Orocaecal transit time measured by breath hydrogen test in pre-school children

The orocaecal transit time (OCTT) was measured in 90 healthy children aged 1 to 5 years with the hydrogen breath test using lactulose (10 g in 10 per cent aqueous solution) as the test meal. The re1ationships between OCTT and gender, age, malnutrition status were assessed. The OCTT for 1.5 year-old children was 90.2 +/- 20.25 min (mean +/- SD). There was no significant difference in mean OCTT between boys and girls (89.03 +/- 15.45 vs. 91.05+/- 23.24). The mean OCTT of children who were still breast-fed (92.86+/-27.1 min) was also not different from those who were completely weaned (89.15+/-17.0 min). There was also no difference in OCTT between malnourished and non-malnourished children, and between age groups (1-2 y, 2-3 y, 3-4 y and 4-5 y).

Evaluation of tuberculin response after BCG vaccination:by gestation and by age at immunization

Tuberculin response following BCG vaccination was evaluated in 3 groups of babies. One hundred and sixteen full term babies (Group I) were vaccinated with BCG at birth; 89 full term babies (Group II) received BCG at the end of third month of life and Group III was made up of 48 preterm babies (32-36 weeks) given BCG vaccination at birth. The sizes of PPD induration area [mm] (6.3+/-3.1 Vs 2.5+/-3.0; P< 0.00001) and BCG scar diameter (3.7+/-1.5 Vs 2.7+/-1.3; P< 0.0001) were significantly larger in full term than preterm babies all of whom were vaccinated at birth, whereas no significant difference was observed between full term babies who were vaccinated at different age. The complications of BCG vaccine were not observed in all study groups. This study suggests that tuberculin responses are equivalent at birth and at third month of age in full term babies. Although immune response is not fully developed in preterm babies (32 to 36 weeks of gestation), they can be safely immunized with BCG at birth.

Different types of shigella species isolated from Infectious Diseases Hospital during 1996 and their antibiotic susceptibility patterns

Cross sectional descriptive hospital-based study using convenience sampling method was carried out among 53 dysentery cases admitted to Infectious Diseases Hospital from March to September 1996. It consisted of 67.9 per cent males and 32.1 per cent females. Their ages ranged from one year three months to 80 years. The duration of illness before attending the hospital was one to seven days. They passed motions 16 to 20 times per day. Volume of stool output was small in 62.3 per cent, moderate in 28.3 per cent, with mucus in 62.3 per cent and with blood and mucus in 35.9 per cent. Shigellae was isolated from 45.3 per cent of the cases: Shigella flexneri 2a (54.2 per cent), Shigella dysenteriae A type I (29.2 per cent), Shigella boydii (12.5 per cent) and Shigella sonnei (4.2 per cent). The antibiotic susceptibility pattern revealed that 87.5 per cent of shigellae were resistant to ampicillin, 83.3 per cent to chloramphenicol, 33.3 per cent to cephalothin, 37.5 per cent to furazolidone, 33.3 per cent to nalidixic acid, 83.3 per cent to streptomycin, 91.7 per cent to tetracycline and 33.3 per cent to norfloxacin respectively. It was also noted that 91.7 per cent of shigellae were sensitive to amikacin, 91.7 per cent to augmentin, 83.3 per cent to gentamicin, 58.3 per cent to minocycline, 91.7 per cent to neti1imicin, 66.7 per cent to neomycin, 75 per cent to sisomycin and 62.5 per cent to norfloxacin.

Histopathological severity of antral gastritis in relationship to Helicobacter pylori colonisation

The association between Helicobacter pylori (HP) colonisation in gastric antrum and the degree of severity and activity of gastritis and the concomitant relationship with gastric atrophy and intestinal metaplastic changes were studied. A total of 204 pieces of endoscopic biopsy tissues were collected from the outpatient endoscopy unit of New Yangon General Hospital in 1994. Routine Haematoxylin and Eosin stain as well as special stains such as modified Giemsa and Carbol fuchsin stains were used for bacterial identification and quantitative analysis. a significant correlation (P value <0.001) was obtained between density of HP colonisation and severity of gastritis as well as its activity (p value <0.001). However, no significant degree of atrophic changes and intestinal metaplastic changes were noted in these biopsies. a continuation for a better understanding of the pathogenesis of HP and its consequences is necessary.

Post-mortem histological and dissecting microscopic appearance of the proximal jejunum of Myanmar children

A comparative morphological study of jejunal villi under the dissecting microscope and their histological changes under the light microscope was performed on 100 childhood necropsies from Yangon Children Hospital. they were from a-day-old meonate to twelve-year-old children. Four patterns of villi morphology were observed under the dissecting microscope: finger-like, tongue-like, leave-like and ridge villi. Histologically, inflammatory cells infiltration in the lamina propria and submucosa with vascular congestion of graded severity were observed. There is no correlation between villi morphology and histological changes. Tongue-like and leave-like villi could be regarded as normal for our children. Although histological examination of the post-mortem jejunal materials yields limited value, it could be of supportive or additive value if studied simultaneously with the dissecting microscopy.

Etiologic agents, clinical and laboratory characteristics of acute versus persistent diarrhoea in children who attended the Yangon Children's Hospital

To identify the etiologic agents, clinical and laboratory characteristics of acute and persistent diarrhoea in children less than 12 years of age, a hospital based prospective study was carried out for 18 months in Yangon Children's Hospital. A total of 487 children, 327 with acute and 160 with persistent diarrhoea participated in the study. Intestinal pathogens including bacterial agent 31 per cent, viral agent 6.3 per cent and protozoa 33 per cent were detected in 71 per cent of persistent diarrhoea cases, whereas in acute diarrhoea cases intestinal pathogens were identified in 64 per cent, among which bacterial, viral and protozoal agents were 28 per cent, 11.5 per cent and 25 per cent respectively. More than one enteric pathogen was detected in 13.7 per cent and 16.5 per cent of persistent and acute diarrhoea cases respectively. male children who suffered from diarrhoea were more than females and peak incidence of acute and persistent diarrhoea occurred in the 2-11 month age group. fever and vomiting were found more frequent in persistent than acute diarrhoea during second week of illness and differences were statistically significant. Shigella species, ETEC and e. histolytica were equally isolated from both acute and persistent diarrhoea whereas rota virus was found more ofter in acute than persistent diarrhoea. The presence of leucocytes and reducing substances in the stool was equally frequent.

Comparative study on detection of urease activity by CLO Test Kit and Microtiter Biopsy Urease Test Kit for evaluation of Helicobacter pylori

A Microtiter Biopsy Urease Test (MBUT) for the detection of Helicobacter pylori was evaluated in the drug trial study conducted in the Endoscopy Department of New Yangon General Hospital. The MBUT was compared with commercially available urease test (CLO Test). Both CLO test and MBUT were performed on antral and fundal gastric tissues biopsied from 35 subjects who underwent upper gastrointestinal endoscopy. 29 (83 percent) cases were positive for Helicobacter pylori when tested by CLO test and MBUT. Thus the sensitivity and specificity of MBUT relative to CLO test was both 100 percent respectively. Tested by MBUT, the urease reaction was positive in 83 percent of cases within 2 hours and 90 percent within 3 hours. Tested by CLO test, it was positive in 60 percent of cases within 2 hours and 67 percent within 3 hours. the accuracy of MBUT was thus similar to that of CLO test for the detection of Helicobacter pylori. Moreover, MBUT is not expensive, can be prepared locally, packed in test kit form and can be supplied to gastroenteroscopy units for diagnostic and treatment purposes.

Prevalence of upper gastrointestinal disease in relation to age: Endoscopic and clinical implications

Reports of 2005 endoscopies were reviewed to determine the age-related prevalence of upper gastrointestinal (UGI) disease as a guide to medical officers in primary and secondary centres for necessary referral to us for endoscopic examination. Results indicated that (1) there were positive findings in 1836 (92 percent) of all endoscopic examinations, and most symptomatic patients can be expected to have at least one UGI abnormality, (2) many patients with UGI symptoms have two or more reportable disease processes, (3) the prevalence of serious or life-threatening diseases such as cancer or large ulcers rises steasily with age, and (4) after age 50 approximately 51 percent of symptomatic patients have a serious UGI disease. Based on these findings, one should expect to diagnose at least one abnormality in most symptomatic patients, and should manage younger patients in their centres as an alternative. However, one should not hesitate to refer patients above 50 to an appropriate centre. Because of high prevalence of serious lesions in the elderly, endoscopy should also be condidered for the initial examination of an elderly patient if poor physical status renders the radiological examination difficult or unreliable.