Glycaemic indices if three commonly eaten varieties of Myanmar Banana

In order to provide information for the nutritional management of diabetes mellitus, glycaemic indices (GI) of three varieties of banana commonly eaten in Myanmar were determined using twelve healty women volunteers with normalglucose tolerance. After an 8-10 hour overnight fast, the subjects consumed one kind of selected banana in amount equivalent to 50 g available carbohydrate portion {~ three and a half pieces of Phee-Kyan (189 g); ~four and a half pieces of Rakhine (165 g)~~ three pieces of Thee-hmwe (yellow) (192 g)}. After a week interval, GI was determined for another kind of banana. Venous blood samples were collected and immediately analyzed for plasma glucose by glucose oxidase method.GIs of Myanmar bananas (mean -+ S.E.M) were 51.7 -+ 7.69 percent for Rakhine, 55.29 -+ 5.66 for Phee-Kyan and 63.73 -+ 8.46 for Thee-hmwe (yellow). They were lower than GI of commonly eaten Myanmar rice, Pawsun. Banana also contains vitamins A and C which were not provided by cooked polished rice. Furthermore, banana hasa higher calcium and fibre content. Therefore, all three varieties of Myanamr banana can be recommended as a source of complex carbohydrate with low or moderateGI for diabetic diet

A study on knowledge regarding HIV/AIDS, their sexual practices and seroprevalence of syphilis/HIV among taxi-drivers in Yangon

Aim-To study a knowledge regarding HIV AIDS, sexual practices and sero-prevalences of syphilis/HIV among taxi-drivers. A cross sectional study on 120 respondants of taxi-drivers from Yangon Division Buses Control Committee was carried out by using the systematic random sampling method with self-administered questionnaire. Majority of taxi-drivers have better knowledge on mode of transmission and little knowledge on ways which do not transmit HIV. Most of them did not know proper use of condom. No case of HIV sero-positive were detected at the time of study.

Screening for and utilization of contraceptive methods among clients at family planning clinic of Central Women's Hospital, Yangon

One thousand one hundred and thirty two clients attending the family planning clinic of Central Women's Hospital, Yangon during a 16-months period, begining in May 1995 were screened according to a set of eligibility criteria, counselled on suitable method(s) among the 4 methods, viz. combined oral contraceptive pills (COC). depot-medroxyprogesterone acetate (DMPA), intra-uterine contraceptive device (IUCD) and condoms, and offered the method of informed choice. Among the clients, 904 (79.85 per cent) were fit for COC. Of these, 9.4 per cent chose COCs whereas 58.9 per cent chose DMPA, Of these, 55.33 per cent chose DMPAs, whereas 30.69 per cent chose IUCDs, 9.1 per cent COCs and 4.9 per cent condoms. Of these 44 clients who were unfit for DMPA, 59.1 per cent had been past users. Likewise, 942 (83.2 per cent) were fit for IUCD. Of these, 36.2 per cent chose IUCDs, whereas 50.8 per cent chose DMPAs, 7.6 per cent COCs and 5.3 per cent condoms. Of those 190 who were unfit for IUCK, 1.6 per cent had been past users. Those who were unfit were reassessed to fulfil the wishes of users. In all, DMPA was the most utilized method (54.2 per cent), followed by IUCD (31.3 per cent), COC (9.0 per cent) and condoms (5.5 per cent). The utilization of IUCK was increased 6 times higher than that in 1990 before provision of contraceptive services by public sector. Tthe creation of such services in the country will definitely improve the optimum contraceptive mix required for a family planning programme.

A preliminary study of CD4+ T-lymphocyte count in tuberculosis patients

We evaluated the CD4+ T cell count in tuberculosis patients, whether it may be a supportive indicator reflecting the immune status of the patient. A total of 55 patients and 50 controls were included. Patients were within the age range of 19-65 years with a mean of 42.836 + or - 16.24 SD. These included 43 male and 12 female subjects with pulmonary and extrapulmonary tuberculosis. Age and sex matched subjects were included as controls. CD4+ T-lymphocyte count was determined manually with Coulter Manual CD4 Count Kit. A significant reduction in mean CD4 count against control subjects was observed (p=0.004, d.f. 103). A correlation coefficient of 0.546 was observed between CD4 count and percentage of differential lymphocyte count from the peripheral blood. the results indicate that measurement of CD4 count using above method is worthwhile for tuberculosis patients as an adjunct to clinical parameters for the assessment of the immune status of the patient.

An epidemiological study of ocular trauma in rural community in Myanmar

The epidemiological study of ocular trauma in rural setting of Chauk, Meiktila and Bago area was carried out by the ophthalmologists and a team of TC & PBL named as "Model Village eye Health survey". the prevalence was 248 cases (1.57 case per 1000). The rate of 0.5 case per 1000 in under 14 years increased to 2.4 per 1000 in 45 to 59 age group. The older age groups were exposed to trauma almost 5 times more than the younger group. The prevalence of ocular trauma was about the same in both sexes 1.8 and 1.4 per 1000 in male and female respetively. 213 persons (85.9 per cent) sustained the injuries in agricultural environment and only 35 (14.2 per cent) were injured by other sources. The number of blunt injury was 93 (37.5 per cent) and injuries by agricultural equipments contributed to 87 cases (35.1 per cent). It was followed by 57 foreign body cases (23 per cent) and others about 4.4 per cent. Cornea was the commonest anatomical site sustaining 64 per cent of injury followed by 12.4 per cent in conjunctiva, 10.8 per cent in the eye ball and 2.8 per cent in the lens. this study illuminates the fact that the strategies to prevent blindness through ocular trauma are to render extensive eye health education down to the communities at the village level and to recruit, train and equip primary eye care workers aat least one for each village to deliver primary eye care services and referral throughout the country.

Male participation in birth spacing

A cross-sectional, descriptive, community-based survey using pre-tested pre-formed questionnaire was carried out on 100 randomly selected husbands of 1000 currently married women of age 15-49 years residing in rural area of Taikkyi Township where 24.2 percent of the married women were current users of contraceptives. Major portion (89 percent) had heard of contraception and 85 percent knew one or more method(s) of spacing birth. Only 1 percent knew what safe period meant although 75.3 percent claimed to have knowledge of the method. The majority desired three children per family. As regards attitudinal responses, 80 percent thought contraception should be the wife's responsibility, 72 percent thought it should be theirs, 23 percent thought contraception should begin at the start of married life, 71 percent preferred male method, 51 percent agreed that contraception should not be practiced, 48 percent disliked methods requiring medical examination and 78 percent thought contraception should be used during lactation. As for effect on health, 70 percent considered it good for the child. Contraception was negatively reviewed by some as to be against religion (22 percent), against culture (18 percent) and against nature (17 percent).

Prescribing practices on contraception among general practitioners and basic health services staff in Taikkyi Township

Sixty-eight health service providers including 14 Medical Doctors (7 Full-time General Practitioners (GPs) and 7 Government Medical Officers), 4 Health Assistants (HAs), 11 Public Health Supervisors (PHS I & II), 5 Lady Health Visitors (LHVs) and 34 Midwives (MWS) practising in Taikkyi Township, were interviewed using a self administered structured questionnaire, to assess their level of knowledge and prescribing practices for contraception. All of the service providers with the exception of some PHS have prescribed some form of contraception during their practice. Among the contraceptives stated to be most prescribed by them, oral contraceptives came first with 94 percent, followed by injections with 92 percent, rhythm method in 37 percent, intra-uterine device in 30 percent, female sterilization in 21 percent, and condoms were prescribed only by 16 percent of them. The real and perceived side effects experienced with various methods are also discussed. The findings suggest that health care providers need to be trained or given refresher courses on contraceptive technology and proper counselling and use of the available methods, appropriate choice of methods suitable for the individual, the real and perceived side effects from various methods and their management. Development of appropriate health education and counselling package for use in birth spacing programmes is also indicated.

Morbidity and mortality pattern of hospitalized elderly patients in YGH (1985-1987)

A record analysis of all elderly patients admitted to YGH during 1985 to 1987 was done to determine the morbidity pattern of hospitalized elderly patients, aged 55 years and above. There was an average admission rate of 7000 patients per year constituting approximately 18 percent of all admissions. The mean duration of stay in hospital for each hospitalized person was approximately 19 to 21 days. The most common morbidity condition for admission to hospital according to International Classification of Diseases (ICD) grouping is neoplasms in 18.9 percent of admissions, followed by diseases of the circulatory system in 18.7 percent and injuries or poisonings in 16.9 percent, digestive system diseases 12.8 percent, and other ill defined causes led to be 21.8 percent. The case fatality for hospitalized elderly is 12.8 percent for the three years. Implications of the study in planning for geriatric services are discussed.

Nutritional status and intestinal parasitosis in school-enrolled and non-enrolled school-age children in Yangon

In Myanmar, over 38 percent of children in the age-group 5-9 years were never enrolled in school in 1990. Also, there is a lack of information on the comparative prevalence of malnutrition and intestinal parasitosis among school-enrolled and non-enrolled school-age children in Myanmar. We, therefore, undertook a cross-sectional survey comprising 3325 school children from 13 primary schools and 164 non-enrolled school-age children from neighbouring quarters in Tharkayta and Mingaladon townships of Yangon during December 1993. Height and weight of the children were measured and a total of 944 stool samples, including 148 non-enrolled children, were examined for the presence of intestinal parasites. Expressing the nutritional status as standard deviation scores for weight-for-height, the prevalence of wasting among 5-10 years non-enrolled school-age children was 19.8 percent, while that for school children of similar age was 13.9 percent. In addition, non-enrolled school-age children had higher infection rates than school children regarding Ascaris Lumbricoides (66.9 percent vs 50.1 percent), Trichuris trichiura (38.5 percent vs 23.9 percent), and Giardia lamblia (5.4 percent vs 2.7 percent). The policy implication of this study is that health and nutritional status of non-enrolled school-age children needs to be promoted and this should be partly solved by the provision of regular and periodic mass chemotherapy against major intestinal parasitoses influencing nutritional status.

Management of severe epistaxis in Pyay Civil Hospital

Epistaxis is usually treated by nasal packing and in failed situation by ligation of the feeding artery, there was considerable morbidity and mortality. In 1994, 24 patients had attended ENT clinic Pyay Civil Hospital for epistaxis out of which (8) patients had undergone arterial ligation both external carotid and ethmoidal arteries because of impending shock with severe epistaxis. This short study, more of clinical presentation is aimed to stress the point that in severe form of epistaxis with impending shock, the arterial ligation (both external carotid and ethmoidal arterics) is one of the practical management in the peripheral centers.

Assessment of the erythrocyte protoporphyrin test for screening of iron deficiency anaemia

A 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.

The efficacy of compression immobilization technique in retarding spread of radio-labeled Russell's viper venom in rhesus monkeys and 'mock venom' NaI131 in human volunteers.

The efficacy of the modified compression immobilization technique in retarding spread of radio-labeled Russell's viper venom in 3 rhesus monkeys (Macaca mulata) and "mock venom" NaI131 in 14 human volunteers was studied. 0.1 microgram of Russell's viper venom having 10 microCi radioactivity in 0.2 ml normal saline containing 0.5% bovine serum albumin was injected subcutaneously at the lateral aspect of the right hind limb of a rhesus monkey. A hand-tight bandaging of a rubber pad measuring 55 x 28 x 16 mm over the injection site and splinting effectively retard spread of radio-labeled venom for the entire length of time applied, although complete immobilization was not achieved. In human volunteers, application of a pad measuring 60 x 50 x 17 mm over the subcutaneous injection site of 20 microCi or 12 microCi/0.2 ml NaI131 with a hand-tight bandaging (60 +/- 10 mmHg) and immobilization of limb was found to be effective in retarding the movement of radioactive NaI131. These results suggested that the compression pads tried in this study effectively retard the spread of radio-labeled Russell's viper venom (MW ranging from 20,000-90,000) and radioactive NaI131 (MW 150) from the site of injection. Thus, it is highly likely that the present compression pad will be useful as a first-aid measure in Russell's viper bite victims.

Comparative study of closed (needle) biopsy and open biopsy in bone tumour at Yangon Orthopedic Hospital

Sixty patients with clinically suspected bone tumour admitted to Yangon Orthopedic Hospital from 1992 March to 1993 July were examined by closed (Trephine needle) biopsy. The results of closed (needle) biopsy were compared with open biopsy results. Of the (60) cases, (30) were benigh and (30) were malig-nant including osteosarcoma, chondrosarcoma and metastatic carcinoma of bone. (97 percent) sensitivity, (93 percent) specificigy, (4 percent) false negative, no false positive and (95 percent) accuracy for closed (needle) biopsy of bone tumour were statistically analysed from this study. A good discrimination could be made between benign and malignant lesions and at times it is very useful to diagnose inflammatory conditions. Inspite of the drawbacks of inadequate samples and false negative results, it is found that closed (needle) biopsy is a simple, safe and reliable diagnostic method and is valuable in diagnosis of bone tumour and subsequent management.

Haematological features of falciparum malaria patients with anaemia at Mandalay General Hospital

Fifty falciparum malaria patients who attended consecutively to Mandalay General Hospital for anaemia were studied. Of these, 26 percent had haemoglobin less than 5 gm percent, 78 percent had hypochromic microcytic anaemia, 16 percent was found with hypochromic normocytic anaemia and 6 percent showed normochronic nomocytic anaemia picture. They all were free from G6PD deficiency, hookworm in stool, and their Coombs test (direct and indirect) were negative. Enlargement of liver and spleen was recorded in 84 percent and 64 percent of patients respectively. Mean SD serum bilirubin was 11.9 5.4 umol/1. Patients with increased serum biliurbin was recorded in only 6 Percent of the patients. Mean conjugated biliurbin level was 8.6 5.2 umol/1. There was no predominance of conjugated bilirubin in patients with raised serum biliurbin. There was no correlation between parasite density and total serum bilirubin or haemoglobin level of the blood. Mean reticulocyte count of the patients was 1.1/cmm. reticulocyte count above 2 percent was recorded in only 8 percent of patients. The mean serum iron level sas 83.75 20.7 ug/100 ml (82.7 ug/100 ml for males and 85.5 ug/100 ml for females). The lowest serum iron level was 40 ug/100 ml. Bone marrow showed normoblastic picture in 62 percent, megaloblastic picture in 8 percent, dimorphic (megaloblastic and normoblastic) in 8 oercent and erythroid hyperplasia in 22 percent of the patients. Iron content in bone marrow was normal in 72 Percent and reduced in 28 percent of cases. Bone marrow with no stainable iron was not recorded in this study. Blood transfusion may be the only immediate form of treatment of patients with severe anaemia (PCV less than 29 Percent) in case of emergency.

Population mobility and malaria contraction on either side if Bago Yoma in Bago Division

During August 1983 to February 1984, household surveys were carried out in four rural areas on either side of Bago Yoma in the Bago Division to describe the extent and patterns of population mobility by enquiring about their travelling history with night visits to the forestd foothill areas for the past one year. Those people residing close or very close to foothill travelled most (12 to 28 per cent) during the wet season while those residing some distance away spent their nights most (14 to 17) during the dry season. The closer the village to the foothill, the longer a forest traveller stayed in the forest, the range being 45-170 days per year in the foothill and 12-14 days per year in the plain villages. Of those forest travellers, there were a few percentage (5 to 20 per cent) of constant habitual traveller to the nearby forest. In addition, at least one member of 40 to 70 per cent of the households spent one night visit in the forest. The implications of the various migratory groups between the villages and the Bago Yoma were discussed in the context of malaria contraction, and control.