Tạp chí Truyền nhiễm Việt Nam

CLINICAL AND LABORATORY FEATURES OF STRONGYLOIDIASIS AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES

Than Manh Hung, Phan Van Manh, Le Thi Hai Yen, Bui Thi Thu Hoai — Mon, 25 Nov 2024 00:00:00 +0000

Objectives: Describe clinical and laboratory features of strongyloidiasis at the National Hospital for Tropical Diseases from November 2018 to January 2024.Subjects and methods: A cross-sectional, retrospective study. Inclusion criteria were based on direct microscopy of Strongyloides stercoralis larvae in body fluid specimens (stool, gastric fluid, respiratory tract fluid, cerebrospinal fluid, etc.).Results: 48 patients were included in the study, 85.42% of cases were male, with a median age of 64.5 years. 83.33% of patients had comorbidities. 60.42% of patients were in the intensive care unit (ICU). There were 33.33% of uncomplicated strongyloidiasis and 66.67% of severe strongyloidiasis. Severe strongyloidiasis had higher rates of fever and neutrophilia than uncomplicated disease. 20.83% of cases had co-infection with sepsis; 27,08% of cases had bacterial co-infection in cerebrospinal fluid. The most common bacteria were E. coli and K. pneumoniae.Conclusions: Patients were mainly male, aged > 60, and had comorbidities. The rate of patients with severe strongyloidiasis is 66.67%. Severe strongyloidiasis had significantly higher rates of fever and neutrophilia than uncomplicated strongyloidiasis.

ETIOLOGY DIAGNOSIS, MANAGEMENT AND TREATMENT OUTCOMES OF CHILDREN WITH EOSINOPHILIC MENINGITIS: 5 YEARS EXPERIENCE IN A MEDICAL CENTER IN SOUTH VIETNAM

Nguyen Dinh Loc, Nguyen Hong An, Huynh Duc Luu, Ngo Thi Mai Phuong — Mon, 25 Nov 2024 00:00:00 +0000

Background:Eosinophilic meningitis (EOM), which is related to parasitic infections in medical literature, can also lead to permanent neurological disability among survivors. Data about the etiology of EOM in Vietnam, as a tropical country, especially on children is still limited. In addition, these patients’ management and treatment outcomes are poorly understood.Objectives:This study was designed to investigate the etiology of common causes, management, and outcomes in children with EOM in Children’s Hospital 2, Vietnam.Subjects and methods:A retrospective case series was conducted at the Infectious Diseases Department of Children's Hospital 2, involving children diagnosed with EOM between March 2018 and March 2023.Results:A total of 53 patients (2.1% among the cases of meningitis) meeting the diagnostic criteria were enrolled in the study. Using cerebrospinal fluid (CSF) PCR assay, 7 out of 53 (13.2%) identified the causative agents. These included 4/7 (57.1%) parasites and 3/7 (42.9%) M. tuberculosis. The treatment rate with corticosteroids was 66.04%, while the rate with albendazole was 60.37%. Post-discharge neurological disability was observed in 11.3% of the cases.Conclusions: EOM is a rare condition, comprising 2.1% of all cases of meningitis in Children's Hospital 2. The causative agents mainly consist of parasites, with special emphasis on Mycobacterium tuberculosis. The mortality rate is low, yet the prevalence of long-term complications remains significant.

THE CHARACTERISTICS OF DISTRIBUTION OF TYPES OF DENGUE VIRUS SERUM AND LEVEL OF CONSENSUS RESULTS AGREEMENT ON DIAGNOSTIC TESTING FOR DENGUE HEMORRHAGIC FEVER IN PEOPLE WITH FEVER OF QUANG NINH PROVINCE IN 2024

Mon, 25 Nov 2024 00:00:00 +0000

Objectives: Characteristics of the Dengue virus serotypes by Realtime PCR method in Dengue hemorrhagic fever patients and comparing the similarity between the results of the Dengue virus serotype testing using the Realtime PCR method with the NS1 rapid test technique on Dengue hemorrhagic fever patients in Quang Ninh Province from 2022 - 2023.Subjects and methods: A retrospective study of the statistical reports on 300 patients suspected of having Dengue fever were collected at the Center for Disease Control in Quang Ninh Province from 2022 - 2023, cross-sectional study.Results:Patients infected with DENV1; 2; 4 accounted for 59.1%, 39.1%, 1.7%, respectively. The distribution of DENV1 type by region, DENV1 in the central region (Ha Long, Cam Pha) (46%) and western region (Uong Bi, Dong Trieu, Quang Yen) (41%) predominates over the eastern region and island districts; DENV2 type is higher in the western region (39.1%) than the central region (33.7%). The distribution of DENV types by subjects (≤ 15 years old, > 15 years old, man and women) and by time, clinical grade, and occupational group did not differ. Overall sensitivity and specificity of the rapid test were 93.19% and 96.92% with 95% CI. Positive predictive value (PPV) is: 99.09%, negative predictive value (NPV) is: 79.74% with 95% CI. The positive rate of rapid test was found to be higher at cut-off period value ≤ 25. The similarity calculated by Cohen's Kappa coefficient was 83.6%.Conclusions: Three types of DENV were detected, of which DENV1 had the highest rate (59.1%) followed by DENV 2 (39.1%), DENV 4 accounted for a very low rate (1.7%). The NS1 rapid antigen test can be used as a very good screening test to identify Dengue virus infection status

COMPARING THE TREATMENT RESULTS OF SEPSIS IN THE COMMUNITY CAUSED BY STAPHYLOCOCCUS AUREUS AND ESCHERICHIA COLI AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES

Nguyen Hong Long, Pham Ngoc Thach, Tran Van Giang — Mon, 25 Nov 2024 00:00:00 +0000

Objectives:To evaluate and compare the treatment results of sepsis in the community caused by Staphylococcus aureus and Escherichia coli at the National Hospital of Tropical Diseases.Subjects and method:Cross-sectional study was applied in this study and it was conducted on a total of 177 patients having treatment at the National Hospital of Tropical Diseases during period from July, 2021 to June, 2024.Results and conclusions: The study results show 106 (59.89%) patients infected by E. coli bacteremia and 71 (40.11%) patients infected by S. aureus bacteremia. The mean age of the study group was 58.41 ± 17.09 years old (from 19 to 93 years old). The mean age of the group of patients with bacteremia caused by E. coli and S. aureus was 62.04 ± 15.82 years old, 53.0 ± 17.60 years old, respectively. The proportion of sepsis caused by S. aureus was 18.8% higher than that caused by E. coli in male patients, specifically accounted for S. aureus (66.2%) and E. coli accounted for 43.4%. S. aureus bacteremia is often caused by skin - soft tissue, musculoskeletal infections. E. coli bacteremia are often caused by digestive and urinary tract infections. The mortality rate due to S. aureus bacteremia is 36.6%, nearly 3 times higher than the mortality rate due to E. coli bacteremia. The treatment time of the S. aureus bacteremia group is longer than that of the E. coli bacteremia group.

CHARACTERISTICS OF ANTIBIOTIC RESISTANCE AND TREATMENT OUTCOMES OF S. AUREUS BACTERIA AT NATIONAL HOSPITAL FOR TROPICAL DISEASES IN PERIOD FROM 2022 TO 2024

Tran Thi Hai Ninh, Nguyen Thi Hoa, Dao Ngoc Son, Nguyen Thi Bich Hue — Mon, 25 Nov 2024 00:00:00 +0000

Overview: S. aureus bacteremia (SAB) progresses severely, can lead to septic shock and death. S .aureusis increasingly resistant to antibiotics. Updating antibiotic resistance characteristics and treatment outcomes of S. aureus bacteremia helps doctors provide appropriate treatment.Objectives: study to describe the antibiotic resistance characteristics of S. aureus and evaluate the treatment outcomes of S. aureus bacteremia patients at the National Hospital for Tropical Diseases 2022 - 2024.Subjects and methods:The study subjects included patients ≥ 18 years old, diagnosed with S. aureusbacteremia at the National Hospital for Tropical Diseases from April 2022 to March 2024, excluding cases with positive blood culture results for multiple etiologies. The study was a cross-sectional descriptive analysis. All samples were selected by a convenience method. Data were analyzed and processed using SPSS22.0 software with applied algorithms.Results and conclusions: S. aureus had a high resistance rate to many antibiotics, MRSA accounted for 88%, multi-resistant bacteria accounted for 89.24%. However, S. aureus strains were still 100% sensitive to vancomycin, linezolid, tigecycline, nitrofurantoin. The average treatment time was 17.29 ± 10.4 days and all patients used antibiotics during the entire hospitalization. The rate of initial antibiotic prescription consistent with the antibiogram was 76.5%. Treatment results did not improve or worsened was 25.8%

ANTIBIOTICS RESISTANCE SITUATION OF KLEBSIELLA SPP. ISOLATED AT NINH THUAN PROVINCIAL GENERAL HOSPITAL

Mon, 25 Nov 2024 00:00:00 +0000

Objectives: Surveylance of the rate of Klebsiella spp. Pathogens were isolated from clinical specimens and assessed antibiotic resistance of Klebsiella spp. through antibiogram.Subjects and methods:All Klebsiella spp. isolated from clinical specimens of patients treated at Ninh Thuan Provincial General Hospital from October 1/2022 to September 30, 2023: Sputum, pus, blood, bronchial fluid, pharyngeal fluid, cerebrospinal fluid, urine Research of Horizontal cut representation.Results and conclusions:During the study period, the number of specimens containing Klebsiella spp. at Ninh Thuan Provincial General Hospital was 98 samples. The proportion of Klebsiella spp. Isolates according to gender: Male was 63.3%, more dominant than Female was 36.7%. The proportion of Klebsiella spp. Isolates by age group predominate in the 50 - 70 age group with a rate of 43.9%. Klebsiella spp. Mainly distributed on pus specimens accounted for 32.7%, sputum accounting for 27.6%, blood accounted for 25.5%. Klebsiella spp. has an ESBL birth rate of 8.2%. Klebsiella spp. has resistance to most antibiotics. Especially, ampicillin (100%), bactrim (93.8%), tetracycline (84.7%), cefuroxime (73.5%).

CLINICAL, SUBCLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES OF ADULT INFLUENZA A AND B PATIENTS AT TAM ANH GENERAL HOSPITAL IN 2022

Bach Nguyen Tra My — Mon, 25 Nov 2024 00:00:00 +0000

Influenza is an acute respiratory infectious disease caused by the influenza virus. Studies on influenza patients' incidence, complications, and treatment outcomes vary. The COVID-19 pandemic has shown changes in circulating influenza strains.Objectives:The study aims to describe the clinical, subclinical characteristics and treatment outcomes of influenza patients to help physicians improve prognosis and treatment outcomes for patients.Subjects and methods: This cross-sectional descriptive study was conducted on 224 adult influenza patients admitted to Tam Anh General Hospital. The sample was conveniently collected from January 2022 to January 2023.Result:61 patients with influenza B (27.2%) and 163 patients with influenza A (72.8%). Clinical characteristics: The average age of the patients was 33.3 years. The most common symptoms were fever, body aches, headache, and productive cough. Biochemical characteristics: Patients had elevated Creatinine levels (0.9%). 45 patients had mildly elevated AST levels (20.1%), and 9 patients had significantly elevated AST levels (2.7%). 30 patients had mildly elevated ALT levels (13.3%), and 10 patients had significantly elevated ALT levels (4.5%). Treatment outcomes:The average treatment duration for patients in the study was 3.50 ± 1.19 days. Patients with CRP > 2.5 mg/dL had longer treatment durations, higher complication rates, and higher antibiotic use compared to those with CRP ≤ 2.5 mg/dL. 87.5% of patients had good treatment outcomes, with symptoms improving and being discharged from the hospital; 12.5% of patients requested early discharge. Common complications included secondary bronchitis (11.6%), rhinosinusitis (4.4%), and pneumonia (2.2%).Conclusions:Influenza A predominates among the cases. Patients with CRP > 2.5 mg/dL have a longer average treatment duration, higher complication rates, and increased antibiotic use compared to those with CRP ≤ 2.5 mg/dL.

CAUSES OF SEPSIS AND USING EMPIRIC ANTIBIOTICS IN PATIENTS WITH SEPSIS AT THAI NGUYEN NATIONAL HOSPITAL

Luong Thi Quynh Nga, Duong Van Thanh, Nguyen Thi Tuyet, Le Thi Luu — Mon, 25 Nov 2024 00:00:00 +0000

Objectives:Describe the causes of sepsis and antibiotic resistance of isolated bacteria in patients with sepsis treated at the Department of Tropical Diseases - Thai Nguyen National Hospital (2020 - 2023).Subjects and method:Study on 114 patients diagnosed with sepsis treated at the Department of Tropical Diseases at Thai Nguyen National Hospital in Viet Nam from January 1, 2020 to August 16, 2023. Descriptive, retrospective study. Results and conclusions: A our specific study conducted 114 patients with sepsis at Thai Nguyen National Hospital in Vietnam. Here's a summary of the key points: Gram-negative bacteria, especially Escherichia coli and Klebsiella pneumoniae, were found to be the most common causative agents of sepsis in our study. Staphylococcus aureus was the most common Gram-positive bacterium. Empiric antibiotic treatment often involves combinations of antibiotics to cover a broad range of potential pathogens. Cephalosporins and penicillins were commonly prescribed, with carbapenems also used. The data on the duration of antibiotic treatment indicates that a significant percentage of patients received antibiotics for 10 - 15 days, and some were on antibiotics for over 15 days. The duration of antibiotic treatment should be individualized, considering various factors like the patient's condition, type of infection, and diagnostic tools available. Reducing the duration of antibiotic treatment is suggested as an effective strategy to combat antibiotic resistance. These information are valuable for improving sepsis management and antibiotic prescribing practices in our hospital.

LEVEL OF AGREEMENT OF THE HBsAg TEST IS EQUAL RAPID AND AUTOMATIC IMMUNOLOGY TEST METHOD IN SCREENING FOR HEPATITIS B VIRUS

Nguyen Thi Ngoc Bich, Nguyen Thu Huong — Mon, 25 Nov 2024 00:00:00 +0000

Objectives:The study aims to evaluate the level of consensus of HBsAg screening test using rapid test and automated immune testing methods in hepatitis B screening at Lao Cai Provincial General Hospital from May, 2024 to - June, 2024.Methods: Cross-sectional descriptive study.Results and conclusions: The study included 980 patients screened for HBsAg using rapid test and automatic immune testing from May, 2024 to June, 2024. The similarity between the two rapid and immunological test methods has Kappa = 0.92, almost complete agreement. The sensitivity of the rapid test is 98.9%, the specificity of the rapid test is 98.5% when considering the immunological method as the gold standard, the rate of HBsAg(+) screening results is > 70 COI screened by the method. Autoimmunity is 10.1%. The age group with the highest incidence is from (30 - 50 years old) accounting for 13%. The proportion of men is 11%, women is 8.5%, Patients residing in rural areas account for a higher rate of 12.2%, and 7.3% in urban areas with P < 0.05. The Tay ethnic group accounts for the highest proportion at 14.5%. There are 2.4% of HBsAg screening cases with indeterminate results (1 - 70 COI). The rate of HBsAg(+) carrier is 10.1%. The similarity between the two rapid and immunological test methods has Kappa = 0.92, almost complete agreement. The sensitivity of the rapid test is 98.9%, the specificity of the rapid test is 98.5%.

REALITY DATA ON THE USE AND EFFECTIVENESS OF CEFTAZIDIME - AVIBACTAM

Nguyen Van Dao, Duong Thanh Hai — Mon, 25 Nov 2024 00:00:00 +0000

Ceftazidime - avibactam (CAZ-AVI), a novel cephalosporin, has proven activity against multidrugresistant Enterobacterales and P. aeruginosa, and it has only been used in Vietnam in recent years.Objectives: This study aimed to describe the usage pattern and treatment effectiveness of CAZ-AVI. Subjects and methods: A retrospective observational study was conducted at Vinmec Times City International Hospital. Adult patients treated with CAZ-AVI for more than 48 hours from September 2021 to June 2023 were enrolled. Data on clinical characteristics, microbiology, and antibiotic regimens were collected, and outcomes such as microbiological and clinical effectiveness were analyzed.Results: A total of 61 patients were included, with an average age of 64.9 years, and 78.7% were male. All patients had at least one risk factor for multidrug-esistant Gram-negative bacteria. The most common infections were pneumonia (54%), urinary tract infections (20%), and abdominal infections (15%). Septic shock occurred in 16% of patients. Out of 61 patients, 39 (63.9%) had positive culture, yielding a total of 51 isolates, primarily Klebsiella pneumoniae (45.1%) and Pseudomonas aeruginosa (21.5%). Carbapenem and CAZ-AVI resistance rates among Gram-negative bacteria were 86.7% and 48.8%, respectively. Among the 36 carbapenem-resistant strains tested for sensitivity to CAZ-AVI, the resistance rate was 58.3%. CAZ-AVI was used empirically in 37.7% of cases, and combination therapy was employed in 65.6% of patients to treat multi drug resistant isolates. The most commonly used antibiotics in combination therapy were aminoglycosides, tigecycline, fluoroquinolones, and colistin. The average duration of treatment was 10.7 ± 5.2 days. Overall, microbiological cure was achieved in 38.5% of cases, while 43.6% experienced microbiological failure. Clinical improvement was observed in 77% of patients, and the 30-day mortality rate was 16.4%. There were no significant differences in microbiological or clinical outcomes between patients with ceftazidime-avibactam-resistant and -sensitive isolates.Conclusions: This study provides important real-world evidence on the use and effectiveness of CAZAVI in treating infections caused by multidrug-resistant Gram-negative bacteria. Despite high resistance rates, the drug showed promising clinical improvement, though microbiological failure remains a concern.

THE VALUE OF ELISA METHOD FOR MEASURING ANTI-VINCULIN ANTIBODIES IN THE DIAGNOSIS OF BLEEDING ULCERATIVE COLITIS AND DIARRHEA-PREDOMINANT IRRITABLE BOWEL SYNDROME AT THANH NHAN HOSPITAL IN 2023

Nguyen Thi Tu Anh, Nguyen Minh Hien, Nguyen Phuong Thoa, Nguyen Cam Thu — Mon, 25 Nov 2024 00:00:00 +0000

Objectives:To evaluate the diagnostic value of the ELISA method for measuring anti-vinculin antibodies in the diagnosis of bleeding ulcerative colitis (UC) and diarrhea-predominant irritable bowel syndrome (IBS-D) at Thanh Nhan Hospital in 2023.Subjects and methods:This was a cross-sectional study conducted with 150 participants, including 30 healthy individuals, 50 patients with UC, and 70 patients with IBS-D. The patients were examined and treated at Thanh Nhan Hospital from January 2023 to June 2024.Results:The average duration of disease for patients with UC and IBS-D was 2.8 ± 2.0 years and 2.9 ± 4.7 years, respectively. The average age of UC and IBS-D patients was 46.8 ± 13.7 years and 48.4 ± 12.0 years, respectively. The average level of anti-vinculin antibodies in the UC and IBS-D groups was 372.0 ± 196.1 (µg/g) and 587.7 ± 315.7 (µg/g), respectively. With an anti-vinculin antibody threshold in serum of 535.8 ng/mL (1.8 OD), the diagnostic value for distinguishing IBS-D from healthy individuals had a sensitivity of 50% and a specificity of 87.5%.Conclusions:The level of anti-vinculin antibodies in the IBS-D group (539.2 ± 299.3 ng/mL) was significantly higher than in the healthy control group (345.8 ± 126.2 ng/mL) and the UC group (372.0 ± 196.1 ng/mL) with p < 0.001. With a serum anti-vinculin antibody cutoff value greater than 535.8 ng/mL (1.8 OD), there is significant diagnostic value in distinguishing between healthy individuals and IBS-D patients, with sensitivity and specificity of 50.0% and 87.5%, respectively.

HEPATITIS C VIRUS TREATMENT STATUS AMONG PATIENTS IN METHADONE MAINTENANCE TREATMENT IN LONG BIEN DISTRICT MEDICAL CENTER, HANOI 2024

Le Thanh Ha, Do Manh Hung, Bui Thi Phuong — Mon, 25 Nov 2024 00:00:00 +0000

Objectives:To evaluate the status hepatitis C virus (HCV) treatment among patients in methadone maintenance treatment (MMT) in Long Bien District Medical, Ha Noi City in 2024.Methods: A cross-sectional descriptive study with analysis on 216 patients in MMT who had hepatitis C.Results:The rates of untreated and discontinued hepatitis C treatment were high, at 69.4% and 2.8% of patients, respectively. Interviews with patients revealed that 33.3% reported inadequate equipment, medication, and treatment services at treatment facilities. The rate of health insurance coverage was low, with only 6.1% of patients being covered.Conclusions: The rate of hepatitis C treatment in patients undergoing methadone maintenance therapy is still low, facing many difficulties, especially in terms of cost and treatment time.

PERSONALIZED MEDICINE FOR DIAGNOSIS AND TREATMENT OF NON-SMALL-CELL LUNG CANCER

Mon, 25 Nov 2024 00:00:00 +0000

Lung cancer, the most common cause of cancer death worldwide, with most patients dying from distant metastases, has become increasingly complex in achieving effective treatment. In lung cancer, particularly in non-small-cell lung cancer (NSCLC), EGFR, ALK, RET, ROS1, BRAF, KRAS, NRAS, NTRK, PIK3CA, DDR2, MET, and ERBB2 have been reported as key oncogenic drivers, which have led to the development and application of targeted therapeutic drugs aimed at these dysfunctional genes. Personalized medicine based on these oncogenic drivers offers the greatest potential benefit in the diagnosis and treatment of NSCLC patients. In particular, personalized medicine is importantly recommended for the treatment of advanced NSCLC. Here, we briefly summarize the significant application of personalized medicine based on key oncogenic drivers for the diagnosis and treatment of NSCLC with targeted therapeutic drugs, both globally and Vietnam.

PREVALENCE OF ASPERGILLUS FUMIGATUS ISOLATED FROM PATIENTS INDICATED FOR PATHOGENIC FUNGAL TESTING AT THE NATIONAL LUNG HOSPITAL IN 2023

Dao Thi Ngoc Lan, Nguyen Van Hung, Duong Hong Quan — Mon, 25 Nov 2024 00:00:00 +0000

Objectives:To describe the prevalence of Aspergillus fumigatus (A. fumigatus) infection in patients indicated for pathogenic fungal testing at the National Lung Hospital in 2023.Subjects and methods: Patients are assigned to undergo fungal testing at the National Lung Hospital in 2023. Cross-sectional descriptive study.Results and conclusions:Of the 26,301 patients who were indicated for fungal testing, 817 (3.11%) of patients had positive fungal culture and identification results for A. fumigatus. Of which, 787 (96.33%) patients were only infected with A. fumigatus and 30 (3.67%) cases were co-infected with A. fumigatus with another fungal species. The proportion of men dominated 83.48%, women accounted for 16.52%. The median age of the patients was 65.19 ± 12.92. In which, the age group from 61 - 80 accounts for the largest proportion with 63.28%. The isolation rate of A. fumigatus in sputum specimens was mainly (71.4%), followed by bronchial fluid (25.4%), and other specimens accounted for a small proportion (< 1%). The isolation rate of A. fumigatus fungi in the departments of the National Lung Hospital was mainly found in the Respiratory Department (24.3%), ranked second in the Emergency Department (17.3%).

ASSESSMENT THE CURRENT STATUS OF IN-PATIENTS PSYCHOSOCIAL SUPPORT NEEDS AT INTERNAL MEDICINE DEPARTMENT OF NATIONAL HOSPITAL FOR TROPICAL DISEASES

Mon, 25 Nov 2024 00:00:00 +0000

The burden of disease includes physical symptoms and psychological stress. Patients who receive psychological support often have better treatment outcomes. Therefore, medical facilities must proactively assess the psychosocial needs of patients to develop comprehensive intervention programs.Objectives:To assess the current status of psychosocial support needs of inpatients at the Department of Internal Medicine, National Hospital for Tropical Diseases for 3 months (August-October 2024).Subjects and methods: Cross-sectional descriptive study, selecting all patients who met the criteria with a convenient sampling method.Results:309 patients who met the criteria were recruited, with an average age of 58,7 ± 18,1; 54,4% were male; 86,7% had health insurance. The proportion of patients with depression and anxiety was 23,3% and 12%, respectively. Only a small proportion of patients (3%) wanted to receive psychosocial support, with a higher proportion of women than men.Conclusions: Although the proportion of patients with depression and anxiety was quite high, only a small proportion wanted to receive psychosocial support, indicating the need to increase patients' awareness of the need for psychosocial support.

THE CURREN SITUATION OF CESAREAN SECTION FOR NULLIPAROUS PREGNANCIES AT THE NATIONAL HOSPITAL OF TROPICAL DISEASES IN 2023

Mon, 25 Nov 2024 00:00:00 +0000

Objectives:To review the indications and results of cesarean sections for nulliparous pregnancies at the National Hospital for Tropical Diseases in 2023.Subjects and methods:A cross-sectional descriptive study combined with a retrospective review of medical records of pregnancies who delivered at ≥ 28 weeks gestational age at the National Hospital for Tropical Diseases from May 2021 to November 2023.Results:Research on 200 medical records shows that the rate of cesarean sections for first-born babies accounted for 67% of the total cesarean sections. Indications for cesarean section were due to genital tract issues (13.5%), fetal position (25%), fetal-related reasons (75%), fetal appendages (5.5%), maternal pathology (4%), and social factors (2%). For fetal-related reasons, 52% were due to fetal distress, 32% to macrosomia, and 14.5% to breech presentation. The Apgar index after 1 minute > 7 reached 98.5%, and after 5 minutes > 7 reached 100%. 96.5% of cases had no complications during or after surgery. Complications included bleeding requiring stitches to stop the bleeding (2%) and surgical wound infection (1.5%).Conclusions:The rate of cesarean sections for nulliparous pregnancies accounted for 67% of the total number of cesarean sections at the National Hospital for Tropical Diseases. The main cause of cesarean sections was fetal-related issues. The rate of postoperative complications was low, primarily consisting of bleeding that required stitches and surgical wound infections.

CHARACTERISTICS OF SOME BACTERIAL PATHOGENS ISOLATED FROM THE PATIENTS WITH VENTILATOR-ASSOCIATED PNEUMONIA AT THE NATIONAL HOSPITAL OF TROPICAL DISEASES IN 2023

Mon, 25 Nov 2024 00:00:00 +0000

Objectives:To describe the characteristics of some bacterial pathogens isolated from patients with ventilator-associated pneumonia (VAP) at the National Hospital for Tropical Diseases (NHTD) in 2023.Subjects and methods:A cross-sectional, retrospective study was conducted on 176 medical records of patients with ventilator-associated pneumonia at NHTD who had bacterial culture results from January 2023 to December 2023.Results:The incidence of VAP in male patients was 56.8%, while in female patients it was 43.2%. The average age was 59.6 years. The average time to identify VAP was 7.6 days, and over 80% of patients had underlying medical conditions. The most common causative agent of VAP was Acinetobacter baumannii (40.3%), while the least common was Acinetobacter pittii (0.3%).Conclusions:The incidence of VAP in male patients (56.8%) was higher than in female patients (43.2%). The average age of the study subjects was 59.6 years, with an average VAP identification time of 7.6 days, and over 80% of the patients had underlying medical conditions. The most common pathogens causing VAP included Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae, accounting for 40.3%, 18.4%, and 16.5%, respectively.

RESEARCH ON PROGNOSTIC FACTORS FOR MORTALITY IN MODERATE TO SEVERE COVID-19 PATIENTS AT THE COVID-19 RESEARCH AND TREATMENT CENTER, HUE CENTRAL HOSPITAL

Ha Van Quyet, Nguyen Duc Hoang, Nguyen Thanh Xuan, Le Van An, Tran Xuan Chuong — Mon, 25 Nov 2024 00:00:00 +0000

Objectives: To investigate the clinical and paraclinical characteristics of moderate to severe COVID-19 patients at the COVID-19 Research and Treatment Center, Hue Central Hospital. To evaluate certain prognostic factors for mortality in moderate to severe COVID-19 patients.Methods: Patients aged 18 years or older diagnosed with moderate to severe COVID-19 (according to Decision No. 250 of the Ministry of Health, dated January 28, 2022), at the COVID-19 Research and Treatment Center, Hue Central Hospital, from December 2021 to September 2023. This research employed a prospective approach.Results:A total of 300 patients were enrolled in this study. The average age was 64,57 ± 18,45 years. The most common comorbidity was hypertension (50.2%). Patients who have been vaccinated (75.3%). The most common clinical signs and symptoms included cough (72%), shortness of breath (56.9%), and fatigue (87.5%). Abnormal paraclinical findings were WBC > 10.109/L (35.7%), LYM < 1.109/L (52.5%), D-dimer > 1000 ng/mL (52.9%), CRP > 10 mg/L (75.5%), Ferritin > 500 ng/mL (52.7%), LDH > 300 U/L (33.2%), positive cytokine storm (23.3%), and TSS 3-6 points (51.9%). The mortality rate was 18%. There was a significant association between underlying conditions, vaccination, LYM, LDH, D-dimer, Ferritin, chest X-rays, cytokine storm, and mortality prognosis in moderate to severe COVID-19 patients (p < 0.05). Non-vaccination was an independent prognostic factor for mortality in moderate to severe COVID-19 patients (OR 2.741; 95%CI: 1.168-6.431; p < 0.005). LDH > 300 U/L was an independent prognostic factor for mortality in moderate to severe COVID-19 patients (OR 6.696; 95%CI: 2.335-19.199; p < 0.001). Conclusions:Cough, shortness of breath, and fatigue are common symptoms in moderate to severe COVID-19 patients. LYM < 1 x 109/L, D-dimer > 1000 ng/mL, Ferritin > 500 ng/mL, and CRP > 10 mg/L were mainly found in lab tests. The patient mortality rate was 18%. Non-vaccination and LDH > 300 U/L are independent predictors of mortality in moderate to severe COVID-19 patients.

CASE REPORT OF TALAROMYCES MARNEFFEI FUNGEMIA IN AN HIV-NEGATIVE PEDIATRIC PATIENT TREATED AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES

Nguyen Manh Truong, Vu Thi Phuong, Bui Van Nam, Dang Thi Thuy — Mon, 25 Nov 2024 00:00:00 +0000

Talaromyces marneffei is a dimorphic fungus frequently encountered in immunocompromised individuals. Particularly, in those with HIV/AIDS or other predisposing factors. Talaromyces marneffei commonly induces invasive and disseminated infections, including fungemia. In this report, we present a case of a 44-month-old male child admitted with a protracted febrile illness. The patient had a history of pulmonary tuberculosis under stable management, presenting with sustained fever, persistent cough, cachexia, anemia, bilateral fine crackles and wheezing upon auscultation, hepatosplenomegaly, and no signs of respiratory distress. Immunological assays assessing both humoral and cellular immunity were unremarkable, and the patient tested negative for HIV. Chest computed tomography revealed bilateral strip-like and nodular pulmonary infiltrates, along with bilateral hilar lymphadenopathy. Blood cultures confirmed the presence of Talaromyces marneffei. The patient exhibited a favorable clinical and laboratory response to Amphotericin B treatment and was subsequently maintained on Itraconazole therapy postdischarge.

HEPATITIS VIRUS IS ONE OF THE MAIN CAUSATIVE AGENTS OF HEPATOCELLULAR CARCINOMA

Le Van Giao — Mon, 25 Nov 2024 00:00:00 +0000

Despite the increasing incidence of HCC related to metabolism-associated steatotic liver disease, viral hepatitis remains the major driver in liver carcinogenesis. Both HCV and HBV viruses have direct oncogenic properties that promote carcinogenesis, especially in active infections. The aim of this review is to summarize the viral mechanisms involved in liver cancer and to evaluate the changing incidence of HCC after antiviral treatment.