MedPharmRes

A review of the role of gastric ultrasound in anaesthesia planning for emergency surgery patients

2026-04-01T12:19:01+07:00

Pulmonary aspiration is a life-threatening complication in emergency surgery, with a mortality rate of 6.6%. The incidence is 1 in 2,000–3,000 cases, and it occurs 4.5 times more frequently than in elective procedures. Although Rapid Sequence Induction (RSI) helps reduce the risk of aspiration, it can also increase the risk of adverse events, such as an undetected difficult airway, hypotension, and hypoxemia during induction. Identifying risk factors related to the patient’s condition, surgical impact, and effects of the anesthesia technique is crucial in planning optimal perioperative management for each patient. Gastric ultrasound is an effective tool for anesthesia planning in emergency surgery. It helps assess stomach contents, which in turn minimizes the risk of aspiration and the need for unnecessary RSI. With 95% sensitivity and 88%-95% specificity, it allows for precise risk stratification. A practical flowchart guides decisions on surgical timing and anesthesia techniques, ultimately reducing complications like aspiration and improving patient safety by tailoring care to the patient’s gastric status.

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Prevalence, colonoscopic features, and risk factors of colonic diverticulosis in Vietnamese adults undergoing colonoscopy: a cross-sectional study

2026-04-01T12:19:04+07:00

Introduction:

Colonic diverticulosis is common in gastrointestinal disease with a rising prevalence in Asia. Regional differences exist in prevalence, distribution, and risk factors of diverticulosis; however, data from Vietnam are still lacking. The purpose of our study was to ascertain the prevalence, colonoscopic features, and risk factors of colonic diverticulosis among Vietnamese adults undergoing colonoscopy.

Methods:

A descriptive cross-sectional study was performed prospectively on patients undergoing colonoscopy at the Gastrointestinal Endoscopy Department of the University Medical Center-Ho Chi Minh City. Metabolic syndrome was established on the Adult Treatment Panel III guidelines. Univariate and multivariate analyses were conducted to identify risk factors.

Results:

There were 480 participants, with a mean age of 53.2±12.7 years. The male-to-female ratio was 0.8. The prevalence of diverticulosis was 29.6%. Right-sided diverticulosis was observed in 69% of cases. Multiple diverticula were present in 68.4% of cases. Multivariate analysis identified advanced age (odds ratio [OR]=2.38, 95% confidence interval (CI): 1.41–4.05, p=0.001), male sex (OR=1.78, 95% CI: 1.05–3.02, p=0.033), central obesity (OR=1.61, 95% CI: 1.03–2.50, p=0.037), metabolic syndrome (OR=1.91, 95% CI: 1.12–3.27, p=0.021), and heavy alcohol consumption (OR=2.23, 95% CI: 1.03–4.84, p=0.042) as independent risk factors of diverticulosis.

Conclusions:

Diverticulosis was prevalent in Vietnamese, with a right-sided predominance of the colon and multiple diverticula. Advanced age, male sex, central obesity, metabolic syndrome, and heavy alcohol consumption were risk factors.

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Factors associated with pain management for trauma patients in pre-hospital emergency care in Ho Chi Minh City

2026-04-01T12:19:08+07:00

Introduction:
Trauma represents a significant proportion of prehospital emergency cases and ranks among the leading contributors to Disability-Adjusted Life Years (DALYs). Implementing pain relief interventions enhances patient survival rates, reduces disability prevalence, and ultimately improves overall quality of life. This study aims to explore the characteristics of prehospital trauma cases and factors associated with pain management in Ho Chi Minh City from 2022 to 2024.

Methods:
All trauma patients managed by prehospital emergency teams in Ho Chi Minh City between 2022 and 2024 were retrospectively enrolled in this descriptive study.

Results:
From 2022 to 2024, a total of 10,038 cases were included in the study, accounting for 20% of all emergencies handled by the prehospital emergency system. Males accounted for 61.7% of the cases, with the mean age of all trauma patients being 48 years (SD 22.3). Common injuries included limb lesion (36.3%), head injury (33.3%), and multiple trauma (9.0%). Doctors led 49% of emergency teams, and medical technicians led 20%. After excluding pre-arrival deaths or cardiac arrest cases (187 cases), 9,851 patients were included in the analysis of pain management. Pain relief was provided in 18.3% of cases, primarily NSAIDs (13.8%), paracetamol (5.5%), and opioids (1.2%). Poisson regression analysis, with a significance level of 0.05, showed higher likelihood of analgesic use among doctors as emergency team leader (adjusted prevalence ratios [aPR]=1.79; 95% CI: 1.59–2.01); for female patients (aPR=1.17; 95% CI: 1.08–1.26); limb injury presented (aPR=1.98; 95% CI: 1.80–2.17); multiple trauma presented (aPR=1.30; 95% CI: 1.14–1.49); chest injury presented (aPR=1.52; 95% CI: 1.28–1.79); and for occupational accident cases (aPR=1.18; 95% CI: 1.06–1.31), compared to other respective groups. Conversely, the rate of analgesic use was lower among patients with head injuries (aPR=0.64; 95% CI: 0.57–0.71).

Conclusions:
Effective pain management in patients is essential and should be promoted through appropriate interventions. Emphasis should be placed on patients with head injuries, ensuring equitable pain management across all patient groups.

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Molecular characterization and antimicrobial resistance of carbapenem-resistant Klebsiella pneumoniae and Escherichia coli at Cho Ray Hospital, Vietnam

2026-04-01T12:19:11+07:00

Introduction:
Due to limited treatment options, the infection of carbapenem-resistant Enterobacterales (CRE), particularly Escherichia coli and Klebsiella pneumoniae, emerges as a critically imminent global health threat. This study aimed to investigate the prevalence and molecular characteristics of carbapenemase genes in CRE isolated from Cho Ray Hospital, and to assess their associated antimicrobial resistance profiles.

Methods:
A cross-sectional study was conducted on 160 non-duplicate CRE isolates collected from various clinical specimens at Cho Ray Hospital. Carbapenemase production was detected phenotypically using the modified carbapenem inactivation method and genotypically confirmed by multiplex real-time PCR targeting blaOXA, blaNDM, blaKPC, blaVIM, and blaIMP.

Results:
K. pneumoniae accounted for 80.6% of isolates, while E. coli comprised 19.4%. The co-occurrence of blaOXA and blaNDM was the most common pattern (46.5% in K. pneumoniae). Notably, blaKPC was found in 17.8% of K. pneumoniae but not in E. coli. Colistin resistance was significantly higher in blaKPC isolates (30.4%) than blaNDM isolates (3.2%).

Conclusions:
The study highlights the high prevalence of dual carbapenemase gene carriage and the emergence of blaKPC at Cho Ray Hospital. These findings emphasize the importance of localized molecular surveillance and targeted infection control strategies in Vietnamese tertiary care settings.

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Application of computed tomography in evaluating imaging features of intraductal papillary mucinous neoplasms

2026-04-01T12:19:14+07:00

Introduction:
Intraductal papillary mucinous neoplasms (IPMNs) are increasingly detected owing to high-resolution imaging. IPMNs have malignant potential, ranging from low-grade dysplasia to invasive carcinoma. However, data from Vietnam are limited. This study aimed to describe computed tomography (CT) features of IPMNs and evaluate their diagnostic value.

Methods:
We performed a retrospective case series of patients with histopathologically confirmed IPMNs between January 2016 and December 2024. Thirty-two patients who underwent preoperative CT scans and met inclusion criteria were analyzed. CT features were assessed for their association with malignancy.

Results:
The cohort comprised 32 patients from 17 malignant and 15 benign cases. The mean age was 64.5±10.2 years of 19 men, 13 women. CT features significantly associated with malignancy were enhancing mural nodules (p<0.001), main pancreatic duct diameter (p=0.047), cyst size (p=0.047), thickened enhancing cyst walls (p=0.031), abrupt ductal caliber change with distal atrophy (p=0.026), and lymphadenopathy (p=0.019). Mural nodules≥5 mm demonstrated high sensitivity and specificity (82.4% and 80%). When patients had ≥4 worrisome features, the corresponding sensitivity (82.4%), specificity (80%), and accuracy (81.3%) in this small surgical series should be interpreted as descriptive, hypothesis-generating estimates rather than as definitive values or as directly comparable to those of high-risk stigmata.

Conclusions:
CT provides valuable information for not only diagnosing IPMNs but also predicting malignant potential. Mural nodules ≥5 mm and accumulation of worrisome features can help identify patients who may benefit from surgical intervention.

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Comparison of continuous norepinephrine and phenylephrine infusion for preventing hypotension during low-dose spinal anesthesia in cesarean delivery: a randomized controlled trial

2026-04-01T12:19:17+07:00

Introduction:
Hypotension is a frequent complication of spinal anesthesia (SA) for cesarean delivery (CD). Phenylephrine is recommended for prophylaxis but may cause reflex bradycardia. Norepinephrine, with mild β-adrenergic activity, may reduce both hypotension and bradycardia. This study compared the efficacy of continuous norepinephrine versus phenylephrine infusion in preventing hypotension during low-dose SA in CD.

Methods:
In this randomized, controlled, single-blind trial, ninety-four term parturients undergoing elective CD under low-dose SA were randomly assigned to receive norepinephrine (0.05 mcg/kg/min) or phenylephrine (0.25 mcg/kg/min) infusion. The primary outcome was the incidence of hypotension. Secondary outcomes included bradycardia, severe hypotension, hypertension, escalation to rescue vasopressors or rescue atropine for bradycardia, nausea and vomiting, and neonatal Apgar scores.

Results:
The norepinephrine group had a lower incidence of hypotension (14.9% vs. 42.6%, p=0.003; RR=0.35; 95% CI: 0.16–0.75), fewer recurrent episodes, and reduced rescue vasopressor needs (p<0.05). Area under the curve (AUC)/time analysis showed that norepinephrine provided more stable blood pressure and heart rate profiles throughout the study. Bradycardia was less frequent with norepinephrine (14.9% vs. 25.5%, p=0.2; RR=0.58; 95% CI: 0.25–1.35). Two patients in the phenylephrine group required atropine. Apgar scores and other adverse events were comparable between groups.

Conclusions:
Norepinephrine infusion at 0.05 mcg/kg/min is more effective than phenylephrine at 0.25 mcg/kg/min in preventing hypotension during low-dose SA for CD, providing better hemodynamic stability and fewer episodes of bradycardia.

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Effectiveness of cupping therapy in managing neck pain and improving cervical mobility in cervical spondylosis patients: a randomized clinical trial

2026-04-01T12:19:20+07:00

Introduction:
Cervical spondylosis is one of the common causes of chronic neck pain. This study aimed to evaluate the comparative effectiveness of fire cupping (FC) therapy versus electroacupuncture (EA) on reducing pain and improving cervical spine range of motion (ROM) in patients with neck pain due to cervical spondylosis.

Methods:
Eighty-two participants with neck pain caused by cervical spondylosis were randomly allocated in 1:1 ratio to either the FC or EA group. Both groups received treatment at EX-B2, A-shi, and Gall Bladder (GB21) acupuncture points. The two-week study assessed pain levels using the visual analog scale (VAS) at 2 points in time post-intervention and evaluated adverse effects weekly.

Results:
After 2 weeks of intervention, VAS scores significantly decreased in both the FC group (from 6 [6–7] to 3 [2–3]) and the EA group (from 6 [6–7] to 2 [1–3]) (p<0.001). However, inter-group pain relief was not statistically significant (p=0.5794, Cohen’s d=0.12; 95% CI [–0.31–0.6]). Both groups showed statistically significant ROM improvement (p<0.001), though the EA group demonstrated better improvement in flexion, extension, and left/right lateral flexion (p<0.05). No adverse effects of FC were reported.

Conclusions:
FC appears to be an effective and safe therapy for neck pain due to cervical spondylosis, showing similar pain relief efficacy with no statistically significant difference compared to EA despite a lower treatment dosage. However, due to methodological limitations, these findings should be interpreted with caution and warrant further validation in rigorously designed studies.

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Phenotyping cough in lung cancer: a focus on productive cough and its link to chronic obstructive pulmonary disease (COPD) in a Vietnamese cohort

2026-04-01T12:19:22+07:00

Introduction:
Cough is a primary symptom in lung cancer that severely diminishes patient quality of life. However, specific clinical data for Vietnamese patients remain limited, hindering targeted treatment. This study sought to characterize cough and identify its key drivers within this specific demographic.

Methods:
A cross-sectional study was performed from January 2025 to May 2025 at the Ho Chi Minh City Oncology Hospital, enrolling 392 patients aged 18 years and older exhibiting cough symptoms. A survey collected data on cough duration, characteristics, intensity (visual analogue scale for cough, VAS-C), and epidemiological factors, including chronic obstructive pulmonary disease (COPD), smoking status, and treatment. Chi-square and Fisher’s exact tests, together with multivariable logistic regression, were employed for analysis.

Results:
Among 392 patients, productive cough was present in 61.2%. The logistic regression model determined that concomitant COPD is the most significant independent risk factor for productive cough (adjusted odds ratios ([aOR]=52.46; 95% confidence interval [CI]: 10.57–260.45; p<0.001). Each year of increased age also raised the odds by 5% (aOR=1.05; p=0.001), while smoking cessation for ≥6 months significantly reduced the risk compared to current smokers (aOR=0.06; p=0.009)

Conclusions:
In our Vietnamese lung cancer cohort, productive cough is the dominant presentation. The occurrence is strongly associated with underlying COPD and older age, whereas quitting smoking offers significant protection. These results emphasize the necessity of integrating COPD management and robust smoking cessation support into oncological care to mitigate cough burden and enhance patient quality of life.

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Prevalence of mental disorders and personality traits among public health students: a cross-sectional study

2026-04-01T12:19:25+07:00

Introduction:
Mental disorders are common among health students. Personality traits have been identified as potential predictors of mental health. This study aimed to assess the prevalence of mental disorders and examine their association with personality traits among students at the Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City.

Methods:
A cross-sectional study was conducted using a self-administered questionnaire consisting of the Self-Reporting Questionnaire (SRQ-20) to assess mental disorders and the Big Five Inventory Short Form (BFI-S) to evaluate personality traits. In this study, “mental disorders” refer to probable cases identified through the SRQ-20 screening tool, which does not provide a clinical diagnosis. Data were analyzed using multivariable Poisson regression models to ascertain the relationship between mental disorders and personality traits.

Results:
Among the 427 students participating in the study, the prevalence of mental disorders was found to be 49.9%. Of those experiencing mental disorders, 39.9% reported mild disorder, 35.7% moderate disorder, and 24.4% severe disorder. Prominent personality traits among students included agreeableness, openness to experience, and conscientiousness. Multivariable regression analysis revealed that mental disorders were associated with neuroticism and extraversion. Specifically, high neuroticism was a strong predictor of mental disorders, while extraversion acted as a protective factor, helping to reduce mental disorders.

Conclusions:
Students with high neuroticism are at increased risk for mental disorders. Conversely, personality traits such as extraversion, openness to experience, agreeableness, and conscientiousness contribute to lower risks of mental disorders. Effective intervention programs are needed to alleviate mental disorders among students.

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Preliminary assessment of content validity and internal consistency of the N-CT-4 students questionnaire in the master’s students in nursing

2026-04-01T12:19:27+07:00

Introduction:
Critical thinking (CT) is a core competency in nursing, essential for clinical judgment, safe practice, and professional development. However, valid and context-specific tools to assess CT in nursing education remain limited in Vietnam. This study is the first to translate, content validate, and reliability test the N-CT-4 Students questionnaire into Vietnamese and to employ it in the survey on Master’s students in Nursing (MSNs), marking the initial use of this tool among graduate-level nursing students.

Methods:
The Vietnamese version of the N-CT-4 Students questionnaire used in this study was translated through a forward–backward translation process. Content validity was assessed through evaluations by six experts, using the item-level and scale-level content validity indices (I-CVI, S-CVI). Internal consistency reliability, measured by Cronbach’s Alpha, was determined through an online survey involving 100 MSNs at the University of Medicine and Pharmacy at Ho Chi Minh City (UMP).

Results:
The Vietnamese version of the N-CT-4 Students questionnaire preserved the meaning of the original English version, which was clear and easy to comprehend. The I-CVI for the N-CT-4 Students components ranged from 0.8 to 1.0. The S-CVI/AVE and S-CVI/UA were 0.99 and 0.95, respectively. The internal consistency reliability of MSNs was 0.982.

Conclusions:
The Vietnamese version of the N-CT-4 Students questionnaire demonstrates strong content validity and high internal reliability, making it a suitable tool for assessing CT among MSNs in Vietnam. Its availability can support nursing educators in evaluating this competency and developing strategies to enhance CT in clinical settings.

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Diagnosis of endometrioid adenocarcinoma of the fallopian tube misinterpreted as ovarian cancer: a case report

2026-04-01T12:19:30+07:00

Primary fallopian tube cancer is a rare gynecologic malignancy, often misdiagnosed as ovarian cancer due to overlapping clinical and radiologic features. We report a case of a 49-year-old woman presenting with abnormal uterine bleeding and lower abdominal pain. Imaging revealed bilateral adnexal masses and elevated CA 125, HE4, and Risk of Ovarian Malignancy Algorithm (ROMA) index. Surgical exploration identified a left fallopian tube tumor and omental involvement. Histopathology confirmed high-grade endometrioid adenocarcinoma of the left fallopian tube with metastatic deposits. The patient underwent total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and adjuvant chemotherapy with Paclitaxel and Carboplatin. This case underscores the diagnostic challenge and clinical significance of recognizing fallopian tube carcinoma in patients with adnexal masses and elevated tumor markers.

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Fever with vesiculopapular eruptions mimicking varicella: an atypical presentation of measles in an unvaccinated adult

2026-04-01T12:19:32+07:00

We describe a case involving a 30-year-old man with a previous history of varicella, who developed an acute febrile episode associated with a progressively spreading skin rash. At onset, the skin eruption presented as maculopapular lesions, later transforming into vesiculopapular eruptions with hemorrhagic characteristics. Typical Koplik spots were also observed on illness day 7, which was day 5 of the rash. The diagnosis was confirmed via positive measles-specific IgM serology.

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