Adrenocortical oncocytoma presenting with gynaecomastia / Journal of the ASEAN Federation of Endocrine Societies

@#Adrenal oncocytomas are rare adrenal neoplasms which are usually large and nonfunctioning. Most of them are benign. We report a rare case of adrenal oncocytoma presenting with bilateral gynaecomastia and hypogonadism in 67-year- old male from Myanmar who had elevated estradiol levels. He successfully underwent an adrenalectomy and the histologic diagnosis was an oncocytoma. The immunohistochemical (IHC) staining was positive for neuron specific enolase (NSE), vimentin and synaptophysin. Feminizing adrenal oncocytoma has not been reported in literature.

Myanmar diabetes care model: Bridging the gap between urban and rural healthcare delivery / Journal of the ASEAN Federation of Endocrine Societies

@#There has been significant magnitude of problems of diabetes in Myanmar, according to the estimates of International Diabetes Federation (IDF) and the recent National Survey on the prevalence of diabetes. There has been a wide gap of equity between the urban and rural healthcare delivery for diabetes. Myanmar Diabetes Care Model (MMDCM) aims to deliver equitable diabetes care throughout the country, to stem the tide of rising burden of diabetes and also to facilitate to achieve the targets of the Global Action Plan for the Prevention and Control of NCDs (2013-2020). It is aimed to deliver standard of care for diabetes through the health system strengthening at all level. MMDCM was developed based on the available health system, resources and the country's need. Implementation for the model was also discussed.

Thyroid dysfunction following irradiation to the neck

Thyroid functions (serum T3, T4 and TSH) were studied among 35 patients who had external radiation of the neck involving the thyroid gland within the past 10 years, and 10 control patients who had radiation else where in the body but not in the thyroid region. Findings were presented, compared with previous reports and discussed. Routine TFTs one year after radiotherapy was recommended and replacement therapy for patients with raised serum TSH is encouraged.

"Extramarital pregnancy"

The nature of the problems in fifty nine cases of extramarital pregnancy studied in the Department of Obstetrics & Gynaecologv Mandalay General Hospital, Is described. Without exception all were Burmese. One third occurred In the teen agers; but the largest number was found in the third decade. 91 per cent were unmarried and nulliparous. Predominantly low socio-economic classes were affected. The most frequent mode of pre-esentation was amenorrhoea and abdominal lump, 57.6 per cent were seen in the first half of the pregnancy, with tendency to confuse the issue. Wide difference of attitudes and reaction of women illegitimate pregnancy exist varying between denial, distress and admission. Only 10.1 per cent were managed in hospital, the rest failed to appear once the diagnosis was made.

Management of lost intrauterine devices in Mandalay General Hospital

The problem of the patients seeking management for 'LOST' IUCs is focussed. The nature of widespread application with respect to regional distribution, personnels, and patient's characteristics, and symptomatology are presented. The radiological diagnostic features or the cases are presented particularly with reference to translocation, double loop insertion and uterine perforation. Hysteroscopy is introduced as a diagnostic procedure. The treatment is mainly be dilatation and curettage; but operative hysteroscopy is highlighted for removal with minimal intrauterine manipulation. The problems of the IUC users is discussed followed by the formulation of same guidelines for the prevention and treatment of serious side effects.

Osteitis pubic in pregnancy

All practicing Obstetrician & Gynaecologist would encounter osteitis pubis at one time or other.The clinical features of pain, tenderness, muscle spasm and difficulty on walking are characteristic. Once familiar with the condition, radiographic studies need not be performed and the patient could be managedThe disease is self limiting and spontaneous cure is the rule. Dramatic improvement follows simple plaster strapping, with detailed description of the technique.

Prevalence of pulmonary tuberculosis in patients with leprosy

Miniature chest X-ray examination was carried out on 603 patients with leprosy (age between 20-40 years) attending the out patient clinic of the Rangoon General Hospital. 2.3 percent of patients with tuberculoid leprosy and 2.6 percent of patients with lepromatours leprosy showed doubtful shadow in the lungs by miniature radiography. As such doubtful shadowis seen in 2.6-3.6 percent of the general adult population in Burma, it would appear that our leprosy patients are neither more nor less prone to suffer pulmonary tuberculosis than the general population.

Hysterectomy in Mandalay General Hospital

Hysterectomies were performed during the period 1965-1969 in the Obstetrics and Gynaecological Department of Mandalay General Hospital. The incidence of hysterectomy is found to be 55 per cent of all the major gynaecological operations: the commonest indication of hysterectomy being myoma of the uterus and the commonest age group between 41 and 45 years. The mortality of hysterectomy is found to be 0.84 per cent and the morbidity is 33.6 per cent.

Comparative study of nutritional problems in the islands of the Mergui archipelago

Assessment of the nutritional status of the people in three islands along the Tenasserim Coast namely, Malik, Pale and Zadeikgyi Islands was done in June 1970. Anthropometry, clinical examination, biochemical tests were carried out and food consumption weaning practices were studied. The growth pattern of children and young adults was found to be below the, 10th percentile of the reference standard and compared favourably with that of Thailand. Low body weight for length (about 70 per cent below the reference standard) was found mostly in children aged 1-2 years. Children aged 1-5 years showed various degrees of protein-calorie malnutrition. Infants under 6 months were not affected. The incidence and type of nutritional deficiency signs differ from one island to another. Signs of riboflavin deficiency were more prevalent among Malik villagers. The inhabitants of Pearl Island were found to have the lowest incidence of nutritional deficiencies. Weaning studies showed that 71.6 per cent of babies were breast fed. The mean age of weaning was 1 year 4 months. No significant differences were found between the serum proteins and haemoglobin levels in the inhabitants of the three islands.

The use of radioactive iodine in thyroid diseases especially in the Rangoon General Hospital

The Radio-isotope Department of the Rangoon General Hospital is using as routine tests in the evaluating of the thyroid gland function : the uptake of I-132 in two and four hour intervals, the uptake of I-131 in two, six and twenty-four hour interval, kidney excretion of radioiodine, conversion radio in twenty-four hour interval and the PBL-131 value. The in vitro test of uptake of radioactive triiodothyronine on resin is newly introduced. The advantage of this test is that is that it is possible to avoid the administration of radioiodine to the patient and therefore it can be used even in pediatric practice. The indications and contraindications of radioiodine tests are discussed. The radiation dose to the patient is calculated. Results of radioisotope laboratory are statistically evaluated and presened in five groups: hypothyroid, euthyroid without goiter, euthy-roid with goitre, borderline cases and thyrotoxic cases. There is a remarkable difference in radioiodine uptake between the group of euthyroid persons with and without goitre. This paper explains these differences as the result of iodine deficiency which is probably the principal cause of the endemic goitre in Lower Burma.

Goitrous cretinism due to the inborn enzymatic defect

The five types of inborn defect in biosynthesis of thyroid hormones are described: 1. defect in the trapping of iodide by the thyroid gland, 2. defect in incorporation of iodide into organic form, 3. defective coupling of iodotyrosines, 4. defect of deiodination of MIT and DIT , 5. abnormal serum iodoporteins. These metabolic defects are transmitted by recessive autosomal genes. A case of goitrous cretinism in an eleven year old Burmese girl whose parents are first cousins is described. The high uptake of radioiodine in the thyroid gland and the rapid discharge of radioiodine from the gland after potassium thiocyanate classify the child into the second group, i.e., defective incorporation of iodine by the thyroid due to the lack of enzyme peroxidase. Early diagnosis and immediate effective treatment of inborn hypothyroidism is very important.

Localisation of placenta by direct placentography

25 cases of placenta praevia group and 4 cases of classical caesarean section group have been studied for the localization of placenta by direct placentography or soft-tissue radiography. the cases pronounced positive or negative by placentography were checked at follow-up during delivery either by caesarean section or by vaginal route, then expressed as positive, negative or false positive or false negative. Localisation of placenta in 97 per cent of the cases was accurate. As such the use of radiography in the localization of placenta is recommended.