Background: Pleural drainage is essential for preventing and managing respiratory complications after video-assisted thoracoscopic esophagectomy (VATE). Conventional largebore drains often cause significant pain. Small-bore drains (e.g., 19F Blake drains) may reduce discomfort; however, evidence regarding their use in VATE is limited. This study compared drainage effectiveness and pain between 19F Blake drains and conventional 28F drains after VATE for esophageal cancer. Methods: This retrospective study included 77 male patients with middle- or lower-third esophageal cancer who underwent VATE with laparoscopic retrosternal tunneling from November 2018 to November 2022. Fifty-five patients received a 28F conventional drain, and 22 received a 19F Blake drain. Outcomes included drainage duration and volume, pain levels (Visual Analog Scale [VAS]), postoperative pneumonia rates, and pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]) on postoperative day 3. Results: The 19F group reported significantly lower pain scores on postoperative days 1–3 (VAS: 2.95–3.25 vs. 4.07–4.62, p<0.001). Drainage duration and pneumonia rates were similar between groups. The 19F group demonstrated a trend toward higher drainage volume and significantly better preservation of pulmonary function, with smaller declines in FVC (ΔFVC: 0.24±0.20 L vs. 0.63±0.17 L, p<0.001) and FEV1 (ΔFEV1: 0.38±0.25 L vs. 0.58±0.25 L, p=0.02). Conclusion 19F Blake drains provide similar drainage effectiveness to that of 28F drains, with reduced postoperative pain and better pulmonary function preservation. These findings support the use of 19F Blake drains to improve patient comfort and recovery following VATE.

Case Report Open Access 15 Methaemoglobinaemia is a rare but potentially life -threatening cause of hypoxemia that may be overlooked in emergency settings. We report a case of acquired methaemoglobinaemia in a 36 - year-old man following inhalation of an alkyl nitrite –containing recreational product (“Super Rush ”). The patient presented with cyanosis and hypoxemia on pulse oximetry despite minimal symptoms and preserved arterial oxygen tension. Diagnosis was confirmed by co -oximetry demonstrating elevated methaemoglobin levels. Prompt treatment with intravenous methylene blue led to rapid clinical and biochemical improvement. This case highlights the importance of suspecting and recognising recreational inhalants as a cause of methaemoglobinaemia and the utility of co -oximetry in patients with unexplained cyanosis and a saturation gap

Case Report Open Access 15 Methaemoglobinaemia is a rare but potentially life -threatening cause of hypoxemia that may be overlooked in emergency settings. We report a case of acquired methaemoglobinaemia in a 36 - year-old man following inhalation of an alkyl nitrite –containing recreational product (“Super Rush ”). The patient presented with cyanosis and hypoxemia on pulse oximetry despite minimal symptoms and preserved arterial oxygen tension. Diagnosis was confirmed by co -oximetry demonstrating elevated methaemoglobin levels. Prompt treatment with intravenous methylene blue led to rapid clinical and biochemical improvement. This case highlights the importance of suspecting and recognising recreational inhalants as a cause of methaemoglobinaemia and the utility of co -oximetry in patients with unexplained cyanosis and a saturation gap

Methods: This study included 41 patients with single-level grades 1 or 2 LS from February 2023 to February 2024. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Bridwell fusion grades were evaluated via lumbar spine computed tomography performed 6 months postoperatively. Results: Over a mean follow-up period of 10.6 months (range, 7–18 months), significant improvements were observed in VAS scores for low back pain (from 7.8±0.8 to 2.1±1.4) and leg pain (from 8.1±1.3 to 1.9±1.5) as well as ODI scores (from 50.4±15.4 to 14.8±10.5). The cohort consisted of patients with grades 1 (73.2%) and 2 LS (26.8%) at L4–L5 (58.6%), L5–S1 (34.1%), and L3–L4 (7.3%) levels. The mean operation time was 182.8±36.4 minutes, with a mean intraoperative blood loss of 190.5±81.3 mL and a mean hospital stay of 7.2±3.6 days. Successful fusion (Bridwell grades I/II) was achieved in 82.9% of the cases, with a 4.9% incidence of cage subsidence. Minor complications included durotomies in two patients (4.9%), whereas no major complications, such as nerve root injury, hardware-related issues, or postoperative infections, were reported. Conclusions The described BE-LIF technique, using HA bone grafts, which are an autologous bone from the preserved IAP, and a TLIF cage, is a viable, safe, and effective option for treating low-grade LS. This approach achieves favorable clinical outcomes and high fusion rates, which provides a cost-effective alternative to advanced surgical implants.

Methods: This study included 41 patients with single-level grades 1 or 2 LS from February 2023 to February 2024. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Bridwell fusion grades were evaluated via lumbar spine computed tomography performed 6 months postoperatively. Results: Over a mean follow-up period of 10.6 months (range, 7–18 months), significant improvements were observed in VAS scores for low back pain (from 7.8±0.8 to 2.1±1.4) and leg pain (from 8.1±1.3 to 1.9±1.5) as well as ODI scores (from 50.4±15.4 to 14.8±10.5). The cohort consisted of patients with grades 1 (73.2%) and 2 LS (26.8%) at L4–L5 (58.6%), L5–S1 (34.1%), and L3–L4 (7.3%) levels. The mean operation time was 182.8±36.4 minutes, with a mean intraoperative blood loss of 190.5±81.3 mL and a mean hospital stay of 7.2±3.6 days. Successful fusion (Bridwell grades I/II) was achieved in 82.9% of the cases, with a 4.9% incidence of cage subsidence. Minor complications included durotomies in two patients (4.9%), whereas no major complications, such as nerve root injury, hardware-related issues, or postoperative infections, were reported. Conclusions The described BE-LIF technique, using HA bone grafts, which are an autologous bone from the preserved IAP, and a TLIF cage, is a viable, safe, and effective option for treating low-grade LS. This approach achieves favorable clinical outcomes and high fusion rates, which provides a cost-effective alternative to advanced surgical implants.

Methods: This study included 41 patients with single-level grades 1 or 2 LS from February 2023 to February 2024. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Bridwell fusion grades were evaluated via lumbar spine computed tomography performed 6 months postoperatively. Results: Over a mean follow-up period of 10.6 months (range, 7–18 months), significant improvements were observed in VAS scores for low back pain (from 7.8±0.8 to 2.1±1.4) and leg pain (from 8.1±1.3 to 1.9±1.5) as well as ODI scores (from 50.4±15.4 to 14.8±10.5). The cohort consisted of patients with grades 1 (73.2%) and 2 LS (26.8%) at L4–L5 (58.6%), L5–S1 (34.1%), and L3–L4 (7.3%) levels. The mean operation time was 182.8±36.4 minutes, with a mean intraoperative blood loss of 190.5±81.3 mL and a mean hospital stay of 7.2±3.6 days. Successful fusion (Bridwell grades I/II) was achieved in 82.9% of the cases, with a 4.9% incidence of cage subsidence. Minor complications included durotomies in two patients (4.9%), whereas no major complications, such as nerve root injury, hardware-related issues, or postoperative infections, were reported. Conclusions The described BE-LIF technique, using HA bone grafts, which are an autologous bone from the preserved IAP, and a TLIF cage, is a viable, safe, and effective option for treating low-grade LS. This approach achieves favorable clinical outcomes and high fusion rates, which provides a cost-effective alternative to advanced surgical implants.

Objectives: The rapid and widespread development of social networking sites has created a potential venue for an increase in cyberbullying among adolescents. While much research has been done on middle school/high school students, this issue for college/university students has yet to receive much attention. The present study described the prevalence of cyberbullying and associated factors among Hanoi Medical University students. Methods: Data were obtained from an online survey of conveniently selected Hanoi Medical University students. A total of 736 students participated and finished a structured questionnaire based on the Cyberbullying Victimization Scale (CVS). Results: The prevalence of cyberbullying victims among Hanoi Medical University students was 17.4%, and 9.0% of the students had engaged in cyberbullying behaviors. Research also indicated that there is an association between cyberbullying behavior and factors such as internet usage duration and frequency of monitoring violent information. Gender didn't have any relationship with cyberbullying victimization but had a significant association with cyberbullying perpetration (OR = 2.37, 95%CI = 1.42 – 3.96). Conclusion: Cyberbullying has become an important phenomenon related to internet usage duration and violent information among students of Hanoi Medical University. Therefore, it is necessary to build healthy internet habits and manage online information to reduce cyberbullying prevalence and promote student health in the digital age.

Postoperative discal pseudocyst (PDP) is a rare complication after surgery for lumbar disc herniation. The literature on this condition is sparse, with most studies being limited to case reports. Various hypotheses regarding the pathogenesis of PDP have been proposed; however, the exact mechanisms remain unclear and are not well described in the current literature. We present a case of PDP following percutaneous endoscopic interlaminar discectomy (PEID), which was revised through biportal endoscopic spinal surgery. Additionally, we conducted a systematic review of the literature, aiming to provide a more detailed description of the proposed mechanisms underlying PDP, particularly after PEID, and to summarize current trends in the treatment of this complication.

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.

Objective: In Viet Nam, tuberculosis (TB) prevalence surveys revealed that approximately 98% of individuals with pulmonary TB have TB-presumptive abnormalities on chest radiographs, while 32% have no TB symptoms. This prompted the adoption of the “Double X” strategy, which combines chest radiographs and computer-aided detection with GeneXpert testing to screen for and diagnose TB among vulnerable populations. The aim of this study was to describe demographic, clinical and radiographic characteristics of symptomatic and asymptomatic Double X participants and to assess multilabel radiographic abnormalities on chest radiographs, interpreted by computer-aided detection software, as a possible tool for detecting TB-presumptive abnormalities, particularly for subclinical TB. Methods: Double X participants with TB-presumptive chest radiographs and/or TB symptoms and known risks were referred for confirmatory GeneXpert testing. The demographic and clinical characteristics of all Double X participants and the subset with confirmed TB were summarized. Univariate and multivariable logistic regression modelling was used to evaluate associations between participant characteristics and subclinical TB and between computer-aided detection multilabel radiographic abnormalities and TB. Results: From 2020 to 2022, 96 631 participants received chest radiographs, with 67 881 (70.2%) reporting no TB symptoms. Among 1144 individuals with Xpert-confirmed TB, 51.0% were subclinical. Subclinical TB prevalence was higher in older age groups, non-smokers, those previously treated for TB and the northern region. Among 11 computer-aided detection multilabel radiographic abnormalities, fibrosis was associated with higher odds of subclinical TB. Discussion: In Viet Nam, Double X community case finding detected pulmonary TB, including subclinical TB. Computer-aided detection software may have the potential to identify subclinical TB on chest radiographs by classifying multilabel radiographic abnormalities, but further research is needed.