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Background/Aims@#As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia. @*Methods@#A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios. @*Results@#Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma ≥10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: ≥20 colonoscopies per month (high volume group) and <20 colo-noscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%). @*Conclusions@#A discrepancy between clinical practice and surveillance guidelines among physicians in Asia was found. Physicians in the low volume group frequently did not adhere to the guidelines, suggesting a need for continuing education and appropriate control. Concerns regarding the quality of colonoscopy and complete polypectomy were the main reasons for nonadherence.
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Background/Aims@#The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education. @*Methods@#Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on. @*Results@#The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching. @*Conclusions@#This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.
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Background/Aims@#The clinical practice pattern of polypectomy is not well-investigated in Asian countries. We aimed to survey Asian endoscopists about their preferred polypectomy techniques for given conditions and images of polyps. @*Methods@#A survey was performed using questionnaires composed of two parts: a scenariobased questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps. @*Results@#A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6–9 mm), and benign-looking intermediate (10–19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscop-ic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the imagebased survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopistsin the colorectal cancer–prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps. @*Conclusions@#The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps <10 mm in size, in contrast to recent guidelines.
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Background/Aims@#The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education. @*Methods@#Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on. @*Results@#The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching. @*Conclusions@#This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.
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Background/Aims@#The clinical practice pattern of polypectomy is not well-investigated in Asian countries. We aimed to survey Asian endoscopists about their preferred polypectomy techniques for given conditions and images of polyps. @*Methods@#A survey was performed using questionnaires composed of two parts: a scenariobased questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps. @*Results@#A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6–9 mm), and benign-looking intermediate (10–19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscop-ic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the imagebased survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopistsin the colorectal cancer–prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps. @*Conclusions@#The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps <10 mm in size, in contrast to recent guidelines.
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Objective: The aim of the study was to assess the effectiveness of educational interventions on the knowledge andcounseling practice of community pharmacists in Hue, Vietnam with respect to common cold management.Method: Thirty-eight pharmacists were invited to participate in educational initiatives, including in-class training andreference to a printed pocket handbook. The knowledge was measured before and after the interventions via a paperbased test, and actual practice was evaluated via a pseudo customer experiment a week later.Results: The interventions significantly improved pharmacists’ knowledge (p = 0.001). In the pre-test, only 37.4%of the participants provided correct answers, but this increased to 83.9% in the post-test. In the pseudo customerexperiment, pharmacists asked about patient identification, age, and symptoms (93.3%, 80.0%, and 80.0%,respectively) but not about medical and medication histories or allergies (less than 20%). All pharmacists offeredadvice as regards dosage, but only half of them shared information on drug names and indications. A third providedguidance on drug interactions. Practices related to inappropriate drug dispensing included the issuance of incorrectmedications or the sale of prescription-only drugs to customers with no prescriptions.Conclusion: Although educational interventions effectively enhance the knowledge and counseling practice ofpharmacists, a huge gap continues to exist between these variables.
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Objectives@#Although the World Health Organization (WHO) initiative “My 5 Moments for Hand Hygiene” has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)’ hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. @*Methods@#A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs’ knowledge and attitudes towards hand hygiene. @*Results@#Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. @*Conclusions@#Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.
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Background: Ankle arthroscopy has been used in Viet Duc Hospital for 4 years and now has become a routine surgery with about 200 patients, who has had ankle arthroscopy to reconstruct the anterior cruciate ligament or operate ragged meniscectomy. Objectives: Evaluate the result of ankle arthroscopy in Viet Duc Hospital and review the indication and surgical technique of ankle arthroscopy in the literature. Subject and methods: Retrospective study on 10 patients with ankle arthroscopy in Viet Duc Hospital from May 2006 to May 2007. Results: 5 patients with impingement, 4 patients with OCD lesion and 1 case of an old displaced fracture of lateral malleolar. Postoperative evaluation with Olerud Molander, ankle function improves at least 10 points and all the patients are satisfied with the results. Conclusions: Ankle arthroscopy gives good result and can be recommended for other cases.
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Background: Situation of extremity injury caused by traffic accidents and occupational accidents are increasing in Vietnam. Therefore, the prevention and fight against these accidents are one of the key objectives to reduce the burden on the families of victims as well as for society. Objectives: To outline situation of extremity injury patients caused by traffic accident, treated in Viet Duc hospital from 2000-2004. Subjects and method: A retrospective study was conducted on 19.845 patients (14.562 males, 5.283 females, aged from 1-97 years old). The subjects were divided into 3 main groups: alone upper extremity injury, alone lower extremity injury and multiple fractures. Results: Extremity injury was common seen in people of working age (78.1%), men more than women (2.76/1 ratio), left foot more than right foot and it was common been in multiple fracture situation due to complex mechanisms of injury (50.3%), alone extremity injury (49.7%). The lower extremity injury was more common seen than upper extremity injury. Open fracture injury (27.3%), in which open fractures in lower extremity were more common seen. Open fractures in both 2 leg bones was the most common seen, accounted for 57.4% among total of open fractures. Amputation accounted for 8.3% among all case of open fractures and 2.3% among all case of extremity injuries. Conclusion: Extremity injury (lower extremity and upper extremity) caused by traffic accidents is common seen. The average, there are 3 emergency surgeries due to open fracture injury were performed daily in Viet Duc hospital per a total of about 11 traumatic emergency surgeries.
Subject(s)
Fractures, Bone , Bone and Bones , Arm Injuries , Leg Injuries , Accidents , TrafficABSTRACT
The research was performed on 2,822 birth-related deaths in women aged 15-49 at 3 provinces Quang Ngai, Song Be and Vinh Phó during 1994-1995. Bleeding was the leading cause of death (55.1%), followed by gestational toxicity and eclampsia (13.04%), uterine rupture (12.3%), umbilical infection and tetanus (10.9%) that occurred only in remote areas and induced abortion (1.89%). Source of this situation related to awareness of pregnant women, specialist level and antenatal care has not met the requirements in fact. Training approaches and favorable treatment policies for primary health workers are needed
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Maternal Mortality , DeathABSTRACT
747 pregnant women received the induced abortion in the Thai Binh centre for the mother and children protection- family planning during 1996-1997 participated to a study. The results have shown that 74% patients were in the reproductive ages (25-39) the juvenile: 0.5%. 76% cases had a history of the induced abortion. The women had no children: 6.7%. The rate of the accident and complication was 11.9% in which the missing placenta that needs repeated abortion: 2.2% there is no death due to complication.
Subject(s)
Abortion, Induced , Pregnant WomenABSTRACT
A study on the application of method of ovaritubal ligation was carried out in Hai Duong, Hoa Binh, Quang Ninh, Binh Dinh, Dac Lac, Dong Nai and Can Tho provinces. Each province was randomly selected 3 district and each district was randomly selected 5-10 commune. Results have shown that there are 3046 women used of the female sterilization from 1993 -1998 who participated to an interview, the rate of fail: 0.92%, the complications after sterilization: 9.8%, common complication: abdominal pain. rate of needs for recovering after sterilization: 2.9%.
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Female , SterilizationABSTRACT
From November 1996 to December 1998 within 90 MRI diagnosed cases of cervical disc herniation found in Hanoi region. 90 male patients with 23-68 years old (on average 45). The result showed that MRI is the best sensible method to determine the cervical disc herniation. The study is performed separately in two levels of the disc herniation: bulging disc 44% and typical disc herniation 56%, pick levels of the disc herniation occur at levels C4/C5 and C5/C6. Cervical canal stenosis and spondylosis may be combined with the disc herniation.
Subject(s)
Magnetic Resonance Imaging , Uterine Cervical DiseasesABSTRACT
From November 1996 up to December 1998 with 90 MRI diagnosed cases of cervical disc herniation found in Hµ Néi region. 73 males patients and 23-68 years old (on average 45). We found that MRI is the best sensible method to determine the cervical disc herniation. The study is performed separately in two levels of the disc herniation: Bulging disc 44% and typical disc herniation 56%. Peak levels of the disc herniation occur at levels C4/C5 and C5/C6. Cervical canal stenosis and spondylosis may be combined with the disc herniation.
Subject(s)
Magnetic Resonance Imaging , Uterine Cervical DiseasesABSTRACT
MR imaging may help detect the bone marrow edema, which is seen as increased signal intensity with poorly defined margins on STIR images. Unfortunately, STIR sequence is not available in our Magnetom 1.0 Tesla menu. Based on old IR sequence in this MR unit, we have tried to make a new STIR sequence. This sequence is proved on image quality in bone contusion and early inflammation diagnosis.