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.

Background: The treatment of kidney stones by surgery is very important for relieve pain, reduce the risk of infection and protect kidney function. Method: This was descriptive prospective cross-sectional study research to identify the outcome of surgery for kidney stone in the Urology Department of Mahosot Hospital. The research was performed between June-December 2017. The subjects consisted of 120 patients. Data were collected using questionnaires by interview, reviewing hospital charts and following the patients post operation. Data were analyzed by using SPSS. Results: The results showed that the majority of patients were aged 43-52 years (30.0%), were mostly male (60.8%), Lao lum (76.7%), with high school education (28.0%), farmers (50.8%), and family history of having kidney stones (55%), previously treated with herbal medicines (72.5%), and presented with pain (90.8%) and hematuria (57.5%). Ultrasound scans demonstrated pyelo-caliciel calculi (50.8%), blood group “B” (43.3%) and hydronephrosis level II (45%). Operation was by bivalve nephrotomy in 37.5%. The operation duration was one hour (51.7%) and management outcome post surgery was successful in 85%, with complications of anemia (0.8%), need for hemodialysis (1.7%), pyelonephritis (8.3%), wound infection (1.7%), and hemorrhages (1.7%). Conclusion The outcome of surgery for kidney stone success is high, but complications persist. Discussion of interventions to reduce complication rates are needed.

Background: Congenital heart disease is the most common causes of major congenital malformations. Congenital heart disease (CHD) represents, globally, 28% of all congenital anomalies, with a prevalence of about 8 to 10 per 1000 people live births, and they mostly require corrective surgery. Objective: To describe outcomes of congenital heart surgery in children under 15 years in Vientiane, Lao PDR. Methods: We undertook retrospective analyses of children with CHD who underwent cardiac surgery by the ASD teams at the Laos-Luxembourg Heart Center, Mahosot Hospital, Vientiane Capital, by reviewing the medical charts of patients discharged during 1st January 2014 to 31st December 2018. Results: Of a total of 415 patients with CHD, 185 underwent cardiac surgery that were the simple lesion 62.1%; moderate lesion 36.0%, complex lesion 1.6%, respectively. The patients who met the inclusion criteria in this study were 158 with a median age of 51 months and those with preschool age of 52.0%. Corrective surgery was the commonest conducted at 98.1%. The major procedure was VSD closure at 34.8%. The post-operative complication found in 30.0%. Overall in hospital mortality rate was 8.8% (by RICHS-1 method). Conclusion Congenital heart disease surgery in children under 15 years old at Laos-Luxembourg Heart Center, Mahosot Hospital was significantly associated with post-operative complications and high mortality. Therefore, trainings on CHD surgery and Post-CHD surgery care must be urgently organized to the Lao cardiac surgeons and nurses to reduce complications and deaths.

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.

Background and rationale: Infections caused by bacteria are significant public health problems and the roots of much illness and death in Laos. Hemoculture is the gold standard for the diagnosis of septicemia and the aetiological agents. However, the result of blood culture depend on many factors, from the collection of blood by nurses until completing and reporting the laboratory analysis. The process of blood collection by nurses plays an important role for optimizing culture yields in the laboratory and the result will be more accurate with a lower contamination rate, if performed using strict sterilized techniques. Correct blood collection and culture practices will also reduce the risks of needle-stick injuries and harm. Objective: To study behavior on blood collection from patients by nurses for culture at Microbiology Laboratory of Mahosot Hospital, Vientiane Capital. Methodology: The study was descriptive, cross-sectional quantitative study to the nurses who were performing blood collection for culture and who answered questionnaires. The reported behavior of the nurses was also compared to that observed by the researcher. Data entered into the Excel and analyzed with STATA. Results: The majority of the study nurses were female (92%) with a mean age of 33 years, a mid-level of nursing study (82.4%), and with an average duration of working of 7 years. The awareness of nurses about the importance of blood collection technique for culture was in the range from 43.3% and 30.0% rating as high and intermediate respectively. Right attitude towards accurate practices was 27.0%. The reported correct practice of blood collection by the nurses was 38% however the correspondent figure by observation was only 12%. Older age, longer work experience, better work knowledge, attitude were significantly associated with correct blood collection procedures (P-value <0.05). Conclusion The techniques and knowledge of the nurses for collecting blood cultures remains low due to lack of knowledge, techniques, procedures and methods to collect and deliver samples. Therefore, adequate and regular trainings are urgently needed.

Background and rationale: Many factors contributing to tooth decay and oral health problems. These includes economic, social and environmental factors. However, the key factors were unknown among nursing students in Lao PDR. Objective: To assess the oral health status, oral care behaviors and factors affecting the oral health care behaviors of nursing students. Methodology: This was a descriptive cross-sectional study. We interviewed and examined the nursing students at University of Health Sciences by completing questionnaires and performed oral examinations, estimating the Decayed, Missing, and Filled Teeth Index (DMFT) and Oral Hygiene Index (OHI). Data were analyzed using SPSS. The descriptive statistics and Chi-square test were used with P-value ≤ 0.05. Results: Of the 200 students recruited, most were female (87.5%), and the median (range) age was 26 (17-45) years old. Tooth decay was noted in 67.0%, estimating the Decayed, Missing, and Filled Teeth Index was 3.11 per people per tooth and this was significantly associated with predisposing factors and reinforcing factors with a p-value <0.05. The students’ oral hygiene with good level was 61.0% and their oral hygiene index was 2.39. Knowledge, attitude and behavior in oral health care of the students were moderate (60.0%) and these were significantly associated with cleaning practice at p-value of 0.002. Conclusion This study shows that some factors are significantly associated with personal behavior, caries and oral hygiene practice in nursing students.

Background: A key success to achieve the highest potential in the nursing profession is the clinical nurse leaders (CNL) who are likely to have key roles for improving quality of patient care, but nothing published about this topic in the Lao PDR. Objective: To evaluate the duties, leadership roles and to develop nursing technical leadership roles in central hospitals, Vientiane Capital. Methodology: The study is action research conducted between 12/2019 - 6/2020, with 3 phases (1) preparation phase, (2) implementation-1 phase, and (3) implementation-2 phase (development of CNL roles. Results: One hundred and eleven clinical nurse leaders from five central hospitals in Vientiane Capital participated in the study of which 92% were female; aged between 30-39 years (50%), and most of them worked in the Internal Medicine departments and their working experience ranged from 10-19 years (40.5%). About thirty-nine percent of the participants were mid-level nurses. The overall performance score for CNL roles was moderate with a mean of 3.2/5. The performance score was significantly different between levels of education of the nurses (for example between those who were auxiliary nurses and those who held the bachelor degree by training) with p-value <0.05. Conclusion The role of clinical nurse leaders in central hospitals evaluated systematically, traditionally and as routine work was not really satisfactory. The overall CNL performance was moderate and there remain some roles that need to be promoted particularly the research role.

Background: Tooth loss is a process caused by many factors related to dental caries, periodontal disease, and socio-environmental factors such as socioeconomic status, education level, access to services, social security status and general health status. Objective: To investigate the oral health status of the elderly in Vientiane Capital and who it correlates with their quality of life. Methodology: A cross-sectional survey of 420 elderly people aged 60 years and above, who were residents of four districts in Vientiane Capital. Data were collected through: a) an interview of oral impacts using the Oral Impact Daily Performance (OIDP Elderly); and b) an extra oral and intraoral examination to measure the prevalence and severity of dental caries and sequelae conducted by two trained and standardized examiners using the modified WHO Oral Health Basic Methods (5th ed). Caries was detected at the cavitation level. All documents were translated from English into Lao and validated by back-translation. Results: Seventy-six percent of the elderly reviewed reported at least one OIDP oral impact. The most common performance affected was eating (70.5%), self- confidence with smiling (26.0%) and cleaning teeth and tooth dentures (24.6%). All of participants had dental caries (DMFT>0). The decayed, missing tooth, filled teeth (DMFT) = 28 teeth per person, the mean DT= 16.9 and missing tooth MT= 11.2. Only 10% of participants had dental treatment. The prevalence of dental caries was significantly associated with quality of life (p<0.001). Conclusion The prevalence of tooth loss is high among the Lao elderly, with the mean number of missing teeth per person of 11. The missing teeth was significantly impacted on the daily living of the elderly. Attention on the prevention and management of dental health of the elderly should be paid more and more in order to improve their quality of life.

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.

Background and rationale: The Institute of Higher Education in Medical Sciences has a key role to play in the made of personnel in response to strategic plans for optimizing health worker staffing. Student participation is an important element in helping to develop the characteristics of a comprehensively able student. Objective: To study the students’ participation towards students ‘activities at the University of Health Sciences. Methodology: This study was a cross-sectional descriptive study of year 1 – 3 students who gave consent to study. Data were collected by using questionnaires during face-to-face interviews. The data were entered in Epi-data and analyzed by SPSS. Results: Of a total of 331 participants, more than half (63.1%) were female. The students’ participation to activities were high (X̅= 3.88 over 5, S.D= 0.54). When considering for each componente, it was found thatn the participation to the academic promotion was high level (X̅= 3.80, S.D= 0.58), to the sports events was at high level ((X̅= 3.91, S.D= 0.65), to the cultural arts was also at high level (X̅= 3.87, S.D= 0.70), and to the volunteer aspect was high level (X̅ = 3.94, S.D= 0.65). Gender segregation for each participation was not statistically significant at the 0.05 level. Conclusion The students from faculties have different opinions on participation to extra-curriculum activities particularly on the promotion of academics, sports, arts and culture, with the exception of volunteers.