Journal of Military Pharmaco-medicine

TREND IN MICROBIAL ETIOLOGY AND ASSOCIATED FACTORS IN COMPLICATED URINARY TRACT INFECTIONS AT BACH MAI HOSPITAL (2019 - 2023)

Thi Linh Tran

Objectives: To analyze microbial etiology and associated factors in complicated urinary tract infections (cUTI). Methods: A retrospective, cross-sectional descriptive study was conducted on 622 cUTI patients at the Rehabilitation Centre, Bach Mai Hospital (2019 - 2023). Results: The median age was 57 years; males accounted for 60.6%. Common risk factors for cUTI included neurogenic bladder (82%) and catheterization (74%). The main pathogens were E. coli (45.8%), K. pneumoniae (16.4%), and E. faecalis (6.8%). The microbial patterns were stable but increasingly diverse, associated with gender and urinary obstruction. Conclusion: E. coli and K. pneumoniae are the two predominant Gram-negative pathogens, while E. faecalis was the most frequent among Gram-positive bacteria. Key factors related to cUTI include neurogenic bladder, male gender, and catheterization. Continuous monitoring of microbiology and adherence to antibiotic treatment guidelines are essential to improve therapeutic outcomes and reduce antimicrobial resistance.

CLINICAL EPIDEMIOLOGY AND BACTERIOLOGY CHARACTERISTICS OF URINARY TRACT INFECTIONS IN CHILDREN AGED 2 MONTHS TO 15 YEARS AT HAI PHONG PEDIATRIC HOSPITAL

Thi Ly Nguyen

Objectives: To describe the clinical epidemiological characteristics, bacteriology, and antimicrobial susceptibility patterns of pathogens causing urinary tract infections (UTIs). Methods: A cross-sectional descriptive study was conducted on 202 pediatric patients aged 2 months to 15 years at Hai Phong Pediatric Hospital. Results:The most affected age group was 2 - 24 months: 85/202 (42.1%). Female patients predominated, with a male-to-female ratio of 1:1.5. Clinical manifestations included fever in 152 cases (75.2%), urinary frequency in 48 (23.8%), dysuria in 38 (18.8%), and cloudy urine in 21 (10.4%). Phimosis in male patients was observed in 16/81 (19.8%). Urinalysis revealed leukocyturia in 100%, positive nitrite in 48 (23.8%), and proteinuria in 112 (55.4%). Positive urine cultures were obtained in 79/202 (39.1%). Identified pathogens included Escherichia coli (E.coli) in 60 (75.9%), Enterococcus faecalis (E.faecalis) in 11 (13.9%), Proteus mirabilis (P.mirabilis) in 3 (3.8%), Klebsiella pneumoniae (K.pneumoniae) in 2 (2.5%), Staphylococcus epidermidis (S.epidermidis) in 2 (2.5%), and Pseudomonas aeruginosa (P.aeruginosa) in 1 (1.3%). E.coli exhibited high resistance rates to commonly used antibiotics such as ampicillin, amoxicillin, cephalosporins, quinolones, and cotrimoxazole, but remained susceptible to aminoglycosides and carbapenems. Conclusion: UTIs are a common disease, particularly in children aged 2 - 24 months, with a higher prevalence in females. Fever was the most frequent clinical manifestation. All patients exhibited leukocyturia. Gram-negative bacteria were the predominant pathogens, especially E.coli. Other detected organisms included E.faecalis, P.mirabilis, K.pneumoniae, S.epidermidis, and P.aeruginosa.

THE STATUS OF CATHETER-RELATED INFECTIONS AND RELATED FACTORS IN HEMODIALYSIS PATIENTS AT THAI NGUYEN NATIONAL HOSPITAL

Tuan Tu Tran

Objectives: To describe the incidence of catheter-related infections and associated factors in hemodialysis patients at Thai Nguyen National Hospital. Methods: A cross-sectional descriptive study was conducted on 96 patients suspected of catheter-related infection at the Department of Nephrology and Dialysis, Thai Nguyen National Hospital, from January to August 2025. Results: The mean age of patients was 60.91 years, with a male-to-female ratio of 3.83:1. The prevalence of catheter-related infection was 36%, with the most common local sign being swelling, warmth, and redness (36.5%). Staphylococcus aureus was the predominant pathogen. Hypertension was the most frequent comorbidity (44.8%), and hyperglycemia was associated with a higher risk of catheter infection. Conclusion: The findings highlight the need for enhanced catheter monitoring and strict glycemic control to reduce the risk of infection in hemodialysis patients.

CHALLENGES IN IMPLEMENTING PERITONEAL DIALYSIS FOR ELDERLY PATIENTS WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE: A CLINICAL CASE REPORT

Thi Diem Hoang

Indications for peritoneal dialysis (PD) have undergone many changes. Previous medical barriers have been reconsidered, and recent data showed that this technique is feasible in patients with a variety of conditions. We presented a case of an elderly female patient who has been performing PD for 30 months despite having multiple complications and an initial assessment that PD might be unfeasible. The aim of the report is to demonstrate the importance of PD as a kidney replacement therapy and underline the role of interprofessional collaboration in patient management.

HYPOALBUMINEMIA IN HEMODIALYSIS PATIENTS AGED OVER 60 YEARS AT MILITARY HOSPITAL 103

TS Thi Thu Ha Nguyen

Objectives: To investigate the prevalence of hypoalbuminemia and its association with selected clinical and paraclinical features in elderly patients with end-stage kidney disease (ESKD) undergoing maintenance hemodialysis. Methods: A prospective, cross-sectional descriptive, uncontrolled study was conducted on 72 maintenance hemodialysis patients aged over 60 years at the Department of Nephrology and Hemodialysis, Military Hospital 103 from June 2023 to June 2024. Results: The prevalence of hypoalbuminemia (serum albumin < 35 g/L) was 18.06%, with a mean albumin level of 38.16 ± 3.27 g/L. Patients with severe anemia (hemoglobin < 80 g/L) had significantly lower albumin levels compared to others (36.81 ± 3.61 vs. 38.71 ± 2.98 g/L; p = 0.023). Likewise, patients who experienced intradialytic hypotension within the past month had significantly lower albumin levels than those without (36.53 ± 2.51 vs. 39.69 ± 3.19 g/L; p < 0.001). A moderate positive correlation was observed between serum albumin and pre-dialysis creatinine levels (r = 0.31; p = 0.008). Conclusion: The prevalence of hypoalbuminemia among elderly hemodialysis patients was relatively high and significantly associated with severe anemia, lower pre-dialysis creatinine levels, and the occurrence of intradialytic hypotension.

EVALUATION OF OVERACTIVE BLADDER TREATMENT OUTCOMES IN POST-STROKE PATIENTS USING MIRABEGRON (BETA-3 AGONIST) AT BACH MAI HOSPITAL

PGS Dao Vu Do

Objectives: To evaluate the treatment outcomes of overactive bladder (OAB) in post-stroke patients using Mirabegron and related factors. Methods: A cross-sectional descriptive study without a control group was conducted on 30 patients diagnosed with post-stroke OAB at Bach Mai Hospital from October 2024 to June 2025. OAB symptoms were assessed using the OAB Symptom Score (OABSS), quality of life was measured with the International Prostate Symptom Score - Quality of Life, and voiding patterns were recorded through a urinary diary. Results: The results showed significant improvement in OAB symptoms (the OAB Symptom Score decreased from 10.97 to 5.7) and quality of life (International Prostate Symptom Score - Quality of Life decreased from 5.51 to 3.17). The frequency of urination, nocturia, urgency, and urinary incontinence significantly decreased (p < 0.05), as reflected in the voiding diary data. Mild side effects such as increased blood pressure and tachycardia were recorded, but did not require discontinuation of treatment. Factors such as age and the type of stroke influenced treatment outcomes. Conclusion: Mirabegron is an effective and safe option for managing OAB in post-stroke patients.

LOWER URINARY TRACT INFECTIONS AMONG INPATIENTS AT THE LOWER URINARY TRACT DEPARTMENT, 108 MILITARY CENTRAL HOSPITAL FROM 10 - 12/2024

Thi Thinh Nguyen

Objective:To describe the clinical, microbiological characteristics, and empirical antibiotic treatment regimens in patients diagnosed with lower urinary tract infections (LUTIs) who were hospitalized in the Lower Urinary Tract Department, 108 Military Central Hospital. Methods: A retrospective, cross-sectional descriptive study was conducted by reviewing the medical records of 119 inpatients diagnosed with LUTIs from October to December 2024. Data collected included clinical presentations, laboratory and microbiological findings, and antibiotic regimens administered. Results: Males accounted for 88.2%, females accounted for 11.8%, and the 62 - 78-year age group comprised 46.2%. The most common symptoms were voiding difficulty (51.3%), urinary frequency (42.0%), urinary retention (41.2%), and painful/burning urination (38.7%). Positive urine cultures were found in 58 cases, predominantly E.coli (36.2%) and P.aeruginosa (19.0%). E.coli remained susceptible to amikacin (85.7%) and carbapenems (85.7 - 90%) but showed high resistance to cephalosporins and fluoroquinolones (> 50%). Empirical initial therapy accounted for 81.5%, with cephalosporin monotherapy being the most common regimen (30.9%). Conclusion: Lower urinary tract infections (LUTIs) in this inpatient cohort are predominantly caused by E.coli with substantial resistance to cephalosporins/fluoroquinolones; aminoglycosides or carbapenems should be considered for severe or high-risk cases.

STUDY ON THE BIVENTRICULAR STRAIN BY SPECKLE TRACKING ECHOCARDIOGRAPHY IN PATIENTS WITH END-STAGE CHRONIC RENAL DISEASE BEFORE AND AFTER KIDNEY TRANSPLANTATION

Vu Thu Ha Pham

Objectives: To investigate the characteristics of the left and right ventricular strain and the relationship between the biventricular function before and after 1 month of kidney transplantation. Methods: A cross-sectional descriptive, controlled study was conducted on 40 patients with end-stage chronic kidney disease who were undergoing kidney transplantation, with clinical and echocardiography monitoring before and after 1 month of transplantation at Military Hospital 103, from November 2022 to May 2023. Results: Left ventricular function after 1 month of kidney transplantation improved compared to before transplantation. EF increased significantly (54.1 ± 7.6% and 58.5 ± 5.8%, p < 0.01). Left ventricular GLS after 1 month of kidney transplantation improved compared to before transplantation (-17.5 ± 3.5% and -20.9 ± 3.6%, p < 0.01). Right ventricular strain (RV4CSL, RVFWSL) after transplantation increased significantly compared to before transplantation (RV4CSL: -17.56 ± 4.82% and -21.14 ± 3.90 %, p < 0.01; RVFWSL: -20.59 ± 6.10% and -24.81 ± 4.58%). Right ventricular strain (RV4CSL, RVFWSL) had a moderate positive correlation with longitudinal left ventricular strain (r = 0.43 and 0.42, p < 0.01, respectively). Conclusion: After kidney transplantation, EF and GLS improved significantly. Right ventricular strain 1 month after transplantation increased significantly compared to before transplantation. Right ventricular strain was positively correlated with longitudinal left ventricular strain.

CHARACTERISTICS OF PRURITUS AND ASSOCIATED FACTORS IN MAINTENANCE HEMODIALYSIS PATIENTS AT THAI NGUYEN NATIONAL HOSPITAL

Tuan Tu Tran

Objectives: To identify the characteristics of pruritus using the 5D-Elman scale in patients undergoing maintenance hemodialysis and to analyze associated factors. Methods: A cross-sectional descriptive study was conducted on 219 maintenance hemodialysis patients at Thai Nguyen National Hospital from March to July 2025. Pruritus was assessed using the 5D-Itch scale (Elman). Results: Pruritus was present in 69.9% of patients, mainly affecting the abdomen, back, thighs, and legs; 50.9% experienced itching in five or more body regions. The severity was predominantly moderate to severe, with 43.4% reporting itching < 6 hours per day. Pruritus significantly impacted sleep quality. Factors associated with pruritus severity included age (B = 0.07; p = 0.018), hypertension (B = 3.43; p = 0.006), diabetes mellitus (B = 4.93; p = 0.001), serum phosphorus (B = 2.03; p = 0.005), WBC count (B = 0.51; p = 0.016), and PTH level (B = 0.02; p = 0.021). Conclusion: Pruritus is a common symptom in hemodialysis patients and is associated with multiple clinical and laboratory factors, highlighting the need for a comprehensive approach to assessment and management to improve quality of life.

INITIAL OUTCOMES OF RETROGRADE INTRARENAL SURGERY USING A FLEXIBLE URETEROSCOPE FOR KIDNEY STONES > 20mm AT 19-8 HOSPITAL - MINISTRY OF PUBLIC SECURITY

Tran Thanh Nguyen

Objectives: To evaluate the effectiveness of retrograde intrarenal surgery (RIRS) using a flexible ureteroscope for stones > 20mm based on research at 19-8 Hospital - Ministry of Public Security. Methods: A prospective, descriptive study was conducted on 24 patients with kidney stones > 20mm who underwent RIRS using a flexible ureteroscope at 19-8 Hospital - Ministry of Public Security from January 2024 to January 2025. Results: The average age was 35.6 ± 12.7 years. The average stone size was 24.7 ± 3.1mm. 79.17% of patients did not require JJ stent placement before stone removal. The average lower-pole infundibulopelvic angle (LIP) was 55.4 ± 15.1°. The average lower-pole infundibular length (IL) was 17.3 ± 6.6mm. The immediate postoperative and after 1 month stone-free rate were 70.83% and 83.33%, respectively. The average operative time was 65.4 ± 17.5 minutes, and the average hospital stay was 3.4 ± 1.2 days. The rates of Clavien-Dindo grade I and II complications were 25% and 20.83%, respectively. Conclusion: RIRS for kidney stones > 20mm using a flexible ureteroscope shows good postoperative results at 19-8 Hospital - Ministry of Public Security.

RESULTS OF PROSTATE SYMPTOM IMPROVEMENT IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA TREATED WITH TRANSURETHRAL ENUCLEATION USING BIPOLAR ENERGY AT 108 MILITARY CENTRAL HOSPITAL

Thanh Hai Pham

Objectives: To determine the international prostate symptom score (IPSS) and associated factors in patients with benign prostatic hyperplasia treated with transurethral enucleation using bipolar energy at 108 Military Central Hospital from 2023 to 2025. Methods: A cross-sectional descriptive, longitudinal case series was conducted on 68 patients with benign prostatic hyperplasia who underwent transurethral enucleation with bipolar energy. Results: IPSS: Preoperative median was 27 (IQR 21 - 29); 1-month postoperative median was 5 (IQR 3 - 7.5); 3-month postoperative median was 2 (IQR 1 - 4), with a statistically significant difference (p < 0.001). Factors including preoperative Qmax and QoL 1-month postoperatively were associated with IPSS 1-month postoperatively (p < 0.05). No factors were associated with IPSS 3-month postoperatively (p > 0.05). Conclusion: Transurethral bipolar energy treatment for benign prostatic hyperplasia results in improvement of prostatic symptoms. Preoperative Qmax and QoL 1-month postoperatively influence IPSS 1-month postoperatively.

LOWER URINARY TRACT OBSTRUCTION DUE TO BENIGN PROSTATIC HYPERPLASIA IN KIDNEY TRANSPLANT RECIPIENTS: A CLINICAL CASE REPORT

TS Nguyen Vu Le

Objectives: To report 2 cases of post-transplant urinary retention at VietDuc University Hospital and compare clinical outcomes. Methods: A descriptive, analysed study was conducted on 2 kidney transplant recipients, including clinical presentation, management, and follow-up outcomes. Results: Case 1 was a 62-year-old male with BPH, developing urinary retention on postoperative day 14. Medical therapy was ineffective, and serum creatinine increased after catheter removal. Transurethral resection of the prostate (TURP) restored graft function; case 2 was a 50-year-old male with diabetes mellitus, developing sepsis due to a prostatic abscess post-transplantation. After intensive antibiotic therapy, TURP and abscess drainage into the bladder were performed, with renal function returning to baseline. Conclusion: In males aged ≥ 50 years, pre-transplant evaluation and management of BPH are essential. Early intervention for lower urinary tract obstruction improves symptoms and preserves graft function.

EVALUATION OF THE EFFECTIVENESS OF LAPAROSCOPIC RENAL CYST UNROOFING AT E HOSPITAL IN 2021 - 2025

Dinh Lien Nguyen

Objectives: To evaluate the outcome of laparoscopic renal cyst unroofing. Methods: A retrospective, prospective, and descriptive study was conducted on 98 patients who underwent laparoscopic renal cyst unroofing at E Hospital from 2021 to 2025. Results: The mean age of the patients was 63.64 years, with a male-to-female ratio of 56:42. Two cases had a family history of polycystic kidney disease. The most common presenting symptom was flank pain (88.7%). The most frequently observed cyst size ranged from 50 - 100mm (73.5%). Bilateral cysts were found in 41.8% of cases, while 56.1% had solitary cysts. The mean operative time was 45.66 minutes (n = 98), with no significant difference in operative time between the two surgical approaches or cyst locations. The mean drain removal time was 2.68 days, and the average hospital stay was 4.05 days. There was a statistically significant difference in drain removal time and length of hospital stay between the two surgical methods. No cases of organ injury or bleeding complications were reported. Conclusion: Laparoscopic renal cyst unroofing is a safe, minimally invasive procedure with a progressively shorter operative time and a success rate of up to 98%. Post-peritoneal laparoscopic surgery provides excellent cosmetic outcomes. The duration of drainage and hospital stay was reduced by 2 - 3 days compared to previous approaches.

EARLY RESULTS OF TRANSURETHRAL ENDOSCOPIC EN-BLOC RESECTION OF TUMOR USING HOLMIUM LASER IN THE TREATMENT OF NON-MUSCLE-INVASIVE BLADDER CANCER COMBINED WITH INTRAVESICAL GEMCITABINE INSTILLATION

Ngoc Thang Vu

Objectives: To evaluate the efficacy and safety of transurethral en-bloc resection of bladder tumors using holmium laser (HolERBT) combined with intravesical Gemcitabine instillation in the treatment of non-muscle-invasive bladder cancer (NMIBC). Methods: A prospective case series study was conducted on 21 patients with NMIBC who underwent HolERBT from January 2024 to March 2025. All patients received intravesical chemotherapy with Gemcitabine 2,000mg per instillation for 6 weeks, from 10 to 14 days after surgery. Results: Male patients accounted for 76.2%, female patients accounted for 23.8%. The mean age was 62.52 ± 14.073 years. Preoperative CT-scan (21/21 cases) detected bladder tumor in 95.2% (20/21 cases), no bladder tumor in 4.8% (1/21 cases). Mean tumor size: 13.8 ± 7.18 mm. The detrusor muscle was obtained in 20/21 cases (95.2%). The mean operative time was 33.43 ± 12.56 minutes. The mean duration of postoperative catheterization was 1.62 ± 0.59 days. Postoperative pathology: Low-grade papillary urothelial carcinoma was 8/21 cases (38.1%), high-grade papillary urothelial carcinoma was 13/21 cases (61.9%); stage pTa: 42.9%, pT1: 57.1%. There were no intraoperative complications. No cases of obturator nerve reflex were observed. Recurrence occurred in 1 case (4.8%) after 9 months. Conclusion: HolERBT in the treatment of NMIBC is safe and feasible.

SURVEY OF SOME CLINICAL AND PARACLINICAL CHARACTERISTICS OF BLADDER CANCER PATIENTS TREATED WITH TOTAL CYSTECTOMY AND URINARY DIVERSION USING THE BRICKER METHOD AT 108 CENTRAL MILITARY HOSPITAL

Ngoc The Do

Objectives: To describe some clinical, paraclinical, and diagnostic characteristics of bladder cancer patients treated with total cystectomy and Bricker urinary diversion. Methods: A retrospective, cross-sectional descriptive study without a control group was conducted on 40 bladder cancer patients who underwent total cystectomy and Bricker urinary diversion at 108 Military Central Hospital from March 2021 to May 2024. Results: The average age was 66.89 years old; the male/female ratio was 7/1. The most common symptom was hematuria (67.5%), 37.5% had first-time bladder cancer, and the average duration of the disease was 68.98 ± 131.2 months. The main histopathology was transitional carcinoma (97.5%), with high malignancy accounting for 85%. CT-scans correctly predicted the T stage in 90.0% patients. Conclusion: Bladder cancer detected for the first time requires total cystectomy, accounting for 37.5% with the main histopathology being transitional carcinoma (97.5%). CT-scans play an important role in treatment indications as well as prognosis.

RESULTS OF KIDNEY STONE TREATMENT BY ULTRA-MINI PERCUTANEOUS NEPHROLITHOTOMY AT MILITARY HOSPITAL 175

Van Khan Nguyen

Objectives: To evaluate the results of kidney stone treatment by ultra-mini percutaneous nephrolithotomy (PCNL) at Military Hospital 175. Methods: A prospective, descriptive, longitudinal study was conducted on 196 patients indicated for ultra-mini percutaneous nephrolithotomy (UMP) at Military Hospital 175 from December 2023 to June 2025. Results: Most patients underwent surgery using a single access tract (95.92%), with the majority of punctures made through the lower calyx (61.22%). The average surgical time per patient was 56.08 ± 18.01 (range: 20 - 110) minutes. The stone-free rate 3 months post-operation was 93.88%. No intraoperative accidents occurred. The complication rate recorded in this study was 7.65%, with Clavien-Dindo classification showing 3.06% as grade I and grade II complications; the rates for grade II, IIIa, and IIIb complications were each 0.51%. Conclusion: UMP is an effective and safe method for treating kidney stones, with a high surgical stone-free rate and minimal complications.

TIMING OF URINARY CATHETER REMOVAL AFTER TRANSURETHRAL RESECTION OF THE PROSTATE: CURRENT SITUATION AND OUTCOMES AT THAI BINH MEDICAL UNIVERSITY HOSPITAL

Van Cuong Phan

Objectives: To evaluate the current status of indwelling urinary catheterization duration following transurethral resection of the prostate (TURP) and the associated complications, and to compare the results with recommendations from international guidelines and the latest scientific evidence. Methods: A cross-sectional descriptive study was conducted on 263 patients who underwent TURP at Thai Binh Medical University Hospital from 2013 to 2023. Results: The mean prostate volume measured by ultrasound was 53.11 ± 21.17 grams. The mean duration of catheterization was 5.69 ± 1.33 days. There were 20 cases of urinary retention after catheter removal. Longer catheterization duration was associated with a higher risk of post-removal urinary retention (p < 0.05). Conclusion: The urinary catheterization duration at Thai Binh Medical University Hospital is relatively long compared to the early removal approach recommended in current international guidelines and recent studies. Early catheter removal should be considered when urine is clear, without blood clots, to optimize postoperative care and minimize catheter-related complications.