Validity and Reliability of the Comfort Behavior Scale in Children Undergoing Wound Dressing Replacement in Vietnam

Original Research

Abstract

Background: This study translated and culturally adapted the Comfort Behavior Scale (Comfort-B) into Vietnamese using a standard protocol guided by the World Health Organization.

Methods: The Comfort-B was translated into Vietnamese and then English back-translated by independent translators. These versions were reviewed and assessed by a Vietnamese expert’s panel and an English expert’s panel. Thirty-four nurses of the Nhi Dong 1 Hospital were invited to use the Vietnamese Comfort-B to assess pain while watching five videos recorded before, during and after wound dressing replacement. The eight characteristics of the Vietnamese Comfort-B were assessed by 34 nurses. Fifteen nurses agreed to do the second assessment two weeks from the first assessment. The content validity index was used to assess the relevance and clarity of all items and the whole scale. Agreements between raters were explored using Kappa statistics. Intraclass correlation coefficients (ICC) were used to assess intra-rater and inter-rater reliability. Multi-level linear regression was used to assess changes in the Vietnamese Comfort-B before, during and after wound dressing replacement between two assessments.

Results: The Vietnamese Comfort-B was accredited by the Vietnamese expert’s panel. The English-back translated version was approved by the English expert’s panel. The nurses agreed that the Vietnamese Comfort-B can be used in clinical practice and research. Kappas of all items were ≥0.96 indicating excellent agreement between raters. Alpha coefficients of two assessments were ≥0.97 indicating excellent internal consistency. All ICCs ≥ 0.79 indicated good intra-rater and inter-rater reliability.

Conclusions: The study suggested that the Vietnamese Comfort-B can be used for future studies assessing children’s pain in the local hospital context.

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Stridor or wheezing? Congenital laryngomalacia misdiagnosed with infantile asthma in young children: a case report

Case Study

Abstract

The prevalence of asthma is sharply increasing in pediatric population and has become a global burden of medicine and economics. Nevertheless, evidence for the diagnostic criteria of this condition is still lacking. This condition leads to over-diagnosis of asthma in cases, especially younger children. Stridor and wheezing, pathologic signs of airway obstruction, are sometimes mistakenly identified. As a result, disorders of extra-thoracic airway obstruction may be misdiagnosed with intrathoracic diseases. An example of this confusion is that a 19-month girl admitted to our hospital with a diagnosis of uncontrolled asthma. Careful history taking, physical examinations and laboratory investigations revealed that the patient has laryngomalacia. We report this case in order to share with pediatric colleagues a valuable clinical experience in approaching children with noisy breathing.

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Low thyroid hormone syndrome as a cause of obesity

Case Study

Abstract

It is well-known that hypothyroidism predisposes to weight gain and obesity, but in the synthesis process of the thyroid hormones there are several steps that can fail producing the same consequence. In this respect, almost all studies talk about the decrease in T3 levels in cases of hospitalization but none as the primary cause of obesity. Here we report a case of chronic obesity since childhood with persistent low T3 values, high deiodinase (DIO)-2 and normal reverse T3, thus proposing that low T3 syndrome is not only the result of a critical condition but could be previous to any acute disease leading to weight gain and obesity.

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The effectiveness of music on the result of non-stress test

Original Research

Abstract

Objectives: Determined the effects of music on the result of non-stress test at 33 weeks of gestational ages for prenatal assessment.

Methods: The cohort design was conducted between 89 women who had regular NST (without music), and 88 women who do NST with music. These are women with a single pregnancy of 33 weeks or older who are not in the risk pregnancy group, with no signs of preterm labor.

Results: There were 178 pregnant women participating in the study. The median age of pregnant women in the study group who did not listen to music or listen to music was 30.0 ± 4.60 and 30.4 ± 4.00, respectively. The average gestational age in our study was 36.73 ± 1.64 and 36.07 ± 1.91, respectively, for with and without music group. Music increased the average number of fetal movements in the group of pregnant women listening to the music compared to the group that did not listen to music (11.13 ± 0.91 and 17.52 ± 1.63) during the NST. Music also increased the number of accelerations (5.54 ± 0.43 compared to 7.28 ± 0.47) and the resulting reactive NST in pregnant women.

Conclusion: Music increased the average number of fetal movements and the number of accelerations the group of pregnant women listening to the music compared to the group that did not listen to during the NST. Music also increased

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Comparing the analgesic efficacy between 100 Hz and 2 Hz electroacupuncture on patients with lumbar osteoarthritis

Original Research

Abstract

Background and Objective: Chronic low back pain (CLBP) represents one of the major causes of increasing disability worldwide. Electroacupuncture with different frequencies at the Hua Tuo Jia Ji acupoints has been used to treat CLBP in patients with lumbar osteoarthritis. Basic studies demonstrate that 100 Hz or 2 Hz electroacupuncture has pain-relief effects on CLBP; however clinical evidence for choosing which frequency is still limited. Thus, our study aims to compare the effects of 100 Hz to 2 Hz electroacupuncture for CLBP on patients with lumbar osteoarthritis.

Methods: A randomized controlled trial of 124 patients with lumbar osteoarthritis at the Traditional Medicine Hospital at Ho Chi Minh City from September 2018 to July 2019. Patients were randomly allocated to either intervention group (n = 62) with 100 Hz electroacupuncture or control group (n = 62) with 2 Hz electroacupuncture at the L2-S1 Hua Tuo Jia Ji acupoints for 14 days. Du Huo Ji Sheng Tang decoction was also administered in both groups. Primary trial outcomes were QDSA score and the proportion of patients who achieved pain relief thresholds.

Results: After 14 days of treatment, QDSA score in intervention group decreased significantly compared to control group. 87% of patients in intervention group had pain relief of ≥70%, and only 45% patients in control group had such result. Lumbar flexion range of motion in 100 Hz group tended to be better than in 2 Hz group.

Conclusion: 100 Hz electroacupuncture had superior analgesic effects on lumbar osteoarthritis to 2 Hz electroacupuncture.

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Implementation status of antimicrobial stewardship programs in hospitals: A quantitative analysis study in Ho Chi Minh city, Vietnam

Original Research

Abstract

Vietnam has one of the highest multi drug resistance in Asia. Although, despite many efforts to implement the Antimicrobial Stewardship Programs (the ASP) since 2016, studies that on the implementation policy are very lacking of this program are limited. For that reason, we conducted this cross-sectional study to analyze the viewpoint of health workers (HWs) on the implementation of the ASP at some hospitals in Ho Chi Minh City (HCMC). An assessment of 234 HWs showed that the implementation of the ASP in HCMC hospitals was above average (62.7/100.0). A barrier to the implementation consisted of the deficiency in finances, guidelines for diagnosis, and specific interventions for some common infections, such as distributing current antibiogram and monitoring rate of Clostridioides difficile infections. These were the widely recognized problems in initially implementing the ASP. Although most HWs are aware of the importance of implementing the ASP (79.1%), the specific assessment has not been recorded clearly due to the numerous neutral responses. Despite the support of the leadership, the implementation still faces many difficulties and limitations, especially in 3rd and 4th class hospitals. Besides, there was a lack of wide dissemination of information on the ASP at each unit. To generalize the status of the ASP implementation, researchers should conduct qualitative and quantitative studies with a larger scale.

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The effectiveness of “I PASS The BATON” model in improving nursing handover at a university hospital in Vietnam

Original Research

Abstract

Introduction: Nursing handover is an important process in hospital care where information and responsibilities are transferred from one nurse to another to ensure continuity of care and safety of patients. However, evidence of the effectiveness of using standardized nursing handover approaches, particularly in resource-limited countries, is scarce. This study was conducted in order to evaluate the change in handover practice through the “I PASS the BATON” model in a university hospital in Vietnam and identify factors contributing to the effectiveness of this model.

Material and methods: We provided handover training for nurses in the Emergency Department using the “I PASS the BATON” model and evaluated their application right after the course and one month after the course.

Results: The consistency of the handover skill among participating nurses remained high one month after applying the model in the routine care at the hospital. Overall, the mean score achieved after training was high and remained unchanged after one month. However, significant and marginally significant improvement was found in some components one month after the course including the Action and Timing. In contrast, the Next component decreased over time. Evaluation of nurses’ perceptions about the model were assessed using the Health Belief Model which revealed that perceived susceptibility and seriousness were at the moderate level and significantly decreased after one month. In contrast, perceived benefits and barriers were at a high level and remained unchanged after one month.

Conclusions: The "I PASS the BATON" model was effective in improving nurses’ handover skills and practices.

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Isolation of Lactic acid bacteria showing antagonistic activity against Streptococcus mutans

Original Research

Abstract

Background and Objectives: Streptococcus mutans is a major pathogen that initiates dental plaque and dental caries due to its strong acid production and biofilm-forming ability. Recent studies showed that lactic acid bacteria (LAB), exert useful properties which make them become potential tools to fight against S. mutans and its relating diseases. The current study aimed to isolate and screen for LAB strains that could inhibit S. mutans growth as well as its biofilm production.

Methods and Results: Using the spread plate technique, fifty-one LAB strains were isolated from fermented vegetables and healthy human saliva. From that, fourteen isolates showed the inhibitory effect on S. mutans growth in well-diffusion assay. These strains were then screened on the ability in reducing S. mutans biofilm formation by colorimetric assay. Next, potential LAB was evaluated on some probiotic characteristics including saliva amylase tolerance, acid tolerance, bile tolerance as well as antibiotic susceptibility properties. As a result, four strains showed the most promising features were further tested for the ability to reduce Streptococcus mutans biofilm by scanning electron microscopy (SEM) observation and by expression analysis of biofilm-forming genes (gtfB and luxS) using RT-qPCR method. Finally, these four strains were identified to species level using API® 50 CHL kit and 16S rDNA sequencing method. The result showed that two strains belong to L. plantarums, one belongs to L. brevis and the other is Weisella confusa

Conclusion: This study was successful in isolating LAB that showed promising probiotic effects against S. mutans.

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Prevalence and risk factors of Ureplasma urealyticum and Mycoplasma genitalium among women with secondary infertility in Vietnam – A cross-sectional study

Clinical Article

Abstract

Introduction: Ureaplasma urealyticum and Mycoplasma genitalium are infectious pathogens resulting in non-gonococcal urethritis and complications such as pelvic inflammatory disease (PID) and infertility. This study aimed to determine the prevalence of U. urealyticum and M. genitalium in women with secondary infertility and the related factors to these infections.

Methods: This cross-sectional descriptive study was carried out from July 2017 to June 2018. Cervical specimens were collected from women with secondary infertility at the Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Vietnam. PCR was applied for detection of U. urealyticum and M. genitalium. Tubal patency was assessed by hysterosalpingography.

Results: Prevalence of U. urealyticum and M. genitalium were 37.9% and 2.1%, respectively. The association was not statistically significant among infection and the following factors like age, educational level, occupation, history of miscarriage, history of genital infection and abdominal surgery, or infertility duration (p > 0.05). There was a statistically significant correlation between U. urealyticum infection and tubal damage according to hysterosalpingography (p < 0.05).

Conclusion: In the case of women with secondary infertility, genital infection with M. genitalium was rare, whereas that with U. urealyticum infection was high and appeared to be associated with tubal damage.

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Validation of predictive equations against DXA for estimation of body fat composition in Vietnamese children

Original Research

Abstract

Background: Childhood overweight and obesity are becoming more pronounced in Vietnam, so an assessment tool of high efficiency in the community is warranted. This study sought to validate skinfold thickness (SFT) equations for estimation of body fatness by Goran and Slaughter against DXA to aid in assessing obesity.

Method: A cross-sectional study was conducted on 144 healthy children (ages 6-17) who were conveniently sampled from schools within an urban district. Their anthropometric measurements (height, weight, and SFT) and DXA whole-body results were taken to record body fat percentage (BF%). Bland-Altman analysis and correlation between bias and body fat were employed to understand the agreement between results from each equation and DXA whole body.

Result: BF% was 32.2 ± 7.6% (mean ± SD). 52.8% of the children were overweight or obese. Bland-Altman plots showed that all four SFT equations had wide limits of agreement (LOAs) and largely underestimated the reference BF% by up to 8.90%. Goran equation predicted better when BF% decreased, whereas Slaughter equations produced less bias when there was more body fat.

Conclusion: The prevalence rate of overweight and obesity has become alarming. Besides, Goran and Slaughter equations cannot be used as alternatives for DXA scanning to measure body fat due to their underestimation.

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Hospital-acquired infections in ageing Vietnamese population: current situation and solution

Review

Abstract

Hospital-acquired infection (HAI) is a growing problem all around the world particularly for countries with aging and high-density population such as Vietnam. In this review, we summarized the current status of HAIs in Vietnam regarding types of infection, rates of infection, hospital-stay duration and cost of treatment, and provided an overview with suggestions on strategies in combating these infections especially in Vietnamese settings. From quite dispersed and varied data reported in English and Vietnamese, we have seen HAI rates of less than 10%. Over the years, the HAIs in Vietnam remained quite stable and even slightly decreased in recent years. Among all HAIs, respiratory tract infections are the most common, occurring in up to 80% of cases. Most Vietnamese statistical data on the etiology of HAIs focused on bacterial HAIs, mostly Candidiasis, whereas limited information was found on fungal infections, nosocomial viral and other parasitic infections. The most important HAI causative pathogens in Vietnamese hospitals include Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Candida species. There is absolutely few scientific data, but web-based information on HAIs treatment cost and measures to control the infections were found. Works are reported to be implemented to control HAIs in Vietnam at both national and hospital level. However, further improvement in controlling HAIs in Vietnam should be considered.

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Efficacy of ethanol ablation for treatment of benign cystic thyroid nodules: the first hospital-based study in Vietnam

Original Research

Abstract

Background: In Vietnam, surgery or aspiration is preferred to treat thyroid cysts however each of them still have limitations. Purposes of this study were to evaluate the efficacy and safety of ethanol ablation in treating thyroid cysts and determine factors that predict the outcome of treatment.

Methods: This prospective study was approved by the Ethics Committee of the Institutional Review Board of Family hospital and written informed consent for procedures was obtained. From May 2018 to March 2019, 23 patients who underwent treatment for thyroid cysts by EA were enrolled in this study and were followed up for 1 month at Family hospital. The primary endpoint was efficient after one month as the volume reduction ratio was ≥ 50%. Secondary endpoints were improvements in symptoms, cosmetic scores, and safety. Multiple logistic regression analysis was used.

Results: In the finding, from May 2018 to March 2019, only 17 patients who matched inclusion criteria were included in the analyst, including 7 purely thyroid cysts, and 10 predominantly cystic nodules. Mean volume decreased significantly from 5.21 ± 3.37 ml to 2.35 ± 2.52 ml in corresponding to 52.87% of volume reduction with p < 0.05. Ethanol ablation (EA) success rate was 52.90% after 1 month. Symptoms and cosmetic scores were improved significantly. The thyroid function was constant. No adverse events occurred. Purely thyroid cyst was a predictive factor contributing to the success of EA.

Conclusion: EA seems likely to be a safe and an efficient therapy for patients who had purely or predominantly cystic thyroid nodules.

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Idarucizumab for Urgent Dabigatran Reversal in Clinical Practice: A Case Series of First Use in Vietnam

Case Study

Abstract

The benefits of non-Vitamin K oral antagonists in prevention or treatment of thrombosis have been studied in many randomized control trials. However, episodes of life-threatening bleeding caused by using novel oral anticoagulants have occurred in clinical practice and necessitate the development of aims for reversal of the anticoagulant effects. We report here three cases in which the use of idarucizumab, a humanized monoclonal antibody fragment, has successfully reversed the anticoagulation effects of dabigatran and produced favorable outcomes.

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Tracheomalacia due to trachea compression related to benign goiter

Original Research

Abstract

Introduction: Tracheomalacia can result from long-standing compression by a large goiter. The cartilaginous rings of the trachea may be weakened or destroyed by long-standing compression, causing loss of structural support. Tracheomalacia after resectioning of benign goiter compressing trachea was an important issue. It has extended the time of mechanical ventilation, increased the risk of failure extubating and mortality.

Materials and Methods: Descriptive and prospective study. From November 2014 to January 2017, we have collected 102 patients who had benign goiter compressing trachea and had thyroidectomy. Tracheomalacia was diagnosed and managed intra and postoperatively.

Results: Recognition of women accounted for the majority of 81.4%. The average age was 54.5 years old and the average duration of goiter was 5 years. The patients were hospitalized with the main symptom of dysphagia accounting for 21.6% and difficulty breathing when lying down was 16.7%. On CT scan, the average Goiter was 270g, the average narrow airway diameter was 8.4 mm, of which 12.7% of patients had narrow tracheal diameter <5mm. The rate of tracheomalacia was 4.9%. There were statistically significant differences between the 2 groups with and without tracheomalacia: elderly patients (p = 0.041); goiter long-standing time (p = 0.07); symptoms of positional dyspnea on lying (p = 0.003) and tracheal diameter compressed (p = 0.001).

Conclusion: Tracheomalacia should be noted in patients older than 65 years old, goiter exist longer than 5 years and goiter is over 200g.

Graphical abstract

The short-term result of distal pancreatectomy with splenic preservation

English version

Abstract

Introduction: The tumor of pancreatic body and tail are relatively rare compared to those of head of pancreas.  Splenic preservation in pancreatic carcinoma’s surgery should be decided on every case. This study to determine the feasibility of distal pancreatectomy with splenic preservation, the rate of early complications of splenectomy surgery to preserve the spleen and the factors: tumor size, tumor location, tumor characteristic to help assess the possibility of preserving the splenic vessels in distal pancreatectomy with splenic preservation.

Methods: retrospective study, case series description for all patients aged 16 years and older with distal pancreatectomy and splenic preservation from 01/01/2012 to 31/12/2017.

Result: We had 47 case of distal pancreatectomy with splenic preservation. There were 26 cases of splenic preservation with preserving the splenic vessels (Kimura technique), 13 cases of splenectomy but not preserving the splenic vessels (Warshaw technique). There were 16 cases of laparoscopic surgery, 31 cases open surgery, general complication in surgery 11 cases. The mean age was 41.13 (17-76 years old). The mean hospital stay was 7.7 days (3 days - 21 days). General complication after surgery in 7 cases, pancreatic fistula in 5 cases, no cases need re-operation, no mortality.

Conclusion: The rate of intraopertative incidence was 23.4%; complications after surgery 14.9%. No case of re-operation or mortality in the study. Factors such as tumor size, tumor location, tumor characteristic did not help assess the possibility of preserving the splenic vessels in of distal pancreatectomy with splenic preservation.

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Subacute oral toxicity evaluation of the ethanolic extract of Hydnophytum formicarum Jack. tubers in Phu Quoc, Vietnam

Original Research

Abstract

The tubers of Hydnophytum formicarum Jack. have been used for the treatment of rheumatism, liver and intestinal diseases in the traditional medicine of Vietnam. The 50% ethanolic extract of H. formicarum (EEHF) has been proved anti-inflammatory and analgesic effects as well as hepatoprotective activity at the oral doses of 100 and 200 mg/kg in Swiss albino mice. The aim of this work was to study on the subacute oral toxicity of the EEHF at the doses of 100 and 200 mg/kg for 30 and 60 consecutive days in both sexes of mice. The observations were undertaken on the mortality, the body weights, the toxic signs, hematological and biochemical parameters. At the end of the experiment, the histopathology of liver and kidneys was studied. The results showed that the 100 mg/kg of EEHF did not cause any toxic signs in mice. There was no significant difference of hematological and biochemical parameters between the treated animals and the controls. Histopathological examinations of livers and kidneys showed no significant difference suggesting no morphological disturbances in treated mice. In conclusion, the results indicated that the EEHF did not cause any subacute toxicity in mice at the dose of 100 mg/kg, providing the evidence of the safety of health products from this medicinal plant.

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