Chlamydial infection among obstetrics and gynaecological patients of Mandalay General Hospital

Objective: To determine the prevalence rate of genital Chlamydial infection among hospital patients and their distribution by age, socio-demographic profile and complications. Methods: 140 obstetric and gynaecological patients from Mandalay General Hospital were studied in November 1993. Cervical swabs were tested with IDEA tm test for Chlamydial antigen and confirmed by Confirmatory IDEA tm Confirmatory test when positive. Data collection was by interview using a structured questionnarie. Results: The overall prevalence rate of genital Chlamydial infection was 6.42

, 5.71

for antenatal and 7.14

for gynaecological patients. Prevalence rate was highest in 30-39 age group and lower occupational grades, and in parity 5 and above, and associated with OCS ever users, PROM, and abortion, PID, infertility,cervical ectopy, cervicitis and mucopurulent discharge in 7.69

, 11.76

, 7.14

, 18.18

, 11.11

and 11.11

respectively. There were 82 patients with no discharge and 7.31

tested positive. Out of 9 infected cases, 6had no discharge and in 4, the cervix looked healthy. There were no associated gonococal infection and there was no false positive result. Conclusion: This study shows the need for being always alert to the possibility of infection even in the asymptomatic patients.

Quality of antenatal care at outpatient department of Mandalay General Hospital: time utilization and satisfaction among users

The study was a hospital-based cross-sectional survey using recording and interviewing techniques. Average waiting time (in minutes) before seeing registration clerk, nurses, laboratory staff and medical doctors, for all first visit and follow-up visit patients, were 10,5,8 and 31 respectively. Average time in contact (in minutes) with registration clerk, nurses, laboratory staff and medical doctors, for all patients, were 2,2,11 and 3 respectively. Among first visit patients, only 21 per cent were told of their body weights, 21 per cent were told of their blood pressures, 66 per cent were told of their urine examination results, and 64 per cent were told of their baby's clinical conditions. Similar figures for follow-up patients were, 29 per cent 26 per cent, 83 per cent and 80 per cent respectively at different service point. The types of service offered and the training and performance of the service providers can be concluded as from being adequate.

Efficacy of polymerase chain reaction (PCR) Technique in detection of malaria parasite species

Since 1985, Polymerase Chain Reaction (PCR) technique has been developed and applided as a diagnostic tool for edtection of many parasitic infections. Because of its ability to amplify DNA fragments and using specific nucleotide primers, the test is highly sensitive as well as specific. Efficacy of PCR test in detection of malaria species was compared with that of conventional microscopic examination of Giemsa stained blood film in the study. A study done on (111) patients attending the Central Malaria Clinic revealed that,(20) patients were found to be positive by PCR test, while only (12) patients were positive by microscopic examination could detect only Plasmodium falciparum and Plasmodium vivax, while PCR test was able to detect all human malaria parasite species includinPlasmodium ovale in (10) samples. Thus PCR test was founcd to be highly effective for detection of malaria parasites, especially in cases of mixed infections.

Efficacy of polymerase chain reaction (PCR) technique in detection of malaria parasite species

Since 1985, Polymerase Chain Reaction (PCR) technique has been developed and applied as a diagnostic tool for detection of many parasitic infections. Because of its ability to amplify DN fragments and using specific nucleotide primer, the test is highly sensitive as ell a specific. Efficacy of PCR test in detection of malaria pecies wwas compared with that of conventional microscopic examination of Giemsa stained blood film in the study. a study done on (111) patients attending the Central Malaria Clinic reveald that, (20) patients were found to be positive by PCR test, while only (12) patients were positive by microscopic examination could detect only Plasmodium falciparum and Plasmodium vivax, hile PCR test was able to detect all human malaria parasite species including Plasmodium ovale in (10) samples. Thus PCR test was found to be highly effective for detection of malaria parasites, especially in cases of mixed infections.

Clinical, ultrasonic and pathologic analysis of ovarian tumours at the Central Women Hospital (A prospective study)

During an 18 month period from 1st January 1988 t0 30th June, 1989- 90 cases diagnosed as ovarian tumours were admitted to Unit 11, Central Women Hospital. Pre-operative data collection on clinical features and ultrasonic findings were made. Following laparotomy, operative findings and histopathologic diagnosis were noted. 87 cases had a laparotomy. Out of 82 cases of ovarian tumours, 21 were malignant (25.6 per cent) and 61 (74.4 per cent) benign. The clinical and ultrasonic diagnotic accuracy of ovarian tumours were 87.35 per cent and 91.18 per cent. There was no statistical difference between the two methods in diagnosing ovarian tumours (p>0.05). The accuracy of differentiating malignant from benign ovarian tumours clinically, by ultrasound or by laparotomy using gross findings and histopathology as the definitive diagnosis was also calculated and there was no significant difference (p>0.05). The sensitivity, specificity, predictive values for positive and negative teste were calculated in differentiating benign from malignant ovarian tumours. It was found that clinical diagnosis had the highest sensitivity rate (73.68 per cent) whereas operative findings had the highest specificity rate (96.72 per cent).

The bacteriology of diarrhoea in children

75 samples of stools from children under 5 years at the Children's Hospital Rangoon were examined bacterilogically using Mac Conkey agar and desoxycholate citrate agar as primary plating media and selenite F broth and tetrathionate broth as primary enrichment media. 25 non-diarrhoeic stools from children from an urban quarter in the same age group served as a control. Salmonella typhi was the only well-defined bacterial enteropathogen isolated (1.3 percent). The parasites Ascaris Lumbricoides, Trichurus trichiura and Giardia lamblia were found in respectively 13.5, 5 and 5 percent. It is concluded that in the group studied, bacteria did not play a mojor role in the aetiology of diarrhea, but that the parasites found may have been involved. It is recommended that a survey for enteroviruses in diarrhoeic stools from Burmese children be made. It is also suggested that the role played by other possible aetiological agents in diarrhea be investigated.

Intestinal parasitisms in the Inthas

Stool samples of 107 adult Inthas were examined first at the place of collection and then at the Burma Medical Research Institute Laboratory. Entamoeba coli cysts were found in 10.29 per cent, Ascaris eggs in 3.63 per cent, hookworm eggs in 2.71 per cent and Taenia eggs in 2.71 per cent. The incidence of intestinal parasitisms in the Inthas is compared with the incidence in Tarons and Htalus (Tu, 1967) and in the case of hookworm, also with the incidence in a Burmese village group. It is concluded that the intestinal parasitisms of the Inthas should not constitute a health problem because of their low incidence.

Effect of Desmodium Triquetrum extract on some pathogenic bacteria

An aqueous extract of Desmodium triquetrum was tested against Salmonella typhi, s. paratyphi A, s. paratyphi B, Shigella boydii, s. flexneri, S. shigae, Vibrio eltor, V. cholerae (Inaba serotype), V. cholerae (Ogawa serotype) and Escherichia coli by the serial dilution tube technique. The extract was found to have bactericidal action on the ten bacteria tested. The range of minimum inhibitory concentration (MIC) values was also determined compared with values for streptomycin, chloramphenicol and tetracycline. Large-scale growing of D. triquetrum is suggested to facilitate analysis and identification of the anti-bacterial principle.

Nasal carriage of staphylococcus aureus in Burmese with a note on antibiotic sensitivities

134 Burmese children and adults from urban and hospital areas in Rangoon were examined for nasal carriage of Staphylococcus aureus. 77.4 per cent of 62 individuals in an urban group, 78.33 per cent of 60 nurses, doctors and medical students, 73.43 per cent of 64 Lady Health Visitor trainees, and 10 of 12 surgical patients carried S. aureus in the nares. There was no significant difference in the over-all carriage rates of urban, hospital and Lady Health Visitor trainee groups. 14 infants in a maternity hospital were examined for nasal carriage of S. avreus from the day of birth until until the day of discharge from hospital. All 14 infants carried S. aureus in the nares by the 4th day of life. Antibiotic sensivitities to benzyl penicillin, phenethicillin, cloxacillin, methicillin, streptomycin, chloramphenicol, and tetracycline were determined in 106 strains of S. aureus of both urban and hospital origin. 79.5 per cent of 44 urban strains were sensitive to benzyl penicillin, 15.9 per cent moderately resistant and 4.6 per cent resistant. All 44 strains were sensitive to the other antibiotics used. 73.9 per cent of 46 hospital strains were sensitive to benzyl penicillin, 17.4 per cent moderately resistant and 8.7 per cent resistant. 91.3 per cent were sensitive to streptomycin and 8.7 per cent resistant to this antibiotic. All 46 strains were sensitive to the other antibiotics used. There was no significant difference in the benzyl penicillin resistance rates in hospital and urban strains of S. aureus. Neomycin and chlorhexidine ("Naseptin") nasal cream therapy ws attempted in 4 carriers of S. aureus. Therapy appeared effective in 3 of the 4.