scholarly journals Current Situation of Treatment and Follow-up Re-examination of Children with Epilepsy at Vietnam National Children’s Hospital

Author(s):  
Thi Huyen Tran ◽  
Vu Hung Cao ◽  
Van Hoc Tran ◽  
Danh Ngon Nguyen

Purpose: To assess treatment compliance and follow-up appointment of children with epilepsy at the Vietnam National Children’s Hospital in 2019. Method: A cross-sectional descriptive study was conducted on pediatric patients and primary caregivers came for examination and treatment at the Neurology Department, Vietnam National Children’s Hospital from January 2019 to December 2019. Results: Mean age was 74.3 ± 45.1 (month age). The most common age group was the 2-6 year old group (40.5%), the lower rate was the 6-12 year old group (30.0%), and rest groups was the low rate. The male: female ratio is 1.43:1. Most of the main caregivers are parents (92.5%). Average treatment time was 20.4 ± 15.7 months, the rate of good adherence to treatment 43.5%, 31.5% of children had  moderated adhering to treatment and 25.0% had poor adhering to treatment. Within 6 months, 40.5% of children re-examined on time. The reasons for not complying with on-time re-examination were mainly due to the caregiver's busy work or the child was busy at school (37.8%) and the distance from home to hospital (26.1%). Conclusions: The percentage of patients who complied with treatment and re-examination was not high. Factors that were statistically significant for children's non-compliance were: health insurance level, age of onset, duration of treatment, and frequency of attacks following treatment.

Author(s):  
Hà Ngọc Đạt

Objectives: 1. Describe some clinical epidemiological characteristics of Shigella dysentery in children in the Department of Gastroenterology of Central Children's Hospital in 2019; 2. Comment on treatment results in the above patients. Subjects: All patients under 15 years old are admitted to the Hospital of Gastroenterology, Vietnam National Children's Hospital.. Method of cross-sectional description. Results: More morbidity rates in men than in women. The male / female ratio is 1.8 / 1. In which, the highest incidence is from 1 to 3 years old. In comparison with other seasons, autumn has the highest proportion of hospital patients, accounting for 46.4%. The majority of patients admitted to hospital due to diarrhea and fever accompanied by blood in the stool accounted for 41.3%, some came to the hospital due to high fever with 15/184 patients accounting for 7.9%, high fever. Accompanied by seizures, accounting for 16.5%. The rate of treatment with Ciprofloxacin is 89.5%. The recovery rate is quite high, 93.3%, the percentage of patients who are also significantly better at 6.7% and there is no case of treatment failure.  


2019 ◽  
Vol 1 (1) ◽  
pp. 5-9
Author(s):  
Binita Bhattarai ◽  
Koshal Shrestha ◽  
Sushila Patel ◽  
Laxmi Devi Manandhar ◽  
Rosy Karki ◽  
...  

Background: Chalazion is a common eyelid disease caused by plugged meibomian glands and chronic lipogranulomatous inflammation. It can affect individuals of all ages and may cause local eye symptoms such as irritation and inflammation and cosmetic disfigurement. There are mainly three methods of treating chalazion: Intralesional Triamcinolone Acetonide (0.1-0.3 ml of 40mg/ml), Incision and Curettage and Conservative Treatment (hot compression +lid hygiene + antibiotic ointment) to the affected eyelid. To comparing which method is the best this study has been carried out Methodology: Patients with chalazion presenting to OPD from 15 March to 15 July 2017 were included in the study. They underwent any of the three procedures according to their choice. Follow up visit was done at two weeks to determine effectiveness in terms of reduction of size or complete resolution of the chalazion. Results: Out of 112 patients enrolled in study 65(58%) were females and 47(42%) were male with a male: female ratio of (0.7:1). The mean age of involvement was 25.7years (SD 10.3). At 2 weeks follow up there was complete resolution in incision and curettage (I and C) group 77 %( 41/53) and in Triamcinolone Acetonide (TA) injection group 63 %( 20/32). Pearsons correlations showed that I and C were superior to any other forms of intervention for any size of chalazion followed by intralesional injection of TA. Conclusion: Among the three methods, Incision and Curettage remained the best choice for treatment of chalazion followed by triamcinolone acetonide injection but may need multiple injections. Keywords: Chalazion, Intralesional Triamcinolone, Incision and Curettage, Meibomian Gland


Author(s):  
Thi Ngoc Tran ◽  
Thien Hai Do ◽  
Thi Duyen Tran ◽  
Le Chinh Nguyen

Purpose: To characterize the prevalence and factors associated with ARV adherence in HIV/AIDS-infected children at outpatient clinics, Vietnam National Children's Hospital. Methods: A cross-sectional study was conducted at outpatient clinics, Vietnam National Children's Hospital in 2019. Results: The study results showed that 63% of  HIV/AIDS infected children adhered to treatment and 37% of them did not adhere to ARV. The study investigated the relevance of 11 factors and found 5 factors related to pediatric noncompliance, including a short treatment period of less than 1 year (OR: 17.1; 95% CI: 2,26-75,5 and p < 0,01); waiting time for taking drugs is too long (OR: 19.3; 95% CI: 7.9-50.9 and p < 0.01); main caregivers aged ≥ 50 (OR = 42.3; 95% CI from 17.9-120.1 and p < 0.01. Conclusions: The prevalence of ARV adherence in HIV/AIDS-infected children was 63%. Counseling intervention models to improve drug treatment compliance should be concentrated on newly infected children, treatment duration less than 1 year and their primary caregivers over 50 years old.


Author(s):  
Nguyen Sinh Hien ◽  
Nguyen Huu Phong ◽  
Le Quang Thien

Objective: to evaluate the short-term outcomes of surgical treatment of left-sided infective endocarditis (IE) in Hanoi Heart Hospital. Patients and Methods: A retrospective, cross-sectional and descriptive study on all patients underwent surgery for left-sided IE from 3/2015 to 3/2019 in Hanoi Heart Hospital. Result: 56 patients underwent surgery for left-sided IE in 4 years; the mean age was 45.8 ± 16.0; male-female ratio was 3.3/1. 9 patients (16.1%) had prosthetic valve endocarditis. Preopeative blood cultures were positive in 35.7%, the mainly microorganism was Streptococcus (21.4%). Emergency and urgent surgery was performed in 14.3%; the most frequently postoperative complication was kidney failure, the in-hospital mortality rate was  5.4%. During the average follow-up time of 36.6± 14.2 months, the recurrence rate of IE was 17.8%. Conclusion: surgical treatment of left-sided infective endocarditis is still a great challenge, the early recurrence and motality rate are high.


2020 ◽  
Vol 91 (8) ◽  
pp. e10.2-e10
Author(s):  
Sophia G Raymond ◽  
Jeremy S Stern ◽  
Helen Simmons

AimsDrugs such as neuroleptics are known to have varying efficacy in the management of Tourette’s syndrome, and there is a particular lack of research about their efficacy when used for older patients presenting for treatment for the first time. Therefore, in this study, we aim to describe the outcomes of drug treatment in patients aged 40 years and older who presented to a Tic Disorder clinic.MethodThe Tic Disorder clinic letter database was used to search for patients who presented to the clinic aged 40+. Clinical information gleaned from the letters including age of onset, severity of symptoms, comorbidities and treatments offered was recorded in an Excel spreadsheet. Those patients with incomplete data were removed from the sample. The spreadsheet data was then used to describe the severity of tics in this cohort and the effectiveness of drugs for all patients who used them.ResultsThere were a total of 33 patients aged 40+ who presented to the Tic Disorder Clinic, that we could find a set of clinical notes on. Male: female ratio = 26:7 Tic severity was calculated from either clinical comment, or in most cases, the Yale Global Tic Severity Score (YGTSS). YGTSS of 1–19 is mild, 20–39: moderate and 40–50: severe. Patients with tics since childhood: 75.8%, late onset tics >40 yrs: 15.2%, unknown: 9%. 63.6% have had obsessionality, a common comorbidity of GTS, and 42.4% suffer with two or more psychiatric comorbidities. 25/33 patients tried drugs for tics, whether before or at presentation to this clinic. 40% of them found drugs beneficial; 60% did not, or experienced adverse reactions or were lost to follow up (see bar chart).ConclusionsOverall, even though this study shows that medications for tics is more likely to be unsuccessful or cause adverse effects, it was still effective in a substantial proportion of patients and thus may be a good intervention for some. The study also suggests that this may be more difficult cohort to monitor due to the frequency of absences to follow up.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manning Qian ◽  
Fei Li ◽  
Yuhan Zhang ◽  
Zhongwei Qiao ◽  
Yingyan Shi ◽  
...  

AbstractDiagnosis of pediatric paragonimiasis is difficult because of its non-specific clinical manifestations. We retrospectively reviewed the records of pediatric paragonimiasis in Children’s Hospital of Fudan University from January 2011 to May 2019. The confirmed diagnosis of paragonimiasis was based on positive anti-parasite serological tests from the local Center for Disease Control (CDC). A total of 11 patients (mean age: 7.7 ± 3.1, male–female ratio: 7:4) diagnosed as paragonimiasis were included. 81.8% were from endemic areas such as Sichuan and Yunnan, and 36% had a clear history of raw crab or crayfish consumption. The characteristic clinical features of pediatric paragonimiasis were eosinophilia (100%), pleural effusion (81.8%), hepatomegaly (54.5%), ascites (54.5%), and subcutaneous nodules (45.5%). Misdiagnosed with other diseases including tuberculosis (18.2%), pneumonia (9.1%), intracranial space-occupying lesions (9.1%) and brain abcess (9.1%) led to rehospitalization and prolonged hospitalization. For treatment, a 3-day course of 150 mg/kg praziquantel (PZQ) didn’t show ideal treatment effectivity and 63.6% needed more than one course of PZQ, while triclabendazole in a total dose of 10 mg/kg had a better efficacy to stubborn manifestations. This study indicated that pediatric paragonimiasis was often misdiagnosed, and the treatment with a 3-day course of 150 mg/kg PZQ had a high rate of failure.


2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy


2020 ◽  
Vol 3 (4) ◽  
pp. e000195
Author(s):  
Meagan E Wiebe ◽  
Anna C Shawyer

ObjectiveCentralization of medical services in Canada has resulted in patients travelling long distances for healthcare, which may compromise their health. We hypothesized that children living farther from a children’s hospital were offered and attended fewer follow-up appointments.MethodsWe reviewed children less than 17 years of age referred to the general surgery clinic at a tertiary children’s hospital during a 2-year period who underwent surgery. Descriptive statistics were performed.ResultsWe identified 723 patients. The majority were male (61%) with a median age of 7 years (range 18 days to16 years) and were from the major urban center (MUC) (56.3%). The median distance travelled to hospital for MUC patients was 8.9 km (range 0.9–22 km) vs 119.5 km (range 20.3–1950 km) for non-MUC patients. MUC children were offered more follow-up appointments (72.7% vs 60.8%, p<0.05). No significant differences existed in follow-up attendance rates (MUC 88.5% vs non-MUC 89.1%, p=0.84) or postoperative complications (9.8% vs 9.2%, p=0.78). There were no deaths.ConclusionsPatients living farther from a hospital were offered fewer follow-up appointments, but attended an equivalent rate of follow-ups when offered one. Telemedicine and remote follow-up are underused approaches that can permit follow-up appointments while reducing associated travel time and expenses.


Author(s):  
Henry Olayere Obanife ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Bello B. Shehu ◽  
Ega J. Otorkpa

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Xiaolei Zhou ◽  
Diana Garbinsky ◽  
John Ouyang ◽  
Eric Davenport ◽  
Indra Agarwal ◽  
...  

Abstract Background and Aims : Observation of impactful clinical outcomes in a clinical trial setting for ADPKD is challenging due to the life-long progressive nature of ADPKD and longer-term associated outcomes of interest in this population (e.g., renal function decline, cardiovascular events, and mortality). Since 2004, the tolvaptan (TOL) clinical trial program enrolled subjects in multiple clinical studies with the opportunity to enroll in subsequent clinical trials for treatment and outcomes evaluation. Method : Data from 6 ADPKD studies (protocols 156-04-250, 156-04-251, 156-06-260, 156-09-284, 156-09-290, 156-08-271) were pooled and evaluated over time for overall treatment duration, treatment time, and treatment gaps. Treatment duration for the individual clinical trials ranged from 1 week to up to 3 years. Results : Overall, 1,437 subjects received TOL in these ADPKD clinical trials. For these subjects, the mean overall treatment duration was 4.1 years (3.8 years on treatment) with a maximum of 9.7 years (9.0 years on treatment). In this cohort, 513 subjects (35.7%) received TOL treatment for more than 5 years. Mean treatment compliance was 94.1%. Overall, 723 subjects (50.3%) received TOL treatment in ≥2 trials, with a median treatment gap duration between trials of 0.1 years (maximum, 5.6 years). At least 7 years of follow-up data are available for estimated glomerular filtration rate in 241 subjects (mean at baseline, 78.6 mL/min/1.73m2) and for total kidney volume in 130 subjects (mean at baseline, 1,816.9 mL). Conclusion : This analysis provides longitudinal follow-up over an extended timeframe in a large number of subjects treated with TOL, with the greatest number of subjects being enrolled in clinical trials enriched for rapidly progressing ADPKD. Treatment compliance over years was reasonably good despite treatment gaps.


Sign in / Sign up

Export Citation Format

Share Document