Theo ffdc tinh eiia WHO, d Viet Nam con sd ngd dpc thffe pham hang nam khoang tren 8 trieu ngffdi [5].. trong nhffng thanh phd dang trong tinh trang bao ddng ve van de ATVSTP, Trong dd A
Trang 1TAI L I f U T H A M KHAO
1 Jha, A., Sayami, G., Adhikari, R C , Panta, D.,
Jha, R (2008) Bone marrow examination in cases
of pancytopenia 3 Nepal Med Assoc, 47, 12-17
2 Kibria, S G., Islam, M D U (2010)
Prevalence of Hematological Disorder: A Bone
MantJW Study of 177 Cases In a Private Hospital
at Fandpur Farldpur Med Coll J, S, 11-13
3 Knodke, K., Marwah, S (2001) Bone marrow
examination in cases of pancytopenia J Academy
QinMed,!, 55-59
4 Levine, F C (1999) "Idiopathic"
thrombocytopenia Arch Intern Med, 88, 701-728
I 13 Levine, S P (2003) Thrombocytopenia:
pathophysiology and classification In Greer 3P,
Foerster J, Lukens JN, et al (Eds.), Wintrobe's clinical hematology 11th ed (vol 2, pp
1530-1532) Philadelphia: Lippincott Williams & Wilkins MeKenzie S B (Ed.), (1996) Textbook of hematology, 2nd ed Painsylvania: Willaims& Wilkins
Muhury, M., Mathai, A M (2009)
Megakaryocytic alterations in thrombocytopenia: A
bone marrow aspirabon study Indian J PatholMlcrobioi, 52, 490^94
Pudasaini, S., Prasad, K B R (2002)
hematological disorder Journal of Pathology of Nepal, 2, 309-312
THirC TRANG AN TOAN VE SINH THITC PHAM TAI BEP AN TAP THE COA M O T "SO DOANH N G H I E P - T H A N H PHO HAI DiraNG NAM 2 0 1 3
TbM TAT
Nghien ciiff thUe trang An toan ve sinh thiTc pham
t?i cic bep 3n tap the (BATT) ciia doanh nghiep tren
dja ban thanh phd Hai DUdng , ket qua cho thay : Dien
tich phong che bien < lOOm^ chiem ty le nhieu nhat
(50%); di?n ti'ch phong an 200-500m^ chiem t / le
nhiSu nhat (45%); Cdn ed 44% BATT chUa dat yeu
ve CO sd ha tang; 20% BATT ngudi phuc vu (NPV)
khdng mang day dii bao hp lao dpng khi lam viec;
Tren cac mau xet nghiem deu thay co ty le nhiem vi
(Jyhp thu'c pham chin, ban tay NPV, Trong do ty le
nhiem VSV tren ban tay NPV la cao nhat: Coliform
(72,5%); E.coli (25,0%); S.aureus(32,0%)
SUMMARY
SAFETY S I T U A H O N I N FOOD HYGIENE AT
CANTEENS OF SEVERAL BUSINESSES
-H A I DUONG CITY I N 2 0 1 3
Research the current status of food safety and
hygiene in the canteens of businesses in Hai Duong city,
the results show that processing room area < lOOm^
area of 200 - 500 m^ accounting for the largest
preiportion (45%); there are 44% of the canteens is
' SdYte tinh Hal DuVng
" TnAlmg Cao dSng Y teHai Phdng
Dinh Huy Hung*, Vu Due Long**
unsatisfactorily on administrative procedures; 17.5% is unsatisfactorily on infrastructure, 20% waiters do not carry adequate labor protection at work; 20% waiters do not use clean utensils when processing; In the specimens founded microorganism ratio on cooked food, containers of cooked food , hands of waiters In which the infection rates on the waiters' hands is the highest; Coliform (72.5%), E, coli (25,0%), S, aureus (32,0%),
I OAT VAN OE
An toan ve sinh thffc pham(ATVSTP) hien dang la mdi quan tam Idn ciia nhieu Qudc gia tren the gidi, Tren the gidi ffdc tfnh, hang nam cd khoang 3 - 5 ty ngu'di bj tieu ehay, ed 3 - 5 trieu ngLfdi tff vong, khoang 1.400 trieu Iffpt tre em/nam bi mac benh tieu chay ,trong sd dd 70
% nguyen nhan do an, udng thi/e pham bj d nhiem [ 5 ] , [ 6 ] Tai Viet Nam, sd trffdng hdp ngd ddc thffc pham cd xu hffdng ngay cang gia
t a n g [ l ] , Theo thdng ke chffa day du ciia cue ATVSTP trong cac nam 2007-2011, toan qudc da ghi nhan 927 vu NOTP vdi 30.733 ngu'di mac va
299 ngffdi chet Trung binh cd 185 vu/nam, trong
dd sd vu ngd ddc tai bep an tap the chiem tff 12,7 den 20,6% tong sd vu moi nam, Tuy nhien day chi la sd iieu thdng ke chu'a day du ,thffc te con sd ngd dpc thffe pham hang nam cdn eao hdn rat nhieu[2] Theo ffdc tinh eiia WHO, d Viet Nam con sd ngd dpc thffe pham hang nam khoang tren 8 trieu ngffdi [5] Hai Dffdng la mdt
Trang 2trong nhffng thanh phd dang trong tinh trang
bao ddng ve van de ATVSTP, Trong dd ATVSTP
tai cae bep an tap the (BATT) cua cac doanh
nghiep phuc vu eho ngffdi lao ddng rat can dffdc
quan tam Do vay chiing tdi nghien effu de ta
nay nham mue tieu: 'Wo ta thu'c trang ve sinh
an toan thdc pham tai bep an tap the d mot
so doanh nghiep tren dia ban thanh pho
Hai Du'dng nam 2013."
11 DOI TypNG VA PHU'aNG PHAP NGHIEN CLTU
2.1 Odi tffdng nghien cu'u
- Cac bep an tap the eua doanh nghiep tren dja
ban thanh phd Hai Dffdng tinh Hai Dffdng
- Ngffdi phuc vy (NPV) tai cac BATTciia doanh
nghiep
2.2 Oja dlem va thdi gian nghien cu'u
- Dia diem nghien cffu: Cac doanh nghiep ed BATT
tren dia ban thanh phd Hai Dffdng, tinh Hal Dffdng
- Thdi' gian nghien cffu: 01/2013 - 10/2013
2.3 Pliffdng phap nghien cu'u
2.3.1 Thiet ke nghien cu'u: mo ta cat ngang
2.3.2 Cd mau: Cd mau nghien cffu BATT
dffdc lay toan bd
2.3.3 Cach chgn mau:
- Tai thdi diem tien lianh nghien cffu tren dja ban
doanh nghiep, chiing tdi lay toan bd cd mau la
40 BATT dffa vao nghien cffu
- Danh gia dieu kien ve sinh qua eac mau xet
benh: Mdi bep aji tap the lay 04 mau xet nghiem
tay ngu'di che bien, 01 mau dung eu chu^ dutig
dung trong che bien (td'ng sd 160 mau)
2.4 Phu'dng phap thu thap so lieu:
Thanh lap nhdm dieu tra gom eac can bd ciia chi cue ATVSTP ciia tinh Hai Dffdng, tien hanh tap huan eho nhdm dieu tra, thffc hien dieu tra theo mau phieu dffdc lap san_^ Lay mau xet nghiem theo thffdng qui va gffl mau ve thffc hien tai Labo xet nghiem ATVSTP - Trffdng Dal hpc ky thuat y
te Hal Dffdng theo cac qui chuan
2.5 Xir ly so lieu: Sff dung phan mem
SPSS 16,0 de xff ii va phan tich so lieu
It KET QUA NGHIEN CLTU VA BAN LU/^N
Bang 3.1 Dien tich eae bep an tap the ciia doanh nghiep
Tieu chi
Dien tich phong che
bien
Dien ticti
<100m' 100-200 m^
>200 m^
Tong
Dien tich phong an
<200 m^
200-500 m'
>500 m^
Tong
n
20
15
5
40
5
18
17
40
Tv le (»/o)
50
38
12
100
12
45
43
100
Nhan xet: Sd bep an cd dien tieh phdng che
bien < lOOm^ chiem ti le cao nhat (50%), bep an
dien tieh >200m^ ehi chiem 12%.Phan Idn dien
tich phdng an ciia cac BATT tffdng ddi rdng, sd
phdng an cd dien tich tren 500 m^ chiem ty le
eao nhat 43%, phdng an cd dien tieh nhd hdn
200 m^ chiem ty le thap nhat 12% Bang 3.2 cho
thay dien tich phdng an va khu che bien ciia BATT la kha rdng d ea 2 loai hinh doanh nghiep Ket qua nghien cffu ciia chung tdi cung phu hdp vdi ket qua nghien cffu ciia Biii Vi The nghien cffu tai cac BATT eiia huyen Thuy Nguyen - Hai Phdng ( 2012) [2]
Bang 3.2 Tv ie BATT thu'c hien qu
~~ "^ ^Tieu chuan
Quy mo DN " —— ^
DN* icin (1)
DN vira va nho (2)
P
dinh ve
Oat
n
20
4
(%)
80,0 26,7 P,,2<0,05
hii tuc hanh chinh theo qui
Chap nhan
n
4
5
(%) 16,0 33,3
Pi!<0,05
mo doani' Khong dat
n
1
6
(%)
4,0 40,0 Pij<0,05
nqhiep Tong
25
15
40
*= Doanh nghi^
Nhan xet: Ket qua bang tren cho thay ed 80% DN Idn dat tieu chuan ve thii tuc hanh chi'nh, cd 40%
Trang 3DN Idn va DN vifa va nho ve thu tuc hanh chinh (P<0,05) Chung toi cho rang d nhifng DN ISn difOc
cac nha quan ly cO sd quan tam dau tu" hdn nen thiic hien tot hon
Bang 3.3 Tylet
Cat
Chap nhan
Khong dat
tap the theo qui mo doanh nqhiep ve cO sd ha tanq
DN Idn (1)
18 72,0 (%)
20,0
DN vCra va nho (2)
(%)
46,7 20,0
Tong
(%)
20,0 17,5
<0,05
Tong I 25 I 100,0 J 15 | 100,0 | 40 100,0 , ,
/VAan xet:Jy le BATT cua DN idn dat tieu chuan ve cd sd ha tang cao hdn so vdi DN vira va nho, su'
khac biet cd y nghia thong l<e vdi P<0,05 chung toi cho rang nhUng doanh nghiep idn co nguon lu'c tot hdn nen du'dc dau tu' nhieu hdn
Bang 3.4 Ty ie cac BATT cd du tranq b\ bao hp iao d6ng(BHLB) cho NPV
Siydyng^^
BHLS
Quy mo DN
DO 4 bao ho
DN Idn(l) (%)
DN vifa va nho 11)
(%)
Tong
{%) P(.,2
Nhfin xet: Trong 40 BATT con co 20% BATT ,
viia va nho cd 40% BATT ngu'di phuc vu khong
diJ bao hp va DN Idn la 8%, su" khac biet co y
chiing toi ia do d nhu'ng doanh nghiep idn cd to
chu'c lao dpng va chap hanh iuat tdt hdn.Ciing
vdi npi dung nghien cii'u nay theo tac gia Nguyen
15 100,0 40 100,0 Thj Van (2012), tai Hai Phong thi ti ie sir dung bao ho lao dong ia 62,5% [4]; ciia Pham buy Tuyen (2010) tai Hai Du'dng thi ty lenay la 60,4% [3] Nhu vay ket qua nghien ciru cua chung toi co cao hdn,chLing tdi cho rang cong tac quan iy, hu'dng dan cua cac cO quan quan iy nha nUdc trong ilnh vuc y te trong nhdng nam sau dUdc thuc hien tot hdn
Bang 3.5, Ty le BATT theo qui mo doanh nghiep dat ve trang thiet bj, dung cu sach ndi che
bien va phan phoi tliij'c an chi'n
Tieu chuarT ~-^——.
eat
Chap nhan
Khdnq dat
TSng
DN Idn (1)
n
23
0
2
25
(%)
92,0 0,0 8,0 100,0
DN vira va nhd (2)
n
0
6
15
(%)
60,0 0,0 40,0 100,0
Tdng
n
32
0
8
40
(%)
80,0 0,0 20,0 100,0
•"(l,!)
<0,01
Nh$n xit: Ket qua bang tr^n cho thgy trong 40 BATT cd 20% BATT khong dat tieu chuan , trong dd
BATT ciia DN nho va vira chiem 40% va DN idn chiem 8,0%, su khac biet cd y nghia thong ke vdi P<0,01 Chung tdi cho rang ty ie nay la kha cao va tuong dUdng vdi ket qua nghien ciru cua Biii Vi The (2013) tai Hai Phdng: 82,4% va cao hdn cua Nguyen Thj Van (2012) cung tai Hai Phong ia: 62,5%
Bang 3.6 Ket qua xet nqhiem VSV tren cac mau
E.coli Coliform
Khdng dat(n) Khdng dat (n) Khonq dat (n)
Thi/c pham chin (n = 40)
Dgng cu chu^ dirng thu'c
Nh$n xit: l<et qua bang trSn cho thay cac mau xet nghiem ban tay NPV, thUc pham chin, dung cu
Mi dung thuc pham chin deu cd nhiem VSV, cao nhat tren ban tay NPVj Coiiform 72,5%; S.aureus
32,5%.'Ttieo ket qua nghien ciru ciia Nguyen Thi Van (2012) thi ty le mau dat ve chi Ueu vi sinh doi
Trang 4IV KET LUAN
Qua nghien cffli ve thffc trang ATVSTP tai
eac bep an tap the eua doanh nghiep d Hai
Dffdng ket qua eho thay:
- Dien tich cac bep an : Chiem 5 0 % cac phdng
che bien cd dien tich <iOOm^; chi cd 12% dien
tich >200m^; Dien tich phdng an tff 200-500m^
chiem ty le nhieu nhat ( 4 5 % )
- Chiem 4 4 % cac BATT chu'a dat yeu eau ve
nhffng qui dmh thii tuc hanh chinh
- Cd tdi 17,5% cae BATT khdng dat yeu cau ve
mang day dii bao hd lao ddng khi lam viee ; 2 0 %
BATT ngffdi phyc vu khdng sff dung dung cu
sach khi che bien
- t r e n cac mau xet nghiem deu thay cd ty ie
nhiem VSV trong dd ty le nhiem VSV tren ban tay
NPV la cao nhat: Coliform (72,5%); E.coli
(25,0%); S.au reus (32,5%)
T A I UEU T H A M K H A O
1 Cue An toan thu'c pham - Bp Y te (2005);
"Mdt so cong trinh nghien cffu ve ve sinh an toan thu'c pham Bp Y te HNKH an toan ve sinh thifc pham lan thff i l l Ha Ndi
2 Bui Vi The (2013), Tht/c trang an toan ve smh thUc pham, cdng tac quan ly va kien thffc, thi/c Thuy Nguyen, Hai Phong nam 2012, Luan van 1^ nghiep bac sT chuyen khoa I I , trUcfng (3ai hpc Y khoa Hai Phong, Hai Phong
J Pham Duy Tuyen (2010), thUc trang an toan v^ smh thu'c pham va cong tac quan ly mpt so cd sd djch vu an uong cong cpng tren dja ban thanh ph6 Hai DUPng nam 2010, Luan van thac sT y te cong cpng, tn/dng dai hpc Y khoa Hai Phong, Hal Phong
4 Nguyen Thj Van (2012), thifc trang an toan ve
sinh thUc pham, kien thffc, thai dp eiia ngffdi phyc
vu tai nha hang an udng quan Le Chan, Hal Phong nam 2012, luan van thac sT y te eong cong, tru'dng dai hoc Y khoa Hai Phong, Hai Phdng
5 CDC (2000) Foodborne illness, p 1-17
6 WHO (1997) Epidemiological Surveillance of Foodborne Diseases, Geneva
CHi s o HUYET AP VA LIPID MAU 6' BENH NHAN DAI T H A O DU'O'NG TYP
2 DIEU TRI NGOAI TRU TAI BENH VIEN KIEN AN H A I PHONG
T6M TAT
Nghien cffu du'dc tien hanh tren 123 benh nhan
dai thao dudng typ 2 dieu tri ngoai trii tai benh vien
kien An Hai Phong tff 01/2011 den 06/2011
Ket qua: Nhdm nghien cffu cd tuoi trung binh la
60,4 -I- 9,7; nff chiem 66,7% Ti le dai thao dUdng typ
2 CO tang huyet ap la 48,8%, fang huyet ap gd I:
ap giai doan I I I : 5,7%, Ti le nam bi tang huyet ap
nhieu hdn nff (63,4% so vdi 58,2%) Tuoi cang eao ti
le t§ng huyet ap cang nhieu; d benh nhan tren 70 tud'i,
t9 le tang huyet ap la 60% Thdi gian mac dai thao
mac benh tren 10 nam co ty le tang huyet ap la
66,7% 52,8% dai thao dirdng typ 2 cd tang
Cholesterol; 60,2% cd tang Tryglycerit; 32,5% cd tang
LDL; 39,2% benh nhan cd tang Cholesterol va
Tryglycerit va LDL Nhom dai thao dUdng typ 2 ket
mau cao hdn nhom khong cd tang huyet ap
* SdYte Hai Phdng
Trinh Thi Ly* va cdng sif
S U M M A R Y
BLOOD PRESSURE A N D L I P I D E M I A
I N O U T P A T I E N T W I T H TYPE I I DIABETES TREATED I N K I E N AN
H O S P I T A L H A I PHONG
The study was conducted on 123 outpatient with type 2 diabetes treated in Kien An hospital from 01/2011 to 06/2011
Results: The team has an average age of 50.4 + 9.7; women accounted for 66.7% The rate of type 2 stage I: 28.5%, hypertension stage I I : 14.6%, hypertension stage I I I : 5.7% Percentage of men with hypertension is more than women (63.4% versus 58.2%) As the older patients are, as the rate of hypertension is higher; in patients over 70 years of age, the rate of hypertension is 60% As the duration higher; in patients over 10 years of diabetes, the rate diabetes: 52.8% have Cholesterol increased; 60.2% have Triglycent increased; 32,5% have LDL increased; 39.2% have Triglycerit and Cholesterol increased; 26% have cholesterol, Triglycerit and LDL increased The