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Does premature ejaculation lead to infertility?


I am 29 years old with premature ejaculation, about to get married, so I am very worried about infertility. Could you please tell me if this disease can be cured, is it infertile? (Son, Hanoi)

Reply:

Premature ejaculation is an unwanted ejaculation in a man. This is a common disorder, especially in young people, leading in the group of male sexual disorders. The disease not only causes anxiety, inhibition, and loss of confidence in men, but also affects the husband and wife relationship.

In the sexually active age, on average, 2-3 men experience premature ejaculation. The disease is classified into two types as primary and secondary. Primary A person who from the beginning of his sex life has never been able to control ejaculation. Secondary Before, they still had a satisfying sex life, the disease showed up later.

There are many causes of premature ejaculation such as psychology, mainly a balance between excitement and inhibition, too much excitement can lead to premature ejaculation. Some other reasons such as the elderly have some chronic diseases, have low sex drive, or masturbate.

In addition, there are also causes due to oversensitivity in the penis or some other diseases that increase sensitivity near the ejaculatory organs such as prostatitis, hemorrhoids, anal fistula, spinal cord injury, nerve damage due to prostate cancer. alcohol, hypogonadism.

To conceive, the necessary and sufficient condition is that the egg and sperm must meet and implant in the uterus. So whether premature ejaculation affects childbirth or not depends on the extent of this condition. If there is not enough time for intercourse or when the woman’s cervix has not yet opened to receive sperm, the possibility of conception is very poor, it is very difficult to have children. In case of premature ejaculation but good, healthy sperm can still meet the egg and implant in the uterus, it will not affect childbirth.

There are many measures to treat premature ejaculation, from behavioral therapy, to circumcision… In addition, drugs and psychotherapy can be used. Men with this problem should see a doctor for full advice and guidance.

Master, Doctor Nguyen Van Duc
Department of Urological Surgery – Nam Hoc, Saint Paul General Hospital

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Can low sperm count have children?


My husband and I have been married for over a year but have no children. My test results are normal, my husband has low sperm count, can we have children? (Hoa, 29 years old, Hanoi).

Reply:

For men, having children or not depends a lot on the quality of sperm. If the sperm is healthy, the chances of conception will be higher and vice versa.

In theory, a man needs only one motile sperm to conceive naturally. However, the ability to conceive will be greatly affected if the quality of sperm decreases. With a regular cycle of ovulation and sex, the odds of a healthy couple getting pregnant naturally range from 15 to 20 percent. In the case of reduced sperm quality, depending on the degree of decline, this ratio will decrease. There are also some cases of sperm abnormalities, the conception rate is almost zero.

Sperm are only a small part of semen and cannot be seen with the naked eye. However, some changes may suggest a decline in sperm quality such as low semen volume, dilute semen, lumps, solidification, or color change from milky white to red or blue. To most accurately assess the quality of sperm, you should go to the hospital for a semen analysis when there are abnormal signs above or when the couple has regular sex for 6 months or more but still not pregnant.

In addition, men can improve sperm quality by adding some foods such as oysters and shellfish such as shrimp and crab; red meat and poultry; whole grains; yogurt and dairy foods; vegetable oil. Some green vegetables, spices such as broccoli, cabbage, asparagus, tomatoes, garlic, sweet peppers. Avoid stimulants such as alcohol, coffee, tobacco, processed foods…

In case you and your husband have been expecting a child for more than a year but have not had a child, active medical support and intervention is required. You should go to a reputable facility to check and choose the most effective treatment plan.

Hope you both have good news soon!

Dr. Le Duy Thao
Department of Andrology, Hong Ngoc General Hospital

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How does nCoV hurt the heart?


The initial clinical manifestation of Covid-19 patients is pneumonia, if it progresses to the late stage, it will damage multiple organs, including the cardiovascular system.

This damage may be due to direct viral involvement in the myocardium or indirectly through the systemic inflammatory response and to lung injury. In addition, antiviral drugs used to treat nCoV have been reported to have an arrhythmogenic effect.

The course of nCoV infection includes the following three intertwined stages: Early infection stage, lung involvement stage and super inflammatory phase.

Stage Firstly involves the movement and replication of the virus into lung tissue. Monocytes and macrophages are innate immune factors responsible for fighting the virus during this phase, and patients may have mild symptoms.

Lung tissue damage develops in the next step, and vasodilation, increased endothelial permeability, and leukocyte activation occur during this phase. Monday. This pathogenesis leads to lung injury, hypoxemia, and increased damage to the cardiovascular system.

10% of patients in the second stage progress to stage super inflammatory. The hyperinflammatory phase is characterized by the development of acute respiratory distress syndrome (ARDS), acute cardiac injury, multi-organ failure, secondary bacterial infection, sepsis, and increased appetite. require special care.

The exact mechanism of cardiovascular damage is unclear, but doctors note some signs. For example, acute cardiac injury, with elevated cardiac troponin expression, has been reported in 8-12% of nCoV patients. This lesion is a poor prognostic factor in patients with Covid-19.

Patients infected with nCoV with underlying cardiovascular problems have a worse prognosis. Patients with cardiovascular complications that increase the need for mechanical ventilation and complex arrhythmias associated with stretched myocardium; or arrhythmic side effects of antiviral and anti-inflammatory drugs.

Cardiovascular lesions associated with nCoV. Photo: Provided by Doctor

Note to heart patients

All cardiovascular patients are at high risk, so they should follow the epidemic prevention guidelines of the Ministry of Health, strictly follow the 5K. They should be vaccinated against Covid-19.

If the patient is in an epidemic area and the heart condition is stable, avoiding direct visits to medical facilities, the patient can talk to the doctor remotely.

To improve the immune system, patients always eat well, avoid alcohol, ensure sleep, do gentle exercises and avoid any unnecessary stress.

Dr. Pham Quang Trinh
Emergency Department, Military Central Hospital 108

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Chest pain, nervousness, heart palpitations after Covid


People who recover from Covid-19 have chest pain and nervousness, need to be examined for timely treatment, combined with breathing exercises and nursing.

Master, Doctor Pham Thi Binh Minh, Ho Chi Minh City University of Medicine and Pharmacy Hospital, Campus 3, said: There are quite a few patients who have recovered from Covid-19 with chest pain, some accompanied by nervous expressions. palpitations, heart palpitations. In an Italian study of 143 patients (mean age 57 years) after about two weeks of hospitalization for Covid-19, 22% had chest pain that persisted for 60 days after discharge.

In the United States, data from many studies on post-Covid-19 bodily disorders, show that the rate of chest pain is 16%, patients with tachycardia at rest is 11%, patients have palpitations and drumming. chest is 11%.

Chest pain, palpitations, heart palpitations may appear while sick, or appear later when the patient has recovered from Covid-19. “The condition of chest pain, nervousness, and rapid heart rate of patients after Covid-19 can be the result of many factors such as post-infection, blood clotting disorders, side effects of treatment, invasive procedures. , lack of oxygen in the blood … or due to psychological trauma “, Dr. Minh shared.

A person experiencing post-Covid-19 chest pain may simply be due to aching muscles in the chest wall, which can also occur in people infected with other viruses. However, we need to rule out all dangerous causes of chest pain, such as myocardial infarction, myocardial ischemia, pulmonary embolism, pneumonia… and all other diseases of the heart and lungs. . Therefore, patients with chest pain need to be examined to properly assess the condition of the disease.

According to Dr. Minh, recent studies show that some Covid-19 patients appear after recovering standing tachycardia syndrome. This is a condition in which the heart beats faster when changing positions from lying or sitting to standing. Heart rate can increase over 120 beats/min to meet the blood needs of the brain and heart when changing positions suddenly. Accompanying symptoms may include dizziness, palpitations, palpitations, and fatigue.

In addition, scientists also noted that many post-Covid patients have a rapid heartbeat even at rest, causing a feeling of nervousness and palpitations. Therefore, patients should be carefully examined by a doctor to promptly detect related cardiovascular and respiratory diseases.

Doctor Tran Thi Ngoc Chau, Ho Chi Minh City University of Medicine and Pharmacy Hospital, Campus 3, said: According to traditional medicine, heart palpitations, nervous palpitations, and chest pain are classified as mental conditions. You are in charge, you are in charge, you are late. Precious mind is palpitation, the pulse is palpitations, or panic attacks. Hungry system, late hung only shows chest pain, chest discomfort.

“After recovering from the disease, the patient still suffers from loss of body’s qi and blood, damage to the five viscera, causing internal injury. Patients with chest pain and heart palpitations after Covid-19 often have symptoms of: The syndrome of spirochetical heart disease, schizophrenia with symptoms of depression of the heart and lungs, depressed mind, damaged lungs (respiratory organs), Dr. Chau analyzed.

The commonly used traditional herbs can be mentioned as worshiping gods, vien chi, typhus, apple cider vinegar… have the effect of nourishing the mind, sedating; Ginseng is a great source of energy; dong quai, biogeo… effect of nourishing blood, nourishing blood.

“In addition, methods such as ear acupuncture (acupuncture of the ear), acupressure, and relaxation training help to regulate blood and blood, balance yin and yang, and provide psychological support… to help patients recover quickly. recovered,” said Doctor Chau.

Le Cam

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What should pregnant women do after receiving the Covid-19 vaccine? – VnExpress


Pregnant women should not be alone in the first three days after injection, strictly monitor their health, create psychological comfort for the best immune response.

Pregnant women are considered a special target group when receiving the Covid-19 vaccine. The pregnant woman’s body has to bear the double burden; The kidneys, liver, cardiovascular and respiratory systems work with greater intensity. After the injection, they experience the same side effects as normal people such as fever, fatigue, headache, chills, joint pain, increased pain sensation, swelling, redness, restlessness, etc. Pregnant women need to be very careful, monitor and treat promptly if there are severe side effects.

Master, Doctor Vu Nguyet Anh, Deputy Head of General Planning Department, Hanoi Obstetrics and Gynecology Hospital, recommends that the first three days after vaccination against Covid-19 pregnant women should not be alone because this is the body’s time. Side effects are often present. Pregnant women actively monitor their own health, eat nutritiously, get enough sleep, and feel comfortable to have the best immune response after vaccination.

If the fever is below 38.5 degrees after injection, loosen clothes, apply/wipe with a warm towel on the forehead, armpits, groin, drink enough water, do not catch cold, measure the temperature again after 30 minutes. If the fever is 38.5 degrees or higher or body aches, pain at the injection site, take antipyretic, ordinary pain reliever containing paracetamol according to the instructions of medical staff. In case the fever does not reduce or the fever is higher than 39 degrees, the pregnant woman should immediately notify the medical staff and go to the nearest medical facility.

In case of swelling, redness, pain, small lumps at the injection site, monitor health. If the swelling is bigger, the symptoms do not decrease, the pregnant woman should go to the doctor immediately. Do not apply, apply on painful swelling at the injection site of poultices from herbs, leaves or ointments…

Pregnant women with a schedule of tetanus and measles vaccinations should arrange to have them at least 14 days before the Covid-19 vaccine or 28 days after the Covid-19 vaccine.

Pregnant women in Hanoi get the Covid-19 vaccine. Photo: Giang Huy.

Chile

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People with chronic obstructive pulmonary disease (COVID-19) are more likely to get worse


Patients with chronic obstructive pulmonary disease (COPD) have structural damage to the airways, lung parenchyma, immunosuppression, increased mucus secretion, etc., thereby increasing the risk of Covid-19 infection and severe disease.

Associate Professor, Doctor Le Tien Dung, Head of Respiratory Department, Ho Chi Minh City University of Medicine and Pharmacy Hospital, said: Covid-19 affects the patient’s whole body, especially the respiratory tract (such as interstitial pneumonia). can progress to severe, causing hypoxia in the blood, and ultimately death. During the epidemic, people with COPD have many factors that increase the risk of infection.

“The use of corticosteroids, the patient’s immunosuppression, the persistent increase in mucus secretion, the structural damage to the airways, the lung parenchyma… put COPD patients at increased risk of Covid-19.” Dr. Dung explained.

COPD is also one of 20 underlying diseases that increase the severity of Covid-19 as recommended by the Ministry of Health on August 21. According to Dr. Dung, in fact, people with chronic obstructive pulmonary disease when infected with Covid-19 often develop severe disease and have a high risk of death.

Patients with COPD must maintain regular medication use. “Should actively monitor body temperature, symptoms of disease such as cough, shortness of breath, phlegm, fatigue, quickly consult a doctor when symptoms worsen. , must quickly go to the hospital for timely intervention”, the doctor advised.

Regarding the risk of infection, people with COPD need to strictly follow the epidemic prevention measures as recommended by the World Health Organization and the Ministry of Health, such as washing hands frequently with soap and clean water. Regularly clean and disinfect frequently touched objects and surfaces Avoid touching your eyes, nose, and mouth. Avoid gatherings and limit going to crowded places. Avoid close contact with people who have a fever or cough. Maintain healthy habits such as exercising at home and eating nutritious…

Maintain a reasonable diet, ensure nutrients and minerals. Eat a balance of nutrients with 50% starch, 15% protein, 35% fat. According to Dr. Dung, it is recommended to use fats from fish or plants, eat green vegetables, fresh fruits to supplement vitamins and trace elements, especially foods containing a lot of vitamins A, C, and E. . In addition, patients should drink 2-3 liters of water a day to limit constipation, dilute sputum, and help cough and sputum easily.

“Sit up when eating, eat small pieces, eat slowly and limit foods and foods that can cause bloating and indigestion. Limit foods and drinks with a lot of gas, easy to get full because they have can make it difficult to breathe,” advised the doctor.

Exercise to improve resistance and follow epidemic prevention guidelines. People with COPD need to quit smoking quickly if they are still using, get a flu vaccine every year, a pneumococcal vaccine every three years.

Le Cam

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How long does herd immunity last after vaccination? – VnExpress


70% of the population vaccinated against Covid-19 will create herd immunity. Can herd immunity be created in other ways, and will it last or only be short-term according to the effectiveness of the vaccine? (Nguyen Nam Giang, HCMC).

Reply:

Herd immunity is when most people in a community have acquired immunity to an infectious disease (either through vaccination or prior illness). When a certain number of the population is immune, the infection cycle is broken, the virus is no longer easily transmitted from person to person. As a result, the chain of infection slows down or stops.

The concept of “generating herd immunity by allowing the virus to spread naturally” is completely wrong. Because, letting the virus grow freely leads to many people getting sick and dying, increasing the medical burden and causing genocide due to epidemics like in previous centuries. Natural herd immunity is certainly not the right strategy and option for Covid-19. Vaccination against Covid-19 is the best way to achieve herd immunity.

If there is herd immunity, we will protect those who cannot be vaccinated, those who are susceptible to disease and are prone to death, such as young children, the elderly, and people with weakened immune systems. The more people get vaccinated against Covid-19, the fewer people get sick and the more people in the community are protected.

Depending on the goals and disease patterns of each country, vaccine coverage needs to be between 70-95% of the population to achieve herd immunity (that is, the maximum number of people in that country who are vaccinated against the vaccine). 70-95% of the total population), making the virus no longer able to spread significantly to the remaining unvaccinated population.

For diseases controlled by vaccines (measles, diphtheria, varicella, etc.), herd immunity lasts as long as vaccine coverage remains large enough.

For the Covid-19 pandemic, in addition to vaccine coverage, the effectiveness of vaccines with different variants of the virus also affects herd immunity. Some experts around the world believe that it is difficult to achieve herd immunity anytime soon because the new Delta variant of nCoV can infect even vaccinated people.

People in Hanoi get vaccinated against Covid-19 during a large-scale vaccination campaign, in early August. Photo: Giang Huy

Master, Doctor Nguyen Hien Minh
Immunization Unit, Ho Chi Minh City University of Medicine and Pharmacy Hospital

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Drinking alcohol can prevent nCoV?


According to the guidelines of the World Health Organization or the US Centers for Disease Control and Prevention (CDC), there are three types of alcohol that can be used for medical disinfection: ethanol, n-propanol and isopropanol.

Alcohol to kill the virus must be from 60 to 70 degrees or more, and the virus must stick to the skin of the hands. We also cannot hold alcohol with high alcohol content in our mouths to kill the virus, not to mention that the virus has already penetrated into the cell. Using alcohol mainly to kill viruses in the hands, utensils and items to disinfect … but drinking alcohol into the throat is not effective. Instead of drinking alcohol, you can gargle with salt water every day.

The Department of Health also recommends that alcoholic beverages do not protect you from the risk of infection. You should limit your alcohol intake to protect your health. People who cannot drink alcohol should also not practice drinking to prevent Covid-19 because it does not work.

In addition, the methods of smoking leaves, essential oils, eating garlic, lemongrass, and perilla only work to reduce the symptoms of the disease, but not to cure the disease. The disease is self-limiting. We can use these methods to relieve colds, warm the respiratory tract, not because of it, we can cure covid-19, no god thinks it is a new method. Note, people with a high fever should not be steamed.

Doctor Truong Huu Khanh
Specialist consultant of Infection – Neurology, Children’s Hospital 1

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Signs of aggravation of asymptomatic F0


F0s with severe warning signs such as rapid breathing, difficulty breathing, chest pain, skin and mucous membranes are paler than usual… they should immediately notify medical staff for emergency treatment and referral.

Specialist Doctor 1 Tong Ho Tu Phuong, Department of Otolaryngology, City Children’s Hospital, is working at the field hospital for Covid-19 treatment and treatment number 4, Binh Chanh district, at noon on 13/02. 7, the unit provided emergency treatment and safely referred an asymptomatic F0 that suddenly worsened.

Elderly female Covid-19 patient with high blood pressure. She had been healthy before, but by noon, she started to feel tired. The patient’s blood oxygen concentration (SpO2) is now only 70%. The patient was immediately assisted by doctors to breathe oxygen through a mask, then transferred to the emergency room, given positive pressure oxygen, ready for intubation when needed and transferred to a higher level for further treatment.

At the field hospital, doctors examine patients online, through video calls on the phone. After assessing the patient’s condition, if the situation worsens, the doctor will be there to directly examine and handle the situation.

Through this case, Doctor Phuong recommends that asymptomatic Covid-19 patients, if they see signs such as rapid breathing, feeling short of breath, chest pain, seeing skin color, and mucous membranes are paler than usual. … it is a warning that the disease is getting worse, it is necessary to immediately notify the medical staff for timely treatment. In particular, F0 people who are obese, people over 65 years old, have underlying diseases (high blood pressure, diabetes, cardiovascular …) need to monitor their health more closely.

At this point, the medical staff will assess whether the patient is hypoxic or not, by measuring SpO2. If the SpO2 index is less than 93%, it can be understood that the patient’s lungs have been damaged, needing oxygen support through the nose or mask, or oxygen with positive pressure and transfer the patient to the hospital.

Medical staff emergency treatment for asymptomatic female Covid-19 patients suddenly worsened at noon on July 13, at field hospital No. 4. Photo: City Children’s Hospital.

The doctor also pointed out common symptoms, including fever over 38 degrees Celsius, sore throat, runny nose, stuffy nose, muscle aches, headache, nausea, vomiting, diarrhea, coughing a lot… In this case, medical staff will support on-site treatment.

In the 4-storey treatment model, Covid-19 field hospitals in Ho Chi Minh City are the first floor, receiving monitoring, care and treatment of over 10,000 asymptomatic or mild symptoms. These patients can develop severe, critical situations at any time, according to Dr. Phuong. Therefore, medical staff always closely monitor each patient, if the patient becomes seriously ill, they will be given first aid on the spot, then transferred to the hospital on the second floor of the pyramid (the floor for patients with severe symptoms) for treatment. specialist treatment.

Doctor Phuong suggested that F0 at the field hospital adhere to the 5K principle in the hospital, “absolutely limit close contact with other patients, even in the same room”. Patients self-monitor their vitals closely, mainly by measuring their temperature with a specially distributed thermometer. Maintain good personal hygiene, supplement nutritious food, eat lots of fruit, vitamin C, drink lots of water, gargle regularly, do light exercise (no exertion), get enough sleep, feel comfortable to reduce stress…

“The 5K principle, active eating and drinking, and early detection of severe disease are the three key points that F0 has no symptoms or has mild symptoms to follow,” said Dr. Phuong.

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Should people with HIV get the Covid-19 vaccine?


People infected with HIV belong to the group of chronic diseases, if infected with Covid-19 can have severe complications, therefore, priority should be given to receiving the Covid-19 vaccine.

Doctor Khuat Thi Hai Oanh, Director of the Center for Support for Community Development Initiatives (SCDI), said that people with chronic diseases are one of 11 priority groups for vaccination against Covid-19.

All Covid-19 vaccines approved by the World Health Organization are safe for immunocompromised people. Some vaccines, such as AstraZeneca and Pfizer, have been tested in some people with HIV and found to be safe. These vaccines do not use live viruses but use genetic material. These genetic materials cannot replicate on their own, so people with weak immunity are not afraid that the vaccine will produce viruses in the body.

“The Covid-19 prevention vaccines being used in Vietnam are completely injectable for people with HIV,” said Dr. Oanh.

In the past, some opinions have suggested that antiretroviral drugs are effective in preventing Covid-19, but so far there has been no accepted evidence. The approved vaccines do not interact with ARV drugs, so the vaccine does not reduce the effectiveness of treatment.

Oanh said that the difficulty of HIV patients is the fear of revealing personal information. This is a well-founded concern because in order to be registered in the priority category, HIV patients need to report their status to a local health facility or vaccination organization.

According to Dr. Oanh, facilities responsible for organizing and implementing injection programs need to practice properly so as not to violate the right to information protection of people living with HIV. If necessary, an information assurance process should be in place and health professionals should be trained in its implementation. The Ministry of Health and the Department of HIV/AIDS Prevention and Control play an important role in monitoring the implementation and removing this barrier so that people living with HIV can safely access vaccination.

According to the Department of HIV/AIDS Prevention and Control, the number of people living with HIV in the community is about 250,000, of which more than 213,000 people have known their HIV status.

On average, every year, Vietnam tests HIV for more than 700,000 people at high risk, detecting 8,000 to 10,000 infected people. The whole country is regularly treating 150,000 people infected with HIV/AIDS with ARV drugs.

Le Nga