Loss to Follow-Up (LTFU) during Tuberculosis Treatment

Loss to follow-up (LTFU) is a serious issue in the field of tuberculosis (TB) since it can lead to TB outbreaks and drug resistance. The proportion of LTFU patients differs among different countries, regions, year, and institutions. In some countries, the number of patients that were LTFU nearly reaches half of the total patients. Underlying factors such as age, gender, education, residence, financial factors, migration, and social stigma are discussed in this chapter. These factors should always be taken into consideration whenever a treatment program is designed. Suggestions have been made regarding some interventions that could potentially solve the problem of LTFU. With these points in mind, an ambitious approach should be taken to reduce the number of LTFU patients up to zero

A Case of Cardiac Calcified Amorphous Tumor Presenting with Concomitant ST-Elevation Myocardial Infarction and Occipital Stroke and a Brief Review of the Literature

Cardiac calcified amorphous tumor (CAT) is an extremely rare benign intracavitary tumor of the heart. It may mimic other cardiac tumors and can present with signs or symptoms of systemic embolization. There are limited data regarding CAT in the literature. We report a case of a 68-year-old woman with a cardiac CAT and mitral annular calcification (MAC), who presented with acute ST-elevation myocardial infarction (STEMI) and occipital stroke. After extensive review of the literature, we believe that this case is possibly the first description of a cardiac CAT presenting with STEMI. The CAT was surgically removed, and the diagnosis was confirmed by histology. The patient tolerated the surgery and reported no events at 6-month follow-up

Effect of dietary garlic and thyme seed supplementation on the production performance, carcass yield and gut microbial population of broiler chickens

A total of 200 Cobb 500 male broilers were randomly allocated to 4 treatments consisting of 5 replications with 10 chicks each in order to evaluate the effect of dietary garlic and thyme seed supplementation on the production performance, carcass yield and gut microbial population. Treatments were control diet (T1), control diet with 1% thyme seed powder (T2), control diet with 1% garlic powder (T3) and control diet with 0.5% thyme seed and 0.5% garlic powder (T4). Feed intake, body weight, weight gain, feed conversion ratio (FCR), carcass yield was not significantly (p>0.05) improved by dietary treatments compared to control. Escherichia coli (E. coli) count in the gut of broilers did not show significant difference among dietary treatments. However, Lactobacilli count in the gut of broilers significantly (p<0.05) increased in T2 compared to that of T1. Lactobacilli count in the gut of broilers received T1, T3 and T4 did not differ significantly (p>0.05) with each other. It was concluded that thyme seed was reliable as feed additive in the broiler diet and could provide positive advantages to the colonization and proliferation of Lactobacilli

A Rare Case of Carotid Web Presenting with Ischemic Stroke in a Young Woman and a Brief Review of the Literature

Carotid web is a radiological description of a shelf-like intraluminal filling defect in the carotid bulb. It is histologically defined as atypical fibromuscular dysplasia (FMD), with abnormal fibrosis and smooth muscle cell hyperplasia in the tunica intima. The spur-like intraluminal protrusion can serve as a nidus for thrombus formation, which could cause systemic embolism and ischemic strokes. We report a case of a 20-year-old female patient presenting with acute ischemic stroke in the ipsilateral middle cerebral artery (MCA) territory. We also discuss the incidence, the prevalence, the pathophysiology, the treatment, and the recurrence of carotid web based on the currently available literature

Effect of Murdannia edulis Faden roots on serum prolactin level and mammary glands of lactating female albino rats

Background: Murdannia edulis (Stokes) Faden (Myit-Cho in Myanmar) is a herb which has widely been used to induce or increase lactation by ethnic groups living in Tamu township of Sagaing division in Myanmar. This study aimed to explore the effect of Murdannia edulis on serum prolactin level and mammary glands of the lactating female rats. Methods: The type of the study was laboratory based experimental study. Thirty-six lactating dams were divided into six groups of 6 lactating rats in each group (n=6), namely group I (normal saline) as control, group II (5 mg/kg metoclopramide) as standard, groups III and IV (1 gm/kg and 2 gm/kg watery extract of Murdannia edulis), groups V and VI (1 gm/kg and 2 gm/kg ethanolic extract of Murdannia edulis), respectively. The extract and the drugs were orally administered from day 4 to 15 of lactation. At 16 days of lactation, the heart blood of lactating dams was collected under chloroform anaesthesia and serum prolactin level of dams was measured by using ELISA kit. The histological changes of mammary glands of the rats were also assessed. Results: The significant higher serum prolactin level were seen in ethanolic extract 2 gm/kg body weight treated group when compared to control. Histology of mammary glands in ethanolic extract treated rats showed stimulation of lobuloalveolar cell development. Conclusions: The lactogenic activity of the roots of Murdannia edulis may be due to promoting prolactin secretion and lobuloalveolar cell development of mammary glands

Early Success With Retention in Care Among People Living With HIV at Decentralized ART Satellite Sites in Yangon, Myanmar, 2015–2016

Introduction: Myanmar is one of the countries in the Asia-Pacific region hit hardest by the HIV epidemic that is concentrated among urban areas and key populations. In 2014, the National AIDS Programme (NAP) launched a new model of decentralized service delivery with the establishment ART satellite sites with care delivered by HIV peer workers.Methods: ART satellite sites are implemented by non-government organizations to service high burden HIV areas and populations that suffer stigma or find access to public sector services difficult. They provide continuity of HIV care from outreach testing, counseling, linkage to care, and retention in care. Anti-retroviral (ART) initiation occurs at health facilities by specialist physicians. We conducted a retrospective cohort study of people living with HIV (PLHIV) who were initiated on ART from 2015 to 2016 at five ART satellite sites in Yangon, Myanmar to assess outcomes and time from enrolment to ART initiation.Results: Of 1,339 PLHIV on ART treatment in 2015–16, 1,157 (89%) were retained, and 5% were lost from care and 5% reported dead, at the end of March 2018. Attrition rates (death and lost-to-follow-up) were found to be significantly associated with a CD4 count ≤ 50 cells/mm3 and having baseline weight ≤ 50 kg. Median time taken from enrolment to ART initiation was 1.9 months (interquartile range: 1.4–2.5).Conclusion: We report high rates of retention in care of PLHIV in a new model of ART satellite sties in Yangon, Myanmar after 3 years of follow-up. The delays identified in time taken from enrolment to ART initiation need to be explored further and addressed. This initial study supports continuation of plans to scale-up ART satellite sites in Myanmar. To optimize outcomes for patients and the program and accelerate progress to reduce HIV transmission and end the HIV epidemic, operational research needs to be embedded within the response

XRD and SEM Analysis, and Semiconductor Type Determination of TiO2 for Dye-sensitized Solar Cell

Titanium dioxide (TiO2) is a wide band-gap n-type semiconductor. Anatase TiO2 is the most common structure used in high performance dye-sensitized solar cell (DSSC). Nanoporous TiO2 serves double-duty as an electron acceptor and a scaffold to hold large numbers of dye molecules in DSSC. The porosity of TiO2 is a key feature as it has roughly a thousand times greater a surface area than the equivalent flat area. In this work, TiO2 crystallite size (43.55 nm) has been calculated by using XRD data, and the morphology and the grain-size of TiO2 (average grain size of 0.2 mm ~ 0.3 mm) with different solvents have been also studied by SEM

Re-evaluation of the phylogeny based on mitochondrial cytochrome b gene in the house shrew, Suncus murinus-S. montanus species complex, with special reference to Yemen and Myanmar populations

The house shrew (Suncus murinus-S. montanus species complex) is considered to have been unintentionally introduced by humans from their original range to other regions around the　Indian Ocean and neighboring seas, but this has yet not fully been investigated. A phylogenetic tree and haplotype network were reconstructed　based on the mitochondrial cytochrome b gene nucleotide sequences (1140 bp) of 179 individuals of house shrews from 46 localities in southern East Asia, Southeast Asia, West Asia, and islands in the western Indian Ocean. There was small genetic variation among shrews in Japan (Okinawa), southern China, Vietnam, and insular Southeast Asia. However, the shrew populations in Myanmar and Sri Lanka showed of a variety of different haplotypes. In the region of the western Indian Ocean, three interesting findings were obtained. First, the shrews on Zanzibar Island (Tanzania) shared same haplotype as those in southwestern Iran, and the haplotype was close to a group in Pakistan, despite these three regions being distantly located. Second, inferring from the haplotype network, it was suggests that the shrews in Yemen might have derived from Madagascar/Comoros populations. Third, the shrews on Réunion Island were genetically different from other populations around the western Indian Ocean but closer to Malaysia and Myanmar populations. Thus, the present study demonstrates that there have been dynamic immigration/emigration processes in the house shrews, especially for those around the western Indian Ocean. In addition, the house shrews in Myanmar may include several different species