Monthly Archives: Tháng Năm 2019

Measures hormonal contraceptives: patch, vaginal ring, injection, rod implantable contraceptive

Hormonal contraceptives are methods of using hormones to regulate the process of ovulation. Method hormonal contraceptives are favored as put the ring, the patch, injection or que use implantation contraceptive.

1. Contraceptive hormonal what is ?

Hormonal methods use hormones to regulate or prevent ovulation, thus helping to prevent pregnancy. Contraceptives, including measures as diverse as: the pill, put the ring, the patch, injection or use the rod implant contraceptive.

The method hormonal contraceptives work by releasing the hormones estrogen and progestin into a woman’s body to prevent ovulation. In addition, we also can make mucus in the cervix to thicken, making it difficult for the contact of the eggs with sperm or do thin layer of the endometrium, causing the fertilized egg difficult to cling to the endothelium. Measures hormonal contraceptives do not help prevent the disease spread through sex, including HIV. Therefore, men should still use condoms to avoid the risk of this disease.

2. The methods of hormonal contraceptives

The patch

Is a little sticker, size about thin about 4,5cm2, which is glued directly to the skin of the buttocks, abdomen, upper back or biceps. Patch is capable of releasing estrogen and progestin into the bloodstream to prevent ovulation. The stickers are used in cycles of 4 weeks or 28 days. News is in a period of 3 weeks, just a week you have to change the patch once. To the fourth week do not use stickers and menstruation will occur. After week 4, paste the patch new and repeat the same process earlier. Note do not remove the stickers while the day to day activities, such as bathing, swimming, exercise, sports.


  • Can help to improve acne condition and reduce the phenomenon of menstrual migraine.
  • High efficiency, easy to use
  • Support can help mitigate the symptoms for pre-menopausal women


  • Can lead to a number of risks rare after: cause blood clots in the legs, myocardial infarction, and stroke, gall stones and liver tumors. This risk is higher in some cases, such as women over age 35 who are smokers. Therefore, you should consult your doctor about the risks that can be encountered before performing
  • May cause nausea, headache, itching skin.


Iud is a small device (often shaped T-shaped) is placed into the uterus and for the contraceptive effect lasts many years. Now there are many types of iud such as Multiload, Tcu 380A, Mirena, in which the most modern is the ring that contains endocrine, progestin (Mirena). Once placed, progestin will be released gradually and create effective contraceptive, lasting


  • The rate of contraception is high, about 95 – 97%, and the contraceptive effect lasts, can to 5 years
  • After removing the can pregnant be right back
  • Can reduce pain during the menstrual cycle, improve acne condition
  • User is for people who have contraindications to estrogen.


  • Can affect clotting mechanism, blood pressure, metabolism, liver tumors, gallstones, but quite rare
  • There may be rong blood for several cycles after the set round.
  • There may be symptoms such as weight gain, headache, back pain, relief from the pain, uterine contractions
  • Out gas nowhere in the first time due to the reaction of the endometrium and can be inflammation, itching pussy.

Rod implantable contraceptive

Rod implant contraceptive is a bar menu is small in size approximately with a matchstick. Doctor will surgery to put this rod down under the patient’s skin, usually the skin arm.


  • Que implantation contraceptive effect of preventing pregnancy lasting about 3 years. In the case of unwanted pregnancy, just take the rod implant out of the body is can immediately normal pregnancy.
  • Rod implantable contraceptive that can be used both for women who are breastfeeding.


  • One risk can occur when taking que implantation to avoid pregnancy is ectopic pregnancy.
  • In addition, you can encounter a number of other risks such as weight gain, depression, acne, vaginal bleeding irregularities, headache,…

Injectable contraceptives

The doctor will inject a injections contain progestin is medroxyprogesterone acetate (DMPA). A injections have a contraceptive effect for about 3 months. Injected contraceptives must be taken every 3 months at a time. The first injection is usually done within the first 5 days of the menstrual cycle.


Method injectable contraceptives can reduce the risk of cancer of the endometrium, decreases migraines into menstrual period and may also apply for women who are breastfeeding.


  • Injectable contraceptives can increase the risk of cardiovascular diseases. Therefore the subjects are at high risk as a history of stroke, high blood pressure should consider when you want to perform this method.
  • After stopping the injectable hormone contraceptive, it takes about 10 months even longer can get pregnant again.
  • Many cases of osteoporosis when using injectable hormones. This phenomenon may disappear when to stop injection.
  • Injectable contraceptives can also lead to some side effects such as vaginal bleeding, weight gain, headaches, dizziness, fatigue,…


    Pulmonary tuberculosis are contagious?

    From the lungs, bacteria can through the blood, lymph to the organs in the body (lymph nodes, bone, liver, kidney,…) and cause disease in the body that of the body.

    1. Pulmonary tuberculosis are contagious?

    Pathogens cause disease mainly due to infections from an infected person through the respiratory activity such as sneezing, coughing, spitting… This is the easiest way and the most common cause of pulmonary tuberculosis infection from one person to another.

    When the body has to the poor, just inhalation or contact with tuberculosis bacteria is has a high risk of disease. The amount of tb bacteria from a sick person emit air may be transmitted to the 10 – 15 other people.

    The doctor said a number of factors create favorable conditions for pulmonary tuberculosis easily infect more than as malnutrition, chronic diseases, tobacco addiction, alcoholism, use of drugs not prescribed, diagnosed with HIV… These people when in contact with the patient or meet the elements, infectious bacteria will be easy to tuberculosis.

    2. Pulmonary tuberculosis is spread by the way?

    Bacteria tuberculosis will be transmitted through the path basically follows:

    2.1 pulmonary tuberculosis spread through respiratory

    Inhalation is the fastest route, nearest to spread pulmonary tuberculosis from an infected person to others. Through chat, contact with sick people cough, spit, sneeze, blow nose… pulmonary tuberculosis can easily infect. The bacteria tuberculosis released to the environment enters the body and very fast development, the formation of the disease in others.

    2.2 pulmonary tuberculosis spread by rubbing

    Ordinary people absolutely can be spread tuberculosis through the scratch, scratch, the wound when rubbed with sick people. Therefore need to avoid contact with sick people when the sick person is the wound caused by rubbing.

    2.3 Advocacy tuberculosis spread by activities

    Common with pulmonary tuberculosis also have a high risk of disease. Use of common towels, shared bowls, chopsticks … is the route of infection of pulmonary tuberculosis from an infected person to normal person. When living with the disease tuberculosis, the patients need to go to the clinic soon to detect as well as early treatment if infected.

    2.4 pulmonary tuberculosis is spread from mother to child

    Pulmonary tuberculosis is spread from mother to child. However not 100% of cases children are infected with tuberculosis from her mother. When my mom disease should be monitored and made the doctor’s appointment to minimize the risk of infection with tuberculosis from mother to child.

    2.5 Diseases tuberculosis sexually transmitted

    In sex when two people perform French kiss, exchange saliva, it is easy to infect with tuberculosis for the rest.

    3. Measures for prevention of spread of tuberculosis

    • Boost health, clean and airy, good living environment
    • The sick person should wear a mask when coughing, sneezing should cover your mouth, spitting phlegm into place regulations and sputum or the source of infection must be destroyed right method.
    • Advantage of the sun as much as possible for where in and the widgets of the disease.
    • Create the conditions for good ventilation so that the air is circulated to reduce the lowest concentration of particles containing tuberculosis bacteria in the air.

    Pulmonary tuberculosis can completely spread across the road awfully simple, every person need to know how to prevent as well as treat properly.


      Treatment and rehabilitation in children with cerebral palsy may be hard

      Cerebral palsy can spastic accounted for about 70 – 90% of the total number of people with cerebral palsy, visible manifestations in this group is the muscle spasticity, difficulty when moving. Some extreme cases can cause paralysis of the extremities, in which the human torso and four limbs are paralyzed, at the same time the body controls mouth and tongue is also paralyzed.

      1. Cerebral palsy can it be fixed?

      Cerebral palsy does not mean that the entire brain hurt without the brain only hurt a part and mainly the part of the brain hurt is the part of the brain controls language and movement. Although the brain injury is not likely to recover completely but also does not progress to deteriorate.

      The issue of cerebral palsy to be spastic causing as gestures, posture and other related matters to cerebral palsy can be better improve or deteriorate depending on whether we choose the method of treatment.

      2. Cerebral palsy treatment how?

      Treatment cerebral palsy is an issue many parents are concerned and wondering which method is effective. Currently, there are many treatments for cerebral palsy, such as acupuncture, reflexology, diagnostic interface, high-pressure oxygen, stem cell transplant , or rehabilitation… However, to date, science on the world shows that rehabilitation is the method good and effective good improvement for children with cerebral palsy.

      Treatment of cerebral palsy is not treated in 1 – 2 months without treatment cerebral palsy need to combine many different methods. Treatment of cerebral palsy need to coordinate between the family and treatment doctor, combination of physical therapy and recovery of motor function for children with developmental delay of motor, speech and language therapist for children who have speech delay or have difficulty with phonics; air conditioning feeling for children who have sensory disorders; training personal skills for children with cerebral palsy to adapt to defects of themselves and improve self-service capabilities of their own.

      2.1. Physical therapy

      This method of rehabilitation is performed immediately after the diagnosis of cerebral palsy to be spasticin order to increase motor skills of the child such as sitting, walking, improve muscle force and prevent contractures deformation body. Can use tools such as cornices, gutters, or powder to prevent shrinkage muscles and improve the function of feet, hands.

      Besides, the application of physical therapy rehabilitation also helps to overcome the active suppression unusual in pediatric patients with cerebral palsy. In the process of rehabilitation should pay attention are symmetrical between the two sides because this is the foundation guarantee for the balance of the body as well as the perception of the child.

      For the treatment of cerebral palsy to be spastic by the method of physical therapy is considered the treatment support safe and most effective. When it detects children with cerebral palsy to be spastic , it should physical therapy for the child as soon as possible because it will avoid the deformation retraction muscles and joints at the same time help the child to skills development motor through which the guide wire is vibrated and perception gradually appears, help the child to overcome the situation in a better way.

      2.2. Orthopaedic surgery

      This is the method to do the sick in case of bad cramping too heavy. For the child has the condition cerebral palsy can spastic both lower limbs heavy, need surgery to remove selectively a number of branching nerves in the back govern the operation cost can do permanent reduction of spasticity as well as improved motor skills such as sitting, standing, walking. This surgery is usually conducted when the child is 2 – 6 years of age.

      2.3. Treatment of cerebral palsy with stem cells

      Stem cells are extracted then pumped back into the blood and the spinal cord By the circulation of cerebrospinal fluid, the stem cells are turning up the brain and reside there. It helps blood vessels, extract a number of substances have anti-inflammatory and stimulates the neural stem cells in situ differentiation, proliferation. At the same time themselves stem cells, this can differentiate into glial cells help nerve conduction better.

      In other words, stem cells are used to replace cell damage, grow new brain cells and activates the cells are damaged (but not dead). After that, patients continue to be technician guide rehabilitation exercises at the hospital and at home.

      Methods of treating cerebral palsy with stem cells safe for most patients. The disease as early treatment results get been satisfactory. There are only a few cases of mild fever and pain, but when drugs are in control are the side effects of this.

      And according to statistics many studies in the world showed that, application of stem cells to treat cerebral palsy likelihood of success by 60-70%, improve the most obvious is motor abilities (adaptation, integration with the community), then the language ability and awareness.

      2.4. Education

      In addition to set out, need extra attention, communication, spirit of children with cerebral palsy for children to develop communication skills, social. For older children, need to learn how to independent activities of daily living (e.g. personal hygiene). Avoid to young depends entirely on relatives, if the child can do.

      Treatment of cerebral palsy besides the technical elements of medicine also requires long-term perseverance, the coordination of many specialized industry paediatrics, psychology, linguistics… and most importantly parents, who themselves have to persevere, help the child.

      Hospital international Vinmec Times City have applied methods stem cells successfully treated many cases of cerebral palsy has seemed all hope. The entire process of separating the stem cell transplantation treat cerebral palsy at Vinmec is done very closely, ensure safety according to international standards. The surgeries are run by experts, leading doctors in charge of the same system, machinery, medical equipment modern.

      In addition, Vinmec also construction process, pairing standard to be able to share the experience with colleagues, create more opportunities to receive treatment for children with cerebral palsy across the country.

      Customers can directly to Vinmec Times City to visit or contact hotline 0243 9743 556 to be supported.

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        Que contraceptives are often implanted in the skin how?

        Que contraception is the pipe plastic containing contraceptives, usually implanted under the skin of the hands without agreement of the woman. You will not have to use any contraceptive methods any other in time que use implantation contraceptive.

        1. Que contraceptive is implanted in the skin how?

        Rod implantable contraceptive available size the size of a matchstick, which is implanted in the skin under the arms of women, usually arm is not convenient to avoid advocacy, many moves after performing the implantation.

        This method uses 1 or more small stick containing the hormone Progesterone implanted in the skin under the arm. This Hormone goes into the body and the release fast or slow this hormone will decide to implant rods in, how long it will have effect.

        Depending on the number of rods of contraception and type of rod is implanted that time promoting effects can range from 3-7 years.

        2. After the implant rod contraception, then how long have effect?

        If done implant rod contraception in the first 5 days of the menstrual cycle, que implanted contraceptives will take effect immediately after 24 hours. The effect will be slower than if the rod contraceptive is implanted at another point in the menstrual cycle.

        Besides, if you perform implant rods at the base medical reputation and due to the expert doctor good make, que contraception to ensure quality, it will exert fast effects.

        If done implant rod contraception in the address is not reliable, que contraceptives of poor quality not only exert slow but also have side effects in addition to desire.

        Most dangerous is the transplant que infection, que transplanting move to another location. When there are needs you can’t remove the rods out

        3. Advantages and disadvantages of the method of implant rod contraception

        Que contraception contraception is safe and effective, however, this method also inevitably limitations exist:


        • Que implanted contraceptives less affect the health
        • The amount of hormone in que contraception just enough to exert a contraceptive effect
        • Does not affect sex life
        • This method bring about effective contraception is high ( over 90%)
        • Consistent with the vast majority of sisters
        • Implant rod contraception safety and convenience
        • Women who are breastfeeding can use this method
        • Time to pregnancy back short


        • Que contraceptives cause a few side effects like headache, dizziness, hormonal changes..
        • Some objects are menorrhagia or can amenorrhea temporary…

        To exert the advantages and limit the disadvantages of the measure implant rod contraception, sisters, need to actively learn and choose the address implant rod contraception reputable and reliable.

        Need to comply with the instructions of the therapist in the process of implantation rods. Strictly follow the instructions of the doctor and need to remove the rod to avoid pregnancy out when the time is used.

        Any method of contraception has its advantages and disadvantages so depending on the object to choose the right method. To choose the method of contraception after birth best suited, you should find out consider about the health situation, conditions, circumstances.

        When you see manifestations of the side effects are prolonged, unusual and appearance of other signs, need, visit, monitor and be consulted promptly at the medical facility reputation and the good doctor expertise avoid to long cause these complications affect health.

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          Prenatal Genetic Screening Tests

          Antenatal screening tests are usually indicated for pregnant women to determine if the fetus is at risk of birth defects. So what is prenatal DNA screening and how is it done?

          1. Antenatal screening

          Performing prenatal testing is useful in identifying different options for pregnancy or special pregnancy management and childbirth to improve the baby's outlook.

          Pregnant women, regardless of age, have the option to perform prenatal screening tests . However, the older the mother, the greater the risk that the baby will have chromosomal abnormalities. Therefore, mother's age is the most common cause of prenatal testing.

          Reasons for the appointment of prenatal testing include

          • The previous family or child history had a genetic problem
          • Parents already know that they carry specific genes
          • Ultrasound results show abnormal results
          • Screening results show that pregnancy is in the high risk group

          Visit and consult with specialist doctors to determine which tests are available and when the test is appropriate.

          2. Prenatal screening tests

          First, we will learn what genetic disorders are and the effects of these disorders

          2.1. What is genetic disorder?

          Genetic disorders occur when a person's chromosome (chromosome pathology) gene or gene (single-gene pathology) is altered. Chromosomal pathology consists of two main forms, the disorder of the number and structure of the chromosome.

          An deviation mutation is a condition of excess or lack of chromosomes. Trisomy is when there is an excess of a chromosome (eg, Down syndrome or trisomy 21: 47, XX / XY, + 21), even if there is a missing chromosome (eg syndrome Turner or monosomy X: 45, X). In addition, genetic disorders due to genetic abnormalities such as sickle cell anemia, cystic fibrosis, Tay-Sachs disease and many other diseases.

          2.2. Two main types of genetic testing before birth

          There are two types of prenatal testing for major genetic disorders, including:

          • Prenatal screening test: These tests will tell you the risk of having a baby with some genetic syndromes: including trisomy 13, 18, 21 and some other genetic syndromes
          • Prenatal diagnostic tests : These tests can diagnose any fetus with genetic syndrome with an accuracy of up to 99.8%. These tests are performed on cells taken from the fetus through amniotic fluid or placental biopsy samples (CVS).

          All pregnant women should be assigned to perform prenatal screening tests. The diagnostic test for birth should be consulted by a Specialist and indicated in case of necessity.

          2.3. What tests are prenatal genetic tests included?

          Screening tests tell you about your baby's risk of certain disorders. These include carrying tests and prenatal genetic screening tests:

          • Carrying tests are performed on parents (or people who are planning to be parents), using blood samples or scanned tissue samples on the inside of the cheeks. These tests are to determine if a person with a copy of the mutated gene can cause genetic disorders. Carrying tests can be performed before or during pregnancy.
          • Prenatal genetic screening tests on blood samples from pregnant women and recorded from ultrasound can check for fetal deviation mutations, brain and spinal malformations, or neural tube defects and some abnormalities. Other disabilities of the abdomen, heart and facial organs. These tests are usually performed in the first 3 months of screening - the middle 3 months and in very few cases in the last 3 months. In addition, a new test for non-invasive screening is a test of extracellular free DNA.

          Ultrasound helps screen 60-70% of major morphological and structural defects of the fetus, for example, the morning after nape, brain, spinal anomalies, cardiovascular system and other defects. Serum biochemical screening helps screen the risk of trisomy 13, 18, 21 and neural tube defects.

          Each stage of pregnancy has its own characteristics and needs specific tests, the following section analyzes the mechanisms and effects of tests from time to time.

          2.4. Screening for birth defects in the first 3 months?

          Screening of the first 3 months of fetal malformations includes pregnancy blood tests and screening ultrasound. Both tests are performed at the same time and at intervals of 10-13 weeks of pregnancy.

          Double test tests determine the concentration of 2 substances in the mother's blood released by the fetus

          • PAPP-A (PAA): A type of glycoprotein produced from the placenta
          • Free β-hCG (FBC): An ingredient in the structure of hCG (human chorionic gonadotropin).

          Screened ultrasound, also called ultrasound skin, measures the thickness of the posterior area of ​​the fetus. Abnormal measurement results show an increased risk of Down syndrome or other multiple deviations. It is also thought to be related to morphological defects of the heart, abdomen wall and bones.

          2.5. The screening tests the middle 3 months and the last 3 months of pregnancy

          Screening tests in the second and third trimesters of pregnancy include:

          Triple test tests determine the concentration of 3 other substances in maternal blood, also produced by the fetus, including:

          • AFP (Alpha-fetoprotein): A type of glycoprotein derived from the fetus.
          • uE3 (Unconjugated estriol): Occurs on the 8th day of the fetus.
          • β hCG (Beta human Chorionic Gonadotropin): A type of placenta-produced steroid. Triple tests screen for Down syndrome, Tam infection 18 and neural tube defects. This test is done from the 15th week to the 22nd week of pregnancy, most accurately at week 16 - 18.

          Ultrasound screening from 18-20 weeks of pregnancy examines major morphological defects of the brain and spine, parts of the face, abdomen, heart and limbs.

          Concerned about dangerous amniocentesis may potentially risk miscarriage and complications for mother and fetus, Professor Yuk Ming Dennis Lo developed a blood test for prenatal genetic syndrome through DNA. of the fetus in the mother plasma, or the test of free extracellular DNA.

          2.6. What is a free extracellular DNA test?

          Free extracellular DNA is a small amount of DNA released from the placenta into the blood of a pregnant woman. Free extracellular DNA in pregnant blood samples can screen for Down syndrome, Tam infection 13, Tam infection 18 and sex chromosome number problems. This test can be done starting from the 10th week of pregnancy. Positive extracellular DNA test results must be monitored by invasive diagnostic tests such as amniocentesis or prickle biopsy.

          Extracellular DNA testing is often indicated for pregnant women with a high risk of having a baby with chromosomal disorders. For low-risk cases, routine screening tests are the most appropriate option. Free extracellular DNA is not recommended for women with multiple pregnancies.

          Recently, with advanced technology and many outstanding advantages, NIPT (Non-invasive Prenatal Test) non-invasive prenatal screening is being considered a "golden key" in prenatal screening.

          3. Non-invasive prenatal screening test NIPT

          During pregnancy, some baby's DNA sequences are released into the mother's blood. Non-invasive prenatal screening NIPT analyzes information in the DNA sequence found to screen some of the abnormalities. This test is very sensitive to Down syndrome and can be done from the 10th week of pregnancy.

          What effect does the NIPT test have?

          This is a safe and effective method for screening the following diseases:

          • Down syndrome (Also known as Tam infections 21)
          • Edwards Syndrome (Tam infections 18)
          • Patau Syndrome (Tam infection 13)
          • Gender chromosomal abnormalities syndrome such as Turner syndrome (45, XO), super female (47, XXX), Klinefelter (47, XXY), Jacobs (XYY)

          This test helps screen some chromosomal abnormalities, but does not help screen for genetic syndromes related to gene mutations such as congenital thalassemia, sickle cell anemia, disease cystic fibrosis, etc. Prenatal diagnosis based on amniotic fluid or spiny samples remains the gold standard with greater accuracy and wider coverage in the diagnosis of prenatal genetic diseases.

          You should choose NIPT in case:

          • You have prenatal screening tests: ultrasound, combined test for high risk results
          • You do not have the first 3 months screening test due to the delay or where you live without this test
          • You want to be sure you are at high risk before taking an invasive diagnostic test such as amniocentesis or thornus biopsy, which still has a low risk of miscarriage.
          • You are at high risk (for example, an elderly pregnant woman or a previously diagnosed baby with Down or other chromosomal disorders).

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          Protein in the blood, low warning what disease?

          Protein plays an important role in each person’s body. Protein reduction reflects the state cachexia of the body, it causes series of serious consequences.

          1. The role of protein full for body

          Protein in the blood consists of 3 components are albumin, globulin and fibrinogen. Protein full part in high plasma than in serum because there is more fibrinogen .

          Albumin and fibrinogen are synthesized only in the liver. Globulin due to the cells competent for translation to produce (bone marrow, spleen, lymphocytes,…).

          Conventional plasma protein plays the important role in the body:

          • Participation constitutes the body.
          • Create pressure glue for the process of transport and exchange of salt water.
          • Join the constituent system components cushion contribute to keep the pH balance for the blood.
          • In addition it also protects the body: Globulin as immune factors, have the role to protect the body more fibrinogen involved in blood clotting helps stop bleeding when is a scratch, injury.
          • Shipping hormones and enzymes, protein transport duty drugs such as antibiotics, coumarin, salicylate, sleeping pills..

          2. Why blood protein reduce?

          There are many reasons for blood protein low:

          2.1. Decline protein albumin

          Albumin is a protein made in the liver. The amount of albumin in the body accounts for about 60% of the total protein.

          The main role of albumin in the blood is to maintain osmotic pressure glue because it helps hold water in blood vessels. Besides, albumin also acts to transport the important components in the blood throughout the body, such as drugs, hormones and enzymes.

          Because albumin is synthesized in the liver, so it is standard to assess liver function. When disease affects the liver cells, liver cells lose their ability to synthesize albumin. The level of albumin in the blood will decrease dramatically.

          2.2. Decline globulin

          Immunoglobulins have about 25% blood plasma proteins are the molecules that are differentiation have active antibodies. Usually the amount of globulin impaired in the following cases:

          • The postpartum period.
          • Due to air thin the blood.
          • Due to protein loss: nephrotic syndrome, burns, bowel disease causes protein loss.
          • When patients treated with immunosuppressants.
          • Patients with impaired gamma globulin blood congenital or without gamma globulin blood congenital.

          2.3 Reducing the concentration of fibrinogen

          Fibrinogen is a clotting factor, a protein essential for the formation of blood clots. It is produced in the liver and secreted into the blood when needed, along with a number of clotting factors other.

          Salary fibrinogen impaired in the following cases:

          • Diseases of liver weight.
          • Due to the pathology of thrombosis.
          • Do these drugs cause destruction of fibrinogen
          • Due to depletion of fibrinogen or without fibrinogen blood congenital: occur in rare diseases, genetics. In the patient mentioned above (which is mainly in the homozygous), the biology of fibrinogen is transformed, so the patient can present with either bleeding complications, or the formation of thrombosis and disorders ability to create scars.

          3. Protein blood low cause the what are the consequences?

          Protein reduction reflects the state cachexia of the body, it causes series of serious consequences:

          • Reduce the pressure sealant causing suitable, however it only occurs when the loss of large number of
          • Reduced ability to combine, shipping of proteins with many substances, causing disorders 1 number of high-quality heavy body intoxication
          • Blood coagulation disorders, increased bleeding
          • Reduce resistance by the liver reducing the synthesis of antibodies.

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            Diagnosis and treatment of gastrointestinal bleeding

            Gastrointestinal bleeding is the bleeding out of the heart, arteries of the digestive tract, into the gastrointestinal tract. This is the emergency internal surgery dangerous, if not diagnosed and treated promptly can affect the lives of patients.

            1. Diagnosis of gastrointestinal bleeding

            Gastrointestinal bleeding is an emergency, internal, surgical, dangerous, patients need to be hospitalized for examination and treatment as soon as possible. If the delay, gastrointestinal bleeding can cause complications life-threatening for patients.

            The first step in the diagnosis of gastrointestinal hemorrhage is a need to determine the exact location of hemorrhage. The doctor will harness information health history full of patients, and patient.

            Your doctor may will need to check the stool to look for blood blood in stool. Iron supplements, bismuth subsalicylate (Peto-Bismol) or more types of other food, such as red beets can cause the stool can color the outside like gastrointestinal bleeding.

            Blood tests help determine the extent of the hemorrhage and whether the patients are anemia not.

            Gastric lavage is a procedure that can be indicated used to identify bleeding in the digestive tract is high or low.

            Gastroscopy is the method of diagnosis most common to find out the source cause of gastrointestinal bleeding. The endoscope used is a tube soft, small mounted camera. The endoscope can also be inserted through the rectum to observe the large intestine, this procedure called colonoscopy.

            Hemorrhage if not detected by endoscopy is called hemorrhagic hidden, your doctor may need endoscopy again or use the other tricks to find the cause of bleeding hide.

            Endoscopy of the small intestine help to check the small intestine, the procedure performed, including:

            • Endoscopy the small intestine by the tube, push: an endoscope used to survey the upper part of the small intestine.
            • Endoscopy of small intestine by double balloon: the Ball is mounted on the endoscope to help the endoscope move through the entire small intestine.
            • Endoscopic intestine by capsule: Patients swallow a capsule containing a small camera inside. This Camera will transmit the pictures to a computer monitor video as it passes through the digestive tract.

            A number of other tricks can be used in diagnosis to determine the source of gastrointestinal bleeding:

            X-rays have baryt

            Baryt is the contrast to help see the digestive tract through an X-ray, liquid containing baryt can be swallowed or inserted through the rectum, but is now rarely used

            The scanner has radioactive isotopes

            A small amount of radioactive substance will be injected into a vein of the patient. When radioactive material escapes from the circuit it means there is bleeding, is this method is also rarely used.

            Take blood vessels

            The doctor will inject a contrast material into a vein the patient to be able to see the blood vessels on X-ray or computer tomography. In the hemorrhage, contrast material will flow out.

            Open abdominal exploration

            If the above methods cannot identify the origin of blood is procedure surgical open abdominal exploration may be necessary to check the digestive tract.

            2. Treatment of gastrointestinal bleeding

            Treatment gastrointestinal bleeding first need to place intravenous line for infusion, can blood transfusion if bleeding is severe. However, in some cases, severe bleeding, need for resuscitation, and infusion or blood emergency.

            Endoscopy is often used today to stop gastrointestinal bleeding, according to which, the doctor can put instruments through the endoscope to: Inject the substances that cause blood clotting or support coagulation in the bleeding, use a thermal probe, electrocoagulation, or laser, injection clamp blood vessels hurt with rubber ring or clip.

            If endoscopy fails then angiography blood can be specified to inject drugs or other substances into blood vessels to help control some forms of hemorrhage. If endoscopy and angiography were not done, the other treatments or surgery will be conducted to stop the bleeding for patients.

            To prevent gastrointestinal bleeding recurrence doctor treatment of pathologies causing hemorrhage, such as:

            Can say, endoscopy is the most common tool for the diagnosis and treatment of gastrointestinal bleeding should be the hospital prevail. The endoscopic methods traditions still exist many disadvantages, such as: Poor image quality, difficult to observe the lesion, causing discomfort for the patient, the possibility of occurrence of complications is high…

            System hospital international Vinmec apply technical endoscopic hemostatic clip in gastrointestinal bleeding, which was performed by team physician experienced professional:

            Associate professor, Phd, Doctor Nguyen Thuy Oanh – Head of the Single atom Internal digestive – endoscopy, hospital, international Vinmec Central Park, is one of the leading experts on digestive endoscopy, former Chairman of The gastrointestinal Endoscopy Southern, Deputy Chairman of the Association digestive Endoscopy in Vietnam.

            Dr., dr. Bui Xuan Truong – Doctor general Internal medicine Department – hospital international Vinmec Times City, with 20 years of experience in the area of gastrointestinal – hepatobiliary – hepatitis – gastrointestinal endoscopy, and ultrasound of the gastrointestinal tract.

            Customers can directly to the health system, Vinmec across the country to visit the clinic or contact us here for assistance

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              Expression sleep disorders in children

              During sleep online cash yen in the brain of young children secrete growth hormones. Expression sleep disorders in children are often diverse, so need the close attention from parents.

              1. Sleep disorders in babies

              Sleep disorders in infants and young children is a phrase that describes a stage when a baby has slept well suddenly wake up a lot at night,shorter sleep without any apparent reason. This phase usually lasts within a month individually, you young lasts a few months..

              Depending on age, the child can demand time to sleep each day different.

              Newborns: The early weeks new birth, the baby can sleep from 18h – 20h/day, each nap can last from 30 minutes to 3 hours. The sleep of infants, usually do not comply with the law, often sleeping in the daytime more than night. If daytime baby sleep near enough the amount of time it is likely the baby up late at night high.

              However, due to a reason that children sleep less than the sleep time above or young often form both day and night. This means children are facing disease, sleep disorders in babies.

              2. Manifestations of children with sleep disorders

              • Children <6 months: Sleep on demand. This age began forming cycle wake-sleep, night sleep lasts about 9.5 to 11.5 hours. Sleep shorter day ranges from 3.5 to 5.5 hours.
              • Children from 6 months – 1 year: Children sleep according to their needs and biological rhythms, sleep day from 3-4 sleep, reduced to only 1-2 sleep. Total sleep duration in age from 6 months to 1 year of age is about 14 hours/ day.
              • Children from 18 months: Children have less need to sleep during the day.
              • Children from 2.5 years – 5 years: Young very little sleep on because this is the age children love to learn explore the world around them and receive many stimuli from the environment outside, most children can sleep at night.

              When the child has the following signs, think of your children suffer from sleep disorders.

              • Drooping eyelids
              • Yawning a lot, falling asleep.
              • Play less, decreased flexibility
              • Fatigue, drowsiness atony
              • Manifestations of the disease

              Manifestations of children with sleep disorders in many different styles such as: there is the cessation of breathing short, with snoring when sleeping muscle jerk while sleeping, sleeping too much, the movements are cyclical, the hypnosis practice, insomnia, panic attacks night… out of which the hypnosis act, and panic attacks night join quite common.

              The hypnosis practice

              The hypnosis practice is the expression of the child sleep disorders perform seemed to be purposeful when the child suddenly woke up from deep sleep. When that young can do the simple movements such as sitting up in bed, some other children have the complex automation such as travel, dressing, eating and drinking. The hypnosis practice usually occurs at the time 1-2 hours after going to sleep ( i.e. into phase 3 and 4 of sleep, slow), in fever, the child open eyes look, but if you tell young, almost young, do not understand. The last in about under 30 minutes. After the hypnosis man child back to sleep. Next morning, ask your child does not remember anything about the bout had happened in the night.

              Certified hypnosis practice encountered quite common: about 10 – 15 % of children age 5 – 12 years have a hypnosis practice. The proportion of children, boys suffer more than girls.

              Panic attacks night

              Panic attacks night usually occurs in children from 1 to 8 years of age and may be accompanied by the hypnosis practice. The panic usually occurs in stages 3 and 4 sleep slow.

              Symptoms manifestation of the child sleep disorders in panic attacks are: suddenly the child sat up or flailing, screaming, crying after sleeping a few hours. Children manifest fear, stress, restless, eyes open, but seemed still to sleep, the mother could not soothe for quiet or can’t wake for the young state would be. Panic attacks occur lasts 10 – 15 minutes. After the children often fell asleep. Woke up the next day also don’t remember anything about the bout had happened last night.

              • Test

              If the child has the hypnosis practice, loss of sleep, the sleep apnea, suspected seizures night, they need to be doing a number of tests such as: eeg, electromyogram, electrocardiogram, eyeball sex video.

              Activity from months 4/2019, health clinic, Psychological belonging to the general hospital, international Vinmec Times City, receive skills clinics, consultancy and outpatient treatment of psychological problems and mental health.

              The clinic has modern equipment and a team of doctors is the lecturer at the Hanoi Medical University, there is the possibility to implement the psychological test, psychological therapy, intensive service, clinic, healing on the mental, in which treatment of sleep disorders in children.

              • ThS. Doctor Nguyen Van Non – Specialist Psychological, hospital, international Vinmec Times City: experience, 07 years of work at the position is faculty, Hanoi Medical University is a member of The psychiatry in Vietnam.
              • ThS. Doctor Pham Thanh Luan – specialist Doctor, Psychological, hospital, international Vinmec Times City: with 05 years experience in research, clinic, cure diseases, department Psychology, trained at the prestigious University, to practice in-depth expertise in the Republic of France.
              • ThS. Doctor Nguyen Trong Hien – specialist Doctor, Psychological, hospital, international Vinmec Times City: with 06 years as lecturer, Department of Psychology – School of Hanoi Medical University and hospital Geriatric Central same experience to research, discover curing diseases department Psychology such as emotional disorders, related disorders stress and disorders body shape, the developmental disorders in children, youth & the period of childbearing….

              Customers can directly at Vinmec Times City to visit or contact the following hotline number 0243 9743 556 to be supported.

              This article is written for readers in Ha Noi.

                Safe sex during pregnancy

                The majority of people think sex during pregnancy is it is not made, but actually there is no reason required to abstain from reserved unless otherwise indicated by your doctor. Why is this so?

                The fetus is safely protected in the uterus by the amniotic sac surrounds, so that the sex or orgasm does not cause harm to the fetus. However, the doctor can specify to stop sex during pregnancy if pregnant women with a history of miscarriages, and limiting sex when there is some history given as hemorrhage or preterm birth. In fact with each case of specific clinical, the doctor will have the requires different constraints (e.g. no sex, no orgasm, no sexual stimulation,…).

                1. Discussion between spouses on matters sex during pregnancy

                The key to keep the intimacy between husband and wife during pregnancy is to share openly with each other about feelings, especially when there are thoughts, wondering about the advisability of sex during pregnancy or not. Spouses should encourage each other to share, especially when you see your partner react different. Together to discuss, share is the best way to understand thoughts, feelings, excitement of each other.

                2. Raw sexual excitement that change during pregnancy or not?

                Sexual interest change during pregnancy is very common, and it is completely no matter what. Hormonal changes during pregnancy cause a number of people felt increased libido but at the same time that some other file is no longer interested in that anymore.

                While pregnancy first trimester, some people no longer want sex by the changes in the body (irritability, fatigue,…), but some others do not have this phenomenon.

                3. How to reach comfort when having sex during pregnancy?

                When the belly pregnant women to gradually rise, the change of posture during sex will become necessary to create a sense of comfort. This may still be true after the baby was born.

                In some cases, may need to use more lubricant during sex, and let’s always choose the lubricant in the form of water.

                Select the intercourse, to not feel pain. When you reach orgasm, there will be phenomenon of uterine contractility. However, if there is any contractility which appear frequently, or cause pain, see your doctor immediately. Similarly, if you see heavy vaginal bleeding, or rupture of membranes when sex during pregnancy last trimester, immediately stop intercourse and go to the hospital as soon as possible (not to anything penetrating into the vagina once appeared rupture of membranes).

                4. Take the time confided in pregnancy

                If the doctor has a request to restrict the activities of sex during pregnancy, or pregnant women feel no excitement with the intercourse, take the time to share that with your spouse. Love and understanding will be manifest through many different ways. Let’s think about love has formed her in the belly. Let’s enjoy the time together, together walking together, enjoy dinner, relax together.

                5. Duration as soon as possible sex back after childbirth is how long?

                After the birth of the baby, the woman can initiate sex back when the body has fully recovered, when both husband and wife feel comfortable and excited.

                However usually, doctors will recommend that women should wait after going to the clinic the first time proceed to sex.

                After childbirth, some women appear the phenomenon vaginal dryness. To remedy this situation, can use lubricant and always remember to use lubricant to form water.

                6. Whether a woman can get pregnant while breastfeeding or not?

                In the duration of breastfeeding, the woman will appear condition stop ovulation and menstruation (ovulation is the process of egg is liberated from ovary). However the egg can still fall before menstruation re-appeared. Therefore it should be remembered that in this stage, the woman can still become pregnant. Please refer to the contraceptive method, and if necessary, please consult doctor in case of women who do not want to continue to get pregnant.

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                  Glomerulonephritis in children: What you need to know

                  Glomerulonephritis in children is a common disease for children 2 – 12 years old. Need to take the child to go to the clinic and early treatment to avoid the risk of disease transformation into chronic glomerulonephritis.

                  1. Disease glomerulonephritis in children is what?

                  Glomerulonephritis is acute inflammation of the glomeruli due to the mechanism of auto-immunity, often onset by condition streptococcal infection in group A. the Disease is common in young age group 2 – 12, the proportion of young men/young women disease is 2/1. In our country disease, glomerulonephritis levels usually occur in summer (due to bacterial infection of the skin) and winter (due to inflammation of the throat). This disease is directly related to sanitation and living conditions.

                  2. Causes of glomerulonephritis in children

                  Disease glomerulonephritis-level usually occurs when the child has been suffering from the disease, a bacterial infection previously. The cause is due to the local allergies, poor resistance or poor hygiene. Specific:

                  • Children under 3 years old: Suffering from glomerulonephritis level after suffering from the disease-infested skin problems such as dermatitis, impetigo, head.
                  • Children over 3 years old: Suffering from glomerulonephritis levels after sore throat, tonsillitis.

                  3. Symptoms of glomerulonephritis in kids

                  • Swelling: Is common symptoms in children with glomerulonephritis levels. Disease glomerulonephritis in children causes face edema, eyelid swelling, two stools edema, most apparent is in around the ankle. Usually the patient is fit more in the morning and decrease significantly in the evening. This symptom is often encountered in about 10 days the first disease, then gradually reduced when the child is passing urine.
                  • Goal blood: Young blood blood, blood, 1 – 2 times/day, not often , the urine is opaque red as the water washed the meat. This symptom usually appears in the first week the child is suffering from glomerulonephritis, and can come back after 2 – 3 weeks. Later, the number of times urine, blood thinner, about 3 – 4 days urine once and then completely discharged. Condition the blood does not influence the general healthy condition of the body.
                  • Little cottage (oliguria, anuria): common in early weeks when the child is sick, lasts for 3 – 4 days, volume of urine of children under 500ml/day, no increase in urea and creatinine in the blood or increase is not significant. Status oliguria can relapse in 2 – 3 weeks young disease. In number of cases appear acute renal failure symptoms oliguria, anuria lasting and whose symptoms increased urea, creatinine of blood. If acute renal failure, recurrent installments can lead to glomerulonephritis rapidly developing, glomerulonephritis, chronic…
                  • Urine is yellow, there is proteinuria (protein in urine).
                  • Mild fever (37,5 – 38,5 ° C), pain news kidney area, abdominal pain, abdominal distention, go liquid, nausea,…
                  • Increase in blood pressure: a symptom seen in 50% of children suffering from glomerulonephritis levels. Hypertension in children ranges between 140/90 mmHg. Some cases increased blood pressure is paroxysmal and lasts for several days with blood pressure 180/100mmHg. The patient may feel severe headache, dizziness, coma, convulsions due to cerebral edema and can lead to death.
                  • Heart failure: Often accompanied by symptoms of hypertension, paroxysmal due to the sudden increase the volume of circulation and also due to diseases acute glomerulonephritis in children causes pathology the heart muscle. Children with acute heart failure can manifest as difficulty in breathing, not lying is, easily lead to pulmonary edema (sweating, shortness of breath, intense breath, rapid breathing and shallow shrinkage pit on the brisket, pits, spanking, shrinkage cavity, intercostal), cough, spitting out pink foam,… If it is not emergency, timely child can be fatal.

                  4. Glomerulonephritis treatment in children

                  4.1. Treatment principles

                  • Reduce the burden on the kidneys.
                  • Enhanced functionality to create urine of the kidneys.
                  • Early detection and timely treatment of severe complications of the disease.
                  • Destroy streptococci and prevention of the risk of recurrence.
                  • Periodic monitoring, timely detection and treatment of those cases of bad happenings.

                  4.2. Treatment reduce the burden on the kidneys

                  • Bed rest in the acute stage, especially when suffering from hypertension, diabetes, blood many within 2 – 3 weeks.
                  • The child was not heavy activity, just go back to school when the disease has stabilized and only, fitness, labor when the disease has stabilized for a minimum of 6 months.
                  • After 1 – 2 years when the disease was stable kids should be vaccinated.
                  • Anti-cold for young.
                  • Children need to eat light in the day, right many and pale relatively later. Only limited in animals (0.5 – 1g/kg/24h) when a child is anuria, urea in the blood increases. Children should eat more foods rich in carbohydrates and lipids to avoid self-target animals body.
                  • Children should limit the consumption of water. Formula for calculating the amount of water taken into the body by urine output of previous day plus 200 – 300ml. If the child high fever, it can increase 10% of water needs daily.

                  4.3 enhanced functionality to create urine of the kidneys

                  • Apply only when the patient is fit more and for the possible complications of hypertension, heart failure, kidney failure.
                  • Mainly use Furosemide 1 – 2 mg/kg/24h
                  • Antibiotics kill streptococcus and prevention of recurrence
                  • Penicillin in doses appropriate direction prescribed by your doctor to combat streptococcal infections, prevention of re-infection and this drug safe for kidney.
                  • If the child is allergic to Penicillin can be replaced with Erythromycin with the dosage accordingly.

                  4.5. Detection and early treatment of complications

                  Can the brain due to hypertension

                  • Care regime: Need for complete rest in bed, eat light absolute, limit the amount of water on track, strict heart rate, blood pressure, electrolyte balance and can let the children oxygen, respiratory support.
                  • Use diuretic as directed by your doctor.
                  • Medication to lower blood pressure fast effects as directed by your doctor.
                  • Anti-cerebral edema: Millet pillow for 30o and taking medicines as directed by your doctor.
                  • Sedative, anticonvulsant the drug with the dose recommended by the specialist doctor. In convulsions of children should lie first and certainly the tongue to avoid biting the tongue.

                  Heart failure level

                  • Take care with the regime, diuretic, hypotensive, sedative as above.
                  • For breathing oxygen.
                  • Use of heart medication in accordance with the instructions.

                  Acute pulmonary edema

                  • For young, breathing oxygen through a solution of alcohol 10 – 20%.
                  • Injection of morphine for children > 5 years old: 0.25-0.5 mg/age/times.
                  • Pricking 100-200 ml/m2 body area.
                  • Garo 3 chi rotation, in case of too weak or anemia. Garo 3 chi to 1 spend freely, and rotated so that each detail is not garo more than 15 minutes.
                  • Intubation and respiratory support if necessary.

                  Acute renal failure

                  • Ensure the necessary calories provide the body young.
                  • The amount of protein daily reduced to 0.5 – 1g/kg/day.
                  • Restrictions for taking food that contains Sodium and Potassium.
                  • Balance out – to the children.
                  • Cause diuresis strong.
                  • Anti-acidification of the blood with aqueous sodium bicarbonate.
                  • Balance of electrolytes, anti-tank Potassium, anti-ha, Calcium and Sodium.
                  • Dialysis in addition to kidney soon.

                  4.6. Care and periodic monitoring

                  • Every day, parents need to monitor weight, edema, urine output, blood pressure, temperature, vessels of children with glomerulonephritis levels. At the same time, parents should also keep warm and oral hygiene for young daily.
                  • When out of the hospital need to test the child’s urine to detect proteinuria according to schedule: In 6 months every month test once, if still positive, then 6 months then continue to make normal test. If results are negative, then parents can for testing 3 months/times within the first 2 years. If negative 2 times in a row, it can stop the tracking.

                  5. How to prevent glomerulonephritis in children

                  • Anti-streptococcal infections by giving young dental hygiene clean, avoid pharyngitis streptococcal, keep body hygiene, ablution clean to avoid inflammation of the skin, impetigo, head.
                  • Detection and early treatment of pharyngitis due to streptococci.
                  • Avoid contact with people suffering from inflammatory diseases of the glomerular level.
                  • In the young or diseases streptococcal need preventive treatment Penicillin doses as directed by your doctor specialist.
                  • Children with already inflamed glomerular level, prevention of recurrence by treating positive foci of infections due to streptococci and keep warm for children, avoid sudden cold.

                  If detected and treated early, children with inflammatory diseases of the glomerular level can fully recover. So, when children are expression skin infections, respiratory infections or glomerulonephritis, parents should fast for the child to go to the clinic, treatment at the base medical the prestigious.

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