Tạp chí Y Dược Huế

The role of bone marrow biopsy and patterns of bone marrow involvement in patients with lymphoma at Da Nang Hospital

Truong The Diem Trinh — 2026-08-25

Background: Bone marrow biopsy (BMB) is essential for diagnosis and monitoring of hematologic disorders, particularly hematologic malignancies and solid tumors with bone marrow involvement. Since January 2024, the Department of Hematology at Da Nang Hospital has implemented BMB combined with immunohistochemistry, improving diagnostic accuracy.

Objectives: To evaluate the diagnostic role of BMB, with emphasis on dry tap aspiration and patterns of bone marrow involvement (BMI) in lymphoma.

Methods: A cross-sectional descriptive study was conducted on 214 patients undergoing BMB at Da Nang Hospital from January to December 2025.

Results: Among 214 patients who underwent both bone marrow aspiration (BMA) and BMB, the mean age was 65.0 ± 14.4 years, most were older than 40 years, and BMB demonstrated a significantly higher diagnostic yield than BMA. Dry tap aspiration occurred in 19.6% of cases, the majority of which were subsequently diagnosed as malignant by biopsy. In patients with lymphoma, BMB identified BMI in 33 cases, including 9 cases with negative BMA due to marrow fibrosis or focal infiltration. Diffuse and mixed patterns of marrow involvement were the most common forms of BMI and may reflect advanced disease.

Conclusion: BMB provides superior diagnostic and prognostic value, particularly in infiltrative hematologic neoplasms. In lymphoma, BMB is indispensable for accurate detection and characterization of BMI and forms the basis for immunophenotypic classification and treatment strategies.

Antibacterial efficacy of sodium hypochlorite and surfactant-modified chlorhexidine against Enterococcus faecalis: An in vitro study

Le Thi Bao Chi — 2026-08-25

Background: Enterococcus faecalis (E. faecalis) is commonly implicated in persistent endodontic infections and has been identified as a major contributor to endodontic treatment failure. Due to the complex anatomy of the root canal system and the persistent bacterial colonization, mechanical preparation alone is often insufficient to completely eliminate bacteria and their toxins. Therefore, the present study aimed to evaluate the antibacterial efficacy of endodontic irrigating solutions.

Objective: To evaluate and compare the antibacterial efficacy of 5.25% Sodium hypochlorite (NaOCl), 2% Chlorhexidine (CHX), and a surfactant-modified 2% Chlorhexidine (CHX Plus™) against E. faecalis biofilms in an in vitro model.

Materials and Methods: An in vitro study was conducted on 66 human mandibular premolars, which were divided into four groups: 5.25% NaOCl, 2% CHX, 2% CHX Plus™, and a negative control group (0.9% NaCl). The root canals were prepared to a master apical file size of #40 and step-back to #80. The samples were inoculated with E. faecalis (ATCC 29212) and incubated for 7 days to allow early biofilm formation. The teeth were then irrigated, the remaining bacteria were collected, and bacterial counts were quantified by colony-forming unit (CFU/mL) enumeration. Data were analyzed using Kruskal–Wallis and Mann–Whitney U tests (p < 0.05).

Results: All experimental irrigants significantly reduced the bacterial load compared to the negative control group (p < 0.001). Both 5.25% NaOCl and 2% CHX Plus™ demonstrated significantly higher antibacterial activity compared to conventional 2% CHX (p < 0.05). No statistically significant difference was observed between the NaOCl and CHX Plus™ groups (p > 0.05), although NaOCl showed the lowest absolute residual bacterial counts.

Conclusion: All three solutions showed high antibacterial efficacy against E. faecalis. However, 2% CHX was less effective than 5.25% NaOCl and 2% CHX Plus™.

Simultaneous determination of lisinopril and amlodipine besylate in tablets by high performance liquid chromatography

Nguyen Thanh Hung — 2026-08-25

Conclusion: All three solutions showed high antibacterial efficacy against E. faecalis. However, 2% CHX was less effective than 5.25% NaOCl and 2% CHX Plus™.

Mental health status and help-seeking preferences among pharmacy students

Ngo Thi Kim Cuc — 2026-08-25

Conclusion: All three solutions showed high antibacterial efficacy against E. faecalis. However, 2% CHX was less effective than 5.25% NaOCl and 2% CHX Plus™.

Clinical characteristics and associated factors with suicidal ideation and suicide attempts among patients with depression: a priliminary study in Hue, Vietnam

Tran Nhu Minh Hang — 2026-08-25

Background: Depression significantly increases the risk of suicide, particularly in low- and middle-income countries such as Vietnam, where individuals with major depression face an estimated 20-fold higher suicide risk than the general population. Data on clinical characteristics and factors associated with suicidal ideation and attempts among hospitalized depressed patients in Vietnam remain limited, especially in central Vietnam, where Hue Central Hospital serves as a major tertiary referral center for severe psychiatric cases.

Objectives: To describe characteristics of suicidal ideation and attempts among depressed inpatients and identify factors associated with suicide attempts.

Methods: A cross-sectional study was conducted among 38 patients diagnosed with depression (ICD-10 criteria) presenting with suicidal ideation or attempts, admitted to the Mental Health Department of Hue Central Hospital, using convenience sampling. Clinical characteristics were assessed via a self-designed questionnaire. Chi-square and Fisher's exact tests (for expected cell frequencies <5) compared proportions, while bivariate regression identified factors associated with suicide attempts, calculating odds ratios (OR) and 95% confidence intervals (CI).

Results: Suicide attempt prevalence was 36.8% (n = 14). Suicidal ideation occurred between 6 AM and 6 PM in 52.6% of cases. A clear suicide plan was reported by 57.9% of patients, yet only 28.9% disclosed their ideation to others. Attempt methods included medication overdose (64.3%), hanging (14.3%), and cutting (21.4%). Two or more depressive episodes (OR = 5.405; 95% CI: 1.290 - 22.727; p = 0.037) and a history of previous attempts (Fisher's exact test, p < 0.001) were significant risk factors. A trend toward increased risk appeared among patients with psychotic symptoms (OR = 6.111; 95% CI: 0.999 - 37.490; p = 0.077), though not statistically significant.

Conclusion: This preliminary study offers locally relevant data on suicidal behavior among depressed inpatients in Hue, Vietnam. Few patients disclosed their suicidal ideation, and those with multiple depressive episodes or prior attempts warrant close monitoring. Since suicidal ideation most commonly occurred during daytime hours, clinicians should maintain vigilant assessment throughout the day, particularly between 6 AM and 6 PM. These findings should be interpreted cautiously given the small sample size and cross-sectional design; larger prospective studies are needed to confirm these associations.

Evaluate medication adherence to medication in outpatients undergoing treatment for chronic diseases at Hue Family Medicine Clinic

Le Tran Tuan Anh — 2026-08-25

Background: Chronic diseases are the leading cause of death worldwide. Medication adherence is a critical factor in improving treatment efficacy and reducing patient costs.

Objectives: (1) To survey the general characteristics of patients receiving treatment for chronic diseases at the Hue Family Medicine Clinic; (2) To assess home medication adherence among these patients using the GMAS scale.

Materials and methods: A cross-sectional descriptive study was conducted on 127 patients with chronic diseases (diabetes, hypertension, dyslipidemia, other cardiovascular diseases) at the Family Medicine Clinic from July 2024 to September 2024. Medication adherence was evaluated using the GMAS scale.

Results: The mean age of the patients was 63.48 ± 8.65years. On average, patients had 2.23 ± 0.88 primary/comorbid conditions and were prescribed 2.77 ± 1.31 medications. The rate of high medication adherence was 92.1%. However, approximately 30-50% of patients occasionally or frequently forgot their medication due to being busy, traveling, attending social events, or having difficulty remembering. About 20% of patients "frequently or occasionally" discontinued medication on their own, and 28.3% self-adjusted their daily medication regimen.

Conclusion: Interventions are needed to minimize forgetfulness due to changes in routine and to address the self-adjustment of treatment regimens, which may stem from a lack of knowledge or ineffective communication with physicians. Future patient counseling and education programs should focus on these two specific aspects.

Non-obese adults with prediabetes in Central Vietnam: Metabolic risk factors and associations with the triglyceride-glucose index

Nguyen Hai Ngoc Minh — 2026-08-25

Background: Insulin resistance can occur even in non-obese individuals, particularly among Asian populations, where visceral adiposity contributes to metabolic risk. The triglyceride-glucose (TyG) index has emerged as a simple and reliable surrogate marker of insulin resistance. In Vietnam, evidence linking the TyG index to metabolic abnormalities in this group is still scarce.

Objective: To describe the metabolic characteristics of non-obese adults with prediabetes in Central Vietnam and to examine the associations between the TyG index and selected anthropometric and lipid-related risk factors.

Methods: A cross-sectional study of 104 non-obese adults (BMI < 25 kg/m²), aged 20 - 65 years, with newly diagnosed prediabetes (ADA 2022 criteria) consecutively enrolled from community health centers in Quang Binh, Hue, and Da Nang City (October 2022 to October 2025). Anthropometric, glycaemic, and lipid parameters were assessed. An elevated TyG index (≥ 8.5) was used as a surrogate marker of insulin resistance. Pearson correlation and multiple linear regression were performed; triglycerides were excluded from the multivariable model as a direct mathematical component of the TyG formula.

Results: Mean age 50.56 ± 9.68 years; mean BMI of 23.39 ± 1.88 kg/m². Central adiposity (WHtR ≥ 0.5) was present in 67.3%, and 76.0% exhibited elevated TyG index. Dyslipidaemia was prevalent: TC ≥ 5.2 mmol/L in 55.8%, hypertriglyceridaemia in 42.3%, elevated non-HDL-C in 73.1%. TyG correlated significantly with TC/HDL-C (r = 0.532), non-HDL-C (r = 0.479), TC (r = 0.395), and WC (r = 0.243). In multivariable regression, independent predictors of TyG were: TC (β = 0.463, p < 0.001), HDL-C (β = -0.303, p = 0.001), female sex (β = -0.287, p = 0.002), and fasting plasma glucose (β = 0.255, p = 0.002); adjusted R² = 0.371, F(8,95) = 8.589, p < 0.001.

Conclusions: In non-obese Vietnamese adults with prediabetes, the TyG index was significantly associated with central adiposity and atherogenic dyslipidaemia, with total cholesterol emerging as its strongest independent predictor. TyG may serve as a practical surrogate marker for cardiometabolic risk assessment in resource-limited primary care settings. Further prospective studies are needed to confirm these findings and establish clinical utility.

Development and preliminary validation of the measurement properties of the S-Series Functional Scales for the shoulder and knee

Ton That Minh Dat — 2026-08-25

Background: Shoulder and knee musculoskeletal disorders are major contributors to functional limitation. Although established patient-reported outcome measures (PROMs) such as SPADI and KOOS are widely used, their length and lack of structural standardization across joints limit feasibility for routine monitoring and digital health applications.

Objective: To describe the development of the S-Series Functional Scales and to evaluate the preliminary measurement properties of the Shoulder Function Scale (SFS) and Knee Function Scale (KFS).

Methods: The S-Series was developed according to a 4S philosophy (Simple, Short, Structured, Standardized) and grounded in the ICF framework. A cross-sectional validation study was conducted in Vietnam involving 208 participants (104 shoulder, 104 knee), including asymptomatic and clinical groups. Internal consistency (Cronbach’s α), test–retest reliability (ICC), convergent validity (with SPADI, KOOS-12, and EQ-5D-5L), discriminant validity, and feasibility were analyzed.

Results: Both scales demonstrated excellent reliability (KFS: α = 0.96, ICC = 0.95; SFS: α = 0.97, ICC = 0.95). Strong convergent validity was observed with reference instruments (ρ = 0.82–0.83) and the EQ-5D-5L index (ρ ≥ 0.80). Receiver operating characteristic analysis showed excellent discriminative ability, with preliminary cut-off values of ≤ 21 for KFS and ≤ 19 for SFS. More than 84% of participants rated the assessment as helpful.

Conclusion: The S-Series Functional Scales (SFS and KFS) provide a concise, standardized, and ICF-aligned PROM system with promising preliminary psychometric properties, supporting their use in clinical practice and digital health research.

A single-run HPLC–PDA method for simultaneous screening of sibutramine, phenolphthalein, caffeine and furosemide in weight-loss products

Nguyen Dang Thuy Anh — 2026-08-25

Background: A high-performance liquid chromatography method with photodiode-array detection (HPLC-PDA) was developed and validated for the simultaneous quantification of caffeine (CAF), furosemide (FUR), phenolphthalein (PHE), and sibutramine (SIB) in herbal weight-loss products.

Materials and Methods: The method employed methanol for sample extraction and utilized a C18 column with a phosphate buffer-acetonitrile gradient.

Results: Validation according to ICH and AOAC guidelines confirmed excellent linearity (10-150 µg mL⁻¹, R² ≥ 0.991), accuracy (spike recovery: 95.89-103.08 %), and precision (intra- and inter-day RSD ≤ 2.66 %). The limits of detection and quantification were sufficiently low to detect these adulterants at trace levels. Application to 32 commercial products from Vietnam revealed that 28.1 % (9 samples) were adulterated with four synthetic drugs, primarily with SIB alone or in combination with PHE.

Conclusion: These findings underscore the need for enhanced regulatory oversight of the weight-loss supplement market. Thus, this method represents a robust, sustainable, and readily applicable solution for quality control laboratories.

Content validity assessment of a CPR training program tailored to nursing needs in a general hospital

Nguyen Van Cong — 2026-08-25

Objective: This study aimed to identify the cardiopulmonary resuscitation (CPR) training needs of nursing staff from the perspective of key stakeholders and to evaluate the content validity of a competency-based CPR training package developed for a private hospital setting in Vietnam.

Methods: Using a two-phase mixed-methods approach, qualitative data were gathered through six in-depth interviews and three focus group discussions with hospital leaders and nurses to identify training needs. In the second phase, a CPR intervention package was developed and validated by 24 experts using the content validity indices (I-CVI and S-CVI/Average).

Results: The qualitative findings highlighted two key needs: moving beyond compliance-driven continuing medical education toward competency-based CPR training, and adopting flexible, repeated, department-specific training formats that address workload and shift constraints. The final training package comprised three components: modular knowledge and skills training (including simulation and Kiosk-CPR practice), on-site follow-up in clinical departments, and evaluation at multiple time points (pre-training, and 3- and 6-month follow-up). The five CPR competency domains showed excellent content validity (S-CVI/Average 0.97-0.99). The overall package achieved S-CVI/Average of 1.00 for relevance and 0.94 for necessity, exceeding recommended thresholds. Experts rated longitudinal monitoring (3-months and 6-month follow-up) as more necessary than one-time immediate post-course evaluation.

Conclusion: A locally adapted competency-based CPR training package for nurses was systematically developed and psychometrically validated in a private hospital. Strong expert agreement and the emphasis on long-term monitoring provide a robust foundation for future implementation and evaluation of effectiveness.

Correlation and agreement between OMRON VP-1000 Plus-derived cardiovascular risk and SCORE2/SCORE2-OP in a high-risk cardiology population

Hoang Anh Tien — 2026-08-25

Objectives: To evaluate the correlation and agreement between the cardiovascular risk indices measured by the OMRON VP-1000 Plus device and those assessed by the SCORE2 and SCORE2-OP scoring systems.

Methods: A cross-sectional descriptive study was conducted on 78 patients (aged 40–89 years) with no history of atherosclerotic cardiovascular disease at the Department of Cardiology, Hue University of Medicine and Pharmacy Hospital, from March to December 2025. Clinical and laboratory data were collected to calculate SCORE2/SCORE2-OP scores. Simultaneously, automated indices (10-year cardiovascular risk, ABI, baPWV) were measured using the OMRON VP-1000 Plus device.

Results: The study identified a strong positive linear correlation between the 10-year cardiovascular risk estimated by the OMRON VP-1000 Plus and that of the SCORE2/SCORE2-OP systems (r = 0.954, p < 0.001). Notably, the brachial-ankle pulse wave velocity (baPWV) demonstrated excellent predictive ability for the high and very high-risk groups. At a cut-off value of baPWV > 1555 cm/s, the area under the ROC curve (AUC) was 81.2%, with a sensitivity of 81.2% and a specificity of 77.8%; furthermore, the risk of experiencing cardiovascular events was 15.07 times higher (p = 0.002).

Conclusions: There is a high degree of concordance in 10-year cardiovascular risk quantification between the OMRON VP-1000 Plus device and the SCORE2/SCORE2-OP scoring systems. The baPWV index is significantly associated with cardiovascular risk levels, suggesting its potential utility in assisting the stratification and prediction of high and very high-risk patient cohorts.

Value of two-dimensional speckle-tracking echocardiography for diagnosing significant coronary stenosis in patients with negative dobutamine stress echocardiography

Nguyen Thi Ngoc — 2026-08-25

Background: Detection of regional wall motion abnormalities during dobutamine stress echocardiography (DSE) is challenging and dependent on individual interpretation, which may reduce sensitivity and accuracy while increasing the false-negative rate. Two-dimensional speckle-tracking echocardiography (STE) during DSE is a highly sensitive method with the potential to detect false-negative cases among patients with negative DSE results.

Aim: This study assessed the value of global longitudinal strain (GLS) and regional longitudinal strain (RLS) by two-dimensional STE to detect significant coronary stenosis (SCS) among patients with negative DSE.

Methods: This cross-sectional study applied two-dimensional STE to 68 patients with negative DSE. They had stable angina suspected of chronic CAD according to the diagnostic criteria of the ESC 2024 and the Ministry of Health of Vietnam 2023. STE findings were compared against selective coronary angiography (DSA) and multi-slice computed tomography (MSCT).

Results: In the early recovery, GLS and RLS reached highest value. GLS reached AUC = 0.968 and Sensitivity = 84.4%, Specificity = 97.2% at GLS > -16.5%; RLS/LAD reached AUC = 0.863 and Sensitivity = 84.6%, Specificity = 83.3% at RLS/LAD > -16.7%; RLS/RCA reached AUC = 0.863 and Sensitivity = 71.4%, Specificity = 80.6%; RLS/LCx reached AUC = 0.926 and Sensitivity = 90.0, Specificity = 83.3 at RLS/LCx > -12.6%.

Conclusions: GLS and RLS measured during the early recovery phase are valuable in the assessment of coronary artery stenosis. STE-derived strain parameters may provide additional diagnostic information for significant stenosis across all three coronary artery territories in patients with negative DSE.

Phytochemical screening, total phenolic and flavonoid contents and antioxidant activity of Alpinia pinnanensis T.L.Wu & S.J.Chen (Zingiberaceae)

Nguyen Dinh Quynh Phu — 2026-08-25

Background: Alpinia pinnanensis is commonly used in Vietnamese ethnomedicine for treating various ailments such as cough, fever, abdominal pain, flatulence and stomachaches. However, research on A. pinnanensis remains limited.

Objectives: This study was conducted to perform a preliminary phytochemical screening, quantify the total phenolic and flavonoid contents and assess the antioxidant potential of A. pinnanensis.

Materials and methods: The whole of A. pinnanensis was collected from A Luoi district, Thua Thien Hue province. Phytochemical analysis was conducted through specific chemical reactions. Total phenolic and flavonoid contents were quantified using the Folin-Ciocalteu and the aluminum chlorid assays, respectively. Antioxidant activity was assessed via the 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2-azino-bis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS) assays.

Results: Phytochemical analysis revealed the presence of flavonoids, coumarins, saponins and tannins. The aerial part extract showed higher total phenolic (132.94 ± 1.24 mg GAE/g) and flavonoid (13.50 ± 0.11 mg QE/g) contents compared to the underground part. Furthermore, the aerial part extract demonstrated significant antioxidant activity in both DPPH and ABTS radical scavenging assays with IC₅₀ values of 19.03 ± 0.11 µg/mL and 2.63 ± 0.18 µg/mL, respectively.

Conclusion: This study provided the first detailed report on phytochemicals, total phenolic and flavonoid contents and antioxidant activity of A. pinnanensis, highlighting its potential for further exploration in pharmaceutical and neutraceutical applications.

Study of the serum apolipoprotein B/apolipoprotein A1 ratio in patients with chronic coronary syndrome

Pham Quang Tuan — 2026-08-25

Background: Coronary artery disease is one of the leading causes of mortality and disease burden worldwide. Recently, Apolipoprotein B, Apolipoprotein A1, and particularly the ApoB/ApoA1 ratio have been recognized as valuable indicators for cardiovascular risk assessment.

Objectives: To investigate the clinical and paraclinical characteristics, serum levels of Apolipoprotein B, Apolipoprotein A1, and the Apolipoprotein B/Apolipoprotein A1 ratio in patients with chronic coronary syndrome. Additionally, to evaluate the associations and correlations between serum Apolipoprotein B, Apolipoprotein A1, the Apolipoprotein B/Apolipoprotein A1 ratio, and the SYNTAX II score in patients with chronic coronary syndrome.

Materials and Methods: Patients presenting with chest pain and admitted to the Cardiovascular Center of Hue Central Hospital were enrolled and classified into two groups according to the 2021 ACC/AHA guidelines: the obstructive chronic coronary syndrome group and the non-obstructive chronic coronary syndrome group.

Results: The study conducted on 110 patients with chronic coronary syndrome (CCS), multivessel disease predominated, with a mean SYNTAX II score of 28.8 ± 9.44. Apo B, Apo A1, and notably the Apo B/Apo A1 ratio demonstrated significant value in predicting obstructive CCS. The Apo B/Apo A1 ratio yielded the highest diagnostic performance, with an optimal cut-off of 0.86 (AUC = 0.769, Se = 68.3%, Sp = 84.0%). Apo B correlated positively with total cholesterol, triglycerides, and non-HDL-C, whereas Apo A1 correlated positively with HDL-C and inversely with atherogenic lipids. As the SYNTAX II score increased, Apo B and the Apo B/Apo A1 ratio increased, while Apo A1 decreased. The strongest correlation with lesion severity and complexity was observed for the Apo B/Apo A1 ratio (r = 0.745, p < 0.01), clearly reflecting the severity and complexity of coronary artery lesions.

Conclusion: Apo B, Apo A1, and the Apo B/Apo A1 ratio demonstrated significant value in distinguishing patients with obstructive chronic coronary syndrome. Among them, the Apo B/Apo A1 ratio was the strongest indicator, clearly reflecting the severity and complexity of coronary artery lesions. These parameters were closely associated with the lipid profile and the SYNTAX II score. Their application may support more accurate risk stratification and guide more effective therapeutic decision-making.

Molecular characteristics and antimicrobial resistance of Carbapenem-resistant Klebsiella pneumoniae isolated at Can Tho University of Medicine and Pharmacy Hospital, 2024 - 2025

Nguyen Thi Be Hai — 2026-08-25

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a critical therapeutic challenge in hospitals of the Mekong Delta, Vietnam. Data on carbapenemase gene distribution and co-production of multiple genes at Can Tho remain limited.

Objectives: To determine the prevalence and distribution of carbapenemase genes by simplex PCR; to describe antimicrobial susceptibility profiles and analyze associations between resistance genotype and phenotype.

Methods: A cross-sectional descriptive study was conducted on 147 CRKP isolates at Can Tho University of Medicine and Pharmacy Hospital (November 2024–July 2025). Susceptibility testing was performed per CLSI M100 2024 (colistin per EUCAST 2024). Carbapenemase detection followed a two-step approach: mCIM for phenotypic screening, D73C disk test for enzyme classification, and simplex PCR confirmation for five genes (bla_OXA-48-like, bla_KPC, bla_NDM, bla_IMP, bla_VIM).

Results: All 147 isolates were multidrug-resistant (MDR, 100%), with extensively drug-resistant (XDR) at 56.5% and pandrug-resistant (PDR) at 8.0%. Colistin and tigecycline retained the highest susceptibility rates (98.6% and 98.0%, respectively). Carbapenemase production was detected in 57.1%: MBL 34.0%, OXA-48-like 19.0%, KPC 3.4%. Among 100 PCR-tested isolates, 84.0% carried at least one carbapenemase gene: bla_NDM predominated (71.1%), followed by bla_OXA-48-like (56.6%), bla_KPC and bla_VIM (7.2% each); bla_IMP was not detected. Co-production of multiple genes was identified in 34.0%, predominantly the bla_OXA-48-like + bla_NDM combination (82.4%). Agreement between D73C and PCR was good to very good: KPC (κ = 0.903), MBL (κ = 0.735), OXA-48-like (κ = 0.561), all p <0.001.

Conclusion: bla_NDM and bla_OXA-48-like were the predominant carbapenemase genes. The high co-production rate (34.0%) represents an important clinical warning. The mCIM → D73C → simplex PCR workflow demonstrated practical value for carbapenemase detection in clinical microbiology laboratories.

Predictors of successful trial of labor after cesarean: A cross-sectional study

Vo Hoang Lam — 2026-08-25

Background: The rate of repeat cesarean delivery is increasing, and although trial of labor after cesarean (TOLAC) may reduce repeat surgeries, it carries inherent risks. In Vietnam, data on TOLAC success rates and their predictors are limited.

Methods: A cross-sectional descriptive study was conducted on 95 pregnant women at the Department of Obstetrics, Hue University of Medicine and Pharmacy Hospital, from May 2023 to July 2024. The subjects were grouped according to the mode of delivery (successful vaginal delivery vs. cesarean delivery). Univariate and multivariate analyses were performed to identify the factors associated with the mode of delivery.

Results: The success rate of vaginal delivery after cesarean delivery was 25.3%. In the multivariable logistic regression analysis, three independent factors were associated with successful vaginal delivery: previous vaginal delivery (adjusted Odd ratio [aOR]=9.913; 95% confidence interval [CI]: 2.167-45.350; p=0.003), cervical effacement ≥75% (aOR = 19.672; 95% CI: 1.908-202.808; p=0.012), and cervical dilation >4 cm (aOR=21.337; 95% CI: 1.210-376.124; p=0.037).

Conclusion: The success rate of vaginal delivery among women with a prior cesarean scar was 25.3%. Previous vaginal delivery, cervical effacement ≥ 75%, and cervical dilation > 4 cm were independently associated with successful vaginal delivery.

Clinicopathological and immunohistochemical profiles of early-onset breast cancer in women under 45 years old

Nguyen Phuong Thao Tien — 2026-08-25

Background: Early-onset breast cancer (EOBC), defined as breast cancer in women under 45 years, is often associated with more aggressive biological behavior and poorer prognosis compared to older patients.

Objectives: (1) To evaluate the clinicopathological, immunohistochemical characteristics, and molecular subtypes of EOBC; (2) To investigate the associations between selected clinicopathological features and immunohistochemical profiles.

Materials and methods: A retrospective cross-sectional study was conducted on 72 patients with invasive breast cancer aged <45 years at Hue University of Medicine and Pharmacy Hospital from January 2023 to December 2025.

Results: The majority of tumors were >2 cm, with a high rate of lymph node metastasis (61.1%); most patients presented at stage II (54.2%). Invasive carcinoma of no special type (83.3%) and histological grade II (56.9%) predominated. Hormone receptor positivity was observed in 70.8% (ER) and 69.4% (PR) of cases, while a high Ki-67 index (≥20%) was present in 69.4%. Luminal B was the most common molecular subtype (38.0%). Significant associations were found between tumor size and clinical stage, as well as between histological grade and both hormone receptor status and molecular subtype (p < 0.05).

Conclusion: EOBC in this study demonstrates aggressive clinicopathological features and distinct molecular profiles, highlighting the critical role of tumor biology in disease behavior and its potential therapeutic implications.

Keywords: early-onset breast cancer, immunohistochemistry, molecular subtype.

Early childhood developmental status and its associated factors among children aged 36 - 59 months in Vietnam: A comparison of two nationally representative surveys

Nguyen Hoang Thuy Linh — 2026-08-25

Introduction: Early Childhood Development (ECD) is a key determinant of long-term health and human capital. In Vietnam, rapid socioeconomic changes necessitate updated national evidence on children’s developmental status and its determinants. This study aimed to compare developmental status among children aged 36 - 59 months and examine associated factors using two rounds of the Vietnam Multiple Indicator Cluster Surveys (MICS 2013 - 2014 and 2020 - 2021).

Methods: This study analyzed two nationally representative datasets derived from the Vietnam MICS 2013 - 2014 (n = 1,035) and 2020 - 2021 (n = 1,893). ECD was measured using the Early Childhood Development Index (ECDI/ECDI2030). Analyses accounted for the complex survey design, and multivariable logistic regression was performed separately for each survey.

Results: The proportion of children classified as developmentally on track was lower in 2020 - 2021 than in 2013 - 2014 (76.5% vs. 89.8%), although direct comparison should be interpreted cautiously because different assessment tools were used. Across both surveys, Kinh ethnicity, higher maternal education, and participation in early childhood education programs were consistently associated with higher odds of being developmentally on track. Household wealth emerged as a significant determinant only in 2020 - 2021, when children from poorer households had lower odds of being on track. Children not exposed to violent discipline were more likely to be developmentally on track in 2020 - 2021 (AOR = 1.50, 95%CI: 1.04 - 2.13), whereas no significant association was observed in 2013 - 2014.

Conclusion: Compared with the MICS 2013 - 2014 survey, early childhood developmental outcomes appeared lower in the MICS 2020 - 2021 survey, although this difference was likely influenced by the adoption of the more stringent ECDI2030 assessment tool. Socioeconomic and ethnic disparities in developmental outcomes remained evident. Persistent socioeconomic and ethnic inequalities, together with the positive role of early childhood education, highlight the need for equitable access to quality early childhood services and supportive caregiving environments.

Correlation between fetal head dimensions on ultrasound and labor outcomes

Nguyen Xuan Anh Thu — 2026-08-25

Background: Prolonged labor is a risk factor for numerous maternal and fetal complications and is among the primary causes of operative vaginal delivery and emergency cesarean section. Predicting prolonged labor remains challenging. This study was conducted to determine the relationship between fetal head dimensions on ultrasound and the duration of labor as well as other outcomes in Vietnam.

Materials and Methods: A cross-sectional descriptive study was conducted on 191 nulliparous women admitted for delivery at the Hue University of Medicine and Pharmacy Hospital from January 2024 to April 2025. Independent samples t-test or Mann–Whitney U test was used for comparison, Pearson correlation coefficient (r) and ROC curve were analyzed to identify cut-off points for predicting the risk of cesarean section due to a prolonged second stage of labor.

Results: There were 34/191 cases of cesarean section during the second stage. Fetal head dimensions in the cesarean section group were significantly larger than those in the vaginal delivery group (p<0.001). There was a weak positive correlation between biparietal diameter, head circumference and the duration of the second stage (p<0.001). Biparietal diameter and head circumference were larger in cases of complex perineal tears. The Area Under the Curve for biparietal diameter and head circumference in predicting cesarean section due to prolonged second stage was 0.718 and 0.704, respectively.

Conclusion: Ultrasound measurement of fetal head dimensions has prognostic value for adverse maternal labor outcomes.

3D Laparoscopic TAPP repair for incarcerated and strangulated inguinal hernias: A prospective cohort study

Pham Nhu Hien — 2026-08-25

Background: Evidence regarding three-dimensional (3D) laparoscopic transabdominal preperitoneal (TAPP) repair with anatomical mesh for incarcerated and strangulated inguinal hernias remains limited. This study evaluated perioperative and follow-up outcomes of this approach in a selected cohort.

Methods: A prospective single-center longitudinal cohort study included 105 eligible adults with incarcerated or strangulated inguinal hernias who underwent 3D laparoscopic TAPP repair at Hue Central Hospital from June 2022 to June 2025. Patients with peritonitis or bowel necrosis requiring resection were excluded. All enrolled patients completed TAPP. No bowel resection, primary open operation, or conversion to open surgery occurred. Clinical, operative, postoperative, and protocol-defined follow-up outcomes were analyzed. Exploratory subgroup comparisons used the Mann-Whitney U and Fisher’s exact tests.

Results: The mean age was 57.1 ± 17.0 years and 96.2% were male. There were 68 incarcerated hernias treated electively and 37 strangulated hernias treated as emergencies. Ten patients underwent bilateral repair after contralateral hernias were identified intraoperatively. Mean operative time was 82.6 ± 29.8 minutes. Hernia contents were preserved in 104/105 patients (99.0%, 95% CI, 94.8%-99.8%). One patient required partial omentectomy and no bowel resection was performed. Early postoperative complications occurred in 3/105 patients (2.9%, 95% CI, 1.0%-8.1%). Within 24 hours, 81.9% passed flatus and 65.7% resumed independent ambulation. Mean postoperative stay was 3.5 ± 1.2 days, and 97.1% reported returning to normal activities within 14 days. At the protocol-defined assessment at or after 6 months, all patients completed clinical examination and ultrasonography, while 99 underwent computed tomography. Six patients did not return for scheduled computed tomography. No recurrence, surgical-site infection, or mesh-related infection was identified during this limited follow-up.

Conclusion: In selected patients without peritonitis or bowel necrosis requiring resection, 3D laparoscopic TAPP repair with anatomical mesh was feasible and was associated with favorable perioperative and short-term outcomes during limited follow-up. These findings should not be generalized to contaminated surgical fields, patients requiring bowel resection, or the broader population of acute irreducible groin hernias.

Evaluating the effectiveness of hybrid simulation in the practice of medicine (POM) module at University of Medicine and Pharmacy, Hue University

Ho Tran Tuan Hung — 2026-08-25

Background: Competency-based medical education is a central direction in modern medical training, in which hybrid simulation is considered an effective method to create a safe learning environment and enhance clinical skills. Hue University of Medicine and Pharmacy has implemented hybrid simulation in the practice of medicine module; however, its application remains limited.

Objectives: This study aimed to evaluate the impact of hybrid simulation on third-year medical students in this module at Hue University of Medicine and Pharmacy

Materials and methods: A quasi-experimental study was conducted involving 100 third-year medical students who received integrated simulation-based training, compared with a control group of 300 third-year medical students trained using the traditional teaching method, with the same clinical skills being taught in both groups. The class was designed based on the ADDIE model. Data were collected by using the Educational Practices Questionnaire and OSCE scores, and analyzed using SPSS version 26.0 with statistical significance set at p < 0.05

Results: Students reported positive experiences with hybrid simulation, with mean scores ranging from 4.18 to 4.48; learning effectiveness was rated highest. OSCE results showed that the intervention group scored higher in the gynecological examination skills station, while the control group performed better in the vertex delivery skills station.

Conclusion: Students had positive learning experiences with hybrid simulation. Further refinement of scenarios and procedures is needed, along with randomized studies for more comprehensive evaluation.

A cone-beam computed tomography - based survey of the root canal morphology of maxillary first premolars

Nguyen Duc Quynh Trang — 2026-08-25

Introduction: The maxillary first premolar (MFP) is characterized by a highly diverse root canal system. Variations in root canal morphology can complicate endodontic treatment.

Objective: To evaluate the root canal morphology and curvature of MFP using Cone Beam Computed Tomography (CBCT).

Materials and Methods: An in vitro experimental study was conducted on 63 extracted MFP. The samples were scanned using CBCT to analyze the canal morphology and canal curvature on CBCT images.

Results: In the group of MFP with one root, 6 out of 8 Vertucci root canal morphology types were observed (types I, II, III, IV, V, and VII), with proportions of 13.2%, 21%, 36.8%, 13.2%, 13.2%, and 2.6%, respectively. No type VI or VIII root canals were recorded. In the group of MFP with two roots, only 2 out of 8 Vertucci types were observed (types I and V), with proportions of 96% and 4%, respectively. No type II, III, IV, VI, VII, or VIII root canals were recorded. In the buccolingual direction, most canals were moderately curved (52.1%); followed by straight canals (29.3%); and severely curved canals (18.6%). The mean canal curvature was 15.63° ± 10.95°. In the mesiodistal direction, most of the canals were also moderately curved (55.3%); followed by straight canals (41.4%); and severely curved canals (3.3%). The mean canal curvature was 9.08° ± 7.01°.

Conclusion: The morphology and curvature of the root canals in maxillary first premolars are highly variable, increasing the complexity of endodontic treatment. CBCT plays an important role in identifying canal morphology and curvature.

Prognostic value of the icu-sepsa score for mortality in patients with multidrug - resistant infections

Nguyen Van Vien — 2026-08-25

Background: Multidrug-resistant (MDR) bacterial infection is a serious global health problem, especially in Intensive Care Units (ICUs). The ICU-SEPSA score was developed to predict mortality in patients with MDR infections.

Objective: To evaluate the prognostic value of the ICU-SEPSA score for predicting mortality among ICU patients with MDR bacterial infections at Hue Central Hospital.

Methods: We conducted a prospective observational study of 108 patients with MDR bacterial infections admitted to the ICU from June 2024 to June 2025. ICU-SEPSA was recorded at the time the index culture was identified. Univariate logistic regression examined the association between ICU-SEPSA and mortality. Discrimination was evaluated using receiver operating characteristic (ROC) analysis to determine the optimal cut-off, area under the curve (AUC), sensitivity, and specificity. An exploratory combined model with the SOFA score was derived using logistic regression, yielding a linear predictor SOFA + 1.104 × ICU-SEPSA.

Results: The overall mortality was 77.8%. The mean ICU-SEPSA score at the time of culture isolation was 7.0 ± 1.9. On univariate analysis, ICU-SEPSA predicted mortality (OR = 1.420; p < 0.001). At a cut-off value of 7.3, ICU-SEPSA demonstrated moderate discrimination (AUC = 0.686), with 56.0% sensitivity and 83.3% specificity. The exploratory combined model (SOFA + 1.104 × ICU-SEPSA) demonstrated better discrimination (AUC = 0.773); at a cut-off of 10.2, sensitivity was 95.2% and specificity 50.0%.

Conclusions: The ICU-SEPSA score has prognostic value for mortality in ICU patients with MDR bacterial infections, and combining ICU-SEPSA with SOFA further improves predictive performance.

An assessment of clinical characteristics, radiographic features, and patient conditions in endodontic treatment based on the American Association of Endodontists case difficulty assessment form

Le Thi Quynh Thu — 2026-08-25

Background: Accurate assessment of endodontic case difficulty before treatment is essential to reduce procedural errors. The American Association of Endodontists (AAE) (2022) developed a standardized case difficulty assessment form to classify endodontic cases into low-, moderate-, and high-difficulty levels.
Objectives: To describe clinical and radiographic characteristics, patient conditions, and classify endodontic case difficulty according to the 2022 AAE assessment form at Hue University of Medicine and Pharmacy Hospital, and to investigate endodontic procedural errors associated with case difficulty.
Methods: A prospective assessment was conducted on 60 teeths from 52 patients diagnosed with pulpal and/or periapical diseases indicated for non-surgical endodontic treatment at Hue University of Medicine and Pharmacy Hospital from December 2024 to August 2025. All cases underwent clinical and radiographic examination and were classified using the AAE case difficulty assessment form. Postgraduate trainee dentists performed endodontic treatments, and procedural errors were recorded based on radiographic criteria.
Results: High-difficulty cases accounted for 80.0%, while moderate-difficulty cases accounted for 20.0%; no low-difficulty cases were identified. The most common procedural errors were overfilling (18.3%) followed by underfilling, ledge formation (15.0%), inhomogeneity, lack of taper (10.0%), instrument separation (6.7%), and perforation (5%). Procedural errors occurred exclusively in high-difficulty cases, accounting for 41.7%. A statistically significant association was found between endodontic case difficulty and procedural errors (p < 0.05), whereas no significant association was observed between case difficulty and specific error types (p > 0.05).
Conclusions: The AAE endodontic case difficulty assessment form is a valuable tool for clinical decision-making. High-difficulty cases predominated and were significantly associated with a higher incidence of procedural errors.

Liver fibrosis despite normal aminotransferases – Implications for Hepatitis B management and treatment eligibility in Vietnam: A cross-sectional study

Le Thi Tuyet Phuong — 2026-08-25

Background: Chronic hepatitis B (CHB) is a major public health challenge in Vietnam. Many patients have normal alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, yet clinically relevant fibrosis may progress silently. This study assessed fibrosis prevalence using transient elastography (FibroScan®) and identified factors associated with significant fibrosis (≥ F2) in CHB patients with normal aminotransferases.

Methods: We conducted a cross-sectional study among CHB patients aged ≥ 18 years at the Gastroenterology Clinic of 115 People’s Hospital, Ho Chi Minh City, from April 2024 to March 2025. Eligible patients were treatment-naïve with normal ALT and AST (Vietnam Ministry of Health 2019 definition). Clinical, laboratory, and virological data were collected, and liver stiffness was measured by transient elastography. Logistic regression was used to assess predictors of fibrosis.

Results: Among 220 patients, 86.4% had no or mild fibrosis (F0 - F1), 12.3% had significant fibrosis (F2), and 1.3% had advanced fibrosis (F3); none had cirrhosis (F4). In multivariable analysis, older age (OR 1.06; 95% CI 1.02 - 1.11) and lower platelet count (OR 0.98; 95% CI 0.98 - 0.99) were independent predictors of significant fibrosis. According to the 2019 Vietnam Ministry of Health guidelines, 23.2% of patients with normal aminotransferases met indications for antiviral therapy, whereas application of the 2024 WHO criteria increased eligibility to 34.1%.

Conclusions: A substantial proportion of CHB patients with normal aminotransferases had significant fibrosis, underscoring the limitations of ALT-based monitoring. Incorporating non-invasive fibrosis assessment into HBV programs could support earlier treatment and accelerate elimination efforts.

Association between dermatoglyphic patterns and malocclusion in 12–15-year-old children in Hue city, Vietnam

Nguyen Thi Hai Trinh — 2026-08-25

Background: Dermatoglyphics has been increasingly investigated as a potential indicator for early prediction of malocclusion. This study aimed to evaluate the association between fingerprint patterns and occlusal status in children in Hue City, Vietnam.

Materials and Methods: A cross-sectional study was conducted on 177 children aged 12–15 years from March to May 2023 in Hue City. Occlusal status was classified according to Angle’s classification. Fingerprint patterns were analyzed, and total finger ridge count was recorded and compared among different occlusion groups.

Results: Children with Class II malocclusion exhibited a higher frequency of ulnar loop patterns and a lower frequency of plain whorl patterns. Significant differences in total finger ridge count were observed among the occlusion groups (p < 0.05).

Conclusion: Dermatoglyphic characteristics may be useful as a supportive tool for early identification of malocclusion. This may contribute to timely planning of preventive and interceptive orthodontic treatment in pediatric patients

Periodontal risk assessment in patients with periodontal disease at medical center in Phu Vang District, Thua Thien Hue Province

Vo Khac Trang — 2026-08-25

Objective: This study aims to assess the periodontal risk profiles of patients with periodontal disease visiting the Health Center in Phu Vang District, Thua Thien Hue Province, Vietnam.

Methods: A cross-sectional descriptive study was conducted on 200 patients diagnosed with gingivitis or periodontitis from May 2023 to July 2024. Periodontal risk was evaluated using the “Periodontal Risk Assessment” (PRA) tool by Lang and Tonetti (2003). The model analyzed six functional parameters: percentage of bleeding on probing, number of sites with probing pocket depth ≥ 5 mm, number of missing teeth, bone loss/age ratio, presence of diabetes mellitus, and smoking habits.

Results: The distribution of periodontal risk levels among the participants was: low risk (37%), moderate risk (47%), and high risk (16%). Risk levels showed a significant correlation with demographic factors, including male gender, age over 40, marital status, and agricultural labor (p < 0.05). Furthermore, clinical parameters such as the stage and grade of periodontitis were strongly associated with risk levels, with 100% of Grade C patients being classified as high risk.

Conclusion: The study population predominantly exhibited a moderate level of periodontal risk. The PRA tool effectively identifies and analyzes risk factors, facilitating timely clinical interventions and personalized treatment planning for patients with periodontal disease.

Cone-Beam computed tomography assessment of root canal morphology and the relationship of maxillary first molars with adjacent anatomical structures in a Vietnamese sub-population

Le Ha Thuy Nhung — 2026-08-25

Background: Dental treatment of the maxillary first molar is often challenging due to its complex anatomical configuration and the close proximity of its roots to the maxillary sinus.

Objective: This study investigated the root canal morphology and the spatial relationship between the maxillary first molar roots and the maxillary sinus floor using cone-beam computed tomography (CBCT).

Materials and methods: A retrospective cross-sectional study analyzing 459 maxillary first molars from 255 CBCT images across axial, coronal, and sagittal planes was conducted. Parameters assessed included the number of roots and canals, canal configurations according to the Vertucci classification, the spatial relationship between canal orifices, and the distance from the root apices to the maxillary sinus floor.

Results: 100% of maxillary first molars possessed three roots and 56.9% exhibited second mesiobuccal canal. The MB root canal showed significant morphological diversity, with Vertucci Type I (43.1%) being the most prevalent configuration. Regarding spatial orientation, 78.2% of the second mesiobuccal orifices were located mesially relative to the line connecting the first mesiobuccal and palatal orifices. The mean distance between the two mesiobuccal canal orifices was 2.00 ± 0.34 mm, with a statistically significant difference observed between genders. A substantial proportion of roots exhibited Type III (contact) and Type IV (protrusion) sinus-root relationships, particularly in the younger age groups (≤ 20 and 21-30 years). Increased age was significantly associated with a greater distance to the sinus floor and the sinus-root distance was smaller in females compared to males across all roots.

Conclusion: Maxillary first molars demonstrate a high prevalence of a second mesiobuccal canal and an intimate anatomical relationship with the maxillary sinus floor. These findings underscore the necessity of CBCT as an essential diagnostic tool in complex endodontic and oral surgical procedures in the posterior maxilla, crucial for accurate canal localization, precise treatment planning, and minimizing the risk of sinus-related complications.