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The influence of Patau syndrome on the fetus

Patau syndrome – One of the genetic syndromes most commonly encountered in the fetus, as well as the syndrome of other congenital defects, Patau syndrome seriously affect the health of the child right from when he was in the womb.

1. Patau syndrome is what?

Patau syndrome , also called syndrome abnormalities in chromosomes. Normal child is born with 46 chromosomes, arranged in 23 pairs, but when trapped in Patau syndrome, the fetus will have an extra copy of chromosome 13 in every cell of the body.

Chromosome 13 can cause serious problems mentally and physically as neurological defects, weak health, the brain poorly developed. Most of the children born suffer from Patau syndrome are lost before birth or live only in short period after birth; very few of these cases to survive to adulthood.

2. What causes Patau syndrome?

Current still yet to find out the exact cause cause Patau syndrome. However, in the majority of cases, this syndrome commonly affects girls more than boys. Chromosome 13 can come from egg or sperm, but the possibility of many is due to the age of the mother high (from 35 years old upwards).

3. The effects of Patau syndrome on the fetus

Babies born with trisomy 13 often encounter the difficult problems of health, including physical and intellectual. Children often have low birth weight when born, there is the problem of brain structure, affects the formation face, the eyes, the nose of the child. Some consequences of Patau syndrome often seen include:

  • Polydactyly fingers, feet (grows more toe women)
  • Kidney problems, neck or scalp
  • Hernia
  • Head small,ears low
  • Eyes small, distance of two eyes close together
  • Disease “brain interior only”- the brain does not divide into two hemispheres
  • The rate of heart defects high (80%)
  • For girls can lead to a situation of two-horned uterus (uterus has an unusual shape)
  • For boys can have problems testicles: testicles do not descend into the scrotum (cryptorchidism)

For the child with Patau syndrome , lucky to be alive after born can join the serious complications such as:

  • Shortness of breath
  • Congenital heart defects
  • Hearing loss
  • High blood pressure (hypertension)
  • Intellectual disability
  • Neurological problems
  • Pneumonia
  • Epilepsy
  • Delayed development of physical
  • Hard to eat or digest food poorly

4. Diagnosis of Patau syndrome like?

Doctor can detect the physical signs of trisomy 13 in the first pregnancy ultrasound first trimester. Or can diagnose Patau syndrome through the tests, such as screening of DNA without cells (NIPT) or PAPP-A (plasma proteins related to pregnancy A).

However, the tests on only the screening test, and sometimes the result of they can not accurately determine the fetus has a disorder trisomy 13 or not.

These tests only warning that babies have a higher risk of suffering from Patau and need to do more other tests to confirm the results correctly. Pregnant may take a sample of chorionic villi (CVS) or amniocentesis to be 100% sure.

5. Test NIPT

Test NIPT is a screening method for the prenatal non-invasive based on DNA testing of the fetus in the blood mother. Through this test, doctors can detect is malformation of the fetus right from the new pregnancy is 9 weeks old, rather than waiting up to 12 weeks of age as before this, from which help reduce the risk of miscarriage than with amniocentesis usually.

Currently, at general hospital, international Vinmec are deployed laboratory service non-invasive NIPT, can bring improved superior about the results of prenatal screening help early intervention and effective with the the fetus has a malformation.

Although the screening methods, traditional as aspiration amniotic fluid, villus for the accuracy, but potential unsafe elements (miscarriage, vaginal bleeding, infection, leak amniotic fluid). Instead of apply the traditional way to cause direct effects to the fetus then the methods of prenatal screening non-invasive (NIPT) safety trumps.

Doctor just take 20ml of blood in the veins of the mother from gestational week 9 onwards to proceed to sequencing DNA. This result will help the expert to detect whether the fetus has a high risk of unusual a number of chromosome is often seen as a syndrome of Down, Patau, Edward, Turner or not.

Methods of prenatal screening non-invasive NIPT can be considered as suitable choice for the case has taken measures screening traditional (double test, triple test) result in high-risk, before deciding whether to do prenatal diagnosis invasive (aspiration amniotic fluid, villus).

In addition, the pregnant women are older (over age 35), families who have children deformities should also choose the solution NIPT from the early stages of pregnancy to avoid the bad case can occur for both mother and baby.

6. Genetic counseling

When the results are diagnosed the child is suffering Patau syndrome, the doctor will conduct genetic counseling, offers these helpful tips for parents. Since then, the family can weigh in, thinking to make choices based on the analysis results of doctor.

In addition, genetic counseling is recommended to:

  • Learn in detail about the significance test results chromosome
  • Understand the birth a child which also has a risk of being affected from the disease
  • Understand the diagnostic choice for each other

Hospital international Vinmec Times City with a team of professionals experienced and well-trained specialist in deep water and in the water have the background scientific development in the world such Germany, England, France will counseling lessons on genetics for the customer before making the decision to do NIPT.

Besides, The technology center Gen Vinmec is equipped with modern machinery for fast results, accurate and superior safety such as:

  • Clean room system ensure standard
  • System separate and store stem cells automatically AXP – Thermogenesis and Bio-Archive
  • Analyzers, test cells flowcytometer Navios – Beckman Coulkter
  • Centrifuge Eppendorf, Adiplus

Vinmec also committed to:

  • Customers will be advised, full of information about NIPT with expert in pathology, genetics
  • The customer will not get the results without the genetic counseling
  • Process sampling and shipping of blood samples contain DNA of the mother and child according to the standard ISO 15189/2012
  • Ensure privacy and security of customer information
  • Clean room system, modern equipment
  • Be insurance assistance when positive results or false negative

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

Article reference source: Webmd.com

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    Nutrition for patients with liver cancer

    A mode of nutrition science, complete will help improve the efficiency of treatment for patients with liver cancer. However, when cancer liver diet what to eat and what to eat is not something the patient would also know.

    When the liver is hurt, doesn’t work properly and the disease is diagnosed with the disease cancer of the liver also means to step into the process of treating stress, declining health quickly. One thing very wrong that majority of the patients have is just focus on treatment without attention to nutrition, a number of less then abstinence excessive leading to health depletion, does not meet the treatment process.

    1. Nutrition affecting the process of treatment of liver cancer

    According to statistics of the world health organization in Vietnam, each year there are about 95,000 patients die of cancer, which have up to 80% dead weight loss, nearly 40% die because of depleted health. Led to this condition is due to the majority of patients when diagnosed with cancer only focus on treatment but has not paid attention to nutrition to improving physical condition. There are very few patients interested in diet daily for science, provides full nutrients. There are even more people still afraid to eat high will make the tumor grow faster should have abstinence excessive, which leads to the condition, weight loss, malnutrition, not only did not help for the process of treatment but also for health status worsening.

    2. Liver cancer diet eat?

    In fact, liver cancer and the process of treatment will make patients lose interest in eating, therefore, that very few patients who pose the question as: “Disease liver cancer fasting what?”, “food not good?”…with the doctor. As well as many other diseases, besides the healthy food groups there are some foods that patients with liver cancer should avoid to alleviate the unpleasant symptoms caused by the disease, namely:

    2.1 food Groups rich in fat

    Liver cancer fasting what?”, the answer is food groups rich in fat, excessive consumption of foods high in fat will make the liver tired, create a burden for the digestive process of food. Patients should limit the use of foods high in fat such as biscuits, cakes, fried potatoes, sausage….For fats, just consume a moderate amount is enough.

    2.2 food Groups rich in protein

    For patients with cancer of the liver, if the body is receiving too much food rich in protein will cause overload by liver injury, the activity the wrong way, this will cause for the toxins accumulate in the liver and the body and exacerbate the symptoms of the disease. People disease liver cancer should eat eggs, fish, milk, poultry meat… but eat only in moderation.

    2.3 food Groups contain high amounts of salt

    Food group contains high amount of will make for the symptoms of cancer of the liver aggravated in the human body disease, salt makes the body absorb and retain water, will make accumulation of fluid in the liver, so people with liver cancer should abstain from salt, including table salt daily, salt packing, cakes and pies….When processing food for the liver cancer, you should season to taste bland.

    In addition, the doctor will recommend that patients with liver cancer should give up wine, beer, drinks containing caffeine and alcohol by the liver of the patient was very weak, when tolerability of this drink will cause it to work overload, and the condition will aggravate.

    3. Liver cancer should eat fruit what?

    Currently, there are many types of berries, fruits containing high carbohydrates, sugars, fiber and other beneficial nutrients to help the digestive system, increases resistance for people with liver cancer, “the disease of liver cancer should eat what fruit?”, advice of the doctor, the main are: Figs, bananas, grapes, Kiwi, carrots, oranges, tangerines….

    4. Liver cancer end stage what to eat?

    Nutrition scientific, reasonable, help to strengthen the treatment effect will be included, so the disease liver cancer end stage what to eat?, the food need supplements include:

    4.1 Should use organic food

    The liver is department plays a very important role in the detoxification of the body, so when the liver has been hurt by cancer cells, then the disease or selection of products natural or organic would be very good for health, reduce the load burden to the liver.

    A special thing helps alleviate discomfort for patients in the main dining is divided in small meals, there can be 6-8 small meals throughout the day instead of 3 major meals. The food supplement nutrition in liquid form is also great suggestions for the sick, help to increase the appetite for each meal.

    The help of relatives in the preparation of meals for patients with liver cancer is necessary. However, let the patient eat according to preferences, this will help for psychological comfort and more effective for the treatment process.

    4.2 Additional food rich in starch, sugars and fiber

    Sugar is simple carbohydrates and starches are complex carbohydrates and are functions provides energy for the body. Fiber helps the bowels get rid of waste and can also help to reduce the amount of bad cholesterol, very good for patients with liver cancer. Patients can supplement foods rich in starch, sugar and fiber like fruits, legumes, vegetables, whole grains, bread, grain.

    4.3 Additional Vitamins and minerals

    Cancer patients with end-stage liver who are at risk for deficiency of many minerals and vitamin A, B, C and E, folate, magnesium and zinc do weight reduction and increase water loss from diuretics. However, the additional Vitamins and minerals should be the doctor evaluated for compliance with the physical condition and the individual patient.

    Liver cancer causes much pain and fatigue during treatment in patients, this affects the process of eating. However, patients need to have condition can succumb to disease and responsive treatment methods. Building a nutrition scientific, reasonable for patients with liver cancer is necessary.

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      Bleeding, prolonged after abortion

      Bleeding after abortion is the result of the muscles of the uterus does not shrink or the blood vessels do not spasm to stop the bleeding. If bleeding lasts extremely dangerous, need to see a specialist maternity to avoid the complications that can occur.

      1. Bleeding after abortion

      Often, after the abortion women will have symptoms of bleeding in the range 5 – 10 days, the blood volume will decrease gradually day by day and will then be out of the blood, which can include abdominal pain due to uterine contractions if the bleeding or excessive pain or high fever. Besides, because of the location and status of recovery vary between a number of females that some cases will be prolonged bleeding add a few more days.

      Abortion after 2 weeks still bleeding is likely to be due to the inflammation of the uterus, cervix or vagina. Because when the amount of blood much that pregnant women no hygiene skills will be a favorable environment for the parasites attack cause infection.

      2. Prolonged bleeding after abortion

      If abortion after 2 weeks still blood, blood that colors like black, stinking, suffering from clots along with severe abdominal pain, sick, high fever… Need to medical facility immediately, because of the high likelihood you are suffering one of these complications follows:

      • Alive fetus, alive together

      Symptoms are severe abdominal pain, repeated comes out so much blood, dark red blood clots very large. If abortion at some facilities, poor quality, women are very prone to errors, fetus, survive each other… this means get pregnant don’t succeed, women need to some medical center to have the remedy, abortion completely.

      • Infection

      Can because medical tools are not sterile or weaker toilet the genital area, not clean, very easy to make, got pregnant suffering from inflammation, blood, infection gynecology. Characteristic phenomenon is bleeding “closed zone” are red, the stench or the color yellow, abdominal pain, excessive cold… If to long inflammation retrograde up the fallopian tubes, ovaries,… can lead to the risk of not having children, or abortion can cause infertility.

      • Lesions in the uterus

      This is a consequence extremely hazardous to resistance breeding after this women’s world. If tips get pregnancy is the executive by the therapist poor workmanship very easy to encounter the risk of perforation of the uterus, adhesions, uterine…

      • Ice blood

      Metrorrhagia after abortion is one of the complications to encounter if abortion is not safe. This is the symptoms are very dangerous due to make the body lose a lot of blood will be life-threatening if it is not emergency in a timely manner.

      Ice blood cause female genital organs world is a flowing of blood, the blood flows much massively, blood can be diluted or mixed with blood clots. Colic lasts, intense. The systemic symptoms due to loss of blood as much as: dazed, headache, dizziness, hypotension, vomiting, nausea, shock, blood loss…

      So to know for sure you have the abortion it should to return to have a timely treatment if the pregnancy has not yet been broken.

      3. After abortion it is necessary to reassess what?

      Time for re-examination after abortion , then pregnant women will be gynecological to a doctor to check the uterus have good feedback yet? Signs of inflammation the genital tract not? Also sign, out blood pussy again? From there the doctor will prescribe treatment (if necessary).

      If no re-examination will not detect the abnormalities and complications after abortion timely, easily lead to inflammation, adhesions hysteroscopy, influence reproduction later.

      In addition, there should be a mode of living, proper rest and periodic health examination to be active in the protection of health for the individual themselves.

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        The level of burns

        Phenomenon the surface of the skin hurt when exposed to hot temperature too cold, unusual as burns. At each different level of the disease to have the dangerous and unpredictable that not everyone understand.

        1. The level of burns

        Based on the lesions of the skin there will be 3 main levels of burns is:

        • Level 1: skin redness, no peeling skin
        • Level 2: the surface of the skin appear blisters, skin blistering
        • 3rd level: area blistered ass, turning white.

        Often burns will just fall into level 3 on, however, a number of special cases, extreme danger will appear the entire symptoms degree burn 3 and also spread outside the surface of the skin into bone and tendon.

        Specific at each level of burns:

        Levels things 1

        The light burns the most equivalent with the lesion at least, the burns are called by other names ultra burn, burning life, because this case burns only affect the epidermis the skin outermost.

        Signs for level of burns first includes: the skin contact heat red swelling, mild pain, burning, swelling up, when healthy burns the skin it will dry and peeling skin. Degree burns 1 will usually heal quickly in just about 7-10 days, rarely leaving sequelae scarring.

        If extensive burns in the skin areas such as knees, spine, elbows, arms or shoulders… you should still see your doctor avoid the risks not worth having after this.

        At the level burns 1, patients can still be at home, self treatment, self-care by the simple method.

        The 2nd level

        Burns 2 degrees will be more serious than level 1, the skin lesions were no longer just layers of skin epidermis top. Upon this, the surface of the skin has become blistered, red, burning, soreness. Blisters will have the opportunity to grow on the surface of the skin. Gradually tissue the skin becomes thick, soft, look like scales, they’re called secretion of fibrinous. Burns on the skin is vulnerable, fragile, and should be clean, should be tape gauze properly protected, to avoid infections, at the same time the wound will also heal.

        The appearance of acne, water many up, as shows the burns are worsening and long healed over. The case is particularly severe will be indicated doctor skin grafting.

        Burns at 2 degrees usually take about 3 weeks to heal.

        3rd level

        3rd level is where to meet very severe burns and cause damage. Burns to this level is usually deep burns affect not only the surface or outer skin layer, that damage has already spread to the patients no longer feel pain. Burns this severe, there is risk of affecting the nerves.

        The area of burn is important. Burns as wide, then the mortality rate as high. Burns above 15% in adults, 8% children considered as serious.

        Burns level 3, the disease can be observed: ring exposed skin temperature becomes wax and turn white, have the skin area had been scorched dark brown. This case generally does not appear in the acne water and special need corrective surgery. Because of burn, 3rd degree burn is not treated and recovery end points will leave sequelae or cramping severe. However, in the area of severe burns or mild new conclusion is the recovery time.

        With burns level 3 patients should not try to treat at home which need medical facility or doctor to properly treat, avoid any complications, sequelae can occur particularly at risk of causing fatalities when severe burns.

        2. How to reduce the pain, burning sensation when burned

        Burns at level 1

        • Hygiene wounds and soak lightly in pot of cool water, small should soak at least 5 minutes. Should only use cool water, not ice, stone or water stone, direct contact with ice can cause the wound to become worse.
        • Use ibuprofen or acetaminophen as needed to reduce pain. Medication topical anesthetic cocaine, apply to burns a layer of lotion has a protective effect as combined gel or a combination of aloe cream to the skin lesions are mild.
        • Use ointments containing antibiotics applied directly to the burns and gauze liquid to protect the entire around.
        • Use ice compresses gently wrap loose around the burns. Can use more pain medication to feel better.

        Burns at level 2

        • Hygiene wounds and soak lightly in pot of cool water, small should soak for at least 15 minutes. Can apply wet cloth dipped cold water on small burns 2-3 minutes per day.
        • Use ibuprofen or acetaminophen as needed to reduce pain.
        • Use ointments containing antibiotics applied directly to burns and acne spots water.
        • Use tape dry gauze bandage burn wounds, change the bandage once a day. Note wash your hands before washing burns.
        • Check the burn daily see there appear signs such as swelling, pain, red more than not. Not peeling the skin from burns to avoid infection, no more scratching.
        • Use sunscreen before going outside because burns are very sensitive to the sun within 1 year.
        • Should to medical facility when burns are serious repercussions to other parts of the body.

        Burns at level 3

        • Remove cloth, costume… adhesive in the area of burns, do not use embed burns into water or any medication applied to burns.
        • Lifting the device burns up higher than the heart, can ice ice cool, moist, clean.
        • Can skip step two and quickly bring the victim to hospital immediately.

        Note: When electrical burns, chemical burns it is necessary to hospital as quickly as possible because can cause serious injury to the parts in the body.

        3. To avoid burns at all levels

        To be able to avoid the maximum risk of burns per people should be careful while working, at the same time stay away from places where there is risk of accidents and burns. Special home with small children – objects that easily burns most as need note more, as is often the case, occur burns often appear at home in common daily.

        • Young children need to get away from area, kitchen which contains gas, a thermos of water… the furniture easy to cause burns possible.
        • Always keep the extinguisher goods at the place near the stove
        • Recurring monthly check to ensure smoke detectors in the house is stable and works well
        • Bathe the baby should discharge cool down before and avoid for the exposed water before the water the right temperature
        • To the flammable and dangerous such as matches or lighters… keep out of the reach small children, in a safe place
        • Use the power outlet lid or have the foil insulation on the inside.
        • Should not be to long cord, protruded or loằng thing in the house, so check the wire top will always not open power.
        • Use gloves when exposed to chemical cleaners
        • Should use sunscreen, coat sunscreen when outside in summer, avoid the burning skin of hands, face…
        • For smokers, to ensure cigarette butts along the top filter when thrown away had extinguished the fire completely after smoking.

        Adults in the family should also have basic knowledge about the prevention of burnsor first aid to meet any level of burn how at the same time should also have a plan ready to respond when that occurs the risk of burns in addition to.

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          Insomnia in women menopause

          Disorder, premenstrual affect the health of women generally, in that insomnia in pre-menopausal women causing fatigue and the effects mentally.

          1. Insomnia in menopausal women

          Insomnia in women pre-menopause and menopause often fall into about 45 – 53 years old. At this stage, women are often tired, sleep is not deep sleep and often wake up at night.

          2. Causes of insomnia in menopausal women

          The mechanism of action of the body to go to sleep is the central nervous launching the brain and the endocrine glands secrete chemicals that effect a nerve block, take the brain and the grid structure, the bottom of the hill fall into a state of inhibition. Therefore, active sleep, need to have coordination between nervous and endocrine. However, at the stage of pre-menopause and menopause, the woman’s body are the changes about hormonal hormonal.

          Decline in hormones, especially the hormones estrogen and progesterone can be considered the main cause of insomnia in menopausal women. Specific decline in hormones estrogen reduces the ability to absorb and produce magne – a mineral that helps relax muscles. Taut muscles plus phenomenon fuming at the stage of pre-menopause and sweating at night interrupting sleep, sleep apnea in women. Also decline in hormone progesterone also makes women sleep non-sleep and sleep disorders.

          When falling into a state of insomnia, women are often or worry, back, directly affect sleep, thus creating a vicious circle with no end.

          3. Harmful effects of insomnia in menopausal women

          • There are always sensation drowsy in the daytime, lack of energy, body fatigue, sluggishness heavy.
          • Poor cognitive disorders, mental functions, mobility, reduced alertness, self-confidence.
          • Daily activities affected and serious disorders.
          • Insomnia in menopausal women , causing psychological stress, boredom, depression, neurasthenia, memory loss and ability to solve problems, mood instability, often anger.
          • Physiologically, sleep loss causes women decreased libido, difficulty sublimation in story sex due to vaginal dryness burning.
          • Women suffering from insomnia, you skin rapid aging, the poor refreshed, and increases the risk of cardiovascular diseases, diabetes, obesity and cancer…

          4. Overcome insomnia in menopausal women

          To have good sleep at this stage, then the women can follow the following instructions:

          • Build and adhere to timetables, work rest, in a scientific way.
          • Hard training and strengthening health by maintaining exercise regime that the sport has, such as walking, jogging, swimming, aerobic, yoga… workout Time should be at least 30 minutes per day.
          • Limitations and avoid taking stimulants like alcohol, beer, coffee… the evening.
          • To reduce the symptoms of insomnia in menopausal womenshould limit to eat and see movies that touched, excited attitude too before going to sleep.
          • Bedrooms, place to sleep, need to clean and airy.
          • Balance the endocrine progesterone and estrogen by estrogen supplements.
          • In the case of still lose sleep, can taking the drug. However, the drug only works in the short term, if long-term use can affect overall health. When using the drug treatment of insomnia need to be doctor advise, specify and guide and avoid the side effects undesirable.

          5. Explore insomnia in menopausal women

          Activity from months 4/2019, health clinic, Psychological belonging to the general hospital, international Vinmec Times City, can function examination, consultation 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 there is insomnia in menopausal women.

          • 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 the same Central experience, research, examination and treatment of diseases department: Psychology as: lability exposure, The disorders related to stress and disorder form the body, the disorder develops in children, adolescents & 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.

            Diagnosis of depression in adults

            Work pressure, life makes many people susceptible to inhibition, spiritual, emotional disorders lead to depression. The level of expression of the disease depends on the ability to bear the pressure of each person.

            1. Psychological examination

            The first thing to do to diagnose depression in adults is to see a specialist psychologist. Patients will be fully assessed and focus on the following factors:

            • The symptoms, manifestations, current
            • The triggers to traumatic stress (psychological impact as strong as: disease, breakup, lovers, family conflicts…)
            • A history of the stages of neuropathy
            • Reaction to the medicines used before

            Skills diagnosis and treatment of cognitive decline in older adults extremely important. Population growing older each year after age 70 the level of cognitive impairment and depression increased 2-fold. Need to take patients to the examination and diagnosis of the disease even when there are unusual signs. Many people often want to go to the clinic mental illness, so when the condition become severe new to see a doctor, this causes so much difficulty for the treatment of disease.

            2. The patient has suicidal thoughts or not?

            To diagnose the level of depression, then the question about suicidal ideation, thoughts boring life can not be ignored. The screening question clinical not whose main purpose is to diagnose the disease in a formal way, but means provides information extremely important to help identify risk of suicide in patients.

            Questionnaire depression of Beck has the full name is (Beck Depression Inventory-BDI-II) is in common use today. The questionnaire is not specific for older people but there are headings contain the standard amount of depression diagnosis of DSM-IV. If results of the implementation questionnaire is 15 points, then the disease was rated as mild depression, which initially have the signs of depression is important in clinical practice.

            Ladder of Short quotes depression elderly people there are 15 questions was constructed based on measurement screening basic depression in adults. If the result of the 5 points you need survey and a more thorough examination. This ladder serves to diagnose depression can also diagnose Alzheimer’s disease.

            3. Family history

            The state of depression or cognitive impairment happening at the same time when elders in a family need to be noted when diagnosing the disease. Attention should be paid when there is money the family, depression or any mental illness else. Based on the level of decline in declarative cognitive functions behavior, the doctor will try to find more information from the family members, especially those with suspected sa kick mental illness in the family, only the perception changes first happened, is still unknown.

            4. The impact of social change

            Many surveys, research has shown that the results of work daily activities focus on the change in difficulties due to cognitive impairment and depression. Cognitive decline and depression common in elderly people. These two diseases can lead to more impact on emotions and perception in everyday life.

            Accurate assessment of the functional activity in order to determine where is the cognitive impairment caused by Alzheimer’s disease, this is causes loss of motivation, interest in life.

            Status, the circumstances of each patient differ. Doctor need based on these factors, cultural characteristics and to diagnose the disease for patients, most are foreign doctors when diagnosing diseases for Vietnamese people.

            For example, according to research in the world, 41% of patients in the early stages of depression will be manifested insomnia and 44% have signs anxiety disorder. However, most of the patients in Vietnam usually go to the clinic due to loss of sleep, stretching and then gradually discovered anxiety disorders and depression.

            5. Money the diseases of internal medicine

            Need to determine the signs of current patients is due to depression, cognitive impairment or the symptoms of diseases of internal medicine such as impaired thyroid function, the pathology of chronic pain…

            In addition, the pathology medical can also cause the disease state becomes more severe.

            6. The necessary tests

            The tests are performed aimed at eliminating the pathological, medical, expression, subject as depression or cognitive impairment. Includes:

            • Blood count
            • HIV testing
            • Test the concentration of vitamin B12
            • Test folic acid
            • Tests thyroid hormone,…

            In that laboratory thyroid hormone, is testing extremely important, should not be ignored. The identification of pathology, medical also help diagnose levels of depression due to the disease this also contributes to the level of depression worse.

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            7. Diagnostic neuroimaging

            When there is the manifest decline in the ability to process information, ability to concentrate, impaired memory, slow… especially in the elderly, it should perform diagnostic imaging to clearly define the disease state.

            With the manifestation of nerve damage is localized or the risk of blood vessels, patients often are designated as magnetic resonance imaging MRI and computed tomography CT.

            Most of the older patients to see a specialist mental are only the MRI scans before and have used a few drugs but not effective or experience a few side effects of the drug on.

            Clinic psychology – hospital international Vinmec officially went into operation from January 4/2019, with functions of examination, consultation and outpatient treatment of psychological problems and psychological health. With modern equipment, clinic, health Psychology Vinmec is collaborating with professors, experienced professionals:

            • ThS. Doctor Nguyen Van Non – specialist Doctor, Psychological, hospital, international Vinmec Times City: with 7 years experience working with the position is lecturer, department of psychiatry – Hanoi Medical University, psychiatrist at hospital Hanoi Medical University & hospital Geriatric Central, at the same time is a member of The psychiatry in Vietnam.
            • ThS. Doctor Pham Thanh Luan – specialist Doctor, Psychological, hospital, international Vinmec Times City: with 5 years of experience in research, examination and treatment of patients under specialist mental faculties, 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: 6 years as lecturer, Department of psychiatry – School of Hanoi Medical University and hospital Geriatric Central, along with experience in research, examination and treatment of patients under specialist mental illness as: emotional disorders, related disorders stress and disorders body shape, the developmental disorders in children, youth & the period of childbearing….

            Along with the combined deployment of psychological test, psychological therapy, intensive service of diagnosis and treatment, aiming to bring efficient patient care best.

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

            This article is written for readers in Ha Noi.

              Swallow choking – Signs of tumors, esophageal cancer has developed

              In the early stages, esophageal cancer is often less appearance of symptoms. However, when tumors grow larger, the expression also will be more apparent. In particular, the majority of patients with esophageal cancer, they have difficulty swallowing, when swallowing is choking.

              1. Swallow choking (dysphagia) what is it?

              Dysphagia is a medical term only the difficulty when performing the action swallow. This symptom is usually due to pathology in the esophagus or pathology in the oropharynx, or due to the insert molding into the esophagus also causes. So there are many causes difficulty swallowing, according to which also very many in which there is esophageal cancer.

              Degree of difficulty swallowing is also different in each person and at each stage of the disease. In mild, the patient can for food through the esophagus in a gentle way with the feeling of pain when swallowing. When condition worsens, when the solid food and liquid through the esophagus can cause vomiting, the patient is not eating and drinking is.

              Swallow, choking may appear at the same time with other symptoms like feeling nausea, vomiting, cough, shortness of breath.

              2. Esophageal cancer is what?

              Esophageal cancer is cancer that occurs in the esophagus — the tube digestion connects the throat and stomach. When esophageal cancer patients often have symptoms of dysphagia and weight loss. In addition there are other symptoms such as pain when swallowing, hoarse voice, dry cough, possible vomiting or coughing up blood.

              Esophageal cancer including the two main types are carcinoma of the squamous cells of the esophagus (ESCC) – arises from the epithelial cells that line the esophagus (common type) and esophageal adenocarcinoma (EAC) – arises from the glandular cells present in the lower part of the esophagus, where they have transformed into form of intestinal cells (a condition known as Barrett esophagus).

              Cause of esophageal cancer type squamous cells including cigarettes, alcohol, drink very hot, the diet is not full, and chewing betel. The most common cause of esophageal adenocarcinoma is cigarette smoking, obesity and syndrome gastric reflux – the esophagus.

              Disease diagnosis based on biopsy via endoscopy (a camera, optical fibers). Preventive measures include stopping smoking, combined diet healthy. Treatment is different based on each different stage, cancer location, can general mood of each person and individual requirements.

              Squamous cell carcinoma, small – locally can hope to cure. Most of the other cases, this method of treatment is chemotherapy with / without radiation therapy comes with surgery effects slow down the development of tumors. When the disease becomes more complex or the patient is not healthy enough to go through their surgery, palliative care is the last method to be implemented.

              3. Swallow, choke – signs to recognize esophageal cancer

              Symptoms, swallow, choking or difficulty swallowing are symptoms easy to feel and see in the majority of patients with esophageal cancer. At first, patients often present hard to swallow, but do not feel pain. As the disease worsens, difficulty swallowing, will any more pain. At first the patient only difficulty swallowing with solid food, then hard to swallow with the liquid food, even swallow saliva also feel pain and difficult to implement.

              First symptoms of cancer of the esophagus usually difficult to swallow the level of light and swallow the pain. Then, the disease gradually becomes worse over time. So, the disease should be diagnosed as early as possible to increase your chances can cure and recovery.

              4. Warning signs for esophageal cancer, other

              • Often there is the phenomenon of flowing saliva accompanied by bad breath, belching, choking when eating and drinking.
              • A few cases will feel uncomfortable when eating, feels like trapped. At the same time, when cancer cells spread, the patient will also feel chest pain more.
              • Patients decrease weight markedly, occurs dehydration and gradually is depleted due to not eating and swallow.
              • Is mild anemia and or happens slowly. Sometimes there are also signs of bleeding clear cause lack of blood supply, when that cancer cells have gone into the aorta, can cause bleeding of the esophagus causing sudden death.
              • Patients often have a sore throat or back, behind the breastbone or two scapula.
              • Illness heavy, the patient may appear sore throat, prolonged cough, even coughing up blood.
              • Often feel nausea, vomiting.
              • Other manifestations can be caught when the tumor grows as a heavy, sensation the throat, shortness of breath, cough, sputum, hoarseness,…

              5. Patients should what to do when difficult to swallow?

              Patients need to go for a medical examination when there is expression hard to swallow. However, based only on the symptoms ( typically , swallow, choking, difficulty swallowing) is not enough. The diagnosis of esophageal cancer was based on the diagnostic images and tests clinical other. To accurately diagnose esophageal cancer, patients should be endoscopy combined with ultrasound and biopsy.

              • X-rays of the esophagus: the Patient is prepared in a lying posture. If the disease human esophageal cancer, X-ray images can show a segment of the esophagus; images narrow to please the management; see photos tumor.
              • Computed tomography (CT): this Method has higher precision than X-rays, especially when the cancer cells have spread into the wall of the esophagus. In addition, this method also can detect tumors had metastases in the mediastinum or not.
              • Endoscopy: endoscopy of the esophagus accompanied by biopsy is mandatory testing in the case of X-ray does not identify the disease. This method helps the doctor evaluate the level of spread of cancer and the nature of tumor. Besides the combination of endoscopy and brush staining cytologic result positive for cancer on 90% of cases.
              • Ultrasound via endoscopy: this Method helps to determine the depth of tumor infiltration into the wall of the esophagus, at the same time helps to assess the infiltration of the tumor into the lymph nodes of the esophagus.

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                Things to do in the time detect cancer

                When newly diagnosed cancer patients should ask the doctor and see for yourself how much time to take decision of choosing the treatment regimen and begins treating cancer.

                1. Do when know I have cancer?

                1.1. Talk to your doctor about the disease

                In the majority of cases, patients with cancer need a little more time to search, consult and even discuss the treatment regimen of yourself to get the best decision.

                Many people believe that talking with the doctor are often very difficult, due to the topic of cancer always contain much language expertise complex. Both patients and doctors are experiencing difficulty in the exchange of information illness, from which makes the process of communication becomes ineffective.

                Dr. Ann O’mara – head of Research palliative care under the department of Cancer prevention of the National Cancer Institute of the United States (National Cancer Institute – NCI) said:

                “The exchange in an open manner is always important key in the relationship between doctor and patient, just to help patients get more information useful help for doctors better understand the emotions the patients of his”.

                1.2. Understand the symptoms of her illness

                Cancer patients should record the symptoms of his into a book. Let’s lay out the questions and answers to test your knowledge about cancer are suffering:

                • The exact name of the cancer that you have is what? – Example: stomach cancer
                • Your cancer is in what stage? – For example, stage 3A.
                • We already know what about this disease to make treatment decisions how? – For example as the standard biological (biomarker) or

                1.3. Know the risks of the therapy

                Cancer patients need to find out the answer to the following questions:

                • Therapy has these side effects and how these effects this can prevent or control, how?
                • This therapy will be conducted how?
                • Duration of treatment how long?

                1.4. Consult from the other experts

                Every patient with cancer have the right to question and review, consult from the other experts. Doctor treatment also desired the patient to do so. Often, people often asked opinion from a doctor in the treatment centre or who have professional medical to search for multiple methods of care as well as more new information about cancer that they are suffering.

                1.5. Go to the doctor with your friends or relatives

                Relatives or friends can help cancer patients listen, to record the important things, ask the necessary questions and also help get more motivation to continue treatment. If there are people around the same, mentally also more comfortable when have to suffer alone.

                Talk to friends and family about problems you encounter, they will help and support you overcome the difficult phase mentally. First need to talk with the best friend or family ago. Then, create a list of people that can be trusted to share.

                1.6. Prepared financial to treat the disease long-term

                Patients should refer to the staff advisory, financial or social to know about the bills, doctor visits, hospital fees, surgery cost, cost of cancer treatment and the drugs as well as care services, other support. Should consider the treatment site to achieve the highest efficiency with the cancer I have and fit the economic conditions of the family, as well as issues related to health insurance.

                When the diagnosis is cancer, the patient will not fall into a state of depression if carried out the above tips. We all inevitably get sick at a certain time in life. So, the need to maintain a positive attitude combined with serious treatment to be able to recover quickly okay.

                2. What to know relatives with cancer

                2.1. Respect for patients

                In the process of treatment, cancer can make the patient become emaciated, pale, hair, eyebrow hair loss… However, the family should not have proved too worry because now there are methods to help patients with cancer still fresh health by wearing a wig, lipstick, eyebrow pencil…

                In addition, the family should not be changing diapers or their bed linens while there are many who come to visit. Although patients with cancer are experiencing the last days in a coma, but when want to talk about the disease state of patients suffering from cancer, the family should go out of the room, avoid standing at the bedside discussion, especially with the reproach, because did not pay attention to health of self.

                2.2. Allow yourself to grieve

                When the patient suffering from cancer to leave, accepting the absence as well as overcome the pain can be very difficult and never ending. Let yourself be expressing emotions, don’t try to endure because it will make yourself more tired. Each person has a way to heal his wounds in different ways. Time will help your family erase this pain, but need to slowly and gentle with yourself because in no way can help you overcome the pain quickly.

                2.3. Don’t create false hope

                Family not for patients with cancer know the results the diagnosis of cancer because of not wanting to grieving relatives, think despair… family lied and denied to relatives know the condition its true.

                However, patients with cancer can will guess be sick when notice the unusual symptoms such as bleeding, pain, soreness… When you know the truth, patients with cancer will become more frustrated and taken the decision not to correct, for example, away from home, suicide… Instead of so, family, let’s cancer patients facing the illness and learn to accept the truth.

                3. Address clinic psychological health for cancer patients

                Clinic psychology – hospital international Vinmec officially went into operation from January 4/2019, with functions of examination, consultation and outpatient treatment of psychological problems and psychological health. With modern equipment, clinic, health Psychology Vinmec is collaborating with professors, experienced professionals:

                • ThS. Doctor Nguyen Van Non – specialist Doctor, Psychological, hospital, international Vinmec Times City: with 7 years experience working with the position is lecturer, department of psychiatry – Hanoi Medical University, psychiatrist at hospital Hanoi Medical University & hospital Geriatric Central, at the same time is a member of The psychiatry in Vietnam.
                • ThS. Doctor Pham Thanh Luan – specialist Doctor, Psychological, hospital, international Vinmec Times City: with 5 years of experience in research, examination and treatment of patients under specialist mental faculties, 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: 6 years as lecturer, Department of psychiatry – School of Hanoi Medical University and hospital Geriatric Central, along with experience in research, examination and treatment of patients under specialist mental illness as: emotional disorders, related disorders stress and disorders body shape, the developmental disorders in children, youth & the period of childbearing….

                Along with the combined deployment of psychological test, psychological therapy, intensive service of diagnosis and treatment, aiming to bring efficient patient care best.

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

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                This article is written for readers in Ha Noi.

                  Causes infant respiratory

                  Causes of acute respiratory distress in neonates may originate from the lungs, like the diaphragm in inhalation of amniotic fluid, inflammation of the lungs or outside the lungs, such as atrophy of the esophagus, congenital heart disease. When discovering any unusual signs, need fast processing to limit the dangerous complications.

                  1. Acute respiratory distress in the newborn

                  Acute respiratory distress in the newborn, also known as diseases of the membrane in the usually appear after few hours or few days normal breathing after birth. The disease occurs principally in the preterm infants, the incidence rate of disease increase according to weight and time appears disease, specific as follows:

                  The child’s weight at birth (g)

                  The incidence of membrane in (% )

                  1001 – 1250
                  1251 – 1500
                  1501 – 2000
                  2001 – 2500

                  40
                  50,5
                  60,3
                  < 10

                  Time to occurrence of disease after birth

                  The incidence of membrane in (%)

                  0 – 12 hours
                  12 – 24 hours
                  > 24 hours
                  2 – 3 days
                  3 – 4 days
                  5 – 10 days

                  75
                  69
                  50
                  30
                  24
                  10

                  Clinical symptoms of the disease acute respiratory distress in an infant is young, suddenly shortness of breath, intense rapid breathing over 80 times / min, breath, scream, withdraw concave chest, cyanotic skin icon is increasing. Only after several hours of rapid breathing, the child will have expression suffocated, tired, exhausted and breathing rate slow down gradually, then stop breathing and death.

                  1.1 evolution of acute respiratory distress in the newborn

                  • Stage 0 – 5 hours after birth: the Child is still normal respiration.
                  • After 5 – 10 hours: Children may manifest acute respiratory distress, rapid breathing, accompanied by signs of disorder of gas in the blood.
                  • From 10 – 24 hours: the Child begins to exhaustion, breathing slowly, appearing metabolic disorders, acidosis, blood heavy.
                  • After 24 hours: Risk of child mortality if not supported mechanical ventilation during respiratory failure. If, as is respiratory care good, the disease will leave within a week.

                  1.2 causes of acute respiratory distress in the newborn

                  Causes of acute respiratory distress in the newborn primarily related to the factors:

                  • Premature babies: permeability pulmonary capillaries increases, causing extravasation amounts of blood cells and plasma into alveoli. After the alveoli are drawn away by the lymph path, heart, alveoli also contained many red cells and fibrin.
                  • Babies with asphyxia before birth: cell alveoli is hypoxic, not produced surfactant, a surface-active substances. So after the period of normal breathing, the child will suffer from lack of surfactant due to the many alveoli collapsed, causing respiratory failure. When that child attempts to inhale, but air does not get into because alveoli have collapsed.
                  • Syndrome inhalation of amniotic fluid: Children with syndrome, inhalation of amniotic fluid usually have prognosis very bad. Children with respiratory distress soon after birth. The cause is due to children being asphyxiated fetus, so the child has breathing movements before birth and accidentally inhaling amniotic fluid. When born, the child is choking, cyanosis, nose, mouth full of amniotic fluid when infected with the meconium.
                  • Pneumonia: Inflammation of the lungs usually occurs in the first 3 hours after birth due to infection of the fetus. Severe disease, often accompanied by infection, bacteria of blood, bacterial infection of the whole body.
                  • A number of other causes such as Atrophy of the esophagus, congenital heart disease, retard left ventricle, problems in the ductus arteriosus. Diaphragmatic hernia, brain hemorrhage meninges.

                  The pathology also have the potential to cause rhythm disturbances, breathing, stop breathing in infants. Therefore, when discovering any unusual signs, need fast processing to limit the dangerous complications.

                  2. Why should clinic acute respiratory distress for children in hospital, international Vinmec?

                  Hospital international Vinmec is are is address, clinic visits, diagnosis, causes and treatment of acute respiratory distress repute, is many parents believe the choice is where sending and health care for children

                  At general hospital, international Vinmec has a team of experts, pediatricians, Pharmacists and nursing qualified professionals, skilled professionals, many experience, especially conscientious and professional.

                  With the full support of many technical facilities, modern hospital, international Vinmec guarantee to provide care services, comprehensive health, and most effective, reserved for the children.

                  At Vinmec, Hai Phong and Vinmec Nha Trang apply technical pump Surfactant in the treatment of respiratory distress in premature infants caused by a deficiency of surfactant, first developed in premature infants caused respiratory distress syndrome in preterm infants. Therapy Surfactant therapy for pediatric patients ≤ 26 weeks when needed FiO2 > 0,30 and for pediatric patients > 26 weeks required FiO2 > 0,40.

                  Technical pump Surfactant will be difficult to implement if the standard of care generally do not reach high quality. Vinmec has to meet the conditions of rigorous standards to apply therapy Surfactant in the treatment of respiratory failure in the newborn, including full media support and the team of doctors perform well-versed in the technique: intubation, use of ventilators, handle emergency situations, respiratory, circulatory, treatment of ca patients is pneumothorax.

                  For more detailed information about technical pump Surfactant treatment for respiratory distress newborn at Vinmec, customers can sign up for clinic online HERE, or contact our hotline the hospital at the following address:

                  Hospital international Vinmec Hai Phong: 0225 7309 888

                  Hospital international Vinmec Nha Trang: 0258 3900 168

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                    [Vinmec – Ask the experts] No. 01: theme from insomnia (Part 1)

                    Insomnia is a symptom complex, including difficulty sleeping or difficulty maintaining sleep for a long time, causing directly affect the health and spirit of patients, at the same time, insomnia is also a warning sign more dangerous pathologies such as depression, weight gain, chronic pain… To learn more about your sleep, Vinmec answer the questions related to insomnia and treatment measures from the perspective expert.

                    The question is advice by Doctor CKII The Paint – hospital international Vinmec Hai Phong

                    1. You Ta Tuyet Mai (Student, vietnam National University, Hanoi): Hello Doctor I this year 20 years old is student, year 3, the current main job of you is learning and has to do more. Work and learning majority of the time, however I still balance the time to rest and get enough sleep. However recently I appear symptoms such as fatigue, stress, day dozing not focused is that the night is very sober, can play phone continuously without eye fatigue? Your doctor can let you know is so you can get the disease from insomnia, please? And when called insomnia it? Thank you, doctor.

                    Doctor CKII The Paint: Hi! Insomnia is a symptom complex, including difficulty sleeping or difficulty maintaining sleep for a long time. Called insomnia when:

                    • Trouble sleeping at night.
                    • Wake up at night.
                    • Waking up too early.
                    • Not feel relaxed after a night’s sleep.
                    • Daytime fatigue or sleepiness.
                    • Irritability, depression or anxiety.
                    • Difficulty paying attention, focusing on tasks or remembering.

                    Insomnia is often divided into three categories:

                    1. Insomnia transient – occurs when symptoms lasts up to three nights,it is often the result of stress or an event that causes worry.
                    2. Insomnia acute – also known as short-term insomnia. The symptoms exist for several weeks.
                    3. Chronic insomnia – this type lasts for many months, and sometimes years, often related to chronic physical illness: chronic pain, pulmonary disease, chronic obstructive, asthma , sleep apnea, Parkinson’s disease and Alzheimer’s, hyperthyroidism , arthritis…

                    To know the exact status of their disease, you should go to a hospital, medical facility, reputed to be the therapist diagnosis as well as give treatment accordingly.

                    2. Ms. Nguyen Thi Ngoc (Yen phu, Ba Dinh, Ha Noi): Hello doctor, I this year 35 years old is the office staff. The years back here, I often lose sleep despite trying to improve by exercise, changing diet. So cases insomnia is my disease and need treatment? Thank you, doctor!

                    Doctor CKII The Paint: insomnia (insomnia) or trouble sleeping (sleeping dificulties) is a disease affecting the lives of many people. Difficulty sleeping comes in many forms, difficulty falling asleep, disturbed sleep, waking up early not sleep again, or waking up many times during sleep, each time longer than 30 minutes. Women suffer from insomnia more than men, especially at the age close to menopause. The cause maybe due to the disease related rather than due to lack of hocmon. The older the risk of insomnia as high. Can categorize insomnia as follows:

                    • Disease insomnia are related to mental illness.
                    • Insomnia is acute insomnia is brief and often happens because of life circumstances.
                    • Chronic insomnia is when insomnia at least three nights per week and lasts at least three months.

                    Case if your have applied the method to improve sleep without medication, without effective, you should go to see a doctor specializing in neurology or psychiatry for advice.

                    3. Tran Xuan Duc (37 years old – Ly Nhan, Ha Nam): Hello doctor, due to the nature of work should 2 weeks now I usually sleep very little, many days I only get to sleep 5 – 6 hours. Although sleeping less and not increase the diet, I still increased by 2 kg. My friends tell me to gain weight due to loss of sleep. This is not true, thanks to doctor answer help why lose sleep over weight gain?

                    Doctor CKII The Paint: Hello, you described your can summary cause insomnia back your weight gain is as follows: Sleep not enough sleep, the body needs more energy to operate should eat more, while the metabolic process to be less effective, very easy to make hoarding excess fat.

                    Sleep disorders will increase the amount of hormones Ghrelin and Leptin that stimulates appetite, increases the process of fat production and increase weight. So have you only sleep about five hours per night and when to start sleep again seven or eight hours will see weight loss and improved health.

                    4. You Nguyen Ngoc Minh (26, Minh Khai, Hanoi): Doctor I have pregnancy insomnia how to do? You are pregnant in the 3rd month, in addition to morning sickness don’t eat is what I also suffer from insomnia. Lying awake ever get to sleep, but sleep is not deep, only 1 little noise which made me wake up at midnight. I was so afraid affect the child, but the way people tell all with no side effect. Ask your doctor for advice to help you with, sir!

                    Doctor CKII The Paint: You can lose sleep during pregnancy for many reasons. Whatever the reason may be what is, it is important to understand that insomnia is not harmful for your baby. Insomnia during pregnancy is normal and affects approximately 78% of pregnant women .

                    Causes of insomnia during pregnancy include:

                    • Discomfort due to the size of your abdomen increases.
                    • Back pain.
                    • Heartburn.
                    • Frequent urination at night.
                    • Tired, vomiting , poor appetite due to morning sickness.
                    • Hormonal changes.

                    To improve the condition of insomnia during pregnancy, you can apply some following measures:

                    • Posture sleep: should slant to the left. This posture helps the blood circulation to the best pregnancy. Can use pillows U-shaped to support sleep.
                    • Join yoga class pregnant.
                    • Massage legs, arms before going to bed to avoid cramps.
                    • Do not drink too much water before going to sleep.

                    5. You Ding haiyan (28 years old, office worker): Yes, hi doctor. You’re pregnant, babe, first time, 11 weeks already. This batch I often have trouble sleeping, with insomnia again. I this new year 25 years old, office job, so no pressure at all, and also only lost sleep from when pregnant, sir. Do not know wife pregnant suffer from insomnia in the first 3 months there is no danger, ma’am?

                    Doctor CKII The Paint: dear Friends! You should not worry, because insomnia is a condition common during pregnancy and does not affect the fetus. However, if you lost a lot of sleep and prolonged (Sleeping less than 6h per night) may be at risk of a caesarean section higher and the duration of labor is also more prolonged than with the pregnant sleep from 7 hours or more each night. And can cause the fetus underweight, fussy and difficult to feed.

                    Insomnia during pregnancy first trimester are usually due to other causes: In the first months of pregnancy, pregnant will often take plenty of sleep most of the body is too tired when to mobilize blood and oxygen to the formation of the placenta nourishes the fetus. In addition, the growing of the fetus according to the time dilation of the pelvis of the mother presses on the blood vessels causing edema leg pain, back pain makes difficult to sleep.

                    During pregnancy, the mother needs to share nutrients and oxygen for the baby, especially first 3 months, many, mom, morning sickness, the additional nutrients are not enough leads to skinny kick body weakness, fatigue and poor sleep. In the last months of pregnancy, the uterus gradually expands, displaces and presses up the diaphragm, causing movement of the diaphragm reduce should pregnant women have to breathe deep to breathe more to get more oxygen. This makes pregnant feel uncomfortable and affect the quality of sleep.

                    Solutions to improve insomnia symptoms in pregnant in the first month:

                    • Nutrition: Increase foods rich in vitamin B like green leafy vegetables, whole grains can help you sleep better
                    • Should not eat before going to sleep. Limit your intake of sweet drinks which irritate.
                    • Regular physical activity helps blood circulation, sleep, reduce stress. Mom can walk each day or swimming, before sleeping, maybe a warm bath, drink a glass of hot milk,…
                    • In addition, before going to sleep, soak your feet in warm salt water can add the lemongrass, lime leaves,… will help blood flow, from which the mother will sleep a lot more.
                    • Sleeping posture: pregnant women should exercise for yourself proper sleeping posture when pregnant. The best posture and the most comfortable is lie on your left side, knees bent, legs, guards up high. This posture helps reduce the pressure on leg veins, limit status, edema, increase in blood supply to the heart, decrease syndrome, low blood pressure, beneficial for improving blood circulation of blood of the placenta.
                    • Proper rest.

                    6. You Tran Thu Ha (Student year 3 University of National Economics): doctor, Hello, my name is Ha, 21 year old. Current I is a student in year 3. I’m going to do more evening came home it was already 10 p.m. then, add all showered and review the lessons again, the range of about 12 hours as I went to bed but couldn’t sleep. I feel the insomnia is also a disease should be very worried, do not know insomnia can cure not doctor? Help you with.

                    Doctor CKII The Paint: Hi! Insomnia can be treated. The treatment of insomnia should be based on the cause of insomnia.

                    The causes of insomnia include:

                    • Use of mobile phones: blue Light in your phone affects sleep due to impact to the natural circadian rhythms of the body
                    • Eating habits, living without moderation.
                    • Stress stress: is cause insomnia typical of young people. Pressure life makes the body loses balance between spiritual comfort and inhibition, from which a strong impact to the central nervous system, cerebral cortex, severely impair to sleep.
                    • Working computer, using smart devices too much: These devices will emit electromagnetic radiation, this is the causative affects the brain and the nervous system of the eye and is also one of the causes of insomnia in young people.
                    • Substance use: regular use of stimulants such as tobacco, wine, beer….will cause strong influence on the nervous system make the nervous system and brain are always in a state province.
                    • Overfeed when sleeping: In the evening if eat too much before going to sleep will cause us to lose sleep so the body can digest the amount of food that you have loaded on the inside of the body.
                    • With certain types of the disease: rhinitis, sinusitis, the diseases of the stomach, bones, joints… – drug abuse headache.

                    To know exactly his condition, you should go to hospital to be specialist doctor visits and treatment. A number of corrective measures to have more restful sleep:

                    Before going to sleep you let’s put aside the entire the work in progress, let loose body, and let his mind be relaxed by reading, listening to music, playing a game of light entertainment…

                    Adjust routine daily activities, such as increased agitation, maintained time diet proper rest.

                    Minimize the use of phone, computer,… especially before sleep.

                    Absolutely do not buy sleeping pills, about user. In case your doctor thinks that jobs evening part how can the impact cause irritation and stress for the brain, should you have trouble falling asleep. So when going to bed you should relax relax your body, lie still, breathing evenly with sleep will come to you

                    7.You Tran Thi Nguyen (email Address: [email protected]): Dear doctor, I’m 33 years old, have a family and 2 babies (2 years old ). Work is office staff. About 4 months now I experiencing the state of insomnia, normally I sleep from 10am to about 3 am is the province and not sleeping again. Every living habits are not have what change, not stress or think what. I have applied many methods but no improvement. Please be doctor advice.

                    Doctor CKII The Paint: Hello to you, When you wake up too early, and prolonged duration of 04 months. So you have sleep disorders then. But the condition, disorder, your sleep is not too severe, you can just take sleeping pills, herbal pills will help you last long sleep to 05 – 06h morning, break the habit of waking at 3pm. Condition disorders your sleep will improve after a few weeks of taking the drug. However, you should go to a doctor specializing in neurology or psychiatry for consultation and prescription, though the drug which is herbal medicine.

                    On this is a number of questions related to symptoms of insomnia. The question of reading continue to be the doctor answered in the next section.

                    Doctor CKII The Painting has 20 years of experience in the field of neurology. Special doctor has a lot of experience in the diagnosis and treatment of diseases such as sleep disorders, complications cerebral artery, herniated disc spine, parkinson’s disease, epilepsy, diseases of peripheral nerves, headache, dizziness… is a Doctor specialized neurological Medical hospital & medical hospital international Vinmec Hai Phong.