Tạp chí Y học Thảm hoạ và Bỏng

Evaluation result of disaster safety status for Military Hospitals

Sat, 28 Dec 2024 00:00:00 +0000

Aims: To evaluate the level of safety in disasters of a number of strategic and campaign-level military hospitals. Subjects and methods: The surveys were conducted at 9 strategic and campaign-level military hospitals. The hospitals were instructed to establish their own assessment teams and follow the steps outlined in the toolkit for evaluating safe military hospitals in disasters. Results: The structural and non-structural groups had the highest proportion of criteria fully met (85.78%), while the lowest was the group managing operations in emergencies and disasters (38.00%). Regarding the level of safety in disasters, 4 hospitals (44.44%) achieved a high safety level, 5 hospitals (55.56%) achieved a medium level, and no hospital achieved a low safety level. Conclusion: It is necessary to improve the level of safety in disaster military hospitals, especially the criteria related to the management of activities in emergency and disaster situations.

Evaluating experimental drill on deployment of military emergency medical team for disaster relief

Sat, 28 Dec 2024 00:00:00 +0000

Objective: To evaluate the results of implementing the Military Medical Team model for natural disasters. Methods: Organizing experimental drill of simulated earthquake situations with 25 trauma victims and 5 cases of chronic illness. The evaluated content included the implementation of military medical stations and Medical response at military medical stations in terms of admission, triage, emergency care and transferring. Results: The deployment of the military medical station for disaster relief met the requirements of over 80%. The management of the team leaders, the members' activities, proficiency in using equipment and forms as well as coordination were sufficient > 95%. The triage results using START met the scenario requirements from 87.5% and over. All contents of operation achieved 90% or more. Conclusion: The drill met the set requirements; some contents were added to complete the model.

To evaluate safety of the adsorption hemofiltration technique for treatment of septic shock in severe burn patients

Sat, 28 Dec 2024 00:00:00 +0000

Objectives: Evaluating the safety of continuous hemofiltration using an adsorbent membrane to treat septic shock in severe burns patients. Subjects and methods: The study describes 55 episodes of septic shock in 38 severe burn patients (16 - 60 years old) treated at the Intensive Care Unit, Le Huu Trac National Burn Hospital from January 2023 to June 2024. Results: The total number of filters used was 247, of which 8 filters had frozen membranes (3.2%), the average life of the filter was 15.87 hours. There were no cases of systolic blood pressure falling below 90 mmHg when entering the filter. During continuous veno-venous hemodiafiltration (CVVHDF): Body temperature was always within allowable limits; there were no differences in blood potassium levels, blood protein and albumin concentration, and hypocoagulation disorders at all time points (p > 0.05); blood sodium concentration decreased significantly to normal limits (p < 0.01). There was no difference in hypocoagulation status between time points (p > 0.05). There was 1 case of bleeding at the dialysis catheter fixation site (1.82%) and 2 cases of bleeding at the skin graft lesion requiring hemostatic treatment (3.62%). Conclusion: There were no differences in blood potassium levels, blood protein and albumin concentration, and hypocoagulation disorders at all time points.

Histological and biofilm change at the infected wound bed after treatment with Polyhexamethylene biguanide (latex HB®)

Nguyen Tien Dung, Tuong Phi Vuong, Chu Anh Tuan — Sat, 28 Dec 2024 00:00:00 +0000

Objective: Evaluation of the effect of PBH (PBH) on histopathological and biofilm change at the infected wound bed. Subjects and methods: Fifteen infected wounds of 15 inpatients at the Wound Healing Center - National Burn Hospital, from July to August 2024. The wounds were washed by PBH. Evaluation of histological progression on H&E-stained slides and Biofilm on the wound bed using scanning electron microscopy (SEM), at the time before (T0), after 7 days (T1) and after 14 days (T2) using PBH. Results: The extracellular matrix structure at the wound site showed reduced inflammation, with a statistically significant decrease in the number of inflammatory cells at times T1 and T2. The proportion of wounds with biofilm decreased from 50% at T0 to 20.8% at time T1 and 8.3% at time T2. The biofilm structure was disrupted and eliminated at times T1 and T2 when observed under SEM. Conclusion: PBH effectively eliminates bacteria, disrupts biofilm, and promotes wound healing.

Results of wound healing of platelet-rich plasma gel from umbilical cord blood in experiment

Do Thanh Hoa, Do Xuan Hai — Sat, 28 Dec 2024 00:00:00 +0000

Objective: To evaluate the wound healing effect of PRP gel from human umbilical cord blood in experimental studies. Subjects and methods: The extra-long dorsal skin flaps on 18 white rats were treated for wound healing by injecting PRP gel from human umbilical cord blood and the control was injected with 0.9% NaCl at a dose of 0.5ml/injection point. Research results: the living area of the skin flaps injected with PRP gel from human umbilical cord blood on days 3; 7 and 14 were 4.1 ± 0.2, 3.9 ± 0.1 and 3.8 ± 0.1cm2, respectively, significantly different from the control group (p < 0.05). The average number of blood vessels and the average total blood vessel area increased over time when compared with the control group (p < 0.05). Conclusion: PRP gel from human umbilical cord blood stimulates angiogenesis and promotes wound healing in experimental studies.

Evaluation of some characteristics of platelet-rich plasma from umbilical cord blood

Sat, 28 Dec 2024 00:00:00 +0000

The study aims to evaluate some characteristics of platelet-rich plasma (PRP) from umbilical cord blood. Research on 6 umbilical cord blood samples compared with 6 donor venous blood samples, using the GeneWorld kit. The results show that PRP from umbilical cord blood had fewer red blood cells (0.105 (0.07 - 0.17) T/L, 0.32 (0.12 - 0.55), p < 0.01), higher platelet count (701.17 ± 124.75 G/L vs. 457.83 ± 88.95 G/L, p < 0.01) and higher platelet count concentration ratio (2.3 vs. 1.82; p < 0.05). The concentration of EGF in umbilical cord blood plasma was 85.478 ± 28.195 pg/ml, that of healthy donors was 74.973 ± 29.475 (p > 0.05) with VEGF concentrations of 88,090 (67,536 - 135.32) and 10,504 (4,094 - 16,029) pg/mL, respectively, p < 0.05. The EGF concentration in activated PRP from umbilical cord blood and adult blood was 115.72 (50.98 -178.96) pg/mL and 94.91 (50.92 - 159.28) pg/mL (p < 0.05), with VEGF being 281.48 (141.59 - 324.12) pg/mL and 32.6 (11.7 - 53.4) pg/ml, respectively, p < 0.01. In conclusion, umbilical cord blood had normal hematological indices. PRP from umbilical cord blood had fewer red blood cells, higher platelet counts, platelet aggregation ratio, and VEGF concentration than PRP from adult blood. The VEGF concentration in activated PRP from umbilical cord blood was higher than that in adult blood.

Antimicrobial susceptibility profile of Staphylococcus haemolyticus isolated from Vietnamese cancer patients over 4 years

Nguyen Thanh Tung, Hoang My Dung, Nguyen Thi Tuyet Nga, Nguyen Thanh Viet — Sat, 28 Dec 2024 00:00:00 +0000

S. haemolyticus is frequently colonizing the hospital environment and resistance to multiple antibiotics. The antimicrobial-resistant data of S. haemolyticus from Vietnamese cancer patients are limited. This study aims to evaluate the antimicrobial susceptibility profile of 41 S. haemolyticus isolated from Vietnamese cancer patients over a period of 4 years. The rate of methicillin-resistant and multidrug-resistant was 48.8% (20/41) and 95.1% (39/41), respectively. The most frequent sample was blood (65.9%, 27/41), and the second most frequent was sputum (12.2%, 5/41). All isolates were susceptible to quinupristin-dalfopristin, linezolid, tigecycline, and nitrofurantoin, and about 97% of isolates were susceptible to vancomycin. Approximately 96.88% of isolates were resistant to Benzylpenicillin and oxacillin, 93.75% were resistant to erythromycin, and 90.63% were resistant to Ciprofloxacin and Levofloxacin. The high level of methicillin and multidrug-resistant and reduced susceptibility to many antibiotics are causes of concern since they further narrow down the therapeutic options. Quinupristin-dalfopristin, linezolid, tigecycline, nitrofurantoin, and vancomycin are effective against S. haemolyticus infection in Vietnamese cancer patients at Vietnam National Cancer Hospital/Tan Trieu Base. Further studies are needed to surveillance bacterial resistance to guide antimicrobial therapy, reduce antimicrobial resistance rates, and improve the Vietnamese cancer patient’s care.

Nursing care for heart failure patients and related factors at Hanoi Heart Hospital in 2024

Sat, 28 Dec 2024 00:00:00 +0000

Objective: To assess the nursing care quality and some factors related to the outcome of care for hospitalized heart failure patients at Hanoi Heart Hospital in 2024. Method: We performed a cross-sectional study evaluating 21 routine nursing care activities for the level of completion on three days: day 1, day 3, and the day of discharge. We also identified the relevant factors to the patient care outcome. The data was collected from medical records and patient interviews. Results: Among the total of 156 hospitalized heart failure patients participating in the study, 83.3% of patients received good nursing care at the hospital, while only 16.7% of heart failure patients did not receive adequate nursing care. Factors related to the outcome of patient care include: Age group, gender, socioeconomic status, number of hospitalizations per year, disease duration, and patient satisfaction. (p < 0.05). Conclusion: Proper nursing care for hospitalized.

Application of distally based anterolateral thigh flap in a knee soft-tissue defect reconstruction (Case report)

Tong Thanh Hai, Do Trung Quyet, Nguyen Ngoc Chiu, Cao Trung Kien, Vu Quang Vinh — Sat, 28 Dec 2024 00:00:00 +0000

Bone-exposed knee defects are a challenge for surgeons in choosing an appropriate reconstruction method. Distally based anterolateral thigh flap is a top option due to its texture and color which are quite similar to the knee region, its large size, and its sufficiently long pedicle. We report a clinical case of using a distally based anterolateral thigh flap in the reconstruction of a large soft tissue defect around the knee with exposed patella due to high-voltage electrical burns. The outcome is complete flap survival and good functional recovery, the flap donor site is covered by a split-skin graft, which heals during the early stages of healing.

A successful low dose spinal anesthesia in a patient with severe mitral valve stenosis for partial hip replacement surgery: A case report

Nguyen Duy Anh, Tran Dac Tiep, Nguyen Ngoc Thach, Nguyen Tien Duc — Sat, 28 Dec 2024 00:00:00 +0000

Anesthesia for patients with mitral valve stenosis presents a great challenge for anesthesiologists. The choice of spinal anesthesia or general anesthesia for these patients is still controversial, each method has its own advantages and disadvantages. We describe the anaesthetic management for a 73-year-old female patient with a left closed intertrochanteric fracture of the femur with many concomitant diseases: atrial fibrillation, severe mitral valve stenosis, and previous cerebral stroke. The patient had successful partial hip replacement surgery under spinal anesthesia. In the preoperative period, the patient had no difficulty breathing, no chest pain, echocardiography showed severe mitral stenosis due to rheumatism with valve orifice area 0.9 cm2, left atrial enlargement, systolic pulmonary artery pressure 46 mmHg, normal ejection fraction 59% and electrocardiogram showed atrial fibrillation with ventricular response of 93 beats/minute. Left partial hip replacement surgery was successfully performed under spinal anesthesia using 5 mg 0.5% hyperbaric bupivacaine. Loss of sensation reaching the umbilicus provides adequate anesthesia for the surgery. The patient recovered without any complications and was discharged on the 14th day after surgery.

Septic shock with dermatitis and necrotizing myositis due to Vibrio vulnificus infection (Case report)

Sat, 28 Dec 2024 00:00:00 +0000

Vibrio vulnificus (V. vulnificus) is a gram-negative bacterium that can cause serious, potentially fatal infections. V. vulnificus causes three distinct syndromes: Overwhelming primary septicemia caused by consuming contaminated seafood, wound infections acquired when an open wound is exposed to contaminated warm seawater, and gastrointestinal tract-limited infections. Case-fatality rates are higher than 50% for primary septicemia, and death typically occurs within 72 hours of hospitalization. Risk factors for V. vulnificus infection include chronic liver disease, alcoholism, and hematological disorders. When V. vulnificus infection is suspected, appropriate antibiotic treatment and surgical interventions should be performed immediately. Third-generation cephalosporin with doxycycline, or quinolone with or without third-generation cephalosporin, may be potential treatment options for patients with V. vulnificus infection.