Somatic Symptoms in Major Depressive Disorder: A Cross-sectional Study in a Mental Health Setting, Vietnam

Original Research

Abstract

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.

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Development and validation of a LC–MS/MS assay for tenofovir and tenofovir alafenamide in human plasma: Application in a bioequivalence study

Original Research

Abstract

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 AUC0-t, AUC0-∞, and Cmax (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.

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A case report of COVID-19-associated severe psychotic symptoms and suicidal behavior: a late psychiatric intervention

Case Study

Abstract

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.

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Electroacupuncture at Trigger point gains better pain relief effectiveness than Electroacupuncture at Meridian point: A non-blind randomized trial of chronic neck pain treatment among patients at Traditional Medicine Hospital

Original Research

Abstract

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.

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The effectiveness of thread embedding acupuncture in reducing wrinkles at nose and mouth

Original Research

Abstract

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.

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Analysis of single-cell RNA sequencing data revealed the upregulation of Wnt signaling pathway and potential biomarkers in Oral Squamous Cell Carcinoma cancer-associated fibroblasts

Original Research

Abstract

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.

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Effectiveness and safety of thread embedding acupuncture for drug-resistant epilepsy outpatient in Viet Nam: a two-arm parallel design, randomized, controlled clinical trial

Original Research

Abstract

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. 

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A cross-sectional survey-based study of the cold and heat pattern of recovering patients after COVID-19 at the University medical center at Ho Chi Minh City branch 3 and students of the faculty of Traditional medicine, University of Medicine and Pharmacy at Ho Chi Minh City.

Original Research

Abstract

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. 

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The laparoscopic surgery results of isolated enteric duplication in the transverse mesocolon: A case report

Case Study

Abstract

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. 

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The artificial neural network model predicts the number of dengue cases based on weather factors in Vung Tau City of Ba Ria–Vung Tau province: a correlational study

Original Research

Abstract

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,... 

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Effects of Sodium Fluoride – Potassium Oxalate on Blood Lipid Profile Results and Lipid Stability when using this Anticoagulant

Original Research

Abstract

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. 

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Investigating sleep quality and related factors of postoperative patients at Tay Nguyen Regional General Hospital, Dak Lak Province, Vietnam

Original Research

Abstract

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. 

Graphical abstract

Association between sleep quality and internet addiction in high school students

Original Research

Abstract

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. 

Graphical abstract

A cross-sectional study: the prevalence of mental disorders and associated factors in middle school students in Tuy Hoa City, Vietnam in 2021

Original Research

Abstract

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. 

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Clinical characteristics, interventions and outcomes of acute lower gastrointestinal bleeding: A multicenter study in Vietnam

Original Research

Abstract

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. 

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Validation of TWIST score in the diagnosis of testicular torsion in children: A Prospective study

Original Research

Abstract

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. 

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Gastric adenocarcinoma mimicking a submucosal tumor- a diagnostic pitfall in the pediatric population: report of two cases

Case Study

Abstract

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. 

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Formulation of chewing gum containing Lactobacillus brevis NB10

Original Research

Abstract

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. 

Graphical abstract

Developing diagnostic criteria of illness of traditional medicine on patients with carpal tunnel syndrome by a descriptive cross-sectional survey

Original Research

Abstract

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.

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Risk of venous thromboembolism and appropriateness of thromboprophylaxis in patients undergoing lower limb orthopedic surgery in a Vietnamese hospital

Original Research

Abstract

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. 

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Acceptance and willingness to pay for COVID-19 vaccines available in Vietnam: an online study during the fourth epidemic wave

Original Research

Abstract

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. 

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The effects of auricular acupuncture at Lung, Shenmen, Endocrine, Adrenal points on adult eczema: a randomized trial

Original Research

Abstract

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. 

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Effect of gonadotropin-releasing hormone agonist treatment in Vietnamese children with central precocious puberty

Original Research

Abstract

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. 

Graphical abstract

CHROMagarTM Strep B for detecting group B Streptococcus in pregnant women at 35th to 37th of gestation

Original Research

Abstract

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. 

Graphical abstract

Transplant tourism: a literature review on development, ethical and law issues

Review

Abstract

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. 

Graphical abstract

How Vietnamese healthcare students think of nurses: Students stereotypes about Nursing at University of Medicine and Pharmacy at Ho Chi Minh City

Original Research

Abstract

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. 

Graphical abstract

31-item Quality of Life in Epilepsy Inventory: Translation and validation in Vietnamese

Original Research

Abstract

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. 

Graphical abstract

Gastroesophageal reflux in children with recurrent and chronic respiratory diseases: non-acid or acid?

Original Research

Abstract

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. 

Graphical abstract

Cancer-related thrombosis among older patients in a hospital in Vietnam: A retrospective study

Original Research

Abstract

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. 

Graphical abstract

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