Mirizzi syndrome type IV, a rare and complex form of biliary obstruction, has traditionally required major open surgery. This case report describes a groundbreaking alternative: a 44-year-old woman successfully treated using a minimally invasive laparoscopic approach.The less invasive procedure resulted in rapid, complication-free recovery, with no evidence of biliary stricture at the 6-month follow-up. This outcome challenges conventional management and demonstrates that a minimally invasive approach can be both feasible and highly effective in carefully selected patients.

Objective: To describe caregiver burden, quality of life, and associated factors among primarycaregivers of cancer patients at Thai Binh General Hospital in 2025.Materials and methods: An analytical cross-sectional study was conducted among 408 primarycaregivers of cancer patients at Thai Binh General Hospital from August 2025 to March 2026.Data were collected using a structured questionnaire including general characteristics; the ZaritBurden Interview (ZBI), the World Health Organization Quality of Life-BREF (WHOQOL-BREF),the Generalized Anxiety Disorder-7 (GAD-7), the Katz Activities of Daily Living (Katz ADL), andthe Multidimensional Scale of Perceived Social Support (MSPSS).Results: The mean caregiver burden score was 36.1 ± 15.3, and 38.2% of caregivers had highcaregiver burden (ZBI 41–88, including moderate-to-severe and severe burden). The meanoverall quality-of-life score was 53.2 ± 8.7, with 35.3% classified as having low quality of life.In multivariable analysis, high caregiver burden was independently associated with higherfinancial stress and greater patient dependence in daily activities, while low quality of lifewas independently associated with caregiver age ≥40 years and greater patient dependence.Conclusion: A notable proportion of primary caregivers of cancer patients had high caregiverburden and low quality of life. Higher financial stress and greater patient dependence were associatedwith high caregiver burden, whereas caregiver age ≥40 years and greater patient dependencewere associated with low quality of life. The findings suggest that oncology services should screencaregiver burden and consider timely financial, practical, and psychosocial support for high-riskcaregivers. (PDF) Caregiving burden, quality of life, and some related factors among primary caregivers of cancer patients at Thai Binh General Hospital in 2025. Available from: https://www.researchgate.net/publication/408219248_Ganh_nang_cham_soc_chat_luong_cuoc_song_va_mot_so_yeu_to_lien_quan_o_nguoi_cham_soc_chinh_nguoi_benh_ung_thu_tai_Benh_vien_Da_khoa_Thai_Binh_nam_2025#fullTextFileContent [accessed Aug 18 2026].

Objectives: The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a “social vaccine” that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association. Methods: A cross-sectional study was conducted at 18 hospitals and health centers in Vietnamfrom December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (usingthe 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions. Results: Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD.Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63–2.12; p < 0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97–0.99; p = 0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96–0.99; p = 0.001). Conclusion Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.

Objective: In Viet Nam, tuberculosis (TB) prevalence surveys revealed that approximately 98% of individuals with pulmonary TB have TB-presumptive abnormalities on chest radiographs, while 32% have no TB symptoms. This prompted the adoption of the “Double X” strategy, which combines chest radiographs and computer-aided detection with GeneXpert testing to screen for and diagnose TB among vulnerable populations. The aim of this study was to describe demographic, clinical and radiographic characteristics of symptomatic and asymptomatic Double X participants and to assess multilabel radiographic abnormalities on chest radiographs, interpreted by computer-aided detection software, as a possible tool for detecting TB-presumptive abnormalities, particularly for subclinical TB. Methods: Double X participants with TB-presumptive chest radiographs and/or TB symptoms and known risks were referred for confirmatory GeneXpert testing. The demographic and clinical characteristics of all Double X participants and the subset with confirmed TB were summarized. Univariate and multivariable logistic regression modelling was used to evaluate associations between participant characteristics and subclinical TB and between computer-aided detection multilabel radiographic abnormalities and TB. Results: From 2020 to 2022, 96 631 participants received chest radiographs, with 67 881 (70.2%) reporting no TB symptoms. Among 1144 individuals with Xpert-confirmed TB, 51.0% were subclinical. Subclinical TB prevalence was higher in older age groups, non-smokers, those previously treated for TB and the northern region. Among 11 computer-aided detection multilabel radiographic abnormalities, fibrosis was associated with higher odds of subclinical TB. Discussion: In Viet Nam, Double X community case finding detected pulmonary TB, including subclinical TB. Computer-aided detection software may have the potential to identify subclinical TB on chest radiographs by classifying multilabel radiographic abnormalities, but further research is needed.

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.

Objectives: Malaria prevention still faces many difficulties in the mountainous and highland areas, especially the provinces in the Central region and the Central Highlands, Vietnam. This study aims to describe the practice of malaria prevention of forest goers in four high-risk provinces of Vietnam in 2023 and some related factors. Methods: Cross-sectional in 696 foresters in 4 provinces: Gia Lai, Dak Lak, Dak Nong, Binh Phuoc, Vietnam from January 2023 to December 2023. The study used a validated questionnaire and convenience sampling method to select research subjects. Health station staff were trained as data collectors and supervised during data collection. Results: The study subjects with good malaria prevention practices accounted for 54.6%. In addition to sleeping under mosquito nets, subjects also applied other preventive measures such as wearing long-sleeved clothes and mosquito repellant cream, 83.1% and 67.8%, respectively. Gender, ethnicity, religion, education, health insurance, occupation, frequency of work in the forest, and good knowledge about malaria control as it relates to malaria prevention practices. Conclusion: The current status of malaria prevention practices among forest goers in four high-risk provinces is still limited. It is necessary to promote communication measures to improve people's knowledge, attitudes, and practices on malaria prevention

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has increased the workload of healthcare workers (HCWs), impacting their health. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and identify factors associated with poor sleep among HCWs in Vietnam during the COVID-19 pandemic. Methods: In this cross-sectional study, 1000 frontline HCWs were recruited from various healthcare facilities in Vietnam between October 2021 and November 2021. Data were collected using a 3-part self-administered questionnaire, which covered demographics, sleep quality, and factors related to poor sleep. Poor sleep quality was defined as a total PSQI score of 5 or higher. Results: Participants’ mean age was 33.20±6.81 years (range, 20.0-61.0), and 63.0% were women. The median work experience was 8.54±6.30 years. Approximately 6.3% had chronic comorbidities, such as hypertension and diabetes mellitus. About 59.5% were directly responsible for patient care and treatment, while 7.1% worked in tracing and sampling. A total of 73.8% reported poor sleep quality. Multivariate logistic regression revealed significant associations between poor sleep quality and the presence of chronic comorbidities (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.17 to 5.24), being a frontline HCW directly involved in patient care and treatment (OR, 1.59; 95% CI, 1.16 to 2.16), increased working hours (OR, 1.84; 95% CI,1.37 to 2.48), and a higher frequency of encountering critically ill and dying patients (OR, 1.42; 95% CI, 1.03 to 1.95). Conclusions The high prevalence of poor sleep among HCWs in Vietnam during the COVID-19 pandemic was similar to that in other countries. Working conditions should be adjusted to improve sleep quality among this population.

Objectives: Tuberculosis (TB) and drug-resistant TB (DR-TB) are national health burdens in Vietnam. In this study, we investigated the prevalence of rifampicin (RIF) and/or isoniazid (isonicotinic acid hydrazide, INH) resistance in patients with suspected TB, and applied appropriate techniques to help rapidly target DR-TB. Methods: In total, 1,547 clinical specimens were collected and cultured using the BACTEC MGIT system (Becton Dickinson and Co.). A resazurin microtiter assay (REMA) was used to determine the proportions of RIF and/or INH resistance. A real-time polymerase chain reaction panel with TaqMan probes was employed to identify the mutations of rpoB and katG associated with DR-TB in clinical isolates. Genotyping of the identified mutations was also performed. Results: A total of 468 Mycobacterium tuberculosis isolates were identified using the REMA. Of these isolates, 106 (22.6%) were found to be resistant to 1 or both antibiotics. Of the resistant isolates, 74 isolates (69.8%) were resistant to isoniazid (INH) only, while 1 isolate (0.94%) was resistant to RIF only. Notably, 31 isolates (29.24%) were resistant to both antibiotics. Of the 41 phenotypically INH-resistant isolates, 19 (46.3%) had the Ser315Thr mutation. There were 8 different rpoB mutations in 22 (68.8%) of the RIF-resistant isolates. The most frequently detected mutations were at codons 531 (37.5%), 526 (18.8%), and 516 (6.3%). Conclusion To help prevent new cases of DR-TB in Vietnam, it is crucial to gain a comprehensive understanding of the genotypic DR-TB isolates.

Background: Suicide continues to be a leading cause of death worldwide. Recently, more than 45,000 children in the age group of 10 to 19 years died by suicide, making it the second leading cause of death in the age group of 15 to 19, surpassed only by traffic accidents, tuberculosis, and fighting. Objective: To determine the prevalence of suicidal ideation among adolescents whose parents are separated/divorced; and to explore the factors associated with suicidal ideation and describe adverse experiences among adolescents. Methods: A cross-sectional descriptive study was conducted in 309 adolescents with separated/separated parents in Hue City. Data was collected through direct interviews using a structured questionnaire. Suicidal ideation was defined as the presence of thoughts or plans related to suicide within the last 12 months. Multivariate logistic regression was applied to identify factors associated with suicidal ideation in adolescents with separated/ separated parents. Results: The study found that 15.5% (95% CI:11.7 - 20.1) of adolescents with separated /separated parents reported experiencing suicidal thoughts, in which men accounted 8.4% (95% CI:5.6 – 11.2) and women accounted 7.1% (95% CI:4.5 - 10.6). Several factors were identified as increasing the risk of suicidal ideation, including alcohol use (OR = 3.24; 95% CI:1.42 - 7.42), hyperactivity/inattention (OR = 4.96; 95% CI:1.58 - 15.605), and a poor quality of family relationships (OR = 4.82; 95% CI:1.26 - 18.50). On the contrary, certain factors were found to reduce the risk, including being in the 14-15 age group of 14-15 (OR = 0.26; 95% CI:0.10 - 0.69) and participating in physical activity (OR = 0.44; 95% CI:0.21 – 0.94). Conclusions: The research highlights a significant percentage of adolescents with separated / divided parents who experience suicidal ideation. Therefore, it is imperative for families, schools, and society to develop comprehensive strategies to monitor and address various risky behaviours among students simultaneously.

Backgroud: The aim of this study is to update on antibiotic resistance of common pathogenical bacteria isolated in Hue University of Medicine and Pharmacy Hospital (Hue UMP Hospital). Methodology: Use of the agar disk diffusion method to test the susceptibility to antimicrobial agents of 3709 bacterial strains from infected patients hospitalized in Hue UMP Hospital in 2020 - 2022. Results: Among 3709 strains of pathogenical bacteria isolated, S.aureus was found with the rate of 29.9%, followed by E. coli (24.5%), Pseudomonas aeruginasa (17.8%), Enterococcus spp. (11.8%), Klebsiella spp (9.7%) and Acinetobacter spp (4.1%). The proportion of bacterial isolates has changed, but Staphylococcus aureus is still highest rate. S.aureus is resistant to many antibiotics, but MRSA strains have decreased significantly, from 73.3% in 2020 to 62.5% in 2022. Pseudomonas aeruginosa was resistant to some of the group A recommended antibiotics such as ceftazidime, piperacillin-tazobactam with the rate of 56.6% and 48.7%. The percentage of E. coli with ESBL strains (+) was at 28.2% - 30.3%. Enterococus spp strains are still sensitive to vancomycin (83.1% - 91.9%). The rate of Klebsiella ESBL (+) is only 6.9% to 8.2%. The strains of Acinetobacter spp were highly resistant to Piperacillin (100%) and Ceftriaxone (96.5%) but they are still sensitive to imipenems 70 - 71%, highly sensitive to Doxycillin (95.2%) and Cefotaxime (88.4%). Conclusion: Many bacterial strains are resistant to many commonly antibiotics. Providing timely, regular, and effective management of antibiotic resistance patterns for common pathogenic bacteria in hospitals, will help reduce the risk of bacterial resistance.