Proliferative Diabetic Retinopathy Requiring Vitrectomy Over Clinic Management During COVID-19: Impact of Delayed Care

Purpose@#This study aimed to investigate the impact of delayed retinal clinical care during the COVID-19 pandemic on the severity of proliferative diabetic retinopathy (PDR) and drivers of follow-up delay. We compared disease severity and follow-up rates of PDR patients requiring vitrectomy to those managed nonsurgically, and identified factors associated with need for vitrectomy. @*Methods@#The study included 739 patients diagnosed with PDR between January 1, 2018, and March 4, 2021, categorized into two groups based on outcome: vitrectomy nonvitrectomy. Statistical methods such as t-tests and chi-square tests were used to analyze differences in disease severity and follow-up rates before and after COVID-19 shutdown. A multivariate regression evaluated factors leading to vitrectomy by comparing initial ETDRS (Early Treatment of Diabetic Retinopathy Study) DR staging, disease stability, DR progression, proliferative complications, appointment intervals, follow-up variance, rescheduling rate, and no-show rate. @*Results@#Of the 739 patients, 202 required vitrectomy, 537 were managed nonsurgically. The vitrectomy group had more severe or unstable disease before shutdown. The interval between patient visits preshutdown was 29.76 ± 45.11 days in the vitrectomy group and 40.23 ± 56.73 days in the nonvitrectomy group (p < 0.001). Both groups experienced a significant increase in appointment intervals after shutdown, with the vitrectomy group having a greater increase. Both groups had significantly increased rescheduling rate and minimally increased no-show rate. Patient-directed rescheduling was the main driver of appointment delays. Disease factors, such as tractional retinal detachment and higher ETDRS DR staging, increased the odds of vitrectomy, while appointment burden and follow-up variability had a minimal impact. @*Conclusions@#Patients with more severe PDR and greater delay in appointments due to the pandemic were more likely to require vitrectomy for proliferative complications. Patient-directed rescheduling was identified as the main driver of care delays, as opposed to clinic-directed rescheduling. This study highlights the importance of maintaining regular follow-up appointments for PDR patients during pandemics.

Normal Values and Associated Factors in Highresolution Anorectal Manometry in Healthy Vietnamese Adults / Valores normais e fatores associados na manometria anorretal de alta resolução em adultos vietnamitas saudáveis

Abstract Introduction The present study aims to identify normal high-resolution anorectal manometry (HRAM) values and related factors in healthy Vietnamese adults. Methods The present cross-sectional study was conducted at the Viet Duc hospital, Hanoi, Vietnam, during April and May 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values from the digestive tract, including pressure, were recorded. Results A total of 76 healthy volunteers were recruited. The mean functional anal canal length was 4.2 ± 0.5 cm, while the mean anal high-pressure zone length was 3.4 ± 0.5 cm. Themean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit the rectoanal inhibitory reflex (RAIR) was 18.1 mL. The mean rectal sensation values were 32.4mL, 81.6mL, and 159 mL for first sensation, desire to defecate, and urge to defecate, respectively. Dyssynergic patterns occurred in ~ 50% of the study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between male and female patients in terms of maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p<0.01). Conclusions The present study establishes normal HRAM values in healthy Vietnamese adults, particularly regarding normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted to further confirm the constants and their relationships.

Resumo Introdução O presente estudo tem como objetivo identificar valores normais de manometria anorretal de alta resolução e fatores relacionados em adultos vietnamitas saudáveis. Métodos O presente estudo transversal foi conduzido no hospital Viet Duc, Hanói, Vietnã, durante abril e maio de 2019. Voluntários saudáveis foram recrutados para participar do estudo. Valores de medição anorretal, incluindo pressão do trato digestivo, foram registrados. Resultados Um total de 76 voluntários saudáveis foram recrutados. O comprimento funcional médio do canal anal foi de 4,2 ± 0,5 cm, enquanto o comprimento médio da zona anal de alta pressão foi de 3,4 ± 0,5 cm. O índice médio de defecação foi de 1,4 ± 0,8, com valores variando de 0,3 a 5,0. O volume limite médio para eliciar o reflexo inibitório retoanal (RAIR, sigla em inglês) foi de 18,1 mL. Os valores médios da sensação retal foram 32,4mL, 81,6mL e 159 mL para a primeira sensação, o desejo de defecar e a urgência de defecar, respectivamente. Os padrões dissinérgicos ocorreram em aproximadamente 50% dos participantes do estudo e incluíram principalmente os tipos I (27,6%) e III (14,6%). Houve diferenças significativas entre homens e mulheres na pressão de compressão anal máxima, pressão de tosse anal máxima, pressão de distensão anal máxima, pressão de tosse retal máxima e pressão de distensão retal máxima (todos p<0,01). Conclusões O presente estudo estabelece valores normais de HRAM em adultos vietnamitas saudáveis, particularmente no que diz respeito aos valores normais de pressão anorretal e sensação retal. Mais estudos que incluam tamanhos de amostra maiores devemser realizados a fim de confirmar melhor as constantes e suas relações.

Computed tomography evaluation of internal nasal valve angle and area and its correlation with NOSE scale for symptomatic improvement in rhinoplasty / Avaliação do ângulo e da área da válvula nasal interna por tomografia computadorizada e sua correlação com a escala NOSE na melhora sintomática pós rinoplastia

Abstract Introduction: Nasal obstruction is one of the most frequent otolaryngologic complaints; and the collapse of the internal nasal valve is one the main causes of the nasal air flow obstruction. Objective: We aimed to evaluate internal nasal valve by using reformatted CT-scans pre- and post- rhinoplasty at 3 months and to assess its correlation to symptomatic improvement of nasal obstruction using the NOSE scale. Methods: A prospective observational study was conducted between March 2017-May 2018 in a tertiary care otorhinolaryngology center. We included patients suffering from nasal obstruction secondary to internal nasal angle collapse and nasal deformity. Patients with sinusitis, nasal polyposis, and nasal masses were excluded. Results: Twenty consecutive patients underwent rhinoplasty, with a mean age (22.2 ± 2.8), with majority of males (n = 14; 70%). There was no significant correlation between pre- and post- CT-scans of the internal nasal valve angle/area and NOSE scores. A high significant difference was detected between mean pre- and post- NOSE scores (p < 0.0001), which was absent in CT-scan results. Conclusion: Reformatted CT-scans measurements of internal nasal valve area and angle were not of value. NOSE scores pre- and post- rhinoplasty had a significant value to determine degree of obstructive symptom improvement.

Resumo Introdução: A obstrução nasal é uma das queixas otorrinolaringológicas mais comuns, e o colapso ou obstrução da válvula nasal interna é a principal causa da obstrução das vias aéreas nasais. Objetivo: Objetivamos avaliar a válvula nasal interna pré, e 3 meses pós-rinoplastia utilizandotomografias computadorizadas reformatadas e avaliar sua correlação com a melhora do sintoma obstrutivo utilizando a escala NOSE, do Inglês Nasal Obstruction Symptom Evaluation. Método: Um estudo observacional prospectivo foi realizado entre março de 2017 e maio de 2018 em um centro de otorrinolaringologia de atenção terciária. Foram incluídos pacientes que apresentavam obstrução nasal secundário a colapso da valva nasal interna e deformidade nasal. Pacientes com sinusite, polipose nasal e tumores nasais foram excluídos. Resultados: Vinte pacientes consecutivos, a maioria do sexo masculino (n = 14; 70%) com média de idade de 22,2 ± 2,8 anos, foram submetidos a rinoplastia eincluídos no estudo. Não houve correlação significante entre as avaliações tomográficas pré / pós cirúrgicas do ângulo/área da valva nasal interna e os escores NOSE. Foi detectada uma diferençã altamente significante entre os escores médios da escala NOSE entre o pré e pós-operatório (p < 0,0001), mas não nos resultados da avaliação por tomografia computadorizada. Conclusão: As medidas reformatadas de tomografias computadorizadas da área e ângulo da valva nasal interna pré e pós cirúrgicas não tiveram valor. Entretanto, os escores da escala NOSE pré e pós-rinoplastia mostraram uma diferença significante ao determinar o grau de melhora do sintoma obstrutivo.

The COVID-19 pandemic in the ASEAN: A preliminary report on the spread, burden and medical capacities

Objective: To provide preliminary descriptions of the spread, burden and related medical capacity characteristics of the ASEAN countries. Methods: We utilized the data from four main official databases, including WHO reports, the Statistics and Research of the Coronavirus Disease, and the Southeast Asia Program of the Center for Strategic and International Study. The spread of the COVID- 19 pandemic, current burden and the COVID-19 medical response capacities were extracted before April 11, 2020. Results: As of April 13, 2020, the ASEAN countries reported 19 547 COVID-19 positive cases with 817 deaths (case-facility rate of 4.2%). Thailand was the first country in the region that reported having the COVID-19 cases, while Laos was the last to report confirmed COVID-19 cases. Durations for the number of deaths to double were between 8-12 days. For the testing and treatment capacities, the number of PCR tests provided to the populations was the highest in Vietnam, followed by Singapore, Malaysia, and Thailand. Meanwhile, the percentage of the population being tested was the highest in Brunei (2.31%), followed by Singapore (1.30%). Conclusions: A wide range of interventions were taken into practice in response to the outbreak with an effort of curbing the rise of this pandemic. However, special care should not be overlooked as the pandemic is placing a huge impact on the population and becomes increasingly unpredictable. To tackle the spread of the pandemic in the region, the ASEAN countries should work together as one community to provide better responses to future pandemics and other transboundary public health challenges.

Investigation of the estrogenic activity of Pueraria candollei variety mirifica extract on rats

Background: Pueraria candollei variety mirifica (PM) has been widely used as ingredient in many rejuvenating products. In this study, we aimed to assess the estrogenic activity of PM extract grown in Vietnam.Methods: Estrogenic activity of PM extract was estimated on immature female rats by using uterotrophic method to measure the weight of the reproductive organs. Estrogenic activity of PM extract also was investigated in mature female ovariectomized rats by evaluating the vaginal cells growth, reproductive organs weight, serum estradiol concentration.Results: Our results showed that PM extract at doses of 100 mg/kg, 200 mg/kg had increased the reproductive organs weight in immature rats and female ovariectomized rats. In addition, PM extract had increased the serum estradiol concentration and the vaginal cells growth by increasing the percentage of keratinocytes in female ovariectomized rats.Conclusions: Our results showed that PM extract has strong estrogenic activity in rats.

Study Design for the 2016 Baseline Survey of a Health System Strengthening Project in Quoc Oai District, Hanoi, Vietnam

BACKGROUND: In order to provide essential scientific evidence on the population's health status and social health determinants as well as the current capacity of the health care system in Vietnam to health policy makers and managers, Vietnam Ministry of Health, Hanoi University of Public Health, Hanoi Medical University, and Ho Chi Minh University of Medicine and Pharmacy collaborated with Seoul National University (Korea) and conducted a health system survey in the Quoc Oai district (of Hanoi capital) that represented northern rural Vietnam. METHODS: The study design was a cross-sectional study. The survey covered different topics (more than 200 questions) and was administered in three separate questionnaires: 1) Basic information of all household members; 2) Household characteristics; and 3) Individual characteristics. Socio-demographic characteristics among the households and individuals were collected from 2,400 households sampled by multi-stage cluster sampling method: more than 200 questions. RESULTS: The household size of Quoc Oai was larger than the national average and there was no significant difference in gender composition. In addition, the proportions of pre-elderly, age 55–64, and elderly group (65 years old and over) were higher than the national population statistics. In this context, demographic transition has begun in Quoc Oai. CONCLUSION: This study design description provides the basic information about a baseline survey of a future prospective cohort (as a part of a collaborative project on strengthening the health system in Vietnam) to the prospective data user of this survey.

Thinning and drilling laser-assisted hatching in thawed embryo transfer: A randomized controlled trial / 대한생식의학회지

OBJECTIVE: In frozen and thawed embryos, the zona pellucida (ZP) can be damaged due to hardening. Laser-assisted hatching (LAH) of embryos can increase the pregnancy rate. This study compared thinning and drilling of the ZP before frozen embryo transfer (FET). METHODS: Patients were randomly allocated into two groups for LAH using thinning or drilling on day 2 after thawing. Twenty-five percent of the ZP circumference and 50% of the ZP thickness was removed in the thinning group, and a hole 40 µm in diameter was made in the drilling group. RESULTS: A total of 171 in vitro fertilization/intracytoplasmic sperm injection FET cycles, including 85 cycles with drilling LAH and 86 cycles with thinning LAH, were carried out. The thinning group had a similar β-human chorionic gonadotropin-positive rate (38.4% vs. 29.4%), implantation rate (16.5% vs. 14.4%), clinical pregnancy rate (36.0% vs. 25.9%), miscarriage rate (5.8% vs. 2.4%), ongoing pregnancy rate (30.2% vs. 23.5%), and multiple pregnancy rate (7.0% vs. 10.6%) to the drilling LAH group. There were no significant differences in pregnancy outcomes between subgroups defined based on age (older or younger than 35 years) or ZP thickness (greater or less than 17 µm) according to the LAH method. CONCLUSION: The present study demonstrated that partial ZP thinning or drilling resulted in similar outcomes in implantation and pregnancy rates using thawed embryos, irrespective of women's age or ZP thickness.

Metabolic Syndrome and Insulin Resistance Syndrome among Infertile Women with Polycystic Ovary Syndrome: A Cross-Sectional Study from Central Vietnam

BACKGROUND: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS. METHODS: A cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression. RESULTS: The overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-Müllerian hormone levels increased the risk of IRS, but not that of MS. CONCLUSION: MS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.

Downregulation of kinesin spindle protein inhibits proliferation,induces apoptosis and increases chemosensitivity in hepatocellular carcinoma cells

Kinesin spindle protein [KSP] plays a critical role in mitosis. Inhibition of KSP function leads to cell cycle arrest at mitosis and ultimately to cell death. The aim of this study was to suppress KSP expression by specific small-interfering RNA [siRNA] in Hep3B cells and evaluate its anti-tumor activity.Three siRNA targeting KSP [KSP-siRNA 1-3] and one mismatched-siRNA [Cont-siRNA] were transfected into cells. Subsequently KSP mRNA and protein levels, cell proliferation, and apoptosis were examined in both Hep3B cells and THLE-3 cells. In addition, the chemosensitivity of KSP-siRNA-treated Hep3B cells with doxorubicin was also investigated using cell proliferation and clonogenic survival assays.The expression of endogenous KSP at both mRNA and protein levels in Hep3B cells was higher than in THLE-3 cells. In Hep3B cells, KSP-siRNA 2 showed a further downregulation of KSP as compared to KSP-siRNA 1 or KSP-siRNA 3. It also exhibited greater suppression of cell proliferation and induction of apoptosis than KSP-siRNA 1 or KSP-siRNA 3. This could be explained by the significant downregulation of cyclin D1, Bcl-2, and survivin. In contrast, KSP-siRNAs had no or lower effects on KSP expression, cell proliferation and apoptosis in THLE-3 cells. We also noticed that KSP-siRNA transfection could increase chemosensitivity to doxorubicin in Hep3B cells, even at low doses compared to control. Reducing the expression level of KSP, combined with drug treatment, yields promising results for eradicating hepatocellular carcinoma [HCC] cells in vitro. This study opens a new direction for liver cancer treatment.

FDG-avid portal vein tumor thrombosis from hepatocellular carcinoma in contrast-enhanced FDG PET/CT

Objective[s]: in this study, we aimed to describe the characteristics of portal vein tumor thrombosis [PVTT], complicating hepatocellular carcinoma [HCC] in contrast-enhanced FDG PET/CT scan

Methods: in this retrospective study, 9 HCC patients with FDG-avid PVTT were diagnosed by contrast-enhanced fluorodeoxyglucose positron emission tomography/computed tomography [FDG PET/CT], which is a combination of dynamic liver CT scan, multiphase imaging, and whole-body PET scan. PET and CT DICOM images of patients were imported into the PET/CT imaging system for the re-analysis of contrast enhancement and FDG uptake in thrombus, the diameter of the involved portal vein, and characteristics of liver tumors and metastasis

Results: two patients with previously untreated HCC and 7 cases with previously treated HCC had FDG-avid PVTT in contrast-enhanced FDG PET/CT scan. During the arterial phase of CT scan, portal vein thrombus showed contrast enhancement in 8 out of 9 patients [88.9%]. PET scan showed an increased linear FDG uptake along the thrombosed portal vein in all patients. The mean greatest diameter of thrombosed portal veins was 1.8 +/- 0.2 cm, which was significantly greater than that observed in normal portal veins [P<0.001]. FDG uptake level in portal vein thrombus was significantly higher than that of blood pool in the reference normal portal vein [P=0.001]. PVTT was caused by the direct extension of liver tumors. All patients had visible FDG-avid liver tumors in contrast-enhanced images. Five out of 9 patients [55.6%] had no extrahepatic metastasis, 3 cases [33.3%] had metastasis of regional lymph nodes, and 1 case [11.1%] presented with distant metastasis. The median estimated survival time of patients was 5 months

Conclusion: the intraluminal filling defect consistent with thrombous within the portal vein, expansion of the involved portal vein, contrast enhancement, and linear increased FDG uptake of the thrombus extended from liver tumor are findings of FDG-avid PVTT from HCC in contrast-enhanced FDG PET/CT

In vitro culture of petiole longitudinal thin cell layer explants of vietnamese ginseng (PANAX VIETNAMENSIS HA ET GRUSHV.) and preliminary analysis of saponin content.

The present work describes a procedure that allows for the easy and rapid induction of somatic embryos, calli, shoots and adventitious roots of Vietnamese ginseng (Panax vietnamensis Ha et Grushv.) from longitudinal thin cell layers (lTCLs). In order to investigate the morphogenesis of this medicinal plant, the effect of separately–supplemented plant growth regulators and combinatorial effect of co–supplemented auxins and cytokinins in dark or under 16-hour photoperiod was examined. After eight weeks of culture, the lTCL explants excised from petiole of three-month-old in vitro plants and cultured on a semi solid basal Murashige and Skoog (MS) media supplemented with 1.0 mg/l 2,4-dichlorophenoxyacetic acid (2,4-D) and 0.1 mg/l thidiazuron (TDZ) in dark, 2.0 mg/l α-napththaleneacetic acid (NAA) in dark and 1.0 mg/l 2,4-D under light gave the highest rate of callogenesis (100%), embryogenesis (53.3%) and adventitious root formation (100% with a mean of 16.7 roots), and shoot formation (26.7%), respectively. The metabolite of petiole lTCL-derived calli qualitative and quantitative analyses were performed by using high-performance liquid chromatography and thin layer chromatography. The simple procedure, together with similar saponin profiles between the resulted in vitro tissues and plants grown in nature, suggest its potential use in generating Vietnamese ginseng in large amount for medicinal purpose.

A preliminary research on the effect of Phunamine on some athlete\u2019s standards

Background: To improve the physical fitness of athletes is one of the essential requirements of the Vietnam Sports associations. Research to discover the functional foods to improve the physical fitness of athletes in general, in particular athletic athletes is an interest to scientists. Objective: Evaluation of effect of Phunamine on some of the male, female athlete\u2019s biomedicine and physical fitness standards. Subject and methods: A controlled, double-blind, randomized, clinical experiment was conducted on 30 athletes of the Hanoi Athletic Group. They were then divided into 2 groups: research group: 20 athletes (10 men, 10 women) were administered with 4 phunamine pills per day; control group: 10 athletes (5 men, 5 women) were each administered with 4 placebo pills per day. The 2 groups had tests performed and followed up 30 days pre and post administration. Results: Max-min blood pressure change between the two groups was not significant (t(\u03b1)>0.5). Testosterone concentration change and physical fitness test (run 100m, 400m) of Phunamine dosed group were higher than the placebo group (t(\u03b1)<0.5). Conclusion: Phunamine has the effects of increasing testosterone concentration and improving physical fitness of athletes however the drug has no effect on blood pressure index of athletic athletes.

A preliminary research on the effect of Phunamine on some weight-lifter's biochemical standards

Background: The fitness of athletes is always the top priority of each coach. Therefore, studying to discover the products that are really effective and appropriate for each sport is an urgent matter. Previous research showed biochemical standard is one of the important standards to assess the fitness of athletes. \r\n', u'Objectives: To study the effects of Phunamine on various biochemical standards of male and female weight-lifters. \r\n', u'Method: The self-control clinical experiment was applied in 19 weight-lifters at the Sport University 1 (TuSon) from May to July 2006. The research material was the functional food Phunamine with major component being anchovy combined with Syngnathiformes powder. Results: Testosterone concentration after taking Phunamine was higher than before the research (t(alpha)<0.025 in males; <0.01 in females); activity of LDH enzyme after taking Phunamine was higher than before the research, but the significant difference was only found in female with t(alpha)<0.025; cortisol concentration was also higher than before the research. \r\n', u'Conclusions: Phunamine has the effect of increasing testosterone, cortisol concentration and LDH enzyme activity.\r\n', u'

Study on survival time of microorganisms in fecal material in urine-diverting eco-san toilets

Salmonella typhimurium phage 28B and Ascaris suum ova were used as indicators to evaluate the ability of pathogen destruction of 6 types of dry toilets and the retention time of fecal material processing vault needing for health safety. The results showed that: among three factors: pH, temperature, moisture, pH was the most significantly influenced on the survival time of indicators. When pH>10, Salmonella phages and Ascaris ova were destroyed very fast. These pH values could be reached if after defecation 300mL of wood-ash was added. At least 6 months of retention for fecal materials inside dry toilets are needed

Situation of water supply and environment hygiene in the world

In 2000, there were about 755 millions people lack fresh water, of which 51% lived in the municipal regions of developing countries. In 2020, it will cover the fresh water for people who live in the municipal regions of latrine America and Caribe. 86% of rural people in Africa has not fresh water. There were about 3.3 billions people have been using the unhygienic toilet of which 74% live in the countryside

Double compartment latrine - advantage or disadvantage

The double compartment latrine in Vietnam was designed based on 3 scientific hygienic principles including to seperation, drying and reuse. The advantages of technique were to protect the water resource from contamination, kill the germs and generate the valuable pertilizers resources. It is really a technique of the ecological maintenance. It will be improved more and more.

School-health in the world - situation and trend:

The health related problems can be reduced through the school health programs such as HIV/AIDS, accident and trauma, reproductive health, helminthic diseases, nutrition, drinking water supply and environment, immunization, alcohol drinking, smoking, drug addiction, orodental health. The WHO planned the activities for school health program. The children health has been improving but the young generation must respond to new risks and challenges. In 2000, there were about 26 millions of people with HIV infection with 2 millions deaths due to AIDS, and 3 millions of deaths due to the smoking, the drug resistance microbial are increasingly.

Clinical trial of “hoa long” pill on patients with herpes

The clinical trial of Hoa Long pills was performed in 46 patients with Herpes simplex type I and II. The result showed that: The drug shortened the therapeutic duration and decreased the recrudescence in comparison with control lot. The drug recovered the state of decreased immunity, especially immunoglobulins, leukocytes, lymphocytes, CD5+ and CD72+.

School health services in Hai Phong

In order to making plan and conducting medical mission in Hai Phong, we investigated the actual state of health services at 20 schools in Hai Phong. Basing on obtained materials, we have following results: Medical professional is functioning in 55% of surveyed schools, but most of them have not good qualification. In 86.5% of classrooms, there is good natural light, but nowhere have got standardized school furniture.