Myanmar Medical Journal

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    Abnormal cervical lesions detected at a Colposcopy Clinic
    (1990-01-01) Ba Thike, Katherine; Yin Yin Soe
    A coloposcopy clinic was established in February 1988. An analysis of 300 cases seen at this clinic (over a 20 month period) is presented. The procedure consisted of taking a history, taking a cervical smear, perfoming colposcopy and colposcopy directed biopsy in the majority of cases (260 cases 86.67 per cent). The cases were referred for clinically suspicious cervices, abnormal bleeding per vaginam, abnormal cervical smears or self referral for check-up. The age of the patients ranged from 16 to 74 years, with the majority in the 35-44 age group (137 patients 45.67 per cent). The parity was from nulliparous to parity 14+2.37 of the patients were menopausal. Colposcopy could be satisfactorily performed in 286 patients. Most of the cases seen were colposcopically and histologically normal. Pathological lesions detected were squamous metaplasia (15), cervical intra epithelial neoplasis (14), coexistent cervical carcinoma and cervical intra-epithelial neoplasia (2) and inflammatory lesions (79).
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    ABO blood groups and susceptibility to Malaria
    (2000-01-01) Soe Soe; Khin Saw Aye; Aung Htay; Than Swe
    A total of 425 villagers from four malaria endemie villages in Kanbaunk village tract, Yephyu Township. Taninthayee Division were examined for the presence of malaria parasites in blood and ABO blood groups with the aim to find out if there are any differences in the parasite positive rate among the ABO bolld groups. The distribution of blood groups was 22 per cent, 35 per cent, 38 per cent and 5 per cent for A,B,O and AB blood groups respectively. their allotment are similar to other parts of the country. the parasite positive rate in all persons irrespective of blood group was 23 per cent P. falciparum and P. vivax accounting for 81 per cent and 19 per cent respectively. when the parasite positive rates were compared among the 4 blood groups, they were 20 per cent, 14 per cent, 16 per cent and 14 per cent respectively but there was no significant difference among different blood groups. The ratio of P. falciparum and P. vivax did not differ significantly among the four blood groups. Thus, according to our results ABO blood groups have no relation with malaria susceptibility.
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    Abortion at North Okkalapa General Hospital
    (1994-01-01) Ba Thike, Katherine; Aye Aung; Khin Thet Wai; Myint Maung Maung
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    The acute cardiovascular effects of coffee drinking in Myanmar subjects
    (1999-01-01) Ohnmar; Nyunt Wai; Htay Htay; Lay Thet Htar
    To study the acute cardiovascular effects of coffee drinking, 37 apparently healthy Myanmar volunteers of both sexes (25-45 years) were administered a cup of coffee (after 5 day abstinence from caffeine-containing beverages) or a cup of milk (vehicle control) on two separate days. the order of administration was randomized. Coffee was freshly prepared by adding 2.5 g of instant Nescoffee (approximately equivalent to 2 teaspoonfuls) to a cup of milk (10 g milk powder + 8 g sugar in 150 ml of hot boiled water). The heart rate and rhythm (by 3 minute-auscultations and ECG recordings at various time points), supine brachial arterial bolld pressures (indirect sphygmomanometry) and the respiratory rate (by auscultation) were determined before and every 15 minutes for a total of 90 minutes after administering coffee or mild, Both the systolic and diastolic blood pressures rose progressively and significantly after drinking coffee (SBP: from 103.7 to 113.2 mmHg and DBP: 65.2 to 75.3 mmHg; mean values; p<0.001, Student's paired t test)but not after drinking milk (SBP: from 104.3 to 105.9 mmHg and DBP: 65.3 to 67.2 mmHg; NS). There were no significant changes in the heart rate, or the respiratory rate after drinking coffee or milk. Forty per cent of subjects gave the subjective feeling of palpitation after drinking coffee but none gave this complaint after drinking milk. It was concluded that with this dose of coffee, there was no apparent dysrhythmogenic effect, but the hypertensive effect was appreciable.
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    Adenomyomatous polyp of left hepatic duct
    (1990-01-01) Kyi Soe; Thi Thi Aye; Myint Soe; Khin Maung Kyi; Thein Nyunt
    A case report of adenomyomatous polyp originating from the left hepatic duct causing surgical jaundice is made. Adenomyomatous polyp originating from the left hepatic duct is histologically similar to adenomyomatous hyperplasiaof the gall bladder as shown in the references above. In various journals available here, this type of polyp with its origin from hepatic duct has not been mentioned. Another important point is that it can be mistaken radiologically & clinically as cholangio carcinoma causing obstructive jaundice.
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    Adjustment of drug dosage for individuals
    (1999-01-01) Win Maw
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    Alpha fetoprotein in Myanmar patients with chronic liver diseases
    (1994-01-01) Khin Pyone Kyi; Myo Khin; Khin May Oo; Than Aung; Khin Aye Tha; San San Oo; Khin Maung Win
    In patients with chromic liver diseases, the measurement of serum alpha fetoprotein level is an invaluable laboratory investigation to assess the disease progress and to detect early diagnosis of hepatocellular carcinoma. A total of 150 sera samples were collected from normal individuals, hepatitis B surface antigen carriers, patients with hepatomagaly, fatty liver, chronic hepatitis, cirrhosis and hepatocellular carcinoma. The sera were examined for serum alpha fetoprotein levels by radia-immunoassay technique, one of the most sensitive methods available. The results showed that the sera alpha fetoprotein levels correlate with the severity of the liver diseases as all of normal individuals, hepatitis-B surface antigen carriers, hepatomegaly and fatty liver patients showed normal levels and 5-17 percent of chronic hepatitis and liver cirrhosis patients were low positive. Also 73 percent of hepatocellular carcinoma patients were positive with 50 percent of them revealing high levels of alpha fetoprotein.
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    The amazing stem cell
    (2001-12-01) Kyi Kyi Thinn
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    Amoxycillin administered by two dosage regimens
    (2000-01-01) Nwe Nwe Yee
    The emergence of antibiotic resistance is a problem in Myanmar nowadays and rational use of antibiotics could help solve this problem. A comparative study of amoxycillin administered by two dosage regimens, 250mg 6 hourly and 500 mg 8 hourly, was performed to explore the clinical significance of different dosage regimens based on plasma drug concentration achieved.Using a cross-over design, the study was conducted on 22 healthy volunteers, measuring plasma amoxycillin concentration at different times. Plasma amoxycillin concentration in bothregimens reached well above the known minimum inhibitory concentration (MIC) of common organisms such as r and b haemolytic streptococci, non-penicillinase producing strains of Staph. aureus, Diplococcus pneumoniae, Haemophilus influenzae Neisseria gonorrhoeae, Salmonella species and Proteus mirabilis. So both regimensare appropriate for use in infections by these organisms. For urinary tract infections by Escherichia coli, both dosage regimens may be effective. For systemic infection by E.coli and Shigella species only 500 mg 8 hourly regimen achieved MIC concentration and may be considered more suitable than 250 mg 6 hourly regimen. In case of infections caused by penicillinase producing strains of Staphylococcus aureus Klebsiella pneumoniae, Enterobacter cloacae and Pseudomonas aeruginosa, their MICs higher than the peak plasma drug concentrations were achieved by both dosage regimens. So both regimens are not effective in the treatment of these infections. By assessing peak plasma amoxycillin concentration, it was found that "food disturbs absorption of amoxycillin".
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    Amoxycillin administered by two dosage regimens
    (2000-01-01) Nwe Nwe Yee
    The emergence of antibiotic resistance is a problem in Myanmar nowadays and rational use of antibiotics could help solve this problem. A comparative study of amoxycillin administered by two dosage regimens, 250 mg 6, hourly and500 mg 8 hourly, was performed to explore the clinical significance of differentdosage regimens based on plasma drug concentration achieved. Using a cross-over design, the study was conducted on 22 healthy volunteers, measuring plasma amoxycillin concentration at different times. Plasma amoxycillin concentration in both regimens reached well above the known minimum inhibitory concentration (MIC) of common or gunisms such as alpha & beta hoemolytic streptococci, non-penicillinase producing strains of Staph. aureus, Diplococcus pneumoniae, Haemophilus influenzae, Neisseria gonorrhoeae, Salmonella species and Proteus mirabilis. So bothregimens are appropriate for use in infections by these organisms. For urinary tract infections by Escherichia coli, both dosage regimens may be effective. For systemic infection by E.coli and Shigella species only 500 mg 8 hourly regimen achieved MIC concentration and may be considered more suitable than 250 mg 6 hourly regimen. In case of infections caused by penicillinase producing strains of Staphylococcus aureus, Klebsiella pneumoniae, Enterobacter cloacae and Psudomonasaerugenosa, their MICs higher than the peak plasma drug concentrations were achieved by both dosage regimens. So both regimens are not effective in the treatment of these infections. By assessing peak plasma amoxycillin concentration, it was found that "food disturbs absorption of amoxycillin".
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    Analysis of Dihydrofolate Reductase (DHFR) and Dihydropterotase systhetase (DHPS) genes in plasmodium falciparum from patients treated for malaria in Myanmar
    (2001-01-01) Thuzar Han; Curtis, Jill; Waehurst, David
    The aim of the present study was to analyse the mutation patterns of DHFR and DHPS genes in falciparum from Myanmar adult patients. Five patients were treated with two tablets of co-trimoxazole twice daily for 5 days and another 5 patients were treated with a single dose of three tables of Fansidar. Blood samples from uncomplicated cases of falciparum malaria were collected by finger prick onto glass fibre membrane or filter paper before and 3 or 7 days after treatment. Fragments of genes were amplified by nested polymerase chain reaction (PCR) and variants were identified by specific restriction enzyme digestion. Out of 10 patients, 7 patients were clinically cured at day 37. However, PCR positivity was found in those patients after treatment. Positive PCR may result from amplification of DNA from gametocytes of P.falciparum. The results of pre-treatmentsamples revealed that P.falciparum from malaria patients had point mutations in both DHFR and DHPS genes. 108-Asn and 59-Arg mutations were noted in 9 patients.437-Gly mutation in all 10 patients and 540-Glu mutation in 6 patients. In the post-treatment samples, 108-Asn and 437-Gly mutations were found in all patients.59-arg in 8 patients and 540-Glu in 7 patients. It can be concluded that P.falciparum circulating in Myanmar has already mutated in DHFR and DHPS genes. Even after treatment with antimalarials, the patients still harboured mutated P.falciparum probably gametocyte forms, although they responded well clinically. Therefore, there seems to be no association between mutation patterns in these genes andthe cilnical response to co-trimoxazole and Fansidar.
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    Analysis of maternal deaths in Central Women's Hospital
    (1990-01-01) Than Than Tin; Mya Mya; Tin Htet, Esther
    A retrospective study of maternal deaths occuring during the 5 years period. (from Jan. to Dec. 1988) in Central Woman Hospital. The maternal mortality rates excluding abortion were 1.1 for 1984, 1.17 for 1985, 1.6 for 1986, 1.28 for 1987 and 1.24 for 1988. MMR includingabortions were 1.71 for 1984, 2.3 for 1985, 2.36 for 1986, 2.9 for 1987 and 2.83 for 1988. The maximum number of deaths occurred in the age group 20 to 34 years and in para 0, group. As regards abortion deaths, induced abortion by let-ther' played a major role and sepsis was the major cause of death as confirmed by post moterm report. Sepsis, haemorrhage, uterine rupture, eclampsia and heart failure were leading causes of death occuring during ante-partum, intra partum and post-partum periods. Regarding the mode of delivery, the maximum number of deaths occurred in those delivered by caesarean section. Direct obstetric deaths were more than inderict obstetric deaths.
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    An Analysis of partograms used in N.O.G.H.
    (1995-01-01) Myint Maung Maung; Than Than Aye; Saw Kler Ku
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    Antimalarial drug therapy
    (1998-12-01) Cho Cho Myint
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    Antimalarial drug therapy
    (1998-12-01) Cho Cho Myint
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    Antimicrobial susceptability pattern of commonly isolated gram-negative pathogens from some hospitals in Yangoon
    (2001-12-01) Su Su Hlaing; Khwar Nyo Zin; Khin Yi Oo
    In Yangon hospital-acquired infections with multiresistant Gram-negative bacteria is becoming incerasingly prevalent.In this study, antimicrobial susceptibility pattern of 575 isolated from various clinical specimens including pus , wound swabs, sputum and blood of the patients attending Yangon General Hospital and some other hospitals from January to December, 2000 were studied. Among them, 270 isolates were Pseudomonas spp, whereas 208 and 97 isolates were identified as members of the Enterolates were identified as members of the Enterobacteriaceae family (Escherichia coli, Citrobacter spp, Klebsiella spp and other coliforms) and Acinetobacter spp respectively. It was found that 35.2
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    Aspirations and attitudes towards medical professionalism and awareness of medical ethics among Final Part 2 MBBS students in Myanmar Medical Universities.
    (Myanmar Medical Association, 2015-03-01) Tint Swe Latt; Mya Thida; San Shwe; Hla Hla Win; Yin Thet Nu Oo; Win Thuzar Aye; Wai Wai Myint
    The cross-sectional descriptive study being conducted in 2012 explored the aspirations and attitudes of the Final Part 2 MBBS students towards medical professionalism and their awareness of medical ethics. A total of 920 students from four Medical Universities in Myanmar responded to the self-administered questionnaire. Less than 65% of their parents were graduates and nearly half (48.5%) of them earned their living by own business. Sixty five percent of students admitted their career ambition during high school period as becoming a medical doctor. They had attended the Medical University due to family influence (22.1%), high scores in Basic Education High School examination (22.8%) and their desire for monetary gains (23.5%). Almost all (90%)accepted medical profession as noble and 65.7% of respondents cited that they were fond of giving care to patients. Regarding their attitudes toward medical professionalism, more than 90% of the respondents agreed towards principles of fair distribution of finite resources, honesty with patients, a necessity to improve quality of care, ability to manage conflict of interest and professional self regulation. Only 5.5% of students disagreed that periodic recertification was desirable. Nearly half (45.8%) of them disagreed on improving an access to care regardless of patient’s ability to pay,and also on increasing scientific knowledge by encouraging their patients to participate in clinical trials (63%). For future aspiration, 40.4% of respondents intended to join the government service, of whom 71.6% expected to become clinicians. Eighty seven percent of the students agreed to teach Medical ethics as a separate subject and they preferred group discussions. So, to review and revise the existing curriculum for medical ethics is necessary to improve the professional skills of students.