Aspirations and attitudes towards medical professionalism and awareness of medical ethics among Final Part 2 MBBS students in Myanmar Medical Universities.

The cross-sectional descriptive study being conducted in 2012 explored the aspirations and attitudes of the Final Part 2 MBBS students towards medical professionalism and their awareness of medical ethics. A total of 920 students from four Medical Universities in Myanmar responded to the self-administered questionnaire. Less than 65% of their parents were graduates and nearly half (48.5%) of them earned their living by own business. Sixty five percent of students admitted their career ambition during high school period as becoming a medical doctor. They had attended the Medical University due to family influence (22.1%), high scores in Basic Education High School examination (22.8%) and their desire for monetary gains (23.5%). Almost all (90%)accepted medical profession as noble and 65.7% of respondents cited that they were fond of giving care to patients. Regarding their attitudes toward medical professionalism, more than 90% of the respondents agreed towards principles of fair distribution of finite resources, honesty with patients, a necessity to improve quality of care, ability to manage conflict of interest and professional self regulation. Only 5.5% of students disagreed that periodic recertification was desirable. Nearly half (45.8%) of them disagreed on improving an access to care regardless of patient’s ability to pay,and also on increasing scientific knowledge by encouraging their patients to participate in clinical trials (63%). For future aspiration, 40.4% of respondents intended to join the government service, of whom 71.6% expected to become clinicians. Eighty seven percent of the students agreed to teach Medical ethics as a separate subject and they preferred group discussions. So, to review and revise the existing curriculum for medical ethics is necessary to improve the professional skills of students.

Prevalence trend of youth smoking in 29 Townships of Bago, Magwe and Mandalay Divisions, September 1999

In 1999 September a cross-sectional analytic study was conducted in 29 townships of Mandalay. Magwe and Bago divisions of Myanmar. Randomly selected 2074 urban and 1781 rural 15-24 year old youths from 4808 households were interviewed. 5.6 per cent of females and 67.6 per cent of male youths reported as current smokers. At age 14, 37 per cent of the boys smoked. At age 17, more than half of males smoked, and, at age 22 and older, nearly 80 per cent of them were already smoking. Girls started smoking later than boys. Only 1 per cent of 15-year-old girls smoked. When the females reached age 22-24, approximately 10 per cent of them smoked. Comparing different youth cohorts, the younger started smoking earlier than the older youths. Median age of starting tobacco smoking for the 16 year old males was 16; that was approximately 3 years earlier than the median age of smoking for the 24 years old males.

The effect of combination of chloroquine with sulfadoxine pyrimethamine on patients with uncomplicated falciparum malaria

The effect of chloroquine, sulfadoxine- pyrimethamine and chloroquine plus sulfadoxine-pyrimethamine were studied on 97 patients with uncomplicated falciparum malaria. 53. 1 per cent of the patients were resistant to chloroquine at R2 and R3 level. Among patients treated with sulfadoxine- pyrimethamine, 25 per cent were resistant to the same level. But, when chloroquine is combined with sulfadoxine-pyrimethamine only 12.1 per cent of the patients were resistant at R2 level. There were no patients who were resistant at R3 level to the combined drugs. All the patients were free from toxicity that can be related to the two drugs. Apart from simple additive effect, there may also have the potentiating effect of combining two drugs. Hence for a developing country like Myanmar with the problem of multidrug resistance, this method of treatment may be considered for semi-immune patients with uncomplicated falciparum malaria.

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.

The run-out of p-aminohippurate from kidney slices of white rats in the presence of papaverine

Papaverine in vitro in the concentration of 10 minus power 4 M had no effect on the release of PHA from rat kidney slices at 28? C, when the medium was changed every 30 sec during the 10 min of the experiment : the rate constant of the slow component of the run-out in the control experiments was equal to 0.1441 min minus power 1, lthat of the papaverine treated series equaled to 0. 1674 min minus power 1. In using 5 min intervals for transferring instead of 30 sec the rate constant of the papaverine-free series was significantly lower than that of the papaverine-treated one : 0.091 min minus power 1 versus 0.0731 min minus power 1. There exists a direct relationship between the lost amount of PAH during the 30 sec intervals and actual total PAH-concentration of the kidney slices. Papaverine has no effect on the run-out of PAH at 28? C, because at this temperature the PAH-release is due to processes not requiring energy. At the same time papaverine blocks the reaccumulation of the released PAH. Papaverine affects the in vitro movement of PAH in the kidney slices by inhibiting the uptake of PAH.

Body surface area of Burmese subjects

Body surface area of 208 males and 203 females was determined using the linear formula method of DuBois and DuBois. Surface area obtained by actual measurement is found to be greater than that calculated from the height and weight formula of DuBois and DuBois but lower than that of Banerjee, Rohatgi, Mukherjee and Sen for Indian females. A new formula to calculate the body surface area of Burmese subjects has been derived and a nomogram based on this formula has been prepared.

Energy expenditure in agricultural activities in Burma

The energy expenditure of 21 men and 8 women from the villages of Chitteegone in the Mingaladon area and Danyingone in the Insein area was studied during paddy cultivation. Three subjects of typical farmers were chosen for recording daily activities in termittently throughout the year using the diary technique of Garry, Passmore, Warnock and Durnin (1955). The mean daily energy expenditure of these subjects during various agricultural seasons was calculated. The mean metabolic cost keal/min/subject was determined on the above subjects and more than one determination were encountered on some individuals. The validity of the assessed metabolic cost for use in future energy expenditure for paddy cultivation was proved and found to be satisfactory.