Hanoi Medical University Hospital Research Articles

Evaluation of the Role of MSCT in the Diagnosis of Ureteral Kidney Stones

A study of 100 patients with ureteral kidney stones, in which 66 cases of kidney stones and 68 cases of ureteral stones were taken with 128 slices of computerized tomography at Hanoi Medical University Hospital from September 2019 to the end of January 2020. Results: male/female ratio was 1.7/1. The mean age was 51.2 ± 11.7. The rate of renal function decline (creatinine increase) was 18%. The supersonic, X-ray, and Multi-slice Computer Tomography (MSCT) detected stones in 89%, 84%, and 100% of cases, respectively, including 32% of kidney stones, 34% of ureteral stones, 34% of stones in both kidneys and ureters, 63.6% kidney stones in many positions. Patients with two or more stones accounted for 78.8% and the average kidney stone size was 15.5 ± 10.9 mm. Ureteral stones in the upper third accounted for 54.4%, one stone accounted for 77.9%, and the average size of ureteral stones was 9.1 ± 3.6 mm. Complications of nephrolithiasis caused by stones account for 82%, and grades II and III are the most common. Complications of ureteral dilatation due to stones accounted for 51%, perirenal fat infiltration accounted for 24% and 32% of cases of drug excretion lasted more than 1 hour. Conclusion: MSCT plays an important role in diagnosing urinary stones and assessing renal function before treatment.

Stress Is Associated with Quality of Life Reduction among Health Professionals in Vietnam: A Multisite Survey

Stress in healthcare workers is increasingly common in recent times. Stress can have negative effects on the mental health and quality of life of healthcare workers. This study is aimed at measuring the quality of life and determining the relationship between quality of life and stress of health professionals in some hospitals in Vietnam. A cross-sectional descriptive study was conducted on 520 health professionals working at Hanoi Medical University Hospital and Thai Binh Medical University Hospital. The World Health Organization Quality-of-Life Scale (WHOQOL-BREF) and the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) scale were used to assess the quality of life and the stress status of healthcare workers. Multivariate regression was performed to measure the relationships between stress and quality of life. Results showed that the level of stress of health workers according to the DASS-21 scale at mild, moderate, severe, and very severe was 10.7%, 8.7%, 5.6%, and 2.9%, respectively. The mean score of overall quality of life was 60.97 ± 11.39 . Health workers under stress had a decrease in quality of life scores in physical, mental, social, and environmental domains. Stressed health workers had a reduced quality of life. Attention should be paid to providing appropriate interventions to reduce stress and improve the quality of life in healthcare workers.

Effectiveness of goal-directed fluid therapy guided by estimated continuous cardiac output (esCCO) in major gastrointestinal surgeries: a randomized controlled trial

Background & Objective: This study was conducted to compare the effectiveness between goal-directed fluid therapy guided by Estimated Continuous Cardiac Output (esCCO) monitoring and liberal infusion therapy on the early perioperative and postoperative complications, as well as long-term complications in major gastrointestinal surgeries.
 Methodology: A randomized controlled trial was conducted at Hanoi Medical University Hospital, Hanoi, Vietnam from October 2020 to October 2021. There were 138 patients enrolled in the study and divided randomly into two groups: Group LIF (liberal infusion therapy) and Group GD (goal-directed fluid therapy using esCCO monitors). The logistic regression (univariate and multivariate) analysis models were performed to evaluate the relationship between the complication (yes or no) and potential predictors.
 Results: Mortality and length of hospital stay in the esCCO group were not different from those in the liberal infusion therapy group (P > 0.05). Postoperative respiratory complications such as pneumonia and pulmonary edema were lower in the Group GD but not statistically significant compared with the Group LIF (5.7% vs 7.4% with P > 0.05). There was a higher rate of acute kidney injury in the Group GD than in the Group LIF, but the difference was not statistically significant (5.7% vs 1.5% with P > 0.05). Other complications such as bleeding, wound infection, and tissue edema in the Group GD was almost equivalent to those in the Group LIF and the difference was not statistically significant.
 Conclusion: Goal-directed fluid therapy according to esCCO guidelines reduced the amount of intraoperative fluids while maintaining hemodynamic stability during surgery, but has not shown a real effect in reducing postoperative complications. Further studies with a larger number of patients are needed, in high-risk groups of patients requiring intravenous fluids according to esCCO guidelines to better evaluate the effectiveness of reducing postoperative complications.
 Abbreviations: esCCO - Estimated Continuous Cardiac Output; esSVI - Estimated Stroke Volume Index; PEEP -Positive End-Expiratory Pressure; MAC - Minimum Alveolar Concentration
 Key words: esCCO; Gastrointestinal Surgeries; Goal-directed Fluid Therapy; Infusion Therapy; Randomized Controlled Trial
 Citation: Hoang Vu P, Anh Duong ND, Viet Duc Tran VD, Tran TH, Luu VX, Truong QT, Nguyen HT, Ochiai R. Effectiveness of goal-directed fluid therapy guided by estimated continuous cardiac output (esCCO) in major gastrointestinal surgeries: a randomized controlled trial. Anaesth. pain intensive care 2023;27(3):371−378; DOI: 10.35975/apic.v27i3.2242
 Received: November 15, 2022; Reviewed: April 29, 2023; Accepted: April 29, 2023

FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF INPATIENTS WITH TYPE 2 DIABETES AT HANOI MEDICAL UNIVERSITY HOSPITAL, 2020

Aims: To identify factors associated with nutritional status of inpatients with type 2 diabetes. Methods: A cross-sectional study was conducted on 97 inpatients with type 2 diabetes at the Department of Endocrinology and Respiratory, Hanoi Medical University Hospital, in 2020. Results: The rates of overweight-obesity and abdominal obesity were 22.7% and 55.7%, respectively. The patients with secondary education or less had a 3.2 times and 10.6 times higher risk of being overweight-obese and abdominal obesity, respectively, compared with the patients with higher education. Women were 2.8 times more likely to have abdominal obesity than men. Patients with physical inactivity or infrequent physical activity had a 2.5 times higher risk of abdominal obesity compared with patients with frequent physical activity. Patients who abuse alcohol were 3.7 times more likely to be overweight -obese than those who did not abuse alcohol. Conclusion: High rates of overweight-obesity and abdominal obesity were found in inpatients with type 2 diabetes in the Department of Endocrinology and Respiratory. Education level and alcohol abuse were significantly associated with overweight-obesity. Gender, education level, and physical activity level were factors associated with abdominal obesity in patients with type 2 diabetes.

Single-step laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography in patients with cholecysto-choledocholithiasis

Current treatment of complicated calculous biliary disease typically involves a two-step procedure consisting of pre- or post-operative endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC). This practice creates drawbacks as there is the need for two anesthesia inductions and longer hospital stay. The combination of LC and ERCP (LC + ERCP) for patients with cholecysto-choledocholithiasis has shown safety advantages, reducing anesthesia inductions and bringing high efficiency. This is a retrospective case series implemented at the Department of General Surgery - Hanoi Medical University Hospital between March 2020 and July 2022. In total, 44 patients met the criteria of this study. The average age of the cohort was 55.43 ± 18.12 years. The mean operating times of ERCP and LC were 58.05 ± 20.10 min and 54.09 ± 23.80 min, respectively. There was one intra-operative adverse event and no conversion. The mean hospital stay was 3.95 ± 2.28 days, and the rate of stones clearance was 100 per cent. LC combine ERCP in a single setting is a safe, effective procedure in treating cholecysto-choledocholithiasis.

Incision caring for thyroid nodules surgery without drainage at Hanoi Medical University Hospital

Thyroid nodules are the most common among endocrine gland tumors, including benign thyroid nodules and thyroid cancer. Surgery is the mainstay of treatment in thyroid nodules. Drainage making patients more painful after surgery, and at the same time prolonging hospital stay. WE conducted a randomized controlled trial. Study subjects were randomly divided into 2 groups: placement of drainage and no drainage by random selection before surgery. Total of 84 study subjects include patients with thyroid nodules who underwent surgery at the Department of Oncology and Palliative Care, Hanoi Medical University Hospital from May 2018 to November 2018. Average age was 47.12 ± 11.2 (17 - 76) years old; tumor palpable sign was 58.3%; 58.3% of nodules are in two lobes and nodules ≤ 10mm was 39.3%, TIRADS 4: 76.2%; and 58.3% thyroid cancer and 41.7% benign thyroid nodule. Univariate analysis of clinical characteristics between the two study groups: Similarities in age group, tumor size, number of tumors, histological diagnosis between the two intervention groups. Group without drainage had VAS0: 3.8 ± 0.2, VAS1: 2.3 ± 0.8, complications of fluid collection accumulation 9.5%, subcutaneous hematoma accumulation 4.8%, hypoparathyroidism 4.8%, hoarseness 7.1%, no cases of bleeding requiring reoperation and postoperative infection, hospital stay 4.7 ± 0.5 days, satisfaction level 4.6 ± 0.5, higher than drainage group. No drainage in several thyroid surgery cases is safe, with shortened surgery period, hospitalized period, and brings comfort and convenience to patients in the postoperative period.

Early results of laparoscopic lobectomy in the treatment of non-small cell lung cancer at Hanoi Medical University Hospital

Background: Lung cancer is the leading cause of cancer death in Vietnam. Total endoscopic lobectomy is indicated for the treatment of suitable stage non-small cell lung cancer. We conducted a study on patients undergoing laparoscopic lobectomy at Hanoi Medical University Hospital to evaluate the feasibility and safety of the surgery.
 Methods: We conducted a study from January 2022 to December 2022 on 30 patients undergoing endoscopic lobectomy for non-small cell lung cancer at the Cardiovascular and Thoracic Surgery Unit, Hanoi Medical University Hospital.
 Results: Most of the patients were in early stage, there were 4 patients with stage IIIA, the average operating time was 96 minutes, the average hospital stay was 5.7 days. . There was 01 death due to pulmonary embolism and 1 case of air leak > 7 days after surgery.
 Conclusion: Total endoscopic lobectomy at Hanoi Medical University hospital shows feasibility and safety although there are still many problems to improve to improve the quality of treatment

A longitudinal assessment of appetite loss and nutritional care among postoperative patients in Vietnam.

Post-operative appetite loss is an important complication affecting surgical outcomes. It has been estimated that nearly 60% of patients having gastrointestinal or major elective surgeries suffer from malnutrition. Appetite refers to the physical desire for food appetite, and losing appetite after surgery may result in a decrease in body weight, impairment of intestinal absorption and eventually, malnutrition among postoperative patients. This study aims to assess appetite status and other relevant factors among abdominal postoperative patients in Vietnam. A cross-sectional study was conducted on 169 abdominal postoperative patients from June 1st to August 30th, 2016 at Hanoi Medical University Hospital, Hanoi, Vietnam. Appetite score was computed by using the Council on Nutrition Appetite Questionnaire (CNAQ). This study used GEE to account for the potential correlation of outcomes of the longitudinal assessment, assuming an independent correlation structure. The primary and secondary outcome measures: highest average appetite score was recorded in the preoperative day and the score declined throughout seven-day duration. Patients who were female, under general anesthetics and being under open surgery tended to get lower appetite scores. The majority of patients had moderate to good appetite in both the preoperative day and seven days post-operation. Women should receive more care and help in regaining their appetite after surgery. Treatment for appetite loss through non-pharmaceutical measures should be prioritized. Interventions that increase the appetite of patients after abdominal surgery should be targeted on patients being under general anesthetic as well as open surgery and be undertaken with caution.

Deep Inferior Epigastric Perforator Flap for Immediate Breast Reconstruction following Mastectomy in Breast Cancer Patients: An Initial Experience in Vietnam.

Breast reconstruction in breast cancer patients is an optional surgery that improves the quality of life while preserving the efficacy of chemotherapy and radiotherapy. Deep inferior epigastric perforator (DIEP) flap is a new but reliable and safe technique for autologous breast reconstruction. After mastectomy, immediate reconstruction is the preferred method because of its aesthetic result and convenience. This study is aimed at summarizing our experience in DIEP flap for immediate breast reconstruction. A prospective study was performed on 30 breast cancer patients who underwent intermediate breast reconstruction for DIEP flap after mastectomy from June 2019 to June 2021 in Hanoi Medical University Hospital. Clinicopathology characteristics, tumor stage, treatment, and complications were evaluated. The mean age of patients was 44.9 (range: 29-73 years). 86.7% of patients were in stages I and II. Five patients (16.7%) received neoadjuvant chemotherapy. 20 patients (66.7%) underwent nipple-sparing mastectomy (NSM) procedures. The mean operating time was 341 minutes. The mean time to receive chemotherapy was 34.68 days. The mean number of perforators was 1.30. The overall flap success rate was 90%. Twelve patients (40%) experienced complications. Four patients (13.3%) returned to the operating room due to venous congestions. Two patients (6.67%) had complete flap loss. Other complication: fat necrosis (6.7%), seroma (13.3%), partial flap loss (3.3%), abdominal wound dehiscence (6.7%), pneumonia (3.3%), and pulmonary embolism (6.7%). After one-month postoperation, 88.9% of patients were satisfied with their breasts, and 74.07% were satisfied with the operation. DIEP flap is a new but reliable and safe technique for autologous breast reconstruction. Though patients opting for breast reconstruction still have a low risk of complication and reconstruction failure, this procedure should be used more frequently in appropriate patients to improve their quality of life.

Quality of life in patients with lower extremities deep venous thrombosis using veines-qol/sym questionnaire

Acute venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common disorder with an annual incidence rate of 1-2 cases per 1000 persons. Health-related quality of life in patients after having DVT is impaired if not treated correctly. The VEINES - QOL (Sym) is a disease-specific instrument used to assess health-related quality of life in patients with chronic venous disease of the legs. A descriptive cross-sectional study was conducted on 32 patients diagnosed with deep vein thrombosis and treated at Vietnam National Heart Institute and Hanoi Medical University hospital. Our study indicated statistical differences in patients’ quality of life (QOL) before and one month after treatment. Mean difference for VEINES-QOL was 1.4 (p-value = 0.02), for VEINES-Sym was 1.6 (p-value = 0.01). Our study brought conclusions: anticoagulation therapy increased QOL in patients with DVT; and the principal factors influencing long-term QOL were oldage, BMI, recurrent DVT, and proximal DVT.

Testicular histopathology and associated factors in men with non-obstructive azoospermia

The testicular histopathological characteristic in azoospermic men can significantly help in the diagnosis, prognosis and treatment of infertile patients. This study assessed the pathology specimens of 88 azoospermic infertile men seen at Hanoi Medical University Hospital. The most common histopathological pattern was Sertoli cell-only syndrome (40.9%), followed by hypospermatogenesis (29.5%) and Germ cell maturation arrest (18.1%). There were significant differences in the mean testicular volume and serum concentrations of LH and FSH among patients with different histopathology patterns. Analysis using multinomial logistic regression model showed only FSH was significantly associated with the severity of histopathological pattern. Each unit increase in the level of FSH was associated with a 7.1% increase in the odds of a more severe histopathology (95%CI: 1.01 - 1.12).

Convolutional Neural Networks Improve Radiologists’ Performance in Breast Cancer Screening for Vietnamese patients

ABSTRACT Nowadays, breast cancer is one of the leading cancers in Vietnam, and it causes approximately 6000 deaths every year. The rate of breast cancer patients was calculated as 26.4/100000 persons in 2018. There are 21,555 new cases reported in 2020. However, these figures can be reduced with early detection and diagnosis of breast cancer disease in women through mammographic imaging. In many hospitals in Vietnam, there is a lack of experienced breast cancer radiologists. Therefore, it is helpful to develop an intelligent system to improve radiologists’ performance in breast cancer screening for Vietnamese patients. Our research aims to develop a convolutional neural network-based system for classifying breast cancer X-Ray images into three classes of BI-RADS categories as BI-RADS 1 (“normal”), BI-RADS 23 (“benign”) and BI-RADS 045 (“incomplete and malignance”). This classification system is developed based on the convolutional neural network with ResNet 50. The system is trained and tested on a breast cancer image dataset of Vietnamese patients containing 7912 images provided by Hanoi Medical University Hospital radiologists. The system accuracy uses the testing set achieved a macAUC (a macro average of the three AUCs) of 0.754. To validate our model, we performed a reader study with the breast cancer radiologists of the Hanoi Medical University Hospital, reading about 500 random images of the test set. We confirmed the efficacy of our model, which achieved performance comparable to a committee of two radiologists when presented with the same data. Additionally, the system takes only 6 seconds to interpret a breast cancer X-Ray image instead of 450 seconds interpreted by a Vietnamese radiologist. Therefore, our system can be considered as a “second radiologist,” which can improve radiologists’ performance in breast cancer screening for Vietnamese patients.

Results of care and treatment of patients after atrial septal defect intervention and some related factors in 2020-2021

The study was conducted on 108 patients with atrial septal defect (ASD) who indicated ASD occlusion by percutaneous instrument at the Vietnam Heart Institute-Bach Mai Hospital, Hanoi Medical University Hospital, Hanoi Heart Hospital. from December 2020 to September 2021.Objectives: Describe the clinical and paraclinical characteristics, analyze the results of care for patients with atrial septal defect after intervention and related factors.Research Methods: A prospective descriptive study, a longitudinal study.Results: The majority of patients had good clinical results after 1 month of discharge (65.74%). The rate of pulmonary arterial hypertension after intervention was lower in the group with good results, statistically significant compared with the group with poor results. The group with good results had a lower percentage of patients with anemia, statistically significant compared with the group with poor results. The group with good results had a lower rate of complications after the procedure, which was statistically significant compared with the group with poor results. The difference in the rate of completing 5 steps of implementing the medicine and the rate of meeting the health education requirements between the two groups of good and bad results is statistically significant (p < 0.05). There are 3 factors: Pulmonary artery pressure after intervention still increases (≥35 mmHg); anemia; Postprocedural complications were independently associated with the risk of poor outcome 1 month after discharge. The group with satisfactory health education has a higher rate of patient adherence to treatment than the group that does not meet the requirements of health education (p<0.05).Conclusion: The long-term outcomes of patients with ASD occlusion with percutaneous instruments are related to the treatment, care, and health education counseling of nurses.

Results of total vaginal hysterectomy in patients with cervical intraepithelial neoplasia

Abstract Introduction: Cervical intraepithelial neoplasia (CIN) is considered a precancerous lesion and is usually treated aggressively. Total hysterectomy is indicated in some cases and can be performed through the abdomen, vaginally, through laparoscopic surgery and robotic surgery combined with laparoscopic surgery. It is necessary to study to evaluate the effectiveness of total vaginal hysterectomy. Patients and methods: Clinical non-controlled interventional study in 32 patients with high - grade squamous intraepithelial lesions who underwent a total vaginal hysterectomy at Department of Oncology and Palliative Care at Hanoi Medical University Hospital from August 2018 to May 2021. Results: The average age in the study was 48,9 years old,mainly in the age group < 44 years old, accounting for 37,5%. The majority of patients came to the clinic because of vaginal discharge. All patients had a detailed clinical examination, gynecological ultrasound, PAP test, cervical biopsy to confirm the diagnosis before surgery. The average surgery time was 55,9±14,9 minutes, and the average volume of blood loss was 76,8 ± 23,5ml. Post-operative patients recover movement soon, the level of pain is reduced. There was none of case with intra- and postoperative complications were recorded. During the follow-up process, no vaginal intraepithelial neoplasia and abdominal lymphadenopathy recurrence was detected. Conclusion: Total vaginal hysterectomy in patients with high grade squamous intraepithelial lesion is considered as safe and feasible. Key words: Cervical intraepithelial neoplasia, total vaginal hysterectomy. Human papiloma virus.

Augmentation Rhinoplasty in Cleft Lip Nasal Deformity Using Alloplastic Material and Autologous Cartilage.

Secondary cleft rhinoplasty typically requires large amounts of cartilage grafts for augmentation. The purpose of this study was to present our short-term experience with alloplastic implants in cleft rhinoplasty. This was a retrospective cohort study of cleft lip and palate patients treated with secondary rhinoplasty at Hanoi Medical University Hospital and Ruby Hospital between 2017 and 2020. All rhinoplasty procedures consisted of lower lateral cartilage repositioning, a dorsal augmentation with silicone implant, columellar strut implant or graft, and onlay tip grafts. Cartilage was obtained from the septum and concha, and no cartilage was harvested from the rib. The study outcomes included the Rhinoplasty Outcome Evaluation (ROE) survey, a modified Mortier scoring scale, 8 intranasal measures of symmetry, and 4 nasofacial measures of tip projection and nasal length. Changes in patient satisfaction and nasal esthetics were compared before and after surgery. A total of 38 patients were included in the final study sample, of whom 65.79% had unilateral clefts. The overall complication rate was 7.89%, and there were 2 cases of infection and 1 case of dorsal implant displacement. Following rhinoplasty, ROE satisfaction scores significantly increased (+39.36, P <0.01) and Mortier severity scores decreased (-3.06, P <0.01). Nostril symmetry nearly normalized in width, height, and inclination. Mean columellar deviation decreased from 8.82 to 2.08 degrees, and nasal projection increased as assessed on multiple analyses. Patients with bilateral clefts had similar improvements in ROE and Mortier scores. In our experience, synthetic implants simplified the correction of cleft nasal deformity and eliminated the need for costal cartilage. We found that our protocol produced acceptable and stable short-term clinical results without increasing the complication rate above what has been reported with autologous grafts.

Neglected Foreign Bodies in Bronchi in Adults: Experience of 2 Cases

Tracheobronchial foreign body (FB) aspiration is a life-threatening condition that is more common in children than in adults. They are often diagnosed immediately and the foreign body is extracted as soon as possible. However, cases of neglected foreign body aspiration where it is unknown to the patients or they have forgotten the history of aspiration have been reported in the literature. The symptoms depend on the site of the FB impaction ranging from chronic mild wheezing, through to a cough, a complaint of discomfort, general shortness of breath, recurrent pneumonia, or mimicking asthma. In this article, we intend to illustrate two cases of forgotten bronchial foreign bodies that were successfully treated via the process of bronchoscopic extraction in Hanoi Medical University Hospital.

Efficacy and safety of pembrolizumab monotherapy in advanced non-small cell lung cancer patients treated at Hanoi Medical University Hospital

This study evaluated the efficacy of pembrolizumab monotherapy response rate and progression-free survival and its tolerabilty in advanced non-small cell lung cancer patients. Thirty patients with lung cancer in metastatic or recurrent settings were treated with pembrolizumab monotherapy at Hanoi Medical University Hospital from October 2017 to October 2021. The mean age was 65.37 ± 5.46 (40-81). Most patients were male (86.7%). Most had non-squamous cell carcinoma (70%) and a Tumor Proportion Score (TPS) ≥ 50% (63.3%). The complete response rate was 3.3%, the partial response rate was 36.7%, and the stable disease rate was 43.3%. The overall control rate was 83.3%. Patients with TPS ≥ 50% had significantly higher response rate (47.4% vs 27.3%, p &gt; 0.05). Median PFS was 9.6 ± 0.84 months; the figure for patients with TPS ≥ 50% was higher than for patients with TPS 1-49% (10.9 months vs. 7.2 months), p &lt; 0.05. Only 6.2% had hyperthyroidism, and 3.1% had hypothyroidism, all in grade I. Therefore, pembrolizumab treatment in advanced non-small cell lung cancer is effective with a high disease control rate and is well-tolerated.

Associated factors of depressive symptoms in patients with erectile dysfunction

The presence of depression in patients with erectile dysfunction not only worsened the condition but also makes its management more complicated. We conducted a cross-sectional study to investigate several factors associated with depression of 131 patients with erectile dysfunction at Hanoi Medical University Hospital. The depression rate of the subjects was 45.8%. Compared with the non-depressive group, the patients with depression had a lower mean age (39 ± 13.3 and 50 ± 14.1 years old, p &lt; 0.001) and a greater frequency of masturbation (0.6 ± 1 and 0.1 ± 0.5 times/week, p = 0.001). The factors that correlate with the severity of depression on the PHQ-9 scale were age and masturbation frequency (r = -0.352 and 0.346, p &lt; 0.001). The factors associated with depression include age under 40 (OR = 5.15, p &lt; 0.001), single (OR = 6.53, p &lt; 0.001), masturbation (OR = 5.02, p = 0.001) and the sudden onset of erectile dysfunction (OR = 2.36, p = 0.03). The results show that depression occurs in patients with erectile dysfunction at a relatively high rate, therefore, depression needs to be screened for this group of patients, especially those with risk factors.

Medications adherence in patients with osteoporosis after vertebroplasty or kyphoplasty at Hanoi Medical University Hospital

Poor adherence to medication therapy is currently one of the most critical obstacles facing osteoporosis care and it is one of the main barriers for optimal therapeutic osteoporosis management, especially after surgical intervention. This paper presents medication adherence and explores factors associated with medications non-adherence in patients with osteoporosis after vertebroplasty or kyphoplasty. This is a retrospective case series included osteoporosis patients underwent vertebroplasty or kyphoplasty at Hanoi Medical University Hospital in 2019. Medication adherence was assessed using the validated Osteoporosis specific Morisky Medication Adherence Scale. A total of 42 patients participated in the study. Level of osteoporosis medication adherence decreased gradually with time of using medication: high adherence level after 1 month with OS-MMAS score was 8. Mean score of medium and low adherence after 3 months and 6 months were 6.64 ± 1.19 and 4.64 ± 2.18, respectively . 57.14% of participants had low adherence (6 months). 73.81% patients forgot to take medication. The associated factors of medication adherence are residence area, occupation, education level, number of medication used, frequency of osteoporosis medication, failure to take medication and side effects. The current study reveals a low level of medication adherence and sheds the light on different causes of medication non-adherence among patients with osteoporosis after vertebroplasty or kyphoplasty. Identifying barriers for medication non-adherence is an important initial step for developing effective clinical pharmacy interventions for patients with osteoporosis.

Clinical and subclinical features of 612 cases of hematospermia at hanoi medical university hospital

Six hundred twelve patients with hematospermia were involved in a study to investigate the clinical and subclinical features of hematospermia. The average age of the patients was 39.42 ± 11.67 years. In the episodes of hematospermia, 22.45% of patients had a history of alcohol consumption. 16.25% of patients described a pattern of postponed or interrupted sexual intercourse before ejaculation. The rate of positive tuberculosis in PCR tests was 1.27%. 1.92% of patients had elevated total PSA. Positive culture accounted for 8.94 %. The testosterone level of these patients was relatively low for their age. While 26.01% of these patients had a decreased testosterone concentration (12.1nmol/L), 2.7% had low testosterone values (12.1 - 15 nmol/L).