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.

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.

This article describes Viet Nam Ministry of Health’s (VMoH) activities to prepare for and respond to the threat Zika virus (ZIKV), including the adaptation of existing surveillance systems to encompass ZIKV surveillance.

Background: The strategy of Integrated Management of Childhood Illness (IMCI) was developed as an approach/tool for reducing the childhood mortality in developing countries. IMCI was approved by the Ministry of Health of Viet Nam and has been implemented in more than 3500 communal health centers nationwide. Aims: 1) To discover the quality of health care services for children under-5 and the situation of IMCI in health facilities. 2) To propose solutions to improve the quality of health care services for children. Materials and method: The cross-sectional study using quantitative and qualitative approaches conducted 58 direct observations in health workers, interviewed 58 caretakers, comprehensively interviewed 20 local leaders and technical staffs, facilitated 12 focal group discussions and reviewed 120 records of 12 commune health centers. Results: IMCI was considered by all of the participants as a comprehensive approach to improving the quality of childhood health care at first-level health facilities. IMCI contributed towards improved case management skills of health workers, improved the supply of essential drugs and supplies for child health care. As a result, the quality of health services for children under-5 has been promoted (93% of illness children were correctly assessed and classified, 84.6% of them were correctly treated and counseled). Health workers in Ly Nhan district, Ha Nam province adhered to 8.4+/-1.5 out of 10 essential steps of comprehensive child health care. Contrarily, this indicator was low in the districts of Bac Giang province (4.8+/-1.5), not much different to untrained IMCI health workers. Conclusion: IMCI is a useful strategy to improving the quality of child health care. But there were some difficulties that affected the implementation of this strategy in first-level health facilities.
IMCI ; Child health care

Background: Acute gastroenterophathy usually caused by the Rota virus for children under 5 years old. Objectives: To present various types of data on epidemiology of ROTA virus diarrhea in Ho Chi Minh city from 12/2006-11/2007. Material and method: The data were collected from 500 stool specimens of diarrhea diagnosed chilren hosptalised at Thuy Dien Pediatric hospital 1, Ho Chi Minh city from December/2006 to November /2007. Results:There were 322 rotavirus-positive specimens, representing 64.4%. The proportions of monthly distribution of cases with diarrhea due to rotavirus were 90.1%, 54.39%, 85.37%, 74.51%, 72.92%, 41.67%, 26.67%, 58.33%, 79.31%, 52.63%, 69.05% and 57.78%, respectively. The numbers of rotavirus-positive cases in male and female were 216 (65.26%) and 106 (62.72%), respectively. The proportions of Rota virus positive children compared to total number of diarrheal cases with age 0-3, 3-6, 6-12, 12-24, 24-36 and over 36 months were 2.80%, 7.76%, 40.06%, 40.68%, 5.28% and 3.42%, respectively.\r\n', u'The results of typing identification indicated that the phenotypes of 98 among 100 specimens were identified (98%) in which there were sixty-one specimens of G1P8 (61%), one specimen of G2P8 (1%), fourteen specimens of G3P8 (14%), four of specimens of G4P8 (4%), eighteen specimens of GmixedP8 (18%). There were only two specimens of GnontypeableP8 (2%). Conclusion: Further studies should be carried out to clear this issue.\r\n', u'
Rotavirus ; gel type.

Background: Rotavirus type A is the most common cause of acute gastrointestinal inflammatory in children under 5 years old, especially in age groups 6 and 36 months. Some rotavirus strains are common; seen recently in Vietnam are G1, G2, G3, G4 and G9, P4, P6 and P8. Objective: Surveillance of epidemiological characteristics of rotavirus induced diarrhea in the National Pediatric Hospital from September, 2007 to March, 2008. Subject and methods: Collection of 322 stool specimens of pediatric patients with acute diarrhea (including 213 specimens from male, 109 specimens from female), who were treated in the National Pediatric Hospital. All of these specimens were determined for causes of rotavirus with the enzyme immunoassay (EIA). Results and Conclusion: Among these 322 stool specimens, there were 195 rotavirus positive specimens, accounted for 60.56%. The rate of monthly distribution of rotavirus diarrhea from September, 2007 to March, 2008 were 76%, 56%, 62%, 61%, 64%, 56% and 44%, respectively. Number of rotavirus positive cases in male and female was 56 (26.29%) and 79 (72.48%), respectively. The rate of rotavirus positive children compared to total number of specimens with the age 0-3 months, 3-6 months, 6-12 months, 12-24 months, 24-36 months and over 36 months was 7.69%, 15.9%, 41.54%, 32.82%, 1.54% and 0.51%, respectively. The results of type identification indicated that phenotypes of 37 among 40 specimens were identified (92.5%) in which there were 5 specimens of G1P8 (12.5%), 20 specimens of G3P8 (50%), 1 specimen of G9P8 (2.5%), 2 specimens of G1Pmixed (5%), 9 specimens of G3Pmixed (22.5%), 1 specimen of G unidentified-type P8 (2.5%) and 2 specimens of G3 P unidentified-type (5%).
rotavirus ; diarrhea ; epidemiology

Background: \r\n', u'October 2000, Vietnam was acknowledged as the country to successfully eradicate the polio by WHO.This success was partly due to the oral polio vaccine (OPV) produced on the primary money cells by the Centre of Research, Production of vaccines and biologicals, Ha Noi. In 2006, the Centre developed the single polio vaccine type 1 from primary monkey cells.\r\n', u'Objectives: \r\n', u'To evaluate the safety and antibody titre .\r\n', u'Subjects and method: \r\n', u'6 lots of single polio vaccine type 1 (ISO- 90, Antibodies of Polio type 1,2,3; the standard sample F113 from Japanese research on Polio Institute\ufffd?\r\n', u'Using the tests (T- maker, D maker, PFU, CCID50) to check the safety of single polio vaccine type 1. \r\n', u'Results:\r\n', u'After 14 days, 6/6 lots of viruses were observed via the microscope that they stayed in well developed, and of no serious adverse affects.There was no appearance of degenerated cells. \r\n', u'Conclusion:\r\n', u'6/6 lots of single polio vaccine type 1 produced on Macca mulltta monkey kidney cells with the first time passage at POLYVAC in 2006 are safe and high antibody titre.\r\n', u'
Poliovirus Vaccine ; Oral ;