Myanmar Health Sciences Research Journal
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Item Renal function, plasma sodium and osmolality during the menstrual cycle(1990-08-01) Hla Yee Yee; Shirley, D.GIn order to assess whether hormonal changes occurring during the menstrual cycle affect function, glomerular filtration rate (C cr), and proximal tubular reabsorption of sodium and water (lithium clearance; C li) were assessed in 9 healthy women in 2 phases of the menstrual cycle. Plasmar sodium and osmolality were also measured. Each subject was studied three time ("basal", "proliferative" and "luteal" phases), point on her customary sodium intake, and in a controlled (sitting) posture. There were no significance differences between the phases with respect to any of the renal variables studied. There was a significantly lower plasma sodium in the luteal phase, and a trend towards lower plasma osmolality.Item In vitro and in vivo antimalaial activities of artesunate(1991-04-01) Myint Oo; Myint Lwin; Kyin Hla Aye; Aung Khin; Hual ZikArtesunate, a derivative of Quinghaosu (Artemisinine) was test for antimalarial activities against four isolates of Plasmodium falciparum in vitro and Plasmodium berghei- mouse model in vivo. The minimum inhibitory concentration of Artesunate in vitro was 6.0 p Mol per well whereas in vivo ED 90 was 1.4 mg/kg day.Item Comparative multiple-dose pharmacokinetics of chloroquine in P. vivax malaria patients and healthy volunteers(1996-12-01) Thaw Zin; Ye Thwe; May Aye Than; Khin Tint; Hla Yee; Thida Hmun; Nwe Nwe YinRecent evidence of the emergence of resistance of P. vivax to chloroquine in Myanmar has increased the importance and urgency of understanding the cause of resistance as well as the need for devising the strategies to limit its spread. A comparative multiple-dose pharmacokinetic study was conducted on 5 clinically healthy volunteers and 10 malaria patients with P. vivax, admitted to the No. 2 Miliysty Hospital, Yangon, with the object to study whether there is any pharmacokinetic-dynamic relationship underlying the response of patients to standard chloroquine (1500 mg given over 3 days) therapy. Serum chloroquine concentrations reached well above the MIC level in all subjects with the patients' serum concentration (both peak and trough) and the AUC being significantly (2-3 times) higher than jnormal volunteers (p < 0.02). Both the clearance and the volume of distribution were also significantly lower in the malaria patients as compared to the healthy volunteers (p < 0.05). The elimination half-life (T1/2el) was shorter in malaria patients but the difference was not statistically significant. No significant difference was seen with other pharmacokinetic parameters, between normal volunteers and patients and between patients who do and do not recrudescenced. The study supports the emergence of chloroquine-resistant P. vivax in Myanmar and also excludes the possibility of apparent resistance due to pharmacokinetic causes, especially reduced bioavailability.Item Isolation of haemolytic Escherichia coli from patients with urinary tract infection(1994-04-01) Mar Mar Nyein; Hayashi, H.; Tin AyeOne hundred and eighty-five isolates of Escherichia coli isolated from different sources, such as 131 isolates form 58 diarrhoea cases, 33 isolates from 21 control cases and 21 isolates from 9 urinary tract infection cases with different age groups were studied for haemolytic activity. It was observed that one case from diarrhoea cases showed alpha haemolytic activity; none of the control cases showed any haemolytic activity; and 3 cases of urinary tract infection showed beta haemolytic activity. The haemolytic E. coli isolates were also performed for the plasmid encoded haemolysin determinant and demonstrated to possess the haemolytic phenotype Hly and encodes 107,000 kilodalton. E. coli isolated from the urinary tract infections were also testted for antibiotic sensitivity and found that most of them were resistant to ampicillin, streptomycin and tetracycline.Item The effect of sunlight on contaminated water(1991-08-01) Khin Nwe Oo; Aung Myo HanTo determine the effect of sunlight on contaminated water a study was conducted in Yangoon between February to May 1990. The natural water samples were collected and faecal coliform count (FCC) was determined after 0,1,2,3,4 and 10 hours of exposure to sunlight. Sunlight has bactericidal effect on the faecal coliforms in contaminated water. FCC was zero after 2nd day of exposure by using these 3 commonly used kitchen containers: glass bottles, plastic jars and aluminum pots. Sunlight may be used to decontaminate drinking water if boiling is not possible.Item Total protein and albumin in cerebrospinal fluid of patients with cerebral malaria (Short Report)(1994-08-01) Khin Maung Maung; Tin ShweItem Are we spraying DDT at an appropriate period of time to control malaria in Myanmar?(1993-04-01) Myint HtayDDT spraying activity has been carried out to control malaria in Myanmar for many years. Appropriateness of spray timing is being evaluated by applying moving average method on slide positivity rates in five states and four divisions of the country. It was found that, in order to cover major transmission peaks in many areas, spray timing should be adjusted.Item Clinical features and response to antivenom of Russell's viper bite cases of Nyaunglaybin, Bago Division(1998-04-01) Min Than; Tun Pe; Aye Aye Myint; Nu Nu AungItem Neurotoxicity of artemisinine compounds Short Report(1996-04-01) Tin Shwe; Khin Hlaing; Ko Ko HlaItem A Prospective study of amodiaquine induced agranulocytosis and liver damage in malaria patients(1989-08-01) Thet Naing; Hla Win; Aye Aye Mu; Tin ShweItem Coagulation profile in common malignancies(1997-01-01) Emerald, M; Khin Aye Kyi; Aye Aye Myint; Ne WinThe study of coagulation abnormalities in 55 cases of biopsy proven malignancies (21 cases of carcinoma cervix, 20 cases of carcinoma breast, and 14 cases of carcinoma lung) was undertaken at cancer ward of Yangon General Hospital. Tests included whole blood coagulation time, Quick's prothrombin time, activated partial thromboplastin time, thrombin time, estimation of fibrinogen and FDP level and platelet count. Ninety-six per cent of these patients had one or more coagulation abnormalities. the commonest abnormalities were elevated fibrin degradation products and abnormal prothrombin time. Compared to thrombocytopenia the coagulation abnormalities were more commonly found in this study. the data illustrated that subclinical coagulopathy is relatively frequent in patients with malignancy. These coagulation disorders were not related to liver metastasis nor cancer therapy. there was no significant difference of abnormal coagulation tests results between different malignancies that have been studied. In relation to DIC, these patients were considered to be in a compensated state. Platelet count, thrombin time test, estimation of fibrinogen and FDP level are the most important coagulation tests for eveluating DIC. These tests are suggested to be done in all cancer patients for early detection of subclinical coagulopathy and for prevention of undesirable consequences of bleeding.Item Effect of heprin on Russell's viper venom envenomated experimental rabbits(1989-12-01) Than Than; Soe Soe; Khin Ei HanEffects of heparin were studied on 20 Russell's Viper Venom (RVV) envenomated rabbits. After injection with LD 100 dose of RVV, the experimental animals were divided into four groups. Group 1 rabbits were left untreated; in Group II antivenom treatment was given; in Group III antivenom plus heparin was administered intravenously and in Group IV heparin alone was given. Effectiveness of heparin therapy was assessed by comparing the changes in the blood screening tests of haemostasis such as prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT), survival rate, degree of congestion and haemorrhage in the kidneys, presence or abscence of fibrin deposition and acute tublar necrosis in the kidneys of different groups of animals. Results showed no significant differences in the blood tests and fibrin deposition in the kidneys. However, there is an increase in the survival rate, as well as reduction in the severity of congestion, haemorrhage and acute tubular necrosis of the kidneys in the rabbits treated with specific antivenoms (ASV) plus heparin (Group III) over that treated with antivenom alone (Group II) and heparin alone (Group IV).Item Intestinal Helminthiases in twenty one villages in Taikkyi township(1990-04-01) Than Saw; Thein Hlaing; Myat Lay Kyin<A> field research project was undertaken under the title "The relationship between the control of Ascaris infection and child nutritional status" in 21 villages in Taikkyi township. At the beginning of study in August 1984, a mass stool examination was done on 3 whole villages (n=1052) and on 2-12 year old children (n=1070) in the remaining 18 villages. In addition, deworming was carried out in randomly selected 8 villages, involving different age groups. The results were confined to the baseline study. Ascaris lumbricoides was the principal intestinal helminth and its infection rate was 77.38 per cent in the population as a whole. The prevalences of other infections were 5.63 per cent for Trichuris trichiura, 2.53 per cent for hook worm and 2.07 per cent for strongyloides stercoralis. By age, the prevalence of Ascaris infection was conspicously high in the 5-9, 10-14 and 15-19 years old. The mean worm burden per person in all the ages was 6.6 and the age-specific worm burden was highest in the 5 to 9 year age group, about 10 worms per child. The findings were compared with those of other studies. It is high time to develop a community-based mass chemotherapy programme to control ascariasis in Myanmar based on national experiences in previous control and research projects.Item Comparison of the effect of combinations of parentral artemisinin derivatives (I/M artemether, I/V artesunate) plus oral mefloquine with intravenous quinine plus oral tetracycline on patients with cerebral malaria: A multicentre trial (Preliminary Report)(1996-04-01) Tin Shwe; Myint Lwin; Tan Myint Maung; Ko Ko Hla; Htin Aung Saw; Soe Aung; Than Htay; Kyi Kyi Ngwe; Kyin Htwe; Hla Min; Nilar WinIn order to find out the best drug combination for treatment of cerebral malaria at less equipped hospitals, 105 cases of cerebral malaria belonging to Mawlamyine, Pyin Oo Lwin and North Okkalapa hospitals were studied in a controlled trial of three regimens. (1) Intramuscular artemether total dose 480 mg plus mefloquine 750 mg in a single dose given through nasogastric tube at day 0. (2) Intravenous artesunate total dose 240 mg plus mefloquine 750 mg as in regimen 1. (3) Intravenous quinine dighdrochloride 600 mg in 180 ml infusion of dextrose saline given over 4 hours. The dose is repeated every 8 hours until the patient can swallow the tablets. Then oral quinine sulphate tablets were given 600 mg 8 hourly. Total period of quinine therapy is 7 days. Tetracycline 250 mg capsules were given 6 hourly for 7 days (started via nasogastric tube while the patient is unconscious). There was no significant difference in overall mortality rate, mean parasite clearance time, mean fever clearance time and mean time to regain consiousness between the three groups. Thus quinine-tetracycline (if necessary to supplement with artemether-mefloquine at 48 hours if the patient failed to respond to initial treatment) is suggested, as the drug of first choice for the management of cerebral malaria in Myanmar.Item Clinical features and response to antivenom of Russell's viper bite cases of Danubyu, Ayeyawady Division(1997-01-01) Kyaw Than; Tun Pe; Aye Aye Myint; Nu Nu AungA total of 31 (excluding one cobra bite) Russell's viper bite cases were available for study during 1995-96. The median age of the victim is 24 yr (11-68 yr) and the interval between bite and admission is 4.45 h (2.30-12.oo h). Eighty per cent of the bites occurred in lower limb and 65 per cent were bitten while at work in the field. Length of the snakes varies from 23-110 cm (median 26 cm). Thirteen per cent of the bites are local, 29 per cent no envenoming and 58 per cent systemic of which 67 per cent developed spontaneous systemic bleeding. Nineteen per cent died of renal failure and shock. venom levels of local and systemic are 10-40 ng/ml and 20-199 ng/ml respectively. Clot restoration time in 59 per cent of the cases takes more than 6 h indicating variable efficacy of antivenom in neutralising procoagulant activity of local venom. Albuminuria was detected in 56 per cent. Local blackening (45 per cent) is probably the result of ischaemia and local venom effect.Item Assessment of the erythrocyte protoporphyrin test for screening of iron deficiency anaemia(1994-12-01) Khin Myint Myint Kyaw; Khin Myat Tun; Than Than Lwin; Tin Moe Moe; Phyu Phyu Aung; Khin Saw Aye; Thida Kyaw; Tin Nu SweA total of 84 apparently healthy children between ages of 1-12 years were screened for iron deficiency with the erythrocyte protoporphyrin (EP) test. Serum iron, total iron binding capacity in serum, percent transferrin saturation, haematocrit and haemoglobin values were also determined together with the screening test. Comparing the relationship between EP and percent transferrin saturation, using a percent transferrin saturation value < 10 percent as the criterion of iron deficiency, the optimal cut off limit for the EP test appears to be 80 ug/dl of rbcs. At this level, this screening test showed a sensitivity of 74 percent and specificity of 95 percent and the positive and negative predictive values were 82 percent and 93 percent respectively. thus EP assay which is less expensive and easy to perform can be used as a screening test for the detection of iron deficiency.Item Potency assay of antivenom: Failure of Indian (serum institute) antivenom to neutralise Russell's viper (Daboia russelli siamensis) venom of Myanmar(1996-08-01) Tun Pe; Aye Aye Myint; Kyi May HtweNeutralisation of biological properties of Russell's viper (Daboia russelli siamensis) venom of Tharyarwady by a monospecific antivenom of Myanmar (DN 86608B ex. 4/92) and a polyspecific antivenom of Serum Institute of India (Sii) (batch 109 exp. 4/96) was carried out according to WHO standard tests of neutralising activity. Neutralising potency of Myanmar antivenom was superior to the Indian antivenom and the latter required 16-126 times more antivenom than the former in neutralising haemorrhagic, necrotic, lethality, defibrinogenating and capillary permeability increasing activities of the venom. In immunodiffusion and immunoblotting experiments fewer bands were detected in both. It is concluded that the Indian antivenom (Sii) will be less effective in treating Russell's viper bite cases of Myanmar.Item Plasmodium falciparum; merozoite invasion rate in erythrocytes with b-thalassaemia trait and glucose-6-phosphate dehydrogenase deficient genes(1993-04-01) Myat Phone Kyaw; Myint Oo; Kyin Hla AyeThe malaria parasite invasion-erythrocyte membrane protein variation hypothesis was tested on red cells collected from subjects with G-6-PD deficiency and -thalassaemia trait genes. A series of in vitro competition assays were carried out by using serial dilution technique and the FITC-labelling method (1). The results showed that the invasion rates of P. falciparum merozoites into two G-6-PD hemizygotes deficient cell were Gd- 100 Percent of normal and Gd-Myanmar 95 Percent of normal. But in erythrocytes from two patients with double gene defects viz. G-6-PD mild deficient gene GdB-with -thalassaemia trait gene was 25 Percent and G-6-PD severely deficient gene Gd-Myanmar with -thalassaemia trait gene was 20 Percent susceptible to merozoite invasion. The invasion rate of malaria merozoites in these cells could be inhibited by the partial loss of vital attachement of the red cell membrane required for the process of invasion.Item Highly selective vagotomy in the treatment of chronic duodenal ulcer(1991-12-01) Kyi Soe; Khin Maung Kyi; Thein NyuntA presentation of nineteen cases of D.U. treated by HSV is made. Its advantages and long term sequelae are discussed. The initial safety record of this procedure has continued unblemished and it remains the safest operation in treating duodenal ulcer disease. With proper selection of cases, approximately 10-15 per cent of our D.U. cases are treatable by this method.Item Clinical, ultrasonic and pathologic analysis of ovarian tumours at the Central Women Hospital (A prospective study)(1990-08-01) Ba Thike, Katherine; Nan Oo; Khin Nyunt; Saw Lwin; Khin San TintDuring an 18 month period from 1st January 1988 t0 30th June, 1989- 90 cases diagnosed as ovarian tumours were admitted to Unit 11, Central Women Hospital. Pre-operative data collection on clinical features and ultrasonic findings were made. Following laparotomy, operative findings and histopathologic diagnosis were noted. 87 cases had a laparotomy. Out of 82 cases of ovarian tumours, 21 were malignant (25.6 per cent) and 61 (74.4 per cent) benign. The clinical and ultrasonic diagnotic accuracy of ovarian tumours were 87.35 per cent and 91.18 per cent. There was no statistical difference between the two methods in diagnosing ovarian tumours (p>0.05). The accuracy of differentiating malignant from benign ovarian tumours clinically, by ultrasound or by laparotomy using gross findings and histopathology as the definitive diagnosis was also calculated and there was no significant difference (p>0.05). The sensitivity, specificity, predictive values for positive and negative teste were calculated in differentiating benign from malignant ovarian tumours. It was found that clinical diagnosis had the highest sensitivity rate (73.68 per cent) whereas operative findings had the highest specificity rate (96.72 per cent).