Contributions of GeneXpert® to TB diagnosis in Myanmar.

BACKGROUND: Xpert® MTB/RIF, a rapid, molecular TB diagnostic assay, can detect Mycobacterium tuberculosis and rifampin resistance directly from clinical sputum samples in <2 h with high sensitivity and specificity. The added diagnostic value of Xpert over smear microscopy at a national level in Myanmar has not been previously reported.METHODS: We evaluated 339,358 Xpert and demographic records captured from January 2015 to December 2018 as part of the Myanmar National TB Program Data Utilization and Connectivity Project to examine the additional diagnostic yield of Xpert relative to smear for the detection of M. tuberculosis for TB diagnosis in Myanmar, with a focus on people living with HIV (PLHIV) and sample type.RESULTS: Use of Xpert increased TB case detection by 40% compared to smear microscopy results. Among PLHIV, use of Xpert increased TB case detection by almost 100% compared to smear microscopy results.CONCLUSION: Xpert testing identified more patients with TB than smear microscopy alone, particularly in cohorts with significant proportions of PLHIV. The use of Xpert as a screening tool in countries with a high burden of TB could lead to significantly increased diagnosis of TB at a regional and national level.

Chemical constituents and their biological activities from Taunggyi (Shan state) medicinal plants.

Medicinal plants are essential aspects of readily available primary healthcare remedies. Phytochemical constituents of medicinal plants cover a broad variety of chemical fields to explore medicines. This review highlights selected empirical data on traditional uses, phytochemistry, and pharmacological properties of Taunggyi medicinal plants, Andrographis paniculata, Physalis peruviana, and Cassia fistula. Historically, these plants have been used for many infections and diseases in Taunggyi. More than 361 chemical compounds have been isolated and identified from the selected plants. Some of the chemical constituents have substantial pharmacological properties. It is clear that these herbs have significant potential for useful natural supplements in many contemporary diseases. Thus, the aim of this review compiles an ethnobotanical survey and documentation of medicinal plants in Taunggyi (Myanmar). This review will also inspire Myanmar researcher's to further investigate the potential of these plants in their future work into new compound and new drugs.

Comparison of Visante and slit-lamp anterior segment optical coherence tomography in imaging the anterior chamber angle.

AIMS: To compare the diagnostic performance of two anterior segment optical coherence tomography (AS-OCT) devices in assessing the anterior chamber angle (ACA). METHODS: Visante-OCT and slit-lamp-OCT (SL-OCT) were performed on 101 patients by a single operator. The AS-OCT images were processed by customised 'dewarping' software and assessed by two glaucoma specialists masked to clinical findings. A closed ACA was defined by the presence of contact between the iris and angle anterior to the scleral spur. Measurements of the ACA, anterior chamber depth (ACD), and pupil diameter were analysed. Gonioscopy was performed by another examiner masked to AS-OCT findings. RESULTS: Qualitative analysis could be carried out in 83 (83%) eyes and quantitative analysis in 61 (60%) eyes. A closed angle in at least one quadrant of the eye was observed in 30 eyes with gonioscopy; Visante-OCT imaging identified 29 of 30 (97%) and SL-OCT imaging identified 27 of 30 (90%) of these eyes (P=0.50, McNemar test). Visante-OCT detected more eyes with at least one closed quadrant than SL-OCT (55 vs46 eyes, respectively, P=0.01). Overall, SL-OCT had better agreement with gonioscopy than with Visante-OCT. Both AS-OCTs showed good agreement for ACD measurements; however, SL-OCT tended to provide consistently higher ACA measurements and smaller pupil diameters than did Visante-OCT. CONCLUSIONS: Both AS-OCT devices detected most of the eyes with closed ACA on gonioscopy. However, Visante-OCT detected more closed ACAs than did SL-OCT. The better agreement between SL-OCT and gonioscopy is likely because of the use of visible light during both examinations. The ACA measurements obtained with each device are not interchangeable.