Impact of low T3 syndrome on adverse cardiovascular events in adult patients with acute viral myocarditis / 中华心血管病杂志

Objective@#To determine the impact of low T3 syndrome on adverse cardiovascular events in adult patients with acute viral myocarditis.@*Methods@#The study population consisted of 134 consecutive patients admitted between January 2002 and March 2018 with diagnoses of acute viral myocarditis (onset of symptoms<1 month,patients were divided into low serum free triiodothyronine (FT3, n=20) group and normal FT3 (n=114) group. General information, clinical presentation,electrocardiography at admission,laboratory tests,echocardiography features were analyzed. Low T3 syndrome was defined as a state with decreased FT3 and total triiodothyronine (TT3), normal or decreased free thyroxine (FT4) and total thyroxine (TT4) as well as normal thyroid stimulating hormone (TSH). Composite adverse cardiovascular events included death, persistent ventricular tachycardia (VT) or ventricular fibrillation (VF) and cardiac arrest. Risk factors related with composite adverse cardiovascular events in adult patients with acute viral myocarditis were analyzed by logistic regression analysis.@*Results@#Systolic blood pressure was significantly lower (P<0.01),while heart rate (P=0.004) and the prevalence of VT/VF were significantly higher (P=0.017) in low T3 group than in the normal T3 group. Level of white blood cell,C response protein,fasting glucose (all P<0.01) as well as creatinine (P=0.035) were significantly higher, while level of FT3 and left ventricular ejection fraction (LVEF) were significantly lower (both P<0.01) in low T3 group than in normal T3 group. Multivariate logistic regression analysis revealed that LVEF at admission less than 40% (OR=6.615,95%CI 1.186-36.907, P=0.031) and FT3 level less than 1.79 ng/L (OR=9.131, 95%CI 1.577-52.857, P=0.014) were independent risk factors of increased composite adverse cardiovascular events in patients with acute viral myocarditis.@*Conclusion@#Low FT3 increases the risk of adverse cardiovascular events in adult patients with acute viral myocarditis.

Treatment of tubeless transurethral ureteroscopic 2 μm laser vaporesection for ureter cyst in pediatrics (33 cases) / 中国内镜杂志

Objective To explore the feasibility of tubeless 2 μm laser vaporesection in treating pediatric ureter cysts by ureteroscopy.MethodsClinical data of 33 ureter cysts patients who received tubeless 2 μm laser vaporesections by ureteroscopy were reviewed. The median age of patients was 4 years with a range from 1 to 7 years. The operations were carried out by RevoLix 2 μm laser through ureteroscopy without ureter stents and catheters indwelling.ResultsAll operations were successfully performed. And no serious complications occurred after the operations.ConclusionsTubeless transurethral 2 μm laser treatment by ureteroscopy was a superior micro-invasive surgery method for pediatrics with ureter cysts, with advantages of little blood loss, high safety, convenient operation and infrequent complications.

Free triiodothyronine level indicates the degree of myocardial injury in patients with acute ST-elevation myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies have suggested that hypothyroidism correlated with coronary heart diseases (CHD) mortality in long-term cohort, but whether the thyroid function status is associated with myocardial injury in acute ST-elevation myocardial infarction (STEMI) has not been investigated sufficiently.</p><p><b>METHODS</b>Five hundred and eighty-two hospitalized patients from January 2010 to December 2011, with the diagnosis of STEMI, were enrolled in this study. All patients underwent testing for thyroid function status, cardiac troponin I (cTnI), cardiac enzymes, C-reactive protein (CRP). We investigated the association between thyroid hormone levels and cardiac markers (creatine kinase-MB and cTnI), and thus evaluated the potential role of thyroid function status in predicting the myocardial injury.</p><p><b>RESULTS</b>There were 76 patients (13.06%) who had hypothyroidism including low-T3-syndrome (34 patients, 5.84%), subclinical hypothyroidism (28 patients, 4.81%) and clinical hypothyroidism (14 patients, 2.41%). After adjusting for conventional risk factors (age, gender, smoking, diabetes mellitus, dyslipidemia, hypertension), free triiodothyronine (FT3) was significantly and negatively correlated with log-CKMB (r = -0.244, P < 0.001) and log-cTnI (r = -0.290, P < 0.001), indicating that the lower thyroid hormone level correlates with the severer cardiac injury in STEMI patients. FT3 also had a moderate negative correlation with CRP (r = -0.475, P < 0.001), which might indicate that hypothyroidism may activate the inflammation response. No significant correlation was found between other thyroid parameters (TSH, FT4) and cardiac markers.</p><p><b>CONCLUSIONS</b>As the lower FT3 level correlates with higher level of cardiac markers and lower left ventricular ejection fraction (LVEF), the hypothyroidism may be a predictor for myocardial injury in STEMI. And these results may warrant further study to investigate whether reversing the hypothyroidism could benefit the STEMI patients.</p>

Bacterial pathogens and drug susceptibility pattern: from diarrhoea cases of children

Stool specimens from 200 cases of children with ages of less than five years with history of acute diarrhoea from Yangon Children's Hospital were proceeded for isolation of bacterial pathogens. Enterotoxigenic Escherichia coli ETEC (15.5 per cent), enteropathogenic Escherichia coli EPEC (19 per cent), Shigellae (3.5 per cent), Salmonellae (2.5 per cent), ETEC + EPEC (6.5 per cent), ETEC+Shigellae (1.0 per cent) were isolated. Antibiotic susceptibility pattern of EPEC revealed that they were resistant to ampicillin (96 per cent), tetracycline (90 per cent), streptomycin (82 per cent), chloramphenicol (80 per cent) and septrin (61 per cent); but were sensitive to nalidixic acid (100 per cent), furazolidone (92 per cent), sisomycin (90 per cent), gentamicin (88 per cent), norfloxacin (70 per cent), and cephalothin (66 per cent). For Shigellae they were resistant to ampicillin (100 per cent), cephalothin, chloramphenicol, furazolidone, streptomycin (66.7 per cent) but were 100

sensitive to sisomycin, minocycline, norfloxacin, gentamicin; tobramycin (89 per cent), neomycin (67 per cent) and septrin (56 per cent). For Salmonellae they were resistant to ampicillin (100 per cent), chloramphenicol and tetracycline (80 per cent) but were 100 per cent sensitive to cephalothin, furazolidone, gentamicin, nalidixic acid, norfloxacin, septrin and sisomycin. For ETEC they were resistant to ampicillin (100 per cent), tetracycline (79 per cent), chloramphenicol (53 per cent) and septrin (53 per cent ). They were 100 per cent sensitive to cephalothin, furazolidone, gentamicin, nalidixic acid, neomycin, norfloxacin, septrin and sisomycin.

Potential use of Kyethingha-thee (Momordica charantia L. fruit) in the treatment of maturity onset diabetes mellitus

The hypoglycemic efficacy of Kyethingha-thee dired powder capsule was conducted on five uncomplicated type II non insulin dependent diabetes mellitus patients, who were admitted to the No. 2 Military Hospital, Yangon. Preliminary study revealed that it has hypoglycaemic effect with minimum effective dose of 3 grams for each patient and the time of maximum effect was 4 to 6 hours respectively. Kyethingha-thee was found to be 79.94 percent as effective as tolbutamide and 154.53 percent as effective as TMF 32. So far no adverse side effects were observed in any of these patients.

Antibacterial properties of essential oils from six medicinal plants

The essential oils obtained from six medicinal plants namely Vitex sp. (Kyaung-ban), Zingiber officinale (gyin), Cymbopogon citratus (sabalin), Curcuma longa (nanwin), Piper nigrum (ngayokekoung) and Coleus aromaticus (ziyarywethtu) were tested on 20 strains of bacteria. The bacteria comprised of 9 strains of Escherichia coli, 8 strains of Salmonella, and one strain each of Proteus morganii, Staphylococcus aureus, and Shigella sonnei. It was observed that Cymbopogon citratus and Coleus aromaticus were active on most bacteria tested.

The anti-ulcerogenic activity of Plantago major Linn.

Plantago major Linn. (Ahkyaw-baung-tahtaung; Mann-sote ywet; Htaung-Khaung-pwa; Sai-Kyaw-gyi; Phar-Kyaw-ywet) has long been used in official folk medicine for various purposes. Ethnobotanic field survey in Russia has shown that P. major (Plantaginaceae) can be used in the treatment of acid-peptic gastritis. So the plant was investigated for the anti-peptic ulcer activity by the previously standardized method using cimetidine. The aqueous extract of air-dried leaves of the plant was found to have a significant anti-ulcerogenic activity against aspirin-induced ulceration in in-vivo rat model (p < 0.005). The reduced ulcer severity was seen by the ulcer index of 8.4 + 1.0 in the treated group when compared to the ulcer index of 20.6 + 3.5 in the untreated group, showing a 59 percent healing activity of the ulcers.

Anti-oedema activity of Nyctanthes arbor-tritis L.,Curcuma longa L. and Plantago major L.

Nyctanthes arbor-tritis Linn. (Seik-balu); Curcuma longa Linn. (Nanwin) and Plantago major Linn. (Ahkyaw-baung-tahtaung; Mann-sote-ywet; Htaung-khaung-pwa and Phar-kyaw-ywet) have long been used in folk medicine as anti-oedema agenta. Experimental evaluation of anti-oedema property of these plants was studied on carrageenan-induced acute oedema in in vivo method using rats. Aqueous extracts of N. arbor-tritis; C. longa and P. major showed a significant anti-oedema activity ( p < 0.005) at a dose of 3 g/kg. Anti-oedema activities of these plant extracts were observed to be 56 + 7.6 percent; 46 + 8.4 percent and 51 + 4.9 percent respectively when compared with that of the control group. Thus, this study has shown that the tested medicinal plants possess anti-oedema activity.

The effect of some medicinal plants on uterine smooth muscle

Some selected plants reputed for use in menstrual disorders were scientifically investigated for their efficacy. Pllant aqueous extracts were preliminarily screened for the efficacy on rat's uterine smooth muscle. The effects of aqueous extracts of Eclipta alba (L.) Hassk. (Kyeik-hman), Amaranthus spinosus Linn. (Hinnu-nwe-subauk) and Averrhoa carambola Linn. (Zaung-yah) were tested in vitro using isolated rat's uterus smooth muscle. Kyeik-hman, Hinnu-nwe-subauk and Zaung-yah whole plant aqueous extracts significantly induced contraction on the uterine smooth muscle.

Experimental screening for anti-peptic ulcer activity of some Myanmar traditional medicine formulations

Four Myanmar traditional medicine formulations (TMFs), namely TMF-02, TMF-03A, TMF-03B and TMF-08, locally claimed to be useful in treating dyspepsia, were screened for anti-peptic ulcer activity employing two experimental in vivo test models in rats. Only TMF-02, TMF-03B and TMF-08 markedly reduced ulcer severity to the ulcer indices of 17.4, 15.6 and 14.5 respectively. These effects were comparable to cimetidine (13.8), while that of the negative control was 35.Measuring gastric juice acidity in rats employing pyloric ligation confirmed that these three drugs did reduce gastric acidity, particularly diminishing the free acid one-third and shifting gastric pH from 6 to 7.

Direct relaxant effect of some plant extracts on isolated tissue models

The effects of two different extracts of three medicinal plants namely Piper betle L. (Kun), Coleus aromaticus Benth. (Ziyar-ywet-htu) and Ageratum conyzoides L. (Khway-thay-pan) leaves on the smooth muscles of guinea pig and rat were tested invitro using isolated segments of trachea, intestine and uterus. The extracts inhibited the contractions of guinea pig tracheal muscle induced by carbachol and histamine stimulation. The alcoholic extracts also inhibited the spontaneous movement of huinea pig ileum induced by histamine stimulation. Furthermore, the alcoholic extracts inhibited the contractions of rat uterus induced by 5-HT stimulation. These data suggest that the alcoholic extracts have antihistaminic and anti 5-hydroxytryptamine effects and the active principle may probably resides in the saponin glycoside component.

Blood sugar lowering effect of Momordica charantia L. fruit (kyethingha thee) in rabbit model

In Myanmar, diabetes mellitus can be counted as a single health problem occuring at all ages as reported by various workers. Momordica charantia L. fruit (Kyethingha thee) has been reported to possess antidiabetic activity in experimental animal model by various workers. The plant is widely distributed and also cultivated in Myanmar for its edible fruits. Therefore, it was thought that, if it will be worthwhile to investigate and confirm experimentally, whether the fruit grown in Myanmar possess similar hypoglycemic activity. Blood glucose levels of adrenaline-induced diabetic rabbits were determined after oral administration of expressed fruit juice (10 ml/kg) which was approximately equivalent to 400 mg/kg of the substance singificantly inhibited the hyperglycemic blood glucose level on adrenaline-diabetic rabbits at 2 hr.

A rapid diagnosis of malaria parasites by acridine orange staining method

The study was designed to find out the diagnostic value of Acridine orange staining method in detection of malaria parasite (Plasmodium falciparum) in comparison with the conventional thick and thin blood films. Thirty two P. falciparum and two P. vivax malaria cases were included in thestudy and the thick blood film and acridine orange staining methods were found to be more sensitive in detecting asexual and sexual parasites (gametocytes) than the thin film. It needs 2-4 weeks time to train a technician to beable to detect the parasites in thick and thin film methods, but acridine orange staining method can be transferred within an hour. Another advantage of acridine orange staining method is the shortest examination time, lasting only 45 seconds whereas the thick and thin blood films need 5 to 10 minutes. Hence, it is concluded that the acridine orange staining method is useful for quick diagnosis of malaria although accessary eauipment is required.

Study of inhibitory effects of some traditional medicine formulations on adrenaline-induced hyperglycaemia in animal models

Traditional medicine formulations TMF-27, TMF-28 and TMF-32 have been used traditionally to treat diabetes in Myanmar. Blood Glucose levels of adrenaline-induced diabetic rabbits were determined after oral administration of maximum dose of the traditional medicine formulations TMF-27 TMF-28 and TMF-32 and their watey extracts respectively. From the data obtained, it was concluded that the oral administration of 1.6 g/kg TMFs did not produce inhibition of hypergly-caemic effect in rabbits. Only the water soluble extract of TMF-32 inhibited the hyperglycaemic blood glucose level on adrenaline-diabetic rabbits (p<0.05) ans rats (p<0.05).

The effect of antimalarials on the development of Plasmodium Falciparum trophozoites

The effect of different antimalarials (Artemether, Quinine, Chloriquine, Amodiaquine and Sulphadoxine/ Pyrimethamine) on the in vivo development of a sexual parasites during the treatment of falciparum malaria was studied on 29 patients. Maturation of trophozoites from tiny to large ring forms were noted on blood films taken every 6 hourly. The shortest clearance time of tiny forms and fastest parasite clearence rate was detected in the artemether treated group than other antimalials. The parasite clearance time also does not depend on the disappearance time of tiny ring forms, though it does on small and large forms. The drug resistant cases showed longer durationof clearence time of small and large forms in both the sulphadoxine/pyrimethamine and artemether treated groups. The possible early interpretation of resistant cases and application of the methods for the documentation of the action of the antimalarial was discussed.