OBJECTIVES: Pulmonary sequestration is a rare congenital malformation, and part of its treatment requires the removal of the aberrant artery by surgical means. MATERIALS AND METHODS: Five patients treated at Military Hospital 103 - Department of Thoracic Disease were diagnosed with PS via CT scan, MS-CT, and DSA, and histopathological data were evaluated retrospectively between January and December 2019. RESULTS: In all patients, surgery is the preferred option, with two cases of video-assisted thoracoscopic surgery (one lobectomy and one wedge resection), and three cases of hybrid video-assisted thoracoscopic surgery (adhesive inflammation was observed, the bronchus is challenging to reveal, to resect, and tend to bleed when resecting). The average length of stay following surgery is 11.6 ± 8.1 days. The mean duration of postoperative follow-up is 13.8 ± 3.3 months, all patients had a good quality of life, and no respiratory problems such as hemoptysis or pneumonia were detected. CONCLUSION: The excellent outcomes obtained in all patients in our study during the follow-up period (13.8 ± 3.3 months) established the appropriate indication and treatment. However, these are preliminary findings; a longer study period with a larger sample size is required to draw more valid conclusions.
Tran Viet Tien,1 Dinh Cong Pho,2 Le Thu Hong,3 Hien Pham Ba,4 Le Van Nam,1 Pham Ngoc Hung5,61Department of Infectious Diseases, Military Hospital 103, Vietnam Military Medical University, Hanoi City, Vietnam; 2Faculty of Medicine, Vietnam Military Medical University, Ha Dong District, Hanoi City, Vietnam; 3Department of Microbiology, Military Hospital 103, Vietnam Military Medical University, Hanoi City, Vietnam; 4Department of Infectious Diseases, Dong Da Hospital, Hanoi City, Vietnam; 5Department of Epidemiology, Vietnam Military Medical University, Hanoi City, Vietnam; 6Department of Training, Vietnam Military Medical University, Hanoi City, VietnamObjectives: To study the prevalence of drug resistance and genotype testing for HIV drug resistance on HIV/AIDS patients with first-line antiretroviral treatment failure at Dong Da Hospital, Hanoi, Vietnam.Patients and methods: Forty-seven patients in Dong Da Hospital, Hanoi, with confirmation of first-line antiretroviral therapy (ART) failure were enrolled in this study from June 2006 to December 2016. Both the protease and reverse transcriptase genes were amplified and sequenced using Trugene®, HIV-1 Genotyping Kit and OpenGene®, DNA system at the biomolecular laboratory of the National Institute of Hygiene and Epidemiology, Vietnam. The Stanford HIV database algorithm was used for interpretation of resistance data and genotyping.Results: Drug resistance mutations were 90.7% in patients with first-line treatment failure. Amongst patients with drug resistance mutation, 97.7% resisted to non-nucleoside reverse transcriptase inhibitors (NNRTIs), followed by nucleoside reverse transcriptase inhibitors (NRTIs, 95.3%) and protease inhibitors (PIs, 11.6%). Amongst the genetic mutations resistant to NNRTIs, G190S mutation was the highest (51.2%), K101HQ mutation was 39.5% and Y181I mutation was 34.9%. In genetic mutations to NRTIs, M184V mutation was 88.4%. In thymidine analogue mutations, K70R mutation was the most common (37.2%), followed by D67N, T215F and T69N mutations (27.9%, 27.9% and 25.6%, respectively). In genetic mutations in PIs, M36I and K20R mutations made up 9.3%. In NNRTIs, the prevalence of nevirapine resistance was 55.8%, and that of efavirenz resistance was 4.7%. In NRTIs, the ratio of lamivudine resistance was 93.0%, and that of zidovudine resistance was 9.3%. No lopinavir/ritonavir resistance was recorded.Conclusions: Drug resistance mutations in patients with first-line ART failure had a high prevalence of NNRTI and NRTI resistance but still susceptible to PIs.Keywords: HIV-1 drug resistance, first-line antiretroviral therapy failure, genetic mutation for drug resistance, virological failure
Nam Nguyen Van,1 Pham Ngoc Hung,2,3 Le Tien Dung,4 Le Viet Anh,1 Dinh Cong Pho,5 Bui Dang The Anh,2 Vu Anh Hai1 1Department of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Training, Vietnam Military Medical University, Hanoi, Vietnam; 4Department of Thoracic Surgery, Phạm Ngá»c Thạch Hospital, Ho Chi Minh City, Vietnam; 5Department of Infection Control, Military Hospital 103, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Vu Anh HaiDepartment of Thoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Ha Dong District, Hanoi, VietnamTel +84986112345Email vuanhhai.ncs@gmail.comBackground: Mid-term outcomes of video-assisted thoracoscopic surgery (VATS) lobectomy for early stage non-small cell lung cancer (NSCLC) in Vietnam should be evaluated and discussed.Methods: This prospective descriptive study was conducted on 94 patients with NSCLC under stages I–IIA who were treated with VATS from November 2011 to July 2014.Results: The median patient age was 55.5 ± 10.8 years. The rate of successful VATS for NSCLC treatment was 98.9%, and the conversion rate (from VATS to thoracotomy) was 1.1%. The operative time was 143.8 ± 38.9 minutes, the amount of blood loss was 194.8 ± 150.5 mL, and the postoperative complication rate was 10.6%. The ICU length stay was 2.8 ± 1.0 days, and the postoperative hospital length stay was 7.7 ± 2.1 days. Among the 89 patients with successful follow-up, one (1.1%) had a recurrent tumor, and ten (11.8%) had metastasis. The 1- and 2-year relative survival rates were 95.9% (3 deaths) and 80.8% (9 deaths), respectively.Conclusion: VATS treatment for early stage NSCLC is an effective method with safe outcomes. The mid-term outcomes were acceptable with 1- and 2-year relative survival rates of 95.9% and 80.8%, respectively.Keywords: video-assisted thoracoscopic surgery, VATS, non-small cell lung cancer, NSCLC, early-stage, short-term outcomes, mid-term outcomes
Nguyen Trung Kien,1 Phillip Geiger,2 Hoang Van Chuong,1 Nguyen Manh Cuong,1 Ngo Van Dinh,1 Dinh Cong Pho,3 Vu The Anh,1 Nguyen Truong Giang41Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Anesthesiology, Perioperative, and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, VA, USA; 3Faculty of Medicine, Vietnam Military Medical University, Hanoi, Vietnam; 4Department of Cardiothoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, VietnamObjective: To evaluate the preemptive analgesic effect of combination pregabalin with celecoxib for lumbar spine surgery.Methods: A prospective, randomized study was conducted among 60 lumbar spine surgery patients and divided into two groups. Postoperative pain relief was achieved with intravenous patient-controlled analgesia with morphine. The preemptive analgesia group received oral pregabalin (150 mg) and celecoxib (200 mg) 2 hrs before surgery, and the control group received a placebo. Pain was assessed by visual analogue scale (VAS). Side effects and morphine consumption were monitored until 48 hrs after surgery.Results: VAS score at rest and during movement was statistically significantly lower in the preemptive analgesia group at most time points (p<0.05). Morphine consumption was significantly lower in the preemptive analgesia group compared with control group in the 24 first hours (29.03±4.38 mg vs 24.43±4.94) and 48 hrs (52.23±9.57 mg vs 44.20±10.21 mg), p<0.05. Hemodynamics, respiratory rate, and SpO2 were similar for both groups. The sedation score was only statistically significant at H8 time point. The incidence of nausea/vomiting in the preemptive group did not statistically differ from the control group.Conclusion: Preoperative administration of pregabalin combined with celecoxib had a good preemptive analgesia effect and reduced intravenous morphine consumption after lumbar spine surgery. Side effects were mild and transient.Keywords: preemptive analgesia, pregabalin, celecoxib, lumbar spine surgery
Nguyen Truong Giang,1 Nguyen Van Nam,1 Nguyen Ngoc Trung,1 Le Viet Anh,1 Nguyen Manh Cuong,2 Ngo Van Dinh,2 Dinh Cong Pho,2 Phillip Geiger,3 Nguyen Trung Kien2 1Department of Cardiothoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Anesthesiology, Perioperative, and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, VA, USA Background: Paravertebral block has been proven to be an efficient method to provide post-thoracotomy pain management. This study aimed to compare patient-controlled paravertebral analgesia (PCPA) and intravenous patient-controlled analgesia (IVPCA) in terms of analgesic efficiency, respiratory function, and adverse effects after video-assisted thoracoscopic surgery (VATS) lobectomy.Patients and methods: The prospective randomized trial study was carried out on 60 patients who underwent VATS lobectomy (randomly allocated 30 patients in each group). In the PCPA group, an initial dose of 0.3 mL/kg of 0.125% bupivacaine with fentanyl 2 µg/mL was administered, followed by a 3 mL/h continuous infusion with patient-controlled analgesia (2 mL bolus, 10-minute lockout interval, 25 mL/4 h limit). In the IVPCA group with morphine 1 mg/mL solution, an infusion device was programmed to deliver a 1.0 mL demand bolus with no basal infusion rate, with a 10-minute lockout interval and a maximum of 20 mL/4 h period. Postoperative pain was assessed by visual analog scale at rest and on coughing. Arterial blood gas and spirometry were monitored and recorded for the first 3 postoperative days. Side effects to include were also recorded.Results: The PCPA group had statistically significant lower pain scores (P<0.0001) at rest at all times. Lower pain scores on coughing were statistically significant in PCPA group in the first 4 hours. Postoperative spirometry showed that both the groups had comparable recovery trajectories for their pulmonary function. Arterial blood gas analysis showed pH and PaCO2 were in a normal range in both the groups. The incidence of headache was higher in the IVPCA group (13.3% vs 0%; P=0.038).Conclusion: PCPA effectively managed pain after VATS lobectomy, with lower pain scores, similar respiratory function, and fewer side effects than standard IVPCA treatment. Keywords: patient-controlled paravertebral analgesia, PCPA, intravenous patient controlled analgesia, IVPCA, video-assisted thoracoscopic surgery, VATS
Nguyen Van Chuong,1 Dinh Cong Pho,2 Nguyen Thi Thanh Thuy,3 Dinh Toan Nguyen,4 Nguyen The Luan,5 Luu Hong Minh,5 Luong Thi Khai,6 Nguyen Thuy Linh,3 Nguyen Trung Kien7 1Department of Neurology, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam; 2Faculty of Medicine, Vietnam Military Medical University, Ha Dong District, Ha Noi, Vietnam; 3General Hospital District No 8, Ho Chi Minh City, Vietnam; 4Hue Medical and Pharmacy University, Hue City, Vietnam; 5Tien Giang University, My Tho City, Tien Giang Province, Vietnam; 6Lang Son Medical Institute, Lang Son City, Lang Son Province, Vietnam; 7Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Ha Noi, Vietnam Objective: To describe the rate and demographics of pain among Vietnamese people in 48 provinces and describe the impact of pain on individuals, levels of satisfaction with treatment results, and behavior of pain sufferers.Methods: The cross-sectional study was conducted in adults presenting to outpatient clinics throughout 48 provinces in Vietnam and were randomly selected for inclusion in this study. A physician trained to administer a questionnaire in a standardized fashion interviewed each patient and collected data regarding gender, age, career, acute and chronic pain, diagnoses, treatment, and satisfaction with treatment.Results: There were 12,136 respondents (50.65% male and 49.35% female) from 48 of the 63 provinces in Vietnam. About 86.53% of respondents reported experiencing pain that affected their daily lives, with 24.10% complaining of acute pain and 62.43% having chronic pain. About 67.71% reported pain that affected job performance. Headache was the most common complaint in 35.43% of the respondents. Fewer than half (43.35%) of all patients with pain sought help from a doctor; only a quarter (27.50%) sought help within 1 month of experiencing that pain. A majority (61.98%) of patients who did seek help were satisfied with treatment results. The median cost of treatment was between 150 and 250 USD.Conclusion: Pain severe enough to impact patients' daily lives is common in Vietnam. Treatment costs are a significant economic burden and may help explain why only a minority of patients seek treatment. Access to lower cost, effective treatment for pain should be improved. Keywords: survey, chronic pain, impact of pain, health care, Vietnamese adults
Nguyen Trung Kien,1 Nguyen Truong Giang,2 Bui Van Manh,1 Nguyen Manh Cuong,3 Ngo Van Dinh,3 Dinh Cong Pho,4 Vu The Anh,3 Dao Thi Khanh,5 Luu Quang Thuy,6 Pham Van Dong71Center of Emergency, Critical Care Medicine, and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 2Department of Cardiothoracic Surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 3Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 4Faculty of Medicine, Vietnam Military Medical University, Hanoi, Vietnam; 5Department of Pharmacy, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 6Center of Anesthesia and Surgical Intensive Care, Vietduc University Hospital, Hanoi, Vietnam; 7Anesthesia and Pain Medicine, Cho Ray Hospital, Ho Chi Minh City, VietnamBackground: Local anesthetic systemic toxicity (LAST) is a life-threatening complication that may follow application of LAs through various routes. Despite increasing usage of LA techniques in a large number of health-care settings, contemporary awareness of LAST and understanding of its management are inadequate.Case presentation: We report two cases who suffered LAST following brachial plexus block for surgery on the upper extremity. The first patient received an ultrasound-guided supraclavicular block with 300 mg lidocaine (6 mg/kg) and 50 mg ropivacaine (1 mg/kg) in 25 mL without epinephrine, and the second patient received an ultrasound guided interscalene block with 200 mg lidocaine (4.5 mg/kg) and 45 mg ropivacaine (1 mg/kg) supplemented with epinephrine 1:200,000. Both patients presented with symptoms of central nervous and respiratory system depression, the first roughly 10 minutes after injection, and the second immediately after withdrawal of the needle. In both cases, thorough recovery was obtained using lipid-emulsion therapy.Conclusion: The complication of LAST following ultrasound-guided brachial plexus block could be treated successfully applying the American Society of Regional Anesthesia and Pain Medicineprotocol of intravenous administration of lipid emulsion.Keywords: local anesthetic system toxicity, lipid emulsion
The Son Trinh,1 Nguyen Ba Hung,2,3 Le Thi Thu Hien,2 Ngo Anh Tuan,4 Dinh Cong Pho,5 Quan Anh Dung,6 Duc Anh Do,7 Ha Duc Quang,2 Hoang Van Ai,1 Pham Ngoc Hung8,9 1Military Institute of Clinical Embryology and Histology, Vietnam Military Medical University, Hanoi, Vietnam; 2Andrology and Fertility Hospital of Hanoi - AF Hanoi, Hanoi, Vietnam; 3Vinmec Times City International Hospital, Hanoi, Vietnam; 4Department of Health Economics, Vietnam Military Medical University, Hanoi, Vietnam; 5Department of Infection Control, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 6Faculty of Medicine, Vietnam Military Medical University, Hanoi, Vietnam; 7Faculty of Medicine, University of Medical Sciences of Revolutionary Armed Force (UCIMED de Las FAR), Marianao, Havana, Cuba; 8Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam; 9Department of Training, Vietnam Military Medical University, Hanoi, VietnamCorrespondence: Pham Ngoc HungVietnam Military Medical University, Ha Dong District, Hanoi, 100000, VietnamTel +84939613388Email pnhungqy@vmmu.edu.vnBackground: In this study, we evaluated MHH patients who wished to preserve fertility, assessing the efficacy of a short course (12 months) of a combined hCG +clomiphene citrate.Materials and Methods: The cross-sectional study included 19 patients with hypogonadotropic hypogonadism who were admitted to the Andrology and Fertility Hospital of Hanoi between March 2016 and March 2018. Using hCG every three days in combination with clomiphene citrate 25mg per day until normal testosterone levels are reached, maintain the dose until spermatozoa are present.Results: The mean age was 30.2 ± 5.6. Differences in penis length between the time before and after treatment were significant (p=0.005). The average dose of hCG using in our study was 5579 ± 1773.7 IU. After treatment 6 months and 12 months, the changes in clinical features in all patients and the total hypogonadotropic hypogonadism group were statistically significant (p< 0.001). In particular, the differences in testosterone hormone levels in the partial hypogonadotropic hypogonadism group were also statistically significant (p=0.03). No adverse event was observed in our study. The number of patients appearing sperm in the semen is 9 patients (47.4%) after 12 months, but most of the sperm were completely deformed (< 1%), and the average motility in the progressive motility group was below 8%.Conclusion: In conclusion, a combination of hCG and clomiphene citrate may be an option for MHH patients who desired fertility. After 12 months, 47.4% of patients have sperm in semen but almost all of them were deformity. Hormone profile and secondary sexual characteristics improved significantly. There was no adverse event in our study that considered it as safe therapy.Keywords: male hypogonadotropic hypogonadism, MHH, total HH, total hypogonadotropic hypogonadism, partital HH, partial hypogonadotropic hypogonadism, clomiphene citrate, CC, human chorionic gonadotropin, hCG, treatment
