VNUHCM Journal of Health Sciences

Microbiological profile and antibiotic utilization patterns in nosocomial pneumonia: a cross-sectional study in the intensive care unit of Thong Nhat Hospital

Uyen Thi Nguyen — 2024-12-31

Objectives: The objective of this survey was to investigate the microbiological characteristics and antibiotic usage patterns in the treatment of hospital-acquired pneumonia (HAP) patients in the Intensive Care Unit (ICU) setting.

Materials and methods: A cross-sectional study analyzed 83 medical records of patients diagnosed with hospital-acquired pneumonia and ventilator-associasted pneumoniae. The study took place from January to December 2022 in the Intensive Care Unit of Thong Nhat Hospital. Data included epidemiological characteristics, causative pathogens, prescribed antibiotics.

Results: Gram-negative bacteria, particularly Acinetobacter baumannii (26.1%), Klebsiella pneumoniae (21.8%), and Pseudomonas aeruginosa (19.3%), were the predominant isolates. The susceptibility of Acinetobacter baumannii and Pseudomonas aeruginosa to all antibiotic groups was significantly low, below 50%. The susceptibility of Klebsiella pneumoniae was also low for all antibiotic groups, with rates below 30%, except for colistin (87.5%) and gentamicin (66.7%). The majority of patients received combination therapy with three or more antibiotics, accounting for 72.1%. Colistin was the most frequently prescribed antibiotic at a rate of 63.3%, followed by carbapenems including meropenem and imipenem, with rates of 30.1% and 20.4% respectively. The rate of antibiotic resistance in Methicillin-resistant Staphylococcus aureus (MRSA) was also relatively high, with linezolid at 51%, teicoplanin at 11.7%, and vancomycin at 6.1%.

Conclusions: To prevent the emergence of antibiotic resistance in hospital-acquired pneumonia, it is essential to prioritize the implementation of infection control measures and ensure the responsible use of antibiotics in treatment.

Evaluation of meniscal injury on magnetic resonance imaging and knee arthroscopy in patient with anterior cruciate ligament tear

Vo Thanh Toan — 2025-01-24

Introduction: Meniscal injuries often occur associated with anterior cruciate ligament (ACL) injury (rate 55 - 80%), failure to detect meniscal tear in patients with ACL tears will make tears become more complicated and more difficult to repair over time.

Objective: to determine the degree of correlation between magnetic resonance imaging (MRI) and knee arthroscopy in diagnosing meniscal injuries in patients with ACL tears.

Subjects and Methods: A prospective descriptive study was conducted on 91 patients who underwent knee MRI and were diagnosed with ACL tears through knee arthroscopy at Thong Nhat Hospital from April 2023 to April 2024. Results: Accuracy of MRI and its correlation with arthroscopy in detecting meniscal injuries: 70.3%, with a Kappa coefficient of 0.401, p<0.001, indicating a low degree of agreement between MRI and arthroscopy results. Diagnosis of meniscal injury location: 57.1%, with a Kappa coefficient of 0.346, p<0.001, indicating a low degree of agreement between MRI and arthroscopy results.

Diagnosis of the injury region: Accuracy over 85%, with Kappa coefficients ranging from 0.3 to 0.57, p<0.001, depending on the location and region of the meniscal injury. Diagnosis of the morphology of meniscal injuries: Accuracy over 89%, with Kappa coefficients ranging from 0.258 to 0.616, p<0.001, depending on the location and morphology of the injury.

Conclusion: There is a minimal to moderate correlation between MRI and arthroscopy in detecting, diagnosing the location, region, and morphology of meniscal injuries in patients with ACL tears. Therefore, careful consideration is needed before concluding meniscal injuries based on MRI in patients with ACL tears.

The relationship between risk habits, oral hygiene status, and the effectiveness of radiation-induced oral mucositis treatment

Trinh Huu Le — 2024-12-31

Background: Risk habits (smoking, drinking) and oral hygiene have been reported to contribute to the exacerbation of radiation-induced oral mucositis. Objective: To determine whether there is a relationship between risk habits, oral hygiene status, and the effectiveness of radiation-induced oral mucositis treatment.

Methods: A randomized controlled clinical trial study was conducted on head and neck cancer patients from Ho Chi Minh City Oncology Hospital from 10/2022 - 06/2023, evaluating the relationship between the effectiveness of radiation induced-oral mucositis treatment of 2 groups of patients using PVP-I 1% in combination with honey and PVP-I 1% alone, with risk habits and oral hygiene status.

Results: There was no relationship between the time of onset and the level of radiation-induced oral mucositis and smoking, drinking, or oral hygiene status. At the end of radiotherapy, there was no association between the effectiveness of radiation-induced oral mucositis treatment and smoking, drinking habits, oral hygiene status, smoking duration, and alcohol consumption level (p>0.05).

Conclusion: Smoking, drinking habits, and oral hygiene status may not affect the effectiveness of radiation-induced oral mucositis treatment.

Evaluation of internal reliability and EFA analysis of students' satisfaction on Dental education program - University of Medicine and Pharmacy at Ho Chi Minh City

Thanh Van Tran — 2024-12-31

Surveying learners’ opinions is one of the crucial data channels in the accreditation and quality assurance of education and training, serving as a database to help training programs consider quality improvements. Since 2019, the University of Medicine and Pharmacy at Ho Chi Minh City has conducted surveys on the satisfaction levels of graduating students regarding the quality of training programs in all undergraduate programs. However, the survey sample has not yet been statistically evaluated for internal reliability and the grouping of survey questions. In this study, the survey results of Dental programs (Dental Surgery and Dental Prosthetics programs) were used as a representative sample for statistical analysis using Cronbach’s Alpha and Exploratory Factor Analysis (EFA). The results showed that the number of survey samples collected (115 samples) met the sampling requirements. The survey questions had high Cronbach’s Alpha coefficients (above 0.8). The EFA analysis suggested regrouping the questions into three main survey groups: Quality of the training program, Quality of the teaching staff – training organization, and Quality of student support activities. This research result will serve as a basis for improving the survey model used for all other training programs at the University of Medicine and Pharmacy at Ho Chi Minh City in the coming years.

Drug-related problems on antibiotic therapy among patients in the intensive care unit at a Grade 1 Hospital, Ho Chi Minh City

Uyen Thi Nguyen — 2024-12-31

Objectives: To determine prevalence, characteristics, and factors related to drug-related problems (DRPs) of antibiotic therapy among patients in the intensive care unit at a grade 1 hospital, Ho Chi Minh City.

Materials and methods: A descriptive cross-sectional study was conducted on 132 medical records of patients with antibiotics from January 2022 to December 2022 in the intensive care unit at a grade 1 hospital, Ho Chi Minh city. DRPs were assessed using following documents: The Sanford guide on antimicrobial therapy 2022, Antimicrobial guideline 2022 in hospital where we conducted this study, Vietnamese National Drug Formulary 2018, summary of product characteristics, Micromedex and eMC. DRPs were classified according to the Pharmaceutical Care Network Europe system version 9.1. Multivariable logistic regression analysis was used to determine the predictors of DRPs.

Results: In total, 332 DRPs were identified and 84.8% medical records had at least one DRP involving antibiotics. Inappropriate problems related to dosage (58.1%), serious drug interactions (36.2%), inappropriate administration (4.5%), and inappropriate indication (1.2%) were identified. Female patients related to an increased risk of DRPs compared to male patients (OR = 4.138; 95%; CI: 1.052 – 16.271; p = 0.042). Patients with eGFR ≥ 60 mL/min/1,73m2 were less likely to experience DRPs (OR = 0.197; 95% CI: 0.051 – 0.765; p = 0.019). Patients who received five or more drugs were more likely to experience DRPs than those using fewer drugs (OR = 6.068; 95% CI: 1.489 – 24.725; p = 0.012).

Conclusions: The prevalence of drug-related problems on antibiotic therapy in the intensive care unit was found to be high. Further prospective studies are warranted to determine the clinical impact of DRPs and appropriate interventions on antimicrobials in the intensive care unit are needed to improve DRPs.

Clinical characteristics and liver cirrhosis stages in patients with untreated chronic hepatitis b at thong nhat hospital

Vũ Hà — 2024-12-31

Objective: Assessment clinical characteristics and liver fibrosis stages in chronic hepatitis B patients without specific treatment based on the combination of two non-invasive methods: APRI score and liver elasticity ultrasound using ARFI technique Materials and method: A cross-sectional descriptive study was conducted on 242 patients diagnosed with chronic hepatitis B from January to April 2024 at the Department of Gastroenterology, Thong Nhat Hospital. Data were collected on age, gender, clinical symptoms, liver function tests, and liver elastography to assess fibrosis stages. Results: From January to April 2024, a total of 242 patients met the inclusion criteria and were enrolled in the study. The mean age was 53 ± 14.39 years, and the male-to-female ratio was 3:1. The majority of patients (58.7%) were asymptomatic. The prevalence of mild liver fibrosis (F0-F1) in the study population was 25.6%, significant fibrosis (F2) was 42.6%, advanced liver fibrosis (F3) was 14.5%, and cirrhosis (F4) was 17.3%. The prevalence of significant or severe liver fibrosis was 74.4%. Conclusions: In our study, a high proportion (74.4%) of untreated chronic hepatitis B patients had moderate or severe liver fibrosis. If we rely solely on an ALT level of twice the upper limit of normal to determine treatment, as recommended in previous guidelines, we may miss many cases of severe liver fibrosis that require treatment but have normal ALT levels. This highlights the value of non-invasive methods for assessing liver fibrosis in routine clinical practice for chronic hepatitis B patients.

Analysis of survey results to determine factors affecting student satisfaction with training programs at Ho Chi Minh City university of medicine and pharmacy

Anh Duy Le-Ba — 2024-12-31

Higher education quality can be approached and measured from multiple dimensions. Various classification systems and measurement tools have been developed due to the significance, quantity, and importance of service quality dimensions depending on the cultural orientation and values of stakeholders. Students play a crucial role in the development of quality assurance and accreditation systems in education. Our previous research proposed a student satisfaction survey tool consisting of three components: Program Quality, Faculty Quality - Training Organization, and Support Services Quality. To analyze and identify significant factors affecting student satisfaction and to develop targeted solutions to enhance student satisfaction, this study statistically analyzes the survey results on final-year students’ satisfaction with the training services at University of Medicine and Pharmacy at Ho Chi Minh City. A cross-sectional study with a full-sample collection method was conducted among final-year students of the regular undergraduate program from May to July 2022. An online questionnaire was administered using Education Management Software (PMT-EMS). Data, once processed and cleaned using Excel, were analyzed with STATA software. Criteria were tested with Chi-square/df values less than 5, absolute fit indices (GFI), Turker-Lewis Index (TLI), and Comparative Fit Index (CFI) values greater than 0.9, and RMSEA model error values below 0.08. Additionally, Average Variance Extracted (AVE) and Composite Reliability (CR) were used to assess reliability and convergent validity. RMSEA, Chi-square/df, CFI, GFI, and AGFI indices were used to evaluate the model. Furthermore, NFI, RFI, and IFI (greater than 0.9) were used to test model fit and the impact of observed variables. The study found that the factor most significantly affecting student satisfaction is support services. The second most influential factor is the quality of the support staff and training organization.

Spontaneous regression of a cystic hygroma: A Case Report

Vi Kieu Banh — 2024-12-31

Cystic hygroma, caused by defects in the formation of the venolymphatic system, is a common condition in prenatal diagnosis with a prevalence of approximately 1:1000 to 1:6000 live births. It is often associated with adverse pregnancy outcomes. According to the Society for Maternal-Fetal Medicine, up to 90% of cases diagnosised with cystic hygroma result in fetal demise. At Department of Antenatal Care - Tu Du Hospital, we report a clinical case of live newborn with prenatal diagnosis of cystic hygroma that underwent spontaneous regression during pregnancy, with normal genetic testing resul. At 5 days old, the newborn had normal echocardiography and general examination at the Children’s Hospital 2 revealed no abnomolities. Therefore, cystic hygroma is not an indication for medical termination of pregnancy. The fetus diagnosed with cystic hygroma requires appropriate prenatal counseling, genetic testing to rule out chromosomal abnormalities, and subsequent fetal ultrasound to assess the progression of cystic hygroma and exclude other fetal malformations.