Nang Hospital Research Articles

Knowledge, Attitudes, and Practices on Covid-19 Prevention of Vietnamese Patients: A Cross-Sectional Study

Background: The COVID-19 pandemic had a significant global impact, and although it has been controlled at the moment, the possibility of a resurgence is remains high if appropriate preventive measures are taken. Da Nang was one of the largest cities where the epidemic broke out and spread intensively in Vietnam. Knowledge, attitudes, and practices (KAP) towards COVID-19 play an important role in controlling and preventing the disease. Objectives: To evaluate the KAP toward COVID-19 prevention among patients who visit to Da Nang Hospital for examinations and identify some related factors. Methods: A cross-sectional study was conducted on 350 patients who visited the Department of Medical Examination of DaNang Hospital from November 2022 to April 2023. The questionnaire assessing knowledge, attitude, and practice of COVID-19 prevention of patients with 30 items was used and revised with the permission of the original author. Chi-square tests and odds ratios (ORs) with a 95% confidence interval (CI) were used to identify factors related to patient characteristics and knowledge, attitude, and practices of COVID-19 prevention. The results were considered statistically significant when p < 0.05. Results: The percentage of participants with good knowledge, positive attitude, and successful practice on COVID-19 prevention accounted for 86.6%, 89.1%, and 56.3% respectively. Factors related to knowledge include sex (OR=1.88, 95% CI: 0.99-3.52, p-value < 0.05), age, education level, and family economy; attitudes include education level, place of residence (OR=0.44, 95% CI: 0.20-0.84, p-value < 0.05), occupation; and COVID-19 infection status (OR=0.47, 95% CI: 0.23-0.95, p <0.05); and practices include sex (OR=0.57, 95% CI: 0.37-0.88, p-value <0.05), age, education level , place of residence (OR= 0.65, 95% CI: 0.42-0.95, p-value <0.05) and occupation . Conclusion: Research results showed that patients who visit to Da Nang Hospital for examinations have a high level of good knowledge and a positive attitude, while successful practices in COVID-19 prevention were not high. Thus, it is still necessary to promote and improve patients' knowledge about disease prevention vaccines, as well as enhance the practice of washing hands and covering mouths when coughing and sneezing for better disease prevention.

The Etiology of Infertility in Couples Referred to Da Nang Hospital for Women and Children

The Etiology of Infertility in Couples Referred to Da Nang Hospital for Women and Children

Cost analysis of establishing and operating the first human milk bank at Da Nang Hospital for Women and Children in Vietnam: an activity-based costing ingredients study

BackgroundBreastfeeding is the biological norm for feeding infants and young children. When mothers’ breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This study aims to estimate and analyze such costs at the first facility established in Vietnam.MethodsAn activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation.ResultsThe total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB's 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021.ConclusionAlthough the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs.

Newborn screening and diagnosis for Glucose-6-phosphate dehydrogenase deficiency at Danang Hospital for Women and Children

Background: G6PD deficiency can result in acute hemolysis anemia during times of increased reactive oxygen species production. This study aimed to investigate the rate of high risk among newborns who were screened for G6PD deficiency, as well as some clinical characteristics of those who had this disease at Da Nang Hospital for Women and Children. Materials and Methods: 10,020 newborns were screened for G6PD deficiency using dried heel blood spots,. Samples of peripheral venous blood is drawn from high-risk infants for diagnostic testing. Results: The proportion of high-risk newborns was 1.12%, with boys having a greater incidence than girls (1.71% versus 0.48%). G6PD activity was higher in premature infants than in term infants. G6PD activity was higher in infants having low birth weight (< 2500 g) than in ones having normal birth weight (≥ 2500 g). Only 45.54% of high-risk newborns were tested for diagonosis. Among them, 92.16% had diagnostic confirmation. G6PD deficiency in class II accounts for 31.91%, whereas class III accounts for 68.09%. Boys accounted for 87.23% and jaundice accounted for 82.98% of infants with G6PD deficiency. Only 6.38% of those had a family history of G6PDD deficiency. Conclusion: Da Nang Hospital for Women and Children’s newborn screening programme identified 1.12% of newborns as high risk for G6PD deficiency. Most neonates with G6PD deficiency were in classes II and III, with males being the main gender, and jaundice being the most common symptom. Key words: G6PD deficiency, newborn screening, hell blood, enzyme activity

Assessment of the Antibiotic Resistance Characteristics of Staphylococcus aureus Isolated at Da Nang Hospital for Women and Children, Vietnam

Background: Infections caused by multidrug-resistant Staphylococcus aureus (S. aureus), typically from methicillin-resistant S. aureus (MRSA) have become a global problem, including Vietnam. Objectives: To assess the prevalence of S. aureus infections, pathogenic characteristics, and evaluate antibiotic resistance profiles. Methods: This was a cross-sectional descriptive study of 191 S. aureus isolates cultured from clinical samples with antibiotic resistance profiles at the Department of Microbiology, Da Nang Hospital for Women and Children, Vietnam, from July 2021 to September 2022. Strain identification and susceptibility tests were performed by using an AST-GP Card in VITEK 2 Compact. Results: The proportion of S. aureus infection was high in females (56.02%) and children under 6 years (65.97%). The major clinical sample of S. aureus was pus (63.87%) and most commonly isolated in the Outpatient Department (31.41%). S. aureus showed resistance to over 70.00% of the antibiotics in group A, with lower resistance (1.05% - 48.69%) towards those in groups B and C. The rates of isolation of vancomycin-resistant S. aureus and vancomycin-intermediate S. aureus were 1.57% and 1.05%, respectively, but no isolates resistant to linezolid was found. The proportion of MRSA was found to be 78.01%. Prevalence of multidrug-resistance MRSA (MDR-MRSA) was markedly high (79.87%). Conclusions: The presence of S. aureus with varying antibiotic sensitivity patterns was found, as well as multidrug resistance. The prevalence of MRSA and MDR-MRSA was noticeable in this study.

Factors associated with high exclusive breastfeeding rates among preterm infants under 34 weeks of gestation in Da Nang, Vietnam: A retrospective cohort study.

Preterm infants have higher mortality than full-term infants. While breastfeeding dramatically reduces preterm death, it is limited by biological and practice barriers, particularly for babies born before 34 weeks gestational age. Da Nang Hospital for Women and Children developed a quality improvement approach to improve breastfeeding of preterm infants by strengthening feeding support, non-separation, and kangaroo mother care (KMC). To determine breastfeeding outcomes following discharge and explore factors associated with improved feeding, mothers of infants under 34 weeks gestational age born October 2021 to March 2022 and discharged alive were interviewed at six months and their medical records were reviewed. Out of 104 preterm infants included, all were exclusively breastfed at discharge and one month, 86.5% at three months, and 63.5% at six months; 47.1% received immediate skin-to-skin contact, 31.7% immediate and continuous KMC, and the remaining 68.3% continuous KMC beginning at a median of three days. Exclusive breastfeeding at six months was associated with the mother antenatally seeking breastfeeding information (odds ratio (OR) = 14.5; 95% confidence interval (CI) = 1.2-173.6), avoiding bottle-feeding at home (OR = 7.7; 95% CI = 1.7-33.7) and reduced with each day delay between birth and full breastfeeding (OR = 0.8; 95% CI = 0.6-0.9). Hospital environments that limit mother-baby separations and feeding delays, including rooming-in of mothers and infants, KMC, and breastfeeding support from birth, enabled 100% of preterm infants born before 34 weeks gestational age to breastfeed exclusively with continued rates higher than previously reported. Addressing antenatal and post-natal factors limiting practice can further improve longer-term breastfeeding outcomes. The approach can be adapted to achieve high exclusive breastfeeding rates, regardless of gestational age.

Clinical algorithm reduces antibiotic use among children presenting with respiratory symptoms to hospital in central Vietnam.

To assess the safety and utility of a pragmatic clinical algorithm to guide rational antibiotic use in children presenting with respiratory infection. The effect of an algorithm to guide the management of young (< 5years) children presenting with respiratory symptoms to the Da Nang Hospital for Women and Children, Vietnam, was evaluated in a before-after intervention analysis. The main outcome was reduction in antibiotic use, with monitoring of potential harm resulting from reduced antibiotic use. The intervention comprised a single training session of physicians in the use of an algorithm informed by local evidence; developed during a previous prospective observational study. The evaluation was performed one month after the training. Of the 1290 children evaluated before the intervention, 102 (7.9%) were admitted to hospital and 556/1188 (46.8%) were sent home with antibiotics. Due to COVID-19, only 166 children were evaluated after the intervention of whom 14 (8.4%) were admitted to hospital and 54/152 (35.5%) were sent home with antibiotics. Antibiotic use was reduced (from 46.8% to 35.5%; p = 0.009) after clinician training, but adequate comparison was compromised. The reduction was most pronounced in children with wheeze or runny nose and no fever, or a normal chest radiograph, where antibiotic use declined from 46.7% to 28.8% (p < 0.0001). The frequency of repeat presentation to hospital was similar between the two study periods (141/1188; 11.9% before and 10/152; 6.6% after; p = 0.10). No child represented with serious disease after being sent home without antibiotics. We observed a reduction in antibiotic use in young children with a respiratory infection after physician training in the use of a simple evidence-based management algorithm. However, the study was severely impacted by COVID-19 restrictions, requiring further evaluation to confirm the observed effect.

Studying variable in serum apolipoprotein B levels in damaged coronary artery patients

ABSTRACT Introduction: Atherosclerosis is the most important cause of increasing coronary heart disease. When cholesterol LDL-C levels are low, an increase in Apo B is associated with 60% of the cardiovascular risk factors. This study find out the association between serum Apolipoprotein B levels with the degree of coronary artery lesions Methods: The study consists of 110 patients who were diagnosed with a meaningful damaged coronary artery through angiography at Hoan My Da Nang hospital, from March 2018 to September 2019. Research method: cross-sectional description. Results: The average value of serum Apo B in group 1 was 133.67 ± 17.56 mg/dl, and in group 2 it was 113.92 ± 16.78 mg/dl. The difference is statistically significant, p &lt; 0.01. Cardiovascular risk factors in the study did not have a meaningful effect on serum Apo B levels. Dyslipidemia does not have a strong correlation with serum Apo B levels. Thereby, it is possible to recognize serum Apo B as an independent indicator along with other cardiovascular risk factors. Serum Apo B levels increase linearly according to the number of damaged coronary artery branches. There is a proportional correlation between serum Apo B levels and the degree of coronary artery lesions (r = 0.48, p &lt; 0.01). Conclusion: Apo B is associated with the degree of coronary artery lesions.

Factors associated with mortality among extremely preterm infants at Da Nang Hospital for Women and Children

Introduction: Management of extremely preterm infants under 28 weeks of gestation remains a challenge for neonatal care. This study was carried out to describe morbidity and mortality rates of extremely preterm infants and to investigate factors associated with mortality in this group. Methods: A longitudinal study was conducted from admission to discharge or death on 102 extremely preterm infants under 28 weeks of gestation who were managed at the Neonatal Unit, Da Nang Hospital for Women and Children from May 1, 2020 to May 30, 2022. Result: The mean gestational age was 25.5 weeks with an average weight of 815.2 grams. Respiratory distress syndrome requiring surfactant occurred in 58.8%. Intraventricular haemorrahage grade III-IV occurred in 14.7% and necrotizing enterocolitis in 6.9%. The mortality rate was 49%, with 70% among infants &lt; 26 weeks of gestation, and 28.8% in infants 26 - &lt; 28 weeks of gestation. Gestational age, shock, and invasive mechanical ventilation were associated with mortality in extremely preterm neonates. Every 1 week increase in gestational age reduced the risk of death by 2.5 times. Shock and invasive mechanical ventilation increased the risk of death with Odds ratios being 17.7 and 49.9, respectively. Conclusion: Mortality and morbidity among extremely preterm neonates were high. Future interventions should focus on preventing complications and improving suboptimal care. Key words: extremely preterm infant, neonatal mortality, neonatal intensive care.

Differences in the Microbiological Profile of Raw and Pasteurized Breastmilk from Hospital and Community-Based Donors at the First Human Milk Bank in Vietnam.

Background: Microbiological quality is one of the key safety standards in human milk bank (HMB) operations. We describe the profiles of bacteria in donor human milk (DHM) before and after the pasteurization of samples collected from breastfeeding women in the hospital and from the community in the first HMB in Vietnam. Methods: Data were collected between February 2017 and January 2022 from an online HMB monitoring system. First, DHM samples were cultured, and the number of colony-forming units (CFU) were counted before (n = 708) and after pasteurization (n = 1146). The gram-staining method combined with the Vitek 2 Compact system were used to identify types of organisms at the Da Nang Hospital for Women and Children’s Laboratory. Passing criteria for DHM included pre-pasteurization samples had a total colony count <105 CFU/mL and post-pasteurization was <10 CFU/mL. Results: During five years of operation, Da Nang HMB had 491 donors (48.7% were hospital and the rest community donors) who donated an average amount of 14.2 L over 45 days. Of this DHM volume, 84.9% of donor samples passed the pre- and post-pasteurization microbiological tests. DHM from community donors had a higher pass rate (87.8%) compared to that from hospital donors (79.5%). Before pasteurization, 15.4% of DHM samples had a bacteria count <103 CFU/mL, 63.0% had 103-<105 CFU/mL, and 21.6% had ≥105 CFU/mL. Most of the unpasteurized DHM samples (93.0%) had microorganism growth: with one organism (16.4%), two (33.9%), three or more (43.6%). After pasteurization, 17.9% samples had a bacteria count of 1−9 CFU/mL and 7.2% had ≥10 CFU/mL. DHM samples from community donors had a lower bacterial count and number of organisms than those from hospital donors both before and after pasteurization. The highest microorganisms from unpasteurized DHM samples were Staphylococcus epidermidis (74.2%), Acinetobacter sp. (52.1%), gram-positive bacillus (51.7%), Staphylococcus coagulase-negative (15.8%), and Staphylococcus aureus (10.5%). Common microorganisms from pasteurized DHM were gram-positive bacillus (21.0%), Staphylococcus epidermidis (3.9%), and Acinetobacter sp. (0.9%). Samples from the hospital tended to have a higher contamination with those microorganisms than those from community donors. Conclusions: The majority of DHM samples in Da Nang passed microbiological testing criteria. DHM from community donors had higher pass rates than hospital donors. Corrective actions are needed to improve HMB operations and hospital microbiological quality standards, as well as general improvements in water and sanitation.

Survey of knowledge and attitude on standard prevention of healthcare workers in the prevention of COVID-19 at Da Nang Hospital

Introduction: Standard precautions (SP) are bacteriological controls applicable to all patients regardless of diagnosis and time of care, making an important contribution to reducing the risk of infection and morbidity. institute. Therefore, it is very necessary to understand the current status of knowledge and attitude about SP of medical staff. Objectives: To describe the status of knowledge and attitudes towards standard prevention and to learn some factors related to standard knowledge and attitude of healthcare workers in the prevention of Covid-19 at Da Nang Hospital. Methodology: A cross-sectional description of 424 healthcare workers at Da Nang Hospital. Results: 94.3% of healthcare workers with standard prevention knowledge, and 5.7% of healthcare workers still have not. Most healthcare workers have a positive attitude about standard prevention (90.6%), and only 9.4% of healthcare workers have a negative attitude about standard prevention. There was a relationship between occupation, professional qualifications, year of seniority, and correct knowledge of standard precautions. The difference was statistically significant with p &lt; 0.05. Conclusion: The percentage of health workers with the correct knowledge and positive attitudes about standard prevention is quite high. The group of doctors has corrected knowledge about standard prevention higher than the group of nurses, technicians, midwives, and other staff, significant with p &lt; 0.05. Research subjects with a university degree or higher or working experience of fewer than 5 years have higher knowledge of standard prevention than the other group of subjects and have statistical significance with p &lt; 0.05. Key words: standard precautions, healthcare workers

The impact of Covid-19 pandemic on Gastroenterology Department activity of Da Nang Hospital

Objective: Covid-19 is a global pandemic that severely affects healthcare systems around the world. The aim of this study was to evaluate the impact of Covid-19 in the treatment and operation of the Department of Gastroenterology, Da Nang Hospital. Materials and menthods: Retrospective descriptive study was conducted from January 1, 2019 to December 31, 2020 at the Department of Gastroenterology, Da Nang Hospital. Results: During the period of 02 years, a total of 12,282 patients were included to our analysis (in 2019: 7838 patients, with 54.4% male 45.6% female, mean age 51, 46 ± 18.87 years. In 2020: 4446 patients with 57.2% male and 42.8% female, mean age 52.05 ± 18.36 years). During the Covid-19 epidemic, the most common groups of hospitalized symptoms included melena (7.3%), Hematochezia (6.3%), Hematemesis (6.3%) and jaundice (8.3%). Similarly, the disease groups increased the rate of hospitalization such as gastric ulcer (15.6% compared to before the epidemic 11.9%, p &lt; 0.001), combined gastro-duodenum ulcer (4.7% compared to 3.1%, p &lt; 0.01), stomach cancer (5.1% vs 3.4%, p &lt; 0.01), colorectal cancer (14.7% vs 10.3%, p &lt; 0.01), cirrhosis (58% vs 54.4%, p &lt; 0.05), acute hepatitis (9.7% vs 5.8%, p &lt; 0.05), acute pancreatitis (70.7% versus 63.1%, p &lt; 0.05). In particular, the number of gastrointestinal endoscopy decreased significantly during the Covid-19 epidemic compared with before the epidemic (17156 timescompared with 10880, p &lt; 0.001), of which the number of gastroscopy and ERCP was mainly reduced. In contrast, the rate of emergency endoscopy increased significantly compared to the pre-epidemic period (6.69% vs 5.85%, p &lt; 0.01), so the number of endoscopy intervention also increased significantly (5.29% vs 2.71%, p &lt; 0.001) as well as the need for surgical intervention also increased (5.6% vs 4.2%, p &lt; 0.001). The rate of patients with complications and death was also higher during the Covid-19 epidemic than before the epidemic, respectively (2.5% vs 1.7%, p &lt; 0.01), mortality (1.4% vs 0.9%, p &lt; 0.01) and duration of hospitalization were also longer (6.7 ± 4.54 vs 6.44 ± 4.68 days, p &lt; 0.01). Conclusion: The Covid-19 pandemic has significantly reduced the number of patients at the Department of Gastroenterology, Da Nang Hospital. It is necessary to change the mode of operation to flexibly adapt to the current situation. Thereby helping to significantly reduce the impact on non-Covid-19 patients Key words: Covid-19 pandemic, Department of Gastroenterology, Da Nang Hospital

Impact of non - invasive prenatal testing on prenatal diagnosis at Da Nang Hospital for women and children

ABSTRACT Background: Non-invasive prenatal testing (NIPT) is being applied more widely in Vietnam. However, the effects of NIPT on prenatal diagnosis have not been studied much in our country. This study aims to analyze the impact of NIPT on the changes in the number of routine screening tests for chromosomal abnormalities 21, 18, and 13 and the impact of NIPT on invasive prenatal diagnostic procedures and propose strategies to screen for fetal aneuploidy. Results: NIPT did not change the number of routine screening tests for chromosomal abnormalities 21, 18, and 13. The rate of amniocentesis used to confirm the diagnosis of aneuploidy was decreased by 6,32 (p &lt; 0,0001, 95% CI: 3,99 – 10,45). Among the strategies to detect aneuploidy 21, 18, and 13 suitable for socio-economic conditions in Vietnam, a 2-step screening method can be applied. Conclusions: NIPT did not change the number of routine screening tests. NIPT reduced the number of invasive prenatal procedures. The screening strategy for fetal aneuploidy should follow a two-step approach.

Very preterm infants admitted to a tertiary neonatal unit in central Vietnam showed poor postnatal growth.

We aimed to evaluate the postnatal growth of very preterm infants. This was a cross-sectional observational study of neonates born before 32weeks of gestation and admitted to the neonatal unit at Da Nang Hospital for Women and Children, Vietnam, between 1 February 2020 and 30 September 2020.Morbidities, therapies, nutrition modalities and growth status were recorded from admission to discharge. The 78 infants (51% female) were born at a median of 29weeks and mean birth weight of 1247grams. The mean weight gain velocity from regaining their birth weight until discharge was 12.7±4.9g/kg/d. At discharge, the Z-scores for weight, length, both weight and length and weight for length were lower than at birth in 94%, 67%, 64% and 95% of infants and the Delta Z-scores were less than -1 in 73%, 44%, 39% and 82%. Late-onset sepsis (LOS) and bronchopulmonary dysplasia (BPD) were significantly associated with growth failure, with adjusted odds ratios of 3.6 and 20.1, respectively. The high rate of poor growth among the very preterm infants in our study indicates the need to reduce LOS and BPD and ensure the availability of human milk fortifier, vitamin and mineral supplements.

Early essential newborn care is associated with improved newborn outcomes following caesarean section births in a tertiary hospital in Da Nang, Vietnam: a pre/post-intervention study

BackgroundTo improve maternal and neonatal outcomes, Vietnam implemented early essential newborn care (EENC) using clinical coaching and quality improvement self-assessments in hospitals to introduce policy, practice and environmental changes. Da...

RESEARCH ON POSTPARTUM URINARY RETENTUON AND SOME RELATED FACTORS IN VAGINAL DELIVERY IN DA NANG HOSPITAL FOR WOMEN AND CHIDREN

Objective: To determine the rate of urinary retention after vaginal delivery and evaluation some factorsrelated to urinary retention after vaginal delivery at Da Nang Hospital For Women And Chidren.Methods: Cross-sectional study describing 673 women giving birth vaginally, at Da Nang HospitalFor Women And Chidren from March 2018 to the end of September 2018. The pregnant womenin the research group will be examined, interviewed, and refer to the medical records to record thevariables according to the research questionnaire.Results: Women who are primigravida with postpartum urinary retention rate 6.6%, higher than2.4% for multigravida who have postpartum urinary retention. In infants with a weight of ≥ 3500grams, the prevalence of birth urinary retention was 16.7%, higher than that of women with babies&lt;3500 grams with neonatal urinary retention (1.7%). The rate of postpartum urinary retention amongwomen who had a baby with a head circumference ≥ 36 cm was 24.3% higher than for women with ahead circumference &lt;36 cm (3.6%). The rate of urinary retention in pregnant women: asisted vaginaldelivery was 50.0%; time of labor in stage 1 lasted ≥ 12 hours was 13.0%; the duration of second stagelabor was 16.4% prolonged, higher than the rate of urinary retention in the group of pregnant women:vaginal delivery (4.6%); period of labor for stage 1 &lt;12 hours (2.1%); period of labor for stage 2 didnot last long (3.3%). In the group of women who did not exercise early after giving birth, the rate ofurinary retention was 37.5%, higher than this group of women with early movement after birth, 1.3%.Conclusion: The rate of urinary retention after vaginal delivery is 4.8%. Factors: giving birth incomparison, giving birth to a large baby with a gestational weight: ≥ 3500 grams, head circumference≥36 cm, asisted vaginal delivery, long stage 1 labor, long stage 2 labor, early postpartum inactivityincreases the risk of postpartum urinary retention

Factors Associated with the Use of Pasteurized Donor Milk for Healthy Newborns: Experience from the First Human Milk Bank in Vietnam.

Background: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother’s own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste resources, and reduce the availability of PDM for at-risk newborns. We conducted this study to examine factors associated with the prescription and prolonged use (>48 h) of privately purchased PDM to healthy newborns. Methods: Prospective observational study of 2440 mothers of healthy, term, and normal birthweight newborns born at Da Nang Hospital for Women and Children between April and August 2019. In addition to the descriptive analysis, we performed multiple logistic regressions to examine factors associated with the prescription of PDM (n = 2440) and prolonged PDM use among those who used PDM (n = 566). Results: Twenty-three percent (566/2440) of healthy, term, and birthweight ≥2500 g newborns received PDM and were included in the study. The prevalence of PDM use was higher for cesarean births (OR: 2.05; 95% CI: 1.66, 2.55) and among male newborns (OR: 1.33; 95% CI: 1.09, 1.62), but lower for farmers or workers (vs. other jobs; OR: 0.71; 95% CI: 0.54, 0.93), family income <10 million VND (vs. ≥10 million VND; OR: 0.67; 95% CI: 0.55, 0.82), and duration of skin-to-skin ≥90 min (vs. <90 min; OR: 0.54; 95% CI: 0.39, 0.76). Prolonged PDM use (12.4% of 566 newborns who used PDM) was associated with the mother having a higher socioeconomic status job (professional, small trader or homemaker; OR: 4.00; 95% CI: 1.39, 12.5), being a first-time mother (OR: 3.39; 95% CI: 1.92, 6.01) or having a cesarean birth (OR: 2.09; 95% CI: 1.02, 4.28). Conclusions: The prescription and prolonged use of privately purchased PDM was associated with non-medical factors unrelated to the ability to breastfeed effectively. The findings suggest the need for improved breastfeeding communication, counseling and support skills for health staff, development, and application of strict criteria on PDM use for healthy newborns and better routine monitoring of PDM use over time.

Đánh giá kết quả phẫu thuật nội soi khâu vỡ bàng quang trong phúc mạc tại Bệnh viện Đà Nẵng

Abstract Introduction: To evaluate results of treatment from our preliminary experience of laparoscopic repair for intraperitoneal bladder rupture. Materials and Methods: 31 patients with traumatic intraperitoneal bladder rupture admitted to Da Nang Hospital from 1/2017 to 5/2020. Results: 31 patients with average ages (mean ± standard deviation) were 35.3 ± 9.0 years old. Operation time (mean ± standard deviation) was 67.5 ± 25.5 minutes. Hospital stay (mean ± standard deviation) was 9.5 ± 0.7 days. No intra- or postoperative complications were noted. The successful rate was 100%. Suprapubic cystostomy was placed in (mean ± standard deviation) 8.5 ± 0.7 days Conclusion: Laparoscopic repair of traumatic bladder rupture should be performed in hemodynamically stable patients without associated concurrent injuries. Key word: Intraperitoneal bladder rupture, laparoscopy, trauma. Tóm tắt Đặt vấn đề: Đánh giá kết quả phẫu thuật và kinh nghiệm của chúng tôi qua khâu vỡ bàng quang đơn thuần bằng phẫu thuật nội soi. Phương pháp nghiên cứu: 31 người bệnh nhập viện cấp cứu vì vỡ bàng quang trong phúc mạc đơn thuần, được phẫu thuật cấp cứu và điều trị tại khoa Ngoại tiết niệu Bệnh viện Đà Nẵng từ 1/2017 đến 5/2020. Kết quả: 31 người bệnh với độ tuổi trung bình lúc nhập viện là 35,3 ± 9,0 tuổi; Thời gian phẫu thuật trung bình là 67,5 ± 25,5 phút; Thời gian nằm viện trung bình là 9,5 ± 0,7 ngày; Không có biến chứng trong và sau mổ. Tỷ lệ thành công phẫu thuật 100%. Tất cả người bệnh được rút dẫn lưu bàng quang trung bình 8,5 ± 0,7 ngày. Kết luận: Phẫu thuật nội soi khâu vỡ bàng quang trong phúc mạc là phẫu thuật ít xâm lấn, có thể chỉ định trong phẫu thuật cấp cứu vỡ bàng quang đơn thuần, huyết động ổn định. Từ khóa: Vỡ bàng quang trong phúc mạc, phẫu thuật nội soi, chấn thương.

Cost comparison of transcatheter and operative closures for patients with secundum atrial septal defects in Vietnam

We aim to estimate and compare the costs of operative and transcatheter closure for patients with secundum atrial septal defect (ASD) in Vietnam. This was a retrospective cross-sectional study based on medical records of congenital heart diseases (CHD) patients in Da Nang Hospital, Vietnam from 2010 through 2015. All costs in this study were calculated according to a provider's perspective. All pricing data were converted into USD at the 2015 exchange rate. A total of 258 patients with secundum ASD were recruited in the study, including 35 patients treated by operative closure and 223 patients treated by transcatheter closure. The total treatment costs of the transcatheter closure group (US $3,107.9) were higher than those of the operative closure group (US $2,080.5). The cost of the procedure and medical supplies accounted for 67.3% of the total treatment cost in the operative closure group, while the cost of occlusion devices accounted for 62.2% of the total cost in the transcatheter closure group. Given the advantages of the transcatheter closure procedure, reducing occlusion device costs may increase the proportion of patients treated with this technique.

Gestational diabetes diagnosed in third trimester of pregnancy: an observation at a Hospital of Women and Children in Vietnam

Background. Gestational diabetes mellitus (GDM) remains a significant concern within the medical community due to its high risk, as well as its serious side effects on both the mothers and the fetuses. This study aims to assess the prevalence and the risk factors of gestational diabetes mellitus in pregnant women at Da Nang Hospital for Women and Children. Methods. A cross-sectional study was conducted on 706 pregnant women at 2428 weeks of gestation at Da Nang hospital to determine the prevalence of gestational diabetes. Multivariate regression analysis was used to clarify the independent risk factors associated with gestational diabetes. All participants were interviewed and tested for the oral glucose tolerance test (OGTT) to identify the number of gestational diabetes, which was diagnosed according to the American Diabetes Association (ADA) diagnostic criteria in 2014. Results. Gestational diabetes prevalence was 10.2%; categorized by the number of matched diagnostic criteria: 1 criterion: 7.1%; 2 criteria: 2.1%; 3 criteria: 1.0%. There are four independent risk factors for gestational diabetes determined through multivariate regression analysis: maternal age > 30 years (OR = 2.376), a history of gestational diabetes (OR = 12.211), pre-pregnancy BMI ≥ 23 kg/m2 (OR = 10.775), a history of fetal macrosomia > 3800 g (OR = 4.655). The risk of gestational diabetes in the group with risk factors was 6.21 times higher than that in the group with no risk factors. Conclusion. More attention should be paid to the risk factors for gestational diabetes, such as maternal age > 30 years, a history of gestational diabetes, pre-pregnancy BMI ≥ 23 kg/m2, a history of fetal macrosomia > 3800 g in all pregnant women.