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.Identification of Phenolic Compounds from Vietnamese Artichoke (Cynara scolymus L.) Leaf and Their Antioxidant Activities
Anh Nguyet Thi NGUYEN ; Thanh Tuyen Thi VU ; Hong Tuoi Thi DO ; Thien Hai NGUYEN ; Huan Van LE ; Hong Khuyen Thi PHAM ; Phu Chi Hieu TRUONG ; Dong Phuong PHAM ; Manh Hung TRAN
Natural Product Sciences 2024;30(1):39-51
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.
6.Evaluation of the positivity of the fecal occult blood test compared to the microscopic detection of red blood cells
Chi Cao LE ; Nu Phuong Anh TON ; Thi Minh Chau NGO ; Phuoc Vinh NGUYEN ; Thi Bich Thao DO ; Thi Ngoc Thuy HA ; Minh Tiep VO ; Thi Giang TRAN ; That Dong Duong TON
Hue Journal of Medicine and Pharmacy 2023;13(7):31-38
Backgrounds: Fecal occult blood testing (FOBT) is commonly used in colorectal cancer screening programs. Many studies have compared different FOBT methods, but the correlation between traditional red cell microscopy and FOBT remains unclear. Objectives: 1) To evaluate the rate of positive FOBT in patients with different disease groups; 2) To compare the sensitivity and specificity of red blood cells detection in fresh stool by microscopy technique and FOBT. Materials and methods: This was a cross-sectional study involving 120 patients from Hue University of Medicine and Pharmacy Hospital who requested a stool test from 4/2021 to 4/2022. Fresh stool samples were examined for the presence of red blood cells using traditional microscopy and FOBT technique. Results: The overall positivity rate of FOBT was 20%, and in the group of gastrointestinal diseases (n = 24), clinical anemia (n = 21), hepatobiliary diseases (n = 26) and other diseases (n = 49), it was 37.5%, 23.8%, 11.5% and 14.3%, respectively. In comparison with the FOBT technique, microscopic RBC detection had a sensitivity of 33.3% and a specificity of 100%. Conclusions: A high rate of fecal occult blood tests was observed in patients with gastrointestinal disorders. Microscopic erythrocyte detection has low sensitivity and many disadvantages compared to the rapid test. This rapid test should be widely used in clinical practice to aid in the diagnosis of gastrointestinal bleeding
7.Initial results of the change of periostin in non-ST elevation myocardial infarction patients after 3 months
Trung Tin NGUYEN ; Chi Thang DOAN ; Van Minh HUYNH ; Thi Minh Phuong PHAN
Hue Journal of Medicine and Pharmacy 2023;13(7):46-51
Background: Periostin (PN) concentration increases in the blood of patients after acute myocardial infarction (AMI) and affects the process of cardiac remodelling leading to myocardial fibrosis. This study aimed to evaluate the correlation between serum PN levels with cardiac function and short-term prognosis (after 3 months of AMI) in patients with non-ST-elevation AMI. Methods: Case-control study, 3-month follow-up. 35 patients with AMI and 37 healthy people were chosen as the control group. In the group of patients, serum PN was obtained from day 5 - 7 of the disease. The correlation between PN and TIMI, GRACE scores, body mass index (BMI), laboratory findings, and 3-month post-MI data including pro B-type natriuretic peptide (pro-BNP) and echocardiographic parameters. Results: Serum PN levels increased significantly when patients had AMI, negatively correlated with ejection fraction (EF) (r = - 0.462, p = 0.005), positively correlated with left ventricular end-diastolic diameter (LVDd) (r = 0.413, p = 0.014). Conclusions: AMI increases serum PN levels, and PN can be used to predict cardiac function 3 months after MI in patients with non-ST elevation AMI.
8.The Role of Loneliness and Self-Control to the Association between Nomophobia and Depression Symptoms among Vietnamese High School Students
Be Thi Ngoc Nguyen ; Ngoc Phuong Hong Nguyen ; Long Minh Dau ; Quynh-Anh Ngoc Nguyen ; Uyen Thi Thanh Le
ASEAN Journal of Psychiatry 2023;24(no. 5):1-11
Numerous studies have also revealed that students with a high level of Nomophobia have an increased risk of depression. However, few researchers are interested in examining how the association between nomophobia and depressive symptoms mediates loneliness and self-control. This study aimed to investigate, among Vietnamese High School Students, the association between nomophobia and depressive symptoms, specifically focusing on the role that loneliness and self-control play as potential mediators of that relationship. The Nomophobia Scale (NMP-Q), Depression Anxiety Stress Scale 21 (DASS-21), The UCLA loneliness scale version 3 (UCLA III), and The Brief Self-Control Scale (BSCS) were completed by 556 Vietnamese high school students. Using the PROCESS macro, mediation analyses were conducted to investigate the relationship between variables. According to our findings, nomophobia was positively associated with symptoms of depression, and loneliness and self-control partially mediated this relationship. It is suggested that methods for preventing claustrophobia and depressive symptoms be taken seriously in order to increase self-control and decrease loneliness.
9.An outbreak of type B botulism in southern Viet Nam, 2020
Tinh Huu Po ; Ha Phan Ai Nguyen ; Nhan Dinh Trong Le ; Phuong Hoai Hoang ; Ninh Thi Ha ; Chinh Van Dang
Western Pacific Surveillance and Response 2022;13(1):23-29
Objective: To investigate the cause of a botulism outbreak in several provinces in Viet Nam in 2020.
Methods: An initial investigation was conducted to confirm the outbreak and to form hypotheses about the potential causes, followed by a case–control assessment of the plausible causative food item. Collected food samples were tested to identify the pathogen, and mouse bioassays were performed. Control measures were introduced to stop the outbreak and to prevent similar events in the future.
Results: Twelve people in six southern provinces of Viet Nam were identified as having symptoms of botulism, of whom 11 were in critical condition requiring breathing support. A history of foods eaten in the 4 days before illness onset indicated that all the cases had eaten a tinned vegetarian pate, and a case–control assessment showed that this was significantly associated with the outbreak, with an odds ratio of 35.2 (95% confidence interval: 3.4–infinity). Clostridium botulinum type B was detected in three of eight pâté samples collected from the houses of cases. In the mouse bioassay for the toxicity of the pâté samples, all the mice died with clinical symptoms of botulism.
Discussion: A tinned vegetarian pate was the plausible cause of a botulism outbreak in Viet Nam in 2020. Revision of food safety regulations to improve quality control of tinned foods to prevent future outbreaks is recommended.
10.Findings and lessons from establishing Zika virus surveillance in southern Viet Nam, 2016
Lan Trong Phan ; Quang Chan Luong ; Thi Hong Hien Do ; Cindy H Chiu ; Thang Minh Cao ; Thao Thi Thanh Nguyen ; Hai Thanh Diep ; Thao Phuong Huynh ; Dung Tri Nguyen ; Nga Hong Le ; Satoko Otsu ; Phu Dac Tran ; Thuong Vu Nguyen ; Masaya Kato
Western Pacific Surveillance and Response 2019;10(2):22-30
Objective:
To document the evolution and optimization of the Zika virus (ZIKV) disease surveillance system in southern Viet Nam in 2016 and to describe the characteristics of the identified ZIKV-positive cases.
Methods:
We established a sentinel surveillance system to monitor ZIKV transmission in eight sites in eight provinces and expanded the system to 71 sites in 20 provinces in southern Viet Nam in 2016. Blood and urine samples from patients who met the case definition at the sentinel sites were tested for ZIKV using real-time reverse transcription polymerase chain reaction at the Pasteur Institute in Ho Chi Minh City (PI-HCMC). We conducted descriptive analysis and mapped the ZIKV-positive cases.
Results:
In 2016, 2190 specimens from 20 provinces in southern Viet Nam were tested for ZIKV at PI-HCMC; 626 (28.6%), 484 (22.1%), 35 (1.6%) and 1045 (47.7%) tests were conducted in the first, second, third and fourth quarters of the year, respectively. Of these tested specimens, 214 (9.8%) were ZIKV positive with 212 (99.1%) identified in the fourth quarter. In the fourth quarter, the highest positivity rate was those in age groups 30–39 years (30.0%) and 40–59 years (31.6%). Of the 214 ZIKV-positive patients, 210 (98.1%) presented with rash, 194 (90.7%) with fever, 149 (69.6%) with muscle pain, 123 (57.5%) with joint pain and 66 (30.8%) with conjunctivitis.
Discussion
The surveillance system for ZIKV disease underwent several phases of optimization in 2016, guided by the most up-to-date local data. Here we demonstrate an adaptable surveillance system that detected ZIKV-positive cases in southern Viet Nam.


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