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: 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. 

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.