Tạp chí của Trường Đại học Y Dược Hải Phòng
The deviation between digital and silicone impression for abutment teeth
The advancement of intraoral scanners has allowed for more efficient workflow in the dental practice. The aim of this research was to analyze the impression deviation between intraoral scan technique and conventional polyvinyl siloxane (PVS) material by 3D software. A case series study was performed with 16 teeth. Tooth preparation was taken with supra- or level- gingival heavy chamfer finishing line, then all samples were taken impression using either digital intraoral scanner (Trios 3th generation, 3Shape, Denmark) (group A) and PVS material (Silagum, DMG, Germany) (group B). The analysis was performed on the abutment teeth with parameters: the number of different areas, the deviation level of the surface area, the disparity value in 3 spatial dimensions. Result showed a notably difference between the two impression methods.
Evaluation of practice of postoperative thromboembolism prophylaxis among colorectal cancer patients in the National Cancer Hospital
The study was carried out to investigate the appropriateness of thromboprophylaxis for colorectal cancer patients after surgery. A descriptive retrospective study was conducted among patients aged 18 and above, who underwent colorectal cancer surgery at the Department of Internal Medicine, National Cancer Hospital from January 2021 to June 2021. Criteria for appropriate prophylaxis were set up based on the international and local thromboprophylaxis guidelines and anticoagulants’ summary of product characteristics (SmPC). The prophylaxis regimen of patients after 166 surgeries were evaluated. The major surgeries accounted for 92.8 % of the surgeries. The proportions of patients with high and moderate risks of postoperative venous thromboembolism (VTE) were 91% and 8 %, respectively. The rate of patients who received any form of thromboprophylaxis was 16.3% while the rate of patients indicated with appropriate methods of VTE prevention was 83.7%. The proportion of patients without prophylaxis was significantly higher among patients with moderate VTE risk compared to those at high risk (p=0.004). Among patients with appropriate thromboprophylaxis, 100% were prescribed an appropriate anticoagulant at a suitable dose. However, all of them initiated the therapy later than the recommendations and 96.4% had shorter prophylactic duration. There was still a gap in the appropriate practice of post-surgical thromboprophylaxis for patients undergoing colorectal cancer treatment. The initiation time and the duration of prevention still deviated from the standard recommendations.
Adverse drug reactions (ADRs): Managing and Monitoring at 199 Hospital
On time detection of Adverse Drug Reactions (ADRs) helps avoid the harmful effects to patients, and promptly prevent mishaps or disasters to our health care. To assist in monitoring the safety in the use of drugs for patients, and providing maximum data to the National Center for DI&ADR on the drug safety of Phase 4 (the drugs are widely used in the community), clinical pharmacists have monitored ADRs actively instead of waiting for clinical reports. A cross-sectional description study was done by interview, review profiles, examine inpatients randomly at any time of the treatment (priority to choose patients with complex pharmacotherapy or high-risk drugs causing adverse reactions). A total of 455 interviews, examinations, and follow-ups of 15 ADRs cases were actively exploited by pharmacists (3.3%). Harmful reactions are also recorded in most specialties. The first rate was acute reaction (47%, 7 cases), the second rate was sub -acute reaction (33%, 5 cases), and the delayed reaction accounted for at least (20%, 3 cases). There are 14 drugs that are suspect or certainly related to adverse reactions, 8 of these are high-risk drugs on A-PINCH list (accounting for 57%). Proactive ADRs monitoring is necessary to minimize the risks for patients. Clinical pharmacists should get involved in the process and follow through. Aside from providing health care providers with frequent trainings to keep them with the up-to-date information needed, an improvement of prescription software to minimize ADRs should be applied.
The prevalence of overweight/obesity and some risk factors in high schoolers at Le Quy Don high school of Haiphong City in 2019
The study aimed to determine the prevalence of overweight/obesity and describe some risk factors among high schoolers of Le Quy Don in Hai An County, Hai Phong City in 2019. Studied subjects included 1381 high schoolers aged from 15 to 17 years old. Method was a cross-sectional study. The prevalence of overweight was 13.5% and obesity was 10.5% (overweight/obesity was 24.0%). The prevalence of overweight/obesity in male high schoolers was 30.9% higher than that of female high schoolers 18.7%. The prevalence of overweight/obesity in level 10 was 22.4%, level 11 was 23.9%, and level 12 was 26.1%. There were 3 risk factors relating to overweight/obesity on the final model of Multinomial Logistic Regression analysis such as sex (OR=1.99), having an overweight/obesity person in the family (OR=1.83), and less physical activities (OR=0.53). Overweight/obesity affected nearly a quarter of high schoolers of Le Quy Don, mainly in male high schoolers. Sex, having an overweight/obesity person in the family, and less physical activities were risk factors of overweight/obesity.
Implementation of enhanced information service at Pham Ngoc Thach Hospital
The study aimed to investigate the needs for DI service and evaluate the effectiveness of the enhanced DI service at Pham Ngoc Thach (PNT) hospital. HCPs at PNT hospital completed the first survey on the demand for DI in June 2022 and the second survey on the effectiveness of the DI service in April 2023. The DI service provided by the CPs focused on articles updating relevant medication use and enhanced prompt responses to DI inquiries from other HCPs. The first survey received a total of 278 responses. All participants agreed that implementation of DI service was necessary, out of which, 81.4% agreed that DI service was absolutely essential. The participants admitted that searching DI was difficult due to time-consuming (45.7%), language barrier (32.0%), and uncertainty of information accuracy (30.2%). The DI topics of interest included method of administration, adverse drug reaction, drug selection, and dose adjustment, which accounted for 73.4%, 68.7%, 65.1%, and 64.4%, respectively. Of 203 participants taking part in the second survey, 165 (80.8%) agreed that the DI service provided by CPs was clinically useful. More than three-quarters of the participants agreed that DI articles written by the CPs were intelligible (78.8%) and up-to-date (77.8%). Regarding the approaches to solve DI inquiries, about half of the participants preferred verbal consulting the CPs (56.9%), whereas 41.7% selected reading the published DI articles provided by the CPs. Besides, 80.8% participants agreed that DI inquiries were answered in time and promptly. Conclusion: HCPs deemed DI essential, and the enhanced DI service at PNT hospital was considered clinically useful.
Some common hemodynamic disorders and risk factors in patients after Blalock- Taussig Shunt in Vietnam National Children’s Hospital in 2021
The aims of this study were to describe some common hemodynamic disorders and evaluate some risk factors in patients after Blalock-Taussig Shunt (BTS). It was a cross-sectional study in 70 patients less than 5kg with a closed heart surgery by the simple BTS. Patients’ hemodynamic data were collected, some early hemodynamic disorders such as under shunt, over shunt, and capillary leak were described within 48 hours after the BTS, and related factors were recorded. Hemodynamic data were described and compared between complication groups and then some risk factors related to hemodynamic disorders were described. The rate of hemodynamic disorders within 48 hours after the BTS were 94.0%, in which 37.1% were under shunt, 42.9% were overshunt, and 54.3% had capillary leak. Patients with capillary leak after the BTS had higher cardiovascular indexes than those of the others. Neonatal patients and patients who were operated by midline incision had higher risk of capillary leak than the others. BTS patients had a high rate of hemodynamic disorders within 48 hours after the BTS. The neonatal age and the midline incision were risk factors relating to the capillary leak status after the BTS.
Antibiotic prophylaxis for surgical procedures at A Tertiary Hospital, Vietnam
Background: Surgical site infections (SSIs) are serious health care problems, increasing treatment costs, prolonging hospital stay, and even leading to permanent disability and death. Fortunately, it can be prevented by appropriate antibiotic prophylaxis for surgical procedures. Hai Phong International Hospital was established in 2015 with more than 500 patient beds and over 450 surgeries each month, serving many patients with high quality. However, up to now, there have not been any specific reports related to the use of antibiotics in surgical patients at the hospital. Therefore, this study aimed to describe the status of prophylactic antibiotic use in surgery patients at Haiphong International Hospital in 2021. Methods: A descriptive retrospective study was conducted using medical records of all surgery patients at three surgery departments (General; Urology and Orthopedic Surgery) at Haiphong International Hospital, Vietnam, in 2021. Results: The study included 186 surgery patients without preoperative infection. The median age of patients in the study was 46 years old with the range of 34-60. Orthopedic and urologic procedures were the most common surgery with 30.6% and 26.3%, respectively. The most commonly used antibiotics were Ampicillin/Sulbactam (41.9%) Metronidazole (27.4%); Cefazolin (24.7%); Ciprofloxacin (22%); Cefoperazole (14%). The time of administering the antibiotic was mostly within 30 minutes after closing the incision (49.5%). The duration of antibiotic use after surgery ranged from 1 to 28 days, of which 73.1% used from 8 to 14 days. The overall appropriateness of prophylactic antibiotic use was very low with only 1.6%. The main problems were prolonged prophylactic duration (98.4%), inappropriate antibiotic selection (83.3%), inappropriate administration time (66.7%), and inappropriate antibiotic dosage (50.5%). Conclusion: The overall appropriateness of prophylactic antibiotic use was very low. The main problems were prolonged prophylactic duration, inappropriate antibiotic selection, inappropriate administration time, and inappropriate antibiotic dosage. Therefore, developing the guidelines for surgical prophylactic antibiotics in the hospital is necessary to prevent surgical site infections and antibiotic resistance.
Initial outcomes laparoscopic transabdominal preperitoneal (TAPP) with a grip self-fixating mesh for inguinal hernia
Objective: To assess the initial outcomes of the technical application and treatment of inguinal hernia (IH) using transabdominal preperitoneal laparoscopy (TAPP) with a grip self-fixating mesh at Hai Phong University Hospital from January 2022 to December 2023. Patients and Methods: This study included 30 patients diagnosed with IH who were treated with TAPP at the Hai Phong Medical University Hospital from January 2022 to December 2023. Results: The mean age was 54.5 ± 12.1 years. Of these, 58.4% were aged < 60 years. There were 19 (63.3%) had right-sided IH and 11 (36.7%) had left-sided IH. Indirect IH was observed in 23/30 patients. The mean operation time was 87.3 ± 12.7 minutes. The mean postoperative pain duration was 3.1 ± 1.5 days. The mean length of hospital stay was 5.76 ± 1.17 days, the shortest was 3 days, and the longest was 9 days. The mean time to return to normal activities was 1.3 ± 0.5 days. Four of the 30 patients experienced postoperative complications, including one patient with wound infection, one patient with urinary retention, and two patients with thigh numbness. Conclusion: TAPP with grip self-fixating mesh for IH yielded good outcomes and rapid postoperative recovery.
Plasma b-type natriuretic peptide concentrations during the adolescent period
DOI: https://doi.org/10.59070/jhs010323022 Objective: Determine plasma NT-ProBNP concentrations during the adolescent period. Object and methods of the study: a prospective, cross-sectional study on 112 patients from 10-18 years old examined at the Department of Adolescent Health, Vietnam National Children's Hospital. Quantify plasma NT-ProBNP concentration and compare this index across juvenile stages, gender, and body mass index. Results: NT-ProBNP concentration in females was higher than in males with a statistically significant difference (p<0.05). There was no statistically significant difference in NT-ProBNP concentrations between the early, middle, and late adolescence stages (p>0.05). In girls, NT-ProBNP concentrations were higher during puberty than during pre-pubertal periods (p<0.05), whereas in boys, NT-ProBNP concentrations during puberty were lower than during pre-pubertal (p<0.05). NT-ProBNP concentration was highest in the underweight group, followed by the normal and overweight groups, and lowest in the obese group with a statistically significant difference (p<0.05). Conclusion: There are differences in NT-ProBNP concentrations according to gender and no changes were observed in the adolescence stages. NT-ProBNP concentrations varied during puberty and according to body mass index (p<0.05).
Early results of endoscopic bipolar transurethral resection of non-muscle invasive bladder cancer at Viet Tiep Hospital
Objective: To evaluate the early results of endoscopic bipolar transurethral resection (Bi-TUR) of non-muscle invasive bladder cancer (NMIBC) at Viet Tiep Hospital. Patients and methods: This study included 33 patients diagnosed with NMIBC who were treated with Bi-TUR at Viet Tiep Hospital between April 2022 and August 2023. Results: The mean age was 66.8 ± 11.4 years, the youngest was 40 years, and the oldest was 87 years. The male-to-female ratio was 5.6/1. The most common location of the tumor was the lateral wall in of 24/33 patients, accounting for 72.7%. The mean operation time was 45.1 ± 9.5 minutes. Among the 33 patients, 30 (90.9 %) had no complications. One patient had postoperative bleeding, accounting for 3%, and two patients had urinary tract infections, accounting for 6.1%. Evaluation of the surgical results after surgery showed that 30/33 patients achieved good results. Three patients achieved fair results. The most common histological type was transitional cell carcinoma in 32/33 patients, accounting for 97%. Conclusion: The Bi-TUR for NMIBC is safe and effective, reducing many intraoperative and postoperative complications.
Value of plasma NT-ProBNP concentration in the diagnosis of congenital heart in children
Objective: Research the value of plasma NT-ProBNP concentration in diagnosing congenital heart disease in children. Objects and methods of study: Controlled study on 80 children with congenital heart disease at the Vietnam National Children's Hospital from April 2018 to August 2019. Results: NT-ProBNP concentrations in all types of congenital heart disease were higher than in the control group (p<0.05). NT-ProBNP concentration was highest in the left-right shunt group and lowest in the cyanotic congenital heart disease group with a statistically significant difference (p>0.05). NT-ProBNP concentration was highest in the severe heart failure group, followed by the moderate, mild and no heart failure groups and were all higher than the control group (p < 0.01). NT-ProBNP concentration was the highest in the severe pulmonary hypertension group, followed by the moderate, mild, and no pulmonary hypertension groups and were all higher than the control group (p<0.05). The optimal cutoff point of NT-ProBNP is 671 pg/ml, which is valuable for diagnosing congenital heart disease with a sensitivity of 90.2%, a specificity of 53.1% and an area under the curve of 0.735. Conclusion: NT-ProBNP levels are increased in congenital heart disease in children. Increased NT-ProBNP concentrations are associated with left-right shunting, degree of heart failure and pulmonary hypertension.
Joint international post-graduate training program in pediatrics between Hai Phong University of Medicine and Pharmacy and Australia
Hai Phong University of Medicine and Pharmacy was the first Vietnam institution collaborating with the Westmead Children's Hospital and the University of Sydney, Australia to organize the International Postgraduate Pediatric Certificate (IPPC), which was later renamed as Sydney Child Health Program (SCHP). The IPPC/SCHP framework is comprised of 9 modules, with over 100 online English lectures. The IPPC/SCHP was a highly valuable course since it not only increased students' English ability, particularly medical English, but also helped them to ameliorate their capacity to diagnose, treat, and take better care of children's health. By December 2022, seven IPPC/SCHP training courses were completed, and 36 students were graduated from the Program.
Communication improvement activities of mind-healing mentor-pharmacists
With the advancement of AI and digital technology, including ChatGPT, our lives and the perception of patients as “medical service consumers” are changing in line with other social changes, and the concept of patient treatment is changing rapidly. It is urgently necessary to think about the roles of pharmacist for patients and to seek for the direction of change. We have been making steady efforts to become a “Pharmacists that heals the hearts of patients” by growing the consciousness of pharmacists amidst these changes. Through various activities such as patient counseling committee, customer satisfaction committee, mentor class, learning team activity, and accompanying program, we are promoting mutual understanding among employees and strengthening patient-pharmacist communication capabilities. Cases from the patient counseling committee are loaded onto the hospital’s online education program to be shared with all staff, and the patient counseling committee activities and counseling cases, leaflets are shared with other hospitals. As an activity to improve patient experience, a checklist that can be used in all areas where pharmacists meet patients was developed and applied during counseling. We provided an opportunity to think about the roles of pharmacists for patients’ healthy and happy life. Perceptions of the role of Pharmacists for patient safety are changing. Through various activities and results for effective communication between patients and pharmacists, we can help patients use medicines appropriately and grow into “mentor pharmacists” who can lead patients to solve the root cause of their diseases on their own.
The incidence of malnutrition in children under 5 years old at 2 communes in Tu Ky District, Hai Duong Province in 2023
Objective. The study was done to estimate the incidence of malnutrition in children under 5 years old in Tu Ky district, Hai Duong Province in 2023. Subjects and Method. Subjects included 602 children under 5 years old in the study setting. The method was a cross-sectional study. Results. The incidence of underweight was 6.1%, stunting was 12.3%, and wasting was 10.8%. Underweight affected more females than males (6.4% so vs 5.9%), similarly, wasting affected more females than males (11.0% vs 10.6%). In contrast, stunting affected more males than females (14.2% vs 10.4%). The incidence of 3 kinds of malnutrition gradually increased and peaked when children were 2 to 3 years old, then the incidences gradually decreased when children were 4 to 5 years old. Conclusions. Malnutrition is a common disease in children under 5 years old in Tu Ky. The disease occurs in both males and females but is moderately common.
Value of serum NT-ProBNP concentration in the diagnosis of some acquired heart diseases in children
Objective: Research the value of plasma NT - ProBNP in diagnosing acquired heart diseases in children. Objects and methods of the study: Cross-sectional descriptions of 107 patients included myocarditis, dilated cardiomyopathy, supraventricular tachycardia, and Kawasaki disease at the Vietnam National Children's Hospital. Quantify plasma NT- ProBNP concentrations and compare between these pathological groups and the control group. Results: NT-ProBNP concentrations in cardiovascular diseases were higher than in the control group with a statistically significant difference (p<0.05). NT-ProBNP concentration was highest in the myocarditis group, followed by supraventricular tachycardia and dilated cardiomyopathy, and lowest in the Kawasaki group (p < 0.05). The optimal cut-off points of NT-ProBNP in diagnosing myocarditis, dilated cardiomyopathy, and Kawasaki are 1195, 943.6 and 176.4 pg/ml, respectively. NT-ProBNP concentration in the group with systolic dysfunction (EF<50%) was statistically significantly higher than the group with normal systolic function (EF≥50%) with p<0.001. Conclusion: NT-ProBNP concentrations increase in some acquired heart diseases such as myocarditis, dilated cardiomyopathy, supraventricular tachycardia, and Kawasaki. NT-ProBNP concentration correlates with left ventricular systolic function
Early surgical results of totally preperitoneal endoscopic (TEP) repair for inguinal hernia
Objective: To assess the initial outcomes of Laparoscopic Totally Extraperitoneal (TEP) surgery for inguinal hernia (IH). Patients and Methods: This study included 58 patients diagnosed with IH who were treated with TEP at the Viet Tiep Hospital between September 2021 and September 2023. Results: The mean age was 57.1 ± 11.7 years. Of these, 58.4% were aged < 60 years old. There were 37 (63.8%) had right-sided IH and 21 (36.2%) had left-sided IH. Most patients (79.3 %) had indirect inguinal hernias. The mean operation time was 60.3 ± 21.3 minutes; postoperative hospital stay was 5.1 ± 1.6 days. Intraoperative and postoperative complications were mild and infrequent. Regarding early surgical outcomes, most patients have excellent results, accounting for 91.4%. No poor results were observed. Conclusion: TEP for IH is a safe and effective method to minimize early complications and adverse events
Clinical and subclinical features and results of treatment of neonatal unconjugated hyperbilirubinemia jaundice due to maternal child blood group incompatibility at Haiphong Children’s Hospital from 2017 to 2022
Objectives. The study was done to describe clinical and subclinical features and results of treatment of neonatal unconjugated hyperbilirubinemia due to maternal child blood group incompatibility at Haiphong Children’s Hospital from 2017 to 2022. Subjects and Methods. Subjects included 51 infants with UHBJ due to maternal-child blood group incompatibility. The method was a case-series report. Results and Conclusions. The male/female ratio was approximately 1:1. The majority of patients were normal newborns. A history of having a sibling with neonatal jaundice accounted for a low rate. Most of the cases with jaundice occurred 24 hours after birth, the cases occurring 72 hours after birth accounted for a low rate. Jaundice in zones 3 and 5 accounted for the highest rate. ABO incompatibility accounted for 78.4%, and Rh was 22.6%. Which OA form accounted for 45.1%, and the OB form was 33.3%. The average concentration of UB on admission was about 23.27± 5.72 mg%. After 24 h of PT, the average UB reduced by 5.82± 1.3 mg%. At the end of PT, the average UB was very low: 8.12± 3.89 mg% (The average UB reduced by 60% compared to that before the PT). Exchange transfusion reduced 50% UB right after ET (from 28.12± 4.83 mg% to 13.02± 5.9 mg%). After 48 h of ET, the average UB reduced to 10.6± 4.28 mg%, and after 72 h, it decreased to a very low level 9.1± 3.21 mg%. 84.3% of patients recovered, 5.9% were referred to higher hospitals. The average hospitalization time was 6.47± 2.76 (days).
Determination of plasma B-type natriuretic peptide concentrations in the neonatal period
Objective: Determine plasma NT-ProBNP concentration in the neonatal period. Objects and methods of the study: Prospective, cross-sectional study on 96 children from 1 day to 28 days at the Vietnam National Children's Hospital. Quantifying the plasma NT-ProBP concentration and comparing between age groups, gender, and preterm – full-term infants. Results: NT-ProBNP concentration was highest at 1 day of age and then gradually decreased with age with a statistically significant difference (p<0.05). There is a negative linear correlation between NT-ProBP concentration and age (r = -0.82; p < 0.05). There was no difference in NT-ProBNP concentration according to gender (p>0.05). NT-ProBNP concentrations in preterm infants were higher than in full-term infants (p<0.05). Conclusion: NT-ProBNP concentration increases after birth and gradually decreases with age. There were differences in NT-ProBNP concentrations between full-term and preterm infants but no differences by gender.
Surgical outcomes of TransAbdominal PrePeritoneal laparoscopic surgery (TAPP) for inguinal hernia at Viet Tiep Hospital
Objective: To assess the outcomes of TransAbdominal PrePeritoneal (TAPP)surgery for inguinal hernia (IH). Patients and Methods: This study included 52 patients diagnosed with IH who were treated with TAPP at Viet Tiep Hospital between March 2021 and September 2023. Results: The mean age was 56.8 ± 10.3 years. Right-sided hernias accounted for 31 patients (59.6 %), while left-sided hernias accounted for 21 patients (40.4%). The majority of patients with indirect IH accounted for 65.4%, while those with direct IH accounted for 34.6%. No mixed hernias were observed. Mean operation time was 79.1 ± 14.8 minutes; postoperative hospital stay was 6.12 ± 1.25 days. The mean pain duration was 3.3 ± 1.2 days. Postoperative complications were mild and infrequent. Regarding the early surgical outcomes, most patients (82.7%) showed excellent results. No poor results were observed. Conclusion: TAPP for IH resulted in good surgical outcomes and a short recovery time. Comparative studies and randomized controlled trials are required to verify the effectiveness of this technique.
Clinical Epidemiology, paraclinical characteristics and treatment results of patients with acute laryngitis at Hai Phong Children's Hospital in 2022
Objectives: A study with the following objectives: to describe some clinical, and subclinical characteristics and treatment results of acute laryngitis at Hai Phong Children's Hospital from January 1st, 2022, to December 31st, 2022. Subjects and method: A descriptive study using retrospective data from 111 medical records of inpatients with acute laryngitis. Results: This study showed that this disease was more common in children under 60 months of age, in boys than in girls, and in children from suburban areas more than in urban areas. The disease was popular in winter-spring with the most common symptoms such as hoarseness, barking cough, fever, stridor, and chest retraction. All the patients were cured or relieved with the use of nebulized adrenaline to relieve laryngeal dyspnea and corticosteroids in combination with injection, oral, and oral medications. Conclusion: The rate of children admitted to hospital with laryngeal dyspnea level II and III was still quite high in this study (36%). It is important to note the trend of increasing Influenza type B infection and decreasing RSV infection rates after the COVID-19 epidemic in children with acute laryngitis.
Inhaled colistin for treatment of pneumonia due to multidrug-resistant gram-negative bacteria at a tertiary hospital, in Vietnam
Background: There is a return of colistin as the treatment of last resort for multi-resistant bacteria. However, due to the limited penetration in the lung parenchyma and the renal side effects, the effectiveness of intravenous (IV) colistin therapy has been questioned. Colistin inhalation therapy is deemed tolerable, safe, and could be a beneficial therapy. However, the efficacy and safety of colistin monotherapy is still unclear. Therefore, this study aimed to describe the use of inhaled colistin in patients with drug-resistant bacterial pneumonia at a tertiary hospital in Vietnam from July 2021 to September 2022. Methods: A descriptive retrospective study was conducted using medical records of all inpatients who were treated with inhaled colistin at a tertiary hospital in Vietnam, from July 2021 to September 2022. Results: This study included 12 hospital pneumonia patients, aged 81.5±13.5, equivalent to 21 inhaled colistin treatment courses. The disease mainly causes Acinetobacter baumannii (100%), Klebsiella pneumonia (47.62%), and Pseudomonas aeruginosa (38.09%). 100% of patients were taken an aerosol colistin dose of 4 million IU every 8h of aerosol for 30 minutes from 7 to 14 days. The success of clinical efficacy was 95.23% while the success of microbiological efficacy was just 42.86%. 5/12 patients have recurrent infection, and 1 patient used 6 courses of aerosol colistin treatment in 1 hospitalization. Changes in kidney function before and after the use of colistin aerosol are negligible. Conclusion: Colistin inhalation therapy has been shown effective in treating multidrug-resistant pneumonia without causing kidney toxicity. However, the rate of recurrent infection in the study was quite high, so a prospective study with a larger sample size should be conducted to further evaluate the efficacy and toxicity of inhaled colistin therapy.
The current status of dietary characteristics of outpatients with chronic obstructive pulmonary disease at Viet Tiep Friendship Hospital, Hai Phong in 2022
A cross-sectional descriptive survey on 100 people with chronic obstructive pulmonary disease receiving outpatients at Viet Tiep Friendship Hospital in Hai Phong aims to describe the current status of dietary intake of patients. The study period was from December 2021 to June 2022. The dietary intake of patients was assessed by questioning and recording methods in the past 24 hours. Research results show that: The average dietary energy was 1770,2 ± 485,8 kcal/day, 26% higher than the recommended daily requirement. Substances that meet the recommended daily requirement consist of Energy-generated substances: Protein; Minerals: Na; K; Vitamins: C; B1. Substances that do not meet the recommended daily requirement consist of Lipid (181,6%); Glucid (115,5%); Canxi (50,0%); Vitamin A (33,0%); Vitamin B2 (66,7%). Patients should be encouraged to restrict starch, eat more plant-based fats, and foods rich in Calcium, vitamin A, and vitamin B2.
Complications in single-incision laparoscopic surgery transabdominal preperitoneal (SILS-TAPP) for inguinal hernia
Objective: Single-incision laparoscopic surgery transabdominal preperitoneal (SILS-TAPP) inguinal hernia (IH) repair represents an innovative advancement in minimally invasive surgical techniques. However, there have been concerns about the complication rate of this technique. We aimed to systematically review the complications of SILS-TAPP in detail. Methods: We comprehensively searched the published literature between 1980 and 2022 on Pubmed, Embase, Scopus, Web of Science, and Proquest. Studies of IH patients aged < 18 who underwent SILS-TAPP were included. The results must include the intraoperative and/or postoperative complications rate of surgery. Studies not in English, studies of patients who underwent another surgery apart from hernia repair, and review articles were excluded. The abstract and full-text screening were done. Results: Primary search on a major database platform gained 348 records of articles. After screening, 9 studies were included. Nine studies recruited 1561 patients. Men were dominant. Recurrent IH accounted for about 4%. Two studies reported using specialized laparoscopic instruments (Roticulator), while the other eight used conventional instruments. No major intraoperative complications were reported. Blood loss was minimal. There was only one case wherein an additional trocar was placed. Postoperative complications were observed in about 5% of cases, including seroma, hematoma, urinary retention, port site infection, ileus, foreign body sensation, and port site hernia. Recurrence was rare, accounting for about 0.3%. Conclusion: Complications of SILS-TAPP are not frequent and mild. The recurrent rate is small. Therefore, SILS-TAPP can be a good alternative for open and laparoscopic hernia repair.
Transabdominal preperitoneal (TAPP) laparoscopic versus Lichtenstein surgery for unilateral primary inguinal hernia in elderly men
Objective: Transabdominal preperitoneal laparoscopic surgery (TAPP) inguinal hernia (IH) repair has been an alternative to the Lichtenstein procedure. However, there have been concerns about the risks of TAPP in the elderly. We aimed to compare surgical outcomes between the two surgeries in older men with IH. Methods: We retrospectively recruited elderly men with IH who underwent either Lichtenstein or TAPP surgery from 2020 to 2022 in a tertiary hospital. Inclusion criteria were patients aged 60 years or older with unilateral inguinal hernia. Patients with recurrent, incarcerated, strangulated hernia, and femoral hernia were excluded from the study. Study indicators included characteristics of patients and surgical and postoperative outcomes. The follow-up time was 6 months and one year after surgery. Results: The mean age of patients who underwent Lichtenstein and TAPP surgery was 71 and 67 years, respectively. BMI, prevalence of comorbidities, and Nyhus classification of hernia did not differ between the two groups. Lichtenstein procedure was likely to take longer than TAPP (61.2 mins versus 40.5 mins, p = 0.002). Intraoperative complications were not frequent in both groups. Meanwhile, the pain duration of patients who underwent Lichtenstein surgery was longer than those of TAPP (3.5 days versus 2.1 days, respectively). Additionally, TAPP surgery offered shorter hospital stays than Lichtenstein surgery (3.3±1.6 days versus 5.3±2.1 days, respectively). The most prevalent postoperative complications were seroma, accounting for about 10% in each group. The postoperative complication rate and recurrent rate were similar. Conclusion: Lichtenstein and TAPP surgery are safe and feasible for elderly patients with inguinal hernia. However, TAPP offers shorter operation time, pain duration, and hospital stay than the Lichtenstein procedure.
Short-term results of duodenum-preserving pancreatic head resection for solid pseudopapillary neoplasm in children at the National Children's Hospital
Objective: To evaluate the results of duodenum-preserving pancreatic head resection for treating solid pseudopapillary neoplasm (SPN) of the pancreas in children at the National Children's Hospital. Methods: A descriptive, retrospective study of 11 patients diagnosed with pancreatic SPN and treated surgically at the National Children's Hospital from May 2022 to May 2024. Results: The average age of diagnosis in children was 10.9 years (range: 8-15 years), predominantly affecting female patients (81.8%). The main clinical symptoms were epigastric and left hypochondrial pain (81.8%). The average tumor size was 51.3 mm (range: 2.6-10 cm). Computed tomography (CT) imaging revealed a predominantly mixed structure in 9 out of 11 patients (81.8%). All patients underwent duodenum-preserving pancreatic head resection, with no severe intraoperative or postoperative complications. Conclusion: SPN is a rare pancreatic tumor with low malignancy, minimal invasiveness, and low rates of metastasis and recurrence. Thus, surgery is a safe and effective treatment method for children, with a low complication rate.
A case of extensive colonic dilation complicated by ileus due to Hirschsprung's disease in adults: An easily missed diagnosis
Hirschsprung's disease is a congenital condition characterized by the absence of ganglion cells in the colon. While approximately 90% of cases are diagnosed before the age of five, the occurrence of Hirschsprung's disease in adults is rare and frequently overlooked. This report presents the case of a 61-year-old male patient who was admitted to the hospital with symptoms indicative of intestinal obstruction caused by dilatation of the entire colon. A comprehensive medical history combined with computed tomography findings suggested Hirschsprung's disease. The patient subsequently underwent a subtotal colorectal resection with ileorectal anastomosis. A postoperative follow-up at five months indicated favorable outcomes.
Evaluation of surgical outcomes in treating severe and very severe carpal tunnel syndrome in gout patients at Viet Tiep Friendship Hospital
Objective: To evaluate the surgical outcomes of treating severe and very severe carpal tunnel syndrome (CTS) in patients with gout. Methods: This retrospective study involved the surgical release of the carpal tunnel and decompression of the median nerve in 40 patients (45 hands) diagnosed with severe and very severe CTS in the context of gout at the Huu Nghi Viet Tiep Hospital from January 2020 to June 2022. Symptom severity and hand function were assessed in all patients by using the Boston scoring system and clinical tests. Results: After 24 months post-surgery, the Boston score decreased significantly from 4.63 points to 3.2 points, with a noticeable reduction in numbness symptoms. However, recovery from muscle atrophy was slow. Conclusion: Surgical treatment of severe and very severe CTS in patients with gout contributed to symptom improvement and enhanced hand function, thereby enhancing the overall quality of life and daily activities.
Surgical outcomes of fixation of closed intercondylar humerus fractures using locking plates at the 108 Military Central Hospital
This study aimed to describe the clinical and paraclinical characteristics of patients with closed intercondylar humerus fractures and the outcomes of surgical fixation using locking plates at the 108 Central Military Hospital. A retrospective cross-sectional study of 33 patients from January 2020 to December 2023 found that the average age of the patients was 49.35 ± 11.2 years. Fracture classification according to AO was 27.3% for type C1, 66.7% for type C2, and 6% for type C3. The mean Mayo Elbow Performance Score (MEPS) was 93 ± 6. According to Morrey’s scale, 81.8% of patients had good to very good outcomes, while 18.2% had fair outcomes, with an average Morrey score of 85.4 ± 11,2. Conclusion: Surgical treatment with locking plates for intercondylar humerus fractures is a good treatment method, providing favorable anatomical and functional recovery for patients, and enabling early functional rehabilitation post-surgery.