Objective: The risk of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from schoolchildren to their household and the protective effects of vaccination in these settings remain poorly understood. We assessed the transmission dynamics of schoolchildren with SARS-CoV-2 within their households and the protective effects of coronavirus disease (COVID-19) vaccination among household members in Viet Nam. Methods: We estimated the attack rate, vaccine effectiveness and adjusted risk ratio (aRR) of factors associated with SARS-CoV-2 transmission to household contacts of children confirmed to have COVID-19 who attended three schools in Ha Nam, Phu Tho and Thanh Hoa provinces between September and December 2021 using multivariable regression with household-level random effects. Results: This retrospective cohort study included 157 children infected with SARS-CoV-2 and their 540 household contacts. The attack rate among household contacts was 24.6% (133/540). Overall, vaccine effectiveness among household contacts was 39% (95% confidence interval [CI]: -1 to -63), higher among males than females and higher in adults aged >40 years. COVID-19 transmission was greater among female household contacts compared with males (aRR: 1.35, 95% CI: 0.94 to 1.95), although not statistically significant, and highest among those aged 19–39 years (aRR: 2.51, 95% CI: 1.50 to 4.21). Fully vaccinated household contacts had significantly lower infection risk (aRR: 0.46, 95% CI: 0.26 to 0.84). Discussion: We found substantial onward transmission of SARS-CoV-2 from schoolchildren to household members, and older people were more likely to be protected by vaccination. We recommend that schoolchildren and all household members living with schoolchildren receive at least two doses of a COVID-19 vaccine. Recognizing the role of schoolchildren in the onward transmission of COVID-19 is an important lesson learned by Viet Nam that can help not only in managing other outbreaks but also in protecting schoolchildren by predicting the progress of the outbreak and preparing for a timely response.

Background: s/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results.There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape. Methods: We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated. Results: The median operative time was 289.6 min (178−540 min), the median intraoperative blood loss was 209 mL (30−1,600 mL).Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%. Conclusions The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.

Background: s/Aims: Parenchymal-sparing anatomical hepatectomy (Ps–AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps–AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α– Fetoprotein was 25.2 ng/mL. All cases (100%) had Child–Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien–Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.

Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients’ factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men’s Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: “low libido”, “erectile dysfunction”, “ejaculatory dysfunction”, “premature ejaculation”, “retrograde ejaculation”, “delayed ejaculation”, “anejaculation”, and “orgasmic dysfunction” between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socioeconomic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient’s individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.

Objective: Human respiratory syncytial virus (RSV) is a primary cause of paediatric severe acute respiratory infection (SARI) worldwide, especially in developing countries. We investigated the genetic characteristics of RSV in northern Viet Nam to determine the prevalence and distribution of subtypes as well as the diversity and transmission patterns of genotypes. Methods: In two facilities, from January 2017 to December 2020, 1563 clinical specimens were collected from paediatric patients hospitalized with SARI and tested for RSV. Selected positive samples underwent sequencing analysis targeting the second hypervariable region of the G gene using next-generation sequencing. Results: The RSV positivity rate was 28.02% (438/1563 samples), and prevalence was highest in children aged <1 year (43.84%; 192/438). Subtype RSV-A accounted for 53.42% (234/438) of cases, RSV-B for 45.89% (201/438), and there was coinfection in 0.68% (3/438). Both subtypes cocirculated and peaked during August–September in each year of the study. Phylogenetic analysis showed that RSV-A samples belonged to the ON1 genotype, which has three subgenotypes: ON1.1, ON1.2 and ON1.3. However, we did not find the 72-nucleotide duplication in the second hypervariable region of the G gene, a characteristic of genotype ON1, in any RSV-A samples. RSV-B samples belonged to genotype BA9. Discussion: Our results provide additional molecular characterization of RSV infections in Viet Nam. Specially, our study is the first to report the absence of the 72-nucleotide duplication in the G gene of RSV-A genotype ON1 in Viet Nam, which may help in understanding the genetic evolution of RSV and be useful for vaccine development in the future.

In the present study, bioactivity-guided extraction and isolation of the n-hexane fraction of the fruits of Vietnamese Schisandra sphenanthera led to the isolation of five dibenzocyclooctadiene lignans as gomisin N (1), schisandrin C (2), gomisin H (3), gomisin D (4), and gomisin C (5). All the isolates were tested for their inhibition of NO production in LPS-induced RAW 264.7 cells. Among them, compounds 4 and 5 showed weak inhibition of NO production with IC 50 values of 25.0 ± 1.6 and 24.8 ± 2.0 µM, respectively. Compound 1 exhibited NO production inhibition with an IC 50 value of 15.8 ± 2.1 µM, meanwhile, schisandrin C (2) showed the most potent inhibition with an IC 50 value of 8.5 ± 0.5 µM. In addition, compound 2 had a concentrationdependent inhibitory effect on the protein expression of the inflammatory enzymes iNOS and COX-2. Their physicochemical properties and ADMET data were predicted by in silico, indicating favorable drug-like properties as well as low acute oral toxicity. The results suggest that the fruit of S. sphenanthera and its phytochemical constituents might be used as anti-inflammatory agents.

Objectives: Online misinformation has reached unprecedented levels during the coronavirus disease 2019 (COVID-19) pandemic. This study analyzed the magnitude and sentiment dynamics of misinformation and unverified information about public health interventions during a COVID-19 outbreak in Da Nang, Vietnam, between July and September 2020. Methods: We analyzed user-generated online information about five public health interventions during the Da Nang outbreak. We compared the volume, source, sentiment polarity, and engagements of online posts before, during, and after the outbreak using negative binomial and logistic regression, and assessed the content validity of the 500 most influential posts. Results: Most of the 54,528 online posts included were generated during the outbreak (n = 46,035; 84.42%) and by online newspapers (n = 32,034; 58.75%). Among the 500 most influential posts, 316 (63.20%) contained genuine information, 10 (2.00%) contained misinformation, 152 (30.40%) were non-factual opinions, and 22 (4.40%) contained unverifiable information. All misinformation posts were made during the outbreak, mostly on social media, and were predominantly negative. Higher levels of engagement were observed for information that was unverifiable (incidence relative risk [IRR] = 2.83; 95% confidence interval [CI], 1.33–0.62), posted during the outbreak (before: IRR = 0.15; 95% CI, 0.07–0.35; after: IRR = 0.46; 95% CI, 0.34-0.63), and with negative sentiment (IRR = 1.84; 95% CI, 1.23–2.75). Negatively toned posts were more likely to be misinformation (odds ratio [OR] = 9.59; 95% CI, 1.20–76.70) or unverified (OR = 5.03; 95% CI, 1.66–15.24). Conclusions Misinformation and unverified information during the outbreak showed clustering, with social media being particularly affected. This indepth assessment demonstrates the value of analyzing online “infodemics” to inform public health responses.

The Omicron variant caused a surge of infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Viet Nam in early 2022, signalling community transmission. We report on active whole-genome sequencing surveillance of positive SARS-CoV-2 samples collected at that time in northern Viet Nam from international arrivals and community clusters. We used an amplicon protocol developed with 14 polymerase chain reaction products and the Illumina iSeq 100 platform. Overall, 213 nasopharyngeal or throat swabs were analysed, of which 172 samples were identified with the Omicron variant. Of these, 80 samples were collected from community cases in February 2022, among which 59 samples were sublineage BA.2 and one sample was the recombinant XE variant. Our results indicated that Omicron had replaced Delta as the dominant variant in a very short period of time and that continuously conducting active whole-genome sequencing surveillance is necessary in monitoring the evolution and genomic diversity of SARS-CoV-2 in Viet Nam.

Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30–70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm2, which was sufficient to cover both patients’ skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.

Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30–70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm2, which was sufficient to cover both patients’ skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.