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Nguyen Thanh Xuan,1 Nguyen Xuan Hung,2 Tran Hoai An,2 Nguyen Dang Phuoc,2 Nguyen Huu Son,3 Pham Nhu Hiep1 1Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, Hue City, Vietnam; 2Department of Cardiovascular Surgery, Cardiovascular Center, Hue Central Hospital, Hue City, Vietnam; 3Department of Pediatric Neurology, Pediatric Center, Hue Central Hospital, Hue City, VietnamCorrespondence: Nguyen Thanh XuanDepartment of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, 16 Le Loi Street, Hue City 530000, VietnamTel +84945313999Email thanhxuanbvh@hotmail.comBackground: Complete atrioventricular septal defect is a complex cardiac malformation characterized by an ostium primum atrial septal defect, a common atrioventricular valve, and a variable deficiency of the ventricular septum inflow. The left AV valve and right AV valve have no clear division. The treatment of complete atrioventricular septal defects has evolved in recent decades, but it remains challenging. This retrospective study evaluated early and late outcomes in patients undergoing surgery at a single heart center.Patients and Methods: We retrospectively evaluated outcomes in 52 complete atrioventricular septal defect patients undergoing definitive repair from January 2016 to January 2018. All patients were repaired with either the classic one-patch technique or the two-patch technique.Results: The mean age at operation was 4.12 ± 0.26 months (2 months– 3 years). Forty cases (76.9%) included in the study have Down’s syndrome. After the operation, the atrioventricular valve showed marked improvement, and pulmonary artery pressure tended to decrease when compared with preoperative levels. Arrhythmias in two cases with 3rd-degree AV block required permanent pacing (3.8%). In-hospital mortality was observed in 1/52 (1.9%) of patients. The 3-year overall survival rate after repair was 98.1%. No significant difference was found between the two groups.Conclusion: The surgical repair of complete atrioventricular septal defects demonstrated excellent results at a very early age and even in the case of Down’s syndrome.Keywords: complete atrioventricular septal defect, repair, outcome

Since 2008, we have conducted epidemiological cohort studies on the relationship between dioxin exposure and disruption with children in the area sprayed with defoliants during the Vietnam War. In a long-term survey of children through the age of five, we observed androgen disruption due to decreased dehydroepiandrosterone (DHEA) and testosterone levels. In this study of 7-year-old, we separately elucidated androgen disruption for boys and girls, and discussed with respect to hormone disruption with sex differences on the steroid hormone biosynthesis process. This follow-up was conducted with 96 mother-child pairs in Vietnam (hotspot area: 45, non-sprayed area: 51). We took a questionnaire, the physical measurement and assayed 7 steroid hormones in their serum by LC-MS/MS. We examined the relationship between the hormone levels in the serum and dioxin levels in the maternal breast milk. The results showed that the serum DHEA level in the 7-year-old children in the hotspot recovered to levels in the non-sprayed area. The testosterone level of 66.5 pg/mL for boys in the non-sprayed area was 1.5 times the girls level of 44.6 pg/mL, a male-dominant effect. The testosterone level in boys and girls from the hotspot were significantly lower than in the non-sprayed area with no sex difference. The 17β-hydroxysteroid dehydrogenase (17β-HSD) activity was significantly higher in boys than in the girls from the non-sprayed area, but was significantly lower in the hotspot boys than in the non-sprayed area boys. Both the testosterone level and 17β-HSD activity in the boys were inversely correlated with the TEQ total PCDD/Fs in the maternal breast milk. These results indicated that dioxin delayed the expression of the testosterone level and 17β-HSD activity with growth in the 7-year-old boys. The serum DHEA in the 7-year-old children recovered to the levels of the children in the non-sprayed area., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: To evaluate the nutritional status of children from 12 to 36 months of age in Kimdong, a rural district in Hungyen Province, Northern Vietnam, in 2017., Subjects and Methods: A cross-sectional study was carried out on 327 children aged 12-36 months. The data collected included anthropometric measurement, serum hemoglobin (Hb), and vitamin D concentration. Blood analysis was done at the Center Laboratory of Hungyen Obstetrics and Pediatrics Hospital. Underweight, stunted, and wasted children were classified based on z-scores cut-off less than -2 SD of weight for age (WAZ), height for age (HAZ), and weight for height (WHZ), respectively. Overweight and obese children were defined if WHZ was more than + 2SD. Anemic child was applied when Hb concentration was less than 110 g/L while vitamin D deficiency was termed for level less than 20 ng/L., Results: The prevalence of underweight, stunted, wasted, and overweight/obese children was 7.6%, 23.5%, 6.7%, and 1.2%, respectively. The prevalence of anemia and vitamin D deficiency was 33.3% and 47.7%, respectively. Malnutrition, anemia, and vitamin D deficiency were not statistically different by sex. Malnutrition and vitamin D deficiency were not statistically different by age group but anemia by age groups was significantly different., Conclusions: Stunting is still prevalent in children aged 12-36 months in Kimdong. Moreover, anemia and vitamin D deficiency also affected children in this area. Some interventions should be conducted to improve the nutritional status of children in Kimdong district.

The Bien Hoa airbase (south of Vietnam) is known as one of the Agent Orange hotspots which have been seriously contaminated by Agent Orange/dioxin during the Vietnam War. Hundreds of samples including soil, sediment and fish were collected at the Bien Hoa Agent Orange hotspot for assessment of the environmental contamination caused by dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs). The toxicity equivalency quotient (TEQ) concentration of PCDD/Fs in soil and sediment varied from 7.6 to 962,000 and 17 to 4860 pg/g dry wt, respectively, implying very high contamination of PCDD/Fs in several areas. PCDD/F levels in fish ranged between 1.8 and 288 pg/g TEQ wet wt and was generally higher than advisory guidelines for food consumption. 2,3,7,8-Tetrachlorinated dibenzo-p-dioxins (2,3,7,8-TCDD) contributed 66-99 % of TEQ for most of the samples, suggesting 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) from Agent Orange as the major source of the contamination. The vertical transport of PCDD/Fs was observed in soil column with high TEQ levels above 1000 pg/g dry wt (Vietnamese limit for necessary remediation activities- TCVN 8183:2009 (2009)) even at a depth of 1.8 m. The vertical transport of PCDD/Fs has probably mainly taken place during the "Ranch Hand" defoliant spray activities due to the leaks and spills of phenoxy herbicides and solvents. The congener patterns suggest that transports of PCDD/Fs by weathering processes have led to their redistribution in the low-land areas. Also, an estimate for the total volume of contaminated soil requiring remediation to meet Vietnamese regulatory limits is provided.

Seventeen toxic congeners of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were determined in breast milks using the high resolution gas chromatography/high resolution mass spectrometry (HRGC/HRMS) method. Twenty seven breast milk samples were collected from primiparae who have lived over 5 years in wards namely Chinh Gian, An Khe, Khue Trung, and Hoa Thuan Tay which are located near the Da Nang Agent Orange hot spot (the AO/Dioxin hot spot). The samples were then analyzed for PCDD/F residues in order to assess the human exposure to dioxins from the AO/Dioxin hot spot, especially health risk to the breast-fed infants. The average TEQ levels in the four studied cohorts ranged from 8.1 to 26 pg/g lipid, with the highest level up to 51 pg TEQ/g lipid found in the An Khe ward. The TEQ level was correlated with geographical position and ranking in the order of Khue Trung, Hoa Thuan Tay, Chinh Gian and An Khe. The mean estimated PCDD/Fs infant's daily intake in the cohort of Khue Trung, Hoa Thuan Tay, Chinh Gian and An Khe was about 41, 122, 124, and 134 pg TEQ/kg bw/day, respectively, which are much higher than the tolerable daily intake proposed by the World Health Organization (4 pg TEQ/kg bw/day)., (Copyright © 2014 Elsevier B.V. All rights reserved.)