The prevalence and related factors of phantom vibration among medical students: A first look in Vietnam

Original Research

Abstract

Background: Phantom vibration (PV) is an illusionary perception in which people perceive their mobile phone vibrates while it actually does not. Recently, PV has attracted attention in psychology and medical field. There are several studies investigating the prevalence and risk factors associated with this phenomenon. However, the findings are inconsistent. The prevalence of PV fluctuates from 21% to 89% among different groups and its mechanism remains unclear. Further understanding is necessary to identify the settings in which PV may harm the population and warrant further exploration.

Objectives: This study aims to explore the prevalence of PV among medical students in Ho Chi Minh City and settings that PV can risk people’s health. Relationships between PV and phone usage habits as well as psychiatric disturbance also are investigated.

Methods: By using online questionnaire on 377 undergraduate medical students in Ho Chi Minh City, Vietnam, the cross-sectional study explored factors associated with PV, including demographic, behavioral phone usage, and mental/emotional factors using the Self Reporting Questionaire - 20 (SRQ-20). The descriptive and association analyses were employed using R software.

Results: The study found a significant association between mental/emotional factors (i.e. mental disturbance and phone attachment) and PV (OR=2.15, 95% CI=1.21-3.81, p value=0.009; OR=1.75, 95% CI=1.02-3.01, p value=0.043 respectively), which suggests an important role of mental/emotional factors in explaining the potential mechanism of PV. A high proportion of participants also experienced PV while driving (55.5%) within the last month. This implies the impact of PV possibly becomes significant, causing an increase in the risk of traffic accident due to distracted driving.

Graphical abstract

Risk factors of short-term complications after pancreaticoduodenectomy treated periampullary carcinomas

English version

Abstract

Introduction: Pancreaticoduodenectomy has been a radical treatment for periampullary carcinoma, which is a collection of malignant neoplasia of the periampullary region. Although the mortality has declined dramatically, the complications are still high. This study aims to determine the occurring rate of short-term complications after pancreaticoduodenectomy and to identify the risk factors related to those complications. Comprehension of these problems help increase the outcome.

Materials and Method: It is a cross-sectional study of the patients with periampullary cancer, who undergo pancreaticoduodenectomy at Cho Ray Hospital from January 2012 to October 2016.

Results: Overall complication rate was 25.65% from 230 patients. In which, pancreatic fistula and surgical site infection were the two most frequent complication (10.43% and 4.38% respectively). Pancreatic fistula was highly significantly associated with Wirsung’s duct diameter less than 3 mm (p = 0.015) and soften pancreatic parenchyma (p = 0.004). The soften pancreatic parenchyma also increased the risk of surgical site infection (OR 4.588), but it was not statistically significant (p = 0.056). Soften pancreatic parenchyma increased the haemorrhage complication significantly (p = 0.04) (OR: 10,668, 95% confidence).

Discussions: Pancreatic main duct’s diameter, pancreatic density and Hemoglobin may relate to the early postoperative complications following pancreaticoduodenectomy. Detailedly, in particular for pancreatic fistula, 2 risk factors recognized are Wirsung’s diameter less than 3mm and soft pancreatic density. Meanwhile low concentration of hemoglobin in blood may increase the risk of incisional infection. Pancreatic density related to the complication of haemorrhage.

Conclusions: Short-term complications’ rate following pancreatoduodenectomy remains high. Understanding the risk factors help us choose which case should be operated and do pre-operative preparation better.

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Identification of Curcuma aromatica growing in Vietnam and its potential anticancer components

Original Research

Abstract

Curcuma aromatica, the herbal medicine belongs to Zingiberaceae family, is well known for anti-tumor activity through multiple pathways and a potential candidate for complementary medicine in cancer treatment. The aims of this study were to distinguish between Curcuma species based on polymorphisms of the nucleotide sequence of chloroplast DNA (cpDNA) and preliminarily analyze their potential-anticancer compounds. Totally six samples supposed C. aromatica growing in An Giang province, Vietnam were collected. The contents of curcumin, curdione, and germacrone in the six samples were analyzed and compared by using the high-performance liquid chromatography (HPLC) method. All specimens were identified according to their trnSfMintergenic spacer sequences by Sanger sequencing. Among the six samples, three were determined as C. aromatica, two were C. longa, and one was C. zedoaria. Curcumin, curdione, and germacrone, known as anticancer compounds, were simultaneously found in sample NT3 that identified as C. aromatica by Sanger sequencing. The obtained results revealed a potential herbal candidate for complementary and alternative medicine.

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Direct cost of treatment in patients with acute ST-elevation myocardial infarction in Vietnam

Original Research

Abstract

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.

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Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

Original Research

Abstract

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam.

Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed.

Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens.

Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

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Familial achalasia with an autosomal dominant pattern of inherence: Report of a Vietnamese family

Case Study

Abstract

Current pathophysiologic knowledge of achalasia suggests the important involvement of genetic predisposition. However, familial achalasia is very rare and most of the case reports in literature have shown an autosomal recessive pattern of inherence. We hereby report a case of familial achalasia with autosomal dominant pattern of inherence affecting ten members in three generations of a Vietnamese family.

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Associated factors of ethnic mothers’ knowledge, attitude, practice about diarrhea disease in children under 5-year old in Daklak province

Original Research

Abstract

Background and Objectives: Diarrhea is one of the first causes of morbidity and mortality among children, especially in poor and developing countries including Vietnam. For decades, although Vietnam has implemented different health interventions to suppress diarrhea spread, this disease has been continuously concerned as a national health problem. Hence, the aim of this study was to assess ethnic minority mothers’ knowledge, attitude and practice (KAP) associated with diarrhea in children under 5 years old; Then to find out the correlation among KAP, and discover some factors related to good knowledge, positive attitude, correct practice about diarrhea in under 5-year old children of the mothers in Pediatrics Department of Daklak General Hospital, 2014.

Method: A community based cross-sectional study was carried out from September 2013 to July 2014 in Pediatrics Department - Daklak General Hospital with the participation of 153 ethnic mothers who has children with diarrhea. The mothers were interviewed directly following the questionnaire, whose structure was adapted from the World Health Organization (WHO) and author Hau Van Pham. The collected data were checked for completeness, consistency and then entered into Epidata 3.1 and analyzed using SPSS 20.

Results: The data from 153 participants showed that the ethnic mothers had good knowledge accounted for 39.9%, whereas more than half of ethnic mothers (64.7%) had a positive attitude towards prevention of diarrhea among under-five children. However, the correct practice in taking care of children with diarrhea was not high (40.5%). As expected, there was statistically significant correlation between the mothers’ knowledge and their attitudes (p < 0.001), as well as their practice toward diarrhea treatment (p=0.005). Analyzed data exhibited that knowledge of the mothers about diarrhea was influenced by their differences in socio-demographic factors, including educational level (p<0.001), occupation (p=0.002) and an ability to access information related to diarrhea in children under 5 (p<0.001). Similarly, the socio-demographic factor (p=0.028) and access to information about diarrhea (p<0.001) have an effect the correct practice in the prevention of diarrhea. There was a statistically significant correlation between the good practice in preventing diarrhea and the socio-demographic factor, including the mothers’ educational level (p<0.001) and the occupation (p=0.021).

Graphical abstract

Effect of auricular acupuncture on exam anxiety in first-year medical students

Original Research

Abstract

Background and Objectives: Exam anxiety is a commonly seen problem among medical students. Auricular acupuncture has been shown to have an anxiety-reducing effect, however, data on exam anxiety is limited. Research in dental and preoperative anxiety has indicated that anxiety level could be reduced by using ear acupoints on the non-dominant side. Therefore, this study aims to determine whether needling at acupoints on the non-dominant side can reduce exam anxiety in medical students.

Method: This is a prospective observational study on 32 students at The Faculty of Traditional Medicine, Ho Chi Minh City University of Medicine and Pharmacy. Eligible students received auricular acupuncture on the non-dominant side at the Master cerebral, Tranquilizer and Relaxation points. Levels of anxiety were measured using a visual analogue scale before and after the intervention as well as before the exam. The State-Trait Anxiety Inventory, heart rate, exam performance and adverse events occurring during the study were also collected.

Results: Exam anxiety level and heart rate decreased 30 minutes after auricular acupuncture (p<0.05). Before the exam, exam anxiety level and heart rate increased significantly compared to after the intervention but still lower than baseline (p<0.05). The exam anxiety level with heart rate at each time point did not differ significantly in gender and trait anxiety levels (p>0.05). No adverse events from auricular acupuncture were observed.

Conclusion: Auricular acupuncture at the Master cerebral, Tranquillizer and Relaxation points on the non-dominant side is effective in reducing exam anxiety in medical students.

Graphical abstract

Botanical, genetic characteristics and preliminary screening of the phytochemical constituents of Hydnophytum formicarum Jack. in Phu Quoc forest, Vietnam

Original Research

Abstract

In Vietnamese folk medicine, Bi ky nam (H. formicarum) tuber has been widely used to treat rheumatism, liver and intestinal diseases. This work aimed to study botanical, genetic characteristics and screening of the phytochemical constituents of wild H. formicarum of Phu Quoc Island, Vietnam. Anatomical characteristics of the plant material were described. Fresh leaves were used to analyze DNA barcodes based on rbcL region amplified by PCR. Sequences of DNA products were identified by Sanger method and BioEdit 7.0.5 software, then compared to the control rbcL sequences published in GenBank by BLAST. The tuber powder was studied for pharmacognostic parameters, preliminary phytochemical screening and total phenolic contents by Folin-Ciocalteu method. Results showed that the similarity between the rbcL sequences of H. formicarum leaves collected in Phu Quoc and the control one published in Genbank was 99%. Moisture content, total ash value and acid insoluble ash value of dried tuber powder were 11.06%, 9.60% and 0.70%, respectively. Raw material contained carotenoids, triterpenoids, flavonoids, phenolics, tannins, saponins, reducing substances and amino acids. Total phenolics content was about 58.847 mg pyrrogallol equivalent/g dried powder weight. Our results provided information about botanical, genetic and preliminary phytochemical characteristics of H. formicarum growing on Phu Quoc Island. This could be useful for the authentication of H. formicarum as a medicinal material.

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Validity and Reliability of Neonatal Infant Pain Scale (NIPS) in Neonatal Intensive Care Unit in Vietnam

Original Research

Abstract

Background: The study aimed to culturally adapt and validate Neonatal Infant Pain Scale (NIPS) for use in Vietnamese settings.

Methods: The original NIPS was translated into Vietnamese using a standard protocol. Registered nurses of Neonatal Intensive Care Unit (NICU), Tien Giang General Hospital, Vietnam used the Vietnamese NIPS for assessing neonatal pain and then provided feedback on acceptability of the scale. Five registered nurses of NICU were randomly selected and used NIPS for assessing neonatal pain while watching thirty videos at two times, two weeks apart from each other. Pulse rates per minute and oxygen saturation (SpO2) were also recorded for validity evaluation. Intraclass correlation coefficients (ICC) with two-way random effects were applied to assess intra-rater and inter-rater reliability. Multilevel linear regression was applied to assess the association between NIPS score with pulse rates and SpO2 adjusting for raters, three periods and two assessments.

Results: The Vietnamese NIPS was accepted and valued by nurses at the NICU. ICCs between the first and second assessments were from 0.53 to 1.00 for five raters before, during and after clinical procedures showing moderate to excellent intra-rater reliability. ICCs among five raters were moderate to good before and after, but poor (ICC<0.4) during clinical procedures. NIPS score was not associated with SpO2, but with pulse rates per minute.

Conclusions: The preliminary results showed that the Vietnamese version of NIPS is reliable and should be used. However, it is recommended that further research should be conducted to confirm its reliability and validity.

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The effect of diet on the fluctuations of human gut microbiota

Review

Abstract

It was previously thought that the establishment of the gut microbiota was completed within the first two years of life, and this community maintains fairly stable throughout the adult lifetime thereafter. However, recent evidence shows that the gut microbiota composition is constantly changing in the gut environment and is heavily influenced by diet. The individual differences responding to diets would root on the fluctuations of gut microbiota if dietary fluctuations affect the composition of gut microbiota so significantly.

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The efficiency of combining modified acupuncture and motor relearning method on post-stroke patients

Original Research

Abstract

Background and Objectives: Combining modern medicine and traditional medicine in the rehabilitation of post-stroke motor deficit has shown interesting results. Many studies on modified acupuncture, a combination of modern and traditional techniques, have proven its effectiveness in motor rehabilitation in post-stroke patients. Furthermore, the effectiveness of the motor relearning method in the treatment of post-stroke paralysis has been elucidated. Therefore, our study aims to determine whether the combination between modified acupuncture and motor relearning method can improve treatment outcomes.

Method: Multicenter randomized controlled trial (Traditional Medicine Hospital of Ho Chi Minh City, General Hospital of Soc Trang Province, and People Military Hospital of Soc Trang Province) from July 2014 to July 2015. 66 post-stroke patients were divided into two groups: The control group received modified acupuncture combined with Bobath method and the trial group received modified acupuncture combined with motor relearning method. After six weeks, patients were evaluated according to the Barthel score, the 10-hole test, and the ability to walk.

Results: The trial group showed better results than the control group. There was a significant difference between the two groups in the Barthel score and the ability to walk, excluding the 10-hole test. After treatment, 77.42% of patients in the trial group showed improvement compared to only 51.61% in the control group (P < 0.05).

Conclusion: The combination of modified acupuncture and motor relearning method is more effective than the combination of modified acupuncture and Bobath method in the rehabilitation of motor deficit after stroke.

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Extrapulmonary Intrapleural Hydatid Disease- A Case Report

Case Study

Abstract

Hydatidosis is a zoonotic disease caused by the tapeworm Echinococcus granulosus. It mostly involves liver and lungs whereas the unusual sites are spleen, kidney, peritoneal cavity, skin, muscles, heart, brain, vertebral column, ovaries, pancreas, gallbladder, thyroid gland, breast, and bones.  Herein, we describe a unique case of intrapleural hydatid cyst which was solely confined to the pleural space without involvement of lung parenchyma and other associated structures. Despite the fact that Pakistan is an endemic country for hydatid disease, we could not identify any single documented case of intrapleural hydatid disease from Pakistan. The purpose of our case report is to promote awareness among fellow healthcare professionals about this rare variant of hydatid disease and to prevent any missed diagnosis and life-threatening complications. Hence, once the diagnosis was established, we performed a right-sided thoracotomy. Intraoperatively, the lung was collapsed due to the pressure effects of hydatid cysts. The hydatid cysts were evacuated completely from the pleural cavity and postoperatively the patient had an uneventful recovery and remained asymptomatic during all the follow-up visits. Conclusively, the hydatid disease may involve unusual sites such as the pleural space. A strong clinical suspicion, supportive radiological findings, and positive serological evidence play a critical role in the establishment of the diagnosis.

Graphical abstract

Factors predicting physical and mental health-related quality of life among post-myocardial infarction patients: Bayesian model averaging analysis

Original Research

Abstract

Coronary artery disease was the cause of half of morbidity and mortality due to cardiovascular diseases in 2013. Myocardial infarction (MI) has been a common medical emergency with high mortality rate and complications unless it is early and appropriately treated. Health-related quality of life (HRQoL) has been popularly used in assessment of health state among coronary artery disease patients undergone both medical and surgical therapies. Bayesian model averaging approach statistically facilitated for identifying potential predictors of HRQoL among post-MI patients following up at University Medical Center, Ho Chi Minh City. The cross-sectional descriptive study was conducted on 146 participants diagnosed and treated with acute myocardial infarction from April 1st 2017 to June 30th 2017. The better HRQoL in physical component summary was associated with higher educational levels (coeff­icient=1.2) and weekly moderate – intensity physical activity (coeff­icient=0.002) but the contrast status for the female (coeff­icient =-3.7) in the fit model with R2= 0.24, BIC=-25.7 and posterior probability=11.7%. The good economic household (coeff­icient=9.8), more daily sitting time (coeff­icient =1.4) and weekly moderate – intensity physical activity (coeff­icient =0.004) predicted the increase of mental component summary score in the given model with R2= 0.08, BIC=-20.3 and posterior probability=25%. The post – MI patients experienced low physical health much more than mental health. The female and suitable physical activity should be concerned in the rehabilitation program as well as follow-up care during the discharge process.

Graphical abstract

Post-Delivery Brachial Plexus Injury in Neonates: A Case Series

Case Study

Abstract

Brachial plexus injury in neonates is a rare obstetrical complication, but it can cause huge anxiety to parents if occurring and sometimes leading to legal disputes in obstetrical practice. Trauma during birth delivery is mainly due to the over-stretch of fetal neck which is the main cause of brachial plexus injury in infants. However, those injuries are self-limited and most of them will self-recover. We conducted a retrospective analysis on ten cases diagnosed of post-delivery brachial plexus injury under monitoring at Tu Du Hospital from January to November 2018. Such factors as maternal obstetrical history, labor characteristics, mode of delivery, clinical symptoms and treatment approach of those cases were collected and analyzed. The risk factors of brachial plexus injury in our study included large fetus, interventional delivery, prolonged second stage of labor and shoulder dystocia. All the cases were treated with physiotherapy and recovered after 3 – 6 months. Family counseling and infants’ recovery played an important role in the management of those cases.

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