Neurocritical care is an ever-changing field. The publishers and author of The Flying Publisher Guide to Critical Care in Neurology have made every effort to provide information that is accurate and complete as of the date of publication. However, in view of the rapid changes occurring in medical science, as well as the possibility of human error, this site may contain technical inaccuracies, typographical or other errors. It is the responsibility of the reading physician who must rely on experience and knowledge about the patient to determine the best treatment and care pathway. The information contained herein is provided “as is”, without warranty of any kind. The contributors to this book, including Flying Publisher & Kamps, disclaim responsibility for any errors or omissions or for results obtained from the use of information contained herein.
"This thesis describes the utilisation of reproductive health services: family planning, antenatal care and delivery services in Vietnam and analyses socio-economic factors influencing the utilisation of these services. It is based on one cross-sectional survey conducted in the Red River Delta in 1992 and on two surveys performed in 1991 and 1994 in the northern mountainous area. Women in reproductive age were interviewed in their homes on their reproductive history, current use of contraceptive methods, antenatal visits and anti-tetanus vaccination, and delivery care for their last pregnancy as well as on their socio-economic status. Family planning services were relatively frequently used while antenatal care and delivery services were under-utilised both in rural and in mountainous areas. In the Red River Delta, the contraceptive prevalence of women was 70%. The intra-uterine device was the most common method. Thirty per cent of pregnant women had received at least one antenatal check-up and 20% of them had had at least one anti-tetanus vaccination shot. But only 5% of them had had three antenatal check-ups as recommended by the programme. One third were delivered at home. Most women did not adhere to the family planning policy since half of them had more than two children and a shorter spacing between the deliveries than recommended by the policy. In the mountainous area, where a primary health crre programme was running, the contraceptive prevalence increased from 48% in 1991 to 60% in 1994. The antenatal attendance was low and did not change from 1991 to 1994. About two tllirds of the pregnant women had at least one antenatal check-up but only one fifth of them had had three antenatal check-ups. About two thirds were delivered at home, both in 1991 and 1994. Mothers with shorter education were less prone to get antenatal check-ups and deliver in a health institution. The utilisation of services also varied with religion, ethnicity, parity and with poverty indicators like food security and housing conditions. Mothers with more children were more likely to use contraceptives but they were less likely to use antenatal care and delivery services. Mothers with lower education, farmers, and Catholics had ashorter spacing between the first and the second child,and the probability of them getting a third child was higher The results suggest a need for strengthening reproductive health sevices ,especially the antenatal care and delivery servies and encouraging disadvantaged groups of women touse these services"
This is prospective study. The patients were isolated from the patients with head injuries who was diagnosed and treated at VietDuc Hospital between January 2003 and June 2004. The authors discribed the clinical, radiological signs and epidemiological factors, analysed these factors and assessed the primary care. Results: This study included 1127 patients: 895 male (79,4%) and 232 female (20,6%). There were 950 patients from 15 to 60 years old (84,3%). The traffic accidents was found in 859 cases (76,2%), and more common than in many developed countries, 40% from Krauss and 52% from Berry (p< 0,05). The road accident was more frequent in holiday, weekend and outwork-time. 60% patients have the traffic acident whene they come from holiday and 35,6% come from their office. There was 91,0% motor traffic acident and only 6,9% of them have had the helmet. 81,3% patients were transfered from province hospital. There was only 8,7% patients who was injured from work accidents, 4,5% from assault and 0,2% from sport accidents. 97,9% patients was transfered by car, more than 42,1% in 1997 (p<0,05) and 57,9% patients have medical care beore reaching hospital. Only 8,1% severe head injuries have had the intensive care before coming to VietDuc hospital, less than 98,9% in Reilly series (p<0,01). Conclusion: The road accidents was most common in head injuries, mostly in male, ages from 15 to 60 and occured in holiday time.
"Background: Sexually transmitted infections (STI) and other reproductive tract infections (RTI) constitute a huge health and economic burden in low-income countries. The infections may result in severe sequelae, particularly in women, and facilitate HIV acquisition and transmission. In Vietnam, women from rural or remote areas delay before seeking care for STI. Little is known about the situation regarding STI/RTI in the community. Aims: To explore perceptions and attitudes towards STI/RTI among people in the community; to assess the knowledge of STI and possible associations between socioeconomic determinants and STI knowledge among women aged 15 to 49; to investigate the prevalence of STI/RTI and related factors among married women aged 18 to 49; and to assess healthcare providers’ (HCPs’) knowledge and reported practices regarding STI. Methods: Ten focus group discussions (FGDs) were conducted with a total of 73 participants aged 15 to 49 (46 women and 27 men) in Bavi district (Study I). Face-to-face interviews using a structured questionnaire about STI knowledge were carried out among 1805 women aged 15 to 49 randomly selected from 17 clusters of an epidemiological field laboratory in Bavi district (FilaBavi) (Studies II, III). In total, 1,012 married women, in addition to being interviewed, underwent a gynaecological examination. Specimens were collected for laboratory diagnostics of chlamydia, gonorrhoea, trichomonas, bacterial vaginosis (BV), candidiasis, hepatitis B, HIV, and syphilis (Study III). HCPs working in Bavi district, including 390 medical personnel and 75 pharmacy personnel participated in a self-completion questionnaire survey on STI knowledge and case scenarios (Study IV). Results: In the FGDs, RTI, gonorrhoea and syphilis was described as three stages of an STI. Health- seeking patterns for STI/RTI were reported to differ between men and women: self-medication was a common practice among women, while men were more likely to seek healthcare from private HCPs. Complaints were voiced about clinicians’ negative attitudes towards STI/RTI patients (Paper I). Among 1,805 women, 78% did not know of any symptom of any STI. Of 40 possible correct answers, the mean knowledge score was 6.5. Young and/or unmarried women demonstrated very low levels of STI knowledge. Experience of an induced abortion predicted a higher level of knowledge (Paper II). Of the 1,012 married women, 39% were aetiologically confirmed as having an STI/RTI. Endogenous infections were most prevalent (candidiasis 26%, BV 11%) followed by hepatitis B 8.3%, Chlamydia trachomatis 4.3%, Trichomonas vaginalis 1%, Neisseria gonorrhoeae 0.7%, genital warts 0.2%, HIV and syphilis 0%. Prevalence of any STI was 6.0%. Age under 30 years or using an intrauterine device were significantly associated with increased risk of BV. Determinants of candidiasis were vaginal douching, high education level and low economic status, whereas a determinant of chlamydia was high economic status. Out migration of the husband was associated with an increased risk of hepatitis B surface antigen seroposivity among women. Compared with the laboratory diagnostics, both self-reported symptoms and clinical diagnosis had very low sensitivity and positive predictive values (Paper III). Of 465 HCPs, 70% acknowledged the necessity for partner treatment for BV or candidiasis cases (which is often not the case). Sharing clothes/food or kissing were commonly mentioned as transmission routes of STI (60%). Mean score of knowledge and reported practice were 28.2 (minimum 0, maximum 50, median 26) and 4.7 (minimum 0, maximum 20, median 2), respectively. Of the HCPs, 34% and 78% had suboptimal knowledge and practice score (below 50% of the total score). Being a medical doctor, assistant medical doctor, midwife or serving STI patients predicted a higher level of knowledge. Additionally, serving STI patients, being a midwife, female provider, and having participated in STI/RTI training courses predicted higher level of practice (Paper IV). Recommendations: Health education interventions to improve knowledge of STI/RTI for community members as well as HCPs are urgently needed. Further, communication between STI/RTI patients and clinicians needs to be improved. Syndromic algorithms should be supplemented by risk assessment in order to reduce under and over treatment. Microscopic diagnosis could be applied in primary care settings to achieve more accurate diagnoses. Vaccination to prevent hepatitis B for migrants should be considered.
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