The situation of antibiotic use for diarrhea treatment on pediatric inpatient at Pediatrics - Kien Giang General Hospital in 2019-2020

Background: To survey for evaluation the use of antibiotic for diarrhea treatment on pediatric inpatient in compliance with MOH, WHO or treatment regimen. Objectives: (1) To describe the situation of antibiotic use for diarrhea treatment and (2) to determine factors that affected on indication of antibiotic for pediatric inpatient under 15 years at Kien Giang General Hospital in 2019. Subjects and methods: A cross-sectional study on 251 medical records of pediatric inpatients who treated by one of any drug from 01/2019 to 12/2019. Results: one antibiotic was prescribed in 71.7% in comparison with 17.1% on two antibiotics. The antibiotic prescription was based on the results of blood test including examinations of white blood cells (WBC), the percentage of neutrophils (Neu%) and/or C-reactive protein (CRP) (59.4%), stool with white blood cells and/or red blood cells (1.6%), high fever without causes (27.9%), watery stool (86.3%), loose stool with blood (100%), loose stool (97.9%). The most used antibiotics are ceftriaxone (53.4%), ciprofloxacin (12.4%). Duration of antibiotic use is 5 days in median. Conclusion: The rate of antibiotic prescription that met MOH and WHO guidelines was 88.3% in comparison with 11.7% of non-conformance. The compliance prescriptions based on antibiogram were 77.8%, non-compliance were 22.5%. The compliance dosage refered to guideline was 86.4%, non-conpliance was 2.4%. The duration of hospitalization and neutrophil are factors that affected the use of antibiotics (p < 0.05). Keywords: diarrhea, pediatric inpatient, antibiotic, Pediatrics-Kien Giang General Hospital

CLINICAL CHARACTERISTICS AND EVALUATION OF THE EFFECTIVE TREATMENT OF CUTANEOUS WARTS BY ELECTROSURGERY

Background: Cutaneous wart is a common disease caused by the infection of Human Papillomavirus, this disease has diverse clinical characteristics and many different treatments. We conducted this study to evaluate the clinical features and the efficacy electrosurgery treatment. Methods: A total 75 patients was diagnosed with cutaneous wart and treated by electrosurgery method at Dermatology Clinic of Hue University of Medicine and Pharmacy Hospital. Results: The age has a wide distribution. The female/male ratio was nearly egal. Most patients had a single lesion. Plantar wart was predominate with 63.3%. After the procedure, 90.8% of patients had mild and moderate pain. The rate of post-operative bleeding was high 85.3%. In the first week, the dried wound was 64.2%. The average healing time was about 4 weeks. The infection rate was 11%. Conclusion: The most common clinical form was plantar wart; electrosurgery had many advantages but some disadvantages in wound healing related to heat damage. Keywords: cutaneous wart, electrosurgery, HPV.

Indications and techniques of mr urography

Magnetic Resonance Urography (MRU) provides a comprehensive assessment of both morphology and function of the urinary system by using various sequences of T1W, T2W, 2D and 3D. T1W and T2W 2D images are optimal to evaluate the morphology of the kidneys and the urinary tract. Fast gradient echo 3D T1W sequence with the use of fat saturation technique (Fatsat or Dixon sequences), gadolinium administration, diuretic maneuver, and maximum intensity projection allows visualization of the urinary tract similar to that of conventional intravenous urography. MRU is also helpful in investigating renal function based on the hemodynamic study of contrast medium. Recent data prove that MRU, except for the study of renal calculi, is not inferior to computed tomographic urography (CTU) in evaluating diseases of the urinary system such as neoplasm, malformation and obstruction. MRU is an alternative to CTU when CTU is contraindicated. This article aims to review the techniques of MRU to optimize visualization of the urinary system and their indications in daily practice. Key words: MRU, MR hydrography, MR dynamic

HEALTH LITERACY AND HEALTH CARE SEEKING BEHAVIOR OF THE ELDERLY IN HUE CITY

Objectives: To assess the health literacy and identify the relationship between the health literacy and health care seeking behavior among the older persons in Hue city. Methods: A cross-sectional study was conducted in Hue city. 400 older persons were interviewed directly using a structured questionnaire. Health literacy was assessed by HLS- Asian- Q. Multivariate logistic regression model was used to identify the relationship between health literacy and health care seeking behavior. Results: 20.0% of the respondents got inadequate health literacy. The proportion of the elderly who achieved health literacy in health care, health prevention and health promotion were 25.7%, 10.0% and 28.0%, respectively. The percentage of the elderly who have sought health care services and health promotion services were 76.7% and 68,0%, respectively. There was a relationship between health literacy and treatment seeking behaviour (OR= 3.71; 95% CI: 1.25-11.01) and health prevention service seeking behaviour among participants (OR=3.30; 95% CI:1.16-9.40). Conclusions: Health literacy of the elderly was still low in Hue city. There is influence of health literacy on health care seeking behavior among them. Enhancing health literacy for the older persons should be a necessary solution to improve their health status. Keywords: Health literacy, health seeking behavior, older persons, Hue city.

SERUM THYROGLOBULIN AND ANTI THYROGLOBULIN LEVELS IN PATIENTS WITH THYROID NODULES

Objectives: To compare the levels and pathological values of serum Tg and TgAb between the patients with benign and malignant thyroid nodules and evaluate the relationship between serum Tg and TgAb levels with the rim characteristic and elasticity score of the nodule by thyroid elasto-echography. Subjects: 30 patients with thyroid nodules, Serum Tg and TgAb levels and thyroid elasto-echography are examen before operation. Results: The ratio of the positive Tg level of malignant thyroid nodules was higher than the benign thyroid nodules (16.7% vs 8.3%) but the serum Tg level was not significantly different (33.48 ± 38.67 ng/ml vs 27.32 ± 28.44 ng/ml, p > 0.05) and The ratio of positive TgAb level of malignant thyroid nodules was higher than that of benign thyroid nodules (22.2% vs 0%) but serum TgAb level was not different (64.15 ± 14.91 UI/ml vs 16.9 ± 14.48 UI/ml, p > 0.05). The combination of the ratio of positive Tg and positive TgAb level did not show any difference in the ratio of pathological value between benign and malignant thyroid nodules (5.6% vs 0%). Serum Tg levels in patients with irregular rim thyroid nodules were higher than those in patients with regular rim thyroid nodules but the serum Tg level was not different when evaluated with the elastic score. Conclusions: The mean level and ratio of the pathological value of serum Tg and TgAb did not differ between malignant and benign thyroid nodules. There is a relationship between serum Tg level and irregular rim characteristic of thyroid nodule (p < 0.05). Key words: serum thyroglobulin level, serum anti thyroglobulin level, thyroid nodule.

THE FREQUENCY OF SOME CLINICAL SYMPTOMS ACCORDING TO TRADITIONAL MEDICINE IN PATIENTS WITH SHOULDER AND NECK PAIN

Backgrounds: Shoulder and neck pain is a common disease in the world as well as in Viet Nam and tends to increasingly rejuvenate, it impacts on patient’s ability to work and quality of life. Surveying the clinical symptoms according to the traditional medicine on purpose of making diverse diagnostic and towards comprehensive treatment. Therefore, in this study we contribute to build standardization of diagnostic symptoms according to traditional medicine. Objectives: To survey the frequency of some clinical symptoms according to traditional medicine and find outseveral factors related with frequency appear clinical groups of shoulder and neck pain. Materials and Methods: Including 87 patients were diagnosed with shoulder and neck pain treatment at the Traditional Medicine Department of Hue Central Hospital and Thua Thien Hue Traditional Medicine Hospital. Research methodology is descriptive cross-sectional. Results: about the tongue body: higher abnormal group is 18.4% pale tongue, 27.6% enlarged tongue. About the tongue fur: 75.9% white fur, 58.6% thin fur, slippery fur (31%) is higher than dry fur (17.2%). Cold symptom are the most common: warm compress relieve pain (62.1%). Heat symptom are the most common: dry thirsty mouth (34.5%). About pain feature, common symptoms such as press relieve pain (64.4%), dull pain (71.3%) and persistent pain (69%). About the pulse: sunken pulse 65.5%, slow pulse (31.1%), moderate pulse (47.1%), weak pulse (55.2%). Conclusion: symptoms have high rate such as pink moist tongue, white fur, dull pain, sunken pulse. Symptoms have low rate such as bluish purple tongue, sticky slimy fur. There were significant relationships between clinical groups and age, gender, disease duration, warm compress relieve pain, body palpation and pulse frequency (p <0.05). Key words: frequency, symptoms, shoulder and neck pain, traditional medicine.

THE SURGICAL TREATMENT OF ACHALASIA ON LAPAROSCOPIC HELLER MYOTOMY WITH DOR ANTIREFLUX PROCEDURE AT HUE CENTRAL HOSPITAL

Background: Achalasia is a primary motor disorder of the esophagus characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. Diagnosis is confirmed by clinical symptoms, endoscopic, radiographic and manometric. Although pneumatic dilation has a role in the treatment of achalasia, laparoscopic Heller myotomy is considered by many experts as the best treatment modality for most patients with newly diagnosed achalasia. Objective: To evaluate the efficacy and safety of laparoscopic Heller myotomy with Dor antireflux procedure. Patients and Methods: Prospective analyses of the patients of achalasia undergoing laparoscopic Heller myotomy with Dor antireflux procedure from 01/2012 to 06/2020. We evaluated the data according to outcome measures, characteristics and treatment results of achalasia after laparoscopic Heller myotomy with Dor antireflux procedure. Results: We found 11 patients with achalasia were diagnosed and treated by laparoscopic. 100% of the patients have dysphagia, weight loss; 81.8% have chest pain and regurgitation. Mean operative duration was 148 ± 21 minutes. There was no complications had found in our patients. Follow-up after 3 - 6 months by Eckardt score show that 90.9% had a good result, 01 patient with persistent symtomps (Eckardt score > 3) had to undergo a pneumatic dilation. Conclusion: The results of the laparoscopic Heller myotomy with Dor antireflux procedure were safe and effective. Keywwords: Achalasia, laparoscopic Heller myotomy, Dor antireflux procedure

PREVALENCE OF DEPRESSIVE DISORDERS USING ICD 10 CLINICAL CRITERIA AND ASSOCIATION WITH HEALTH BEHAVIOR, TREATMENT ADHERENCE AND COMORBIDITIES AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS

Background: The prevalence of depression is high in patients with type 2 diabetes mellitus (T2DM). Several studies showed that suitable health behavior and treatment adherance could be factors asociated with low prevalence of depression among patients with type 2 diabetes mellitus. Objectives: 1. To investigate the prevalence of depressive disorder using ICD10 clinical criteria among patients with T2DM. 2. To analyze the association between depressive disorder with health behavior, treatment adherence and commorbidities in the participants. Subjects and methods: This is a descriptive cross - sectional study on 210 inpatients with T2DM at the Department of General Internal Medicine, Hue University of Medicine and Pharmacy Hospital and at the Department of Endocrinology - Neurology, Hue Central Hospital. PHQ - 9 with the cutoff of 10 was used to screen depressed patients among participants, then psychiatrists used clinical criteria of ICD 10 to diagnose depression definitively. Patients who were diagnosed with depression according to clinical criteria were analyzed the association between depression with health behavior, treatment adherence and comorbidities by using univariable and multivariable logistic regression. Results: The prevalence of depressive disorder among patients with T2DM assessed by clinical criteria of ICD 10 was 31.4% in which severe (7.6%), moderate (19.5%) and mild depression (4.3%). Health behavior associated with depression in patients with T2DM are light or moderate activities such as practising yoga, walking, riding bicycle ... that help reduce the rate of depression, while working hard or playing heavy sports increases the rate of depression. In addition, patients with 2 or more complications, hypertension and kidney diseases increased the risk of depression in univariate analysis. The multivariate analysis of risk factors for depression were infectious diseases. Conclusion: Depression is found at a high rate among patients with T2DM. Light or moderate physical activity reduces the prevalence of depression. The complications and associated infectious disease are risk factors for depression. . Key words: Depression, type 2 diabetes mellitus, health behavior, comorbidities, treatment adherence

CHARACTERISTICS OF SEXUALLY TRANSMITTED DISEASES IN DERMATOLOGY DEPARTMENT, HUE CENTRAL HOSPITAL

Background: Sexually transmitted diseases are popular, not only affecting the health but also affecting the psychology and social behavior of patients. After being diagnosed, the patients were hospitalized at the Department of Dermatology, Hue Central Hospital. Therefore, we conducted this study to investigate some characteristics of sexually transmitted diseases. Materials and methods: Cross-sectional study on 72 patients having one of sexually transmitted diseases,we investigated some characteristics and clinical forms. Results: The proportion of male and female was the same and the most common age group was 15-25 with 44.4%. Most patients had two or more sexual partners with 62.5% and very few often used condoms. Only three diseases were diagnosed with genital warts, syphilis and urethritis; among them genital warts was the most common 66.7%. Latent syphilis and small papules were the most common clinical forms of syphilis, condylomata acuminata, respectively. Conclusion: Sexually transmitted diseases were relatively common among inpatient diseases and had diverse characteristics. Keywords: sexually transmitted diseases, gonorrhea, syphilis, condylomata acuminata

SURVEY THE FREQUENCY OF CLINICAL SYMPTOMS ACCORDING TO TRADITIONAL MEDICINE IN PATIENTS WITH LOW BACK PAIN

Background: Low back pain is a very common disease in daily life and clinical, which affects much to the health. Traditional medical symptoms of low back pain are very diverse and clinically difficult to diagnose. So we conduct this study to contribute to the standardization of symptoms according to traditional medicine and initially contributed to the improvement of diagnosis and treatment of diseases. Objectives: to survey the frequency of clinical symptoms according to traditional medicine in patients with low back pain and find out some factors related to the frequency of clinical types of the disease. Subjects and Methods: Including 92 patients were diagnosed with low back pain and treatment at the Traditional Medicine department of Hue Central Hospital and Thua Thien Hue Traditional Medicine Hospital. Research methodology is descriptive cross-sectional. Results: The symptoms of the tongue: 65.2% pale red tongue, 6.5% bluish purple tongue, 37.0% enlarged tongue, 8.7% thin tongue. About the tongue fur: 68.5% white fur and 31.5% yellow fur, 42.4% moist fur, 4.3% sticky slimy fur, 58.7% thin fur and 41.3% thick fur. The symptoms of the pulse: 17.4% floating pulse, 69.6% sunken pulse, nmoderate pulse 43.5%, powerful pulse 84.8%, weak pulse 15.2%. Among the patients have 33.7% constipation, 45.7% nocturia, 34.8% inability to sleep, 17.4% night sweating 12.0% spontaneous sweating. Conclusion: Symptoms: pale red tongue, white fur, moist fur, thin fur, constipation, nocturia, inability to sleep, sunken pulse, moderate pulse, powerful pulse have high rate; Symptoms have low rate such as bluish purple, the thin tongue, sticky slimy fur. There were significant relationships between clinical types and age, tongue color, tongue fur color, pain properties and pulse frequency (p < 0.05). Key words: Low back pain, symptoms, traditional medicine.