Background: Leg bone fracture is common seen in orthopedic trauma. Currently, the trend of treatment is using a less invasive technique. Especially, with application of C-Arm in surgery, closed Kuntscher nailing technique has made the treatment of leg bone fractures achieving more new improvements. Objectives: To summarize the experiences in the technical implementation process and to assess results of treatment. Subjects and method: A descriptive, retrospective study was conducted on 112 patients was confirmed diagnosed with leg bone fractures (81 males, 31 females, the average aged 29\xb15.3), were operated in Da Nang General Hospital from January, 2004 to June, 2006. All of them were performed with Kuntscher intramedullary nail in tibia without opening fracture cavity, in condition of without C-Arm. Results: The patients with combined injuries included 5 cases of 2 legs fracture, 2 cases of hip fracture, 5 cases of leg fracture in 2 stages, 1 case of collabone fracture. Postoperative observations: no case of infection, patients were discharged after 2-7 days, the average length of hospitalization was 3\xb12.4 days. Complication: 1 case of secondary deviation, no case of any delay to heal bone, broken nails. Recording a case of nail was rise up to cause painfully and synovial capsule inflammation of knee joint. Conclusion: The implementation of this less invasive technique should be orderly done. The most ideal indication was tibial shaft fractures in stage of middle 1/3. Because of a minimally invasive technique so patients were less painful, fracture healing quickly, early mobilization could be set, surrounding joints were not affected.
Tibial Fractures/surgery ; Fracture Fixation ; Intramedullary/ methods ;

Effect of marcaine plus fentanyl combination for lumbar epidural anesthesia was investigated in random series of 33 patients who were undergoing lumbar discectomy. Patients received 1mg/kg marcaine with 1mcg/kg fentanyl. The volume of local anesthetic solution was calculated basing on the number of segments that needed to block: 1.5 - 1.6ml per segment. It was found that the marcaine plus fentanyl combination provided high effect (100%) on epidural anesthesia, rapid onset (7.51.8 min), long working duration (33070 min), caused milder hemodynamic changes, decreased the incidence of adverse events and produced satisfactory operating condition.
Bupivacaine ; Fentanyl ; Anesthesia, Epidural

A prospective study involved 64 patients (43 men, 21 women) aged from 20 to 62 years with lumbar disc herniation who had operated at Military Hospital 103. These patients were divided into 2 groups. Group 1 received marcaine (0.25%-0.375%) plus fentanyl, group 2 received marcaine (0.35% - 0.5%) alone for lumbar epidural anesthesia. The volume of local anesthetic solutions injected epidurally was calculated based on number of segments that had to block, with dose of 1.5 - 1.6 ml per segment. The results showed that compare with marcaine alone, the combination of marcaine and fentanyl provided better analgesic effect, faster onset and longer duration of action, caused milder hemodynamic changes, decreased the incidence of adverse effects and produced satisfactory post-operative condition
Bupivacaine ; Fentanyl ; Analgesia, Epidural

200 patients aged 18-67 including 109 males, 91 females were diagnosed definitely as lumbar disk prolapsas by saccoradiculography and treated surgically in the Hospital N0103 from Nov 1999 to Nov 2003. Saccoradiculography give accurate results, without complication and consistent with post operative diagnosis. The tecnique can be used at provincial level, in lacking of MRI
Hernia ; Intervertebral Disk ; Lumbar Vertebrae

71 patients with severe burns, who had had various organ dysfunction were divided randomly into 2 groups: one underwent continuous veno-venous hemofiltration (CVVH), and the other was control group. Results showed a significant decrease of plasma level of cytokine, including IL2, IL6, IL8 and TNF after CVVH (p<0.01). In addition, mortality rate of CVVH group accounted for 38.71%, considerably lower than those of the control group
blood ; Burns ; Cytokines

A study on 125 patients, who were operated on lumbar spinal disk herniation, included 67 men and 58 women, from 18-70 years old. These patients were divided into 2 groups: group 1 was given epidural anesthesia: 34 men and 32 women used bupivacaine 1mg/kg –1, fentanyl 1µg/kg-1, adrenaline 1/2000.000 with a volume of desensitizer was 1.5 – 1.6ml/spinal cord unit. Fentanyl was mixed into drug injected in extra dura mater. Group 2 was given subarachnoid anesthesia: 33 men and 26 women used bupivacaine 0.15mg/kg –1, fentanyl 1µg/kg-1. Respiration indexes had been measured before and after anesthesia 30 minutes. Results: 30 minutes after anesthesia, group 2 had a decrease of the respiration indexes such as VC, VC%, FEV1, and Tiffeneau, compared that before anesthesia (p<0.05). In the group 1, the respiration indexes reduced not significantly with p> 0.05. Subarachnoid anesthesia had Tiffeneau and VC% were lower than epidural anesthesia (p<0.05). The respiration indexes of subarachnoid anesthesia group decreased but still in the allowance limitation.
Respiration ; Hernia ; Anesthesia ; Surgery

Background: Ha Vi poultry market is a concentrated and spontaneous poultry business place. Ensuring environmental hygiene is not respected.\r\n', u'Objectives: To evaluate infectious situation of airborne fungi at a poultry market\r\n', u'Subjects and methods: From 10/2006 to 9/2007 a survey on the profile of airborne fungi was carried out at the Havi poultry - market. Total fungal spores averaged at 2.753 \xb1 576 cfu/m3, the highest sample is 7.120 cfu/m3\u2022 More than 10 different fungi were isolated. \r\n', u'Results: The common fungi are Cladosporium (30.13%), Penicillium (26.86%), Aspergillus (20.97%, composed of A.niger, A fumigatus, A.jlavus, A.clavatus ...), Fusarium (8.15%), some rare fungi (Rhizopus, Rhizomucor, Mucor, Alternaria, Curvularia, Absidia, Bipolaris ... ) 13.89%. The concentration of airborne fungi at the market was higher than at distance of 300 and 1000 m. The concentrations of total fungi and of each species are affected by some meteorological factors: they were higher in the end of spring, early of summer and autumn, lowest in the winter. The concentrations of Cladosporium, Penicillium were found to be positive correlate with humidity, Aspergillus, Fusarium with temperature. \r\n', u'Conclusion: It is necessary to propose the methods that can reduce influence of airborne fungi pollution to health of people \r\n', u'
Airborne fungi ; Cladosporium ; Penicillium ; Aspergillus ; Fusarium.

Background: Common variants in the fat mass and obesity-related transcript (FTO) gene are related to body mass index and obesity, suggesting its potential association with bone mineral density (BMD) and fracture risk. This study sought to define the association between FTO gene variants and the following phenotypes: (1) BMD; (2) bone loss; and (3) fracture risk. Methods: This analysis was based on the Dubbo Osteoporosis Epidemiology Study that included 1,277 postmenopausal women aged ≥60 years living in Dubbo, Australia. BMD at the femoral neck and lumbar spine was measured biennially by dual energy X-ray absorptiometry (GE Lunar). Fractures were radiologically ascertained. Six single nucleotide polymorphisms (SNPs; rs1421085, rs1558902, rs1121980, rs17817449, rs9939609, and rs9930506) of the FTO gene were genotyped using TaqMan assay. Results: Women homozygous for the minor allele (GG) of rs9930506 had a significantly higher risk of hip fracture (adjusted hazard ratio, 1.93; 95% confidence interval, 1.15–3.23) than those homozygous for the major allele (AA) after adjusting for potential confounding effects. Similar associations were also observed for the minor allele of rs1121980. However, there was no significant association between the FTO SNPs and BMD or the rate of bone loss. Conclusions Common variations in the FTO gene are associated with a hip fracture risk in women, and the association is not mediated through BMD or bone loss.

Health financing has been considered as an important building block of a health system and has a key role in promoting universal health coverage in the Vietnam. This paper aims to describe the pattern of health expenditure, including total health expenditure and composition of health expenditure, over the last two decades in Vietnam. The paper mainly uses the data from Vietnam National Health Account and Vietnam Living Standards Survey. We also included data from other relevant published literature, reports and statistics about health care expenditure in Vietnam. The per capita health expenditure in Vietnam increased from US$ 14 in 1995 to US$ 86 in 2012. The total health expenditure as a share of GDP also rose from 5.2% in 1995 to 6.9% in 2012. Public health expenditure as percentage of government expenditure rose from 7.4% in 1995 to nearly 10% in 2012. The coverage of health insurance went up from 10% in 1995 to 68.5% in 2012. However, health financing in Vietnam was depending on private expenditures (57.4% in 2012). As a result, the proportion of households with catastrophic expenditure in 2012 was 4.2%. The rate of impoverishment in 2012 was 2.5%. To ensure equity and efficient goal of health system, policy actions for containing the health care out-of-pocket payments and their poverty impacts are urgently needed in Vietnam.
Developing Countries/*economics ; Financing, Government/economics/trends ; Health Expenditures/*statistics & numerical data/*trends ; *Healthcare Financing ; Insurance, Health/*economics/*trends ; Vietnam/epidemiology

Background: Dengue virus infection is a major public health problem. A hypothesis put forward for severe dengue is the cytokine storm, a sudden increase in cytokines that induces vascular permeability. Previous studies and our recent meta-analysis showed that IL-6, IL-8, IFNγ, TNFα, VEGF-A and VCAM-1 are associated with dengue shock syndrome. Therefore, in this study we aim to validate the association of these cytokines with severe dengue. Methods & Findings: In a hospital based-case control study in Vietnam, children with dengue fever, other febrile illness and healthy controls were recruited. Dengue virus infection was confirmed by several diagnostic tests. Multiplex immunoassay using Luminex technology was used to measure cytokines simultaneously. A positive association with dengue shock syndrome was found for VCAM-1, whereas a negative association was found for IFNγ. Furthermore, multivariate logistic analysis also showed that VCAM-1 and IFNγ were independently correlated with dengue shock syndrome. Conclusion: IFNγ and VCAM-1 were associated with dengue shock syndrome, although their role in the severe dengue pathogenesis remains unclear. Additional studies are required to shed further light on the function of these cytokines in severe dengue.