A 33-year-old G2 P1001 female at 13 weeks of gestation presented with dyspnea, tachycardia, and hypotension. Initial assessment revealed cardiogenic shock and acute respiratory failure caused by extremely severe pulmonary artery hypertension (PAH). Multidisciplinary efforts led to the diagnosis of severe PAH as an initial manifestation of systemic lupus erythematosus (SLE). Team care included gestational termination via dilation and curettage (D&C), followed by corticosteroids and vasodilator therapy, with excellent clinical and hemodynamic outcomes. 

Introduction: Obesity is acknowledged to be a significant risk factor for mortality in patients with COVID-19. At primary healthcare center, early stratification of high-risk patients is critical in order to provide effective management. There is limited research available in Vietnam concerning the relationship between obesity as defined by Asian- standards and pulmonary damage. Our goal was to find the correlation between the obesity status index by Asian-standardized BMI and the severity of lung injury on chest radiographs patients with COVID-19 in the Vietnamese field hospital.

Methods: A total of 279 confirmed COVID-19 patients (118 males and 161 females) patients were recruited in our study. Two internal medicine physicians independently evaluated chest X-rays using the Brixia score system to assess the severity of lung disease, then agreed. The probability of Brixia scores per chest X-ray film was modeled using Poisson regression with gender and Asian-standardized BMI as predictors.

Results: The study revealed that the median age of our study was 59 years, and the mean BMI was 24.6 ± 3.4 kg/m2. The Pearson correlation between the Brixia score and the BMI was 0.25 with a p-value < 0.05. Both men and women showed that the obese group had the highest Brixia scores. There was a statistically significant difference between Brixia scores of male patients between the normal and obese groups (p-value =0.0446). Poisson regression showed that as the BMI increased, the probability of a higher Brixia score also increased.

Conclusions: According to the findings, the higher the BMI value of a patient, the higher the Brixia score for chest X-rays. This result was recorded in both genders, but more significantly in men. 

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.

Background: Acute myocardial infarction has become a serious financial burden for patients, healthcare system, and society. It is therefore necessary to assess treatment cost of myocardial infarction that had been conducted in many countries in the world and still not fully analysed in Vietnam. Thus, we sought to describe acute ST-elevation myocardial infarction treatment cost and analyse related factors to acute ST-elevation myocardial infarction treatment cost.

Methods and Materials: A retrospective cross-sectional study. Patients who was diagnosed by ST-elevation myocardial infarction at Cho Ray Hospital from June 2018 to February 2019, satisfied inclusion and exclusion criteria.

Results: We collected 130 patients with acute ST-elevation myocardial infarction with male: female ratio of 3:1, at average age of mean ± Standard deviation (SD) = 62.9 ± 12.6. The length of stay in hospital was mean ± SD = 7.1 ± 3.3 days and the median direct cost of MI was 68,902,500 VND (interquartile range (IQR): 5,737,200 – 104,266,000 VND). The average total cost of acute ST-elevation myocardial infarction in the percutaneous coronary intervention group was more than 16 times as the conservative group. The treatment strategies and hospital complications were major factors that affected treatment cost.

Conclusion: The median direct cost of acute ST-elevation myocardial infarction was accounted for 68,902,500 VND. Complications directly affected costs.