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.

The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.

The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.

The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.

Background: This research’s aims are to determine the prevalence of anxiety among students at Hanoi Medical University in the academic year 2020-2021 and some related factors. Methods: This study used a descriptive cross-sectional study on 1325 students at Hanoi Medical University, using DASS-21 scale with questionnaire of anxiety subscale and a self-designed questionnaire. Students were chosen to the study conveniently during the period of data collection. Results: The result of this study showed that the prevalence of anxiety among students was 42.3%. In this population, the moderate subgroup accounted for the biggest prevalence, at 19.1%. The figures for other subgroups, including mild, severe and extremely severe, were 8%, 6.6% and 8.6% respectively. Relevant factors to students’ anxiety were financial difficulties, online learning difficulties and a factor related to Covid 19, which was “afraid of coming home due to the chance of infecting family members with the disease”. Conclusion: Nearly half of students were likely to have anxiety disorders, requiring support measures. Students needed to practice physical exercises, manage schedules to improve their health. Besides, universities should provide financial and academic support to struggling students.

Artichoke (Cynara scolymus L.) is a perennial plant belonging to the Asteraceae family originating from the Mediterranean region. In Vietnam, there are some varieties of artichoke which are extensively cultivated and propagated in highland areas, however, there have been limited detailed scientific publications on the chemical composition and biological activity of artichoke grown in Vietnam. Therefore, this study provides a detailed description of the extraction, isolation, and structural determination of 20 natural secondary metabolites present in harvested artichoke. The antioxidant activity of the extract and the 9 isolated compounds are tested in 1,1-diphenyl-2-picrylhydrazyl radical scavenging and ex vivo malondialdehyde model. Among the selected compounds, 1-caffeoylquinic acid, 3-caffeoylquinic acid, chlorogenic acid, 4-caffeoylquinic acid, cynarin, 1,5-dicaffeoylquinic acid, 4,5-di-caffeoylquinic acid, cynaroside, and scolymoside exhibited strong radical scavenging activity with IC50 values ranging from 5.7 to 61.6 µM. In the malondialdehyde assay, 1,3-dicaffeoylquinic acid (or cynarin) showed the strongest activity with an IC50 value of 24.7 µM, followed by 1,5-di-caffeoylquinic acid (66.8 µM), and 4,5-di-caffeoylquinic acid (127.3 µM). This outcome contributes to establishing a database on the phytochemical and antioxidant activity of the Vietnamese artichoke.

The liver is commonly injured after blunt abdominal trauma. The choice of treatment for liver trauma depends not only on injury severity but also on the patient’s hemodynamic status. Most minor- and moderate-grade liver injuries in hemodynamically stable patients allow for conservative treatment or minimal intervention, while emergency laparotomy is indicated for patients with severe-grade liver trauma and hypotensive shock.We describe a 19-year-old male patient with traumatic shock due to grade IV liver injury and multiple fractures. An emergency laparotomy was performed, but the bleeding could not be controlled, and the patient remained hemodynamically unstable. Hyperacute transarterial embolization was successfully performed. In this case report, we emphasize the importance of transarterial embolization in cases of residual bleeding after initial damage-control surgery, even in hemodynamically unstable patients.

The liver is commonly injured after blunt abdominal trauma. The choice of treatment for liver trauma depends not only on injury severity but also on the patient’s hemodynamic status. Most minor- and moderate-grade liver injuries in hemodynamically stable patients allow for conservative treatment or minimal intervention, while emergency laparotomy is indicated for patients with severe-grade liver trauma and hypotensive shock.We describe a 19-year-old male patient with traumatic shock due to grade IV liver injury and multiple fractures. An emergency laparotomy was performed, but the bleeding could not be controlled, and the patient remained hemodynamically unstable. Hyperacute transarterial embolization was successfully performed. In this case report, we emphasize the importance of transarterial embolization in cases of residual bleeding after initial damage-control surgery, even in hemodynamically unstable patients.

The liver is commonly injured after blunt abdominal trauma. The choice of treatment for liver trauma depends not only on injury severity but also on the patient’s hemodynamic status. Most minor- and moderate-grade liver injuries in hemodynamically stable patients allow for conservative treatment or minimal intervention, while emergency laparotomy is indicated for patients with severe-grade liver trauma and hypotensive shock.We describe a 19-year-old male patient with traumatic shock due to grade IV liver injury and multiple fractures. An emergency laparotomy was performed, but the bleeding could not be controlled, and the patient remained hemodynamically unstable. Hyperacute transarterial embolization was successfully performed. In this case report, we emphasize the importance of transarterial embolization in cases of residual bleeding after initial damage-control surgery, even in hemodynamically unstable patients.

Objective: Unilateral biportal endoscopic (UBE) treatment for lumbar disc herniation (LDH) is an advanced surgical procedure that has recently gained popularity. Numerous reports from developed countries have demonstrated the effectiveness of this minimally invasive technique. We evaluated the initial outcomes of UBE at a healthcare facility with limited resources. Methods: Clinical and radiographic data of 82 patients with LDH treated between July 2022 and June 2023 using UBE discectomy techniques, including the ipsilateral interlaminar approach, contralateral sublaminar approach, and paraspinal approach, were reviewed. Outcomes were analyzed in terms of the modified MacNab criteria, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS), with a mean follow-up of 3.1 months. Results: At the final follow-up, the mean VAS for low back pain improved from 4.5±1.0 to 1.2±0.4 and the VAS for leg pain improved from 7.8±0.9 to 1.6±0.5. The mean JOA score improved from 13.5±2.4 to 24.2±2.1. The modified MacNab criteria were excellent in 56 patients (68.3%), good in 22 (26.9%), and fair in 4 (4.8%). In total, 106 levels of LDH were treated. L4–5 disc herniation was performed in 55 patients (51.9%), L5–S1 in 36 (34.0%), L3–4 in 8 (7.5%), L2–3 in 6 (5.7%), and L1–2 in 1 (0.9%). The ipsilateral interlaminar approach was performed in 93 patients (87.7%), the contralateral sublaminar approach in 7 (6.6%), and the paraspinal approach in 6 (5.7%). Operative time significantly improved after performing 20 cases. In the early stage (1–20 cases), the operation time per level was 102.0±28.2 min, while in the next stage (21–82 cases) it was 78.1±20.4 minutes. No serious complications, including cauda equine syndrome or root palsy, were observed. Three patients had dural tears (2.8%), and 1 had epidural hematoma (0.9%). Conclusion UBE discectomy may be performed safely and effectively for the treatment of LDH in limited-resource settings.