Journal of Health & Aging is the official journal of Thong Nhat Hospital, aimed at introducing and updating knowledge about the care and protection of elderly people's health. It is published 12 issues per year. The journal publishes research papers and review articles in the fields of basic medicine, clinical medicine, preventive medicine, public health and medical sociology, with the goal of improving knowledge and practice in medical specialties. Journal information Publishing license: 17/GP-BVHTTDL p-ISSN: 3093-3102; e-ISSN: 3093-3110 Publication frequency: issues/year DOI prefix: 10.63947 Plagiarism detection tool applied: Ithenticate. Articles with a plagiarism rate greater than 25% will not be considered for evaluation. Journal homepage: https://tcsuckhoelaohoa.vn Hospital homepage: https://bvtn.org.vn Peer review process Manuscripts within the scope of publication that meet the requirements of the manuscript preparation guidelines will be sent to the editorial board members in charge. The manuscripts will then undergo a double-blind peer review process by at least 2 independent experts in the corresponding field. The editorial board member in charge will make a decision before being approved by the Editor-in-Chief. Confidentiality commitment Journal of Health & Aging is committed to implementing and complying with legal regulations and related guidelines on the confidentiality of personal information. The information users enter into the forms on the Journal's Online Publishing Management System is only used for purposes within the journal's scope of publication and will not be provided to any other third parties, or used for any other purposes. Research ethics: Research directly reflects the quality of the authors' work and the supporting institutions. To be published, articles are peer-reviewed and evaluated according to the rigorous and scientific process set out by Journal of Health & Aging - Thong Nhat Hospital. Therefore, it is important to standardize and ensure ethical standards for all parties involved in publishing activities: authors, journal editors, reviewers, publishers and the community of journals owned or funded by society.
BISPHOSPHONATE INDUCED OSTEONECROSIS OFTHE JAWS
Section: Original Research Categories: Research Keywords: Bisphosphonate, bisphosphonate induced osteonecrosis of the jaws (BIONJ) Bisphosphonate (BP) is a group of drugs used to treat osteoporosis, multiple myeloma, skeletal metastasis cancer. BP’s mechanism of action is to reduce bone resorption by inhibiting the osteoclasts activity. Therefore, the indication of BP is increasingly widespread and becomes the first class of drugs in the treatment of osteoporosis. At Frienship Hospital, over the past five years, we have encountered 12 cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) at various stages. The key message we wish to convey in this report is to kindly encourage close collaboration between internal medicine specialists and oral maxillofacial surgeons during bisphosphonate therapy, in order to minimize the risk of BRONJ complications for patients.
bisphosphonate induced osteonecrosis of the jaws (BIONJ)
Copyright (c) 2026 The Author(s). Published by Journal of Health and Aging. https://creativecommons.org/licenses/by-nc-nd/4.0
OUTCOMES OF Z-PLASTY SURGERY IN FUNCTIONAL RESTORATION OF CONTRACTED FINGERS
Section: Original Research Categories: Research Keywords: Z-plasty, finger contracture, five-flap Z-plasty, web space release, functional outcome, scar revision, hand surgery Finger contractures, resulting from burns, trauma, or congenital anomalies, often lead to significant functional impairment. Z-plasty is a versatile reconstructive technique used to release scar contractures while preserving local tissue characteristics. This study aimed to evaluate the functional outcomes of different Z-plasty techniques in the surgical release of contracted fingers. We conducted a prospective descriptive case series involving 31 patients (38 fingers) undergoing Z-plasty for digital contractures. Depending on the location and severity of the contracture, three Z-plasty techniques were used: five-flap, double-opposing, and single 60° Z-plasty. Patients were followed for a mean of 5.6 months. Primary outcomes included range of motion (ROM), web space angle, and DASH scores. Complications and patient satisfaction (VAS) were also assessed. All techniques demonstrated significant improvements in finger extension and flexion. Mean extension deficit improved from −35.4° to −8.1°, and flexion increased from 62.3° to 81.7° (P < .001). The five-flap Z-plasty achieved the greatest gain in web space angle (from 24.2° to 46.8°). DASH scores decreased significantly from 47.6 to 21.8 (P < .001), with patient satisfaction increasing from 4.2 to 8.1 on VAS. Minor complications occurred in 5 patients (16.1%), with no cases of flap necrosis or wound infection. Z-plasty is an effective and low-risk technique for releasing digital contractures and restoring hand function. Five-flap and doubleopposing Z-plasty provide greater functional improvement in web space contractures, while single Z-plasty remains effective for linear joint contractures. These techniques offer reliable outcomes without the need for skin grafting, supporting their continued use in reconstructive hand surgery.
ASSESSMENT OF CLINICAL FEATURES, DIAGNOSTIC FINDINGS, AND TREATMENT OUTCOMES OF COLONIC DIVERTICULITIS AT THE DEPARTMENT OF GASTROINTESTINAL SURGERY, THONG NHAT HOSPITAL
Section: Original Research Categories: Research Keywords: colonic diverticulitis, clinical features, CT-scan, WSES classification, medical treatment, surgery Colonic diverticulitis is increasing in Asia, yet data on clinical patterns in Vietnam remain limited. This study aimed to evaluate the clinical, laboratory, imaging characteristics, and treatment outcomes at Thong Nhat Hospital. A retrospective descriptive study was conducted on 105 patients from January 1 to September 1, 2025. Data on demographics, clinical features, laboratory tests, CT findings, WSES classification, treatment strategies, and outcomes were collected and analyzed using SPSS 26.0, with p < 0.05 considered statistically significant. The mean age was 53.9 ± 20.0 years, with 31.4% aged ≥65. Males accounted for 67.6%. The most common symptom was right lower quadrant pain (55.2%). CT revealed diverticula mainly in the sigmoid colon (40.0%), cecum (37.1%), and right colon (19.0%). WSES stages were: 1a (57.1%), 1b (19.0%), 2a (11.4%), 2b (7.6%), 3 (3.8%), and 4 (1.0%). Medical treatment was applied in 89.5% of cases, percutaneous drainage in 1.0%, and surgery in 9.5%. The mean hospital stay was 7.6 ± 4.4 days, significantly longer in complicated cases and those requiring invasive interventions (p < 0.05). Colonic diverticulitis in Vietnam often affects middle-aged males, with location varying by age: cecum/right colon in younger patients and sigmoid colon in the elderly. CT-scan plays a crucial role in diagnosis, staging, and guiding treatment.
EVALUATION OF THE EFFECTIVENESS OF MOTOR FUNCTION REHABILITATION AFTER STROKE USING PHYSIOTHERAPY COMBINED WITH ELECTROACUPUNCTURE AT THONG NHAT HOSPITAL, 2025
Section: Original Research Categories: Research Keywords: Stroke, physiotherapy, electroacupuncture Stroke is the leading cause of severe disability among adults worldwide. In Vietnam, the burden is rising rapidly. The increasing incidence drives higher healthcare costs, reduced work capacity, and greater social pressures. Accordingly, post-stroke motor rehabilitation is a priority to reduce mortality and complications and limit disability. At Thống Nhất Hospital, physiotherapy combined with electroacupuncture has been used for years under the guidance of the Ministry of Health, with observed functional benefits. Still, its effectiveness has not been formally evaluated. This study aimed to generate evidence to guide regimen selection and optimise patient outcomes. Materials and Methods: A clinical interventional study without a control group was conducted, employing a pre- and post-treatment comparison. Eighty-six patients newly diagnosed with stroke within the preceding three months, receiving inpatient or outpatient care at the Departments of Rehabilitation, Emergency Interventional Cardiology, Neurology, and Traditional Medicine at Thống Nhất Hospital from January to October 2025, were included. Motor function recovery was assessed through manual muscle testing and the Barthel Index after 30 days of treatment. Results: The proportion with muscle strength grades 0–2 fell from 53.49% to 17.44%, whereas grades 4–5 rose from 29.07% to 59.30%. The mean Barthel Index increased from 44.24 ± 18.16 to 69.07 ± 17.90. Post-intervention classifications were completely independent, 12.79%; partially dependent, 76.74%; entirely dependent, 10.47%. Conclusion: Physiotherapy plus electroacupuncture appears safe and effective for post-stroke rehabilitation, improving muscle strength and independence in activities of daily living. Benefits extend beyond statistical significance to practical gains in quality of life and community reintegration.
TRANSTHYRETIN CARDIAC AMYLOIDOSIS REVEALED BY MULTIMODALITY IMAGING IN AN ELDERLY PATIENT WITH HFpEF
Section: Case Report Categories: Research Keywords: Amyloid cardiomyopathy, transthyretin, scintigraphy Amyloid cardiomyopathy is an infiltrative disease caused by extracellular deposition of amyloid fibrils within the myocardium, most commonly from immunoglobulin light-chain (AL) or transthyretin (ATTR) sources, leading to progressive heart failure, arrhythmias, and conduction disturbances. We present the case of an 80-year-old man with heart failure with preserved ejection fraction (HFpEF) and comorbidities who was admitted for acute onset dyspnea accompanied by profound hypotension at home. Together with a non-clonal free light-chain profile, these findings supported a diagnosis of transthyretin (ATTR) cardiac amyloidosis. This case highlights the value of integrating electrocardiogram, echocardiography, cardiac magnetic resonance, and bone-avid tracer scintigraphy to establish the diagnosis of ATTR cardiomyopathy and guide management in settings where disease-modifying therapy remains limited.Keywords: supraclavicular brachial plexus nerve block, adductor canal block, popliteal sciatic block, heart failure, limb amputation.
ASSESSMENT OF HEART FAILURE KNOWLEDGE IN OUTPATIENTS WITH CHRONIC HEART FAILURE AT THONG NHAT HOSPITAL
Section: Original Research Categories: Research Keywords: Chronic heart failure, quality of life Chronic heart failure is one of the leading causes of hospitalizations, impaired quality of life, and increased socioeconomic burden. Adequate disease awareness and effective self-care are key factors in improving prognosis and reducing hospital readmissions. A crosssectional descriptive study was conducted from January 1 to May 31, 2025, involving 200 patients. The tools used included the Dutch Heart Failure Knowledge Scale (DHFKS), a qualityof-life questionnaire, and a self-care assessment. Results: 66% of patients were aged ≥60 years, 94.5% had health insurance, and 78.5% resided in urban areas. Heart failure with reduced ejection fraction (HFrEF) accounted for 73.5%, significantly higher among patients aged ≥60 years (78.8%, p = 0.026). Hypertension (91%) and dyslipidemia (77%) were the most common comorbidities. A total of 78% of patients demonstrated good knowledge of heart failure. Regarding self-care behaviors, most adhered to a low-salt diet and regular weight monitoring, though physical activity remained suboptimal. Dyspnea and lower limb edema significantly impacted quality of life. When symptoms occurred, patients commonly contacted healthcare providers. Conclusions: The majority of outpatients with chronic heart failure demonstrated good disease awareness; however, improvements in self-care practices and multidimensional support are needed to enhance quality of life and reduce disease burden.
THE CONTROL OF SOME HORMONES RELATING TO CUTANEOUS AGING: MECHANISMS, MANIFESTATIONS, AND MANAGEMENT
Section: Review Article Categories: Research Keywords: estrogen, progesterone, testosterone To summarize current evidence on the interaction between endocrine factors and skin aging, with a focus on the role of hormones and endocrine pathways. This review was conducted through a literature search in PubMed using the keywords “hormone,” “skin aging,” and “cutaneous aging.” Studies addressing the role of hormones in age-related changes of skin physiology were reviewed and synthesized. Skin aging is closely associated with hormonal changes. In women, the sharp decline in estrogen during menopause is a central factor driving aging, leading to reduced collagen and elastin synthesis, dermal thinning, loss of hydration, and increased sensitivity to environmental stressors. In men, the gradual decrease in testosterone also contributes to skin aging, though typically less prominently. Overall, the evidence highlights hormones as key regulators of skin health and resilience. The changes of some hormones play an important role in the process of skin aging. These findings underscore the potential of future skin rejuvenation strategies targeting endocrine pathways.
FACTORS ASSOCIATED WITH PALLIATIVE CARENEEDS AMONG CANCER INPATIENTS AT TAY NGUYENREGIONAL GENERAL HOSPITAL
Section: Original Research Categories: Research Keywords: Palliative care, cancer, needs, associated factors, geriatric Cancer is an increasing health burden, particularly among older adults [14]. Palliative care (PC) plays a crucial role in improving patients’ quality of life. This study aimed to identify palliative care needs and associated factors among cancer patients at the Central Highlands Regional General Hospital in 2024. Subjects and Methods: A cross-sectional descriptive study was conducted among 434 cancer patients aged ≥18 years hospitalized from January to September 2024. Data were collected through face-to-face interviews using a structured questionnaire. Statistical analysis was performed using SPSS 20.0 with multivariate logistic regression. Results: 88.2% of patients had palliative care needs. The highest needs included communication & social relationships (83.9%), physical support (81.8%), and psychological support (73.5%). Factors associated with higher needs included female gender (OR=3.21; p=0.001), rural residence (OR=2.61; p=0.004), unemployment/retirement (OR=3.07; p=0.001), metastatic cancer (OR=2.87; p=0.004), and presence of complications (OR=2.45; p=0.012). Conclusion: Most cancer patients, particularly older adults, have diverse palliative care needs. Integrating geriatric considerations into palliative care is essential to address physical, psychological, and social needs comprehensively, thereby improving quality of life and reducing healthcare burden.
CLINICAL CHARACTERISTICS, IMAGING, AND SURGICAL OUTCOMES OF CHRONIC SUBDURAL HEMATOMA AT LONG KHANH REGIONAL GENERAL HOSPITAL FROM 2021 TO 2024
Section: Original Research Categories: Research Keywords: Chronic subdural hematoma, single burr hole, hematoma surgery Chronic subdural hematoma (CSDH) is a common condition in the elderly, often associated with a prior history of trauma and progressively worsening symptoms if not diagnosed and treated promptly. This study aims to describe the clinical characteristics, imaging findings, and surgical outcomes of patients with CSDH treated at Long Khanh Regional General Hospital from 2021 to 2024; A total of 34 patients diagnosed with CSDH underwent single-burr-hole surgical drainage between January 2021 and September 2024. The mean patient age was 68.4 ± 16.9 years, with males accounting for 88.2%. Trauma was the primary cause (52.9%), including falls in 29.4% of cases. Motor weakness was the most common symptom (64.7%), followed by headache (55.8%), altered consciousness (23.5%), and aphasia (20.6%). Most patients presented with mild traumatic brain injury (GCS 13–15, 76.5%), while coma was recorded in 8.8%. CT imaging showed a mean hematoma thickness of 21.1 ± 6.3 mm and a mean midline shift of 9.4 ± 4.8 mm; unilateral CSDH was observed in 70.6% of cases. All patients underwent single-burr-hole surgery. Postoperatively, 88.2% achieved a GCS of 15. There were no cases of infection or intraoperative bleeding. Recurrence occurred in four patients, including one requiring reoperation after three weeks; the mortality rate was 2.9%. The average hospital stay was 10.7 ± 5.4 days. At discharge, 73.5% of patients had good outcomes, and 73.5% returned to normal life within one month. In conclusion, single-burr-hole drainage for chronic subdural hematoma is effective, safe, and associated with favorable outcomes, low complication rates, and good functional recovery in most patients.
THE APPLICATION OF SPECTRAL CT IN THE EVALUATION OF CORONARY ARTERY DISEASE AT THONG NHAT HOSPITAL – HO CHI MINH CITY
Section: Review Article Categories: Research Keywords: Coronary CT angiography, spectral CT, virtual non-contrast images . At Thong Nhat Hospital, Ho Chi Minh City, the spectral CT system has brought significant advancements in the diagnosis of coronary artery disease. The post-processing applications of spectral CT that are used include: virtual monoenergetic images (MonoE), effective atomic number (Z-effective), iodine density map, iodine no water, virtual non-contrast images (VNC), and enhanced visualization of contrast-enhancing structures. The diverse types of images obtained from the spectral CT technique bring many benefits such as reducing the contrast media dose for patients and reducing artifacts to improve image quality, thereby helping to more accurately assess the degree of coronary stenosis. Iodine maps also help assess myocardial perfusion status, providing more comprehensive and accurate information about coronary artery disease. The use of VNC to calculate the calcium score as a replacement for true non-contrast (TNC) images is currently in the research phase at Thong Nhat Hospital with promising initial results, holding the promise of replacing TNC in CS assessment, thereby reducing the radiation dose for patients. This article aims to present the applications of spectral CT and actual clinical cases at Thong Nhat Hospital - Ho Chi Minh City to clarify the application of spectral CT in the evaluation of coronary artery disease.
ADVANCES IN FLEXIBLE BRONCHOSCOPY FOR EARLY DIAGNOSIS OF LUNG CANCER
Section: Review Article Categories: Research Keywords: flexible bronchoscopy (FB), lung cancer Lung cancer remains the leading cause of cancer-related death. In central airway lesions, flexible bronchoscopy (FB) is the diagnostic backbone, as it allows direct visualization, lesion localization, and sampling, while integrating new technologies such as autofluorescence bronchoscopy (AFB), narrow-band imaging (NBI), endobronchial ultrasound (EBUS), optical coherence tomography (OCT), electromagnetic/CBCT-guided navigation bronchoscopy (ENB, CBCT), robotic bronchoscopy, and “real-time pathology” techniques such as confocal laser endomicroscopy (CLE). Over the past 5–7 years, evidence shows these technologies significantly enhance sensitivity/early detection, increase diagnostic yield for small peripheral nodules, reduce complications compared with transthoracic biopsy, and open the era of artificial intelligence (AI) for lesion recognition and procedural training. This article summarizes key advances, clinical impact, limitations, and implementation prospects in Vietnam.
EVALUATING THE EFFECTIVENESS OF EARLY MOBILIZATION IN PATIENTS AFTER GASTROINTESTINAL TUMOR SURGERY AT THONG NHAT HOSPITAL
Section: Original Research Categories: Research Keywords: Rehabilitation, Early mobilization, Gastrointestinal tumor, ERAS To evaluate the effectiveness of early mobilization on patients after gastrointestinal surgery. This is a cross-sectional study observed on 78 patients who underwent gastrointestinal tumor surgery at the Department of Gastrointestinal Surgery, Thong Nhat Hospital, from October 2024 to June 2025. We collected and analyzed data on age, sex, time to first flatus, Visual Analog Scale (VAS) pain scores, Timed Up and Go test performance, postoperative complications, and time to discharge. Physiotherapy was typically initiated two days postoperatively and combined respiratory with mobility training. Patients who achieved early mobilisation demonstrated earlier return of bowel function, shorter hospital stay, lower VAS pain scores, and better functional mobility as indicated by shorter Timed Up and Go test durations at postoperative days 1, 3, and 7 compared with those without early mobilization. The study demonstrated that the early mobilization group had an earlier time to first flatus, shorter length of hospital stay, lower pain levels, and better functional mobility compared with the non-early mobilization group.
EVALUATION OF CLINICAL OUTCOMES OF AUTOLOGOUS PLATELET-RICH PLASMA THERAPY FOR SIMPLE SHOULDER PERIARTHRITIS AT THONGNHAT HOSPITAL
Section: Original Research Categories: Research Keywords: Periarthritis shoulder, platelet-rich plasma, Visual analogue scale Autologous Platelet-Rich Plasma (PRP) is an increasingly popular biological therapy in sports medicine and rehabilitation, particularly for periarticular soft tissue pathologies of the shoulder. To evaluate the clinical efficacy of autologous PRP in treating simple shoulder periarthritis over a 4-month follow-up period and to analyze factors associated with treatment outcomes. Methods: A longitudinal clinical intervention study was conducted on 30 patients diagnosed with simple shoulder periarthritis. After 4 months, the mean Visual Analogue Scale (VAS) score significantly decreased from 5.6 to 2.6, accompanied by improvements in ultrasonographic findings. Greater pain reduction was observed in younger patients. Adverse effects were primarily limited to mild, self-limiting injection-site pain resolving within 3 days. Autologous PRP is a safe and effective treatment for shoulder periarthritis, especially in younger populations.
EPIDEMIOLOGICAL RESEARCH IN HOSPITAL: KEY CONSIDERATIONS FOR DESIGN AND INTERPRETATION
Section: Review Article Categories: Research Keywords: Selection bias, Collider bias, Hospital-based research Most epidemiological and observational clinical studies in Vietnam are conducted on hospitalized patients, frequently lacking a control group. Despite their practicality and data accessibility, these studies are often utilized to address questions that exceed the inferential capacity of their design. In this article, I analyze the methodological limitations of hospital-based epidemiological research, particularly in the absence of a control group, within the context of medical research in Vietnam. Drawing on conceptual analysis and epidemiological principles, the article discusses common sources of bias in hospital-based studies, including selection bias, collider bias, the lack of control groups, and the regression toward the mean phenomenon. Inpatients represent a highly selected population, influenced not only by disease severity but also by healthcare accessibility, referral pathways, and socio-economic factors. Conditioning the analysis on a hospitalized group can distort the association between exposure and disease, creating spurious correlations or masking true causal relationships. Without a control group, observed associations are easily misinterpreted as population-level risk factors. Furthermore, before-after studies in hospitals are susceptible to regression toward the mean, leading to inaccurate evaluations of intervention efficacy. Prognostic models developed from inpatient data may perform well in training environments but often fail to generalize to broader settings. While hospital-based research remains vital for describing severe illness, inpatient prognosis, and evaluating care processes, its inferential scope is inherently limited. Clearly identifying these methodological boundaries and anchoring interpretations to sampling conditions is essential to avoid biased conclusions and to enhance the quality of medical research in Vietnam.
STATIONARY CYCLING DOSAGE FOR PAIN REDUCTION IN OLDER ADULTS WITH KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW
Section: Original Research Categories: Research Keywords: Knee osteoarthritis, Stationary cycling, Pain reduction, Older adult, Systematic review This systematic review aimed to identify an effective stationary cycling dosage for pain reduction in adults aged 60 years and older with knee osteoarthritis. The review was conducted according to PRISMA 2020 guidelines, searching PubMed, the Cochrane Library, and PEDro for randomized controlled trials reporting the dosage of stationary cycling interventions. The primary outcome was pain reduction, assessed using standardized scales such as KOOS, WOMAC, and AIMS2. Five studies involving 377 participants were included in the analysis. All 5 studies reported statistically significant pain reduction compared with baseline or control groups. The synthesized intervention dosage comprised a total duration of 8–24 weeks, a frequency of 3–7 sessions per week, a session length of 25–60 minutes, and an intensity ranging from 40–85% of maximum heart rate or 60–110 pedal revolutions per minute. No adverse events relating to the interventions were reported. However, all included studies were judged to be at high risk of bias, primarily due to the inability to blind participants and the use of self-reported scales. Stationary cycling is an effective intervention for pain reduction in older adults with knee osteoarthritis, but the application of training dose should be interpreted cautiously and individualized.
MEDICATION UTILIZATION AND STATIN ADHERENCE IN THE MANAGEMENT OF DYSLIPIDEMIA AT THONG NHAT HOSPITAL, HO CHI MINH CITY, 2016-2023
Section: Original Research Keywords: dyslipidemia, statin, treatment adherence, MPR, PDC Dyslipidemia (DLP) is a major risk factor for cardiovascular disease, and statins are the first-line treatment. The level of adherence to statin treatment has a significant impact on treatment outcomes in patients. This study aims to evaluate the medication utilization patterns and statin adherence levels at Thong Nhat Hospital during the 2016-2023 period. A retrospective cross-sectional study was conducted on 23,373 outpatients with dyslipidemia (ICD-10: E78) who had a continuous treatment duration of ≥1 year. Demographic characteristics, comorbidities (CCI), and prescription information were analyzed; statin adherence levels were assessed using MPR and PDC, with the threshold for good adherence being MPR >80% và PDC ≥80%. The mean age was 66,1 ± 12,2 with 72% of patients aged ≥ 60 years and a high multimorbidity burden (mean CCI of 5.91). Among 461,435 examination visits with prescribed treatment, statins accounted for 96.4%, primarily rosuvastatin and atorvastatin at moderate doses. The utilization rate of fixed-dose combinations (FDC) increased from 10.1% (2016) to 25.5% (2023). Adherence levels were low, with a mean MPR of 0.33 and PDC of 0.30; only 5.64% of patients achieved MPR > 80% and 3.53% achieved PDC ≥80%. The study indicates that statins are primarily used in dyslipidemia treatment with a growing trend toward FDC usage; however, the level of treatment adherence remains low.
DRUG UTILIZATION PATTERNS IN OUTPATIENTS WITH OSTEOARTHRITIS AT THONG NHAT HOSPITAL VIETNAM FROM 2016 TO 2024
Section: Original Research Categories: Research Keywords: Osteoarthritis, drug utilization, co-prescription network Osteoarthritis is a chronic musculoskeletal disorder characterized by pain, functional impairment, and diminished quality of life, with knee, hip, and hand osteoarthritis representing the most prevalent clinical manifestations. This study aimed to analyze patient characteristics and patterns of medication utilization in the outpatient management of osteoarthritis at Thong Nhat Hospital during the period from 2016 to 2024. A retrospective cross-sectional study was conducted involving 40,916 patients diagnosed with osteoarthritis based on ICD-10 codes M16, M17, and M18. The results indicated that knee osteoarthritis accounted for most cases (97.28%). The mean age of patients was 59 years, with most patients belonging to the 30–65 and ≥65 age groups. A high prevalence of comorbid conditions was observed, particularly cardiovascular diseases and metabolic disorders. Oral NSAIDs were the most frequently prescribed medications (66.2%), followed by analgesics and topical NSAIDs. Co-prescription network analysis demonstrated that oral NSAIDs occupied a central position in most medication combination patterns, especially among patients with knee osteoarthritis, who exhibited a higher degree of polypharmacy compared with patients with osteoarthritis affecting other joint sites. These findings provide evidence to support individualized treatment strategies and to improve the effectiveness of osteoarthritis management in the Vietnamese clinical context.
CURRENT STATUS OF TREATMENT ADHERENCE AND RELATED FACTORS AMONG OUTPATIENTS WITH CHRONIC DISEASES IN THU DUC CITY 2024-2025
Section: Original Research Categories: Research Keywords: Chronic disease, treatment adherence, regular check-ups To describe the current status of treatment adherence among outpatients with chronic diseases and to analyze factors associated with treatment adherence in Thu Duc City during 2024–2025. Cross-sectional descriptive study. The study included 253 patients with hypertension, 150 patients with diabetes mellitus, and 130 patients with chronic obstructive pulmonary disease (COPD) treated at Le Van Viet Hospital and Thu Duc City Medical Center (Facilities 1, 2, and 3) from July 2024 to March 2025. The mean age was 65.7 ± 10.9 years; 52.2% were male and 47.8% were female. The duration of illness was 6.8 ± 6.5 years. Hypertension and diabetes were mostly discovered incidentally; 74.6% of COPD patients were diagnosed when symptoms appeared. 10% of hypertensive patients, 17.3% of diabetic patients, and 6.2% of COPD patients had at least one comorbidity. 67.7% of hypertensive patients had blood pressure <140/90 mmHg. Blood glucose levels were 137.7 ± 50.4 mg/dL (96%). 24.6% of COPD patients were in GOLD stage 3 or 4. The overall treatment adherence rate was 23.8% good, 48.6% fair, and 27.6% poor. Better treatment adherence was observed among patients who lived with family, were diagnosed through regular check-ups, had a disease duration of less than 5 years, and had no comorbidities (p < 0.05). Treatment adherence was significantly associated with achieving treatment goals, particularly among patients with hypertension, and to a lesser extent among those with COPD and diabetes. Conclusion: Treatment adherence plays an essential role in the management of chronic diseases.
ROLE OF FLOW CYTOMETRY IN THE DIAGNOSIS OF HEMATOLOGIC DISEASES
Section: Original Research Categories: Research Keywords: flow cytometry, hematological disorders This study aimed to describe the characteristics of common hematological disorders through immunophenotypic analysis using flow cytometry (FCM). A retrospective descriptive study was conducted on all patients aged 16 years and older who were analyzed by FCM testing at the Hematology Department, Thong Nhat Hospital from January 2023 to March 2025. Convenience sampling was applied. Data analysis was performed using Microsoft Excel 2021. A total of 104 patients were tested by flow cytometry. The median age at diagnosis was 68 years [55.8–77]. Baseline hematologic findings showed anemia (Hb 9.3 ± 2.6 g/dL) and wide variations in white blood cell (20.1 ± 42.4 K/uL) and platelet counts (197 ± 172.3 K/uL), reflecting the diversity of underlying hematologic conditions. FCM demonstrated high diagnostic value in identifying and classifying various hematologic disorders: distinguishing acute leukemia lineages (myeloid/B-lymphoid/T-lymphoid), detecting monoclonal lymphoid populations in lymphomas, and differentiating benign from malignant plasma cells in multiple myeloma. Correlation with bone marrow morphology was high, especially in diagnostically challenging cases. However, FCM could not fully replace bone marrow examination in assessing cellular morphology and tissue architecture. In conclusion, Flow cytometry is a powerful complementary tool in the diagnosis of hematologic disorders. 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z-index: 2000000000 !important;">
EVALUATION OF EARLY AND MID-TERM OUTCOMES OF LAPAROSCOPIC RIGHT HEMICOLECTOMY WITH LYMPH NODE DISSECTION IN ELDERLY PATIENTS
Section: Original Research Categories: Research Keywords: laparoscopic surgery, right hemicolectomy, elderly patients, colon cancer, survival To evaluate the safety and mid-term outcomes of laparoscopic right hemicolectomy in elderly patients (≥65 years old). A retrospective descriptive study was conducted on 52 patients aged ≥65 years who underwent laparoscopic radical right hemicolectomy with lymph node dissection at Thong Nhat Hospital from 01/2020 to 01/2025. Data analysis was performed using SPSS software version 25.0. The early complication rate was 15.4%, and the 30-day mortality rate was 1.9%. The median number of harvested lymph nodes was 13.2 (92.3% of patients had ≥12 nodes). The 36-month disease-free survival (DFS) and overall survival (OS) rates were 62.5% and 68.9%, respectively. Only 55.6% of indicated patients completed the adjuvant chemotherapy regimen. Laparoscopic right hemicolectomy is a safe, feasible, and oncologically sound procedure for elderly patients. The mid-term survival outcomes were impacted by a low adjuvant chemotherapy completion rate.
NUTRITIONAL ASSESMENT IN ONCOLOGY OUTPATIENTS: A REVIEW OF SCREENING AND ASSESSMENT TOOLS
Section: Original Research Categories: Research Keywords: Nutritional Assessment, Oncology Outpatient, Cancer Cachexia, Sarcopenia Malnutrition and the associated phenotype of sarcopenia significantly compromise treatment tolerance, increase toxicity risk, and worsen overall survival in cancer patients. Given that the majority of oncological care occurs in the ambulatory setting, systematic nutritional assessment is a critical, mandated component of supportive care. This review synthesizes current evidence to evaluate the optimal screening and assessment tools suitable for routine use in outpatient oncology practice. A comprehensive narrative review was conducted, focusing on recent clinical guidelines and peer-reviewed literature concerning the validation and clinical utility of nutritional assessment instruments. Tools were analyzed across two tiers: Tier 1 (Screening) for feasibility and sensitivity; and Tier 2 (Comprehensive Assessment) for diagnostic accuracy regarding muscle loss and inflammation. The Malnutrition Screening Tool (MST) and Mini Nutritional Assessment Short Form (MNA-SF) emerged as the most practical and sensitive Tier 1 tools for general and geriatric oncology, respectively. For Tier 2, the Patient-Generated Subjective Global Assessment (PG-SGA) remains the gold standard. Crucially, the integration of objective measures—specifically Handgrip Strength and AI-assisted analysis of CT-derived Skeletal Muscle Index (SMI)—is essential for accurately diagnosing sarcopenia. Furthermore, the C-Reactive Protein/Albumin Ratio (CAR) is a powerful biomarker confirming the inflammatory drive of cachexia. Effective nutritional assessment mandates a structured, tiered approach. The reliance on advanced tools for objective body composition analysis is paramount for personalized care. Future efforts must focus on digitalizing this pathway, utilizing AI for automated sarcopenia detection, and ensuring robust resource allocation to oncology dietitians.
ACROMEGALIC CARDIOMYOPATHY IN AN OLDER ADULT: A CASE REPORT AND A REVIEW OF DIAGNOSTIC AND THERAPEUTIC APPROACHES
Section: Case Report Categories: Research Keywords: cardiomyopathy, acromegaly, acromegalic cardiomyopathy Acromegalic cardiomyopathy is classified as an endocrine cardiomyopathy. Acromegaly is characterized by the hypersecretion of Growth Hormone (GH) and its peripheral mediator, Insulin-like Growth Factor 1 (IGF-1). The etiology in the majority of cases is a pituitary adenoma. Chronic elevation of circulating GH and IGF-1 levels affects cardiomyocyte growth, myocardial contractility, and triggers various indirect mechanisms culminating in cardiomyopathy. The clinical phenotype typically presents as hypertrophic cardiomyopathy; however, without hormonal control, it may progress to a dilated cardiomyopathy phenotype with reduced ejection fraction. In this article, we report a clinical case in an older patient presenting with dyspnea. Based on clinical and diagnostic findings, the patient was diagnosed with acromegaly secondary to a pituitary adenoma, complicated by heart failure with reduced ejection fraction (HFrEF). Management included diuretics for decongestion and optimization of Guideline-Directed Medical Therapy (GDMT), with planned pituitary tumor resection upon stabilization of heart failure. However, the patient declined surgical intervention.
EVALUATION OF THE ANALGESIC EFFICACY OF BALLOONLESS VERTEBROPLASTY WITH BONE CEMENT IN PATIENTS WITH OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES
Section: Original Research Categories: Research Keywords: vertebral compression fracture, osteoporosis, vertebroplasty Osteoporotic vertebral compression fractures are a major cause of back pain and reduced spinal function in elderly patients. To evaluate the pain-relieving effectiveness of vertebroplasty in patients with osteoporotic vertebral compression fractures. A prospective study was conducted on 26 patients, assessing VAS, Macnab, and ODI scores before and after cement vertebroplasty, analyzed according to the number of fractured vertebrae. VAS scores significantly decreased from 4.85 ± 0.61 to 1.81 ± 0.49 after the procedure (p < 0.001). Macnab and ODI scores also improved markedly, with pain relief observed even in patients with multiple fractured vertebrae. Vertebroplasty is a minimally invasive procedure that effectively reduces pain and improves spinal function in patients with one or multiple osteoporotic vertebral fractures.
POSTOPERATIVE ANXIETY IN PATIENTS UNDERGOING RETROGRADE URETEROSCOPIC LASER LITHOTRIPSY: A CROSS-SECTIONAL STUDY AT THONG NHAT HOSPITAL
Section: Original Research Categories: Research Keywords: Anxiety, Ureteroscop, Ureteral calculi, Postoperative period Ureteral calculi account for approximately 20–40% of urinary tract stone diseases, second only to renal calculi. Retrograde ureteroscopic laser lithotripsy is a widely used minimally invasive procedure, offering rapid recovery and low complication rates. However, postoperative anxiety remains a clinical concern. A descriptive cross-sectional study was conducted on 165 patients undergoing retrograde ureteroscopic laser lithotripsy at Thong Nhat Hospital between March and September 2023. The prevalence and severity of postoperative anxiety were assessed using standardized measures. Postoperative anxiety was identified in 95.15% of patients, predominantly at a mild level. Mild and moderate anxiety were observed in 83.64% and 11.51% of cases, respectively, with a mean score of 4.53 ± 2.58. The most common concerns included fear of complications (84.8%), postoperative pain (66.1%), and indwelling JJ stent placement (43.6%). Postoperative anxiety was highly prevalent among patients undergoing retrograde ureteroscopic laser lithotripsy, although generally mild in severity. These findings underscore the importance of comprehensive perioperative counseling and psychological support to reduce patient anxiety and enhance recovery outcomes.
BALANCE IMPROVEMENT IN OLDER ADULTS WITH TAEKWONDO
Section: Original Research Categories: Research Keywords: Taekwondo, Balance, Older adults, Fall, Injury Impaired balance in older adults can directly lead to falls, leading to injuries, reduced quality of life, and increased dependence in daily activities. To diversify neuromotor exercises, evidence on the effectiveness of Taekwondo has been reviewed. Searches using relevant keywords reported that Taekwondo significantly improves both static and dynamic balance measures in individuals over 65 years old. Additionally, the findings suggest that Taekwondo may enhance exercise adherence among participants. These results support the potential of Taekwondo as a exercise to improve balance for older adults, although further high-quality evidence is needed.
THYROTOXIC CARDIOMYOPATHY MANIFESTING AS HEART FAILURE WITH SUPRANORMAL EJECTION FRACTION: A CASE REPORT
Section: Case Report Categories: Research Keywords: cardiomyopathy, heart failure supranormal ejection fraction, thyrotoxic Thyrotoxic cardiomyopathy is categorized within the spectrum of metabolic cardiomyopathies and typically presents with high-output heart failure accompanied by a supranormal left ventricular ejection fraction. In recent years, heart failure with supranormal ejection fraction (HFsnEF) has been increasingly regarded as a distinct heart failure phenotype, exhibiting worse prognosis and suboptimal treatment response compared with the group with preserved ejection fraction. In this report, we present a clinical case of a patient admitted with fatigue, palpitations, and diarrhea. After comprehensive integration of clinical findings, laboratory test results, and imaging data, the patient was ultimately diagnosed with thyrotoxicosis accompanied by heart failure with supranormal ejection fraction. The patient was treated with a combination of antithyroid medication and a beta-blocker. After seven days of therapy, the patient demonstrated marked improvement in clinical symptoms as well as cardiac function on echocardiographic assessment.
heart failure supranormal ejection fraction
PREVALENCE SURVEY ANTIBIOTIC RESISTANCE SOME OF BACTERIA AT CAI NUOC GENERAL HOPITAL IN 2023-2024
Section: Original Research Categories: Research Keywords: Antibiotic resistance, Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus Antibiotic resistance is a major global health challenge. This study aimed to investigate the prevalence and antibiotic resistance patterns of pathogenic bacteria at Cai Nuoc General Hospital during 2023–2024. A cross-sectional descriptive study was conducted using clinical specimens identified and tested for antibiotic susceptibility according to CLSI 2023 standards. The predominant isolates were Escherichia coli 9,9%, Klebsiella pneumoniae 8.1%, Staphylococcus epidermidis 13,5% and Staphylococcus aureus 46,8%. High resistance rates were observed for beta-lactam and quinolone groups. ESBL-producing Gram-negative bacilli accounted for 21,2%, and MRSA for 89,7%. Conclusion: Antibiotic resistance at the hospital remains high, emphasizing the need for antimicrobial stewardship and regular surveillance. <div class="intersub-ai-chat" style="color-scheme: initial; forced-color-adjust: initial; mask: initial; math-depth: initial; position: fixed !important; position-anchor: initial; text-size-adjust: initial; appearance: initial; color: initial; font: initial; font-palette: initial; font-synthesis: initial; position-area: initial; text-orientation: initial; text-rendering: initial; text-spacing-trim: initial; -webkit-font-smoothing: initial; -webkit-locale: initial; -webkit-text-orientation: initial; -webkit-writing-mode: initial; writing-mode: initial; zoom: initial; accent-color: initial; place-content: initial; place-items: initial; place-self: initial; alignment-baseline: initial; anchor-name: initial; anchor-scope: initial; animation-composition: initial; animation: initial; app-region: initial; aspect-ratio: initial; backdrop-filter: initial; 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x: initial; y: initial; z-index: 2000000000 !important;">
CHARACTERISTICS OF CAUSES, CLINICAL, AND SUBCLINICAL SYMPTOMS IN ADULT PATIENTS WITH IRON DEFICIENCY ANEMIA AT DONG THAP GENERAL HOSPITAL
Section: Original Research Categories: Research Keywords: Iron deficiency anemia, gastrointestinal neoplasms, bone marrow response Iron deficiency anemia (IDA) constitutes a significant global health issue. Recent studies indicate that 8-15% of iron deficiency anemia cases are attributable to gastrointestinal malignancies. This study presents a series of cases to elucidate the clinical and paraclinical characteristics, etiologies of iron deficiency anemia (IDA), and to assess the correlation among certain variables in patients. The study results included 119 patients aged 16 years and older diagnosed with iron deficiency anemia (IDA) from June 2024 to May 2025 indicated a median age of 60 ± 17.4 years, with 59.7% being female. Prevalent symptoms of anemia include dizziness, vertigo (96.6%), and pallor of the skin and mucous membranes (82.4%). The majority of individuals with severe anemia (87.4%) exhibited inadequate bone marrow response (RPI = 0.3 ± 0.1). The median ferritin level was 10.3 ± 7.5 ng/mL, exhibiting a strong correlation with red blood cell shape (MCV, MCH, MCHC) and transferrin levels. The primary cause was chronic iron deficiency, with 9.2% attributed to gastrointestinal neoplasms, predominantly affecting men at a rate of 72.7%. Studies indicate that TMTS is a prevalent condition, particularly among women and the elderly. It is crucial to screen for the etiology of iron deficiency, particularly gastrointestinal neoplasms, in elderly males.
ANESTHESIA AND PERIOPERATIVE MANAGEMENT FOLLOWING ERAS PROTOCOL IN KIDNEY TRANSPLANTATION FROM BRAIN-DEAD DONORS AT THONG NHAT HOSPITAL: A CASE SERIES OF SIX PATIENTS
Section: Case Report Categories: Research Keywords: Kidney transplantation, brain-dead donor, anesthesia and perioperative management, ERAS protocol Kidney transplantation is one of the most effective treatment options for patients with end-stage renal disease. However, a considerable number of patients die while waiting for transplantation. We conducted a descriptive case series of six kidney transplantations from brain-dead donors in Thong Nhat hospital. All six procedures were completed successfully following a standardized Enhanced Recovery After Surgery (ERAS) anaesthetic protocol. No patients experienced postoperative nausea or delayed graft function, and early urine output exceeded 2 mL.kg⁻¹.h⁻¹ in all recipients. The prevalence of end-stage renal disease is steadily increasing, while the disparity between available organ supply and transplantation demand continues to widen. Organs from brain-dead donors represent an effective strategy to address this shortage. Kidney transplantation is a highly complex surgical procedure that necessitates meticulous anesthetic planning to ensure patient safety and optimize graft function. ERAS‑based protocols offer safe and effective perioperative management, resulting in reduced complications, shorter hospital stays and improved patient satisfaction.
INPATIENT MORBIDITY PATTERNS AND HEALTHCARE ACTIVITIES AT PHU YEN TRADITIONAL MEDICINE HOSPITAL BEFORE, DURING, AND AFTER THE COVID-19 PANDEMIC (2020–2023)
Section: Original Research Categories: Research Keywords: disease pattern, traditional medicine, COVID-19 The COVID-19 pandemic had a widespread impact on all aspects of human life globally, and specifically on Phu Yen Province (now part of eastern Dak Lak Province) in Vietnam. Numerous studies reported significant declines in outpatient visits, hospital admissions, and healthcare service utilization during this period. Evaluating the changes in disease patterns and healthcare service delivery at Phu Yen Traditional Medicine Hospital from 2020 to 2023 is essential for guiding service quality improvements and strengthening preparedness for future public health emergencies. To assess the variation in inpatient disease patterns and describe healthcare service activities at Phu Yen Traditional Medicine Hospital between 2020 and 2023. Study subjects included all inpatient medical records with primary ICD-10 diagnosis codes at Phu Yen Traditional Medicine Hospital from January 1, 2020 to December 31, 2023. Research design: retrospective cross-sectional descriptive study. From 2020 to 2023, musculoskeletal and neurological diseases were the most common. In 2021, COVID-19 cases appeared, with a notable rise in infectious diseases among patients under 15 (94.6%). Clinical staffing remained stable; bed numbers increased from 2022. During the pandemic, patient visits declined but clearly recovered by 2023. Bed occupancy was lowest in 2021 (69.7%) and peaked in 2023 (113.8%). The inpatient disease pattern and hospital service activity at Phu Yen Traditional Medicine Hospital were notably affected by COVID-19, with a sharp decline in 2021 followed by recovery starting in 2022.