A summary of the clinical practice guidelines for the management of patients with Peripheral Arterial Disease in Myanmar / Journal of the ASEAN Federation of Endocrine Societies

@#Peripheral artery disease (PAD) broadly encompasses vascular diseases caused primarily by atherosclerosis and thromboembolic pathophysiologic processes that alter the normal structure and function of the aorta, its visceral arterial branches, and the arteries of the lower extremity. The aims of the Myanmar clinical practice guidelines for the management of patients with PAD are to assist physicians in selecting the best management strategies for an individual patient with peripheral artery disease with main focus on lower extremity artery disease (LEAD) due to atherosclerosis, to help the physician to make decisions in their daily practice, and to aid in appropriate referrals to specialists. Early detection and treatment guidelines for the treatment of PAD are important to reduce the morbidity and mortality of patients with vascular problems in Myanmar.

Household income, health and education in a rural area of Myanmar.

This study was to determine the relationship between a commonly used social stratification indicator, net equivalent income, and self-rated health, long-term disability, visual acuity status, death rate, birth rate, unsafe delivery and school enrollment in a rural area of Myanmar. Data were collected from 3,558 respondents in 805 households of all ages. Data analysis for various items was based on different age groups. The results from two income groups (highest and lowest) are as follows: the percent of those who self-rated their health as very good were 17.8% and 10.4% in the highest and lowest income groups, respectively (adjusted coefficient = 0.30, 95% Cl 0.11-0.50); those with an acute medical condition were found in 16.3% and 20.8% in the highest and lowest income groups, respectively (adjusted OR = 1.35, 95% Cl 1.08-1.68); those with long-term disability were found in 15.3% and 21.2% in the highest and lowest income groups, respectively (adjusted OR = 1.39, 95% Cl 1.05-1.84); and those with poor visual acuity at a distance of 13 feet were found in 8.1% and 13.5% in the highest and lowest income groups, respectively (adjusted OR = 1.64, 95% Cl 1.18-2.30). The birth rate ratio was 1.3, the death rate ratio was 1.2, and school enrollment was found in 92.8% and 83.2% in the highest and lowest income groups, respectively (adjusted OR = 0.34, 95% Cl 0.1-0.8). These results indicate that there is an urgent need to strengthen the health care infrastructure and educational system, targeting the poor in rural areas.

Mekong malaria. II. Update of malaria, multi-drug resistance and economic development in the Mekong region of Southeast Asia.

In an expansion of the first Mekong Malaria monograph published in 1999, this second monograph updates the malaria database in the countries comprising the Mekong region of Southeast Asia. The update adds another 3 years' information to cover cumulative data from the 6 Mekong countries (Cambodia, China/Yunnan, Lao PDR, Myanmar, Thailand, Viet Nam) for the six-year period 1999-2001. The objective is to generate a more comprehensive regional perspective in what is a global epicenter of drug resistant falciparum malaria, in order to improve malaria control on a regional basis in the context of social and economic change. The further application of geographical information systems (GIS) to the analysis has underscored the overall asymmetry of disease patterns in the region, with increased emphasis on population mobility in disease spread. Of great importance is the continuing expansion of resistance of P. falciparum to antimalarial drugs in common use and the increasing employment of differing drug combinations as a result. The variation in drug policy among the 6 countries still represents a major obstacle to the institution of region-wide restrictions on drug misuse. An important step forward has been the establishment of 36 sentinel sites throughout the 6 countries, with the objective of standardizing the drug monitoring process; while not all sentinel sites are fully operational yet, the initial implementation has already given encouraging results in relation to disease monitoring. Some decreases in malaria mortality have been recorded. The disease patterns delineated by GIS are particularly instructive when focused on inter-country distribution, which is where more local collaborative effort can be made to rationalize resource utilization and policy development. Placing disease data in the context of socio-economic trends within and between countries serves to further identify the needs and the potential for placing emphasis on resource rationalization on a regional basis. Despite the difficulties, the 6-year time frame represented in this monograph gives confidence that the now well established collaboration is becoming a major factor in improving malaria control on a regional basis and hopefully redressing to a substantial degree the key problem of spread of drug resistance regionally and eventually globally.

A study on knowledge regarding HIV/AIDS, their sexual practices and seroprevalence of syphilis/HIV among taxi-drivers in Yangon

Aim-To study a knowledge regarding HIV AIDS, sexual practices and sero-prevalences of syphilis/HIV among taxi-drivers. A cross sectional study on 120 respondants of taxi-drivers from Yangon Division Buses Control Committee was carried out by using the systematic random sampling method with self-administered questionnaire. Majority of taxi-drivers have better knowledge on mode of transmission and little knowledge on ways which do not transmit HIV. Most of them did not know proper use of condom. No case of HIV sero-positive were detected at the time of study.

A study on knowledge regarding HIV/AIDS, opinon on prevalence of HIV infection in the locality and sexual practice among trishawmen in Mandalay

Myanmar Medical Association (Mandalay Branch), general Practitioners'Section Myanmar Medical Association/Japan/s Grass Root Grant Assistance cosponsored an Anti HIV/AIDS project in Mandalay for fifteen months, conducted by General Practitioners' Section of Myanmar Medical Association (Mandalay Branch), the projection being 20,000 persons belonging to four high risk groups. Trishawmen of five townships in Mandalay were one of these high risk groups. Out of them 111 were randomly selected for a cross-sectional study. This study covered their educational status, their knowledge, attitude, practice and behaviour regarding HIV/AIDS, condom usage and sexual exposure to commercial sex workers which will be reported in details.

KAP study on HIV/AIDS among fishermen, traders, drug abusers and commercial sex workers in kawthaung township (September 1993)

As a baseline study for implementing an intervention programme for HIV/AIDS/STD prevention in Kawthaung area, a combined team of members of Myanmar Medical Association and World Vision International conducted a KAP study on HIV/AIDS among 213 fishsermen, 263 traders, 24 drug abusers and 31 commercial sex workers in September 1993. The results of this study showed that a substantial proportion of all study groups had some correct but incomplete knowledge on transmission and prevention of HIV/AIDS whereas a high proportion of these groups was still practising risk behaviours concerning sex and drugs. Only 8.5 to 12.5 percent of males inteviewed in this study regularly used condoms during sexual intercourse outside their marriage. For history of getting STD, it was foound that as much as 74.2 percent of CSWs had STD in the pats. CSWs also had the highest proportion of drug abuse 45.2 percent. Among male respondents, 13.2 percent of fishermen, 9.5 percent of traders and 20.8 percent of drug abusers had homosexual experience. The risk of getting HIV.AIDS and STD was high among all these study groups irrespective of their marital status.

A study of patients with ammonia poisoning

This study was undertaken to determine the clinical course of ammonia poisoning admitted to North Okkalapa General Hospital after accidental burst of ammonia tank in ice factory of South Okkalapa Township. Total number of five patients were admitted to NOGH medical ward in Oct; 1993. All patients were suffering from conjunctivitis, keratitis, pharyngitis, laryngitis, bronchitis and pneumonitis. Among these five patients, only two patients had severe pneumonitis. All patients recovered but one patients had corneal opacity and two patients had persistant bronchitis. This figure was compared with other reports. Although it is a rare occupational hazard in Myanmar, we would like to alert all clinicians and persons concerned because our nation is trying to become an industrialized country.