Renal cell carcinoma metastasizing to the myeloproliferative bone marrow

No abstract available.

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.

Screening for and utilization of contraceptive methods among clients at family planning clinic of Central Women's Hospital, Yangon

One thousand one hundred and thirty two clients attending the family planning clinic of Central Women's Hospital, Yangon during a 16-months period, begining in May 1995 were screened according to a set of eligibility criteria, counselled on suitable method(s) among the 4 methods, viz. combined oral contraceptive pills (COC). depot-medroxyprogesterone acetate (DMPA), intra-uterine contraceptive device (IUCD) and condoms, and offered the method of informed choice. Among the clients, 904 (79.85 per cent) were fit for COC. Of these, 9.4 per cent chose COCs whereas 58.9 per cent chose DMPA, Of these, 55.33 per cent chose DMPAs, whereas 30.69 per cent chose IUCDs, 9.1 per cent COCs and 4.9 per cent condoms. Of these 44 clients who were unfit for DMPA, 59.1 per cent had been past users. Likewise, 942 (83.2 per cent) were fit for IUCD. Of these, 36.2 per cent chose IUCDs, whereas 50.8 per cent chose DMPAs, 7.6 per cent COCs and 5.3 per cent condoms. Of those 190 who were unfit for IUCK, 1.6 per cent had been past users. Those who were unfit were reassessed to fulfil the wishes of users. In all, DMPA was the most utilized method (54.2 per cent), followed by IUCD (31.3 per cent), COC (9.0 per cent) and condoms (5.5 per cent). The utilization of IUCK was increased 6 times higher than that in 1990 before provision of contraceptive services by public sector. Tthe creation of such services in the country will definitely improve the optimum contraceptive mix required for a family planning programme.

Cost analysis of hospitalized malaria patients in Taikkyi Township

A hospital-based study was conducted in Taikkyi Township to elicit the various types of cost incurred and factors influencing these costs. data were obtained from malaria cases of different severity admitted to two hospitals from July to October, 1995. All study subjects were interviewed by using a pretested standardized questionnaire. the total costs of illness per patient for one episode of malaria were estimated as kyats 2582 for uncomplicated malaria case, kyats 4568 for other severe and complicated malaria case and kyats 4758 for malaria with other disease case. In the cost before and during hospitalization, direct cost was more than indirect cost. Cost for income lost and drug cost were the highest. Multivariate analysis revealed that days of illness and days of absence from work before hospitalization, malaria parasite density status, income lost of patient and total attendant's cost before hospitalization, family income, distance between home and hospital and days of actual illness were important determinants for various types of cost incurred for hospitalized malaria patients. This study will focus on the need for large-scale similar studies in the country in future.

Male participation in birth spacing

A cross-sectional, descriptive, community-based survey using pre-tested pre-formed questionnaire was carried out on 100 randomly selected husbands of 1000 currently married women of age 15-49 years residing in rural area of Taikkyi Township where 24.2 percent of the married women were current users of contraceptives. Major portion (89 percent) had heard of contraception and 85 percent knew one or more method(s) of spacing birth. Only 1 percent knew what safe period meant although 75.3 percent claimed to have knowledge of the method. The majority desired three children per family. As regards attitudinal responses, 80 percent thought contraception should be the wife's responsibility, 72 percent thought it should be theirs, 23 percent thought contraception should begin at the start of married life, 71 percent preferred male method, 51 percent agreed that contraception should not be practiced, 48 percent disliked methods requiring medical examination and 78 percent thought contraception should be used during lactation. As for effect on health, 70 percent considered it good for the child. Contraception was negatively reviewed by some as to be against religion (22 percent), against culture (18 percent) and against nature (17 percent).

Morbidity and mortality pattern of hospitalized elderly patients in YGH (1985-1987)

A record analysis of all elderly patients admitted to YGH during 1985 to 1987 was done to determine the morbidity pattern of hospitalized elderly patients, aged 55 years and above. There was an average admission rate of 7000 patients per year constituting approximately 18 percent of all admissions. The mean duration of stay in hospital for each hospitalized person was approximately 19 to 21 days. The most common morbidity condition for admission to hospital according to International Classification of Diseases (ICD) grouping is neoplasms in 18.9 percent of admissions, followed by diseases of the circulatory system in 18.7 percent and injuries or poisonings in 16.9 percent, digestive system diseases 12.8 percent, and other ill defined causes led to be 21.8 percent. The case fatality for hospitalized elderly is 12.8 percent for the three years. Implications of the study in planning for geriatric services are discussed.

Nutritional status and intestinal parasitosis in school-enrolled and non-enrolled school-age children in Yangon

In Myanmar, over 38 percent of children in the age-group 5-9 years were never enrolled in school in 1990. Also, there is a lack of information on the comparative prevalence of malnutrition and intestinal parasitosis among school-enrolled and non-enrolled school-age children in Myanmar. We, therefore, undertook a cross-sectional survey comprising 3325 school children from 13 primary schools and 164 non-enrolled school-age children from neighbouring quarters in Tharkayta and Mingaladon townships of Yangon during December 1993. Height and weight of the children were measured and a total of 944 stool samples, including 148 non-enrolled children, were examined for the presence of intestinal parasites. Expressing the nutritional status as standard deviation scores for weight-for-height, the prevalence of wasting among 5-10 years non-enrolled school-age children was 19.8 percent, while that for school children of similar age was 13.9 percent. In addition, non-enrolled school-age children had higher infection rates than school children regarding Ascaris Lumbricoides (66.9 percent vs 50.1 percent), Trichuris trichiura (38.5 percent vs 23.9 percent), and Giardia lamblia (5.4 percent vs 2.7 percent). The policy implication of this study is that health and nutritional status of non-enrolled school-age children needs to be promoted and this should be partly solved by the provision of regular and periodic mass chemotherapy against major intestinal parasitoses influencing nutritional status.

Study of KAP on HIV infection/AIDS among medical doctors in Yangon

HIV infection/AIDS related knowledge, attitudes and precautionary practices were studied among medical doctors in various health institutions, which included general hospitals, specialist hospitals, township health centers and GP clinics in Yangon, between June and August of 1991. The main objective of the study is to provide necessary information that may promote the appropriate use of health education services for the prevention of HIV infection/AIDS in health workers, particularly those at high risk. A total of 425 questionnaires were delivered and 378 (99.9 percent) returned. The survey results indicated that (99 percent) of the respondents had ever heard of AIDS and only (74 percent) knew the difference between AIDS and HIV infection. Knowledge concerning aetiology, transmission, diagnosis, control and prevention of the disease were revealed to provide the necessary information for effective management. Positive and negative attitudes towards HIV infected person were assessed and practices towards prevention of HIV infection/AIDS in health care settings were discussed in detail.

Factors associated with HIV seroprevalence among intravenous drug users in Yangon

A crosss-sectional seroprevalence survey was undertaken to determine seroprevalence of HIV infection and the factors associated with HIV seropositivity among the newly registered 205 male intravenous drug users (IVDUs) at the Drug Dependency Treatment and Research Unit in Yangon from December 1991 to September 1992. Of the 178 individuals tested for HIV antibodies, 60.1 percent were found to be positive, 95 percent confidence interval (CI) being 51.4 percent and 68.9 Percent. Moreover, the risk of getting HIV infection was higher among: IVDUs aged 30 years or above than those aged below 25 years [Odds ratio (OR) = 2.76, 95 Percent CI: 1.12, 6.81]; IVDUs using drug of over 18 months than those using 6 months or less (OR = 5.07; 95 Percent CI: 2.36, 10.87): IVDUs sharing syringes and needles with two or more persons than those who did not share (OR = 2.45; 95 Percent CI: 1.02, 5.89); IVDUs visiting to professional drug injectors for initiation of habit than those who did not visit (OR = 2.27; 95 Persent CI: 0.96, 5.37); and IVDUs who had hiven history of imprisonment than those who had not (OR = 2.65; 95 Percent CI: 1.04, 6.75). In addition, the above two variables, viz, age and duration of drug use did not confound the effect of needle sharing on HIV infection among the IVDUs. The strengths and weaknesses of the study design and the implications of the study to AIDS control are discussed.

A knowledge-attitudes-practices study on AIDS/HIV infection in intravenous drug users at Yangon Drug Dependency Treatment and Research Unit

A Standardized questionnaire was administered to 198 new and 112 recurrent cases of intravenous drug users enrolled at the Drug Dependency Treatment and Research Unit in Yangon to elicit knowledge about, attitudes towards and practices on AIDS/HIV infection. The respondents were all males, with the mean age of 26 years among new and 28 years among recurrent cases. Over 90 Percent of both groups resided in Yangon City. Recurrent users had higher level of knowledge abot correct mode of transmission of HIV infection than new cases. For instance, over 73 Percent of recurrent and about 50 Percent of new cases knew that HIV infection could not be transmitted via air or drinking water. 93-97 Percent of recurrent patients believed that transmission of HIV infection was possible through blood, sexual contact or IV drug use against 85-92 Percent of new cases. Concerning drug suing and sexual behaviours, recurrent cases took more frequent injections per day, prefered to be alone during drug use, did not take more care in cleansing syringes and needles, but had lesser contact with sex workers than new ones. The findings are compared with those of similar studies in other risk groups. The implications of the study are discussed.

Epidemiology of sports injury in Myanmar athletes

An epidemiological study of sports injury was conducted in early part of 1990. Records of five different federations, namely track and field, foot ball, volley ball, boxing and weight lifting from outpatients department of the Aung San Stadium, were collected for 1985, 1986, and 1987. An interview study was also carried out in 116 Myanmar selected athletes from the above five federations, to determine the possible causal factors of sports injury. Three year average incidence rate of sports injury in five federations was 5.5 per 100 athletes. Common sites of injury, major types of injury, type of treatment, health seeking pattern, causes of sports injury were described, and discussed.

Nutritional status and rate of growth in children of rural Taikkyi

An investigation comprising a cross-sectional component to determine nutritional status and a longitudinal component to determine rate of growth of 2-12 year old children was carried out over a period of 2 years ending in August 1986 in a rural area of Thaikyi Township. The boys had higher values than girls for height for age, and weight for age from 2-11 years, and for mid-arm circumference from 2-10 years, after which the girls had values for the above nutritional indicators. Moreover, the girls had more triceps and subscapular skinfold thickness than boys by age. However, younger ages (2 to 4 years) and higher skinfold thickness than older ones (5 to 12 years) among the boys or girls. The malnutritional rate was about 50 per cent by height for age or weight for age, but was only 4.7 per cent weight for height. The girls had non-significant higher growth rate than boys and rates for both sexes 1 year were respectively. 5.78 cm among the 2-5 year and 6-10 year olds in terms of height, and 2.06 kg and 2.66 kg in weight among the above age groups. The data of the present study could from some basis for future assessment of nutritional status of children in country.

Intestinal Helminthiases in twenty one villages in Taikkyi township

<A> field research project was undertaken under the title "The relationship between the control of Ascaris infection and child nutritional status" in 21 villages in Taikkyi township. At the beginning of study in August 1984, a mass stool examination was done on 3 whole villages (n=1052) and on 2-12 year old children (n=1070) in the remaining 18 villages. In addition, deworming was carried out in randomly selected 8 villages, involving different age groups. The results were confined to the baseline study. Ascaris lumbricoides was the principal intestinal helminth and its infection rate was 77.38 per cent in the population as a whole. The prevalences of other infections were 5.63 per cent for Trichuris trichiura, 2.53 per cent for hook worm and 2.07 per cent for strongyloides stercoralis. By age, the prevalence of Ascaris infection was conspicously high in the 5-9, 10-14 and 15-19 years old. The mean worm burden per person in all the ages was 6.6 and the age-specific worm burden was highest in the 5 to 9 year age group, about 10 worms per child. The findings were compared with those of other studies. It is high time to develop a community-based mass chemotherapy programme to control ascariasis in Myanmar based on national experiences in previous control and research projects.

Emergency laparotomy in Yangon General Hospital

<The> information recorded in the Operating Theatre Register kept at the Accident and Emergency Service (AES) of the Yangon General Hospital in 1985 and 1986 were collected to determine the magnitude, distributions and durations of operation of laparotomy conditions. Annually, about 1394 cases of major surgery were performed at the AES. Of these, laparotomy constituted about 91.3 per cent , and appendicitis topped the list. By sex, male preponderance was observed in all diseases or conditions. By age, 20 to 29 years formed the commonest age group. The day-to-day performance of laparotomy cases was randomly and independently distributed (poisson distribution) while thoses cases performed per week, month or similar days of the week in a year were constant (uniform distribution). Least numbers of cases were admitted between midnight and 8:00 am and operated on between 4:00 am to 12 noon. Within 4 hours of arrival, 50 per cent of cases of common diseases had their operations started. The overall duration of operation per case lasted about 1 hour. It is recommended to study on patients and management in a wider contex of the AES to improve the emgrgency services.