we have at this inaugural conference will pave the way towards the transformation of our health education system. The conference aims to provide a forum for sharing innovations and advances in the medical education, stimulate discussions among medical education leaders, inspire further innovations, and foster a community of medical educators invested in advancing medical education research and quality improvement.

This entire volume is devoted to select the manuscripts, which was generated from the conference. We hope that it will be productive, and you will be inspired, energized and motivated to continue the efforts towards health education reform for your university/college, and for the country of Vietnam.

Nowadays, pursuing postgraduate study abroad after completing a Medical Doctor (MD) degree in their home country is common among Vietnamese doctors. There are several challenges in studying overseas that international students need to overcome to ensure a favorable outcome of their learning journey. The presenting paper mainly discussed about the challenges related to English and academic writing skills and aimed to provide some tips for studying effectively in developed countries. Based on his own experiences as a postgraduate international student in Australia, the author found that a successful learning journey could be facilitated by (1) feeling free to ask, (2) making friends with the locals and other international students, (3) exploring the local life, (4) learning and using a reference management software, and (5) attending all free academic skills workshops and consultations provided by the university.

Background: Assessments of professional behaviors such as professionalism Mini clinical examination (PMEX) and OSCE (POSCE) are playing an important role in driving the practice professionalism in medical training. Simulation-based assessment or POSCE has been used to evaluate several professional attributes. However, few evidence of content validity proving that whether POSCE is really measuring specific professional attributes have been reported in medical education literature.

Methods:  The four-step process of developing FM POSCE was analyzed to highlight the validity evidence according framework of Downing (2003). Group of 5 independent FM experts from Vietnam, Boston University, US and Liege, Belgium evaluated the blueprints, scenarios and item lists on a scale (1-totally disagree to 5-totally agree) regarding to what extent test blueprint, cases and item lists were relevant to the content domains and cultural context. The results of their evaluation were considered as an evidence of content validity. The mean and standard deviation of the scores given by them were calculated using SPSS, 20.0.

Results: Important evidence of content validity were found in the process of developing POSCE. Content experts’ evaluation showed that all professional attributes represented medical professionalism. However, the adequacy of professional attributes to evaluate the broad construct of professionalism was controversial (M=3.75, SD=0.95). Cases are relevant to assess these professional attributes and culture. Only the cases of “Respecting the patient” and “Making altruistic decision” contained some inappropriate marking items (M=3.75, SD=0.95; M=3.00, SD=0.92).  

Discussion and conclusion: FM POSCE developed in Vietnamese context can assess six specific professional attributes. This study suggested a process of developing POSCE that has several features such as using both sources of expertise and medical literature to build up the content of POSCE to improve the content validity.

My first days of learning about ECG was during the summer of second year at the medical school. I went through the graduation test with very little knowledge about ECG. I started learning ECG by comparing the ECG tracings with the echocardiographic results. However, the echo could not help in case of arrhythmia. So I spent my time reading the “Marriott's Practical Electrocardiography” – kind of textbook of ECG. It was so boring and I quickly gave up the goal of finishing the book. Then I changed to another strategy. Every time I saw an arrhythmic case, I went back home reading a whole chapter about some entity. This strategy proved to be effective. Gradually my skill of interpreting an ECG was built up. From the point of reading an ECG superficially and making a quick diagnosis (which is erroneous most of the time), I became very tedious in finding subtle abnormal signs. When you work really hard, life always has some rewards. I had been selected to study abroad about cardiac electrophysiology.  Nowadays, being the Head of Cardiac Electrophysiology department in my hospital, my daily work is to deal with challenging arrhythmic cases. Interpreting elusive ECG tracings is always a passion for me.

Nowadays, obesity has been becoming one of the most popular problems to the global health. Molecular design with the aid of computing method is an efficient and cost-saving solution in the initial research of new potential drugs for the treatment of obesity. This study focused on benzyl amino chalcone derivatives as they have a benzyl group that can mimic the hydrophobic effect of the long chain carbon of Orlistat, a drug used to treat obesity. Initially, 102 molecular structures were prepared and docked into the protein by using AutoDock Vina version 1.5.6. Fourteen structures having good docking scores were selected to synthesize using a Claisen-Schmidt reaction. Afterward, these synthesized chalcones were tested biological activity against pancreatic lipase by spectrophotometric determination at a wavelength of 405 nm, using p-nitro phenyl palmitate as the substrate. The co-crystallized ligand of pancreatic lipase enzyme was redocked into the enzyme and the RMSD was 1.4976 Å which showed the ligand and the protein preparation could regenerate the practical experiment. As the docking results, the binding affinities of top ten compounds varied from -8.6 and -10.2 kcal/mol. Biological testing resulted in 4 derivatives with IC₅₀ >120 µM, 8 derivatives with 60 µM < IC₅₀ < 120 µM and 2 derivatives with IC₅₀ < 60 µM. In addition, the docking results also confirmed the key role of amino acid Ser152 in interacting with the ligands. The benzyl amino chalcone derivatives are required for further investigation to become a lead compound for anti-obesity drug discovery.

Since 2011, English for Specific Purposes (ESP) curriculum in Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City (Vietnam) has been changed in accordance with pharmaceutical specialization orientation and did apply the active learning-learner centered teaching methods. Our study used three self-administered questionnaires to collect the feedbacks from sophomores, final-year and pharmacist graduating in 2016 in evaluating ESP course effectiveness. Data analyzed with STATA 13 indicated that English lecturers made efforts to organize the active learning activities in ESP class but their target has neither been effective nor met the required students’ needs in academic purposes as well as their occupational purposes. In addition, students’ passivity and lack of apparent motivation made it more difficult to apply the active learning method. Generally, final-year pharmacy students and newly graduated pharmacists, besides their moderate English competence, had a low frequency in using English. It is also found that there exists the relationship between final-year pharmacy students’ frequency of using English, their English competence and pharmaceutical specialization as well as that between English use frequency and occupation.