Tạp chí Y Dược Huế

Research on clinical, biological characteristics, and treatment of hyperkalemia in acute kidney injury patients

Tran Thuy Quynh, Vo Tam, Hoang Trong Hanh, Dam Trung Nghia, Hoang Anh Tien — Thu, 30 Apr 2026 00:00:00 +0700

Purpose: This study investigated the clinical and paraclinical characteristics and severity of hyperkalemia in patients with acute kidney injury (AKI) treated in the Intensive Care Unit of Hue Central Hospital, and evaluated treatment outcomes and associated factors.
Methods: A total of 121 AKI patients treated from March 2022 to June 2023 were included. Data on medical history, clinical features, laboratory findings, and hyperkalemia treatment outcomes were collected and analyzed.
Results: Hypertension was the most common comorbidity (38.8%), followed by pulmonary disease (34.7%) and diabetes (20.7%). AKI was most often detected during hospitalization (62.8%). The leading cause was sepsis/infection (90.9%), followed by nephrotoxic drugs (38.0%). Common clinical manifestations included dyspnea or tachypnea (86.0%), shock or cardiac arrest (76.0%), edema (60.3%), and fatigue (57.0%). Most patients had normal consciousness (66.9%), while 13.2% were comatose. Stage 3 AKI predominated (54.5%), with 60.3% having urine output < 0.5 ml/kg/hour. Electrocardiographic abnormalities included tachycardia or bradycardia (79.3%), ST segment depression (23.1%), flattened P waves (14.9%), and peaked T waves (13.2%). Hyperkalemia (serum potassium ≥ 5.5 mmol/L) occurred in 52.1% of patients, with severe hyperkalemia (≥ 6.5 mmol/L) in 10.7%. Mild hyperkalemia was most common (76.0%), while severe cases accounted for 21.5%. Calcium chloride was the most frequently used treatment (79.4%), followed by diuretics (63.5%), sodium bicarbonate (58.7%), and insulin with glucose infusion (57.1%). Continuous renal replacement therapy (CRRT) was applied in 19.0% of patients. Potassium levels normalized to < 5.5 mmol/L in 81.0% of patients within 6 hours and 84.1% after 6 hours. Serum potassium levels improved significantly after medical therapy or CRRT (P < 0.001). No significant associations were found between treatment outcomes and age, sex, BMI, admission characteristics, timing of detection, or hematological parameters.
Conclusions: AKI patients in the ICU commonly presented with dyspnea and shock/cardiac arrest. Hyperkalemia was frequent (52.1%), including 10.7% severe cases, but potassium levels improved significantly with appropriate treatment.

Evaluation of risk factors, endoscopic characteristics, and severity in patients with acute esophageal variceal bleeding

Thu, 30 Apr 2026 00:00:00 +0700

Background: Upper gastrointestinal bleeding (UGIB) is a medical and surgical emergency with a poor prognosis. Upper gastrointestinal endoscopy remains the gold standard for diagnosing esophageal variceal. However, the integration of risk factors, clinical and endoscopic findings plays a crucial role in formulating treatment strategies, prognostication, and preventing rebleeding in patients with Upper gastrointestinal bleeding. Subjects and methods: A cross-sectional study conducted on 38 patients with Acute esophageal variceal Bleeding at the Gastrointestinal Endoscopy Center, Hue University of Medicine and Pharmacy Hospital from November 2023 to November 2024. Results: Melena was the most common symptom in patients with Acute esophageal variceal bleeding. Grade III esophageal variceal were the most common endoscopic finding, present in 65.9% of patients. Other endoscopic findings included: cherry red spots: 57.8%; red wale marks: 26.3%; diffuse redness: 8.1%; blood blisters: 7.8%. Lower platelet counts were associated with more severe gastrointestinal bleeding. Grade III esophageal variceal and red wale marks were the most common findings across all severity of gastrointestinal bleeding. Conclusion: Acute esophageal variceal bleeding is a life-threatening complication with high mortality. Risk factors such as medical history, hemoglobin levels, platelet counts, and endoscopic characteristics are related to the extent of bleeding for these patients.

Association between serum sclerostin levels and chronic kidney disease–mineral and bone disorders in hemodialysis patients

Vo Thi Hoai Huong, Nguyen Hoang Thanh Van, Phan Thi Minh Phuong — Thu, 30 Apr 2026 00:00:00 +0700

ABSTRACT

Objective: (1) To evaluate the mineral and bone disorders, bone mineral density, and serum sclerostin levels in patients with chronic kidney disease undergoing maintenance hemodialysis, compared with a healthy control group with normal renal function. (2) To evaluate the relationship between serum sclerostin concentration and CKD – Mineral and Bone disorders (CKD-MBD) in hemodialysis patients.

Patients and methods: This is a cross-sectional descriptive study on 51 CKD hemodialysis patients at the Department of Nephrology - Musculoskeletal, Hue Central Hospital and 60 healthy people with normal kidney function regularly came for health check-ups at the Internal Medicine Clinic of Hue University of Medicine and Pharmacy from April 2023 to 2025.

Results: The study population in our research consisted of two groups: a control group comprising 60 individuals, including 25 males and 35 females, with a mean age of 49.27 ± 10.98; and a G5HD group including 31 males and 20 females, with a mean age of 47.92 ± 14.88. The difference in age between the two groups was not statistically significant (p>0.05). The mean serum calcium (adjusted for serum albumin), phosphorus, and PTH concentrations in 52 patients undergoing hemodialysis in the study were 2,330 ± 0.218 mmol/l; 2,034 ± 0.588 mmol/l, and 711,318 ± 905,620 pg/dL, respectively. In terms of blood calcium disorders, 11.76% of patients had hypocalcemia and about 1/5 had hypercalcemia. Our study found that 86.27% had hyperphosphatemia and more than 90% of G5HD patients had increased serum PTH levels. Regarding bone density in the G5HD group, the mean BMD at the femoral neck, total femur, and lumbar spine were 0.820 ± 0.221; 0.840 ± 0.194 and 1.003 ± 0.194 g/cm², respectively. The mean serum sclerostin concentration in the control group of our study was 359.52 ± 168.21 pg/mL. The G5HD groups exhibited significantly higher serum sclerostin level compared to the control group (p < 0.05); the mean concentrations was 937.152 ± 881.105 pg/ml. Serum sclerostin concentrations in hemodialysis patients were significantly negatively correlated with serum PTH and bone mineral density at the femoral neck and total hip (p<0.05).

Conclusion: In conclusion, according to our study, CKD-MBD are common in patients with end-stage renal disease undergoing maintenance hemodialysis. Serum sclerostin levels were significantly higher in the hemodialysis group compared to healthy controls. Regarding the association between sclerostin and mineral-bone disorders as well as bone mineral density in hemodialysis patients, our findings demonstrate that serum sclerostin levels were significantly and inversely correlated with PTH levels and bone mineral density at the femoral neck and total hip.

Psychometric properties of the Vietnamese SDM-Q-9 for measuring patient-perceived shared decision-making in primary care

Thu, 30 Apr 2026 00:00:00 +0700

Background: Shared decision-making (SDM) is a core component of patient-centred chronic disease care, yet little is known about how to measure patient-perceived SDM in Vietnamese primary care. This study evaluated the psychometric properties of the Vietnamese version of the 9-item Shared Decision-Making Questionnaire (SDM‑Q‑9) among adults with chronic diseases. Methods: A cross-sectional survey was conducted among patients receiving ongoing care for chronic conditions at the Family Medicine Centre, Hue University of Medicine and Pharmacy, in 2025. The SDM‑Q‑9 was translated and culturally adapted using forward-backwards translation and cognitive debriefing. Internal consistency was assessed using Cronbach’s alpha and corrected item-total correlations. Structural validity was examined using confirmatory factor analysis (CFA). Construct validity was evaluated through known-group analyses based on clinical characteristics and patient-reported experiences of consultation. Results: The Vietnamese SDM‑Q‑9 showed good internal consistency (Cronbach’s alpha = 0.81); corrected item–total correlations ranged from 0.30 to 0.68, and removing any item did not improve alpha. Early-stage SDM items showed lower factor loadings (0.32) and floor effects, whereas later-stage items demonstrated higher loadings (≥0.63) and ceiling effects. The CFA showed a poor fit for the original one-factor model (χ²/df = 10.67, RMSEA = 0.22, CFI = 0.63), and alternative models showed partial improvement (with the highest CFI of 0.73), but did not meet the conventional criteria. SDM-Q-9 scores differed by consultation-related experiences (all p < 0.01) but not by disease duration, disease control, or medication adherence (all p > 0.05). Conclusions: The Vietnamese SDM‑Q‑9 demonstrates acceptable reliability and construct validity for assessing patient-perceived SDM in chronic disease management in primary care. The findings support retaining all nine items to preserve conceptual completeness and international comparability. Further validation in larger and more diverse samples is warranted to strengthen evidence for its broader application in research, education, and quality improvement.

Factors associated with the severity of positive and negative symptoms in inpatients with schizophrenia in Vietnam: A Cross-sectional Study

Thu, 30 Apr 2026 00:00:00 +0700

Background: Schizophrenia is a complex, debilitating disorder imposing a substantial global burden. Its symptomatic heterogeneity has prompted a shift from traditional subtypes towards a dimensional understanding, validating the positive-negative dichotomy as two core domains with divergent neurobiological substrates. While this structure is established, the specific clinical, functional, and sociodemographic factors modulating each domain’s severity can vary across populations. In Vietnam, despite schizophrenia being a significant public health concern, a critical gap exists. There is a lack of comprehensive investigations concurrently examining a broad range of associated factors for both symptom domains in an inpatient setting.
Objectives: To identify factors independently associated with the severity of positive and negative symptoms among inpatients with schizophrenia in Vietnam.
Materials and methods: A cross-sectional study was conducted with 121 inpatients (ICD-10 diagnosis) at Hue Psychiatric Hospital from September 2024 to April 2025. Data were collected on sociodemographic, clinical, and functional characteristics. Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS). Cognitive and social functioning were measured with the Mini-Mental State Examination (MMSE) and Social Functioning Questionnaire (SFQ), respectively. Two separate multiple linear regression models were constructed to identify independent associated factors for PANSS positive and negative subscale scores.
Results: The model for positive symptoms demonstrated a modest fit (Adjusted R² = .126, p < 0.001), identifying general polypharmacy (≥ 3 medications) as the sole independent factor associated with higher severity. The model for negative symptoms demonstrated a substantial fit (Adjusted R² = .392, p < 0.001), where higher severity was independently associated with lower cognitive (MMSE) scores, poorer social functioning, and the absence of substance use history.
Conclusion: The determinants of positive and negative symptoms in schizophrenia are markedly distinct. Positive symptoms were primarily associated with clinical-diagnostic features and treatment complexity, while negative symptoms were strongly linked to cognitive and functional impairments. These findings highlight the need for personalized, dimension-specific therapeutic strategies to improve patient outcomes in Vietnam.

A survey of oral hygiene status (OHI-S) and its association with white spot lesions among University of Medicine and Pharmacy, Hue University students wearing fixed orthodontic appliances

Thu, 30 Apr 2026 00:00:00 +0700

Background: Fixed orthodontic appliances hinder oral hygiene maintenance, promote the development of white spot lesions (WSLs), and impose a significant risk on the dentition.
Objective: to evaluate the prevalence and association of oral hygiene status and WSLs among orthodontic patients attending orthodontic departments at Hue University.
Methods: A cross-sectional study was conducted in 2024 on 100 students from the University of Medicine and Pharmacy, Hue University, undergoing fixed orthodontic treatment. Data were collected through clinical assessment of patients’ enamel damage index (WSLs) (International Caries Detection and Assessment System, ICDAS) and oral hygiene status (Simple Oral Hygiene Index, OHI-S).
Results: Among 100 orthodontic patients (mean OHI-S: 1.32 ± 1.39), 48% had fair, 30% had poor, 22% had good hygiene, with no cases of excellent hygiene. The prevalence of WSLs was 44.0%. Female had lower OHI-S scores (1.28 ± 1.38 vs. 1.45 ± 1.43) and a lower of WSLs prevalence (40.79% vs. 54.17%) than males. There were moderate positive correlations of OHI-S and WSLs (r = 0.27, p = 0.0053) and treatment duration (r = 0.35, p = 0.03). Treatment duration had a strong, positive correlation with WSLs (r = 0.72, p = 0.0000).
Conclusions: Among orthodontic patients, there were high prevalence of poor to fair oral hygiene with high occurrent of WSLs. Female had better oral health status and lower occurrence of WSLs. Poor oral hygiene and longer treatment duration was associated with a higher prevalence of WSLs.

Prognostic value of pretreatment anemia in patients with diffuse large B-cell lymphoma treated with R-CHOP

Nguyen Thi Thuy, Nguyen Thi Linh, Phan Minh Tri, Phan Thi Do Quyen — Thu, 30 Apr 2026 00:00:00 +0700

ABSTRACT

Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. While R-CHOP is the standard of care, treatment failure remains a challenge. Pretreatment anemia is a common paraneoplastic manifestation, yet its prognostic utility in Vietnamese patients remains under-investigated.

Materials and Methods: A combined prospective and retrospective study was conducted on 106 patients with CD20-positive DLBCL treated with first-line R-CHOP at Hue University of Medicine and Pharmacy Hospital, Hue Central Hospital and Da Nang Oncology Hospital from December 2022 to August 2025. Pretreatment anemia was classified according to NCI-CTCAE v5.0. Clinicopathological features, toxicity, treatment response, and survival were analyzed.

Results: The prevalence of pretreatment anemia was 32.1%, with the majority being Grade 1 (26.4%). Anemia was significantly associated with B symptoms (p=0.034) and older age (p=0.039). Regarding efficacy, non-anemic patients had approximately 12 times higher odds of responding (Odds Ratios = 11.897; 95% CI: 1.33–106.34, p = 0.014). Toxicity analysis showed a 3.8% treatment-related mortality rate due to severe infections. There was no statistically significant difference in overall survival or progression-free survival (p > 0.05).

Conclusion: Pretreatment anemia is a robust and easily accessible predictor of poor early treatment response in Vietnamese patients with DLBCL treated with R-CHOP. Anemic patients have significantly lower odds of achieving remission. While long-term survival benefits were obscured by treatment-related toxicity in this cohort, the strong link between hemoglobin levels and therapeutic efficacy suggests that anemia should be integrated into risk stratification.

Association between oral health and quality of life among primary school students in Hue city, Vietnam

Nguyen Thi Nhat Vy, Nguyen Gia Kieu Ngan — Thu, 30 Apr 2026 00:00:00 +0700

Background: Oral health problems, especially dental caries, remain highly prevalent among children and reduce quality of life.
Objectives: This study assessed oral health status and oral health-related quality of life (OHRQoL) among Vietnamese primary school children and examined its associations with clinical factors.
Materials and method: A cross-sectional study was conducted among 343 children aged 8-11 years at a Hue City elementary school. Participants completed the Child Perceptions Questionnaire (CPQ) to evaluate OHRQoL across four domains: oral symptoms, functional limitations, emotional well-being, and social well-being. Clinical examinations measured dental caries (DT+dt), missing teeth (MT+mt), and oral hygiene (OHI-S). Data were analyzed using descriptive statistics, t-tests, ANOVA, and multivariate linear regression.
Results: The sample comprised 180 females (52.5%) and 163 males (47.5%). Mean DT+dt was 6.5 ± 3.9, MT+mt 0.2 ± 0.6, and OHI-S 1.5 ± 0.7. The total CPQ score was 13.6 ± 11.9, with no significant gender differences but increasing scores with age (significant in emotional well-being, p = 0.042). Regression analysis showed DT+dt (β = 0.50, p < 0.01), MT+mt (β = 2.54, p < 0.05), and OHI-S (β = 2.75, p < 0.01) as significantly associated with total CPQ scores, with domain-specific effects strongest in emotional and social well-being.
Conclusion: Clinical oral health factors are strongly associated with OHRQoL among Vietnamese primary school children, particularly a high burden of untreated dental caries and poor oral hygiene.

CagL amino acid sequence polymorphism of Helicobacter pylori in Vietnamese patients with gastroduodenal diseases

Tran Ha Duy Khang, Nguyen Thi Mai Ngan, Thai Thi Hong Nhung, Pham Van Linh — Thu, 30 Apr 2026 00:00:00 +0700

Background: H. pylori CagA protein plays the most critical pathogenesis role of gastroduodenal diseases. CagA translocation is dependent on the CagL protein encoded by the cagL gene. Objectives: This study aimed to investigate CagL amino acid sequence polymorphisms of H. pylori and its associations with gastroduodenal diseases. Materials and methods: The cagL partial nucleotide sequences of 72 H. pylori strains from Vietnamese patients with gastroduodenal disorders were investigated via Sanger sequencing, then were translated into amino acid sequences. Results: The findings showed nine variants of amino acid polymorphism within the CagL hypervariable motif at residues 58–62, in which the DEIGK variant was the most prevalent, accounting for 40.28%, the DKIGK variants represented 30.56%, both DKMGE and DTTGE variants accounted for 8.33%. The five remaining variants, including YEIGK, NEIGQ, NKIGQ, DEIGQ and DTIGK, had low frequencies (1.39–4.17%). Notably, we observed a novel amino acid sequence polymorphism pattern at residues 140-144 with four variants as EAELQ, EGKLK, LGKLK, and EAKLQ, which accounted for 61.11%, 30.56%, 5.56%, and 2.78%, respectively. Stratifying gastroduodenal diseases, the EAELQ variant rates in the gastric cancer and precancerous lesions groups were 86.67% and 70%, respectively, whereas those in the non-atrophic gastritis and peptic ulcers groups were only 47.37% and 44.44%, respectively. The difference in these rates was statistically significant (p=0.038). Conclusion: This preliminary study highlighted the genetic diversity of the H. pylori cagL gene, revealing distinct polymorphism patterns unique to Vietnam. The EAELQ variant at CagL residues 140–144 may serve as an indicator of gastric cancer risk.

Imaging characteristics of lumbar spine lesions and their associations in patients with axial spondyloarthritis

Nguyen Hoang Minh, Nguyen Hoang Thanh Van, Le Thi Hong Van — Thu, 30 Apr 2026 00:00:00 +0700

Background: Axial spondyloarthritis (axSpA) is a chronic inflammatory disease with heterogeneous clinical manifestations. Lesions of the sacroiliac joints and the lumbar spine play an important role in functional limitation in patients with axial spondyloarthritis. Therefore, this study aimed to evaluate lumbar spine lesions on imaging and to investigate their associations with clinical characteristics and disease activity.
Methods: A cross-sectional descriptive study was conducted on 45 patients with axial spondyloarthritis treated at the Department of General Internal Medicine – Endocrinology – Rheumatology, Hue University of Medicine and Pharmacy Hospital, from 2/2023 to 8/2024.
Results: A total of 73.3% of patients had an ASDAS-CRP score > 3.5, indicating very high disease activity. On radiography, abnormalities related to lumbar spine involvement were observed in 6/32 cases, among which 5 cases showed tangential osteophytes and Romanus lesions, accounting for 15.6%. Active lesions of the lumbar spine on MRI were detected in 13/45 patients (28.9%), with vertebral corner inflammation being the most common finding. Age, disease duration, CRP levels, BASDAI, and ASDAS-CRP were significantly associated with the number of lesions detected on MRI.
Conclusion: Lumbar spine lesions on MRI were identified in 28.9% of patients with axial spondyloarthritis, with a median disease duration of 2 years. Only 6/32 cases showed abnormalities related to axial spondyloarthritis on X-ray. Lumbar spine involvement was associated with age, disease duration, CRP levels, and disease activity indices including BASDAI and ASDAS-CRP.

Molecular biological effects of led-based photobiomodulation therapy on bone regeneration: a systematic review

Thu, 30 Apr 2026 00:00:00 +0700

Background:

Bone regeneration is essential for dental procedures such as implant integration and orthodontic movement. Photobiomodulation (PBM), particularly using light-emitting diode (LED), has emerged as a promising non-invasive method to enhance bone healing, though its molecular mechanisms remain unclear and findings across studies are inconsistent. This systematic review aims to synthesize current evidence on the molecular effects of LED-based PBM on bone regeneration, focusing on bone formation and resorption.

Materials and method:

A systematic review was conducted following PRISMA 2020 guidelines. Literature searches were performed in PubMed and ScienceDirect up to November 10, 2024. Studies included full-text original research evaluating molecular effects of LED-PBM on bone compared to non-irradiated controls. Risk of bias was assessed using the QUIN tool for in vitro studies and SYRCLE for in vivo studies.

Results:

Out of 4646 articles, 16 met the eligibility criteria. Risk of bias was moderate to low overall, with some methodological limitations noted, particularly in blinding and allocation procedures. Wavelengths ranged from 405 to 830 nm, with red light being the most frequently used. Most studies reported increased expression of key osteogenic markers (ALP, RUNX2, OCN, OPN), improved calcium deposition, and modulation of inflammatory and signaling molecules ( ROS, ATP).

Conclusion:

This review confirms that LED-PBM promotes bone regeneration by upregulating key osteogenic markers and signaling pathways, offering a molecular basis for protocol refinement in dental applications.

In vitro and in silico evaluation of monoacylglycerol lipase inhibitory activity of apigenin carbamate derivatives

Tran The Huan, Cao Thị Cẩm Nhung, Nguyễn Thanh Bích Châu, Trần Thành Đạo — Thu, 30 Apr 2026 00:00:00 +0700

Background: Monoacylglycerol lipase (MAGL) is a key enzyme in the endocannabinoid system, involved in multiple physiological and neurological processes. Developing MAGL inhibitors from semi-synthetic flavonoid scaffolds such as apigenin carbamates offers a promising approach.
Objectives: This study aimed to evaluate the MAGL inhibitory activity of semi-synthetic apigenin carbamate derivatives using integrated in vitro and in silico approaches.
Materials and Methods: Four apigenin carbamate derivatives synthesized from natural apigenin were tested for MAGL inhibition using a 4-nitrophenyl acetate hydrolysis assay. Binding affinity and complex stability were investigated through molecular docking and molecular dynamics simulations.
Results: Compounds A1 and A3 demonstrated improved MAGL inhibitory potency (IC50 33.04 and 40.60 µM, respectively) over apigenin, with favorable predicted binding affinities and stable interactions in the enzyme active site. Molecular dynamics simulations indicated that A1 maintained greater conformational stability, whereas A3 formed more frequent hydrogen bond interactions.
Conclusion: Apigenin carbamate derivatives, particularly A1 and A3, are promising semi-synthetic leads for MAGL inhibitor development.

Chemical composition and biological activities of the leaves essential oil of Alphonsea monogyna collected in Hue city

Hoang Xuan Huyen Trang, Le Thi Truc, Dinh Dien, Doan Quoc Tuan — Thu, 30 Apr 2026 00:00:00 +0700

Background: Alphonsea monogyna (Roxb.) Hook.f. & Thomson belongs to the genus Alphonsea, distributed in Southeast Asian countries. Information on the chemical composition and biological properties of A. monogyna remains limited. This study aimed to investigate the chemical composition of the leaf essential oil of A. monogyna and evaluate its antioxidant, anti-inflammatory, and antibacterial activities.
Materials and Methods: The essential oil was extracted by hydrodistillation and analyzed by GC–MS. Antioxidant activity was assessed by the ABTS•⁺ assay, nitric oxide (NO) inhibition was determined in LPS-stimulated RAW 264.7 macrophages, and antibacterial activity was evaluated using the broth microdilution method.
Results: A total of 47 compounds were identified, accounting for 99.21% of the total oil, dominated by sesquiterpene hydrocarbons (50.99%) and oxygenated sesquiterpenes (36.84%). The main constituents were guaiol (13.48%), germacrene D (10.31%), bulnesol (9.85%), and bicyclogermacrene (8.26%). The essential oil exhibited moderate antioxidant activity (IC50 = 61.64 ± 1.13 µg/mL), significant NO inhibitory effect (IC50 = 56.35 ± 2.57 µg/mL), and selective antibacterial activity against Gram-positive bacteria (Staphylococcus aureus, Bacillus subtilis, Lactobacillus fermentum).
Conclusion: The essential oil of A. monogyna demonstrates promising antioxidant, anti-inflammatory, and antibacterial potentials, suggesting its value as a natural source of bioactive compounds for pharmaceutical applications.

Assessment of peripapillary retinal nerve fiber layer thickness in school-aged myopic eyes using optical coherence tomography

Tran Nguyen Tra My, Nguyen Thi Thu, Vo Tran Vy Khanh — Thu, 30 Apr 2026 00:00:00 +0700

Background: Myopia is a major global health challenge, projected to affect 50% of the world population by 2050, with over 60% prevalence in Asian school-aged children. Assessment of peripapillary retinal nerve fiber layer (pRNFL) thickness using optical coherence tomography (OCT) provides critical insights into myopia-associated structural alterations.
Objectives: To characterize refractive and biometric parameters, pRNFL in school-aged myopic children and identify factors associated with pRNFL.
Materials and Methods: This cross-sectional study examined 123 eyes of 74 myopic children aged 6-18 years. Comprehensive ophthalmic evaluation included visual acuity, cycloplegic refraction, axial length measurement, and spectral-domain OCT for pRNFL quantification. Statistical analysis assessed correlations between pRNFL parameters, spherical equivalent refractive error (SE), and axial length.
Results: Mean participant age was 11.46 ± 3.10 years, with mean SE of -3.35 ± 1.76 diopters and axial length of 24.92 ± 0.97 mm. Global mean pRNFL thickness was 102.75 ± 9.15 μm. Quadrant measurements showed superior 133.31 ± 18.59 μm, inferior 130.85 ± 15.25 μm, nasal 65.77 ± 13.07 μm, and temporal 81.11 ± 13.03 μm. Global pRNFL thickness demonstrated significant positive correlations with SE (p < 0.05) and negative correlations with axial length (p < 0.05).
Conclusions: This study establishes normative pRNFL values for Vietnamese school-aged myopic patients, revealing significant correlations between pRNFL thickness, refractive error, and axial length, providing evidence-based clinical monitoring references.

Clinical significance of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in breast cancer according to immunohistochemical subtypes and disease stage

Thu, 30 Apr 2026 00:00:00 +0700

Background: Systemic inflammation plays a pivotal role in breast cancer (BC) progression and has been increasingly recognized as an important component associated with tumor aggressiveness. Inflammatory indices derived from routine blood tests, particularly the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), reflect the balance between tumor-promoting inflammatory responses and host antitumor immune surveillance. Objectives: To evaluate changes in systemic inflammatory markers in BC patients compared with healthy controls and to analyze their associations with TNM stage and immunohistochemical (IHC) subtypes. Methods: A descriptive cross-sectional study was conducted at Hue University Hospital, enrolling 24 newly diagnosed, untreated female BC patients and 24 healthy women. Clinical characteristics, TNM staging, and immunohistochemical (IHC) profiles (ER, PR, HER2, Ki-67) were collected. Patients were classified into early-stage (TNM I–IIA) and late-stage disease (TNM IIB–IV). Based on IHC profiles, tumors were categorized into Luminal A, Luminal B, HER2-positive, and triple-negative breast cancer (TNBC), with Luminal A considered low-risk and non-Luminal A subtypes considered higher-risk. NLR and PLR were calculated from peripheral blood counts and compared between groups, across disease stages, and IHC-based risk categories. Results: BC patients exhibited significantly higher NLR and PLR than controls (P < 0.05). Both indices were significantly elevated in BC patients with advanced-stage (IIB–IV) compared with early-stage (I–IIA). Patients with high-risk IHC subtypes, particularly non-Luminal A tumors, showed significantly higher NLR levels than those with Luminal A tumors. In contrast, conventional tumor markers, including CEA, CA 15-3, and C-reactive protein, did not show statistically significant differences across TNM stages or IHC subtypes. Conclusion: NLR and PLR are closely associated with disease stage and immunohistochemical subtypes in breast cancer. As simple, low-cost, and readily available parameters, these indices may provide complementary information to conventional markers for initial risk stratification and clinical assessment in breast cancer patients.

Prevalence of osteoporosis in adults aged 50 and over at Hue University of Medicine and Pharmacy Hospital in 2025

Nguyen Hoang Thanh Van, Hoang Ngoc Dieu Tram, Le Huu Quyet, Truong Huu Hung — Thu, 30 Apr 2026 00:00:00 +0700

Background: Osteoporosis is the most commonly occurring bone disease and represents a major public health challenge. Fractures related to osteoporosis that are especially common in the elderly are associated with significant morbidity and high health costs.
Objectives: Survey on the prevalence of osteoporosis in adults over 50 visiting the hospital of Hue University of Medicine and Pharmacy and some factors associated with osteoporosis.
Materials and Methods: A descriptive cross-sectional study including 957 adults aged 50 and over at Hue University of Medicine and Pharmacy Hospital from January 1, 2025 to July 1, 2025.
Results: Osteoporosis in the lumbar spine, femoral neck and any proportion had respectively 42.8%, 12.9%; osteopenia in the lumbar spine, femoral neck had proportion of 30.4%, 37.8%, respectively. The overall prevalence of osteoporosis was 44.1% and the overall rate of osteopenia was 33.4%. The study found an association between several factors with osteoporosis: the prevalence of osteoporosis increased with age and was consistently higher in females than males, regardless of skeletal sites (p < 0.05).
Conclusion: In Vietnam, the overall rate of osteoporosis in adults over 50 is relatively high and the rate of osteoporosis in the lumbar spine is higher than that in the femoral neck. Osteoporosis was associated with age and sex.

The efficacy of limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation for removal of common bile duct stones in elderly patients

Vinh Khanh, Nguyen Van Thinh — Thu, 30 Apr 2026 00:00:00 +0700

Background: Bile duct stones are prevalent in tropical regions, including Vietnam, and can lead to serious complications such as cholangitis, septic shock, and mortality. The treatment of common bile duct (CBD) stones through endoscopic retrograde cholangiopancreatography (ERCP) has significantly enhanced the management of bile duct stones, resulting in reduced complications and facilitating quicker recovery, particularly in elderly patients. Methods: This study is a cross-sectional descriptive analysis involving follow-up on 34 patients (≥ 60 years) diagnosed with common bile duct (CBD) stones who underwent ERCP. Results: The stone clearance rate was 97.1%. Larger stones (≥ 20mm) had a lower success rate than smaller stones. The overall complication rate was 14.7%, with the most common being self-limiting bleeding after Oddi sphincterotomy. The average hospital stay after ERCP was 5.53 ± 3.33 days. Conclusion: Limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation during ERCP is a minimally invasive, effective, and safe technique for elderly patients with CBD stones.

Clinical and histopathological characteristics of soft tissue tumours at Hue University of Medicine and Pharmacy Hospital

Nguyen Van Mao, Tran Van Bao, Tran Thi Nam Phuong, Tran Nam Dong — Thu, 30 Apr 2026 00:00:00 +0700

ABSTRACT

Background: Soft tissue tumors represent a relatively common and heterogeneous group of lesions characterized by diverse yet nonspecific clinical manifestations. Although histopathology remains the diagnostic gold standard, the application of advanced techniques such as immunohistochemistry is indispensable to ensure the accurate diagnosis with the latest WHO classification. Objectives: (1) To describe clinical characteristics and the histopathological classification of soft tissue tumors. (2) To evaluate the expression of immunohistochemical markers in soft tissue tumors. Materials and methods: A cross-sectional study was conducted on 166 patients diagnosed with soft tissue t umors between 04/2025 and 01/2026 at Hue University of Medicine and Pharmacy Hospital. Results: Malignant soft tissue tumors accounted for 21.1% of cases. The majority presented with a single lesion (91.6%), most commonly located in the superficial trunk (34.4%). Tumors smaller than 5 cm comprised 68.1% of cases. Adipocytic tumors were the most frequent (42.8%). Lipoma and hemangioma were predominant in the benign group (53,4% and 15,5%), fibrohistiocytoma in the borderline group (61,5%), and fibrosarcoma in the malignant group (22,7%). Immunohistochemistry revealed the expression of characteristic markers that supported the diagnostic classification, Vimentine (+) 100%, Desmine (+) 5/5 cases and SMA (+) 3/5 cases for smooth tumours, CD68 (+) 100% for fibrohistiocytic tumours, CD34 (+) for vascular and the other tumours.. Conclusion: Malignant soft tissue tumors accounted for 21.1% of cases. Besides histopathology, immunohistochemistry revealed the expression of characteristic markers that supported the key role for the classification of tumour types.

Keywords: soft tissue tumours, histopathology, clinical characteristics, immunohistochemistry

Relationship between serum Sclerostin concentration and 6-minute walking distance and ABE groups in patients with Chronic obstructive pulmonary disease

Thu, 30 Apr 2026 00:00:00 +0700

Objectives: (1) Describe the clinical and paraclinical characteristics of patients with chronic obstructive pulmonary disease (COPD), (2) Investigate serum Sclerostin concentration and its relationship and correlation with 6-minute walking distance, symptom groups and ABE groups in patients with COPD. Materials and methods: Cross-sectional study on 43 patients with COPD admitted to the Department of Internal Medicine - Endocrinology - Rheumatology, Hue University of Medicine and Pharmacy Hospital, and the Department of Endocrinology - Pulmonology, Hue Central Hospital from July 2024 to June 2025. Results: The average age and BMI of the study group were 62.58 ± 8.05 years and 20.92 ± 3.01 kg/m2, respectively. Patients in the study group smoked 36.77 ± 18.83 packs/year. The proportion of patients in the GOLD I, II, III and IV groups were 2.3%, 58.1%, 27.9% and 14.0%, respectively. The average number of acute episodes was 1.24 ± 2.03 acute episodes/year. 58.1% of patients were in the multiple symptoms group and 41.9% of patients were in the few symptoms group. In addition, the proportions of patients in groups A, B and E were 25.6%, 34.9% and 39.5%, respectively. Serum sclerostin concentration in group E was statistically significantly lower than that in groups A and B (p < 0.05). The area under the ROC curve (AUC) of serum sclerostin concentration to predict stage E was 0.774 (p < 0.001). With a cut-off point ≤ 6.330 pmol/l, serum sclerostin concentration was able to predict stage E with a sensitivity of 88% and a specificity of 69% (95%CI: 1.57 – 5.24). There was a positive correlation between serum sclerostin concentration and 6-minute walk distance (r = 0.305, p < 0.05). Conclusion: Serum sclerostin concentration is a prognostic factor for disease stage and exercise capacity in patients with COPD.

Clinical features, biological characteristics and prognostic factors in patients with pancreatic cancer

Trinh Pham My Le, Ho Dang Quy Dung, Tran Dinh Tri, Tran Van Huy — Thu, 30 Apr 2026 00:00:00 +0700

Abstract

Background: Pancreatic cancer is a rapidly progressive disease with a low 5-year survival rate, an increasing incidence, and substantial difficulty in diagnosis at the early stages. Detecting suspected cases of pancreatic cancer to send patients for imaging tests and take samples for histopathology is an extremely important issue. The objectives of this study were: (1) Characterize the clinical and biological features of patients with pancreatic cancer; and (2) Evaluate overall survival and identify prognostic factors associated with mortality.

Subjects and Methods: This was a prospective descriptive study conducted in patients with suspected pancreatic cancer who underwent endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) at the Endoscopy Department, Cho Ray Hospital.

Results: A total of 89 patients were diagnosed with pancreatic cancer. Abdominal pain was the most frequent presenting symptom (92.1%). Hyperglycemia at the time of diagnosis was observed in 57.3% of patients. Elevated CA19-9 and CEA levels were found in 80.9% and 44.9% of cases, respectively. The mean overall survival from diagnosis was 4.44 ± 2.62 months. Patients receiving chemotherapy had significantly longer overall survival compared with those receiving non-specific treatment (P<0.001). Tumor size, vascular invasion, and distant metastasis were identified as independent prognostic factors for mortality (P<0.05).

Conclusions: The clinical presentation of pancreatic cancer is generally nonspecific, with abdominal pain being the most common symptom. Tumor size, vascular invasion, and distant metastasis are independent prognostic factors in patients with pancreatic cancer.

Research on the relationship between markers of iron metabolism in patients with hypochromic microcytic anemia

Thu, 30 Apr 2026 00:00:00 +0700

Background: Hypochromic microcytic anemia (HMA) is a common condition with serious consequences if not detected and treated promptly. Hematological tests and biochemical indicators assessing iron metabolism help to identify the causes of HMA, especially iron deficiency anemia (IDA), hemoglobinopathy (HGP) and anemia of chronic disease (ACD).
Objective: To determine several indicators assessing iron metabolism in HMA.
Subjects and methods: A cross-sectional study was conducted on 168 patients with HMA who visited and received treatment at Hue University of Medicine and Pharmacy Hospital from January 2025 to January 2026, with three groups of causes including IDA, HGP and ACD.
Results: The clinical manifestations of HMA were diverse. The most common symptom was pallor (48.2%), followed by fatigue (47.6%), anorexia (31.0%), dyspnea (19.0%). The cut-off values of serum iron, ferritin, transferrin saturation (TfS), unsaturated iron binding capacity (UIBC) in the prediction of HMA were 47.7 μg/dL, 112.7 μg/L, 13.7%, 50.0 μmol/L, respectively. The cut-off values of transferrin and TfS in the prediction of HGP were 274.5 mg/dL and 6.5%, respectively. Transferrin was an independent predictor of HGP and ACD, while serum iron and TfS were independent predictors of ACD.
Conclusions: Patients with HMA exhibited heterogeneous clinical manifestations. Serum iron, ferritin, TfS, and UIBC were useful predictors of HMA. Transferrin independently predicted HGP and ACD, whereas serum iron and TfS independently predicted ACD.

Evaluating the surgical outcomes of distal radius fractures treated with locking plate fixation at Hue University of Medicine and Pharmacy Hospital

Tran Nhat Tien, Le Phuong Thao, Le Hong Phuc — Thu, 30 Apr 2026 00:00:00 +0700

Background: Distal radius fractures are among the most common fractures, particularly in older adults following a fall onto an outstretched hand, and are associated with impaired wrist function and reduced quality of life. Open reduction and internal fixation using locking plates provides stable fixation, limits secondary displacement, and facilitates earlier functional recovery.
Objective: To evaluate the surgical outcomes of distal radius fractures treated with locking plate fixation at Hue University of Medicine and Pharmacy Hospital.
Materials and Methods: This prospective longitudinal study included 42 patients who underwent surgical fixation of distal radius fractures using locking plates at Hue University of Medicine and Pharmacy Hospital between March 2023 and June 2025.
Results: Most patients were older than 60 years, and females accounted for 71.4% of the cohort. The predominant injury mechanism was low-energy domestic falls, with AO/OTA fracture types B3 and C2 being the most common. Radiographic parameters assessed using the Scheck criteria showed significant postoperative improvement. At 6 months, functional outcomes assessed by the Green and O’Brien score were rated as good or excellent in 97.6% of patients. According to the QuickDASH score, the majority of patients had returned to normal function at 6 months (88.1%). No major postoperative complications were recorded. However, neither upper extremity functional recovery (QuickDASH or Green & O’Brien scores) nor postoperative anatomical restoration on radiographs differed significantly among fracture types classified according to the AO system.
Conclusion: Surgical treatment of distal radius fractures using locking plate fixation yields favorable functional outcomes with a low complication rate.

Evaluation of awareness, attitudes, and satisfaction levels of families of children with unilateral complete cleft lip and palate treated with nasal alveolar molding appliances

Thu, 30 Apr 2026 00:00:00 +0700

Background: Cleft lip and palate (CLP) significantly impacts aesthetics, function, and the psychological well-being of both the child and their family. Presurgical orthopedics, particularly the Nasoalveolar Molding (NAM) appliance, it reduces the width of the lip cleft, improves nasal symmetry, and enhances feeding function for the child. This study aims to evaluate the awareness, attitudes, and satisfaction levels of families of children with unilateral complete CLP treated with NAM appliances, providing insight into the psychosocial benefits of this therapy.
Materials and methods: A descriptive cross-sectional study was conducted on 31 parents or caregivers of children diagnosed with unilateral complete CLP. Participants were recruited from Hue University of Medicine and Pharmacy Hospital and Nghe An Obstetrics and Pediatrics Hospital between February 2022 and September 2024. Data on demographics, awareness, attitudes, and satisfaction were collected using a structured questionnaire administered through direct interviews after the completion of NAM therapy.
Results: Among the 31 infants, none were able to breastfeed at birth. After the first day of NAM appliance placement, 30 infants (96.8%) were able to bottle-feed successfully. All parents believed that NAM improved their child’s appearance and considered the orthodontist a key member of the CLP care team. Majority (96.8%) recognized that NAM improved feeding. However, 67.7% of families reported that their quality of life was affected by having a child with CLP. Regarding attitudes, 77.4% of families felt the infant experienced discomfort during the impression-taking process, yet 96.8% found the treatment useful for the child and 19.4% found frequent follow–up appointments to be time–consuming or inconvenient. Nonetheless, all were willing to encourage other parents to use NAM before surgery. The overall satisfaction rate was high, with 74.2% of families reporting being “completely satisfied” with the treatment results.
Conclusion: These findings underscore the importance of incorporating NAM into CLP care protocols and providing comprehensive support to families throughout the treatment process.

Mechanistic study of betulinic acid extraction from Tetracera scandens (L.) Merr. using bio-based solvents: molecular interactions, α-glucosidase docking, and solvent cytotoxicity

Le Trong Nhan, Tran The Huan, Nguyen Hoai — Thu, 30 Apr 2026 00:00:00 +0700

Background: Betulinic acid (BA) is a poorly water-soluble triterpenoid, limiting its extraction efficiency from medicinal plants and motivating the use of bio-based solvents (BioSs). Objectives: This study aimed to elucidate the extraction mechanism of BA from Tetracera scandens using pentane-1,2-diol (PED) and hexane-1,2-diol (HED), to provide molecular-level insight into the potential interaction of BA with α-glucosidase using docking simulations, and to assess the cytotoxicity of the solvents. Materials and methods: Solvent–solute interactions were investigated using quantum chemical calculations. Molecular docking simulations with α-glucosidase were performed, and the cytotoxicity of the solvents was evaluated on HEK-293A cells. Results: PED and HED exhibited favorable interactions with BA, contributing to improved extraction efficiency. Molecular docking results indicated stable binding of BA to α-glucosidase. Both BioSs did not exhibit cytotoxic effects toward normal human cells. Conclusion: PED and HED are promising BioSs for the extraction of BA, and the proposed solvent system demonstrates appropriate mechanistic relevance and safety for potential applications.

Development and validation of an HPLC method for the quantification of strychnine in Strychnos wallichiana Steud. ex DC.

Nguyen Viet Khan, Truong Tieu Bang, Le Anh Khoa, Chu Thi Huong, Dao Thi Cam Minh — Thu, 30 Apr 2026 00:00:00 +0700

Abstract

Background: Strychnos wallichiana Steud. ex DC. is a medicinal plant, in which strychnine exhibits strong biological activity but also carries high toxicity. Accurate quantification of strychnine in this medicinal plant is essential to ensure safe usage, particularly in research and medical applications. The objective of this study is to develop and validate a method for the quantification of strychnine in S. wallichiana using HPLC. Materials and methods: S. wallichiana samples were collected from Nghe An province. Strychnine was extracted from the plant material and analyzed using high-performance liquid chromatography (HPLC). Method validation was performed in accordance with analytical guidelines. Results: The chromatographic conditions include an ACN:buffer system (H₃PO₄ 0.3% + (C₂H₅)₃N 0.2%) in a 12:88 ratio and a flow rate of 0.5 mL/min on an InertSustain™ C18 column (4.6 x 250 mm; 5 μm), and a detection wavelength of 263 nm. The analytical method demonstrated system suitability and high specificity, with a wide linear range and reliable accuracy and precision. Conclusion: The developed HPLC method meets the required standards for the quantification of strychnine in S. wallichiana medicinal plant material.

Evaluation of early outcomes of surgical fixation in metacarpal and phalangeal fractures

`Dang Le Hoang Nam, Nguyen Ba Luu, Le Nghi Thanh Nhan — Thu, 30 Apr 2026 00:00:00 +0700

Background: Metacarpal and phalangeal fractures are common injuries of the upper extremity. Surgical treatment allows accurate reduction, stable fixation, and early functional rehabilitation. Various fixation techniques have been applied, including Kirschner wire (K-wire) fixation, intramedullary fixation, external fixation, mini-plate and screw fixation, or combinations thereof. To further clarify treatment outcomes of metacarpal and phalangeal fractures, we conducted the study entitled “Evaluation of surgical outcomes in metacarpal and phalangeal fractures.”

Materials and Methods: This prospective descriptive study included 33 patients with metacarpal and/or phalangeal fractures indicated for surgical fixation using mini-plates and screws or Kirschner wires at the Department of Orthopedic Trauma and Thoracic Surgery, Hue University of Medicine and Pharmacy Hospital. Clinical, radiographic characteristics and treatment outcomes were assessed at 3 months postoperatively using the ASSH scoring system.

Results: The mean age was 39.16 years; the male-to-female ratio was 2.67:1. At 3 months, radiographic bone union was achieved in 94.7% of cases, while delayed union occurred in 5.3%. According to ASSH criteria, range-of-motion outcomes were excellent in 63.2%, good in 34.2%, and fair in 2.6% of cases. The mean total active motion (TAM) at 3 months postoperatively was 231.27 ± 9.96°.

Conclusion: With a low complication rate and favorable early functional recovery, surgical fixation is an effective treatment for metacarpal and phalangeal fractures, helping to avoid joint stiffness commonly associated with prolonged cast immobilization.

Body Composition and Bone Mineral Density in Patients with Spondyloarthritis: A Case-Control Study

Nguyen Hoang Thanh Van, Nguyen Dinh Huan — Thu, 30 Apr 2026 00:00:00 +0700

Objectives: This study aimed to investigate the relationship between bone mineral density (BMD) and various body composition parameters in Vietnamese patients with SpA.

Methods: A case-control study was conducted at Hue University of Medicine and Pharmacy University Hospital, Vietnam, involving 43 patients with SpA and 71 age-, sex-, and BMI-matched healthy controls. Dual-energy X-ray absorptiometry (DXA) was used to assess body composition, measuring BMD and Z-scores at the lumbar spine, femoral neck, and total hip. Additional parameters included muscle mass index (appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), body fat percentage (BF%), and fat mass index (FMI). Multivariable linear regression models were used to analyze the associations between BMD and body composition variables, with mean differences and 95% confidence intervals calculated.

Results: SpA patients had significantly reduced BMD in the lumbar spine and total hip compared to the healthy control group. Furthermore, significant positive correlations were observed between femoral neck BMD and both ASM (r=0.304, p=0.047) and ASMI (r=0.319, p=0.037), as well as between total hip BMD and ASMI (r=0.307, p=0.045).

Conclusions: The findings highlight the importance of monitoring BMD in patients with SpA due to the observed bone loss. Further research is warranted to fully elucidate the complex interplay between inflammation, body composition, and bone health in SpA.

Evaluating the Fisher,s technique for unilateral complete cleft lip repair: A critical literature review

Huynh Thi Le Chau, Tran Tan Tai, Le Trung Chanh, Le Van Nhat Thang — Thu, 30 Apr 2026 00:00:00 +0700

Cleft lip is a common congenital deformity that significantly affects facial aesthetics, oral function, speech development, and psychosocial well-being. Traditional surgical techniques, such as Millard’s rotation-advancement and Tennison-Randall’s triangular flap have limitations in achieving optimal aesthetic outcomes, particularly in recreating a natural philtral column and a symmetrical nasal base. In 2005, David M. Fisher introduced the anatomical subunit approximation technique, a modification that integrates concepts from previous techniques while emphasizing alignment along aesthetic subunits of the lip. This method utilizes precise markings and measurements to design incisions that follow the natural philtral column, combined with a small superiorly based triangle (average 1.24 mm) above the cutaneous roll for optimal lengthening without distorting Cupid’s bow. A laterally based vermilion flap is also employed to correct central vermilion deficiency, ensuring a continuous and harmonious vermilion border. Studies have demonstrated that Fisher’s technique provides better outcomes in terms of scar camouflage, philtrum reconstruction, and nasal symmetry compared to traditional methods. However, it requires thorough anatomical knowledge and meticulous surgical planning due to its technical complexity. This review highlights the principles, surgical steps, advantages, limitations, and reported clinical outcomes of Fisher’s technique for repairing unilateral complete cleft lip, emphasizing its importance as an advanced surgical approach in modern cleft care.

Isolated lesser tuberosity fracture of the humerus literature review and case report

Ho Man Truong Phu, Nguyen Thanh Long, Nguyen Dang Huy Nhat — Thu, 30 Apr 2026 00:00:00 +0700

Background: Isolated fractures of the lesser tuberosity of the humerus are exceptionally rare and often challenging to diagnose due to non-specific symptoms and their infrequent occurrence. The accurate diagnosis and timely treatment of such fractures are critical to prevent complications such as chronic shoulder pain and functional impairment.
Objective: This study aims to review the clinical presentation, diagnostic challenges, and treatment outcomes associated with isolated lesser tuberosity fractures of the humerus. Additionally, we present two case reports that highlight the surgical management of these injuries and their outcomes.
Methods: Both male patients, aged 31 and 35 sustained their injuries from falls and presented with acute shoulder pain and limited motion. Initial X-rays were inconclusive, leading to further imaging with CT scans, which confirmed the diagnosis. Both patients underwent open reduction and internal fixation (ORIF). Postoperative follow-up included serial radiographs and clinical assessment of shoulder motion.
Results: ORIF restored the lesser tuberosity to its anatomical position in both cases. Follow-up radiographs demonstrated maintained reduction and progressive union, while clinical examination showed marked improvement in pain and shoulder function. At 3 months, case 1 had mild residual limitation of abduction and extension, whereas case 2 recovered near-full shoulder motion after rehabilitation.
Conclusion: Isolated lesser tuberosity fractures, though rare, require careful clinical evaluation and imaging for accurate diagnosis. Early and accurate diagnosis of isolated lesser tuberosity fractures is crucial to prevent long-term complications. Surgical management, particularly ORIF, appears to be a reliable approach in treating these fractures, resulting in favorable outcomes. Further research is needed to establish standardized treatment protocols for these uncommon injuries