Dry eye rate and its relationship with disease stage in patients with primary hypertension:a cross-sectional study in Vietnam

AIM:To determine the dry eye(DE)rate and its relationship with disease stage in patients with primary hypertension.METHODS:A cross-sectional study included 432 patients with primary hypertension(with an equal number of patients in each group:144 in stage Ⅰ,Ⅱ,and Ⅲ hypertension)and 144 healthy subjects as a control group.The Ocular Surface Disease Index(OSDI)and Schirmer Ⅰ test without anesthetics were conducted on all 576 subjects.Subjects with OSDI scores<13 and Schirmer Ⅰ values equal to or under 10 mm were diagnosed with DE.RESULTS:The ratio of DE in hypertension patients was higher than in the control group(41.7%versus 18.8%;P<0.001).The proportion of patients with DE increased gradually according to the hypertension stage:27.1% in stage Ⅰ,40.3% in stage Ⅱ,and 57.6% in stage Ⅲ,P<0.001.Age,duration of hypertension,plasma urea,creatinine,and high-sensitivity C-reactive protein(CRP-hs)levels in hypertension patients with DE were higher than those without DE,P<0.001.Advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma creatinine,and CRP-hs levels were independent factors associated with DE in primary hypertension patients,P<0.001.CONCLUSION:DE is a common disorder associated with advanced age,a long duration of hypertension,diabetes mellitus,elevated plasma CRP-hs,and creatinine levels in patients with primary hypertension.

The COVID-19 pandemic in the ASEAN: A preliminary report on the spread, burden and medical capacities

Objective:To provide preliminary descriptions of the spread,burden and related medical capacity characteristics of the ASEAN countries.Methods:We utilized the data from four main official databases,including WHO reports,the Statistics and Research of the Coronavirus Disease,and the Southeast Asia Program of the Center for Strategic and International Study.The spread of the COVID-19 pandemic,current burden and the COVID-19 medical response capacities were extracted before April 11,2020.Results:As of April 13,2020,the ASEAN countries reported19547 COVID-19 positive cases with 817 deaths(case-facility rate of 4.2%).Thailand was the first country in the region that reported having the COVID-19 cases,while Laos was the last to report confirmed COVID-19 cases.Durations for the number of deaths to double were between 8-12 days.For the testing and treatment capacities,the number of PCR tests provided to the populations was the highest in Vietnam,followed by Singapore,Malaysia,and Thailand.Meanwhile,the percentage of the population being tested was the highest in Brunei(2.31%),followed by Singapore(1.30%).Conclusions:A wide range of interventions were taken into practice in response to the outbreak with an effort of curbing the rise of this pandemic.However,special care should not be overlooked as the pandemic is placing a huge impact on the population and becomes increasingly unpredictable.To tackle the spread of the pandemic in the region,the ASEAN countries should work together as one community to provide better responses to future pandemics and other transboundary public health challenges.

Changes of Food Expenditure and Food Consumption of People Living in Ba Vi District, Hanoi, Vietnam from 1999 to 2013

Background: During the nutrition transition period which began in the early 1990s in Vietnam, dietary intake had been changed significantly because of changes in lifestyle and living standard. Objectives: This paper aims to describe the trend for food expenditure and the frequency of meat consumption in households in Ba Vi district, Hanoi, Vietnam from 1999 to 2013. Methods: This is a longitudinal study conducted in Ba Vi district, Hanoi. Semi-annual, face-to face interviews were conducted by well-trained interviewers with 11,922 households to collect data of the household’s income, spending for food and meat consumption. Chi-square test for trend was performed to evaluate the changes of food expenditure over the years. P-value under 0.05 was considered statistically significant. Results: There were ten times increase in household’s mean income and five times increase in mean food expenditure from 1999 to 2013. The percentage of household food expenditure per total family expenditure was really high (55% in 2013). The percentage of rice expenditure per total food expenditure decreased dramatically from 59.9% in 1999 to 33.1% in 2013 while spending for other animal-based, high-protein food was an upward trend, particularly meat (10.7% in 1999 to 24.2% in 2013). The percentage of rice expenditure in well-off households was lower than poor households (55% vs. 61.8% in 1999 and 31.4% vs. 36.5% in 2013). However, the percentage of spending for meat in well-off households were much higher than that of poor households (>10%). Conclusion: Our finding indicated that mean income and food expenditure, particularly meat intake, of households had increased dramatically from 1999 to 2013. The increase of meat intake requires reallocation and direction of Vietnam public health funding and strategy.

Knowledge of child nutrition when breastfeeding—A study of mothers living outside Hanoi

Objective: To evaluate the knowledge of?nutrition?among mothers of children less than two years of age and changes in theoretical knowledge after a nutrition course. Method: A pilot study with a pre-post-test design. Thirty mothers of children who were less than two years of age from outside Hanoi participated in the study. The mothers’ knowledge of breastfeeding, supplementary food and diet when the child was suffering from diarrhea was collected using 19 self-reported questions. A one-day nutrition course at which the mothers answered the same questions before and after the course was run. Results: All the invited mothers were included in the study. There was a lack of knowledge about breastfeeding and nutrition at baseline, but it improved after the nutrition course. The greatest improvement in knowledge related to breastfeeding less than 30 minutes after delivery, not giving milk or fruit juice instead of breast milk, increasing the frequency of breastfeeding in the event of a smaller amount of milk and knowledge about giving supplementary food after six months. Moreover, the results revealed that the mothers reported better knowledge of the consumption and frequency of more healthy food supplements. Conclusion: There was a lack of knowledge about nutrition among the mothers with children less than two years of age. The course demonstrated effectiveness in every aspect of nutritional knowledge, tested in the posttest. The findings in this study could provide important information for authorities in the health sector to improve the nutritional state of children in the community.

Toilet habits in kindergarten children in a kindergarten in Hanoi

Objective: Describe children’s toilet habits in a kindergarten setting. Subjects: Forty-one children aged 4-5 years, parents and six teachers participated. Method: Open-ended interviews and observations. Results: In school children avoided going to toilet, this could cause incontinence. Related Factors: Inadequate toilet standards and differing cleaning routines as at home. Children were uncomfortable and shy using the toilet, and some children seemed to prefer playing and school work instead of going to the toilet during breaks. Conclusion: Children of 4-5 years of age are sometimes not able to control their bladder and bowel habits in an environment differing to home.

Synchronous rectal adenocarcinoma and intestinal mantle cell lymphoma:A case report

BACKGROUND Mantle cell lymphoma(MCL)of the gastrointestinal tract is a rare malignancy,accounting for about 0.2%of malignant colorectal tumors.MCL synchronous with rectal adenocarcinoma is extremely rare.We know of only a few cases reported in the literature.We describe the case of a patient with synchronous rectal adenocarcinoma and intestinal MCL.CASE SUMMARY A 63-year-old man was admitted to our hospital due to abdominal pain and hematochezia over the past month.The patient was diagnosed with middle rectal cancer cT2N0M0 and underwent surgery.However,we found a large tumor in the small intestine during surgery.The patient underwent total mesorectal excision for rectal cancer and resectioning of the ileal segment containing the large mass.Pathology and immunohistochemistry revealed the presence of both rectal adenocarcinoma and pathognomonic MCL stage IIE presenting as multiple lymphomatous polyposis.The patient subsequently underwent RDHAP/RCHOP chemotherapy and was maintained with rituximab.A Positron Emission Tomography and Computed Tomography(PET/CT)scan showed that the disease responded well to treatment without tumor-increased metabolism in the gastrointestinal tract.CONCLUSION Synchronous rectal adenocarcinoma and intestinal MCL presenting as multiple lymphomatous polyposis are extremely rare.MCL is often discovered fortuitously when rectal cancer is diagnosed.The coexistence of these tumors poses treatment challenges.

Assessment of Post-Laparoscopic Cholecystectomy Pain at Viet Duc Hospital, Vietnam

Gallstones are common and costly in the world. This disease also have high health burden with high mortality. Currently, Laparoscopic Cholecystectomy has become a gold standard for surgical treatment of symptomatic gallstones. Pain is usually the first concern after surgery. Postoperative pain decreases with time but it is severe enough to interfere with daily activities of patients. Pain after the surgery is also affected by many factors. This cross-sectional study aimed to 1) assess pain intensity and interference pain with daily activities;2) describe the association between pain intensity and interference with daily activities of patients;3) explore factors that influence post-operative pain after Laparoscopic Cholecystectomy. Data were collected by 50 patients who were undergoing Laparoscopic Cholecystectomy completed questionnaire including the Visual Analogue Scale (VAS) and the Brief Pain Inventory (BPI). Data were analyzed based on three aims. As this is the first time that this type of study is conducted in Vietnam, it is expected that the results will contribute significantly to local knowledge and should add to global perspectives. From understanding the factors that affect severity of pain, this study is expected to design nursing intervention strategies to improve daily activities among patients undergoing LC.

Quality of Sleep among Pregnant Women

Objectives: The study aimed to describe the quality of sleep and explore factors especially Sleep Hygiene Practices associated with sleep quality among pregnant women. Study design: This is a cross-sectional study. Methods: 119 healthy pregnant women in two central hospitals in Vietnam were participated in this study. The Pittsburgh Sleep Quality Index (PSQI) was employed to evaluate sleep quality and the Modified Sleep Hygiene Practices was used to describe sleeping practices among pregnant women. Results: The results showed that while 58.8% pregnant women had quite good sleep quality, 41.2% of pregnant women had mild to moderate quality sleep disturbance. The quality of sleep was better in second trimester, but then getting worst in the third trimester. Multipara experienced worse sleep quality than nullipara. Poor sleep quality had a positive correlation with unhealthy Sleep Hygiene Practices including using an uncomfortable bed (p < 0.05), going to bed with variable bedtime (p < 0.01), watching TV or making call in bed other than sleep (p < 0.05), going to sleep without sleep sensation (p < 0.001) and staying in bed even though it was difficult to fall asleep (p < 0.001). Conclusion: Pregnant women should be taken care of on sleep quality, especially in the first and third trimester as they experience more change in hormone and physiology. Sleep Hygiene Practices should be emphasized in health education for pregnant women.

Cholecystitis-an uncommon complication following thoracic duct embolization for chylothorax: A case report

BACKGROUND Chylothorax is an uncommon condition in which chyle leaks into the pleural cavity,and biliary peritonitis is a rare complication of thoracic duct embolization in clinical practice.CASE SUMMARY We describe the case of a 50-year-old woman who presented with chylothorax and underwent thoracic duct embolization using a coil and a mixture of histoacryl glue and lipiodol.The patient developed upper abdominal pain and fever after the intervention.She was diagnosed with biliary peritonitis and treated with cholecystectomy at Hanoi Medical University Hospital.CONCLUSION Although thoracic duct embolization is considered a safe and minimally invasive procedure,it is not without risk.Following thoracic duct embolization,severe or persistent abdominal pain should be explored utilizing imaging data and laboratory results to determine problems as soon as possible.

Acceptance to Use Daily Oral Pre-Exposure Prophylaxis (PrEP) as an HIV Prevention Method and Ability to Pay for PrEP among Men Who Have Sex with Men in Ho Chi Minh City, Vietnam

Background: Men who have sex with men (MSM) are disproportionately affected by HIV in Vietnam. Regardless of international and national agencies’ efforts, the HIV epidemic in MSM has been increasing in recent years. Novel and evidence-based HIV antiretroviral pre-exposure prophylaxis (PrEP) maybe needed to combat the HIV epidemic among this population in Vietnam. This study aims to identify how MSM accept the use of PrEP as an HIV prevention method and their ability to pay for it. Method: This is a cross-sectional study of 373 MSM seeking HIV testing in a community-based HIV clinic in Ho Chi Minh City, Vietnam from January to April 2016. Potential participants were briefly informed about ethical considerations, screened for eligibility, and signed an informed consent form when selected. Face-to-face interviews were conducted by the clinic’s staff. Descriptive and analytical analysis was performed by STATA 13.0. Results: Of 373 participants, only 92 men (24.7%) reported having known about PrEP. Out of 360 men who were questioned about their acceptance of PrEP as an HIV prevention method, 274 (76.1%) embraced the use of PrEP. The median maximum affordable monthly PrEP cost was one million Vietnam Dong (VND) (equivalent to US$43) and the median average affordable monthly PrEP cost was 0.5 million VND (approximately $21.7). The majority of men (68.8%) could afford an average of less than $43 a month for PrEP. Conclusion: There is a relatively high level of PrEP acceptance among MSM in Ho Chi Minh City, Vietnam. To increase PrEP acceptance, raising awareness and understanding of PrEP is recommended. To expand PrEP interventions in Vietnam, the target population’s ability to pay should be a key focus.

Nutritional Practices among Ethnic Minorities and Child Malnutrition in Mountainous Areas of Central Vietnam

Background: Despite the success of National Action Plan on Nutrition program in reducing malnutrition among children under 5 years old in Vietnamin recent years, the rate of malnutrition inVietnamremains higher than that rate in other surrounding countries. The rate is especially high in mountainous areas. This study aims to explore the association between the mother’s nutrition care practice and the nutritional status of their children. Methods: 400 Children under 5 years of age and their mothers from Thanh Hoa—a Northern Province of Vietnam were included in this survey. Weight and height of the children were measured. Information related to the mother’s knowledge and practices pertaining to child health care and nutrition was collected. Results: The malnutrition rate was 29.3% by weight for age score (WAZ), 28.3% by height for age score (HAZ) and 10.0% by weight for height score (WHZ). 27.3% of mothers discarded the colostrum milk. 21.3% of children were fed with chewing rice before breastfeeding. Exclusive breastfeeding up to four months was 17.8% and exclusive breastfeeding rates for 6 months or more was 8.6%. Weaning practice before four months of age was 53.7%. There was an association between malnutrition with mother’s ethnic group, and the frequency of consumption of protein rich food. Conclusion: Malnutrition of ethnic minority children under five years of age is still a public health problem in the central mountainous areas ofVietnam. Inappropriate breastfeeding and weaning practice among ethnic minority women were associated with this high rate. Further effort should continue to improve the nutrition status of ethnic minority children under 5 years of age. Customized, culturally adapted interventions for ethnic minority women to strengthen their nutrition care knowledge, attitude and practice, especially breastfeeding and weaning practice are the key to achieving better nutrition status of their children.

Implementation and assessment of diverse strategies for physical activity promotion in Vietnam--A case report

Background: Regular physical activity(PA) has documented effects in prevention and treatment of many non-communicable diseases(NCDs).Physical inactivity is recognized as the fourth leading risk factor for premature death, worldwide. Despite these facts, physical inactivity is increasing,not only in high-income, but also in middle-and low-income countries. To address this negative trend, evidence-based methods to increase PA are needed. The purpose of this paper is to describe the implementation and assessment of 4 strategies designed to increase PA in Vietnam.Methods: Four strategies were used: i) introduction and evaluation of an education and training program on the Swedish method of Physical Activity on Prescription(PAP) among health care professionals, ii) translation of the PAP evidence-based handbook, Physical Activity in the Prevention and Treatment of Disease(called FYSS in Swedish) into Vietnamese, iii) launch of a mass-media campaign to promote PA, and iv)advocacy to support development of PA guidelines in Vietnam.Results: The evaluation indicated that the participating health care professionals had a positive attitude to PAP. However, they also reported uncertainty in prescribing PA. FYSS was translated and disseminated successfully to health care professionals. A mass-media campaign identified the beneficial effects of PA to health care professionals, journalists, policy makers, and the public. Last, the process of developing national guidelines on PA was initiated.Conclusion: This project led to enhanced awareness and appreciation of PA in the prevention and treatment of NCDs among health care professionals as well as initiation of national PA guidelines. Important lessons also were learned in the presentation of PAP, which will be considered when designing similar projects in the future.

Pattern of smoking cessation and its associated factors in Vietnam

Background: Even though the number of research on tobacco in Vietnam has recently increased rapidly, there remains a lack of reporting on the pattern of quit smoking and its correlates. It is necessary to have scientific evidence on this issue to help the policy makers and the Public Health sector to have appropriate intervention program to enhance the smoke cessation smoke program and improve the health status of the smokers. This study aims to: (1) Describe the pattern of smoking cessation in Vietnam 2010. (2) Examine the association between smoking cessation with some associated factors in Vietnam 2010. Methods: Data used in this paper were obtained from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. A total of 11,142 households were selected for this survey using a two-phase sampling design analogous to a three-stage stratified cluster sampling. Both descriptive and analytical statistical analyses were carried out. Multivariate logistic regression modeling was performed to examine the association between the patterns of quit daily;quit smoke;attempt to quit and intend to quit among smokers with relevant factors. Results: The prevalence of the different type of cessation among male and female were 23.3% and 28.6% for quit daily;19.1% and 1.0% for quit;55.6% and 44.4% for attempt to quit and 29.6% and 19.3% for intend to quit respectively. The prevalence of quit daily and quit increased with age whereas attempt to quit decreased with age. Prevalence of cessation was highest among the group who were asked about smoking tobacco by health care providers. Some determinants of quit daily and quit include age, area, and knowledge of illnesses caused by smoking. There was no association between attempt and intend to quit with any socio-characteristic except for area. People in rural area were 2.1 and 1.7 times more likely attempt to quit and intend to quit than those in urban area, respectively. Conclusion: The GATS Vietnam 2010 showed that the prevalence of cessation in Vietnam was low. Quit daily and quit had association with age, area, knowledge about the top three consequences of smoke. People in rural area were 2.1 and 1.7 times more likely attempt to quit and intend to quit than those in urban area, respectively.

Overweight, obesity and associated factors among secondary school students in a northern city of Vietnam in 2011

Overweight and obesity is an emerging public health problem among school-aged children in Bac Giang city in the Northen part of Vietnam recently. This study aims to identify overweight-obesity prevalence of secondary school children in this city and it’s associated factors. The study was a nested case control in a cross-sectional study design in 1528 secondary students selected from 4 secondary schools in 2 inner communes and 2 suburban communes of Bac Giang city, Vietnam. Result: Overweight prevalence among secondary school students in Bac Giang was 6.7%, the prevalence of obesity was 2.0%. Overweight and obesity is more prevalence in male students, inner communes and students from family have higher income and higher food expense. Overweight and obesity was associated with higher energy intake, more fat consumption, having supplement meals and bedtimemeal, increased physical activities and increased sleep duration. Conclusion: Education campaign targeting reducing overweight and obesity should target both parents about dietary adequacy and balance and children about more physical activities.

Development and Validation of a Questionnaire to Measure Health Professionals’ Attitudes toward Identification of Female Victims of Domestic Violence

Back ground: Domestic violence against women is a major public health problem and violations of women’s human rights. Health professionals could play an important role in screening for the victims. From the evidence to date, it is unclear whether health professionals do play an active role in identification of the victims. Objectives: To develop a reliable and valid instrument to measure health professionals’ attitude to identifying female victims of domestic violence. Methods: A primary questionnaire was constructed in accordance with established guidelines using the Theory of Planned Behaviour Ajzen (1975) to develop an instrument to measure health professionals’ attitudes in identifying female victim of DV. An expert panel was used to establish content validity. Focus groups amongst a group of health professionals (N = 5) of the target population were performed to confirm face validity. A pilot study (N = 30 nurses and doctors) was undertaken to elicit the feasibility and reliability of the questionnaire. The questionnaire was also administered a second time after one week to check the stability of the tests. Results: Feedbacks of the expert panel’s and group discussion confirmed that the questionnaire had the content and face validity. Cronbach’s alpha values for all the items were greater than 0.7. Strong correlations between the direct and indirect measures confirmed that the indirect measures were well constructed. High test-retest correlations confirmed that the measures were reliable in the sense of temporal stability. Significance: This tool has the potential to be used by researchers in expanding the knowledge base in this important area.

Acetabular Defects of Hip Tuberculosis: Recommended Classification and Reconstruction in Hip Arthroplasty

Background: This study aimed to propose a classification of acetabular defects in advanced-stage hip tuberculosis based on preoperative radiographs and intraoperative evaluation, thereby providing options for reconstructing each type of defect in hip arthroplasty. Materials and Methods: We conducted a prospective study with 45 patients with active hip tuberculosis at stage IV who were treated with a total hip replacement strategy. We collected the patients’ acetabular defect data from preoperative radiographs and intraoperative observations. The defects were classified into types based on defect severity and reconstructive complexity. The hip replacement outcomes were evaluated at least 12 months after the operation. Results: The classification system includes three types: type I: localized or extensive defects inside the acetabulum, not affecting the acetabular rim, medial wall, or columns. Type II: extensive defects inside the acetabulum, affecting the acetabular rim or (and) medial wall. Type III: extensive defects inside the acetabulum, causing the medial wall and the acetabular column to lose function. Each type has a corresponding reconstruction. The outcome includes that 41/45 patients had excellent results;3/45 patients had good results. The patients had good results due to nerve and muscle damage caused by tuberculosis not related to the acetabular defects. Conclusion: This is a simple, practical classification system of acetabular defects in hip tuberculosis. The outcome of hip reconstruction using this classification was excellent without any cases of dislocation or protrusion.

Hip Tuberculosis at Stage IV: Outcomes and Some Conditions for Total Hip Replacement

Background: Treatment of hip disorders during active hip tuberculosis has long been a controversial issue. Some authors have reported performing hip replacement with different strategies with very good outcomes. This study aimed to describe the surgical outcomes and necessary conditions for total hip replacement in active hip tuberculosis. Methods: We conducted a quasi-experimental study. The study enrolled 40 patients with 42 active tuberculosis hips at stage IV treated by total hip replacement from October 2016 to December 2019 at the National Lung Hospital. We followed up with the patients for at least 12 months, evaluated surgical outcomes, and investigated the factors associated with these outcomes by logistic regression analysis. Results: Surgical outcomes showed that 37 patients (88.1%) had excellent hip function, no abscesses, and no sinus tract formation. Four cases (9.5%) had sinus tract formations. One case (2.4%) had good hip function. Binary logistic regression models revealed that sinus tract formation was associated with preoperative tuberculosis infection syndrome. The average time to obtain antituberculosis drug treatment preoperatively was 4.6 weeks. Conclusion: Total hip replacement for active hip tuberculosis is a practical and promising treatment method. Surgeons should consider improving patients’ conditions before performing total hip replacement, administering antitubercular drugs, and arthrotomy to eliminate all abscesses, and decrease the risk of tuberculosis infection syndrome and the inflammatory response.

Comparison of Treatment Efficacy of Different Number of Botulinum Toxin Type A Injection Sites for Crow’s Feet Lines: A Single-Center Retrospective Clinical Study in Vietnam

Objective:Botulinum toxin type A is frequently used to treat crow’s feet lines.However,the optimal dose and injection sites are still controversial.The objective of this study was to compare the efficacy of different botulinum toxin type A injection patterns for the treatment of crow’s feet.Methods:This single-center,retrospective,clinical study was conducted at the National Hospital of Dermatology and Venereology from July 2020 to December 2020.Data on 60 patients with crow’s feet were collected and divided into 2 groups(3-or 4-point intramuscular injection)according to the intramuscular injection technique the patients received.The treatment efficacy was assessed based on the changes in the Crow’s Feet Grading Scale score at 1,4,and 16 weeks after treatment.Repeated measures analysis of variance was used for the assessment of changes in scores over time between the two groups.Results:After treatment,the average Crow’s Feet Grading Scale score was significantly decreased compared with the pretreatment score at all timepoints(1,4,and 16 weeks)in both states(dynamic:For 3-point intramuscular injection technique,1 week:1.90±0.71 vs.2.97±0.56;4 weeks:1.87±0.68 vs.2.97±0.56;16 weeks:2.60±0.67 vs.2.97±0.56.For 4-point intramuscular injection technique,1 week:1.73±0.83 vs.3.03±0.49;4 weeks:1.73±0.74 vs.3.03±0.49;16 weeks:2.57±0.68 vs.3.03±0.49,all P<0.001.and static:For 3-point intramuscular injection technique,1 week:1.20±0.89 vs.2.20±0.85;4 weeks:1.20±0.89 vs.2.20±0.85;16 weeks:1.87±0.97 vs.2.20±0.85;For 4-point intramuscular injection technique,1 week:1.50±0.86 vs.2.30±0.84;4 weeks:1.33±0.84 vs.2.30±0.84;16 weeks:1.87±0.97 vs.2.30±0.84.All P<0.001).The average subjective patient-rated satisfaction scores after treatment were significantly higher in the 4-point injection group than in the 3-point injection group(P=0.028).The adverse events were post-injection bruising in 3 patients and a feeling of eyelid tightness in 3 patients.Conclusion:Botulinum toxin type A injection is an effective treatment for crow’s feet.Adding a fourth injection maintains the same therapeutic effect and does not increase adverse effects.Patients with lower-fan crow’s feet patterns may benefit more from 4-point injection therapy.However,the present findings require confirmation in studies with larger sample sizes,longer follow-up times,and different botulinum toxin type A doses.

Focused research in emergency medical systems in Asia: a necessity for trauma system advancement

Since trauma is a growing health problem worldwide,emergency trauma care including emergency medical services(EMS)is becoming an integral part of the healthcare system.The optimal EMS which will improve access to trauma care,will be different in each country because of different healthcare systems,trauma etiology,and economic situations.To adopt models that have succeeded in developed countries is not always appropriate.In order to identify the optimal EMS model in developing countries,comparing the systems among many countries in detail and examining their advantages and disadvantages would be necessary.Therefore,this article tries to identify important elements of EMS to achieve mature EMS systems based on comparisons of 7 Asian countries,and discusses the need to conduct more detailed and extensive comparisons.

Nutritional status of Vietnamese infants assessed by Fenton growth chart and related factors:A cross-sectional study

Importance:Nutritional status of infants,measured by birth weight and length,is an essential factor in neonatal development.Malnutrition in newborns may lead to a higher risk of mortality,neurological and cognitive impairment,and poor language development.Objective:This study aims to assess the nutritional status of infants and related factors regarding maternal anthropometric characteristics and medical history.Methods:A cross-sectional study was conducted at the National Hospital of Obstetrics and Gynecology,Vietnam from May 2021 to May 2022 on 340 infants and mothers.Low birth weight was defined following the Intergrowth-21 standards.Stunting was evaluated using the Fenton growth chart when the length was below the 10%percentile line of the gestational week.Multivariate regression models were applied to identify factors associated with the nutritional status of infants.Results:We found that 12.4%and 14.1%of infants in our study fell into stunted and underweight categories,respectively.Infants of mothers over 35 years old,having a height lower than 150 cm or experiencing anemia during pregnancy were more likely to be stunted or have low birth weight.Serum albumin deficiency during pregnancy was strongly associated with the infant being underweight(odds ratio[OR]=2.8,95%confidence interval[95%CI]1.1–7.3).Newborns were more likely to be stunted if their mothers had a history of preterm birth(OR=3.3,95%CI 1.1–10.2).Interpretation:Maternal nutritional status is closely related to infant malnutrition,particularly in preterm infants.Improving the understanding of mothers regarding prenatal care,reproductive healthcare,adequate nutritional diet,and multi-micronutrient supplements during pregnancy is therefore important.