Background: COVID-19 is a rising health problem that affects not only the infected patients but also the non-COVID-19 group. There is a reduction of non-COVID-19 healthcare services during COVID-19 outbreaks which leads to subsequent increment of mortality. This study aims to investigate the impact of the fourth COVID-19 surge on the cardiology outpatient visits at Nhan dan Gia Dinh hospital.

Method: A retrospective observational study was conducted using extracted data from the healthcare informative system of Nhan dan Gia Dinh hospital. Monthly trends of cardiology outpatient visits between May 1st, 2021 to August 31st, 2021 were compared with those of the previous four months and the same period of the year 2020. The demographic characteristics, diagnoses, and prescription behavior were described.

Results: Non-COVID-19 cardiology outpatient visits showed a stable trend until the beginning of the fourth outbreak, in May 2021 when they dropped drastically by 50%. A reduction of 50% was observed in every diagnosis. There was a substantial decrease in visits from other provinces as well as in the concurrent diagnosis of cancer. No change in the rates of prescribed medications was observed besides the lengthening of the prescription time.

Conclusion: The fourth COVID-19 wave caused a serious impact on cardiology outpatient care which might lead to an adverse prognosis. Though there has been some adaptive modification in prescription, this phenomenon calls for more attention and adequate measurements in the non-COVID-19 population for the later outbreaks. 

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. 

Introduction: Streptococcus pneumoniae is the most common cause of community-acquired pneumonia (CAP) in children. Recently, the rapid emergence of antibiotic-resistant pneumococci has posed enormous challenges for CAP treatment and public health. This study aims to provide clinicians with updated data about the antimicrobial susceptibility of S. pneumoniae and improve the treatment guidelines in CAP in children.

Methods: This cross-sectional and in-vitro study was conducted at three hospitals in Quang Nam province and Da Nang city in Vietnam. Pneumococcal strains were isolated from nasopharyngeal aspirate samples of 360 CAP in-patients under five years of age. The susceptibility of clinically used antibiotics was investigated using the disk diffusion test and the E-test for identifying the MIC. Multi-drug resistant (MDR) S. pneumoniae isolates were also determined.

Results: 21.9% of CAP children patients were pneumococcal carriage. The susceptibility testing demonstrated that all 56 tested pneumococcal isolates were resistant to erythromycin and azithromycin, whereas none of the isolates developed the resistance to levofloxacin, vancomycin, and linezolid. The clindamycin- and cotrimoxazole-resistant pneumococci rates were 96.4% and 87.5%, respectively. For β-lactam antibiotics, the resistance proportions of pneumococcal isolates to penicillin G, co-amoxiclav, amoxicillin, cefotaxime, and ceftriaxone were 3.6%,1.8%, 1.8%, 1.8%, and 3.6%, respectively. 83.9% of the tested isolates were MDR S. pneumoniae.

Conclusion: Our data support using penicillin G, amoxicillin, co-amoxiclav, or cefotaxime as the first-line therapy for uncomplicated-pneumococci-induced CAP in Quang Nam – Da Nang, while vancomycin, linezolid, and levofloxacin should be used as alternatives or in MDR cases. 

Introduction: COPD affects the quality of a patient’s life and leads to death. Identifying TCM symptoms and clinical patterns proportions in the community will make diagnosis and treatment more effective. In Vietnam, there were no epidemiological documents about COPD in TCM. Therefore, this study wished to survey stable COPD patients to find out the proportions of symptoms and patterns in TCM to create a basis for further practice.

Methods: The survey was conducted as a descriptive cross-sectional study. Participants were stable COPD outpatients at the Clinic and respiratory function test of the University Medical Center HCMC from September to December 2018. According to the survey form based on the TCM diagnostic criteria, the proportions of symptoms and patterns were recorded.

Results: After three months, 116 patients were recruited. The proportions of 30 TCM symptoms and signs were recorded. The proportions of patients were as follows: 80.17% met Lung qi deficiency, 76.72% for Lung-kidney qi deficiency, 53.45% for Lung-kidney qi and yin deficiency, 47.41% for Lung-spleen qi deficiency, and 2.59% for not meeting any of the diagnostic criteria. Patterns were overlapping in the same patients.

Conclusions: All TCM symptoms and patterns in the diagnostic criteria appeared in COPD patients. The deficiency of the Lung and Kidney was the most common. Most patients were classified into many different patterns with multi organs damage. More multicenter studies with bigger participants numbers are suggested. 

Introduction: The increasing number of older people around the world has increased the demand for elderly care nursing services. Understanding nursing perceptions can identify willingness to work with older people.

Objective: This study aims to determine predictors for nursing students’ perception of working with older people.

Methods: A cross-sectional study was performed on 292 nursing students at the University of Medicine and Pharmacy. Stratified random sampling with an online self-reporting questionnaire was used to collect data from first- to fourth-year nursing students. Data analysis was performed using SPSS 20. Independent t-test, ANOVA and Pearson’s correlation were utilised to determine the correlation of demographic variables, knowledge and attitude with perception. Moreover, multiple linear regression was applied to determine predictors for the perception of working with older people.

Results: The mean score of perception of working with older people amongst undergraduate nursing students was 51.79±6.31. Factors related to perception include gender (p=0.004), geriatric nursing choice (p=0.007), knowledge about ageing (p=0.001) and attitude towards older people (p<0.001). Multiple linear regression analysis showed that gender (β=−0.149, p=0.005), geriatric nursing choice (β=0.154, p=0.003), knowledge about ageing (β=0.122, p=0.021) and attitude towards older people (β=0.367, p<0.001) are predictors for the perception of working with older people.

Conclusion: An in-depth understanding of ageing and attitude towards older people in the geriatric curriculum plays a vital role in promoting nursing students’ perception of working with older people. 

Introduction: The COVID-19 pandemic has spread around the world that severely affects people's life and the health system of countries. Enhancing the population’s awareness and prevention behaviors are crucial. This study aims to assess the knowledge, attitudes, and behaviors regarding COVID-19 prevention of outpatients and visitors at the University Medical Center in Ho Chi Minh City (UMC).

Methods: A cross-sectional study was conducted on 765 participants who were conveniently selected when they arrived at UMC between March 2021 and April 2021. A questionnaire was developed based on guidelines of Viet Nam Ministry of Health (Viet Nam MOH), World Health Organization (WHO), and other prior studies to evaluate the general knowledge regarding COVID-19 disease, disease prevention, attitude, and behaviors on prevention methods.

Results: The results showed low proportions of participants who had good knowledge of COVID-19 disease (29.15%) and prevention measures (38.17%) that were in contrast with a high percentage of positive attitudes (89.08%). There were 22.09% of participants were identified as good preventive behaviors based on seven surveyed measures. An association between prevention knowledge and prevention behaviors was observed when participants with good knowledge showed 2.15 times-higher odds of good behaviors (95%CI: 1.52, 3.04, p-value<0.001) compared to those with insufficient knowledge. Gender, occupation, accommodation, living with family or friends, comorbidities, and history of COVID-19 -related isolation were associated with good behaviors (adjusted p-value <0.05).

Conclusions: The percentage of knowledge and the compliance rate for COVID-19 prevention measures is low, and there is a positive association between prevention knowledge and good behaviors. Therefore, communication programs to improve the community's knowledge and to increase good practice rates are necessary and urgent. 

Introduction: Ramipril, which is an angiotensin-converting enzyme (ACE) inhibitor, is prescribed to treat heart failure, diabetic kidney diseases and high blood pressure. The United States Pharmacopeia 43 (USP 43) and British Pharmacopoeia 2020 (BP 2020) require testing ramipril methyl ester (impurity A) in ramipril pharmaceutical substances as well as corresponding finished products. This study was conducted with the aim of synthesis and standardization of impurity A as related substance and using established reference impurity A in impurity test of ramipril pharmaceutical products.

Method: Impurity A was synthesized from ramipril by transesterification reaction with methanol and potassium hydroxide. The synthesized product chemical structure was elucidated from its spectroscopic data. High performance liquid chromatography (HPLC) method was utilized to determine its purity and establish it as reference standard. Finally, the assay of impurities in ramipril pharmaceuticals was determined by HPLC method, using the established impurity A standard.

Results: Ramipril methyl ester was successfully synthesized and purified with 39.2% yields (about 1.08 g). Impurity A purity determined was over 98% and conformed to establish reference standard. The assigned purity value of impurity A is 99.01%. Additionally, the assay of impurities in available ramipril pharmaceuticals by application of a HPLC method referred from USP 43 was conducted.

Conclusion: Impurity A was successfully synthesized and standardized as reference standard for impurities test of ramipril.