Intracellular, serum and 24-hour urinary Magnesium in patients with Type 2 Diabetes Mellitus.

Low magnesium status has been shown to have a negative impact on glucose homeostasis and insulin sensitivity, as well as on the evolution of diabetic complications. In the present study, 45- to 65- year old type 2 diabetic patients and normal age-matched subjects (n = 40 each) were recruited and their intracellular total magnesium level, serum total magnesium level, and 24-hour urinary total magnesium excretion were assessed. The magnesium levels were measured by spectrophotometric method using calmagite. In type 2 diabetic patients, intracellular magnesium concentration was significantly lower (4.26 ± 0.61 vs. 5.76 ± 0.59 mg/dL, P < 0.001) and 24-hour urinary magnesium concentration significantly higher (125.60 ± 33.32 vs. 72.04 ± 14.55 mg/24 hr, P < 0.001) compared with those of healthy subjects. Serum magnesium levels of diabetic patients and healthy subjects showed no significant difference (1.69 ± 0.30 vs. 1.76 ± 0.31 mg/dL, P > 0.05). There was a significant negative correlation between intracellular and 24-hour urinary magnesium excretion (r = -0.548, n = 80, P < 0.01). There was no correlation between serum and intracellular magnesium (r = -0.021, n = 80, P > 0.05) and, serum and 24 hour urinary magnesium excretion (r = -0.128, n = 80, P > 0.05).

A case of severe acute pancreatitis.

A 30 yr old lady, presenting with dyspnoea, fever, nausea and vomiting was admitted to the hospital by a physician with the provisional diagnosis of urinary tract infection. Later it turned out to be severe necrotizing pancreatitis and took treatment from the surgical team. A laparostomy was done and she had undergone serial operations to combat the complications of severe pancreatitis. The laparostomy, which provided thorough peritoneal toilet, proved its effectiveness for the treatment of severe pancreatitis.

Assessment of treatment adherence among TB patients under public private mix (PPM TB) general practitioners’ clinics in Yangon, Myanmar.

Treatment adherence plays a key role towards the achievement of TB control programmes. Poor or non-adherence to TB treatment among TB patients can pose the risk for drug resistance, relapse and prolonged illness. This study is to assess the treatment adherence among TB patients under Public-Private-Mix (PPM) DOTS program in Yangon, Myanmar and to identify the influencing factors. A total of 175 TB patients who have been receiving anti TB treatment from the general practitioners’ clinics were used in this cross sectional study and individually interviewed to collect data: socio demography, clinical characteristics, adherence to anti TB treatment, knowledge, perception, accessibility, affordability, availability and acceptability of service; and social support. Of 175 respondent TB patients, a majority of 167 (95.4%) were adherent to the treatment whereas 8 (4.6%) were non adherent mainly due to co morbidities and suffering multiple side effects. There were significant associations between perception, accessibility to and availability of services and social support and treatment adherence. Co morbidity and multiple side effects had also significant association with treatment adherence.It can be concluded that this study revealed the good adherence among TB patients and reflected some influencing factors for treatment adherence which would be beneficial to takeremedial measures for program ‘s weaknesses and for further successful implementation of PPM DOTS program and national TB control program as well.

Tuberculosis: a mimicker of malignancy

Tuberculosis infection remains an important cause of mortality. The clinical and radiological manifestations can be non-specific and resemble many other conditions, including malignancies. This could lead to diagnostic delay. We report the case of a 48-year-old woman with tuberculosis presenting with a right upper lobe mass manifesting as metastatic lung cancer. She also had liver cirrhosis secondary to chronic hepatitis B infection. She developed hepatitis two weeks into her tuberculosis treatment. Our case highlights the importance of considering tuberculosis in patients suspected to have underlying malignancy and to be aware of the potential adverse effects of treatment.

A Comparative study of Amodiaquine and Chloquine in the treatment of Falciparum Malaria

75 patients were studied in Tauggyi, Shan State where chloroquine resistant falciparum malaria is prevalent. Response of the patients were followedup to 7 days for assessment, one group to chloroquine & another group to amodiaquine. In sensitive patients there was no difference in terms of fever and parasite clearence but in terms of treatment failures cholroquine was 48.8percent and amodiaquine was 20 percent.

The detection of malaria parasite from three different parts of the body

Blood films from three different sites of the body of 56 patients were studied for malaria parasites. In the higher parasite density group the mean parasite count varies, the highest obtained from finger capillary blood, anticubital venous blood being intermediate and intradermal blood had the lowest count. The probable reason for this variation is discussed. In the lower parasite density group the mean speed in finding one parasite was statistically not significant in the three methods. Steps in performing intrademal blood letting is presented.

Falciparum malaria and pregnancy: relationship and treatment response.

Fifty-two patients with falciparum malaria during pregnancy were studied in Taunggyi, Shan States, Burma, during the period of April 1985 through December 1986. Severely ill cases were all treated with quinine, but uncomplicated cases were randomised to receive either quinine or amodiaquine. Fifty-one age-matched non-pregnant female patients were also randomised to receive either quinine or amodiaquine. All clinical and laboratory parameters were comparable between pregnant and non-pregnant group of patients. Falciparum malaria was most frequent among primigravidae, and occurred most frequently in the second trimester for all parities. There were no differences in parasite density, fever clearance and parasite clearance between groups with different parity or gestational period. Quinine and amodiaquine treatment were equally effective. The outcome of pregnancy with and without anti-malarial prophylaxis is discussed.