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Objective: This study aimed to assess the effectiveness and determine the optimal cut-off point of the ADNEX model in women presenting with a pelvic or adnexal tumor. Method: All women presented with adnexal mass and were scheduled for operation at Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital, Vietnam during June 2019 – May 2021 were included and categorized according to their histopathologic reports into ovarian cancer groups and benign ovarian tumor groups. Multivariable logistic regression was used to explore for potential predictors. The ADNEX model with and without CA125 was used to assess the risk of ovarian cancer preoperative. The goldden standard to evaluate the accuracy of ultrasonography using the ADNEX model was the pathological report. In addition, the accuracy as well as optimum cut-off point of the ADNEX model was estimated with and without CA125. Results: A total of 461 participants were included in analysis and predictive model development, 65 patients in ovarian cancer group and 361 in benign tumor group. The ADNEX model combined with CA125 proved to be a useful predictor with an area under ROC of 0.961 (0.940 – 0.977) with Youden’s index of 0.8395, p0.001. The ADNEX model without CA125 also had high predictive value between benign and malignant tumors, with an area under ROC of 0.956 (0.933 – 0.973) with Youden’s index of 0.8551, p0.001. Cut-off of the ADNEX with CA125 was 13.5 and without CA125 was 13.1 for sensitivities were 90.8 (81.0 – 96.5) and 93.9 (85.0 – 97.5), specificities 93.2 (90.2 – 95.5) and 91.67 (88.5 – 94.2). The difference in the predictive value of malignancy-risk between the ADNEX model with CA125, without CA125 was not statistically significant, p=0.4883. Conclusion: The ADNEX model, with or without the combining marker CA 125, provides a valuable predictive value for ovarian tumor malignancy preoperative.

The aim of this study is to determine whether the myocardial performance index (MPI) is increased in fetal growth restriction (FGR) fetuses and if increased MPI is related to adverse outcomes of FGR. This is a prospective cross-sectional study. Seventy-three late-onset FGR fetuses and 97 gestational-age matched control fetuses were enrolled in this study. Fetal blood flow parameters including MPI values were measured and compared between the two groups. For the effect of severity of growth restriction on MPI value, they were also compared with < 3rd and 3rd – 10th centile groups. FGR fetuses were divided into two groups by favorable and adverse outcome and ultrasound parameters were compared between these two groups. Moreover, significant factors related to adverse outcomes by univariate analysis were analyzed by multivariate logistic regression analysis. Pulsatility index of umbilical arterial flow (UA-PI), MPI and amniotic fluid index in the FGR were significantly different from the control fetuses. However, no significant difference between < 3rd and 3rd – 10th centile groups was detected in MPI and UA-PI. The increased levels of MPI and UA-PI were independently related with adverse outcome of late-onset FGR pregnancy. In conclusion, MPI values were increased in late-onset FGR pregnancy, and the higher level of MPI could predict adverse outcome as well as the measurement of UA-PI. Clinicians should consider cardiac dysfunction in FGR through increased MPI., This is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Aim: To measure the overall level of quality of work life (QWL), and its association with personal and work-related factors among nurses working at a provincial general hospital in Vietnam. Design: A cross-sectional study. Methods: One hundred and sixty nurses were selected by stratified random sampling. Questionnaires were used to survey personal factors, job position, salary, and working years, including work life dimensions. The reliability of the instrument used for the survey was tested using Cronbach alpha, which yielded an index of 0.925. Data were analyzed using the Chi-square test (p < 0.05), and Pearson’s and Spearman’s correlation coefficient. Results: The overall score of QWL among nurses was moderate, scaled at 3.04 (± 0.55). A weak positive correlation between QWL and age (r = 0.196), working years (r = 0.204), and care-giving responsibilities at home (r = 0.179) was revealed. Educational level was most strongly associated with QWL (r = 0.515), and a multiple linear regression analysis confirmed that the standardized coefficient was highest for education (0.365). Conclusion: The majority of the nurses had a moderate level of overall QWL, with education the key associated factor. Our findings may help to improve the nursing profession, and, hence, the quality of healthcare in Vietnam.

Local injection of methotrexate (MTX) has been widely used for caesarean scar pregnancy (CSP),but the optimal candidate remains undetermined. The aim of this study is to determine the risk factors associated with treatment failure among patients who received a single dose of local MTX. This is a retrospective cohort study. Clinical information was compared between treatment success vs. failure groups. Risk factors related to treatment failure were also investigated with multivariate analysis. Of 47 patients diagnosed with CSP, 30 received local MTX injection. The initial serum ß- human chorionic gonadotropin (hCG) level in the failure group was significantly higher than in the success group (p = 0.048), and the cut-off value was 47,000 mIU/ml. The rate of type 2 position of the gestational sac in the failure group was significantly higher than in the treatment success group (p = 0.031). A high initial serum ß-hCG level (≥ 47,000 mIU/ml) was identified as the independent risk factor for treatment failure (adjusted odds ratio = 21.9; 95% confidence interval = 1.3–383.1). Type 2 gestational sac position and a higher level of ß-hCG at diagnosis appear to be associated with poor outcomes after local injection of a single dose of MTX., This work was supported by JSPS KAKENHI (Grant Number: 15H02660).

Introduction Episiotomy has been the most common procedure in obstetrical practice; however, its benefits remain controversial, especially in case of postpartum pelvic floor disorder and sexual dysfunction. Aim The aim of this study was to evaluate early complications, pelvic floor, and sexual dysfunction after delivery with episiotomy and their associated factors. Methods 158 healthy pregnant women at term (38 weeks 0 days to 41 weeks 6 days), aged above 18 years old, who vaginally delivered a singleton baby with cephalic presentation were recruited. The subjects were evaluated through 3 interviews at 1−3 days, 6 weeks, and 3 months after delivery, respectively. Main Outcome Measure The evaluations were accomplished primarily by administration of 2 validated questionnaires: the Pelvic Floor Distress Inventory Short-form 20 to evaluate symptoms of pelvic floor dysfunction, and the Female Sexual Function Index to evaluate effects on the women’s sexual life. Results Among early complications, pain while sitting (30.4%) was the most prominent trouble, other pelvic disorders, such as urinary incontinence (11.4%), urinary retention (10.8%), or flatus incontinence (8.9%), were also observed in a remarkable number of participants. Average Pelvic Floor Distress Inventory Short-form 20 score was 7.0 ± 10.2 after 3 months. At that time, the prevalence of sexual dysfunction was 40.7%. Trouble occurred commonly in the domains of desire (68.9%) and pain (58.5%). Associated factors of sexual dysfunction were maternal age over 30 years and parity. These factors, in combination with birth weight over 3,500 gram (g), were also associated factors of pelvic floor disorders. Conclusion Pelvic pain was the most popular postdelivery complication. Urinary and bowel dysfunction were self-limited complications. Despite being considered a simple technique, episiotomy and its repair must be performed rigorously in order to allow the best recovery of pelvic floor and sexual function.

Cervical cancer is a significant public health problem, with 570,000 new cases and 300,000 deaths of women per year globally, mostly in low- and middle-income countries. In 2018 the WHO Director General made a call to action for the elimination of cervical cancer as a public health problem.New thinking on programmatic approaches to introduce emerging technologies and screening and treatment interventions of cervical precancer at scale is needed to achieve elimination goals. Implementation research (IR) is an important yet underused tool for facilitating scale-up of evidence-based screening and treatment interventions, as most research has focused on developing and evaluating new interventions. It is time for countries to define their specific IR needs to understand acceptability, feasibility, and cost-effectiveness of interventions as to design and ensure effective implementation, scale-up, and sustainability of evidence-based screening and treatment interventions. WHO convened an expert advisory group to identify priority IR questions for HPV-based screening and treatment interventions in population-based programmes. Several international organizations are supporting large scale introduction of screen-and-treat approaches in many countries, providing ideal platforms to evaluate different approaches and strategies in diverse national contexts.For reducing cervical cancer incidence and mortality, the readiness of health systems, the reach and effectiveness of new technologies and algorithms for increasing screening and treatment coverage, and the factors that support sustainability of these programmes need to be better understood. Answering these key IR questions could provide actionable guidance for countries seeking to implement the WHO Global Strategy towards cervical cancer elimination.

Introduction: A healthy sexual life would contribute to a lasting intimate couple relationship; pregnant women were susceptible to physical, psychological and social changes leading to sexual alterations and dysfunction in pregnancy. In ***, despite not being a novel domain, sexuality has not been extensively evaluated due to the influence of Eastern tradition, which creating promotes unsecured feelings of insecurity when talking about sex.Aim: To investigate the female sexual function alteration during the 1st trimester of pregnancy and some related factors among *** women.Methods: A descriptive cross-sectional study comprising 383 women aged from 18 years old having routine antenatal visits at Department of Obstetrics and Gynecology, *** Hospital from April 2016 to March 2017. Data were collected by interviews using is Female Sexual Function Index (FSFI) questionnaire.Main outcome measures: Subjects’ sexual function alteration, using the validated *** version of Female Sexual Function Index.Results: The prevalence of women with female sexual function alteration before pregnancy was 53% and in 1st trimester was 88.8%. The frequency of intercourses during 1st trimester of pregnancy is lower than before pregnancy (pst sexual intercourse, pregnancy planning, obstetrical history, sexual initiative, religion, academic level, and jobs (pConclusions: Sexual function alteration among first trimester pregnant women is a problem which should be considered, and medical staff should provide counseling to them to improve the quality of their sexual life and maintain normal course of pregnancy.

Introduction: A healthy sexual life would contribute to a lasting intimate couple relationship; pregnant women were susceptible to physical, psychological and social changes leading to sexual alterations and dysfunction in pregnancy. In Vietnam, despite not being a novel domain, sexuality has not been extensively evaluated due to the influence of Eastern tradition, which creating promotes unsecured feelings of insecurity when talking about sex.Aim: To investigate the female sexual function alteration during the 1st trimester of pregnancy and some related factors among Vietnamse women.Methods: A descriptive cross-sectional study comprising 383 women aged from 18 years old having routine antenatal visits at Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy Hospital from April 2016 to March 2017. Data were collected by interviews using is Female Sexual Function Index (FSFI) questionnaire.Main outcome measures: Subjects’ sexual function alteration, using the validated Vietnamese version of Female Sexual Function Index.Results: The prevalence of women with female sexual function alteration before pregnancy was 53% and in 1st trimester was 88.8%. The frequency of intercourses during 1st trimester of pregnancy is lower than before pregnancy (pst sexual intercourse, pregnancy planning, obstetrical history, sexual initiative, religion, academic level, and jobs (pConclusions: Sexual function alteration among first trimester pregnant women is a problem which should be considered, and medical staff should provide counseling to them to improve the quality of their sexual life and maintain normal course of pregnancy.

Additional file 1. Data collection tool.

This study assessed the knowledge, practices, attitudes, and educational needs related to research ethics across health professions faculty, including nursing, in a university located in Vietnam. Consistent themes across five focus groups and two interviews included promoting knowledge of research ethics, ethics in context, and the value of international partnerships to promote ongoing knowledge of research ethics. Results from this study can be used to strengthen the university's curriculum reform efforts for nursing programs and other health profession curricula across the university. Research partnership opportunities may further the development of research ethics among nursing faculty and students.

Objectives To evaluate the validity of serum CA-125, Human Epididymis protein 4 (HE4) and Risk of Malignancy Algorithm (ROMA) at standard and optimal cut-offs, in preoperative prediction of epithelial ovarian carcinoma (EOC) in Vietnam. Subjects and methods Cross-sectional, descriptive study on 277 patients with ovarian masses hospitalized at the OBGYN Departments, Hue University Hospital and Hue Central Hospital, Vietnam, from 01/2016 to 11/2017. All patients had measurements of serum CA-125 by Elecsys 2010 system and HE4 by immunoassay ARCHITECT® HE4 kits; ROMA calculated, and preoperative malignancy risk estimated. Matching these values to postoperative histopathology resulted in the preoperative prediction values. Results There were 30 (10.8%) cases of EOC. Median values of CA 125, HE4, and ROMA of EOC and benign tumors were 214.20 U/ml, 18.91 U/ml; 90.00 pmol/l, 39.80 pmol/l; and 55.20%, 4.80%, respectively. The sensitivities and specificity of CA125, HE4, and ROMA to distinguish between malignant and benign tumors at standard cut-offs were 83.3% and 78.5%; 50% and 98.38%; 80.0% and 84,6%, and those at optimal cut-offs were 83.3% and 86.6%; 80.0% and 91.5%, 86.7% and 88.7%, respectively. AUCs of CA-125, HE4, and ROMA were 0.872, 0.894, 0.912; and those for the post-menopausal group were 0.900, 0.894 and 0.924, respectively. Conclusion Serum CA 125 and HE4 levels and ROMA have good validity in the diagnosis of EOC, of which ROMA gives the best result. The ROMA index should be applied in clinical practice to help in the assessment and management of patients with suspected ovarian cancer., Highlights • HE4 and ROMA yielded good validity in the preoperative diagnosis of epithelial ovarian cancer. • In pre-menopausal group, the modified ROMA cut-off value (9.89%) yielded a better specificity. • ROMA can help with the assessment and management of patients with suspected ovarian cancer.