Prolonged fasting before surgery, traditionally used to reduce the risk of pulmonary aspiration, often leads to significant patient discomfort, including hunger, thirst, and fatigue. Preoperative carbohydrate loading, particularly with maltodextrin, has emerged as a strategy to enhance patient comfort and recovery. This study aimed to evaluate the effects of maltodextrin intake 2 hours before surgery on perioperative discomfort in patients undergoing gynecological laparoscopic procedures. A randomized controlled trial was conducted from April 2024 to September 2024 at Hanoi Obstetrics and Gynecology Hospital. Seventy patients scheduled for elective gynecological laparoscopic surgery were randomly assigned to either the carbohydrates group (maltodextrin solution intake) or the control group (traditional fasting). The intervention group consumed 300 mL of a 15% maltodextrin solution 2 hours before surgery, while the control group adhered to standard fasting protocols. Hunger, thirst, and fatigue were assessed using visual analog scales before anesthesia and 2 hours post-surgery. The maltodextrin group reported significantly lower levels of hunger (3.5 ± 0.6 vs 4.7 ± 1.4, P = .03), thirst (1.7 ± 1.3 vs 3.1 ± 1.8, P < .05), and fatigue (2.1 ± 0.9 vs 3.9 ± 1.5, P < .05) before anesthesia compared to the fasting group. These differences persisted 2 hours after surgery, with the maltodextrin group continuing to exhibit lower discomfort levels (P < .05). Preoperative maltodextrin intake significantly reduces perioperative hunger, thirst, and fatigue in patients undergoing gynecological laparoscopic surgery.

We report two rare cases of spontaneous left iliac vein rupture associated with May-Thurner syndrome. A 60-year-old patient presented with acute lower abdominal pain and was diagnosed with a retroperitoneal hematoma and left iliac vein thrombosis. She was managed conservatively with anticoagulation and inferior vena cava (IVC) filter placement, resulting in complete thrombus resolution within 2 months. A second patient, aged 65 years, presented in hemorrhagic shock with extensive deep vein thrombosis of the left lower limb. After resuscitation and transfusion, she underwent IVC filter placement and anticoagulation, with full thrombus resolution confirmed at the 3-month follow-up. These cases highlight the diagnostic challenges of spontaneous iliac vein rupture and the importance of early recognition. Conservative management with anticoagulation and IVC filter placement may be a safe and effective alternative to surgery in stable patients.

Traumatic cervical spinal cord injury (SCI) frequently leads to severe neurological deficits. Early decompressive surgery, when performed shortly after the injury, is believed to improve outcomes. However, the impact of surgical timing, calculated from the moment of injury, and injury characteristics on neurological recovery remains poorly understood. This study aims to assess the impact of early decompressive surgery and injury characteristics on neurological recovery in traumatic cervical SCI patients. A retrospective case-control study was conducted at the 108 Central Military Hospital in Hanoi, Vietnam, between January 2018 and June 2023. Data collected included demographics, injury characteristics, time from injury to decompression surgery, and clinical outcomes at the 1-year follow-up. Among the 193 patients initially screened, 156 met the inclusion criteria. Neurological recovery was observed in 44.2 % of patients. Early decompression within 24 h significantly improved recovery outcomes (OR = 3.12, p = 0.006). Injury at C1–C3 levels, longer spinal cord injury length, and severe spinal canal stenosis were associated with poorer recovery (OR = 0.34, p = 0.015; OR = 0.21, p < 0.001; OR = 0.34, p = 0.009, respectively). Prolonged ICU stay correlated with worse recovery (OR = 0.90, p = 0.002). Early decompressive surgery, thorough assessment of injury characteristics, and minimizing ICU stay duration are critical for improving neurological recovery. These findings highlight the importance of timely surgery and strategic clinical management in enhancing recovery outcomes in traumatic cervical SCI patients.

BACKGROUND Induction immunosuppressive therapy is essential to prevent early acute rejection in kidney transplantation. While basiliximab is typically used in low-immunological-risk patients, low-dose rabbit anti-thymocyte globulin (r-ATG) may offer comparable efficacy with potentially higher infection risk. Evidence comparing both strategies in living-donor transplantation remains limited. MATERIAL AND METHODS This retrospective cohort study included 150 adult patients undergoing their first kidney transplant from living donors at the 108 Military Central Hospital (Vietnam) between January 2022 and January 2025. All recipients were classified as low immunologic risk and received either low-dose r-ATG (4 mg/kg, n=37) or basiliximab (n=113) as induction therapy. Outcomes evaluated included graft and patient survival, biopsy-proven acute rejection (BPAR), renal function (eGFR), and post-transplant infection rates. Multivariable Cox regression was used to identify predictors of rejection. RESULTS The median follow-up duration was 26.65 months. Both groups had 100% patient survival during the follow-up period. Graft failure occurred in 2.7% (r-ATG) and 1.77% (basiliximab) of recipients. BPAR rates were 10.81% and 13.27% in the r-ATG and basiliximab groups, respectively. No significant differences in eGFR or infection rates (CMV, BK virus, bacterial/fungal infections) were observed. HLA mismatch was the only significant predictor of rejection (Class I HR: 3.06; Class II HR: 5.59). CONCLUSIONS In low-risk living-donor kidney transplantation, low-dose r-ATG provides efficacy and safety comparable to basiliximab in terms of graft survival, rejection, and infection rates. These findings support the use of individualized induction strategies, with low-dose r-ATG being a viable alternative to basiliximab in selected patients.

Nhiễm nấm Aspergillus ở hệ thần kinh trung ương (CNS) là một biến chứng hiếm gặp nhưng nghiêm trọng sau ghép gan với tỷ lệ tử vong rất cao. Chúng tôi báo cáo một trường hợp bệnh nhân nam 66 tuổi, tiền sử u lympho non-Hodgkin, đái tháo đường type 2, viêm gan virus B mạn tính, được ghép gan cấp cứu do suy gan cấp. Sau ghép, bệnh nhân ổn định và xuất viện nhưng nhập viện lại ở tháng thứ tư với triệu chứng sốt kéo dài, sau đó xuất hiện liệt nửa người và hôn mê. Khảo sát dịch não tủy và hình ảnh học xác định viêm não do Aspergillus fumigatus với biến chứng vỡ giả phình động mạch não. Bệnh nhân được điều trị kháng nấm tích cực bằng voriconazole, sau đó điều chỉnh phác đồ với isavuconazole kết hợp anidulafungin. Tuy nhiên, bệnh nhân diễn biến nặng với nhiễm trùng bệnh viện, suy đa tạng và tử vong. Ca bệnh này nhấn mạnh tầm quan trọng của chẩn đoán sớm và tối ưu hóa điều trị kháng nấm trong ghép tạng.