Research

The global population is aging rapidly, leading to an increase in the number of elderly individuals who are more vulnerable and require comprehensive healthcare services, including long-term care and skilled nursing facilities. In this context, aspiration pneumonia has become a significant concern due to its high incidence, mortality rate, and substantial financial burden, particularly among elderly patients requiring intensive care unit admission. Aspiration pneumonia is defined as a pulmonary infection resulting from the inhalation of food, liquid, saliva, or stomach contents into the lungs, often due to impaired swallowing or consciousness. Symptoms may include cough, fever, shortness of breath, chest pain, and fatigue . Risk factors include neurological disorders, impaired consciousness, advanced age, and conditions affecting swallowing. Diagnosis is based on clinical presentation, imaging studies such as chest X-rays or CT scans, and, if necessary, swallowing assessments. Treatment typically involves antibiotics, and in severe cases, may include oxygen therapy or mechanical ventilation . Preventive measures focus on managing risk factors, improving swallowing function, and maintaining oral hygiene. This article aims to provide information on aspiration pneumonia in the elderly, including its causes, symptoms, diagnosis, and treatment, to raise awareness and help reduce the incidence and mortality associated with this condition.

The Six Sigma approach enables laboratories to objectively evaluate analytical performance, refine IQC protocols, and establish suitable IQC frequencies. This study aimed to evaluate the quality and optimize the IQC procedure for selected hematology tests on the Advia 2120i automated hematology analyzer. A cross-sectional descriptive study was conducted using internal quality control and external quality assessment data from April 2024 to December 2024 at Phuong Chau International Hospital. The results showed that WBC and PLT achieved sigma values >4 at all three IQC levels. HGB had sigma values ranging from 3 to <6, while RBC had sigma values between 2 and <4 across all three IQC levels. Most tests in this study reached “acceptable” sigma performance or higher. These findings demonstrate that the Six Sigma approach is effective in monitoring and improving test quality by enabling the selection of appropriate IQC strategies for each parameter.

The survey aimed to evaluate and improve the performance of testing methods of 10 biochemistry assays on AU5800 (Beckman Coulter) and cobas c503 (Roche Diagnostics) by Sigma metrics. Cross-sectional study. Ten biochemistry assays: glucose, urea, creatinine (Jaffe), cholesterol, triglycerides, AST, GGT, uric acid, HDL-Cho, total bilirubin. Collect internal and external inspection data on 2 devices under the same laboratory conditions, same test materials, at the same time from January to March 2024, calculate Sigma value. Evaluate performance and take improvement action on low-performing tests. On the AU5800 analyzer, 5 out of 10 tests (urea, creatinine, cholesterol, HDL-cholesterol, and total bilirubin) had Sigma values less than 3; 2 out of 10 tests (glucose and AST) had Sigma values between 3 and 6; and 3 out of 10 tests (triglycerides, GGT, and uric acid) had Sigma values greater than 6. On the Cobas c503 analyzer, 1 out of 10 tests (creatinine) had a Sigma value less than 3; 4 out of 10 tests (urea, cholesterol, AST, and total bilirubin) had Sigma values between 3 and 6; and 5 out of 10 tests (glucose, triglycerides, GGT, uric acid, and HDL-cholesterol) had Sigma values greater than 6. The tests with “acceptable to excellent” performance accounted for 50% on the AU5800 analyzer and 90% on the Cobas c503. The creatinine test (Jaffe method) showed “not good” performance on both systems. After improvement by switching to the enzymatic method on the c503 system, its performance changed from “not good” to “excellent.” On the AU5800 system, the performance of the creatinine (Jaffe) test improved from “not good” to “good".

Appendiceal cancer is a rare condition, often diagnosed late due to nonspecific symptoms. We report a case of appendiceal cancer invading the abdominal wall to evaluate the effectiveness of laparoscopic surgery and a multimodal treatment strategy. A 60-year-old male patient was admitted with persistent right iliac fossa pain for 2 months and a 3kg weight loss. Imaging confirmed an 6x8cm appendiceal tumor invading the abdominal wall and cecum, causing partial bowel obstruction. The patient underwent laparoscopic right hemicolectomy with D2 lymphadenectomy. Pathology confirmed moderately differentiated adenocarcinoma with metastases to 12/17 lymph nodes and peritoneal fluid (stage IVB). Postoperative recovery was uneventful, and the patient was discharged on day 7 with adjuvant chemotherapy scheduled. After 3 weeks of follow-up, the patient remained stable. This case highlights the importance of early diagnosis and radical surgery, combined with adjuvant therapy, in improving outcomes for patients with advanced-stage appendiceal cancer.

Artificial intelligence (AI) is emerging as a disruptive technology with the potential to revolutionize the field of public health management. This study, based on a situational analysis and systematic review, indicates that AI offers significant benefits in disease outbreak forecasting, resource optimization, and supporting human clinical decision-making. However, barriers related to input data quality, algorithmic bias, infrastructure costs, and inadequately regulated legal and ethical issues are persistent challenges for Vietnam. A proposed reference framework for Vietnam, grounded in a review of global research, includes for main pillars for the application of AI in public health management: (1) Data Foundation, (2) Technology and Infrastructure, (3) Human Resources, (4) Legal and Ethical Framework. This framework is expected to be a valuable reference for policymakers, health managers, and technology developers in Vietnam in the field of public health management and community health.

This study was conducted to analyze drug expenditure in treatment at Thống Nhất Hospital in 2024. A retrospective cross-sectional descriptive study analyzing drug usage costs in treatment at Thống Nhất Hospital in 2024. In 2024, Thống Nhất Hospital provided medical examination and treatment services to 650,000 health insurance patients, with over 595,000 outpatient visits, accounting for 90.63%. The total drug expenditure was VND 490.89 billion, representing 36.98% of the total health insurance medical examination and treatment costs. Western medicines accounted for 97.32% of the drug costs, while herbal and traditional medicines made up 2.86%. Imported drugs constituted 76.2% of the total drug expenditure. Original brand-name drugs, Group 1, and Group 2 drugs were the highest-cost categories, accounting for 38.63%, 25.59%, and 13.11% respectively. Cardiovascular drugs and those affecting the endocrine system and hormones were the most utilized, comprising 35.61% and 22.0% respectively. According to the ABC/VEN analysis, essential drugs classified as ‘E’ were the most used in terms of both quantity and cost, accounting for 58.55% and 75.51% respectively. Drug groups such as AV, AE, AN, BV, and CV represented 84.72% of the total drug expenditure. The CN group accounted for only 0.87% of the total drug expenditure in 2024. The study results indicate that the drug formulary used at Thống Nhất Hospital in 2024 aligns with the hospital’s disease patterns. The diverse and comprehensive drug list meets the treatment needs of patients.

Non Small Cell Lung Cancer (NSCLC) is the second most common cancer in both sex but it is still the leading cause of cancer death. Most of NSCLN appear in the late stage so the prognosis is very poor. Although, the patient in early stage NSCLC who underwent standard lobectomy but the recurrent rate is still so high. Adjuvant therapy after standard surgical therapy gives the patient better overall survival (OS) and disease Free Survival (DFS). Recent advances in diagnosis and treatment for NSCLC show the benefit of adjuvant therapy with TKI or Immunotherapy for selected NSCLC patients.

Population aging is a global trend driven by rising life expectancy and declining birth rates, creating profound socio-economic impacts. Vietnam officially entered this stage in 2011 and is now facing one of the world’s fastest aging rates, projected to become an “aged society” by 2036. The country’s primary challenge is the risk of “getting old before getting rich,” as its demographic transition outpaces its national financial accumulation, placing immense pressure on multiple sectors. The healthcare system is unprepared for the surging demand from the elderly, who often suffer from multiple chronic diseases and have treatment costs 7-8 times higher than younger individuals. Vietnam currently lacks sufficient geriatric hospitals, nursing homes, and integrated healthcare models. In terms of social security, a staggering 73% of the elderly do not have a pension and must continue to work or rely on their children, while the pay-as-you-go (PAYG) social insurance system is threatened by demographic shifts. The labor market, despite being in its “golden population” period, is constrained by a low rate of trained labor and low productivity, which affects future financial accumulation capabilities. Simultaneously, traditional family support systems are weakening due to smaller family sizes and geographic dispersion. To adapt effectively, Vietnam needs a comprehensive reform strategy, including promoting sustainable economic growth , improving the labor market , and restructuring the healthcare system towards integrated care, geriatric network development, and long-term care models. Concurrently, developing a multi-pillar social security system is critical to expand coverage and ensure the well-being of the elderly.

Drowning is a leading cause of unintentional injury-related mortality worldwide, particularly in two vulnerable populations: children and the elderly. In addition to respiratory compromise, drowning may lead to serious complications such as hypothermia, prolonged neurological injury, and cardiovascular sequelae — including myocardial damage. Myocardial infarction following drowning is rare and frequently overlooked in the acute setting, as elevated cardiac biomarkers are often attributed to resuscitation efforts. Nevertheless, in patients with pre-existing cardiovascular risk factors, systemic hypoxia combined with acute physiological stress induced by drowning may serve as a trigger for true myocardial infarction. This report describes an incidental finding of underlying coronary artery disease following a drowning event, underscoring the critical importance of comprehensive cardiovascular assessment in drowning survivors for early recognition of life-threatening cardiac events and timely, individualized management

To survey the characteristics of inguinal hernia and compare between the open and laparoscopic inguinal hernia surgery at Thong Nhat Hospital from April 2023 to April 2024. A restrospective study of 139 patients with laparoscopic and open inguinal hernia surgery in Thong Nhat hospital during the study period. Of 139 included patients, 97.8% were men, and the median (IQR) age was 60 (20-88) years. Compared between open and laparoscopic repair was associated with a nonsignificant duration of hospitalization. Most of patient lived in Ho Chi Minh City. We performed 72.66% open surgery. The majority of patients with unilateral inguinal hernias were treated with open surgery (80.34%) and bilateral inguinal hernias were treated with laparoscopic surgery (68.18%). The average duration of hospitalization for patients undergoing inguinal hernia surgery was 7.99±3.6 days. Most of patients has lived in Ho Chi Minh city. Duration of hospitalization was similar for the laparoscopic and open general anesthesia groups. Individualisation treatment with laparoscopic or open repair for patients and the decision should be made considering both patient and surgeon factors.

Femoral hernia is a rare type of hernia with a high risk of complications, commonly seen in elderly women and often mistaken for other groin pathologies. Imaging, particularly computed tomography (CT), plays a crucial role in detecting and differentiating femoral hernias from inguinal hernias and other groin conditions. Key CT imaging findings distinguishing femoral hernias from inguinal hernia are the location of the hernia sac lateral to the pubic tubercle and associated compression of the ipsilateral femoral vein. Additionally, CT can help detect complications of femoral hernias such as incarceration, bowel obstruction, or bowel ischemia, thereby guiding timely and effective management. The presented clinical case clearly illustrates the important role of CT in diagnosing this uncommon type of abdominal wall hernia.