Neonatal bladder rupture is rare as a complication of bladder obstruction due to abnormal anatomy or iatrogenic cause such as umbilical catheterization. The present study describes the case of a 27-day old infant with ascites due to bladder perforation secondary to bladder wall necrosis as a result of severe urinary tract infection. The baby was treated aggressively with antibiotics and underwent successful surgical repair of the perforation.

A627identify the direct costs, including costs for drugs and medical services, and indirect costs, including loss productivity, loss of work, cost for accommodation and transportation due to treatment and other costs of patient and caregivers. Results: Annual total cost per patient with asthma accounts for 6,618,682 VND, from which direct costs are 2.5 times more than indirect cost (4,738,682 vs 1,880,000 VND). The total cost of asthma has increased following the asthma severity with 4, 960,278; 8,098,156; 10,759,234; 13,196,280 VND in mild, intermittent, moderate and severe asthma rate. In the structure of total cost, following the asthma severity, the percentage of direct costs increases and indirect costs decreases especially in the mild rate. Total economic burden of asthma was 23,165 billion VND, from which 71.5% (16,585 billion VND) are for direct costs and 29.5% (6,580 billion VND) for indirect cost. ConClusions: The economic impact of asthma (23,165 billion VND) on asthmatic patients, families and society is significant. According to the study, putting more public health efforts to better control asthma is the first necessary step to reduce the costs of asthma.

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Objectives: To analyze the risk factors associated with the out-come of hospital acquired pneumonia (HAP). MethOds: A prospective observational study, carried out in a tertiary care teaching hospital. HAP patients who fulfill the inclusion criteria were identified and enrolled into the study after taking informed consent. Patients were followed from the day of diagnosis of HAP to till the day of discharge/death. The patient data like demography, social habits, co-morbid diseases, interventions (mechanical ventilation), severity assessment (APACHE II score) and clinical outcome (discharge or death) were recorded in the case record forms. Univariate and Multivariate analysis were used to determine the association of the studied risk factors with clinical out-come. Results: Total of 505 patients were enrolled in the study. Among 505 HAP patients, 417 were improved and discharged; remaining 88 patients were expired. The mean age of study patient population was 55.1±16.2 years and 38.4% patients were more than 60 years of age. The majority of patients were males n= 338 (66.9%). 230 (45.5%) patients were ventilated during their stay in the hospital. Twelve variables (age> 60 years, sex, mechanical ventilation, APACHE-II> 20, cardiac, pulmonary, renal, immunosuppression, diabetes mellitus, liver insufficiency, smoking and alcohol intake) were analyzed for possible association with the clinical outcome of HAP in Univariate analysis. Variables with statistical significance during the Univariate analysis were entered into the multivariate analysis. The following five variables were found statistically significant independent predictors of out-come (mortality) in these patient population in multivariate analysis using logistic regression: mechanical ventilation (OR: 9.81; CI:4.98-19.35; p< 0.001), immunosuppression (OR:4.31; CI:1.65-11.27 ; p< 0.003), liver insufficiency (OR:3.69; CI:1.43-9.55; p< 0.007), APACHE II> 20 (OR:2.72; CI:1.56-4.76 ; p< 0.001) and male sex (OR:2.27; CI: 1.71-4.38; p< 0.015). cOnclusiOns: HAP has contributed significantly to mortality (17.4%). Mechanical ventilation, immunosuppression, Liver insufficiency, APACHE II score > 20 and male sex were found to be independent predictors of mortality in HAP patients.

A633 cost, drugs cost accounted for the highest proportion with 44.52%; the lower is the clinical test cost with 21.67% (3,376,153.70 and 1,643,644.83 VND; respectively). The influential factors on costs of treatment included the place of residence, the number of days in hospital, the stage and the complications of cirrhosis. ConClusions: With the rising trend of liver cirrhosis in Vietnam and the high cost of treatment, national health policies and medical programs should be considered.