Fluoxetine Simultaneously Induces Both Apoptosis and Autophagy in Human Gastric Adenocarcinoma Cells

Fluoxetine is used widely as an antidepressant for the treatment of cancer-related depression, but has been reported to also have anti-cancer activity. In this study, we investigated the cytotoxicity of fluoxetine to human gastric adenocarcinoma cells; as shown by the MTT assay, fluoxetine induced cell death. Subsequently, cells were treated with 10 or 20 μM fluoxetine for 24 h and analyzed. Apoptosis was confirmed by the increased number of early apoptotic cells, shown by Annexin V-propidium iodide staining. Nuclear condensation was visualized by DAPI staining. A significant increase in the expression of cleaved PARP was observed by western blotting. The pan-caspase inhibitor Z-VAD-FMK was used to detect the extent of caspase-dependent cell death. The induction of autophagy was determined by the formation of acidic vesicular organelles (AVOs), which was visualized by acridine orange staining, and the increased expression of autophagy markers, such as LC3B, Beclin 1, and p62/SQSTM 1, observed by western blotting. The expression of upstream proteins, such as p-Akt and p-mTOR, were decreased. Autophagic degradation was evaluated by using bafilomycin, an inhibitor of late-stage autophagy. Bafilomycin did not significantly enhance LC3B expression induced by fluoxetine, which suggested autophagic degradation was impaired. In addition, the co-administration of the autophagy inhibitor 3-methyladenine and fluoxetine significantly increased fluoxetine-induced apoptosis, with decreased p-Akt and markedly increased death receptor 4 and 5 expression. Our results suggested that fluoxetine simultaneously induced both protective autophagy and apoptosis and that the inhibition of autophagy enhanced fluoxetine-induced apoptosis through increased death receptor expression.

Seroprevalence And Associated Factors Of Helicobacter Pylori Among Myanmar Children From The Peri-Urban Community Of Yangon

@#Helicobacter pylori infects 50% of children aged 5 years in developing countries. The infection is associated with socio-economic background and family composition. The aim of this study was to determine the seroprevalence and associated factors of Helicobacter pylori infection among Myanmar children in Insein Township, which is a peri-urban community situated in the northern region of Yangon. A cross-sectional study was carried out in Insein Township on 193 children, aged 2 to 13 years, who were tested for H. pylori antibody by enzyme-linked immunosorbent assay (ELISA) test. Parents were interviewed using a questionnaire. Statistical analyses were done using chi-square test and two-sample t-test. The prevalence of H. pylori infections was 67.36%. The mean age of the participants was 7.6 +/- 3.85 years. Those positive for H. pylori antibody were significantly older (8.18+/-3.8) than those with negative results (6.41+/-3.7). There is no gender preponderance. The sero- positive rate was higher among low socio-economic group. The children who tested positive for H. pylori antibody had a mean family member of 5.97+/-2.22 and those who tested negative had 6.06+/-2.17. Thus, there was no association between H. pylori infection and number of family members. There was no association between H. pylori infection and overcrowding, type of drinking water, type of latrine used and type of housing.Our findings suggest that the prevalence of H. pylori infection among Myanmar children is common, as it is in other developing countries, and also highlight its association with socioeconomic status. Over time, the prevalence of H. pylori infections in children is expected to decline worldwide in parallel with the improvement in socioeconomic status of the nations. There is a need to intensify efforts of improving sanitation and living conditions in order to protect children against H. pylori infection.

Ageing assessment of zirconia implant prostheses by three different quantitative assessment techniques

PURPOSE: To evaluate the influence of cyclic loading on phase transformation of zirconia abutments and to compare the effectiveness of three different quantitative ageing assessment techniques. MATERIALS AND METHODS: Thirty two Y-TZP prostheses fabricated from two brands, InCoris ZI and Ceramill ZI, were cemented to titanium bases and equally divided into two subgroups (n=8): control group without any treatment and aged group with cyclic loading between 20 N and 98 N for 100,000 cycles at 4 Hz in distilled water at 37℃. The tetragonal-to-monoclinic phase transformation was assessed by (i) conventional x-ray diffraction (XRD), (ii) micro x-ray diffraction (µXRD), and (iii) micro-Raman spectroscopy. The monoclinic-phase fractions (M%) were compared by two-way ANOVA. RESULTS: InCoris Zi presented significantly higher M% than Ceramill Zi in both control and aged groups (P<.001). Both materials exhibited significant phase transformation with monoclinicphase of 1 to 3% more in aged groups than controls for all thre e assessment techniques. The comparable M% was quantified by both µXRD and XRD. The highest M% was assessed with micro-Raman. CONCLUSION: Cyclic loading produced significant phase transformation in tested Y-TZP prostheses. The micro-Raman spectroscopy could be used as an alternative to XRD and µXRD.

Peripheral neuropathy induced by drinking water contaminated with low-dose arsenic in Myanmar

BACKGROUND@#More than 140 million people drink arsenic-contaminated groundwater. It is unknown how much arsenic exposure is necessary to cause neurological impairment. Here, we evaluate the relationship between neurological impairments and the arsenic concentration in drinking water (ACDW).@*PARTICIPANTS AND METHODS@#A cross-sectional study design was employed. We performed medical examinations of 1867 residents in seven villages in the Thabaung township in Myanmar. Medical examinations consisted of interviews regarding subjective neurological symptoms and objective neurological examinations of sensory disturbances. For subjective neurological symptoms, we ascertained the presence or absence of defects in smell, vision, taste, and hearing; the feeling of weakness; and chronic numbness or pain. For objective sensory disturbances, we examined defects in pain sensation, vibration sensation, and two-point discrimination. We analyzed the relationship between the subjective symptoms, objective sensory disturbances, and ACDW.@*RESULTS@#Residents with ACDW ≥ 10 parts per billion (ppb) had experienced a "feeling of weakness" and "chronic numbness or pain" significantly more often than those with ACDW  50 ppb). These data suggest a threshold for the occurrence of peripheral neuropathy due to arsenic exposure, and indicate that the arsenic concentration in drinking water should be less than 10 ppb to ensure human health.

Divergence insufficiency, thyroid disease

@#Dengue viruses are single-stranded RNA viruses of the Flavivirus genus. It is a common viral infection worldwide, especially in tropical regions. Various neurological manifestations such as encephalitis, encephalopathy, meningitis, acute disseminated encephalomyelitis (ADEM) acute viral myositis, Guillain–Barré syndrome and others are increasingly reported. However, acute haemorrhagic encephalitis is a very rare presentation. Currently, there are only few previous case reports

H. pylori infection among Buddhist monks in the selected regions of Myanmar.

Background: The prevalence of H. pylori infection is different in various regions of Myanmar, and the results of studies are contradictory regarding incidence of H. pylori infection. The infection rate of H. pylori among the monks could reflect the prevalence of the particular region studied. Objectives: The present study was aimed to determine the Helicobacter pylori status among asymptomatic Buddhist monks in Myanmar, and to observe the efficacy of clarithromycin based first line therapy by using C14 Urea Breath Test (PY test). Method: The Buddhist monks 17 years of age and above from the monasteries of both middle and lower Myanmar were selected by purposive sampling method. After filling out the questionnaire,H.pylori infection was detected by 14C-UBT (PY test, microCOUNTLite Liquid Scintillation Counter). H.pylori positive subjects were treated with 10 days' course of clarithromycin containing standard triple therapy as a first line.14C-UBT test was repeated at week 4 to check for H.pylori eradication status. Results: A total of 399 monks (from Bago and Mandalay city) were enrolled in this study. The mean age was 23.51+/ 8.907 years (range: 18 - 97). Urea breath test was positive in 65.4% of the monks. The prevalence of H. pylori infection was radically similar in different monasteries of different cities: Bago and Mandalay (67.52% ν 63.18%, p = 0.33). Among H. pylori infected monks, 67.7% achieved eradication with clarithromycin containing standard triple therapy. Conclusion: High H. pylori infection rates were found in asymptomatic Buddhist Myanmar monks and the standard triple therapy had moderate efficacy.

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.

Determination of phytochemical constituents and antioxidant activity of Rasayana, Triphala and antiageing herbal plants.

Antioxidants possess the ability to protect the body from damage caused by free radical induced oxidative stress and have antiageing property. ‘Theinga Dara Thanhitar’ book, written by Ashin Nagathein described that ‘Rasayana and Triphala’ drugs have the ability to prevent ageing and illness. This study was carried out to investigate the antioxidant activities of commonly used ingredients of ‘Rasayana’ such as Streblus asper Lour. (Okhne), Cassia fistula Linn. (Ngu), Tinospora cordifolia Miers. (Sindone-Ma-Nwe), Asparagus racemosus Willd. (Shin-Matet), Boerhavia diffusa Linn. (Payan-Nawa), and ‘Triphala’ such as Phyllanthus emblica Linn. (Ze-Phyu), Terminalia chebula Retz. (Phan-Ga) and Terminalia belerica Roxb. (Thit-Saint). Their absorbances were evaluated using 1,1-diphenyl -2-picrylhydrazyl (DPPH) assay method by using spectrophotometer. Yield percents of these plants were ranging from 4.05% to 28.6%. The watery extracts of Okhne, Ngu, stem of Sindone-Ma-Nwe, tubor of Payan-Nawa, Ze-Phyu, Phan-Ga, and Thit-Saint contain phenols and tannins which have free radical scavenging activities. It was found that the bark and stem of Okhne, tubor of Payan-Nawa and ‘Triphala’ had the least IC50 value i.e. the best antioxidant potency. Therefore, the findings from this study supported the experience-based findings of antiageing activities in ‘Triphala’ and ‘Rasayana’ to be evidence-based.

Students’ Perception of Problem-based Learning Conducted in Phase1 Medical Program, UCSI University, Malaysia.

Problem-based learning (PBL) has been introduced in the Phase 1 curriculum of Doctor of Medicine programme at Faculty of Medicine & Health Sciences, UCSI University since its inception in 2005. The main objective of this study was to investigate the perception of medical students on problembased learning sessions. A cross sectional study was conducted on a total of 115 medical students from June 2011 to June 2012. Forty nine (42.6%), 31(27%) and 35(30.4%) medical students from first, second and third years respectively participated in the study. The questionnaire included 23 statements to assess the benefits and disadvantages of PBL and the requirements in PBL sessions. Findings revealed that the majority agreed with statements on benefits - PBL motivates students for self-learning (80.9%), enhances discovery of learning issues (78.3%), provides critical thinking skills (71.3%), improves communication skills (80%) and enhances in obtaining new information (85.2%). Sixty percent (n=69) responded that PBL was time consuming and 84 (73.1%) noted that some students dominate while others are passive in the discussion. Overall positive perception on effectiveness of PBL on students’ learning was obtained in 79 (68.7%) of respondents and the highest agreement was observed among the second year students (93.5%).

Calcium Intake among Myanmar Residing in Bago, Kayin, and Yangon Areas

A cross-sectional survey combined with 24-hour dietary recall and food diary was undertaken to assess the calcium intake of the Myanmar population. The study was conducted from November 2003 to October 2005. A total of 886 subjects of both sexes aged above 2 years from three States and Divisions (Bago, Kayin, and Yangon) of Myanmar were included in the study. The major measures were mean daily calcium intake (mg/day) and major sources of calcium in the diet. Overall mean calcium intake was 197+13mg/day (2-9 years), 421+2mg/day (10-19 years), 399+21 mg/day (20-49 years), and 383+25mg/day (>50 years) for males, while the corresponding values for females were 207+17 mg/day, 366+19 mg/day, 387+16 mg/day, and 327 +19 mg/day. Calcium intake was less than 80% of the recommended dietary allowances (RDA) for Myanmar for ages 2-9 years and 10-29 years in all the study areas, and for the 50 years and above age group in Yangon. Fish paste was found to be the major source of calcium. Milk and milk products contributed very little to total calcium intake, contributing 2.1% for residents in Yangon, 5.1% in Pa-an and none in Bago. Consumption of calciumrich foods, particularly milk and milk products, should be encouraged among the Myanmar people. Towards this end, appropriate nutrition education materials should be developed for promotional purposes.

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

Comparative study on the dietary behaviour, and serum/urinary electrolytes levels of hypertensive males in Thonegwa Township

This study was a cross-sectional, hospital hased, comparative study. It was conducted on 31 pairs of the hypertensive and apparently healthy males between 25-59 years. At the time of hospital admission, dietary bahaviour was interviewed by means of the structured questionnaires.The blood pressure was measured at the time of admission and dischange.Serum sodium and potassium levels and urinary excretion of them were also measured.Family history of hypertension was strongly associated with the hypertensives (p<0.05).Hypertensive subjects consumed palm oil two times (old ratio=2.2) more than normotensive subjects. a significant association of hypertension and daily consumption of soda rich snacks was found in the cases (p<0.05). Tthe mean serum sodium level of the cases was significantly higher than that of the controls (p<0.03) but 24 hour urinary sodium excretion of them was not significantly lower. Thus, increased salt consumption with imparired renal handling of sodium homeostasis would be responsible for higher prevalence of hypertension in Thonegwa Township.

Comparative study on the dietary behaviour and serum/urine electrolyte levels of hypertensive males in thonegwa township

This study was a cross-sectional, hospital based, comparative study. It was conducted on 31 pairs of the hypertensive and apparently health males between 25-59 years. At the time of hospital admission, dietary bahaviour was interviewed by menas of the structured questionnaires. The blood pressure was measured at the time of admission and discharge. Serum sodium and potassium levels and urinary excretion of them were also measured. Family history of hypertension was strongly associated with the hypertensives (P<0.05). Hypertensive subjects consumed palm oil two times (odd ratio=2.2) more than normotensive subjects. A significant association of hypertension and daily consumption of soda rich snacks was found in the cases (p<0.05). The mean serum sodium level of the cases was significantly higer than that of the controls (P<0.03) but 24 hour urinary sodium excretion of them was not significantly lower. Thus, increased salt consumption with impaired renal handling of sodium homeostasis would be responsible for higher prevalence of hypertension in Thonegwa Township.

Seasonal pattern of enterotoxigenic Escherichia coli (ETEC) in children under three years of age

Children aged one month to three years from Yangon Children Hospital were studied. A total of 923 cases of diarrhoea and 932 cases of control were included in this study. The total isolation rate of ETEC was 232 cases (25.2 percent) and 55 casea (5.9 percent) from diarrhoea and control cases respectively. In the diarrhoea group, out of 232 cases of ETEC, 43 cases (4.7 percent) were STLT, 134 cases (14.5 percent) were ST and 55 cases (6.0 percent) were LT. In the control group, out of 55 cases of ETEC, 6 cases (0.6 percent) were STLT, 21 cases (2.3 percent) were ST and 28 cases (3.0 percent) were LT. Although ETEC was found in children all the year round, the incidence rate was higher during the months of February to July with the highest peak of 47.0 percent in June. ETEC occurred in the control cases with the maximum isolation rate of 16 percent in June.

Assessing the accuracy of respiratory rates at different counting periods and methods

The respiratory rates of 198 children (aged 2-59 months) suffering from acute respiratory infections (ARI) were monitored by observation, palpation and auscultation (Gold standard). Two 30-second and one 60-second counts were obtained. The difference among respiratory rate counts determined simultaneously by observation, palpation and auscultation in relation to their mean count was analyzed for 60-second counting period, 30 plus 30-second period and 30-second doubled. The variability among the different counting methods and counting periods was not significantly different whether the children were feeding, sleeping, resting and awake or awake but not resting. The data from the study suggest that respiratory rate counting either by observation or palpation are similar in accuracy and one minute's counting either at a stretch or 30-second doubled or two blocks of 30-second intervals are also similarly accurate.

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.

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.