A study of the impact of Haemophilia on educati on, employment and joint health among pati ents treated at the Yangon General Hospital

A hospital-based cross-secti onal analyti cal study was carried out on 53 patients&nbsp;with haemophilia A at the Department of Clinical Haematology, Yangon General Hospital&nbsp;during the period of October 2014 to September 2016. Haemophilia Joint Health Score (HJHS) and Functi onal Independence Score in Haemophilia (FISH) were used to assess&nbsp;the pati ents&rsquo; physical well-being. All pati ents were males with a mean age of 23.18 &plusmn;&nbsp;10.2 years (r = 12-55). Twenty-four pati ents (45.3%) disconti nued their educati on and among them 66.7% disconti nued due to pain with recurrent bleeding in the joints and&nbsp;33.3% disconti nued due to other reasons. Seventeen pati ents (32.08%) in this study were&nbsp;students, while another 17 pati ents (32.08%) were workers/employed and 19 pati ents&nbsp;(35.85%) disconti nued working. Out of 19 pati ents who disconti nued working, 84.21%&nbsp;disconti nued due to severity of the disease and 15.79% disconti nued due to personal&nbsp;and religious reasons.</p

Pre-operative pseudothrombocytopenia: terrifying but innocuous

An isolated thrombocytopenia was found in a 47-year old man during pre-operative&nbsp;work-up for his closed radial bone fracture on left forearm after a fall. His platelet count&nbsp;was as low as 14 x 103/&mu;L, but there was no active bleeding and past history of bleeding&nbsp;disorder. The clue to true diagnosis started from careful blood film examination - platelet&nbsp;clumps in blood film. Repeat full blood count tests were requested not only with the usual&nbsp;anticoagulant EDTA (Ethylene diamine tetra-acetic acid) but also with heparin as well as with&nbsp;citrate. EDTA-dependent pseudothrombocytopenia was diagnosed which can be confused&nbsp;with other life-threatening platelet disorders. The operation was successfully done without&nbsp;unusual bleeding.</p

Transfusion-Associated Graft-Versus-Host Disease in Two Patients at Yangon General Hospital

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication&nbsp;of blood transfusion. Two male patients admitted to the Department of Clinical Haematology,&nbsp;Yangon General Hospital (YGH) diagnosed to have TA-GVHD in 2011 and in 2016 are presented. Both of the patients received blood donation from close relatives where&nbsp;neither leukoreduction nor irradiation was done. Both patients had fever, skin rashes,gastrointestinal symptoms, raised liver enzymes and pancytopenia. Skin biopsies of both patients showed characteristic histological changes. Unlike graft-versus-host disease that&nbsp;occurred after haemopoeitic stem cell transplantation, TA-GVHD involves the recipient&rsquo;s&nbsp;bone marrow leading to bone marrow aplasia</p

Urban-rural differences in the prevalence of non-communicable diseases risk factors among 25–74 years old citizens in Yangon Region, Myanmar: a cross sectional study

Abstract Background Recent societal and political reforms in Myanmar may upturn the socio-economy and, thus, contribute to the country’s health transition. Baseline data on urban-rural disparities in non-communicable disease (NCD) risk factors are not thoroughly described in this country which has been relatively closed for more than five decades. We aim to investigate urban-rural differences in mean values and the prevalence of selected behavioral and metabolic risk factors for non-communicable diseases and 10-years risk in development of coronary heart diseases (CHD). Methods Two cross-sectional studies were conducted in urban and rural areas of Yangon Region in 2013 and 2014 respectively, using the WHO STEPwise approach to surveillance of risk factors of NCDs. Through a multi-stage cluster sampling method, 1486 participants were recruited. Results Age-standardized prevalence of the behavioral risk factors tended to be higher in the rural than urban areas for all included factors and significantly higher for alcohol drinking (19.9% vs. 13.9%; p = 0.040) and low fruit & vegetable consumption (96.7% vs. 85.1%; p = 0.001). For the metabolic risk factors, the tendency was opposite, with higher age-standardized prevalence estimates in urban than rural areas, significantly for overweight and obesity combined (40.9% vs. 31.2%; p = 0.023), obesity (12.3% vs.7.7%; p = 0.019) and diabetes (17.2% vs. 9.2%; p = 0.024). In sub-group analysis by gender, the prevalence of hypercholesterolemia and hypertriglyceridemia were significantly higher in urban than rural areas among males, 61.8% vs. 40.4%; p = 0.002 and 31.4% vs. 20.7%; p = 0.009, respectively. Mean values of age-standardized metabolic parameters showed higher values in urban than rural areas for both male and female. Based on WHO age-standardized Framingham risk scores, 33.0% (95% CI = 31.7–34.4) of urban dwellers and 27.0% (95% CI = 23.5–30.8) of rural dwellers had a moderate to high risk of developing CHD in the next 10 years. Conclusion The metabolic risk factors, as well as a moderate or high ten-year risk of CHD were more common among urban residents whereas behavioral risk factors levels were higher in among the rural people of Yangon Region. The high prevalences of NCD risk factors in both urban and rural areas call for preventive measures to reduce the future risk of NCDs in Myanmar

Changes in prevalence, awareness, treatment and control of hypertension from 2004 to 2014 among 25-74-year-old citizens in the Yangon Region, Myanmar

Background Hypertension is the leading risk factor for cardiovascular diseases, and little is known about trends in prevalence, awareness, treatment and the control of hypertension in Myanmar. This study aims at evaluating changes from 2004 to 2014 in the prevalence, awareness, treatment and control of hypertension in the Yangon Region, Myanmar, and to compare associations between hypertension and selected socio-demographic, behavioural- and metabolic risk factors in 2004 and 2014. Methods In 2004 and 2014, household-based cross-sectional studies were conducted in urban and rural areas of Yangon Region using the WHO STEPS protocol. Through a multi-stage cluster sampling method, a total of 4448 and 1486 participated in 2004 and 2014, respectively, with the response rates above 89%. Results From 2004 to 2014, there was a significant increase in the age-standardized prevalence of hypertension from 26.7% (95% CI:24.4-29.1) – 34.6% (32.2-37.1), as well as an awareness from 19.4% (17.2-21.9) to 27.8% (24.9-31.0), while treatment and control rates did not change. The age-standardized mean systolic blood pressure increased from 122.8 (SE) ± 0.82 mmHg in 2004 to 128.1 ± 0.53 mmHg in 2014, whereas diastolic blood pressure increased from 76.2 ± 0.35 mmHg to 80.9 ± 0.53 mmHg. In multivariate analyses, hypertension was significantly associated with age, alcohol consumption, overweight and diabetes in both 2004 and 2014, and additionally associated with low physical activity and hypercholesterolemia in 2004. Combining all data, a significant association between study-year and hypertension persisted in different models with an adjustment for socio-demographic variables and behavioural variables, but not when adjusting for a combination of socio-demographic variables, the metabolic variables, BMI and hypercholesterolemia. Conclusion The prevalence of hypertension has risen from 2004 to 2014 in both urban and rural areas of the Yangon Region, while, the awareness, treatment and control rate of hypertension remains low in urban and rural areas among both males and females. It is likely that changes in the metabolic variables, BMI and hypercholesterolemia have contributed to an increase in the prevalence of hypertension from 2004 to 2014. Factors associated with hypertension in both study years were age, alcohol consumption, overweight and diabetes. A national hypertension control programme should be implemented in order to reduce premature deaths in Myanmar

Additional file 1:Table S1. of Changes in prevalence, awareness, treatment and control of hypertension from 2004 to 2014 among 25-74-year-old citizens in the Yangon Region, Myanmar

Associations between study-year and hypertension, adjusted for sociodemographic factors and different combinations of metabolic risk factors, among 25-74-year-old citizens in Yangon Region, Myanmar, 2004 and 2014 combined. (XLSX 12 kb

Consumption of fruits and vegetables and associations with risk factors for non-communicable diseases in the Yangon region of Myanmar: A cross-sectional study

OBJECTIVES: To explore the intake of fruits and vegetables in the Yangon region, Myanmar, and to describe associations between intake of fruits and vegetables (FV) and established risk factors for non-communicable diseases. DESIGN: 2 cross-sectional studies, using the STEPs methodology. SETTING: Urban and rural areas of the Yangon region of Myanmar. PARTICIPANTS: 1486, men and women, 25-74 years, were recruited through a multistage cluster sampling method. Institutionalised people, military personnel, Buddhist monks and nuns were not invited. Physically and mentally ill people were excluded. RESULTS: Mean intake of fruit was 0.8 (SE 0.1) and 0.6 (0.0) servings/day and of vegetables 2.2 (0.1) and 1.2 (0.1) servings/day, in urban and rural areas, respectively. Adjusted for included confounders (age, sex, location, income, education, smoking and low physical activity), men and women eating ≥2 servings of fruits and vegetables/day had lower odds than others of hypertriglyceridaemia (OR 0.72 (95% CI 0.56 to 0.94)). On average, women eating at least 2 servings of fruits and vegetables per day had cholesterol levels 0.28 mmol/L lower than the levels of other women. When only adjusted for sex and age, men eating at least 2 servings of fruits and vegetables per day had cholesterol levels 0.27 mmol/L higher than other men. CONCLUSIONS: A high intake of FV was associated with lower odds of hypertriglyceridaemia among men and women. It was also associated with cholesterol levels, negatively among women and positively among men