ABSTRACT
Background@#Type 2 diabetes mellitus (T2DM) is the most common metabolic disorder and its pathogenesis is characterized by a combination of peripheral insulin resistance and impaired insulin secretory capacity of pancreatic β cell. Genetic predisposition interacts with environmental factors including diet, physical activity, and age leading to the development of diabetes.@*Objective@#To determine the proportion of overweight and obese persons with type 2 diabetes and to compare the fasting blood sugar, fasting serum insulin, insulin resistance and β-cell function in G972R carrier and non-carrier overweight and obese persons with type 2 diabetes.@*Methodology@#One hundred overweight and obese patients with T2DM were recruited from persons with diabetes attending the Diabetes Outpatient Department of Yangon General Hospital. History taking and physical examination were done and blood samples were collected. Plasma glucose level was determined by the glucose oxidase method and fasting serum insulin was measured by enzyme linked immunoassay (ELISA) kit method. Polymerase chain reaction and Restriction Fragment Length Polymorphism were done for genetic polymorphism.@*Results@#Among 100 overweight and obese subjects with T2DM, 81 patients were of homozygous (G/G) genotype, 18 patients were of heterozygous (G/A) and only one patient of homozygous (A/A) genotype. There was no statistically significant difference in the proportion of genotypes between overweight and obese subjects with T2DM.There was no significant difference in fasting blood sugar (FBS), fasting serum insulin, HOMA-IR, β-cell function, lipid parameters between IRS-1 (G972R) carriers and non-carriers. There is significant negative correlation between insulin resistance and TG level (r2=0.0529, p=0.01).@*Conclusion@#It was concluded that IRS-1 G972R polymorphism was not important in insulin resistance, β-cell function and lipid parameters in overweight and obese T2DM. There could be a number of candidate genes in the pathophysiology of diabetes mellitus, genetic sequencing of IRS-1 and other genes in the insulin signaling pathway, and finding out the alteration in their genetic patterns would provide clues for the association of the site-specific polymorphisms of these genes with insulin resistance in T2DM.
Subject(s)
Insulin ResistanceABSTRACT
@#Objective. This study determined the relationship between plasma adiponectin level and corrected QT interval (QTc) in smokers and non-smokers. Methodology.This cross-sectional analytical study was undertaken in 30 smokers and 30 non-smokers. Plasma adiponectin level was determined by enzyme-linked immunosorbent assay (ELISA). The QT interval was measured by routine 12-lead ECG with Lead II rhythm and QTc was calculated. Results. Mean plasma adiponectin level was significantly lower in smokers (27.89±15 μg/ml) than that of non-smokers (52.13±21.57μg/ml) (p<0.001). Mean QTc interval was significantly longer in smokers than that of non-smokers (415.37±29.9 versus 395.63±26.13 ms, p<0.01). Higher risk of low adiponectin level (odds ratio [OR],8.1; 95% confidence interval [CI],1.61-40.77) and QTc interval prolongation (OR,6; 95%CI,1.17-30.73) were observed in smokers. There was weak significant negative correlation between plasma adiponectin level and QTc interval in the study population (n=60, r=-0.407, p=0.001). Moreover, low plasma adiponectin level was significantly associated with prolonged QTc interval in the study population (n=60, Fisher's exact p value<0.05). Risk of QTc interval prolongation was 4.3 times higher in subjects with low plasma adiponectin level (OR,4.27; 95% CI,1.05-17.46). Conclusion. Smokers have greater risk for low plasma adiponectin level and prolonged QTc interval. There is a relationship between plasma adiponectin level and QTc interval.
Subject(s)
Smokers , AdiponectinABSTRACT
Cervical cancer is the second most frequent cancer occurring among the women in Myanmar. Being a preventable cancer, it is crucial to have an organized screening program in place that uses simple, practical and cost effective technology so as to ensure that the screening services have a wide coverage and it is universally accessible. The aim of this study is to fi nd out the effectiveness, safety and acceptability of the method of visual inspection with acetic acid (VIA) and cryotherapy based single-visit approach for use in cervical cancer prevention (CCP) programmes in Myanmar. The study is a descriptive community-based study conducted from July 2013 to October 2014. A well trained central CCP mobile team from Central Women’s Hospital (CWH) of the University of Medicine 1 visited Kungyangon Township fortnightly during the weekends to carry out the study. During the 6 visits undertaken by the team, 1,617 married women between the ages of 30 - 49 years were screened for cervical cancer using VIA method. The screening coverage achieved was 8.97%. The VIA tests were positive in 121 women and the screening positive rate was 7.5%. Cryotherapy was given to 119 eligible women after proper counseling. The treatment rate was 98.35%. Two women needed loop electrosurgical excision procedure (LEEP) surgery. Another two women had invasive cancer on screening. Watery vaginal discharge for 2 to 3 weeks after cryotherapy was the only symptoms reported at the time of one month follow-up. At the time of 1 year follow-up visit, the defaulter rate was 13.45% and 3 women had persistent VIA positive lesions. The overall cure rate was 97.09%. Twenty local basic health staff (BHS) were trained during screening visits of the Central CCP team. A local CCP team was also formed to sustain the screening program at the community level. All women that participated in the study were happy with the single-visit approach and they have been supported by their husbands in their efforts to obtain treatment. In addition, it was found that the women undergoing cryotherapy successfully adhered to home-care instructions prescribed by the CCP team. The study has shown that the screen and treat single-visit approach can be successfully implemented and expanded to other areas so that a universal coverage can be obtained to control cervical cancer in Myanmar.
Subject(s)
Uterine Cervical Neoplasms , Uterine Cervical DysplasiaABSTRACT
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.
Subject(s)
EpistaxisABSTRACT
A cross-sectional study was conducted in 13 hospitals in Yangon Division to explore the current situation with regard to the utilization of hospital pharmacists. In this study, the most commonly performed activities of hospital pharmacists were identified; the relationship between their perceptions of what they have learned and the frequency of performance of some selected activities analysed; and the attitudes of hospital pharmacists and other health team members on the role of pharmacists were being utilized mainly for drug store management. They were not being used apporiately for what they had been trained. Hospital managers and other close associates of hospital pharmacists in hospitals did not know the proper role of hospital pharmacists.
Subject(s)
PharmacistsABSTRACT
Genuine Burmese barks of H. antidysenterica were collected from 3-8 year old trees and their morphology and histology studied and recorded for use as distinguishing characters in checking against adulterations. The types of stone cells, calcium oxlate crystals and the medullary rays were studied. The dimensions of the stone cells and calcium oxalate crystals did not appear to give a reliable index for the differentiation of the ages of the plant of barks as far as 3, 4, 5 and 8 year old barks were concerned.