Changing malaria status among children in Ngapyawtone village, Letpandan Township.

Peripheral blood samples were collected from 60 children (2 - 9 years) residing in Ngapyawtone village, Yayngan village tract, Gway Dauk Kwin Rural Health Centre, Letpandan Township, Bago Division in March, 2012. Temperature, anaemia, jaundice, spleen and liver enlargement were assessed for clinical parameters associated with malaria. Parasite positivity by malaria microscopy and detection of malaria antigen by rapid diagnostic test were done. The malaria parasite prevalence by blood slide microscopy was 8.3%. The malaria parasite prevalence by RDT was also 8.3%. Rapid Immunochromatographic test was performed for Pf/Pv Antibodies. Malaria Antibody positivity rate was 5 % in the study population. Changing pattern of malaria (parasite prevalence, serological prevalence and spleen rate) among children due to effective malaria control program was found in Ngapyawtone village where similar study was done in 1995.

Intracellular, serum and 24-hour urinary Magnesium in patients with Type 2 Diabetes Mellitus.

Low magnesium status has been shown to have a negative impact on glucose homeostasis and insulin sensitivity, as well as on the evolution of diabetic complications. In the present study, 45- to 65- year old type 2 diabetic patients and normal age-matched subjects (n = 40 each) were recruited and their intracellular total magnesium level, serum total magnesium level, and 24-hour urinary total magnesium excretion were assessed. The magnesium levels were measured by spectrophotometric method using calmagite. In type 2 diabetic patients, intracellular magnesium concentration was significantly lower (4.26 ± 0.61 vs. 5.76 ± 0.59 mg/dL, P < 0.001) and 24-hour urinary magnesium concentration significantly higher (125.60 ± 33.32 vs. 72.04 ± 14.55 mg/24 hr, P < 0.001) compared with those of healthy subjects. Serum magnesium levels of diabetic patients and healthy subjects showed no significant difference (1.69 ± 0.30 vs. 1.76 ± 0.31 mg/dL, P > 0.05). There was a significant negative correlation between intracellular and 24-hour urinary magnesium excretion (r = -0.548, n = 80, P < 0.01). There was no correlation between serum and intracellular magnesium (r = -0.021, n = 80, P > 0.05) and, serum and 24 hour urinary magnesium excretion (r = -0.128, n = 80, P > 0.05).

Study of serum gamma-glutamyl transferase and ferritin levels in normotensive and hypertensive Monks.

The main objective of the study is to determine the serum gamma-glutamyl transferase (GGT) and ferritin levels in normotensive and hypertensive monks and to fi nd out whether blood pressure is correlated with serum GGT and ferritin levels in these groups. Normotensive and hypertensive monks age between 40 and 60 years (n=50 each) had participated in the study. Serum GGT was measured by kinetic colorimetric method and serum ferritin level by enzyme-linked immunosorbent assay. The mean serum GGT level of the hypertensive monks was found to be signifi cantly higher than that of the normotensive monks (60.42 ± 25.93 versus 25.32 ± 5.30 U/L) (p < 0.001). The mean serum ferritin level of the hypertensive monks was also found to be signifi cantly higher than that of the normotensive monks (116.87 ± 46.68 versus 37.03 ± 18.79 ng/ml) (p < 0.001). A significant positive correlation between blood pressure (systolic blood pressure, diastolic blood pressure and mean arterial pressure) and serum GGT level was found in hypertensive monks (r = 0.691, p < 0.001; r = 0.482, p < 0.001; r = 0.610, p < 0.001 respectively). No signifi cant correlation between blood pressure and serum ferritin level was found in both groups. An increase in both serum GGT and ferritin levels in the hypertensive group suggested that oxidative stress is involved in the pathophysiology of essential hypertension, and they might rather act as prooxidants in hypertension.

Comparative study between the invasive and non-invasive test for gastric acid secretion

To compare the invasive and non-invasive tests for gastric acid secretion, 30 appearently healthy Myanmar male volunteers (25-45 years) were studied. After overnight fasting, they ingested 150 mg of Mg++ metal suspended in 3 mlof glucose and 100 ml of 7

ethanol on the first day and alcohol without Mg++ onthe second day. Basal gastric juice (by Ryle's tube), urine and breath H2 were collected. Another 11 samples of gastric juice and breath H2 were collected aftermeal for 180 minutes at 15 minute intervals. Hourly urine collection was also done for three hours. Acid contents of gastric juice aand urine were determined byconventional titraton method. Breath H2 was analyzed by microanalyzer (Quintron,Model 12 microlyzer). Correlation coefficients: between maximal acid output (15-60 minutes) and 2nd hour urine acid output-0.50(p<0.05); peak acid output (15-60minutes),0.44(p<0.05); and maximal acid output and breath hydrogen test (75-90 minutes), 0.40 (p<0.05). Thus non-invasive tests (Oral Magnesium Breath Hydrogen Test and urine acid output determination) may also be used as alternative tests in studying the gastric acid secretion.

Psychiatric sequelae of female sterilization

Prior to sterilization 272 cases were subjected to assessment of their personality. Six months after the operation 190 respondents were interviewed regarding the post-sterilization sequelae at the Central Women's Hospital. Housewives were the commonest occupational group, and the socio-economic problem being the most frequent reason besides the basic medical and psychological reasons for sterilization. Belief in the rumours of post-sterilization complications was found to be insignificant contrary to our suspicion. Over half of the sterilized cases were found to suffer post-sterilization sequelae either in isolation or in multiple of symptoms, the most outstanding symptoms being that of nuchal neuromuscular tension. Unstable personality types were more prone to have post-sterilization sequelae singificantly than the stable types.

Hypertension among patients with glomerulonephritis in NOGH

Hypertension is an important cardiovascular disease and a recognized accompaniment of glomerulonephritis. The aim of this study is to determine the incidence of hypertension among patients with glomerulonephritis and determine the various histological types which are associated with hypertension in North Okkalapa General Hospital. The period of study is from 1 December 1992 to 25 October 1993. All patients with biopsy proven glomerulonephritis were included in the study. There were 80 patients with glomerulonephritis and (53 percent) were found to be hypertensive. (65 percent) of those patients with glomerulonephritis who were hypertensive had mesangiocapillary proliferative glomerulonephritis followed by mesangial proliferative glomerulonephritis (43 percent). Oedema, the hallmark of nephritis, was absent in (11 percent) of the hypertensive patients. There were four patients with hypertension associated with pregnancy. (75 percent) had mesangiocapillary proliferative glomerulonephritis. Mesangiocapillary glomerulonephritis is the histological type most commonly associated with glomerulonephritis. As hypertension was the sole presenting feature in (4 percent) of patients with glomerulonephritis, glomerulonephritis should be considered in all young patients with hypertension.

Clinicopathological study of post russell's viper bite renal failure patients

Six patients returning due to various symptoms between 2 months to 11 months after recovering from acute renal failure following Russell's viper bite were investigated. Urine RE, C & S, Blood urea, electrolyte, creatinine, cholesterol, serum protein, were estimated. Ultrasound abdomen and renogram were performed. Renal biopsy was performed if suggestive of renal involvement. Autopsied tissue from four patients in the acute stage were included. Biopsy was taken from five patients with nocturia of 2-4 times. Three patients with proteinuria, (trace to ++). One patient with hypertension of 170/100 mm Hg discovered 8 months after recovery. The glomerular changes consisted of mild degrees of glomerular necrosis. Fluid collection and adhesion between the glomeruli and the Bowman's capsule were seen in all the cases but more marked in the ones who expired. Ballooning of the capillary loops with thickening of the basement membrane were seen only in three biopsied cases who presented with proteinuria and nocturia. Mild to moderate tubular degeneration was noted in all the cases. Interstitial fibrosis occurred in two of the biopsied cases presenting with nocturia. Thus changes in both the glomeruli and tubules and interstitium persist even after 11 months following Russell's bite and may manifest as nocturia, proteinuria and occasionally hypertension.

Clinical trial of low-dose aspirin in treatment of pre-eclampsia

The effectiveness of low-dose aspirin in treatment of pre-eclampsia was studied by a prospective randomized double-blind control trial. A total fifty primigravidae with pre-eclampsia (blood pressure of 160/110 mmHg or more and proteinuria of one pllus or more) were selected. They were randomly assigned to receive either 75 mg Buspro (or) placebo. Conventional treatment was given to both groups. These patients were admitted to the C.W.H up to the fifth day of puerperium. The following variable were noted blood pressure, proteinurea, blood uric acid, platelet count and bleeding time. Mode of delivery, duration of labour, neonatal outcomes and estimated blood loss due to delivery were noted. Low-dose aspirin was associated with better control of blood pressure, lower uric acid level, improved gestational age and less number of abdominal delivery, instrumental delivery (p < 0.05). Neonatal outcomes were better with improved gestational age and heavier birth weight (p < 0.05). There was no clinical evidence of abnormal bleeding in mothers and babies. changes in severity of proteinuria was not different in both groups. (p > 0.05)

Contraceptive prevalence survey in rural Hlegu

A study on the prevalence of contraceptive use in Myanmar females (Phsae II Rural) was undertaken in 26 villages of Hlegu Township. Two thousand five hundred ever married females of age 15 to 49 years were interviewed using the same questionnaire as in the urban phase. It was found that 84.24

of these women possessed knowledge regarding contraceptives. Oral contraception was the most recognised knowledgeable type, followed by the injectable. Sterilization is the third recognised method, The total ever users were 27.96

and current users are 10

. Oral pills were used by 22.50

, injectable by 9.53

and sterilization by 2.9

of knowledgeable persons. The main reason for not using contraceptives is fearfullness of the side effects (32.96

). Other causes were found to be desirous of more children, lack of knowledge and reluctance to interfere with nature. The most preferred method for future use was female sterilization (23.32

).

Relationship of symphysio-fundal height and abdominal circumference to gestational age

Symphysio-fundal height (SF-height), abdominal, circumference (AC), anterior abdominal wall skinfold thickness were measured serially in (506) women with uncomplicated pregnancies in Mandalay General Hospital. A total of (2513) reading were made. The standard graphs of above measurements in relation of gestational age of fetus were drawn. The correlation coefficient (r) values were calculated. Both SF height and AC were increased as gestational age but the numerical values were not equivalent lto weeks of gestation. The engagement of head and anterior abdominal wall skinfold thickness did not change the relationship significantly. The normgravidogram. resulting from this study may be useful in detection of high risk pregnancies in antenatal clinics, although it cannot reflect the gestational age accurately. Further research work is necessary to detect reliability of this normgravidogram in screening of high risk cases.

Contraceptive prevalence survey and urban Mandalay

A study of K A P (knowledge, attitude and practice) on contraceptive in Myanmar females was undertaken in Mandaly. Two thousand five hundred ever married females between the age of 15 and 49 years were interviewed. It was found that 97.8

of these women possessed knowledge regarding contraceptives. Oral contraception was the most knowledgeable recognised method, followed by the injectable type. Sterilization and vasectomy were the third and fourth recongnised methods. The total ever users were 48.92

and 20.88

were current users. Oral pills were used by 28.08

, injectables by 20.53

and sterilization by 5.27

of knowledgeable persons. The reasons for not using the fertility regulation methods were fear of side effects, desiring to have more children, ignorance regarding contraception, not wanting to interfere with nature, financial problems and religious beliefs.

Severe pre-eclampsia at the Central Women's Hospital

A study on hypertensive diseases in pregnancy was carried out at the Central Women's Hospital between December 1985 and November 1986. The patients were interviewed, examined and followed up according to a prepared proforma. There were 119 cases of severe pre-eclampsia, 58 cases of pre-eclampsia, 61 cases of gestational hypertension and 21 cases of eclampsia. Among the cases of severe pre-eclampsia, the majority40.3 per cent were in the 25 to 34 age group, 38.6 per cent were promigravidae. Most of them were house-wives. The majority were of low educational status. Regarding their income, 75 patients (71.3 per cent) had a family income of less than five hundred kyats. There was a higher rate of intervention, the caesarean section rate being 21 per cent. Regarding the risk of association between fetal complications and maternal socio-biological parameters, multigravidae or those from a lower income group had intra-uterine fetal death more often (p < 0.5). Mothers from a lower educational status were higher risk groups for delivery of low birth babies. (p < 0.5).

Analysis of maternal deaths in Central Women's Hospital

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.

Role of colposcopy in detecting cervical intraepithelid neoplasia

A protocol for diagnosing early stage of carcinoma cervix and cervical intraepithlial neoplasia (CIN) is advented. This includes taking of cervical smear, colposcopy and colposcopy directed biopsy. So for only 60 patients have been under study. Four case of mild dysplasia (CIN-I), six cases of moderate dysplasia (CIN-II), six cases of severe dysplasia, four cases of carcinoma in-situ (ten cases of CIN-III) and two cases of carcinoma stage Ia were picked up with colposcopy directed biopsy which gives a pick up rate of 36.67 per cent. The number of cases are still small but the results are impressive.Hence the study will be continued indefinitely.