Methamphetamine use among people who inject heroin in Hanoi, Vietnam

Original Research

Abstract

Introduction: The pattern of drug use in Vietnam has changed rapidly over the past decade, and a large number of people who have a history of heroin injection reportedly use methamphetamine. This paper describes factors associated with methamphetamine use among people who inject heroin in Hanoi, the capital of Vietnam.

Methods: This is a cross-sectional survey among 521 heroin injectors who were recruited through chain referral and outreach at community and clinic settings. Eligibility criteria included: (1) male aged 18 or older; (2) reported heroin injecting during the 12 months before the survey; (3) agreed for a urine test to detect methamphetamine and opiate metabolites. The primary outcome, methamphetamine use, was defined as selfreported methamphetamine use during the 30 days before the survey and/or having a urine test positive for methamphetamine. Structural Equation Model was used to evaluate associated factors for methamphetamine use.

Results: One third of participants qualified as methamphetamine users as defined in this study. A longer history of heroin use (β=0.126, p<0.001), using MDMA and/or cannabis (β=0.28, p<0.001) and not using condom during sex (β=0.139, p<0.001) were positively associated with methamphetamine use. Family functioning (β=-0.141; p<0.001) was protective. The goodness-of-fit of Structural Equation Model was excellent (CFI=0.934; TLI=0.912; RMSEA=0.033; WRMR=0.98).

Conclusions: Methamphetamine use among people who inject heroin is a substantial issue in Hanoi. Family functioning has made a critical contribution on reducing methamphetamine use. Future studies should pay attention to address the role of factors at the family level in addition to individual-level factors towards the pattern of drug use.

Graphical abstract

Spontaneous massive hemopneumothorax: report of three cases

Case Study

Abstract

Spontaneous hemopneumothorax is a rare condition and may be a life-threatening condition that needs prompt diagnosis and urgent intervention. In this study, we reported three male cases of spontaneous hemopneumothorax, two cases presented with chest pain and one with epigastric pain. All cases were successfully treated by early surgical intervention. Total blood drainage was ranged from 1400 to 2000 mL. Video-assisted thoracoscopic surgery was performed successfully in two cases, however, one case was transferred to urgent thoracotomy due to excessive blood clotting in the pleura cavity and continuous bleeding. Leukocytosis was observed in two cases, mostly due to pneumonia or sepsis. The bleeding point was identified in all cases, however, the air leak area could not be identified in two cases. Length of hospital stay after admission was ranged from five to seven days. We recommend that video-assisted thoracoscopic surgery should be considered as a first choice due to its effectiveness in reducing postoperative complications and facilitating rapid recovery.

Graphical abstract

Assessment of Vietnamese nurse’s knowledge and practice regarding patient’s safety after coronary angiography or percutaneous coronary intervention

Original Research

Abstract

Background: Many clinical and paraclinical studies related to coronary artery disease have been done in Vietnam in recent years. However, there have been no studies on nurses’ knowledge and practice regarding patient care after coronary angiography (CAG) or percutaneous coronary intervention (PCI). This study was conducted to assess nurses' knowledge and practice on patient’s safety after CAG or PCI and its associated factors.

Methods: A descriptive cross-sectional study was conducted from December 2019 to June 2020 at the Department of Internal Cardiology, Interventional Cardiology, Intravascular Intervention, and Intensive care unit/Coronary care unit in three general and specialist hospitals in Ho Chi Minh city, Vietnam. 167 nurses who have taken care of patients after CAG or PCI were included in the study through using convenient sampling technique. A translated self-administered questionnaire was utilised. This self-reported survey achieved 100% response rate. Statistical analysis was performed by the Chi-square test (X2). Statistical significance level was at p<0.05 to determine factors related to nurses’ knowledge and practice. Prevalence ratio (PR) with 95% confidence interval (95% CI) were also used to measure the association.

Results: The study findings revealed that only 36% of the study sample had a good knowledge while 78% of them had a good practice on patient’s safety after CAG or PCI. There were association between educational level, working place with the knowledge (PR=1.87-1.92, p<0.01) and practice (PR=1.18-1.35, p<0.05) on patient’s safety after CAG or PCI among Vietnamese nurses. Besides those factors, the number of years working in cardiac specialty were also found to have an association with the practice. A moderately positive correlation between the knowledge and the practice towards patient‘s safety after CAG or PCI has been identified in this study (PR=1.27, 95% CI [1.09 – 1.47], p=0.005).

Conclusions: More than a half of the study sample had poor knowledge but performed good practice in some items of care for patients after CAG or PCI. There was positive association between the knowledge and practice about patient’s safety after CAG or PCI among Vietnamese registered nurses. Educational training programs for staffs working in coronary angiography or percutaneous coronary intervention is recommended to develop.

Graphical abstract

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