Background: Patients with beta-thalassemia major are susceptible to malnutrition, yet limited evidence exists in Vietnam. This study aims to identify factors associated with underweight status among adults with beta-thalassemia major in Vietnam. Methods: This cross-sectional study included 201 adults (≥18 years) with beta-thalassemia major. Underweight was defined as BMI < 18.5 kg/m². Logistic regression was used to examine factors associated with underweight status, including age, sex, ethnicity, place of residence, educational level, marital status, and employment status. Results: Over half of the participants (54.2%) were underweight. Female (aOR = 0.30, 95% CI: 0.12–0.73, p-value=0.008) and married patients (aOR = 0.32, 95% CI: 0.13–0.79, p-value=0.013) were significantly associated with lower odds of underweight status compared to male and unmarried counterparts. Underweight patients had significantly lower fat mass, muscle mass, and bone mineral content, but higher total body water percentage compared to those with normal weight. Conclusion: Underweight status is highly prevalent among adults with beta-thalassemia major in Vietnam, particularly among males and unmarried individuals. These findings underscore the need for targeted nutritional and psychosocial support strategies to improve care and quality of life for this vulnerable population. We recommend implementing tailored nutritional interventions to improve their nutritional status.

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.

Purpose: To determine the efficacy of apparent diffusion coefficient (ADC) values and ratios (lesion/liver tissue, lesion/splenic tissue, lesion/paraspinal muscle) in differentiating benign from malignant solid liver lesions. Materials and Methods: This study retrospectively analyzed data from 115 patients with solid liver lesions who underwent abdominal magnetic resonance imaging (MRI) at a single institution between January 2023 and December 2024. Lesions were classified as benign or malignant based on biochemical tests as well as radiographic and/or histopathologic findings. ADC values and ratios were determined using a 1.5 T MRI scanner.Quantitative variables are presented as mean ± standard deviation or median (interquartile range). Receiver operating characteristic (ROC) analysis was used to determine the cut-off values for ADC value and ratio, for which associated areas under the ROC curve were calculated. Results: The present analysis included 115 lesions—36 benign and 79 malignant. The median ADC value of the benign lesions was significantly higher than that of malignant lesions: 1744.5 × 10-6 mm2 /s vs. 1168.0 × 10-6 mm2 /s, respectively. The average lesion-toliver ADC (rADC l), lesion-to-spleen ADC (rADCsp), and lesion-to-paraspinal muscle ADC (rADC m) ratios for the benign lesions were significantly higher than those of malignant lesions: 1.79 vs. 1.09, 2.31 vs. 1.44, and 1.19 vs 0.80, respectively. A threshold of 1416 × 10-6 mm2 /s was used to differentiate benign vs. malignant lesions, with a sensitivity of 83.3% and a specificity of 78.5%. The cut-off values for rADC l, rADCsp, and rADC m were 1.55, 1.95, and 0.97, respectively, with sensitivities of 69.4%, 69.4%, and 83.3% and specificities of 87.3%, 91.1%, and 79.9%, respectively. Conclusion ADC metrics obtained from diffusion-weighted MRI effectively distinguished benign from malignant solid liver lesions.

Objectives: The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a “social vaccine” that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association. Methods: A cross-sectional study was conducted at 18 hospitals and health centers in Vietnamfrom December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (usingthe 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions. Results: Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD.Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63–2.12; p < 0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97–0.99; p = 0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96–0.99; p = 0.001). Conclusion Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.

The substantia gelatinosa (SG) within the trigeminal subnucleus caudalis (Vc) is recognized as a pivotal site of integrating and modulating afferent fibers carrying orofacial nociceptive information. Although naringenin (4',5,7-thrihydroxyflavanone), a natural bioflavonoid, has been proven to possess various biological effects in the central nervous system (CNS), the activity of naringenin at the orofacial nociceptive site has not been reported yet. In this study, we explored the influence of naringenin on GABA response in SG neurons of Vc using whole-cell patch-clamp technique. The application of GABA in a bath induced two forms of GABA responses:slow and fast. Naringenin enhanced both amplitude and area under curve (AUC) of GABA-mediated responses in 57% (12/21) of tested neurons while decreasing both parameters in 33% (7/21) of neurons. The enhancing or suppressing effect of naringenin on GABA response have been observed, with enhancement occurring when the GABA response was slow, and suppression when it was fast. Furthermore, both the enhancement of slower GABA responses and the suppression of faster GABA responses by naringenin were concentration dependent. Interestingly, the nature of GABA response was also found to be sex-dependent. A majority of SG neurons from juvenile female mice exhibited slower GABA responses, whereas those from juvenile males predominantly displayed faster GABA responses. Taken together, this study indicates that naringenin plays a partial role in modulating orofacial nociception and may hold promise as a therapeutic target for treating orofacial pain, with effects that vary according to sex.

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.

THE RELATIONSHIP BETWEEN DEPRESSION, ANXIETY, STRESS AND INTERNET USE AMONG HIGH SCHOOL STUDENTS The prevalence of mental health issues among high school students has raised concerns globally, with depression, anxiety, and stress being common challenges. This study investigates the relationship between depression, anxiety, stress, and internet use among high school students in Da Nang, Vietnam. The short Internet Addiction Test (s-IAT) and Depression Anxiety Stress Scales (DASS-21) were used to assess internet addiction and mental health symptoms. Data were analyzed using correlation analysis and regression models. Results revealed significant positive correlations between internet use and symptoms of stress, anxiety, and depression, highlighting the importance of addressing problematic internet usage patterns. Additionally, associations were found between demographic variables, such as parental occupations and socioeconomic status, and mental health outcomes, emphasizing the interconnected nature of individual, familial, and societal factors. The study underscores the need for targeted interventions to promote healthy internet habits and mitigate potential harms among high school students. By understanding the complex interplay between internet use and mental health outcomes, stakeholders can develop effective strategies to support the well-being of adolescents in an increasingly digital world. This research contributes to a deeper understanding of the socio-ecological factors shaping adolescent mental health and informs future intervention efforts. ASEAN Journal of Psychiatry, Vol. 25 (6) June, 2024; 1-16.

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

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.

The substantia gelatinosa (SG) of the trigeminal subnucleus caudalis(Vc) is the first relay site for the orofacial nociceptive inputs via the thin myelinatedAδ and unmyelinated C primary afferent fibers. Borneol, one of the valuable timehonoredherbal ingredients in traditional Chinese medicine, is a popular treatmentfor anxiety, anesthesia, and antinociception. However, to date, little is known asto how borneol acts on the SG neurons of the Vc. To close this gap, the whole-cellpatch-clamp technique was applied to elucidate the antinociceptive mechanismresponding for the actions of borneol on the SG neurons of the Vc in mice. In thevoltage-clamp mode, holding at –60 mV, the borneol-induced non-desensitizinginward currents were not affected by tetrodotoxin, a voltage-gated Na+ channelblocker, 6-cyano-7-nitro-quinoxaline-2,3-dione, a non-N-methyl-D-aspartate (NMDA)glutamate receptor antagonist and DL-2-amino-5-phosphonopentanoic acid, anNMDA receptor antagonist. However, borneol-induced inward currents were partiallydecreased in the presence of picrotoxin, a -aminobutyric acid (GABA)A receptorantagonist, or strychnine, a glycine receptor antagonist, and was almost suppressedin the presence of picrotoxin and strychnine. Though borneol did not show any effecton the glycine-induced inward currents, borneol enhanced GABA-mediatedresponses. Beside, borneol enhanced the GABA-induced hyperpolarization under thecurrent-clamp mode. Altogether, we suggest that borneol contributes in part towardmediating the inhibitory GABA and glycine transmission on the SG neurons of the Vcand may serve as an herbal therapeutic for orofacial pain ailments.