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: Buxus latistyla Gagnep. (Buxaceae) has been used as a remedy for treating malaria, haemoptysis, amoebic dysentery etc. However, its chemical constituents are still unknown. Thus, the aim of this study was to identify phytochemicals isolated from this plant. Materials and method: Aerial parts of B. latistyla were collected from Quang Tri province. Pure compounds were isolated using the combination of chromatographic methods. Structures of isolated compounds were identified by analyzing spectral data of nuclear magnetic resonance as well as by comparing with reported data. Results & Conclusion: Five triterpenes were isolated and identified including lupeol (1), lupenone (2), betulin (3), 20(29)-lupene-2α,3α-diol (4), 20(29)-lupene-2α,3α,28-triol (5). This is the first report about those phytochemicals of B. latistyla collected in Vietnam.

Background: Vietnamese herbs are considered as a botanical resource, a precious medicinal source of our country, and are widely used in the residential community in general. Phu Vang district is a coastal plain and lagoon in Thua Thien Hue province, where people’s living standards are not high, health facilities lack equipment. Therefore, the needs for primary health care are necessary to be strengthened, especially in the treatment of common diseases using Vietnamese herbs to reduce costs and improve health for the people. However, the knowledge of the local residents about Vietnamese herbs preventing and treating common diseases at home has not been surveyed. Objectives: (1) To describe the knowledge, attitude and practice on the use of Vietnamese herbs used in the treatment of common diseases of residents in some communes of Phu Vang district. (2) To determine some factors related to the use of Vietnamese herbs in the treatment of common diseases among the residents. Methods: A cross-sectional study was conducted on 400 residents representing the heads of households in three communes of Phu Vang district, Thua Thien Hue province, Thua Thien Hue province. Descriptive statistical analysis and multivariable logistic regression were performed with SPSS software. Results: Knowledge: Good: 45.2%; Fair: 30.8%; Average: 9.0%; Poor: 2.0%. Attitude: 97.0% of residents preferred using Vietnamese herbs in the treatment of common diseases, and 96.6% of residents agreed to continue using Vietnamese herbs to treat similar diseases later. Practice: Good: 7.8%; Fair: 16.7%; Average: 25.3%; Poor: 50.2%. Receiving information about Vietnamese herbs and growing them at home gardens were two factors related to the use of Vietnamese herbs to treat common diseases (p < 0.05). Conclusion: The practice of using Vietnamese herbs to treat common diseases of the residents in Phu Vang district is still low, it is necessary to strengthen educational propaganda to raise the awareness and practice among residents on the prevention and treatment of diseases with Vietnamese herbs at home.

Objective: To evaluate the anti-arthritic effects of Polygonatum kingianum rhizome extract using both in vitro and in vivo models.Methods: Lipopolysaccharide-induced RAW 264.7 macrophages were treated with an ethanol extract of Polygonatum kingianum rhizomes at different concentrations to determine nitric oxide and prostaglandin E2 (PGE2) production. For in vivo study, Polygonatum kingianum ethanol extract was further investigated for its anti-inflammatory effect in a mouse model with collagen antibody-induced arthritis. Phytochemical study of Polygonatum kingianum ethanol extract was also performed. Results: Saponins (142 mg/g total yield) was the main component in the Polygonatum kingianum ethanol extract. 5α,8α-ergosterol peroxide, (E,E)-9-oxooctadeca-10,12-dienoic acid and 3-(2?-hydroxy-4?-methoxy-benzyl)-5,7-dihydroxy-8-methyl-chroman-4-one were isolated from the extract. Polygonatum kingianum ethanol extract exhibited potential anti-inflammatory effects by inhibiting nitric oxide and PGE2 production in RAW 264.7 cells in a dose-dependent manner. The level of arthritis in mice with collagen antibody-induced arthritis was significantly reduced (P<0.01) after treatment with Polygonatum kingianum ethanol extract, particularly at a dose of 1?000 mg/kg body weight. Besides, the extract demonstrated the regulatory effects on serum tumor necrosis factor-alpha, interleukin-6, and interleukin-10 in treated mice. Conclusions: Polygonatum kingianum ethanol extract has beneficial effects on inflammatory cytokine regulation and PGE2 inhibition in an experimental mouse model with collagen antibody-induced arthritis. The phytochemical screening reveals that the saponin, as the main component, and sterols (daucosterol and 5α,8α-ergosterol peroxide) from Polygonatum kingianum ethanol extract may contribute to its promising in vitro and in vivo anti-inflammatory activities.

To evaluate the anti-arthritic effects of Polygonatum kingianum rhizome extract using both in vitro and in vivo models. Methods: Lipopolysaccharide-induced RAW 264.7 macrophages were treated with an ethanol extract of Polygonatum kingianum rhizomes at different concentrations to determine nitric oxide and prostaglandin E2 (PGE2) production. For in vivo study, Polygonatum kingianum ethanol extract was further investigated for its antiinflammatory effect in a mouse model with collagen antibodyinduced arthritis. Phytochemical study of Polygonatum kingianum ethanol extract was also performed. Results: Saponins (142 mg/g total yield) was the main component in the Polygonatum kingianum ethanol extract. 5a,8a-ergosterol peroxide, (E,E)-9-oxooctadeca-10,12-dienoic acid and 3-(2'- hydroxy-4'-methoxy-benzyl)-5,7-dihydroxy-8-methyl-chroman-4- one were isolated from the extract. Polygonatum kingianum ethanol extract exhibited potential anti-inflammatory effects by inhibiting nitric oxide and PGE2 production in RAW 264.7 cells in a dosedependent manner. The level of arthritis in mice with collagen antibody-induced arthritis was significantly reduced (P0.01) after treatment with Polygonatum kingianum ethanol extract, particularly at a dose of 1 000 mg/kg body weight. Besides, the extract demonstrated the regulatory effects on serum tumor necrosis factoralpha, interleukin-6, and interleukin-10 in treated mice. Conclusions: Polygonatum kingianum ethanol extract has beneficial effects on inflammatory cytokine regulation and PGE2 inhibition in an experimental mouse model with collagen antibody-induced arthritis. The phytochemical screening reveals that the saponin, as the main component, and sterols (daucosterol and 5a,8a-ergosterol peroxide) from Polygonatum kingianum ethanol extract may contribute to its promising in vitro and in vivo anti-inflammatory activities.

Background: Phu Cat district, Binh Dinh province is one of the areas contaminated with Agent Orange in Wartime and now up to it still continues to affect the environmental life and health of people living there. Objectives: Investigate the factual status of mortality rate from 2002 to 2006 in Phu Cat district, Binh Dinh province and determine the burden of mortality based on the number of Years of Lost Life (YLLs). Subject and methods: A retrospective study was conducted on all deaths from January 1, 2002 to December 31, 2006 in Phu Cat population. Burden of mortality was analyzed using the WHO standard method. The dead cases were causal diagnosed by Verbal Autopsy tools and update information for mortality rate. Results: Mortality rates were 3.1%o (2002), 3.3%o (2003), 4.08%o (2004) and 2.67% (2005). YLLs from 2002 to 2006 in order are: 55.87%, 57.98%, 73.82%, 48.74% and 49.01%, respectively. The number of mortality in men was higher than women and had a tendency to increase from 2002 to 2004, to decrease during 2005 and 2006. YLLs in group of ages 0-4 was highest in 2004 (150.76%o), followed by 2002 (126.28%o) and was lowest in 2005 (39.72%o). YLLs in groups of ages >60 was high, especially in non-communicable disease. Conclusions: Mortality model from 2002 to 2006 in Phu Cat district, Binh Dinh province was appropriate for the national mortality model. According to YLLs, the burden of mortality was determined as the general burden of mortality from 2002 to 2006 and burden of mortality followed disease groups: communicable disease, nutrition disease and pregnancy; non-communicable disease; poisoned and accident related diseases.
burden of mortality ; mortality

Background: Many research works showed that menstruation is caused by the sudden reduction of the estrogens and progesterone to low levels of secretion at the end of the menstrual cycle. However, it should be investigated to which levels the concentration of these two hormones sharply reduces to cause menstruation. Objective: To determine estradiol concentration at the beginning of menstruation, the second day of menstruation and the ending of menstruation during the menstrual cycle. Subject and methods: 30 women with the normal menstrual cycle and 30 women with the long menstrual cycle were used as subjects to determine estradiol concentration at the day at the beginning of menstruation, the second day of menstruation and the last day of menstruation during the menstrual cycle. Result and Conclusion: In the women group with the normal menstrual cycle, the estradiol concentration: at the day at the beginning of menstruation is 159.93 \xb1 51.29 pmol/L, at the second day of menstruation is 170.58 \xb1 46.54 pmol/L and at the lastday of menstruation is 177.55 \xb1 46.42 pmol/L. In women in the group with long menstrual cycle, the estradiol concentration: at the day of beginning of menstruation is 154.55 \xb1 61.60 pmol/L and at the last day of menstruation is 154.55 \xb1 61.60 pmol/L.
menstrual cycle ; estrogen ; estradiol

Background: peripheral vascular wounds/trauma is a severe type of surgical emergency, the increasing rate due to the rapid increase of traffic, labor and living accidents. Subjectives and Method: retrospective study, all patients with peripheral vascular wounds/traumas (alone or combination in multiple trauma) were emergency operated at Viet Duc Hospital from January 2004 to June 2006. Results: A total of 310 patients with peripheral vascular injuries in the study, of which accounted for 62.3% of injury, trauma group accounted for 37.7%. The mean age of 30. In first aid, pressed tape accounted for high rate (71.5%). Rate of popliteal vascular trauma due to fractures around the knee accounted for 65.5%, the rate of brachial vascular trauma with fractures around the elbow was 50%. Rate of late diagnosis of arterial trauma was 14.6%, higher than the arterial wounds (2.6%). The rate of ultrasound for forelimbs - where vessels were many wounds, was lower than that for hindlimbs - where vessels were many traumas (44% vs 67.9%). For vascular wounds, more directly vascular connection and more intervention on veins, whereas, for arterial trauma, more vascular graft. Rate of complications was low (7.4%), with no deaths. Conclusions: Overall, the results of emergency surgery for peripheral vascular wounds/trauma were well. No cases was death from vascular lesions, rate of complications was low.
Blood Vessels/ injuries ; Emergencies ;

Background: Flail chest is a severe condition of thoracic trauma, and it requires diagnosis and treatment as soon as possible. From year 2000, we developed an improved technique of open fixation in order to adapt the situations of Vietnam health settings. Objectives: To report preliminary results of application of improved open fixation technique in Viet Duc Hospital from 2001 to 2006. Subjects and method: This descriptive, prospective and retrospective study involved 19 patients with flail chest due to closed thoracic trauma or multiple traumas, treated by open fixation technique. The parameters included features of patients, characteristics of this technique and postoperative progression.Results: Of 19 patients, there were 16 males and 3 females, mean age: 47.8 years. All patients presented obvious signs of flail chest preoperatively, but only 9 cases were treated by open fixation technique and pleural drainage immediately. This technique canbe applied in all sugical settings with single local anaesthesia, and any kind of common surgical threads. The most suitable initial pulled weight is 2000 g. All cases of flail chest required pleural drainage. All patients had good outcomes with open fixation technique, no death. There were 3 patients with postoperative complications, all were severe multiple trauma patients. Conclusion: Improved open fixation technique applied in Viet Duc Hospital is simple, effective and safe, and can be widely used in all surgical settings.
Flail Chest ; Flank Pain/ therapy ;

Background: Video-assisted thoracoscopic surgery (VATS) is a now new, effective approach in diagnosis and treatment of thoracic diseases. Objective: To summarize and evaluate the results of VATS for mediastinal tumors. Subjects and method: A retrospective study included patients with mediastinal tumors who performed VATS in Viet Duc Hospital from March 2006 to August 2007. The measurements about age, sex, hospital-admitted reasons, tumor\u2019s size and location, outcomes and complications were analysed. Results: There were sixteen patients, included 9 males and 7 females. The patients\ufffd?average age was 35.3 years (ranged from 16 to 72 years). Clinical characteristics of mediastinal tumors were chest pain (11 cases), trouble breathing (4 cases), cough (2 cases). CT scanner detected mediastinal tumors in all patients (16 cases). Pathologically, 15 patients had benign tumors and only one had malignant tumor. The average time for postoperative drainage withdrawal was 3.0625 days (ranged from 2 to 5 days). The average time of hospital stay was 5 days (ranged from 3 to 11 days). There was no postoperative complication. Conclusion: VATS for mediastinal tumors obtained good outcomes. This was a selective method with many advantages for mediastinal tumors.
Mediastinal Neoplasms/surgery ; Thoracic Surgery ; Video-Assisted ;