Large renal arteriovenous fistula treated by embolization: a case report.

Renal arteriovenous fistula (RAVF) is an uncommon vascular malformation of the kidney, which can be congenital, acquired or idiopathic. Although most patients are asymptomatic, RAVF can lead to hypertension, heart failure, renal insufficiency, hematuria, and progressive increase in size of renal vessels. Diagnosis is aided by radiological studies, with digital subtraction angiography as a gold standard. Besides, ultrasound with color Doppler and computed tomography angiography are noninvasive imaging techniques and can be useful for planning the treatment. A large fistula are generally treated by nephrectomy. Intervention can ameliorate the hemodynamic effects of high flow and to preserve the renal parenchymal function. Although endovascular therapy may be challenging due to the large size and high flow of fistula, this report describes a case of huge RAVF was successfully treated by embolization instead of surgery.

Routine Medical Check-Up and Self-Treatment Practices among Community-Dwelling Living in a Mountainous Area of Northern Vietnam.

This study was conducted to evaluate the routine medical check-up and self-treatment behaviors of people living in a remote and mountainous setting in Northern Vietnam and identify their associations. A cross-sectional study was conducted on 175 people in August 2018 in Cao Son commune, Da Bac district, Hoa Binh. Information regarding routine medical check-ups and self-treatment behaviors was collected by using a structured questionnaire. Multivariate logistic regression was used to examine the associations. Results show that 24% of the mountainous people had routine medical check-ups in the last 12 months. The rate of self-treatment in the past three months was 33.7%. The number of chronic diseases (OR = 1.5, 95% CI = 1.0-2.3), health information sources from radio/television (OR = 3.3, 95% CI = 1.2-9.5), or social media (OR = 24.8, 95% CI = 1.2-512.4) was related to routine medical check-up. People who did not have routine medical check-up were more likely to have self-treatment practice (OR = 6.3, 95% CI = 1.9-21.1) than those who had a regular health check. Promoting health education and communication through mass media to raise people's awareness about regular health check-ups is a promising way to improve people's self-treatment status.

[Tetanus in Ho Chi Minh City, Vietnam: epidemiological, clinical and outcome features of 389 cases at the Hospital for Tropical Diseases]. / Le tétanos à Hô-Chi-Minh-Ville, Vietnam : épidémiologie, clinique et pronostic, à propos de 389 cas à l'Hôpital des maladies tropicales.

The objective of this study is to describe the different aspects of tetanus during the past recent years in southern Vietnam: epidemiology, clinical picture, management, and death risk factors. It is a retrospective study concerning 389 cases admitted in 2007 and 2008 at the reference Hospital for Tropical Diseases in Ho Chi Minh City. 93% of all cases were generalized tetanus, and 50% were severe cases. A majority of patients were adult males (medium age 43, M/ F sex-ratio 2.9). Half of them underwent tracheotomy and 39% assisted ventilation. Case fatality rate was 6.4%, the lowest reported rate worldwide in the last ten years. Fatalities resulted mainly from neuro-vegetative disorders, essentially cardiogenic shock (28% of all deaths) [OR = 16.95; p < 0.001], sepsis (24%) [OR = 3.25; (p < 0,114], and acute renal failure (16%) [OR = 7,22; p < 0.004]. Age over 60-year [OR = 4.53; p < 0.0001] and a leukocyte count>12.000/mm(3) [OR = 2.32; p < 0.020] were significantly associated with fatal outcome, contrarily to incubation and extension phase durations, or delayed serum administration. Systematic extension of vaccination to all adult males, and improved access to post exposure sero-immunization at all levels of health centres throughout the country may further reduce tetanus burden in Vietnam.

Risk factors for delayed HIV diagnosis at the Hospital of Tropical Diseases in Ho Chi Minh City, Vietnam.

The objective was to identify factors associated with delayed diagnosis of HIV infection in Vietnam, defined as having a CD4 cell count of <200/mm(3) at the time of the first positive test. Data were collected retrospectively from the medical records of HIV-infected outpatients who received their initial care at the Hospital for Tropical Diseases in Ho Chi Minh City between July 2004 and August 2005. Among the 204 included patients, 58.3% had a delayed diagnosis. Independent factors associated with a delayed diagnosis were male gender (adjusted odds ratio [AOR] = 2.10; 95% confidence interval [CI] = 1.03-4.41) and having an opportunistic infection at the time of the first positive HIV test (AOR = 3.07; 95% CI = 1.71-5.53). Counselling for early HIV screening is important in populations at risk of infection. Facilitating access to care should be reinforced for symptomatic patients.

East Asia Review, 1973. 10. Vietnam (South).

PIP: In March 1973, the prime minister officially recognized the population problem and sent a request to the United Nations' Secretary General to add Vietnam to the list of signers of the U.N. Declaration on Population. A National Council on Population was created and a Permanent Secretariat was name to coordinate activities of the 6 committees concerned with population. A bill favorable to family planning is expected to pass Congress in 1974. Another bill was signed which limited the family allowance for military families to no more than 4 children. It was assumed that in 1973, the crude birth rate was 42 per 1000, the crude death rate was 12 per 1000, and the growth rate remained unchanged at 3%. Family planning activities in Vietnam are very restricted. No publicity is allowed, and there is a limited staff of health personnel. The number of new acceptors of contraceptive methods in the national program was approximately 23,700. This was a 100% increase over the previous year. Private organizations and practitioners contributed perhaps 10,000 additional new acceptors. The obsolete law of 1920 prohibiting dissemination of contraceptive materials has not been repealed. Training in Vietnam at the present time is still confined almost exclusively to family planning techniques, and there is a need to train more people in demographic research methods. The Minstry of Health completed a morbidity survey and a health service survey in An-Giang province and is currently conducting a fertility and KAP sample survey, an acceptor record and follow-up program, and a health manpower study. The government has set a target of reducing the natural increase rate from approximately 3% in 1973 to around 2% in 1980. In order to do this, the 1920 law must be repealed and new favorable legislation enacted, the National Council on Population will have to be effective, family planning clinics will be established, training programs will be instituted, steps must be taken in the area of information, education, and communication, and efforts must be made to provide adequate data for evaluation and research.^ieng