Background: While advanced age is a known risk factor for postoperative complications following hip arthroplasty, its role as an independent predictor versus a surrogate for comorbidity remains unclear, particularly in developing countries. This study aimed to investigate the independent impact of age on postoperative outcomes and explore the mediating role of key comorbidities in a resource-limited setting. Methods: We retrospectively reviewed 769 adult patients undergoing hip arthroplasty at a Vietnamese tertiary hospital (2021–2024), categorized into three groups: younger adults (18–64 years), older adults (65–79 years), and oldest old (≥80 years). The primary outcome was a composite of major postoperative complications. Multivariable logistic regression and structural equation modeling were used to identify independent predictors and assess mediation effects. Results: Among 769 patients, 363 were younger (47.2%), 241 older adults (31.3%), and 165 oldest old (21.5%). Complication rates increased significantly with age (18.7%, 36.9%, and 60.0%, respectively; p<0.001). However, multivariable adjustment showed that age was not an independent predictor. Instead, heart failure (adjusted odds ratio [aOR]=5.49, 95% confidence interval [CI] 2.19–13.74) and preoperative anemia (aOR=1.77, 95% CI 1.21– 2.59) were identified as independent risk factors. Mediation analysis revealed that the effect of age on complications was significantly mediated through preoperative anemia. Conclusion Increased postoperative risk in older adults is driven by comorbidity burden rather than chronological age. Preoperative anemia and heart failure are critical, independent predictors, with anemia acting as a key mediator for the effects of age. Individualized correction of modifiable comorbidities may be more beneficial than using age alone to assess surgical risk.

BACKGROUND: Acellular tubular artery scaffolds offer structural support for vascular regeneration but are inherently limited by poor anticoagulant properties, which increases the risk of thrombus formation following implantation. This thrombogenicity remains a major obstacle to their clinical application, particularly in small-diameter vascular grafts. METHODS: To address this challenge, the present study investigates the use of the Layer-by-Layer (LbL) assembly technique for heparin immobilization under low-speed rotation. Utilizing a roller tube system, heparin was immobilized onto decellularized scaffolds through electrostatic interactions facilitated by a DHI-based linker. This low-speed rotation LbL approach enhanced the uniformity and stability of heparin deposition compared to traditional static methods. One, 4, 7, 10, 13 deposition cycles were performed to achieve optimal heparin loading, resulting in scaffolds capable of sustained heparin release over 28 days. RESULTS: The heparinized scaffolds exhibited an initial burst release (approximately 80%), followed by a sustained phase with 18.24% ± 0.242 remaining to support prolonged anticoagulant activity. Importantly, the modified scaffolds significantly reduced thrombus formation and exhibited minimal hemolytic activity, indicating improved hemocompatibility. In addition to their antithrombotic properties, the scaffolds also promoted endothelial cell adhesion, which is critical for restoring vascular integrity, regulating vascular tone, and maintaining long-term patency. CONCLUSION These findings highlight the efficacy of roller-assisted LbL heparinization as a practical and scalable strategy to enhance the blood compatibility of acellular vascular grafts. This method holds considerable promise for addressing thrombogenicity in vascular tissue engineering and advancing the clinical translation of bioengineered vascular constructs.

A 47-year-old female was admitted with progressive exertional dyspnea and diagnosed with anomalous drainage of the left pulmonary veins into the coronary sinus (CS), combined with an intact interatrial septum and a small patent ductus arteriosus (PDA). Multimodal imaging, including echocardiography, computed tomography, and cardiac catheterization, helps diagnosis, optimal management and monitoring. The patient successfully underwent surgical repair, which involved rerouting the left anomalous pulmonary veins into the left atrium through a surgically created atrial septal defect, while the CS continued to drain into the right atrium and the PDA was closed directly via a transpulmonary approach. The postoperative course was uneventful.

Background: Patients with beta-thalassemia major are susceptible to malnutrition, yet limited evidence exists in Vietnam. This study aims to identify factors associated with underweight status among adults with beta-thalassemia major in Vietnam. Methods: This cross-sectional study included 201 adults (≥18 years) with beta-thalassemia major. Underweight was defined as BMI < 18.5 kg/m². Logistic regression was used to examine factors associated with underweight status, including age, sex, ethnicity, place of residence, educational level, marital status, and employment status. Results: Over half of the participants (54.2%) were underweight. Female (aOR = 0.30, 95% CI: 0.12–0.73, p-value=0.008) and married patients (aOR = 0.32, 95% CI: 0.13–0.79, p-value=0.013) were significantly associated with lower odds of underweight status compared to male and unmarried counterparts. Underweight patients had significantly lower fat mass, muscle mass, and bone mineral content, but higher total body water percentage compared to those with normal weight. Conclusion: Underweight status is highly prevalent among adults with beta-thalassemia major in Vietnam, particularly among males and unmarried individuals. These findings underscore the need for targeted nutritional and psychosocial support strategies to improve care and quality of life for this vulnerable population. We recommend implementing tailored nutritional interventions to improve their nutritional status.

Objectives: This study examined the accessibility and utilization of sexual and reproductive health (SRH) services among ethnic minority populations in Vietnam’s mountainous regions, with a focus on their perceptions and challenges. Methods: A mixed-methods design was employed, combining a structured survey of 630 adults with semi-structured interviews and focus group discussions to capture both utilization patterns and contextual experiences. Results: Most participants were of Thai ethnicity (77%). Commune health stations and district hospitals were the most frequently used facilities, primarily for genital tract diseases, pregnancy, and contraceptive services. Over 80% reported satisfaction with services; however, major barriers included long waiting times, limited transportation, and geographical isolation. Respondents expressed a preference for district-level and private facilities due to perceived higher quality, while residents in remote areas often relied on village midwives for maternal care. Additional challenges included the absence of school health staff and the financial burden on teachers providing basic medical support. Conclusion: Findings highlight both service availability and persistent inequities. Addressing logistical, cultural, and systemic barriers through culturally sensitive policies and programs is essential to improving SRH equity for ethnic minority communities in Vietnam.

Purpose: Simple virilizing congenital adrenal hyperplasia (SV-CAH) due to 21-hydroxylase deficiency (21-OHD) is an autosomal recessive disease caused by pathogenic variants of the CYP21A2 gene. Children with SV-CAH often experience delayed diagnosis, presenting with pseudo-precocious puberty in males and genital virilization in females. Genotyping is essential for diagnosis, treatment, optimization, and phenotype prediction. This study describes the clinical and genetic characteristics of SV-CAH to guide treatment strategies. Methods: From November 2016 to March 2023, 79 children (accounting for 34.3% of 230 CAH cases in the overall children’s cohort) from 75 families were classified as SV-CAH due to 21-OHD at the Vietnam National Children's Hospital. Forty-three children underwent CYP21A2 mutation analysis using multiplex ligation-dependent probe amplification and complete gene sequencing to detect pathogenic variants. Results: Median age at diagnosis was 4.5 years (interquartile range, 1 day–22.3 years). There were 38.0% males and 62.0% females. The most common symptoms were penile enlargement in males (53.3%) and clitoromegaly (87.8%) in females; the height standard deviation (SD) at diagnosis was 1.90±1.79 SD (-2.02 to 5.43) according to the World Health Organization; and bone age advancement was 4.65±2.59 years. Genetic analysis identified 21 pathogenic variants and 22 genotypes in 43 children. The most common variant was p.I173N (47.7%); the most common genotype was p.I173N/p.I173N (16.3%). Conclusion Children with SV-CAH are often diagnosed late. To avoid that, early genetic analysis should be prioritized, especially for children diagnosed through newborn screening programs. Determining the genotype is crucial for optimizing treatment strategies, ensuring personalized management, and avoiding overtreatment.

Aims: The objective of the study was to isolate bacteriophages and conduct a comprehensive analysis of their potential against Xanthomonas oryzae pv. oryzae (Xoo) strains in the Mekong Delta, Vietnam. Methodology and results: Twelve Xoo strains were isolated from rice fields located in the Mekong Delta, Vietnam. Among these strains, three strains Xoo L019, L020 and L024, showed the highest disease index of bacterial blight. Four phages specific to Xoo were isolated from soil, water and leaf samples, and their morphologies were determined. In a test against 12 Xoo strains, phage L541, MLA23 or W41 could infect 10 of the 12 Xoo strains, while phage LBH01 could infect 8 of the 12 Xoo strains. The stability of the phages to pH, organic solvents, UV-A and UV-B was also evaluated. Conclusion, significance and impact of study The initial characterization of the phages indicates their potential as biocontrol agents against bacterial blight in rice. The study is one of the very first studies about Xoo phages in rice in Vietnam.

Aims: Microorganisms play a vital role in the breakdown of natural organic compounds and are valuable objects for worldwide enzyme production. The aim of this study was to identify favorable production conditions for Bacillus amyloliquefaciens D19 protease, followed by the purification and chemical characterization of this novel enzyme to assess its potential applications in various fields. Methodology and results: In this study, favorable conditions of protease production from B. amyloliquefaciens D19 were determined using a medium containing soluble starch (1.5%), earthworm extract (1.0%), yeast extract (0.5%), NaCl (1.0%), at pH 7.0-8.0, 37 °C for 36 h with 150 rpm shaking condition. The protease was purified and had a molecular weight of about 23 kDa. The optimum condition for casein hydrolysis was at 40 °C and pH 6.5-7.0 in the presence of 1.0 mM Na+ or 5.0 mM Zn2+. The enzymatic activity was maintained at 75-100% at 30-50 °C and in pH 6.0-10.0. The values of Vmax and KM were also determined as 1547 U/mg and 6.33 mg/mL, respectively. Conclusion, significance and impact of study The identified optimal conditions will serve as the foundation for the production of the 23 kDa B. amyloliquefaciens D19 protease, one of the smallest proteases within the Bacillus genus. Moreover, its notable heat resistance, broad pH tolerance, high substrate catalysis and moderate substrate binding affinity make this enzyme a promising candidate for various applications in the food-feed and brewing industries.

Objective: To investigate the cause of a foodborne outbreak that occurred in Dong Nai province, Viet Nam, in 2024, and implement control measures. Methods: An initial investigation was conducted to confirm the outbreak, which was followed by epidemiological and environmental investigations to find the plausible causative food item. Clinical specimens and food samples were tested to identify the pathogen. Results: A total of 547 symptomatic cases were recorded, of whom two were in severe condition requiring extracorporeal membrane oxygenation and ventilation, one of whom died. Among 99 interviewed cases, the mean incubation time was 9 hours (range 2–24 hours), with the main symptoms being fever, abdominal pain, diarrhoea and vomiting. All patients had eaten banh mi from a local bakery. Salmonella spp. were identified in food samples and clinical specimens. The bakery halted production, and the outbreak ended after 1 week. Discussion: All the patients were exposed to only one food in common, which facilitated the investigation process. This outbreak is a reminder to small retailers and take-away shops of the importance of food safety management in preventing similar future outbreaks. All food handlers must comply with food hygiene principles, especially in hot temperatures, which boosts bacterial growth.

Background: The identification of idiopathic inflammatory myopathies (IIMs) requires a comprehensive analysis involving clinical manifestations and histological findings. This study aims to provide insights into the histopathological and immunohistochemical aspects of IIMs. Methods: This retrospective case series involved 56 patients diagnosed with IIMs at the Department of Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, from 2019 to 2023. The histology and immunohistochemical expression of HLA-ABC, HLA-DR, C5b-9, Mx1/2/3, and p62 were detected. Results: We examined six categories of inflammatory myopathy, including immunemediated necrotizing myopathy (58.9%), dermatomyositis (DM; 23.2%), overlap myositis (8.9%), antisynthetase syndrome (5.4%), inclusion body myositis (IBM; 1.8%), and polymyositis (1.8%). The average age of the patients was 49.7 ± 16.1 years, with a female-to-male ratio of 3:1. Inflammatory cell infiltration in the endomysium was present in 62.5% of cases, perifascicular atrophy was found in 17.8%, and fiber necrosis was observed in 42 cases (75.0%). Rimmed vacuoles were present in 100% of cases in the IBM group. Immunohistochemistry showed the following positivity rates: HLA-ABC (89.2%), HLA-DR (19.6%), C5b-9 (57.1%), and Mx1/2/3 (10.7%). Mx1/2/3 expression was high in DM cases. p62 vacuole deposits were noted in the IBM case. The combination of membrane attack complex and major histocompatibility complex I helped detect IIMs in 96% of cases. Conclusions The diagnosis of IIMs and their subtypes should be based on clinical features and histopathological characteristics. Immunohistochemistry plays a crucial role in the diagnosis and differentiation of these subgroups.