1.Clinical and molecular characteristics of simple virilizing congenital adrenal hyperplasia due to 21-hydroxylase deficiency: insight from a tertiary pediatric center in Vietnam
Khanh Ngoc NGUYEN ; Giang Thi Kim DANG ; Ngoc Thi Bich CAN ; Dien Minh TRAN ; Thao Phuong BUI ; Mai Nguyen Thi PHUONG ; Huong Thu PHAM ; Ngoc Diem NGO ; Dung Chi VU
Annals of Pediatric Endocrinology & Metabolism 2025;30(6):330-339
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.
2.Comparative Clinical and Radiological Outcomes of Banana-Shaped Versus Straight Cages in Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Retrospective Cohort Study
Nguyen Ngoc THOI ; Nguyen Le Hoang TUAN ; Le Tuong VIEN ; Nguyen Thanh NHAN ; Hoang Nguyen Anh TUAN ; Nguyen Van THANH ; Tran Nguyen PHUONG ; Bui Hong Thien KHANH
Journal of Minimally Invasive Spine Surgery and Technique 2025;10(2):172-182
Objective:
This study aims to evaluate and compare the clinical and radiological outcomes of biportal endoscopic transforaminal lumbar interbody fusion (BE-TLIF) using banana-shaped versus straight interbody cages. BE-TLIF has emerged as a minimally invasive technique for treating lumbar spondylolisthesis. Banana-shaped and straight cages are the most commonly used cage types in BE-TLIF; however, their relative clinical and radiological outcomes remain unclear.
Methods:
This retrospective cohort study included 34 patients undergoing single-level BE-TLIF from January 2023 to May 2024. Seventeen patients received banana-shaped cages (group A) and 17 received straight cages (group B). Radiological assessments included disc height (DH), segmental lordosis angle (SLA), lumbar lordosis angle, cage position, and subsidence. Clinical outcomes were evaluated using the visual analogue scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Fusion status was evaluated at 12 months postoperatively using computed tomography according to the modified Bridwell grading system.
Results:
Both groups demonstrated significant postoperative improvements in VAS and ODI scores, with no statistically significant differences between the groups. Radiological outcomes, including restoration of DH and SLA, were slightly better in the banana-shaped cage group, but this difference did not reach statistical significance. Straight cages were more often placed anteriorly, whereas banana-shaped cages tended to occupy the midlateral position. Fusion rates were comparable (100% vs. 94.1%, p>0.05), and subsidence occurred in 23.5% of cases in both groups.
Conclusion
Despite differences in cage positioning, banana-shaped and straight cages yielded comparable clinical and radiological outcomes in BE-TLIF. Either cage type can be effectively utilized in BE-TLIF, providing flexibility in surgical planning, particularly in resource-limited settings.
3.Large-scale salmonella outbreak associated with banh mi, Viet Nam, 2024
Tinh Huu Ho ; Phuong Hoai Hoang ; Lam Vo Thi Ngoc ; Minh Nguyen Dinh ; Dong Do Thanh ; Viet Nguyen Dinh ; O Phan Van ; Phuong Nguyen Thi Lan ; Thanh Nguyen Quoc ; Nhan Ho The ; Nhan Le Dinh Trong ; Chinh Van Dang
Western Pacific Surveillance and Response 2024;15(3):36-42
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.
4.Immunohistochemical expression in idiopathic inflammatory myopathies at a single center in Vietnam
Dat Quoc NGO ; Si Tri LE ; Khanh Hoang Phuong PHAN ; Thao Thi Phuong DOAN ; Linh Ngoc Khanh NGUYEN ; Minh Hoang DANG ; Thien Thanh LY ; Thu Dang Anh PHAN
Journal of Pathology and Translational Medicine 2024;58(4):174-181
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.
5.Update on antibiotic resistance of common pathogenical bacteria isolated in Hue University of Medicine and Pharmacy Hospital
Dinh Binh TRAN ; Viet Quynh Tram NGO ; Thi Bao Chi LE ; Thi Chau Anh NGUYEN ; Hoang Bach NGUYEN ; Van Bao Thang PHAN ; Thi Khanh Linh NGUYEN ; Nu Xuan Thanh LE ; Thi Dang Khoa NGUYEN ; Thi Tuyen NGUYEN ; Thi Thuy UNG ; Thi Hai DINH ; Thi Ngoc Mai DUONG ; Minh Ngoc HOANG ; Viet Tu NGUYEN ; Le Bich Ngoc HOANG ; Tuan Khoi TRAN ; Doan Hieu TRAN ; Thi Tuyet Ngoc TRAN ; Van An LE
Hue Journal of Medicine and Pharmacy 2023;13(7):66-74
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.
6.Evaluation of erectile dysfunction in patients with lumbosacral disc herniation
Dinh Khanh LE ; Thanh Minh NGUYEN ; Thi Phuong Hoai DINH ; Ngoc Tri PHAM ; Nhat Minh NGUYEN
Hue Journal of Medicine and Pharmacy 2023;13(7):127-132
Objectives: Survey on erectile dysfunction in patients with lumbosacral disc herniation and evaluation of their clinical improvement after surgical treatment of spinal canal stenosis due to herniated disc. Materials and Methods: 35 patients with lumbosacral were treated with discectomy with posterior intervertebral fusion (PLIF) surgery from 10/2021 - 4/2022 at the Department of Neurology, Hue University of Medicine and Pharmacy Hospital. Patients were evaluated for erectile dysfunction and postoperative improvement using the IIEF-5, CSFQ-14, DASS-21, Oswestry scales. Results: The mean age was 48.49 ± 9.15 years old. 51.4% of patients had the most severe hernia at the L4-L5 disc, 28.6% L3-L4 and 20% L5-S1. 100% of patients with herniated disc have erectile dysfunction. Of which 40% had mild-moderate disorders, 34.3% had moderate disorders, 14.3% had severe disorders and 11.4% had mild disorders. The CSFQ-14 and DASS-21 scales were correlated with erectile dysfunction (p < 0.05). Surgery significantly improved pain (VAS score), activity limitation (ODI and JOA), degree of erectile dysfunction, changes in sexual function, depression and anxiety, stress of the patient 1 month after surgery (p < 0.05). Conclusions: Patients with lumbosacral disc herniation had a 100% erectile dysfunction rate with a mean IIEF-5 score of 11.69 ± 3.77. The CSFQ-14 and DASS-21 scores have a strong positive correlation with erectile dysfunction. Surgical treatment of spinal canal stenosis due to lumbosacral disc herniation improves the clinical status of herniated disc as well as improves erectile dysfunction in these patients.
7.Study on prognostic index for survival m-LCPI in patients with primary non-small cell lung cancer
Thi Mai Thanh HOANG ; Xuan Thuy Anh HA ; Van Khanh DANG ; Minh Tri PHAN ; Thi Xinh Tuoi TRAN ; Ngoc Quynh Huong LE ; Thi Huong Mo NGUYEN ; Nguyen Ha Trang TRAN
Hue Journal of Medicine and Pharmacy 2023;13(7):133-139
Background: Lung cancer is a common cancer with a high mortality rate. The identification of prognostic factors in lung cancer patients in Vietnam is still limited and inconsistent in clinical practice. Objectives: To describe the clinical, paraclinical characteristics and m-LCPI index in patients with primary non-small cell lung cancer and evaluate the factors affecting overall survival in patients with primary non-small cell lung cancer. Methods: Prospective study of 210 cases of non-small cell lung cancer diagnosed with primary non-small cell lung cancer at the Oncology Department of Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital from February 2020 to February 2023. Results: The majority of hospitalizations were at late stages, from stage IIIA (89%), group 3 and 4 in m-LCPI grading scale constituted the majority (80%). Average overall survival at 3 years was 20.0 ± 14 months, and gradually decreased to 54.8%, 40%, and 38.6% after 1 year, 2 years and 3 years, respectively. Regression analysis of COX model between m-LCPI and OS showed statistical significance with m-LCPI 4 (HR = 3.9, 95%CI = 1.57 - 9.69, p = 0.003), while m-LCPI 3 (HR = 2.44, 95% CI 0.97 - 6.13), p = 0.058) had a weak correlation. Conclusion: Our study shows that 38.6% of patients were still alive after 3 years of diagnosis. m-LCPI index is a good predictor of the patients’ overall survival.
8.Understanding the COVID-19 Infodemic: Analyzing User-Generated Online Information During a COVID-19 Outbreak in Vietnam
Ha-Linh QUACH ; Thai Quang PHAM ; Ngoc-Anh HOANG ; Dinh Cong PHUNG ; Viet-Cuong NGUYEN ; Son Hong LE ; Thanh Cong LE ; Dang Hai LE ; Anh Duc DANG ; Duong Nhu TRAN ; Nghia Duy NGU ; Florian VOGT ; Cong-Khanh NGUYEN
Healthcare Informatics Research 2022;28(4):307-318
Objectives:
Online misinformation has reached unprecedented levels during the coronavirus disease 2019 (COVID-19) pandemic. This study analyzed the magnitude and sentiment dynamics of misinformation and unverified information about public health interventions during a COVID-19 outbreak in Da Nang, Vietnam, between July and September 2020.
Methods:
We analyzed user-generated online information about five public health interventions during the Da Nang outbreak. We compared the volume, source, sentiment polarity, and engagements of online posts before, during, and after the outbreak using negative binomial and logistic regression, and assessed the content validity of the 500 most influential posts.
Results:
Most of the 54,528 online posts included were generated during the outbreak (n = 46,035; 84.42%) and by online newspapers (n = 32,034; 58.75%). Among the 500 most influential posts, 316 (63.20%) contained genuine information, 10 (2.00%) contained misinformation, 152 (30.40%) were non-factual opinions, and 22 (4.40%) contained unverifiable information. All misinformation posts were made during the outbreak, mostly on social media, and were predominantly negative. Higher levels of engagement were observed for information that was unverifiable (incidence relative risk [IRR] = 2.83; 95% confidence interval [CI], 1.33–0.62), posted during the outbreak (before: IRR = 0.15; 95% CI, 0.07–0.35; after: IRR = 0.46; 95% CI, 0.34-0.63), and with negative sentiment (IRR = 1.84; 95% CI, 1.23–2.75). Negatively toned posts were more likely to be misinformation (odds ratio [OR] = 9.59; 95% CI, 1.20–76.70) or unverified (OR = 5.03; 95% CI, 1.66–15.24).
Conclusions
Misinformation and unverified information during the outbreak showed clustering, with social media being particularly affected. This indepth assessment demonstrates the value of analyzing online “infodemics” to inform public health responses.
9.Prevalence and risk factors for human papillomavirus infection among female sex workers in Hanoi and Ho Chi Minh City, Viet Nam: a cross-sectional study
Quang Duy Pham ; Kiesha Prem ; Tuan Anh Le ; Nguyen Van Trang ; Mark Jit ; Tuan Anh Nguyen ; Van Cao ; Tam-Duong Le-Ha ; Mai Thi Ngoc Chu ; Ly Thi Khanh Le ; Zheng Quan Toh ; Marc Brisson ; Suzanne Garland ; Gerald Murray ; Kathryn Bright ; Duc Anh Dang ; Hau Phuc Trana ; Edward Kim Mulholland
Western Pacific Surveillance and Response 2022;13(4):1-11
Objective:
Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infections and cervical cancer due to their high number of sexual partners. The objectives of this study were to determine the prevalence of HPV and identify risk factors for high-risk HPV infection among FSWs in Hanoi and Ho Chi Minh City (HCMC), Viet Nam.
Methods:
A cross-sectional study was conducted in Hanoi and HCMC between December 2017 and May 2018. We surveyed and screened 699 FSWs aged ≥18 years for HPV infection and abnormal cytology. A multivariable modified Cox regression model was used to determine risk factors for high-risk HPV infection.
Results
The overall prevalence of any HPV, high-risk HPV and HPV-16/18 infection in the 699 FSWs was 26.3%, 17.6% and 4.0%, respectively, and were similar in both cities. Multiple infections were identified in 127 participants (69.0%).HPV-52 was the most prevalent (7%), followed by HPV-58 (6%). Abnormal cytology was detected in 91 participants (13.0%). FSWs who are divorced (adjusted prevalence ratio [aPR]: 1.96, 95% confidence interval [CI]: 1.01–3.81), widowed (aPR: 3.26, 95% CI: 1.49–7.12) or living alone (aPR: 1.85, 95% CI: 1.01–3.39) were associated with a higher prevalence of high-risk HPV infection.
10.Re-positive testing, clinical evolution and clearance of infection: results from COVID-19 cases in isolation in Viet Nam
Ngoc-Anh Hoang ; Thai Quang Pham ; Ha-Linh Quach ; Khanh Cong Nguyen ; Samantha Colquhoun ; Stephen Lambert ; Huy Luong Duong ; Dai Quang Tran ; Cong Dinh Phung ; Nhu Duong Tran ; Duy Nghia Ngu ; Anh Tu Tran ; Hue Bich Thi Nguyen ; Duc-Anh Dang ; Florian Vogt
Western Pacific Surveillance and Response 2021;12(4):82-92
Objectives:
Asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and test re-positivity after a negative test have raised concerns about the ability to effectively control the coronavirus disease 2019 (COVID-19) pandemic. We aimed to investigate the prevalence of COVID-19 asymptomatic and pre-symptomatic infections during the second wave of COVID-19 in Viet Nam, and to better understand the duration of SARS-CoV-2 infection and the dynamics between the evolution of clinical symptoms and SARS-CoV-2 test positivity among confirmed COVID-19 cases.
Methods:
We conducted a cohort analysis on the first 50 confirmed cases during the second COVID-19 wave in Viet Nam using clinical, laboratory and epidemiological data collected from 9 March to 30 April 2020. Kaplan-Meier estimates were used to assess time to clearance of SARS-CoV-2 infection, and log-rank tests were used to explore factors related to time to SARS-CoV-2 infection clearance.
Results:
Most cases (58%) had no typical signs or symptoms of COVID-19 at the time of diagnosis. Ten cases (20%) were re-positive for SARS-CoV-2 during infection. Eight cases (16%) experienced COVID-19 symptoms after testing negative for SARS-CoV-2. The median duration from symptom onset until clearance of infection was 14 days (range: 6–31); it was longer in re-positive and older patients and those with pre-existing conditions.
Conclusion
Asymptomatic and pre-symptomatic infections were common during the second wave of COVID-19 in Viet Nam. Re-positivity was frequent during hospitalization and led to a long duration of SARS-CoV-2 infection.


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