Tạp chí Nhi khoa

UPDATE ON ALLERGEN-SPECIFIC IMMUNOTHERAPY IN THE MANAGEMENT OF ASTHMA

Van Khiem Nguyen — 2025-08-22

Asthma is a common chronic inammatory airway disease in both children and adults, with a signicant proportion linked to allergic mechanisms. Among current treatment options, Allergen Immunotherapy (AIT) is the only method capable of modifying the natural course of allergic diseases, including asthma.

AIT works by introducing gradually increasing doses of specic allergens into the patient’s body, thereby helping to restore immune tolerance and reduce IgE-mediated allergic inammation. There are two common routes of AIT administration: subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Numerous clinical trials and systematic reviews have demonstrated that AIT is e ective in alleviating respiratory symptoms, improving lung function, reducing the need for controller medications, and preventing severe disease progression. Moreover, the benets of AIT can persist for years after completing the treatment course.

AIT plays a particularly important role in the management of mild to moderate persistent allergic asthma that is inadequately controlled with standard medications, especially in patients with documented sensitization to specic allergens (e.g., house dust mites, pollens). The selection of allergens, assessment of indications and contraindications, and close monitoring throughout the treatment process are critical factors determining the success of AIT. Nowadays, AIT is gaining increasing attention as part of personalized asthma treatment strategies, especially when combined with biologic therapies, aiming to optimize treatment outcomes and improve patients’ quality of life.

OVERVIEW OF THE SITUATION OF MYOPIATIC STUDENTS IN THE VIETNAM’S SCHOOL ENVIRONMENT NOWADAYS, SOME RESEARCH ISSUES NEED TO BE DISCUSSED AND PROPOSE SOME SOLUTIONS

Anh Hao Bui — 2025-08-22

Myopia is the most common type of refractive error in Vietnamese students nowadays, especially this type of refractive error can be seen most clearly in the school environment, with the number of students with myopia increasing over time, every year the current situation is very staggering, aecting student’s health, education quality and their future. The current situation of myopia in students in Vietnam’s school environment poses many research challenges for doctors, when necessary, may require timely medical interventions to control and reduce the rate of myopia in students, in addition to bringing up some discussions about educating and preventing myopia from an early age for students, avoid the harmful consequences in the future, and propose some solutions to help reduce myopia in Vietnamese students nowadays.

EVALUATION OF HUMORAL IMMUNITY IN CHILDREN WITH RECURRENT RESPIRATOTY TRACT INFECTIONS AT THE PEDIATRICS DEPARTMENT OF VINMEC TIMECITY INTERNATIONAL GERENAL HOSPITAL

Thị Minh Hương Le — 2025-08-22

Evaluation of humoral immunity in children with recurrent respiratoty tract infections focuses on the role of immunoglobulin antibadies, helpng to determine the child’s immune responese capability while simultaneously excluding underlying immunodeciency disorders.

Method: A cross-sectional descriptive study of 207 cases, aged 6 months to 8 years, diagnosed with recurrent respiratory tract infections. The study indicators included medical history, respiratory inammation inđẽ according to the ICD 10, frequency of infections, and measurement of antibody levels (IgA, IgG, IgM, IgE). The antibody levels were compared with reference values by age group.

Results: The average age of the study patients was 2.48 ± 1.46 years, with the majority being children under 3 years old (accounting for 69.6%). The percentage of boys is 63,6%. The most frequently encounted conditions, in order, are acute pharyngitis (100%), bronchitis (66,7%), otitis media (53,6%) and pneumonia (45,9%). IgA concentration was reduced in 7,7% children in the study. The younger the child, the higher rate of IgA reduction (14.5% in the 6-12 month age group, 7.1% in the 2-3 year age group). The frequency of lower respiratory tract infections was signicantly higher in the 2-3 year age group with decreased IgA levels (p=0.007). 2.4% of children had decreased IgG levels, mainly concentrated in the under 1 year old group, accounting for 7%. In addition, 23.1% of children had elevated IgE levels regardless of age.

Conclusion: Recurrent respiratory tract infections are more common in young children under 3 years old. 7.7% of children with recurrent respiratory tract infections had reduced IgA and 2.4% had decreased IgG compared to the reference values by age. There is a relationship between decreased IgA levels and the frequency of lower respiratory tract infections in the 2-3 years old group.

ASSESSMENT OF BASIC PEDIATRIC EMERGENCY COMPENTENCIES AMONG HEALTHCARE PROVIDERS IN LAO CAI PROVINCE IN 2024

Minh Dien Tran — 2025-08-22

Objectives: To evaluate the basic pediatric emergency competencies of physicians and nurses in provincial and district hospitals in Lao Cai Province, aiming to propose appropriate intervention and training strategies.

Subjects and Methods: A cross-sectional study conducted from January to March 2024. The study participants included healthcare providers (doctors and nurses) directly involved in the care and treatment of pediatric patients at district hospitals and Lao Cai Obstetrics and Pediatrics Hospital. The assessment involved theoretical examinations and direct observation of practical emergency skills to evaluate knowledge and prociency in basic pediatric emergency procedures.

Results: A total of 128 healthcare providers participated in the study with an average age of 36 years. Of these, 26.6% were male and 73.4% female. The average years of experience in healthcare was 12 years, and in hospitals approximately 10 years. The mean scores for theoretical knowledge of pediatric emergency ranged from 38/100 to 57/100, depending on the hospital. Less than 50% of participants mastered essential emergency skills. Specically, correct chest compression technique was performed by 71% for older children, 72% for infants using two hands, over 70% correctly performed bag-valve-mask ventilation. However, the prociency in endotracheal intubation was low, with less than 50% performing the technique correctly.

Conclusion: The pediatric emergency competencies of physicians and nurses in provincial and district hospitals in Lao Cai remain limited. Implementing appropriate training programs is essential to enhance basic pediatric emergency skills at the local level.

THE CLINICAL FEATURES AND BACTERIAL ETIOLOGIES THAT CAUSE COMMUNITYACQUIRED PNEUMONIA IN CHILDREN AT 108 MILITARY CENTRAL HOSPITAL

Thu Phuong Bui — 2025-08-22

Objectives: Describe the clinical features and bacterial etiologies that cause communityacquired pneumonia in children.

Study subjects and methods: A cross-sectional descriptive study of 207 children with community-acquired pneumonia hospitalized from April 1, 2023 to March 31, 2024.

Results: The male ratio was 54.1%; the age group from 2 months to 5 years old accounted for 59.4%. The main clinical features were cough 100%; fever 56.03%, tachypnea 37.68%; coarse rales: 67.63%, respiratory failure 10.14%. The white blood cell count was 14.65±4.43 G/l; CRP levels increased to 22.49±28.71 mg/l. On chest X-ray, localized lesions accounted for the majority at 48.6%. There were 77.3% positive samples in real-time PCR tests of nasopharyngeal specimens; among them, those positive for one bacterium accounted for the highest at 60.78%; both coinfections of two or three bacterial were found. The positivity rate for each agent H.inuenzae, S.pneumoniae, and M.pneumoniae gradually decreased by 48.36%; 47.05%; 41.83 %. The percentages of samples positive for bacteria in nasopharyngeal uid culture was 74.7%; among them, the positive samples for S.pneumoniae accounted for the highest rate of 28.34%.

Conclusion: Common clinical features in pediatric community-acquired pneumonia are cough, fever, tachypnea, coarse rales, and respiratory failure. The major pathogens are H.infuenzae, S.pneumoniae, and M.pneumoniae

HOSPITAL MORTALITY AND CAUSES OF DEATH AMONG CHILDREN UNDER FIVE YEARS OF AGE IN LAO CAI PROVINCE, 2022–2023

Minh Dien Tran — 2025-08-22

Objectives: This study aims to describe the situation of under-ve child mortality by cause and several related factors at the Lao Cai Obstetrics and Pediatrics Hospital during the period 2022 - 2023.

Subjects and Methods: Medical record data from Lao Cai Obstetrics and Pediatrics Hospital in 2022 and 2023 were used to analyze and report the number of under-five child deaths by age group, gender, place of residence, ethnicity, and cause of death.

Conclusion: The study results indicate that neonatal mortality at Lao Cai Obstetrics and Pediatrics Hospital remains high. Findings highlight the need for earlier and more eective medical interventions in the assessment, triage, emergency management, and resuscitation of children - particularly neonates. Additionally, it is necessary to strengthen the capacity of lower-level health facilities in districts with high mortality rates to help reduce preventable child deaths.

DETECT CHROMOSOMAL ALTERATIONS IN PATIENTS WITH NEUROBLASTOMA USING ARRAY COMPARATIVE GENOMICS HYBRIDIZATION TECHNIQUE

Thanh Tam Nguyen — 2025-08-22

Neuroblastoma is one of the most common malignancies in children, accounting for about 8% of childhood cancers, ranking 4th after acute leukemia, brain tumors and lymphomas.

Samples: 2 patients with mediastinal tumor detected and diagnosed with neuroblastoma, without MYCN amplication being treated at Center of Children’s Cancer, National Children’s Hospital.

Methods: We used aCGH comparative genomic hybridization technique with 60K resolution.

Results: Two patients had detected genetic mutations of SCA and SCA combined with NCA.

Conclusion: Applying aCGH technique with resolution from 60K can detect genetic changes in neuroblastoma patients. This is the basis for more effective prognosis and treatment of neuroblastoma in the future.

PHENOTYPIC AND CYTOGENETIC FEATURES OF TETRASOMY 18P SYNDROME: CASE REPORT

Tien Chung Hoang — 2025-08-22

Tetrasomy 18p syndrome is an extremely rare chromosomal disorder, characterized by intellectual disability, microcephaly, altered muscle tone, and multiple congenital anomalies. The condition results from the presence of an additional isochromosome 18p in the karyotype. Most cases of Tetrasomy 18p syndrome arise from de novo chromosomal mutations. In this study, we report a case of a 4-month-old male patient diagnosed with Tetrasomy 18p syndrome through genetic testing performed at the Department of Human Genetics, Viet Nam National Children’s Hospital. The patient had a karyotype of 47,XY,+i(18) (p10), indicating a de novo mutation.

ADOLESCENT DEPRESSION: INSIGHTS FROM A SUCCESSFUL CASE

Minh Loan Do — 2025-08-22

A 15-year-old girl went to the doctor because of a headache that lasted for 2 months. She initially presented to a neurological clinic but do not respond well to treatment then be referred to a mental health clinic. Signs of in-depth investigation include fatigue, anxiety, sadness, depressed mood, and loss of daily interests, self-harming behavior, suicidal ideation, and sleep disturbances. The child was diagnosed with severe depression with suicidal ideation. The treatment was successful with a combination of pharmacological treatment and psychotherapy over a 13-month treatment period including 1 month of inpatient treatment at the hospital and 12 months of outpatient treatment.

EMERGENCY MANAGEMENT OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA IN NEWBORNS: INSIGHTS FROM THREE RARE CLINICAL CASES

Van Chien Nguyen — 2025-08-22

Supraventricular tachycardia (SVT) is a common arrhythmia in neonates. Most SVT in the neonate is due to a re-entrant mechanism. SVT may initially be asymptomatic, but when prolonged it may result in congestive cardiac failure and shock after a variable period. The efective treatment of any arrhythmia requires attention to overall hemodynamic status and the mechanism of arrhythmia. The present study reports three cases of neonatal patients were referred to our department with tachycardia and hemodynamic instability. Although there are still many limitations in treatment (the frst-line drug as Adenosine, ...), but we have successfully treated it with available resources at the our hospital. In this report, the authors present the clinical, paraclinical and outcomes features of neonatal arrhythmias with review of the literature.