MedPharmRes

Parotitis overview: an integrated approach from classification to treatment strategies

Tran Duc Ky Truong — 2025-12-29

Parotitis is the inflammation of the largest salivary gland, with diverse aetiologies including infections, autoimmune disorders, and mechanical obstructions. The lack of a standardised classification system, along with varied clinical manifestations, poses significant challenges in diagnosis and management. This review aimed to provide a comprehensive overview of the classification, diagnostic methods, and treatment strategies for parotitis, focusing on both acute and chronic forms. A literature review was conducted using PubMed and Google Scholar up to January 2025. Inclusion criteria were English-written studies on human subjects related to parotitis, covering classification, diagnostic methods and treatment strategies. Data were extracted and synthesized to highlight current practices. Parotitis features 5 subtypes, namely: (1) acute viral, (2) acute suppurative, (3) sialolithiasis-associated, (4) chronic non-neoplastic, and (5) chronic neoplastic. Diagnostic tools include clinical evaluation, imaging (ultrasound, computed tomography, magnetic resonance imaging, sialography), and sialendoscopy. Treatment ranges from conservative management to minimally invasive procedures, with surgery reserved for severe cases. Accurate classification and diagnosis are key to the effective management of parotitis. Advances in imaging techniques and sialendoscopy have significantly improved diagnostic accuracy and treatment outcomes. Implementing a standardised approach can optimize patient care, reduce recurrence rates, and prevent complications.

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Lynch syndrome in Vietnamese patients with colorectal cancer: prevalence and clinicopathologic characteristics from a single-center study

Cong Bang Huynh — 2025-12-29

Introduction:

Lynch syndrome (LS) is the most common hereditary cause of colorectal cancer (CRC), but the prevalence and clinical characteristics of this disorder among Vietnamese patients remain underreported. This study estimated the prevalence and described the clinical characteristics of LS in a hospital-based population in Vietnam.

Methods:

A cross-sectional study on prospective data was conducted at the University Medical Center, Ho Chi Minh City (2022–2024), including 190 CRC participants underwent panel genetic testing for LS-associated genes (MLH1, MSH2, MSH6, PMS2, EPCAM).

Results:

LS was diagnosed in 12/190 patients (6.3%); the prevalence for MLH1, MSH2, MSH6 mutations was 3.7%. The most frequent mutations were in MSH2 (25%) and PMS2 (33.3%). LS patients were significantly younger (49.7±14.5 vs. 60.3±12.1 years, p=0.004), with 50% diagnosed before 50-year-old. Right-sided tumours were more common (58.3%). Most LS cases were in stage 3 (50%), and 58.3% had no family history of CRC.

Conclusions:

The LS prevalence in Vietnamese CRC patients was higher than expected, particularly for PMS2 mutations. 58.3% of LS patients had no family history, and 50% wer xe aged ≥50 years, suggesting potential false negatives according to traditional screening criteria. Expanding genetic testing to older patients and those without a family history could improve LS detection and management.

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Source-specific PM2.5 pollution and respiratory health impacts in an urban Asian district: a real-time monitoring study in Ho Chi Minh City, Vietnam

Thuy Thi Truc Phan — 2025-12-29

Introduction:

Fine particulate matter (PM2.5) is a pressing public health challenge in rapidly urbanizing Asian cities. In District 5 of Ho Chi Minh City, Vietnam, localized PM2.5 pollution arises from diverse sources such as stationary street food vendors, religious temples, traffic congestion, and fuel stations. Understanding the relative contribution of these sources is critical for designing effective interventions. This study aims to identify and quantify the contributions of specific local PM2.5 sources to respiratory health outcomes among residents in District 5, Ho Chi Minh City.

Methods:

We conducted a source-specific assessment of PM2.5 exposure and its association with respiratory health outcomes using a real-time sensor network (Airbeam3) deployed at seven sites representative of key emission sources. A total of 184 participants were recruited for the study, including residents living near various PM2.5 sources. Respiratory symptoms were evaluated through a locally adapted American Thoracic Society questionnaire (ATS-DLD-78). Multivariable regression models were used to quantify the impact of specific sources on reported symptoms.

Results:

Stationary street-food vendors and traffic congestion were identified as dominant contributors to PM2.5 pollution. Residents living near continuous traffic and stationary street vendor areas experienced significantly higher rates of sputum production. Stationary street-food vendors exhibited the strongest association with adverse outcomes (β=0.47, p<0.001).

Conclusions:

Our findings highlighted the urgent need for targeted air pollution control strategies in complex urban environments. Interventions such as cleaner cooking technologies and improved traffic management may significantly reduce PM2.5 exposure and its health burden. This study demonstrates the utility of low-cost, real-time monitoring for guiding public health policies in rapidly developing megacities.

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Prevalence of hypertension and its related factors among K’Ho ethnic group from 25 to 64 years old at Lien Dam Commune, Di Linh District, Lam Dong Province: a cross-sectional study

Quynh Ho Ngoc Huynh — 2025-12-29

Introduction:

Hypertension is a major global health concern and a leading cause of preventable mortality. In Vietnam, ethnic minority groups such as the K’Ho may face elevated hypertension risks due to unique cultural practices and socioeconomic disparities. However, little is known about the burden and determinants of hypertension in this population. This study aimed to determine the prevalence of hypertension and examine associated factors among the K’Ho ethnic group in Lien Dam commune, Lam Dong Province.

Methods:

A cross-sectional study was conducted among K’Ho adults aged 25–64 using a multistage cluster sampling method. Data were collected through structured interviews and physical examinations. Hypertension was defined according to the 2022 Vietnam National Heart Association recommendations. Multivariable logistic regression was performed to identify factors associated with hypertension. Model diagnostics, including multicollinearity, Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), and Area under the ROC curve (AUC), were used to evaluate model performance.

Results:

Among 328 participants, the prevalence of hypertension was 31.7%, higher than the national average. The final multivariable model retained seven predictors, showed good model fit and discriminative performance. Significant risk factors included increasing age, overweight/obesity, high sodium intake, binge drinking, and family history of hypertension. Notably, individuals affiliated with Protestantism had significantly higher prevalence of hypertension compared to Catholics.

Conclusions:

Hypertension is highly prevalent among the K’Ho ethnic minority, underscoring the need for targeted public health interventions. Prevention strategies should focus on promoting healthy lifestyles, reducing alcohol and sodium intake, encouraging weight control, and prioritizing early detection, especially among those with a family history of hypertension. The potential influence of religious affiliation on health behaviours warrants further culturally sensitive investigation.

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Cost-effectiveness analysis of the fixed-dose combination of Dorzolamide+Timolol versus Brinzolamide+Timolol in the treatment of ocular hypertension and primary open-angle glaucoma in Vietnam

Nguyen Thi Hong Tran — 2025-12-29

Introduction:
This pharmacoeconomic assessment aimed to explore the cost-effectiveness of the fixed-dose combination of Dorzolamide+Timolol (DTFC) in ocular hypertension and primary open-angle glaucoma (OH/POAG) in Vietnam.

Methods:
A cost-effectiveness analysis from third-party health payer perspective was designed with mixed modelling technique to simulate the long-term care for OH/POAG patients in Vietnam. With fixed-dose combination of Brinzolamide+Timolol (BTFC) as comparator, the treatment process was simulated by the decision-tree model for initial therapy and continued with the Markov model for maintenance therapy. Model parameters were derived from multiple sources, including real-world data, literature reviews and clinician consultations. Sensitivity analysis, including deterministic and probabilistic analyses, was conducted to explore the uncertainty of model outcomes.

Results:
Base case analysis showed that the cost of treatment for each patient by DTFC was 42,906,600 VND, and by BTFC was 43,864,938 VND, while the comparative effectiveness was not different. Costs for healthcare services and medications were the most influential factors to model outcomes. DTFC demonstrated a 51.53% probability of being cost-effective compared to BTFC at the standard willingness-to-pay threshold.

Conclusion:
From third-party health payer perspective, DTFC was the more cost-saving option while maintaining treatment benefits, compared to BTFC.

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Carbapenem resistance and carbapenemase classification of Enterobacteriaceae in intensive care unit: a cross-sectional study

Huong Quynh Nguyen Le — 2025-12-29

Introduction:
Carbapenem-resistant Enterobacteriaceae (CRE) poses a significant challenge in treating infections, leading to increased mortality and healthcare burden. Early and accurate identification of CRE is crucial for appropriate antibiotic selection. This study aimed to evaluate the prevalence of CRE isolated from ICU patients and carbapenemase gene profiles among Klebsiella pneumoniae isolates.

Methods:
A cross-sectional study was conducted on Enterobacteriaceae isolates from 53 ICU patients from March to May 2023. Among 125 initial isolates, 89 non-duplicated Enterobacteriaceae strains were included. Carbapenem resistance was determined from Kirby-Bauer disk diffusion susceptibility testing results. Carbapenemase-producing phenotype and carbapenemase classification were classified from BD Phoenix M50 results using the NMIC-500 CPO panel. Carbapenemase-encoding gene were identified from amplification results of carbapenemase-encoding genes in K. pneumoniae strains using multiplex real-time PCR.

Results:
Of 89 isolates, 51 (57.3%) were carbapenem-resistant, predominantly K. pneumoniae (34/48, 70.8%) and Serratia marcescens (12/13, 92.3%). All isolates were carbapenem-resistant due to carbapenemase production. Class D carbapenemase was the most prevalent (39/51, 76.5%). Among K. pneumoniae isolates, 12/34 harboured single carbapenemase genes: blaOXA-48-like (17.7%), blaKPC (14.7%), and blaNDM-1 (2.9%); Sixteen isolates carried two genes: blaNDM-1 +blaOXA-48-like and blaKPC+blaOXA-48-like; Three isolates possessed three genes: blaKPC+blaNDM-1+blaOXA-48-like. Multiple gene carriage was significantly associated with increased antibiotic resistance (p<0.01).

Conclusions:
This study revealed a high prevalence of carbapenemase-producing, CRE. This significantly increased the risk of spreading multidrug-resistant pathogens. Therefore, stronger infection control measures are in demand. Additionally, automated susceptibility testing and carbapenemase class identification are crucial for guiding treatment decisions.

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Validation of a consumer-grade wearable activity tracker for sleep measurement in Vietnamese patients

Toan Thanh Le — 2025-12-29

Introduction:
The increasing use of wearable activity trackers (WAT) for home-based sleep assessment has raised necessity to clarify their accuracy, particularly in resource-limited settings. This study aimed to validate WAT by polysomnography (PSG) for measuring key sleep parameters—including total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), sleep onset latency (SOL), and sleep stage distribution—in a Vietnamese clinical population, with implications for primary care applications.

Methods:
This cross-sectional study was conducted at the University Medical Center-Ho Chi Minh City, Vietnam, from December 2023 to July 2024. Sleep data were collected from 47 patients undergoing overnight PSG while simultaneously wearing a WAT. Sensitivity, specificity, and accuracy in detecting sleep versus wakefulness were assessed using epoch-by-epoch comparisons. Bland-Altman analysis was used to evaluate the agreement between WAT and PSG measurements, with mean differences and limits of agreement calculated for each sleep parameter.

Results:
The WAT demonstrated high sensitivity (93%) but low specificity (44%) and an accuracy of 79% in identifying sleep versus wakefulness when compared to PSG. No significant differences were found between the two devices in measuring TST , SE, SOL, and sleep stages. However, the WAT significantly underestimated WASO compared to PSG (p=0.011).

Conclusions:
The results are promising, but further confirmation in larger studies is required to confirm the utility of WAT in primary care settings in Vietnam.

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Effectiveness of clinical pharmacist interventions on improving the appropriateness of prescription and treatment outcomes for acute myocardial infarction patients: a before-after study at a Vietnamese hospital

Nhu Quynh Tran — 2025-12-29

Introduction:
Acute myocardial infarction (AMI) is a leading cause of global morbidity and mortality. Clinical pharmacist intervention offers a promising approach to improve prescription appropriateness and treatment outcomes. This study evaluated the impact of this intervention in treatment for AMI patients.

Methods:
A retrospective before-and-after study was conducted on all AMI patients at the Department of Interventional Cardiology, comparing two phases. The pre phase was designed without clinical pharmacist intervention (August 1, 2019, to December 31, 2019) and the post phase with the participation of clinical pharmacists in the prescription process (August 1, 2022, to December 31, 2022); with 6-month post-AMI follow-up periods in each phase. The impact of interventions was evaluated by comparing appropriateness of prescription, treatment outcomes, and adverse drug events (ADEs) between the two phases.

Results:
The study included 183 and 211 patients in the pre and post phases, respectively. The overall rates of prescription appropriateness were significantly higher in the post phase (85.8% vs. 48.6%, p<0.001). The mortality rates within 6 months of AMI discharge in the two phases were 18.6% and 16.5%, respectively (p=0.604). The proportions of patients who experienced ADEs were 57.4% and 56.4%, respectively (p=0.845). Clinical pharmacist interventions were associated with a higher rate of overall prescription appropriateness (OR: 6.734; 95% CI: 4.098–11.065; p<0.001).

Conclusions:
Clinical pharmacist interventions significantly improved the appropriateness of prescription for AMI treatment but did not reduce occurrence of mortality or ADE.

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Discovery of potent inhibitors of NS4B protein of dengue virus type 2 from natural compounds: an in silico approach

Phat Nguyen Pham — 2025-12-29

Introduction:
Dengue fever is an annual infectious epidemic disease caused by the Dengue virus, mainly found in tropical and subtropical regions. Of which, Dengue virus type 2 (DENV2) has been a major cause of severe cases globally. Currently, NS4B is one of the promising targets of dengue drug discovery, as it is crucial for the virus life cycle and highly conserved among different dengue strains. However, up till now, no potent synthetic DENV2 NS4B inhibitors have entered clinical research due to toxicity profiles. Therefore, this study aimed to search for new DENV2 NS4B inhibitors from in-house phytochemical compound database based on integration of in silico approaches.

Methods:
Initially, due to the lack of crystal structure of DENV2 NS4B protein, the 3D structure and binding site of this protein were predicted. Subsequently, virtual screening process was conducted through molecular docking and the most potential compounds in terms of binding affinity were selected for molecular dynamics simulations (MDs) and binding free energy calculation.

Results:
The flavonoid compound D155, derived from Valeriana hardwickii, and the saponin compound D170, extracted from Glinus oppositifolius, exhibited good binding affinities and bound well in the binding site of DENV2 NS4B protein. Notably, MDs study revealed that these two compounds formed stable interactions with NS4B protein during 200 ns of simulation and had a binding free energy <–20 kcal/mol.

Conclusions:
The findings suggested that D155 and D170 can be potential inhibitors targeting NS4B protein of DENV2. Further in vitro and in vivo studies are required to confirm their inhibitory activities.

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Listening to auscultation manikins: efficacy of a single simulation training in a resource-limited setting

Bao Quoc Le — 2025-12-29

Introduction:
Auscultation proficiency remains suboptimal among healthcare professionals, particularly in resource-limited countries. Simulation-based training is a promising measure to address this gap by offering a safe and controlled environment. This quasi-experimental study aimed to assess the efficacy of Student Auscultation Manikin II® (SAM II®)-based training and to determine the influential factors in our academic setting.

Methods:
A total of 370 third-year medical students (MSs) received a single 4-hour SAM II®-based training commenced with clinical rotations. To evaluate student’s performance, a test comprising 16 sounds and diagnoses was conducted at three points in time: prior to, at the end of, and at a short interval after the training. Multivariable linear regression models with intervention as a dummy variable were used to examine whether faculty qualifications and prior clinical exposure were associated with outcomes.

Results:
SAM II®-based training immediately improved student’s heart and lung auscultation performance with statistical significance (Median [IQR]: 5 vs. 4, p<0.001; 5 vs. 3, p<0.001, respectively). Retention rates were 96.8% for cardiac and 88.1% for respiratory auscultation, with no significant difference (p=0.109). Furthermore, our analysis revealed no correlation between their post-training competence, and educators’ qualifications or students’ prior exposure to clinical conditions.

Conclusions:
Our findings demonstrated the immediate efficacy of part-task trainers in enhancing and maintaining auscultation skills over short periods. Clinical faculties with adequate simulation training can instruct MS-3s as effectively as simulation experts. Nevertheless, it is imperative to conduct a comprehensive evaluation of simulator quality to ensure alignment with the learning objectives.

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A case report of pseudohypoaldosteronism type 1 initially misdiagnosed as congenital adrenal hyperplasia in a 3-month-old infant

Lan Thi Chi Huynh — 2025-12-29

Pseudohypoaldosteronism type 1 (PHA1) is a rare and serious disorder caused by aldosterone resistance, leading to significant disturbances in electrolyte balance. Due to overlapping clinical manifestations, it is frequently misidentified as congenital adrenal hyperplasia (CAH), resulting in unnecessary corticosteroid therapy. We reported on the case of a 3-month-old infant who had been initially diagnosed and treated for CAH due to severe salt-wasting symptoms. Further biochemical evaluation and genetic analysis later confirmed PHA1. The patient achieved clinical stabilization with fludrocortisone and sodium supplementation. This case underscored the necessity of differentiating PHA1 from CAH through repeated biochemical assessments and genetic testing to ensure an accurate diagnosis and appropriate treatment strategy.

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A case report of difficult airway management in patients with severe spinal deformity

Thu Quynh Nguyen Tran — 2025-12-29

Airway management in patients with ankylosing spondylitis (AS) poses significant anesthetic challenges, especially in advanced stages characterized by severe spinal deformities, reduced cervical mobility, and fixed flexion contractures. These anatomical limitations complicate tracheal intubation and elevate the risk of airway-related complications. We report a case of a 63-year-old male diagnosed with advanced-stage ankylosing spondylitis (AS), exhibiting a 60-degree fixed thoracolumbar kyphosis and cervical spine ankylosis. The patient who had cervical rigidity with impaired extension, underwent awake nasal intubation using flexible fiberoptic bronchoscopy. The procedure was well-tolerated, and spinal tumor resection proceeded uneventfully under intraoperative neurophysiological monitoring. This case highlights the importance of comprehensive preoperative airway evaluation and individualized planning in patients with advanced AS. Awake fiberoptic-guided intubation can offer a safe and effective approach to securing the airway in anatomically challenging cases.

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