OBJECTIVES: The prevalence of diabetes mellitus is rapidly increasing in Vietnam, particularly among adults aged over 45 years. This study estimated trends in diabetes and prediabetes prevalence and determined risk factors in Vietnamese adults (over 45 years). METHODS: A cross-sectional study was conducted based on data from an annual diabetes screening program among people aged 45-69 years in an urban city in central Vietnam (Da Nang). Joinpoint regression analyses were performed to calculate the annual percentage change and ptrend-values. Multinomial logistic regression analysis was used to determine risk factors. RESULTS: In total, 3,765 men and 9,149 women were included in this analysis. The age-adjusted prevalence of diabetes and prediabetes in 2017 was 11.4% and 52.9%, respectively. The prevalence of diabetes was higher in men (15.1%) than in women (10.3%), but that of prediabetes was similar in both genders (53.4% vs. 52.8%). The prevalence of prediabetes significantly increased during the study period, whereas no upward or downward trend for diabetes was observed. The prevalence of obesity, abdominal obesity, hypertension, and dyslipidemia showed no obvious trend. Obesity, a high waist-to-hip ratio, hypertension, more severe abdominal obesity, and dyslipidemia were significantly associated with a higher risk of diabetes and prediabetes. CONCLUSIONS Diabetes and prediabetes were more prevalent among people aged over 45 years than in the general population. Da Nang has experienced a marked increase in the prevalence of prediabetes. These findings have significant implications regarding the need for nationwide public health interventions and management aiming at diabetes prevention and control.

OBJECTIVES: The prevalence of diabetes mellitus is rapidly increasing in Vietnam, particularly among adults aged over 45 years. This study estimated trends in diabetes and prediabetes prevalence and determined risk factors in Vietnamese adults (over 45 years). METHODS: A cross-sectional study was conducted based on data from an annual diabetes screening program among people aged 45-69 years in an urban city in central Vietnam (Da Nang). Joinpoint regression analyses were performed to calculate the annual percentage change and ptrend-values. Multinomial logistic regression analysis was used to determine risk factors. RESULTS: In total, 3,765 men and 9,149 women were included in this analysis. The age-adjusted prevalence of diabetes and prediabetes in 2017 was 11.4% and 52.9%, respectively. The prevalence of diabetes was higher in men (15.1%) than in women (10.3%), but that of prediabetes was similar in both genders (53.4% vs. 52.8%). The prevalence of prediabetes significantly increased during the study period, whereas no upward or downward trend for diabetes was observed. The prevalence of obesity, abdominal obesity, hypertension, and dyslipidemia showed no obvious trend. Obesity, a high waist-to-hip ratio, hypertension, more severe abdominal obesity, and dyslipidemia were significantly associated with a higher risk of diabetes and prediabetes. CONCLUSIONS Diabetes and prediabetes were more prevalent among people aged over 45 years than in the general population. Da Nang has experienced a marked increase in the prevalence of prediabetes. These findings have significant implications regarding the need for nationwide public health interventions and management aiming at diabetes prevention and control.

Background: In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. Methods: We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. Results: The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA’s branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Conclusion Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

Background: The facial artery is an important blood vessel responsible for supplying the anterior face. Understanding the branching patterns of the facial artery plays a crucial role in various medical specialties such as plastic surgery, dermatology, and oncology. This knowledge contributes to improving the success rate of facial reconstruction and aesthetic procedures. However, debate continues regarding the classification of facial artery branching patterns in the existing literature. Methods: We conducted a comprehensive anatomical study, in which we dissected 102 facial arteries from 52 embalmed and formaldehyde-fixed Vietnamese cadavers at the Anatomy Department, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. Results: Our investigation revealed eight distinct termination points and identified 35 combinations of branching patterns, including seven arterial branching patterns. These termination points included the inferior labial artery, superior labial artery, inferior alar artery, lateral nasal artery, angular artery typical, angular artery running along the lower border of the orbicularis oculi muscle, forehead branch, duplex, and short course (hypoplastic). Notably, the branching patterns of the facial artery displayed marked asymmetry between the left and right sides within the same cadaver. Conclusion The considerable variation observed in the branching pattern and termination points of the facial artery makes it challenging to establish a definitive classification system for this vessel. Therefore, it is imperative to develop an anatomical map summarizing the major measurements and geometric features of the facial artery. Surgeons and medical professionals involved in facial surgery and procedures must consider the detailed anatomy and relative positioning of the facial artery to minimize the risk of unexpected complications.

Objective: The purpose of this study was to identify factors associated with twin pregnancy following day 3 double embryo transfer (DET). Methods: This retrospective cohort study incorporated data from 16,972 day 3 DET cycles. The participants were women aged between 18 and 45 years who underwent in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI) at My Duc Assisted Reproduction Technique Unit (IVFMD), My Duc Hospital, located in Ho Chi Minh City, Vietnam. Results: Of the 16,972 day 3 DET cycles investigated, 8,812 (51.9%) resulted in pregnancy. Of these, 6,108 cycles led to clinical pregnancy, with 1,543 (25.3% of clinical pregnancies) being twin pregnancies. Factors associated with twin pregnancy included age under 35 years (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.32 to 1.71; p<0.001) and cycles involving the transfer of at least one grade I embryo. Relative to the transfer of two grade III embryos, the risk of twin pregnancy was significantly elevated following the transfer of two grade I embryos (OR, 1.40; 95% CI, 1.16 to 1.69; p<0.001) or a combination of one grade I and one grade II embryo (OR, 1.27; 95% CI, 1.05 to 1.55; p=0.001). Conclusion By analyzing a large number of IVF/ICSI cycles, we identified several predictors of twin pregnancy. These findings can assist medical professionals in tailoring treatment strategies for couples with infertility.

Health financing has been considered as an important building block of a health system and has a key role in promoting universal health coverage in the Vietnam. This paper aims to describe the pattern of health expenditure, including total health expenditure and composition of health expenditure, over the last two decades in Vietnam. The paper mainly uses the data from Vietnam National Health Account and Vietnam Living Standards Survey. We also included data from other relevant published literature, reports and statistics about health care expenditure in Vietnam. The per capita health expenditure in Vietnam increased from US$ 14 in 1995 to US$ 86 in 2012. The total health expenditure as a share of GDP also rose from 5.2% in 1995 to 6.9% in 2012. Public health expenditure as percentage of government expenditure rose from 7.4% in 1995 to nearly 10% in 2012. The coverage of health insurance went up from 10% in 1995 to 68.5% in 2012. However, health financing in Vietnam was depending on private expenditures (57.4% in 2012). As a result, the proportion of households with catastrophic expenditure in 2012 was 4.2%. The rate of impoverishment in 2012 was 2.5%. To ensure equity and efficient goal of health system, policy actions for containing the health care out-of-pocket payments and their poverty impacts are urgently needed in Vietnam.
Developing Countries/*economics ; Financing, Government/economics/trends ; Health Expenditures/*statistics & numerical data/*trends ; *Healthcare Financing ; Insurance, Health/*economics/*trends ; Vietnam/epidemiology

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most frequent mesenchymal neoplasms of the gastrointestinal tract. Management of GIST patients is currently based on clinicopathological features and associated genetic changes. However, the detailed characteristics and molecular genetic features of GISTs have not yet been described in the Vietnamese population.METHODS: We first identified 155 patients with primary GIST who underwent surgery with primary curative intent between 2011 and 2014 at University Medical Center at Ho Chi Minh City, Vietnam. We evaluated the clinicopathological features and immunohistochemical reactivity to p53 and Ki-67 in these patients. Additionally, KIT genotyping was performed in 100 cases.RESULTS: The largest proportion of GISTs was classified as high-risk (43.2%). Of the 155 GISTs, 52 (33.5%) were positive for Ki-67, and 58 (37.4%) were positive for p53. The expression of Ki-67 and p53 were correlated with mitotic rate, tumor size, risk assessment, and tumor stage. Out of 100 GIST cases, KIT mutation was found in 68%, of which 62 (91.2%) were found in exon 11, two (2.9%) in exon 9, and four (5.8%) in exon 17. No mutation in exon 13 was identified. Additionally, KIT mutations did not correlate with any clinicopathological features.CONCLUSIONS: The expression of Ki-67 and p53 were associated with high-risk tumors. Mutations in exon 11 were the most commonly found, followed by exon 17 and exon 9. Additionally, KIT mutation status was not correlated with any recognized clinicopathological features.
Academic Medical Centers ; Asian Continental Ancestry Group ; Exons ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Molecular Biology ; Risk Assessment ; Vietnam

Objective: This study aimed to investigate the impact of hyperandrogenism (HA) on the outcomes of ovulation induction (OI) using gonadotropin and intrauterine insemination (IUI) in patients with polycystic ovary syndrome (PCOS). Methods: This was a retrospective cohort study including 415 patients undergoing OI using gonadotropin and IUI treatment between January 2018 and December 2020 at a single infertility center. Baseline characteristics, clinical and laboratory parameters, and pregnancy outcomes were investigated. Results: Among the study population, there were 105 hyperandrogenic (25.3%) and 310 non-hyperandrogenic patients (74.7%). The live birth rate was lower in the HA group than in the non-HA group, but this difference did not reach statistical significance due to the limited sample size (14.3% vs. 21.0%, relative risk=0.68; 95% CI, 0.41–1.14, p=0.153). No predictive factors for live birth were identified through logistic regression analysis. Conclusion HA did not negatively affect the outcomes of OI using gonadotropin and IUI cycles in Vietnamese women with PCOS. The result may not be applicable elsewhere due to the large variation in the characteristics of women with PCOS across races and populations.

Background: s/Aims: Hepatolithiasis and choledocholithiasis are frequent pathologies and unfortunately, with the current treatment strategies, the recurrence incidence is still high. This study aimed to assess the outcomes of laparoscopic choledochotomy using cholangioscopy via the percutaneous-choledochal tube for the treatment of hepatolithiasis and choledocholithiasis in Vietnamese patients. Methods: A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at the Department of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020. Results: A total of 84 patients were analyzed. Most patients were females (56.0%) with a median age of 55.56 years. Among them, 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) had both intrahepatic and extrahepatic stones. The rate of stones ≥ 10 mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. Intraoperative complications were encountered in two patients, but there was no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes.The early postoperative complication rate was 9.6%, and all patients were managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%. Conclusions Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube is a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with a previous choledochotomy.

Background: s/Aims: Hepatolithiasis and choledocholithiasis are frequent pathologies and unfortunately, with the current treatment strategies, the recurrence incidence is still high. This study aimed to assess the outcomes of laparoscopic choledochotomy using cholangioscopy via the percutaneous-choledochal tube for the treatment of hepatolithiasis and choledocholithiasis in Vietnamese patients. Methods: A cross-sectional study of patients with hepatolithiasis and/or choledocholithiasis who underwent laparoscopic choledochotomy using intraoperative cholangioscopy via percutaneous-choledochal tube at the Department of Hepatopancreatobiliary Surgery, 108 Military Central Hospital, from June 2017 to March 2020. Results: A total of 84 patients were analyzed. Most patients were females (56.0%) with a median age of 55.56 years. Among them, 41.8% of patients had previous abdominal operations, with 33.4% having choledochotomy. All patients underwent successful laparoscopic common bile duct exploration followed by T-tube drainage without needing to convert to open surgery. Most patients (64.3%) had both intrahepatic and extrahepatic stones. The rate of stones ≥ 10 mm in diameter was 64.3%. Biliary strictures were observed in 19.1% of patients during cholangioscopy. Complete removal of stones was achieved in 54.8% of patients. Intraoperative complications were encountered in two patients, but there was no need to change the strategy. The mean operating time was 121.85 ± 30.47 minutes.The early postoperative complication rate was 9.6%, and all patients were managed conservatively. The residual stones were removed through the T-tube tract by subsequent choledochoscopy in 34/38 patients, so the total success rate was 95.2%. Conclusions Laparoscopic choledochotomy combined with cholangioscopy through the percutaneous-choledochal tube is a safe and effective strategy for hepatolithiasis and/or choledocholithiasis, even in patients with a previous choledochotomy.