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A study of the chemical constituents of a methanolic extract of the roots of Livistona halongensis (Arecaceae) led to the isolation of two new flavanes, 2S,3S-3,5,7,3'-tetrahydroxy-5'-methoxyflavane (1) and 3,7,3'-trihydroxy-5'-methoxyflavane 5-O-beta-glucopyranoside (2), together with trans-3,5,3',5'-tetrahydroxy-4-methoxystilbene, saccharose and beta-sitosterol-3-O-beta-glucopyranoside. The structures of these compounds were elucidated on the basis of spectroscopic data.

Dioxin exposure levels remain elevated in residents living around former US Air Force bases in Vietnam, indicating potential adverse impacts on infant growth. In this study, 210 mother-infant pairs in dioxin-contaminated areas in Vietnam were recruited at the infants' birth and followed up for 4 months. Perinatal dioxin exposure levels were estimated by measurement of polychlorinated dibenzo-p-dioxins/furans toxic equivalent (PCDDs/Fs-TEQ) in breast milk. The infants' size was measured at birth and 1 and 4 months after birth, and neurodevelopment was evaluated using the Bayley Scales III at 4 months of age. Among 4 dioxin groups (<25, 25-50, 50-75, ≥75 percentile of PCDDs/Fs-TEQ), cross-sectional comparisons of body size and neurodevelopment scales and comparisons of longitudinally assessed body size were performed respectively. At birth, head circumference of girls in the ≥75 percentile group was significantly larger than those in the <25 and 50-75 percentile groups. At 4 months of age, the weight and body mass index (BMI) of boys in the ≥75 percentile group were significantly lower than those in the other groups. Increase in weight was significantly lower in the ≥75 percentile group in both sexes from birth to 1 month but only in boys at 1-4 months of age. Estimated marginal mean values in a mixed model of weight and BMI during the first 4 months of life were significantly lower in the ≥75 percentile group in boys. In girls, marginal mean values for head circumference were increased with increase in dioxin levels. Only in boys, cognitive, language, and fine motor scores in the ≥75 percentile group were significantly lower than those in the other groups. These results suggested a considerable impact of perinatal dioxin exposure on infant growth, particularly in boys exposed to dioxins at high level of PCDDs/Fs-TEQ.

Two new aporphine alkaloids: 8-hydroxy-9-methoxy-1,2-methylenedioxyaporphine (1) and 8-hydroxy-3,9-dimethoxy-1,2-methylenedioxyaporphine (2) were isolated from the ethyl acetate extract of Fissistigma poilanei along with five known compounds: oxocrebanine (3), kuafumine (4), (2R,3R)-3',4',5,7-tetrahydroxydihydroflavonol-3-O-α-L-rhamnopyranoside (5), (+)-catechin 3-O-α-L-rhamnopyranoside (6) and quercetine 3,7-dimethoxy-3'-O-α-L-rhamnopyranosyl-(1 → 2)-β-D-glucopyranoside (7). These two new aporphine alkaloids exhibited a moderate cytotoxic activity against four human cancer cell lines (KB, Hep-G2, MCF-7, LU) as well as antimicrobial activity against Lactobacillus fermentum, Enterococcus faecium, Staphylococcus aureus and Bacillus subtillis.

NADPH oxidase produces reactive oxygen species (ROS). Drosophila melanogaster has two homologs of NADPH oxidase, dNox and dDuox, with functions that remain unclear in vivo. To clarify these functions, two independent transgenic fly lines expressing dsRNA targeted for different portions of dDuox mRNA were used. In both flies, en-GAL4> UAS-dDuoxIR(976-1145) and en-GAL4> UAS-dDuoxIR(370-518), in which dDuox was knocked down selectively in the posterior area of the wing disc, the posterior compartment of the adult wings became paler and more fragile with wing veins that were indistinct by comparison with the anterior one. Fluorescence staining of the en-GAL4> UAS-dDuoxIR(976-1145) adult wings revealed that the ROS concentration in the posterior compartment was significantly lower than that in the anterior compartment. Moreover, in these flies, the posterior compartment of the wing imaginal disc showed a greater number of apoptotic cells detected by immunostaining with anti-cleaved caspase-3 antibody than those in the anterior compartment. Respective knockdown of tyrosine hydroxylase or dopa-decarboxylase showed paler wing blades in the posterior compartment similar to the phenotype of dDuox-knockdown files. Along with this observation, analysis of the catecholic and dityrosine components in the wings of adult flies proved that dDuox plays important roles in the stabilization of the cuticle structure of the wings via tyrosine cross-linking, the sclerotization and melanization processes possibly through ROS production. These dDuox-knockdown fly lines would be useful tools for further studying dDuox functions during the development of Drosophila.

A new dihydrochalcone 4',6'-dihydroxy-2',3',4-trimethoxydihydrochalcone (1) along with nine known compounds, pashanone (2), dihydropashanone (3), pinostrobin (4), 5-hydroxy-7,4'-dimethoxyflavanone (5), 5-hydroxy-6,7-dimethoxyflavanone (6), 5-hydroxy-7,8-dimethoxyflavanone (7), 24-methylencycloartane-3β,21-diol (8), liriodenine (9) and 3,5-dihydroxy-7,3',4'-trimethoxyflavone (10), were isolated from the extracts, exhibiting cytotoxic activity (n-hexane and ethyl acetate extracts) of Miliusa sinensis. The structure of (1) was elucidated by the analysis of spectral data (IR, HR-MS, EI-MS, 1D and 2D NMR).

In an operation by United States Armed Forces during 1961 to 1971, large quantities of herbicides were sprayed in South Vietnam. These herbicides contained 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-tetraCDD), the most toxic congener of dioxins. Several decades after the herbicide spraying ceased, dioxin concentrations in the environment and human remained elevated in the sprayed areas. Breast milk samples from 520 nursing mothers residing in areas including the hot spots as well as the sprayed and unsprayed areas were collected to quantify the levels of dioxins. The total toxic equivalents of 2,3,7,8-substitued PCDDs/PCDFs in breast milk of mothers living in the hot spots, and the sprayed and unsprayed areas were 14.10 pg/g lipid, 10.89 pg/g lipid, and 4.09 pg/g lipid for primiparae and 11.48 pg/g lipid, 7.56 pg/g lipid, and 2.84 pg/g lipid for multiparae, respectively, with significant differences in the values among the three areas. In the hot spots, dioxin levels were highly correlated with the residency of mothers after adjustment for their age and parity.

This paper reports on a 2-year emissions monitoring program launched by the Centre for Environmental Monitoring of the Vietnam Environment Administration which aimed at determining emission factors and emission inventories for two typical types of vehicle in Hanoi, Vietnam. The program involves four major activities. A database for motorcycles and light duty vehicles (LDV) in Hanoi was first compiled through a questionnaire survey. Then, two typical driving cycles were developed for the first time for motorcycles and LDVs in Hanoi. Based on this database and the developed driving cycles for Hanoi, a sample of 12 representative test vehicles were selected to determine vehicle specific fuel consumption and emission factors (CO, HC, NOx and CO(2)). This set of emission factors were developed for the first time in Hanoi with due considerations of local driving characteristics. In particular, it was found that the emission factors derived from Economic Commission for Europe (ECE) driving cycles and adopted in some previous studies were generally overestimated. Eventually, emission inventories for motorcycles and LDVs were derived by combining the vehicle population data, the developed vehicle specific emission factors and vehicle kilometre travelled (VKT) information from the survey. The inventory suggested that motorcycles contributed most to CO, HC and NOx emissions while LDVs appeared to be more fuel consuming., (Copyright © 2011 Elsevier B.V. All rights reserved.)

NADPH oxidase is the major source of non-mitochondrial cellular reactive oxygen species (ROS), and also is reported to be a major cause of various diseases including atherosclerosis and hypertension. In order to screen a new curative reagent that can suppress NADPH oxidase activity, we developed a Drosophila melanogaster fly that would overexpress human Dual oxidase 2 (hDuox2), a member of the NADPH oxidase family, as a screening model. These flies (GMR-GAL4/UAS-hDuox2) had a high generation of ROS in the posterior region of the eye discs along with an easily recognizable rough-eye phenotype, which is an ideal and convenient marker for further screening steps. Moreover, the hDuox2-induced rough-eye phenotype can be rescued by feeding with a culture medium containing mulberry leaves (MLs), which reportedly have an antimetabolic effect. Some commercially available antioxidants such as quercetin-3-O-D-glucoside or quercetin-3-O-glucose-6''-acetate, or the naringin contained in MLs and other herbs, also have shown a similar suppressing effect on the rough-eye phenotype. Our results suggest that flavonoid glycoside is absorbed from the intestine and functions in the body of D. melanogaster as it does in mammalian models such as rats. Thus, the GMR-GAL4/UAS-hDuox2 fly line is a promising model for the screening of novel drugs such as NADPH oxidase inhibitors and/or antioxidants.

Objective: To examine the association between gestational weight gain and maternal body mass index (BMI) among Vietnamese women and the risk of delivering an infant too small or too large for gestational age., Methods: A prospective health-facility-based study of 2989 pregnant Vietnamese women was conducted in the city of Nha Trang in 2007-2008. Cubic logistic regression was used to investigate the association of interest. Infants were classified into weight-for-gestational-age categories according to weight centiles for the Asian population. Gestational age was based on the date of last menstrual period and adjusted by the results of first-trimester ultrasound., Findings: BMI was low (< 18.5), normal (18.5-22.9) and high (≥ 23.0) in 26.1%, 65.4% and 8.5% of the women, respectively. In each of these BMI categories, the percentage of women who delivered infants too small for gestational age was 18.1, 10.0 and 9.4, respectively, and the mean gestational weight gain was 12.5 kg (standard deviation, SD: ± 3.6), 12.2 kg (SD: ± 3.8) and 11.5 kg (SD: ± 4.7), respectively. Among women with low BMI, the risk of delivering an infant too small for gestational age ranged from approximately 40% if the gestational weight gain was < 5 kg to 20% if it was 5-10 kg., Conclusion: Having a low BMI, commonly found in Viet Nam, puts women at risk of delivering an infant too small for gestational age, especially when total maternal gestational weight gain is < 10 kg.

This field trial was conducted to determine whether 40 or 75 mg/kg of praziquantel is suitable for treatment of fishborne zoonotic trematodes (FZT) in naturally infected dogs (n=10) and cats (n=11). Three days after treatment all animals at either dose were negative for small trematode eggs. In two cats and one dog treated with 75 mg/kg, however, a few damaged eggs were found 3 days post-treatment; no small trematode eggs were seen in these animals at day 14 post-treatment. In addition, at the 75 mg dose, two cats and two dogs experienced vomiting or diminished appetite. Therefore a praziquantel dose of 40 mg/kg is suggested for treatment of FZT in dogs and cats., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Fishborne zoonotic trematodes (FZT) are widespread in Vietnam and Southeast Asia. It is now recognized that the risk of being infected from eating raw fish dishes applies not only to humans, but also to domestic animals (e.g., cats, dogs, and pigs) and fish-eating birds. The role of ducks and chicken, commonly raised on fish farms, as reservoir hosts, however, has not been adequately investigated. To study this question, chickens and ducks from integrated poultry-fish farms in Nghia Lac and Nghia Phu communes, Nam Dinh province, Vietnam were surveyed for FZT infections. A total of 50 ducks and 50 chickens from each commune were examined. Results revealed that 12% of chickens and 30% of ducks were infected with various species of trematodes, including two zoonotic species, Centrocestus formosanus and Echinostoma cinetorchis. Both occurred in chickens whereas only E. cinetorchis was found in ducks. Prevalence of these zoonotic species was 12% and 7% in ducks and chickens, respectively. Among other trematodes, Hypoderaeum conoideum, also a zoonotic fluke, was the most prevalent (20-30%). The feeding of snails and fish remains to poultry, either intentionally or by discharge of waste from the slaughter of ducks and chickens into the ponds, was identified as risk factors for trematode infection. The FZT species and low prevalence found in poultry in these communes indicate their role as reservoir hosts is minor., ((c) 2010 Elsevier B.V. All rights reserved.)

In this retrospective study we explore the life trajectory of Vietnamese HIV-positive AIDS widows over a period 2 years after their husbands' deaths in a patrilinear and patrilocal setting where HIV is stigmatized. Some options, such as widows living with their eldest son, are not available to young HIV-positive widows, but the women in our study furthered their own interest by joining support groups, looking for new partners, and strengthening relations with their own family. Most women who returned to live with their family found a new intimate relationship through support groups for HIV-positive persons.

Nine compounds, including six phenylethanoid glycosides: acteoside (1); bioside (2); echinacoside (3); poliumoside (4); phenylethyl glycoside (5); salidroside (6) and three flavonoids; linarin (7); apigenin (8); isorhoifolin (9), were isolated from the flowers of Buddleja officinalis MAXIM. (Buddlejaceae). Chemical structures were confirmed by (1)H-, and (13)C-NMR, and MS spectral methods and compared with those reported in the literature. Antioxidant activities of the methanol and water extracts, and all isolated compounds were evaluated using the total oxidant scavenging capacity (TOSC) assay against peroxynitrite. Results of the assay showed that the phenylethanoid glycosides, a major class of compounds of the flowers of B. officinalis, possess strong antioxidant activity. Of these, acteoside, echinacoside and poliumoside have 9.9-, 9.8- and 9.5-fold TOSC value, respectively, compared with the positive control, Trolox.

How do women and frontline health workers engage in preventing mother-to-child HIV transmission (PMTCT) in urban areas of Vietnam and Indonesia, where HIV is highly stigmatized and is associated with injecting drug use and sex work? This qualitative study explores local dynamics of care, using a mix of observations, focus group discussions, and interviews. In Indonesia the study was conducted in a community-based PMTCT program run by an NGO, while in Vietnam the study explored the care dynamics in routine PMTCT services, implemented by district and provincial public health facilities. In both of these PMTCT arrangements (the routine provider initiated approach in Vietnam and a more client-oriented system in Indonesia), pregnant women value the provision of HIV tests in antenatal care (ANC). Concerns are raised, however, by the unhappy few who test positive. These women are unsatisfied with the quality of counselling, and the failure to provide antiretroviral treatments. Acceptability of HIV testing in ANC is high, but the key policy issue from the perspective of pregnant women is whether the PMTCT services can provide good quality counselling and the necessary follow-up care. We find local level providers of PMTCT are pleased with the PMTCT program. In Vietnam, the PMTCT program offers health workers protection against HIV, since they can refer women away from the district health service for delivery. In Indonesia, community cadres are pleased with the financial incentives gained by mobilizing clients for the program. We conclude that achieving the global aims of reducing HIV infections in children by 50% requires a tailoring of globally designed public health programs to context-specific gendered transmission pathways of HIV, as well as local opportunities for follow-up care and social support.

Fish-borne zoonotic trematodes (FZT) pose a risk to human food safety and health and may cause substantial economic losses in the aquaculture industry. In Nghe An Province, Vietnam, low prevalence of FZT for fish farmers but high prevalence for fish indicate that reservoir hosts other than humans may play a role in sustaining transmission. To determine whether domestic animals may be reservoir hosts, we assessed prevalence and species composition of FZT infections in dogs, cats, and pigs in a fish-farming community in Vietnam. Feces from 35 cats, 80 dogs, and 114 pigs contained small trematode eggs at 48.6%, 35.0%, and 14.4%, respectively; 7 species of adult FZT were recovered from these hosts. These results, combined with data from previous investigations in this community, imply that domestic animals serve as reservoir hosts for FZT and therefore must be included in any control programs to prevent FZT infection in humans.

The purpose of this study is to apply the conceptual framework of the theory of planned behavior (TPB) to explain the consumption of a common food (fish) in Vietnam. We seek to understand the role of norms in explaining intention to consume, and descriptive norms is included as extensions of traditional constructs such as attitude, social norms, and perceived behavioral control. The data were derived from a cross-sectional sample of 612 consumers. Structural equation modeling was applied to test the relationships between constructs, and evaluate the reliability and the validity of the constructs. The results indicate that the models fit well with the data. Attitude, social norms, descriptive norms and behavioral control all had significantly positive effect on behavioral intention. Finally, both intention and perceived behavioral control were highly associated with the frequency of consumption of the common food investigated.

This study was conducted to evaluate techniques for detection of small trematode eggs in faeces of dogs, cats and pigs. Faecal samples from dogs (n=80), cats (n=35) and pigs (n=114) were examined by Kato-Katz technique (KK), formalin-ether sedimentation technique (FE) and a method of combining: filtration, sedimentation and centrifugation, developed at DBL - Centre for Health Research and Development (former Danish Bilharziasis Laboratory) (DBL). Necropsy was performed on 38 dogs, 25 cats and 16 pigs and was considered as a gold standard method for evaluation of the techniques. The results showed 100% specificity for the three techniques. Lower sensitivity was seen for the KK-technique in dog samples in comparison to that for DBL- and FE-technique. The sensitivity of the three techniques was similar in cats and pigs. Based on these findings and practical issues, DBL-technique was chosen as most suitable because the eggs were easily detected and quantified. No toxic chemicals or special equipment were required in comparison with FE-technique that needs ether solution and thus fume cupboards which are often unavailable in local veterinary centres in Vietnam and other developing countries.

Our study was undertaken to investigate the characteristics of Haemophilus influenzae in young children with acute lower respiratory tract infections in Nha Trang, Vietnam. The study population consisted of 116 children less than 5 years of age admitted to Khanh Hoa General Hospital due to acute lower respiratory tract infections between July 2004 and April 2005. Organisms could be detected from nasopharyngeal swabs (NP) in 72 (62.1%) of the 116 children. Haemophilus influenzae was the most common organism, and 39 strains were isolated from 39 children aged 2 to 60 months (mean age, 16 months). We examined 37 of these 39 H. influenzae strains. The serotypes of the 37 isolates were all nontypeable, and 22 strains (59.5%) were beta-lactamase producing. Polymerase chain reaction (PCR) analysis to identify resistance genes revealed that 17 strains had the TEM-1-type beta-lactamase gene alone, 6 strains had the ftsI gene with the same substitution as that in g low-beta-lactamase-negative ampicillin-resistant (g low-BLNAR) strains, and 6 strains had both the TEM-1-type beta-lactamase gene and the ftsI gene with the same substitution as that in g beta-lactamase-producing amoxicillin clavulanic acid-resistant (g BLPACR I) strains, although no BLNAR strains were found. Molecular typing by pulsed-field gel electrophoresis (PFGE) showed that the 6 g low-BLNAR strains had five PFGE patterns and the 6 g BLPACR I strains had four PFGE patterns. Our results indicate that BLNAR strains are still not prevalent, but that g low-BLNAR and g BLPACR I strains are potentially spreading in Nha Trang, Vietnam.

Background: Acute lower respiratory infections (ALRI), primarily pneumonia, are the leading cause of death in children under 5 years of age. Most of these deaths occur in Africa and southeast Asia. Increasing rates of drug resistance in pneumococcal strains emphasize the necessity of prevention of pneumococcal vaccines. The aim of the present study was to determine the frequency of drug resistance and the distribution of serotype of pneumococcal strains isolated from pediatric patients with ALRI in Vietnam., Methods: Two hundred and twenty pediatric patients with ALRI under 5 years of age were enrolled in Hanoi, Vietnam between 2001 and 2002. Bacterial pathogens with a heavy growth (10(6) c.f.u./mL) were isolated from nasopharyngeal secretions on quantitative culture. Fifty-three pneumococcal strains isolated from the nasopharynx of pediatric patients were examined for antibiotic susceptibility including drug-resistant genes and serotyping., Results: A total of 73.6% of pneumococcal strains were genotypic penicillin-resistant Streptococcus pnemoniae (gPRSP), possessing altered penicillin-binding protein genes pbp 1a + 2x + 2b; 67.9% of these strains were gPRSP and simultaneously had the ermB gene, which is responsible for high resistance to erythromycin. The majority of gPRSP strains were serotype 19F or 23F., Conclusion: gPRSP strains with serotype 19F or 23F are highly prevalent among pediatric patients with ALRI under 5 years of age in Hanoi, Vietnam.

Health services around the world offer many guidelines for HIV-positive women who are pregnant or who want to become pregnant, and for women with HIV infected partners. These guidelines are addressed to women and, increasingly, also to men, but pay little or no attention to the role of other members of the family in fertility decisions. This study looked at factors influencing decisions about fertility in families with an HIV-positive member. In Vietnam, the whole family takes a crucial role in deciding whether a woman should become pregnant and whether she will keep her child. This decision is taken in the context not only of the close family but also under the influence of ancestors and the weight given to them within the culture. Key in this regard is the need for parents and grandparents to have male offspring. Health workers share these ideas about preferred family composition and support men and women in the quest for male offspring. Policies and guidelines should take into account these additional family factors and goals as a basis for the design of appropriate programmes to reduce HIV transmission.

Background: The International Collaborative Epidemiological Study of Host and Environmental Factors for Stomach and Colorectal Cancers in Southeast Asian Countries (SEACs) has been conducted in Viet Nam from 2003 to 2008 on a case-control basis. For further effective primary prevention, we examined gastric and colorectal cancer mortality nationwide in eight regions of Viet Nam in 2005-06., Methods: Both demographic data and lists of all deaths in 2005-06 were obtained from all 10,769 commune health stations in Viet Nam. Five indicators included name, age, sex, date of death and cause of death was collected for each case. We selected only communes having the list of deaths with clear cause for each case and crude mortality rate for all causes from 300-600/100,000 as published by the Ministry of Health for a reasonable accuracy and completeness. Obtained data for all causes, all cancers, stomach and colorectal cancer deaths as well as demographic information were processed using Excel software and exported to STATA 8.0 for estimation of world age-standardized cancer mortality rates per 100,000., Results: Data were available for 1,246 gastric cases, (819 male and 427 female) with age-standardized mortality rates from 12.7 to 31.3 per 100,000 in males and from 5.9 to 10.3 per 100,000 in females in the 8 regions of the country. For colorectal cancers, 542 cases (268 male and 274 female) gave mortality rates from 4.0 to 11.3 per 100,000 in males and from 3.0 to 7.8 per 100,000 in females., Discussion: Stomach cancer mortality in males in the region of North East in the North Viet Nam (2005-06) was higher than that in Japan (2002) (31.3 versus 28.7 per 100,000) while colorectal cancer in Viet Nam was lower. While prevalence of Helicobacter pyloris infection in Viet Nam was from 70-75% in both males and females, the stomach cancer rate in males was significantly higher than in females, 31.3 versus 6.8 per 100,000, suggesting an influence of other environmental risk factors. Whether protective factors are operating against colorectal cancer in Viet Nam now needs to be explored.

Acute lower respiratory infection (ALRI), primarily pneumonia, is the leading cause of death in children under the age of five. Bacterial ALRI is preceded by asymptomatic bacterial colonization. Bacterial colonization, therefore, may have an important role in the development of pneumonia in children. This case-control study was conducted in order to determine if intense bacterial colonization was increased in the nasopharynx of pediatric patients with ALRI. One hundred-sixty four pediatric patients with ALRI and 70 healthy children < 5 years of age were enrolled in Hanoi, Vietnam between 2001 and 2002. Bacterial pathogens were isolated from nasopharyngeal secretions and quantitatively cultured. Of 164 patients, 91 were diagnosed as having radiological pneumonia (PN group) and 73 as having acute bronchitis (AB group). Intense growth of any bacterial pathogen (>or= 10(6) colony-forming units/ml) was highest in the PN group (49.4%), followed by the AB group (28.8%), with healthy children having the lowest (17.1%). Patients with intense bacterial growth were more likely to develop pneumonia, but not acute bronchitis, than were patients with light or no bacterial growth. The results of this case-control study suggest that the vertical spread of intense bacterial pathogens colonized in the nasopharynx to the lower airway leads to bacterial pneumonia in children under the age of five.

Thirty-seven Haemophilus influenzae strains from nasopharyngeal swabs (NP) and 44 H. influenzae strains from cerebrospinal fluid (CSF) were investigated. Of the 37 H. influenzae isolates from NP, the serotypes of 30 isolates were nontypeable, 4 were type b, 2 were type c, and 1 was type a, whereas all of the 44 isolates from CSF were type b. The MICs of 16 antibiotics for the H. influenzae isolates from NP and CSF were similar, and no beta-lactamase-negative ampicillin-resistant strain was found. Molecular typing by pulsed-field gel electrophoresis (PFGE) showed that the 37 H. influenzae strains from NP had 22 PFGE patterns, with none predominating, and the 44 H. influenzae strains from CSF had 9 PFGE patterns, with patterns alpha (22 isolates) and beta (12 isolates) predominating. Our results indicate that two predominant types of H. influenzae type b strains have the potential to spread among children with meningitis in Hanoi, Vietnam.

2,4-Dimethoxy-2-methyl-6H-pyran-3-one (1), a hitherto unknown natural product, and the calcium salt of rehmapicroside (2) have been isolated from rhizomes of the Vietnamese variety of Rehmannia glutinosa Libosch together with a series of known compounds: norcarotenoids (3-5), 2-formyl-5-hydroxy-methylfurane (6), the iridoid rehmaglutin D (7), iridoid glycosides (8-12) and phenylethyl alcohol glycosides (13-17). Their structures were determined by mass and NMR spectroscopy.

From the ethyl acetate extract of the tuberous roots of Ophiopogon japonicus (Liliaceae) eight known and five new homoisoflavonoidal compounds were isolated. The new compounds are 5,7-dihydroxy-8-methoxy-6-methyl-3-(2'-hydroxy-4'-methoxybenzyl)chroman-4-one (1), 7-hydroxy-5,8-dimethoxy-6-methyl-3-(2'-hydroxy-4'-methoxybenzyl)chroman-4-one (2), 5,7-dihydroxy-6,8-dimethyl-3-(4'-hydroxy-3'-methoxybenzyl)chroman-4-one (3), 2,5,7-trihydroxy-6,8-dimethyl-3-(3',4'-methylenedioxybenzyl)chroman-4-one (4) and 2,5,7-trihydroxy-6,8-dimethyl-3-(4'-methoxybenzyl)chroman-4-one (5). Their structures have been elucidated by mass and NMR spectroscopy. Compounds 4 and 5 are the first isolated homoisoflavonoids with a hemiacetal function at position 2.

Shigellosis is an important cause of infectious diarrhea in Vietnam, caused mainly by Shigella flexneri. This study provides for the first time in the international literature, data on the development of antimicrobial resistance in Shigella between 1988 to 1998, including data reported to the National Program for Surveillance of Antimicrobial Resistance (NPSAR). Our studies show that about 80% of the Shigella strains tested were resistant to ampicillin, chloramphenicol, oxytetracycline, trimethoprim and sulfonamides. This combination of drugs was also the most common antibiogram among multiple-resistant S. flexneri (57%). Resistance to tetracyclines, sulfonamides and, in particular trimethoprim (p<0.001), increased during the study period. Our findings indicate that tetracyclines and co-trimoxazole (a combination of a sulfonamide and trimethoprim), which are recommended and commonly used drugs for the treatment of shigellosis in Vietnam, may have limited therapeutic effect. In contrast to neighboring countries, low percentages of resistance were found to nalidixic acid and norfloxacin (3-5%) and no resistance was found to ciprofloxacin, indicating that nalidixic acid with its low cost and safety in children could be recommended for the treatment of shigellosis. The NPSAR provides a useful picture of the levels and development of antimicrobial resistance in Vietnam and should receive continued support for further improvement by increasing the number of provinces covered, the numbers of isolates tested from rural areas, and the communication of results to medical practitioners and others prescribing and/or selling antimicrobials.

In order to have basic data for dietary preventive measures against some vascular diseases caused by disorder of lipid metabolism, food intake and lipid status were investigated in three Vietnamese populations with different per capita income levels. Totally, 299 people aged over 18 were involved in this study. Among them, 98 subjects were selected from one commune with low income, 100 and 101 subjects from two urban areas with medium and high income respectively. Food intake was assessed by 24-h recall method and lipid status was evaluated by measuring serum concentration of triglyceride, total cholesterol and its subfractions. The results showed that food consumption, dietary habits and lipid status varied with income levels. In general, diet was still unbalanced in all three groups, and low in fat and protein. In the rural, fat and protein intakes were lower than in the urban. The high prevalence of low serum cholesterol was observed in all three groups, the highest in the rural (45.3%) and the lowest in the urban (11.2%). On the contrary, the prevalence of high serum cholesterol was the lowest in the rural (2%) and the highest in the urban (16%). From these data, it is suggested that the majority of the Vietnamese might be vulnerable to some vascular diseases such as stroke if the situation of low fat intake and low serum cholesterol is not a problem of concern.

In southern Vietnam it is not uncommon that children under 5 years of age die from pneumonia. Reduction of severity and mortality has to rely on proper case management by mothers and health workers on both grass root level and referral level. The responsibility of training of clinical skills of ARI case management in the southern provinces of Vietnam has been delegated to Pediatric Hospital N1 (PHN1) Ho Chi Minh City (HCMC) by Ministry of Health. A pilot project was carried out by the Danish-Vietnamese Study Group. The immediate objects were: to provide basic epidemiological information about ARI in southern Vietnam, to develop training modules and case management intervention modules at primary and secondary level in order to enable mothers, village workers, health post staff and district hospital emergency department staff to treat moderate and severe pneumonia and acute bronchitis in accordance with the WHO management guide for ARI and to evaluate the effect of those modules after implementation in a limited number of communes. The modules were developed at PHN1. Ten commune health stations were carefully selected. The purpose of the project and the conditions for taking part had been explained to the health workers. The doctors and other commune health workers from the 10 commune health stations and doctors from the connected district hospitals attended the training courses at PHN1, HCMC and also at the belonging provincial hospitals. Essential equipment was provided and a pharmacy with essential drugs established. The registered health statistics was collected yearly during on site visits. The local doctors and commune health workers gave seminars for mothers in the villages of the 10 project communes. The mothers' knowledge, attitude and practice (KAP) was tested in interviews before and two months after the seminars had taken place. The spread of KAP was measured by random interviews of mothers six month later. In the interviews information on social conditions was obtained. The mothers' KAP had risen by 25% two months after attending the seminars. A further increase of KAP by 5-10% within the untrained group appeared in a survey 4-6 months later. It was not possible to obtain reliable statistics on morbidity or mortality of ARI in the project area.

This study was conducted to investigate the concentrations of serum fatty acids, lipoprotein(a) and apolipoprotein of three populations in North Vietnam: rural area with low income (n = 101), suburban with average income (n = 97), and urban with high income (n = 95). The results showed the suburban and urban populations had higher fat intake than the rural. The fat intake in quality was different in these three populations. The suburban had the highest consumption of fatty foods rich in n-6 polyunsaturated fatty acid (PUFA). The rural consumed more fatty foods rich in monounsaturated fatty acid (MUFA), but less fatty foods rich in n-3 PUFA than the two other populations. The high index of thrombogenicity (IT) of the Vietnamese diet may result from their low intake of fish and vegetable oils. Risk factors for premature cardiovascular disease (CVD) assessed by serum lipoprotein(a) and apolipoprotein levels were not observed in all three populations. However, coronary heart disease (CHD) and stroke are problems that should be monitored because the increase of CVD morbidity has been reported in Vietnamese people. From a nutritional point of view, the increase of fish and vegetable oils consumption is necessary for the prevention of CVD and CHD in these Vietnamese populations.