1.Comparison Between Oral Rehydration and Intravenous Fluid Therapy Among Children under 5 Years with Acute Diarrhea with some Dehydration in the Emergency Department of the Children’s Hospital, Vientiane, Lao PDR
Vanhpheng Chanphothong ; Khounthavisouk Phaouthai ; Sanyaluck Xayxanasongkharm ; Sengthip Xayyasan
Lao Medical Journal 2022;13(13):28-35
Background:
Worldwide, diarrhea is a common disease in children and is a problem that causes many children to become sick and die. Diarrhea is found to be the leading cause of death of children under 5 years of age, with 700,000 cases per year worldwide. The incidence of diarrhea is increasing in Laos.
Objective:
To study oral rehydration and intravenous fluid therapy in children under 5 years of age with acute diarrhea with some dehydration in the Emergency Department of the Children’s Hospital, Vientiane, Lao PDR.
Methodology:
This was cross-sectional descriptive study; data were collected by using questionnaire interview by doctors. The data entered by Epi-data with analysis by SPSS.
Results:
Among 90 participants it was found that anxiety or irritability, sunken eyes, nausea, vomiting and flatulence were statistically significantly associated with outcome of treatment (p-value <0.05). More than half of the patients are male (52.2%), aged between 1-2 years and most (83.3%) had normal BMI values. In addition, 44.4% had a history of diarrhea for 2 days with 4 to 5 times a day in 34.4% and stools were watery in 57.8%. A number of participants (47.8%) had a history of previous diarrhea before the current illness and most of them had had it 3 times a year (41.9%). When comparing between oral rehydration and intravenous fluid therapy it was found that the children had no symptoms of anxiety or irritable (in 97.8% vs 77.8%), children with sunken eyes (in 91.1% vs 71.1%), children with vomiting (in 100% vs 64.4%) and children with flatulence (in 97.8% vs 80.0%). Excessive thirst and decreased skin turgor were not statistically different between before and after rehydration therapy (p-value >0.05).
Conclusion
The outcome of treatment with intravenous fluids was better than oral rehydration since former decreased vomiting, shortened hospital stays, lowered the costs and increase more parents ‘satisfaction. The oral dehydration therapy often increased the symptoms of flatulence.
2.Evaluation of the Medicine Curriculum at the Faculty of Medicine, University of Health Sciences, Using the CIPP Model
Bounkhong Khanthaxay ; khamseng Thalangsy ; Khammerng Sybounheang ; Vanhpheng Chanphothong
Lao Medical Journal 2022;13(13):71-78
Background and rationale:
The development of skilled staff is the main function of the medical education system, which is the process of building people with knowledge, skills, wisdom, ability to analyze, know how to solve problems, ability to learn by themselves and adapt to changes in the regional-international environment.
Objective:
The study aimed to evaluate the consistency of context, input, process and product of medical curriculum, Faculty of Medicine, University of Health Sciences by using the Context Input Process and Product (CIPP) model evaluation.
Methodology:
This study was cross-sectional descriptive study of medical student years 5 to 6, managers and teachers. Data were collected by using questionnaires in face-to-face interviews. The data were entered in Epi-data with analysis by SPSS.
Results:
1). Contextually, the curriculum philosophy, objectives of curriculum, structure of curriculum and learning contents of each course were regarded as consistent at high level. 2). Regarding the input teaching, students and learning – teaching materials/equipment, pocket book and places were consistent at moderate levels. 3). Considering the process, the curriculum administration, the learning – teaching management, the evaluation and assessment were consistent at high level and 4). for products, the behavior, attitude, virtue and ethical national of professional, communication skill and relationship, basic knowledge, clinic skill, check-up skill by using basic tools and improve of professional knowledge were consistent at high level.
Conclusion
The medical curriculum of the Faculty of Medicine at the University of Health Sciences is consistent at high levels. When considering each aspect, it can be seen that: the context, the process and the product are consistent at high levels. In terms of input factors, there is consistency at a moderate level.
3.Risk Factor Associated with Acute Otitis External at ENT Department, Mahosot Hospital, Lao PDR
Mick Soukavong ; Kongvilay Vongsakhone ; Manivanh phalyvanh ; Buasone Syhavong ; Saysaarth xayyasan ; Vanhpheng Chanphothong ; Sengthip Xayyasan
Lao Medical Journal 2022;13(13):03-12
Background and rationale:
Acute otitis externa is a disease that significantly affects the life and health of people, mostly caused by bacteria, fungi, virus and irritation from chemicals. Besides that, it can also be caused by trauma such as ear picking, spinning ears, swimmer’s ear and wiping the ear too hard, and if not treated in time serious complications are possible.
Objective:
To study the risk factors associated with acute otitis externa at the ENT Department, Mahosot Hospital.
Methodology:
This study was cross-sectional, descriptive study among patients with ear-ache and acute otitis externa. Data were collected by using questionnaire interviewed face to face and by ear examination. The data were entered into Epi-data and analyzed by using SPSS software.
Results:
Of 186 participants, 62.9% had otitis externa, with a mean (95%CI) age of 32 (01-76) years. The commonest age group was those aged less than 15 years old with 29%. Males were 1.88 times more likely to present with otitis externa than females. Occupational groups at risk of disease are farmers/laborers/ housewife/others and those living in rural areas was 2.7 times having acute otitis externa. Those who had swum or had travelled in the forest and ear picking had a higher frequency of acute otitis externa (1.6 times) and patients who regularly cleaned their ears with a cotton swab were 1.39 times of having otitis externa and some patients who used hair clip for ear picking had a higher frequency of acute otitis externa (2.44 times).
Conclusion
Most of patients have common clinical manifestations of which are tinnitus, earache, swelling or redness of the ears, hearing loss and itching. Demographic characteristics, history, and ear health care behaviors are associated with acute otitis external.
4.Evaluation of Village-level Childhood Immunization Coverage in the Lao People’s Democratic Republic: Measles as indicator?
Phouthapanya Xongmixay ; Mayfong Mayxay ; Soudavanh Soysouvanh ; Vanhpheng Chanphothong ; Alouny Meksithong ; Nith Manhavong ; Ko Chang ; Thipphaphone Phommalath ; Leeyounjera Yang ; Phetsavanh Chanthavilay
Lao Medical Journal 2021;12(12):41-52
Background:
Outbreaks of vaccine preventable-disease control and elimination are impeded by impaired focal vaccination uptake. Therefore, we aimed at assessing vaccination uptake and comparing with passive surveillance (PS) report at village level.
Methods:
A community-based cross-sectional survey was conducted in the villages covered by two health centers in Bolikhamxay province, including non-Hmong and Hmong ethnic groups. Data collection was conducted by interviewing mothers or caregivers of children aged 6 to 23 months. The vaccination status was identified by vaccination cards, and compared with PS report at village level, which was collected from health centers. The Pearson’s chi-square test was used to compare these proportions, and pairwise correlation was used for the correlation of observed vaccination coverage.
Finding:
Sixteen villages were included, nine were from Luk52 health center area and 7 from Namkhou health center area. There was a significantly strong correlation for pentavalent pneumococcal conjugate vaccine, Japanese encephalitis, Measles and Rubella and full immunization coverage compared to others. This correlation was not observed in the non-Hmong population. Amongst non-Hmong, the recorded coverage was lower in PS than in the survey regardless of type of vaccine. In contrast, amongst Hmong most vaccines had higher recorded coverage in PS than in the survey except Bacillus Calmette–Guérin (BCG) and hepatitis B at birth dose. MR and JEV vaccine, commonly given at the same time, were the only one that did not have significantly different coverage between PS and the survey (p<0.334).
Conclusion
The mis-estimatation of immunization coverage from the PS reporting system highlights further research needed to determine a better indicator of village-level vaccination coverage, but measles could be an indicator of prioritizing the settings.