Clinical and microbiological characteristics of cryptococcosis in Singapore: predominance of Cryptococcus neoformans compared with Cryptococcus gattii

SummaryObjectivesTo describe the clinical features, treatments, outcomes, and subtype prevalence of cryptococcosis in Singapore.MethodsAll patients with laboratory confirmed cryptococcal infections admitted from 1999 to 2007 to a teaching hospital in Singapore were reviewed retrospectively. Identification and molecular types of Cryptococcus neoformans variants and Cryptococcus gattii were determined by polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). Serotypes were inferred with a multiplex PCR method.ResultsOf 62 patients with cryptococcosis, C. neoformans var. grubii was the predominant subtype (in 95%), affecting mainly immunocompromised hosts (91%) with HIV infection (80%). Patients with HIV were younger (median age 36.5 vs. 49.5 years, p=0.006) and less likely to present with an altered mental status (14% vs. 50%, p=0.013). In contrast, delayed treatment (median 7 days vs. 2 days, p=0.03), pulmonary involvement (58% vs. 14%, p=0.03), and initial treatment with fluconazole (25% vs. 2%, p=0.02) were more common in HIV-negative patients. C. gattii was uncommon, affecting only three patients, all of whom were immunocompetent and had disseminated disease with pulmonary and neurological involvement. All C. gattii were RFLP type VG II, serotype B and all C. neoformans var. grubii were RFLP type VN I, serotype A, except for one that was RFLP type VN II.ConclusionC. neoformans var. grubii, subtype VN I, was the predominant subtype in Singapore, infecting younger, mainly immunocompromised hosts with HIV. C. gattii was uncommon, causing pulmonary manifestations in older, immunocompetent patients and were RFLP type VG II

The Safety of a Conservative Fluid Replacement Strategy in Adults Hospitalised with Malaria

BackgroundA conservative approach to fluid resuscitation improves survival in children with severe malaria; however, this strategy has not been formally evaluated in adults with the disease.MethodsAdults hospitalised with malaria at two tertiary referral hospitals in Myanmar received intravenous fluid replacement with isotonic saline, administered at a maintenance rate using a simple weight-based algorithm. Clinical and biochemical indices were followed sequentially.ResultsOf 61 adults enrolled, 34 (56%) had Plasmodium falciparum mono-infection, 17 (28%) Plasmodium vivax mono-infection and 10 (16%) mixed infection; 27 (44%) patients were at high risk of death (P. falciparum infection and RCAM score ≥ 2). In the first six hours of hospitalisation patients received a mean 1.7 ml/kg/hour (range: 1.3–2.2) of intravenous fluid and were able to drink a mean of 0.8 ml/kg/hour (range: 0–3). Intravenous fluid administration and oral intake were similar for the remainder of the first 48 hours of hospitalisation. All 61 patients survived to discharge. No patient developed Adult Respiratory Distress Syndrome, a requirement for renal replacement therapy or hypotension (mean arterial pressure < 60mmHg). Plasma lactate was elevated (> 2 mmol/L) on enrolment in 26 (43%) patients but had declined by 6 hours in 25 (96%) and was declining at 24 hours in the other patient. Plasma creatinine was elevated (> 120 μmol/L) on enrolment in 17 (28%) patients, but was normal or falling in 16 (94%) at 48 hours and declining in the other patient by 72 hours. There was no clinically meaningful increase in plasma lactate or creatinine in any patient with a normal value on enrolment. Patients receiving fluid replacement with the conservative fluid replacement algorithm were more likely to survive than historical controls in the same hospitals who had received fluid replacement guided by clinical judgement in the year prior to the study (p = 0.03), despite having more severe disease (p < 0.001).ConclusionsA conservative fluid resuscitation strategy appears safe in adults hospitalised with malaria

Accuracy and User-Acceptability of HIV Self-Testing Using an Oral Fluid-Based HIV Rapid Test

10.1371/journal.pone.0045168PLoS ONE79

A Study of Burkholderia pseudomallei in the Environment of Farms in Thanlyin and Hmawbi Townships, Myanmar.

Melioidosis is a tropical infection, first described in Myanmar but now rarely diagnosed there, which is widespread in Southeast Asia. The infection is predominantly acquired by people and animals through contact with soil or water. This study aimed to detect the causative organism, Burkholderia pseudomallei, in environmental samples from farms in Thanlyin and Hmawbi townships near Yangon, Myanmar. One hundred and twenty soil samples and 12 water samples were collected and processed using standard microbiological methods. Burkholderia species were isolated from 50 of the 120 (42%) soil samples but none of the water samples. Arabinose assimilation was tested to differentiate between B. pseudomallei and the nonpathogenic Burkholderia thailandensis, and seven of 50 isolates (14%) were negative. These were all confirmed as B. pseudomallei by a species-specific multiplex polymerase chain reaction (PCR). This is the first study to detect environmental B. pseudomallei in Myanmar and confirms that melioidosis is still endemic in the Yangon area

A first absolute chronology for Late Neolithic to Early Bronze Age Myanmar: new AMS C-14 dates from Nyaung'gan and Oakaie

Late prehistoric archaeological research in Myanmar is in a phase of rapid expansion. Recent work by the Mission Archéologique Française au Myanmar aims to establish a reliable Neolithic to Iron Age culture-historical sequence, which can then be compared to surrounding regions of Southeast Asia. Excavations at Nyaung'gan and Oakaie in central Myanmar have provided 52 new AMS dates, which allow the creation of Myanmar's first reliable prehistoric radiometric chronology. They have also identified the Neolithic to Bronze Age transition in central Myanmar, which is of critical importance in understanding long-range interactions at the national, regional and inter-regional level. This research provides the first significant step towards placing late prehistoric Myanmar in its global context

Classification of Brain Cancer by Using Naïve Bayesian Classifier

Brain tumors typically behave in a unique fashion compared to neoplasm occurring elsewhere in the body. In particular, they rarely spread to other parts of the body and typically produce symptoms due to localized growth within the brain. For this reason, neoplasm in the brain, even malignant tumors, are typically referred to as “tumors” as opposed to “brain cancer”. Classification is the process of finding a set model that describe and distinguished data classes or concepts for the purpose if being able to use the model to predict the class of objects whose class label is unknown. The derived model is based on the analysis of a set of training data. This system focuses on the brain cancer diseases by using Naïve Bayesian Classifier that classifies Benigh Tumor of Glial Cells and Glioma. This system can be mentioned treatment information for the patient

Effect of Alternate Wetting and Drying on Crop Performance, Water Input and Water Productivity of Direct Wet-seeded Inbred and Hybrid Rice

The experiments were conducted to evaluate the yield performance of the inbred and hybrid rice varie-ties under alternate wetting and drying (AWD), to compare the water productivity of rice varieties under AWD condition and to investigate the water saving percent in different rice varieties under AWD. Two water regimes (alternate wetting and drying, AWD and continuous flooding, CF) in main plot and four varieties including two hybrid varieties (Long-9, Yezin Pale Thwe-3) and two inbred varieties (Yaenelo-4 , Yaenelo-1) in sub plot were laid out as split plot design with four replications. During the study peri-od, loam soil in DaikU Township and silty clay loam soil in Maubin Township were observed. The max-imum grain yield and yield components of tested varieties were 2.99 t ha-1 in DaikU and 5.76 t ha-1 in Maubin. The water productivities of AWD were not statistically different with CF but water saving were resulted under AWD in both DaikU and Maubin townships. Hybrid rice produced higher grain yield, yield components, morphological traits and water productivity than those of inbred rice in both townships. Grain yield and water productivity were not significantly different between AWD and CF. However, more water can save under AWD than CF and subsequently found that above 20 % of water saving for hybrid and above 30% for inbred during summer rice growing season in the study areas. Therefore, this study indicated that applied AWD irrigation maintained current yield and reduction of water input for Hybrid and Inbred rice varieties under the tested areas, DaikU and Maubin Townships

Automatic Myanmar Text Summarization System

Automatic text summarization is used as atool to help people in reducing the time spentmanually extracting the main ideas from textdocuments. If the natural disaster news isprovided as the summary form includingimportant and relevant information, people inmanagement level can make comparisons andintelligent decisions quickly without exhaustingenergy by manually extracting the salient points.Moreover, for a normal user, automaticsummary report of the disaster news makes themclear perception and fully awareness of theeffects of the natural disaster by inspecting deathtoll and damage of the natural hazards.Therefore, this paper proposes AutomaticMyanmar Text Summarization framework that isbased on Information Extraction and practicalimplementation of this framework insummarizing natural disaster news which are inseven types: Earthquake, Flood, Landslide,Forest Fire, Tornado, Storm and VolcanicEruption described in Myanmar Language. Thetwo main components of the proposedframework, Myanmar Word Segmentation modelbased on Conditional Random Fields (CRFs)and Information Extraction Model using CRFs approach are also introduced

Weed Infestation in Green Gram-based Cropping Systems in Central Dry Zone of MyanmarWeed Infestation in Green Gram-based Cropping Systems in Central Dry Zone of Myanmar

The study was carried out with two objectives (1) to find out the dominant weeds and common weeds in green gram growing areas of the central dry zone, and (2) to examine weed intensity in differ-ent green gram-based cropping patterns. Dominant weed species were Echinochloa colona, Paspalum distichum and Cyperus iria in Tatkon lowland, Cynodon dactylon, Cyperus iria and Echinochloa colona in Tatkon upland, Cyperus iria and Cyperus rotundus in Magway upland. Common weed species were Cyperus iria and Echinochloa colona in Tatkon lowland, Cyperus iria and Cynodon dactylon in Tatkon upland and Achyrathes aspera, Cyperus rotundus, Cleome viscose, Commelina benghalensis, Digitaia ciliaris, Dactylonctenium aegyptimum, Leucas lanvandulifolia, Phyllanthus niruri, Richardia brasili-ensis and Scirpus juncoides in Magway upland. A total of ten green gram-based cropping patterns were mainly observed in the study areas. Among these patterns, pattern 4 in Tatkon lowland, pattern 5 in Tat-kon upland and pattern 10 in Magway upland could give benefits of reducing the weed density. Pattern 3 and pattern 1 could limit the chance of dominating weed species. Pattern 6 and pattern 9 could maintain diversity of weed flora without substantial increase of weed density in the dry zone area of Myanmar. Weed infestation in all patterns were varying with crops and associated with management practices and, accordingly, these factors may cause various weed species composition