Allopurinol causing generalized exfoliative dermatitis: a case report

Erythroderma is a scaly, erythematous dermatitis of the skin, which occurs in drug allergy, malignancy and underlying skin disorders. The diagnosis is challenging because the extent of skin involvement does not always correlate with the extent of internal organ involvement. Therefore, early recognition of symptoms is vital to minimize morbidity and mortality. Case report: A 52 years old man had asymptomatic hyperuricemia and prescribed allopurinol 300mg, daily. One month later, the rashes started to appear on his trunk and then progressed to the face and upper limbs. Then it continued to spread to the lower extremities. Management involves prompt cessation of the culprit drug, administration of corticosteroids and supportive treatment. It is Concluded that Allopurinol is commonly used in clinical practice for the treatment of symptomatic hyperuricemia and gout. It has been associated with erythroderma especially when used indiscriminately

Operational experiences associated with the implementation of near point-of-care early infant diagnosis of HIV in Myanmar: a qualitative study

Background: Timely diagnosis and early initiation of life-saving antiretroviral therapy are critical factors in preventing mortality among HIV-infected infants. However, resource-limited settings experience numerous challenges associated with centralised laboratory-based testing, including low rates of testing, complex sample referral pathways and unacceptably long turnaround times for results. Point-of-care (POC) HIV testing for HIVexposed infants can enable same-day communication of results and early treatment initiation for HIV-infected infants. However, complex operational issues and service integration can limit utility and must be well understood prior to implementation. We explored and documented the challenges and enabling factors in implementing the POC Xpert® HIV-1 Qual test (Cepheid, Sunnyvale, CA, USA) for early infant diagnosis (EID) as part of routine services in four public hospitals in Myanmar. Methods: This sub-study was part of a randomised controlled stepped-wedge trial (Australian and New Zealand Clinical Trials Registry, number 12616000734460) designed to investigate the impact of POC testing for EID in Myanmar and Papua New Guinea. Infants recruited during the intervention phase underwent POC testing at the participating hospitals as part of routine care. Semi-structured interviews with 23 caregivers, 12 healthcare providers and 10 key informants were used to explore experiences of POC-EID testing. The research team and hospital staff documented and discussed implementation challenges throughout the study. Results: Overall, caregivers and healthcare workers were satisfied with the short turnaround time of the POC test. Occasional delays in POC testing were mostly attributable to late receipt of samples by laboratory technicians and communication constraints among healthcare staff. Hospital staff valued technical assistance from the research group and the National Health Laboratory. Despite staff shortages and infrastructure challenges such as unreliable electricity supply and cramped space, healthcare workers and caregivers found the implementation of the POC test to be feasible at pilot sites. Conclusions: As plans for national scale-up evolve, there needs to be a continual focus on staff training, communication pathways and infrastructure. Other models of care, such as allowing non-laboratory-trained personnel to perform POC testing, and cost effectiveness should also be evaluated

Caregiver experience and perceived acceptability of a novel near point-of-care early infant HIV diagnostic test among caregivers enrolled in the PMTCT program, Myanmar: A qualitative study

Background: The majority of HIV infection among children occurs through mother-to-child transmission. HIV exposed infants are recommended to have virological testing at birth or 4–6 weeks of age but challenges with centralized laboratory-based testing in Myanmar result in low test- ing rates and delays in result communication and treatment initiation. Decentralized point- of-care (POC) testing when integrated in prevention of mother-to-child transmission of HIV (PMTCT) services, can be an alternative to increase coverage of early infant diagnosis (EID) and timely engagement in HIV treatment and care. Aim: This paper aims to explore experiences of caregivers of HIV-exposed infants enrolled in the PMTCT program in Myanmar and the perceived acceptability of point-of-care EID testing compared to conventional centralised laboratory-based testing. Methods: This is a sub-study of the cluster randomised controlled stepped-wedge trial (Trial registra- tion number: ACTRN12616000734460) that assessed the impact of near POC EID testing using Xpert HIV-1 Qual assay in four public hospitals in Myanmar. Caregivers of infants who were enrolled in the intervention phase of the main study, had been tested with both Xpert and standard of care tests and had received the results were eligible for this qualitative study. Semi-structured interviews were conducted with 23 caregivers. Interviews were audio recorded, transcribed verbatim and translated into English. Thematic data analysis was undertaken using NVivo 12 Software (QSR International). Results: The majority of caregivers were satisfied with the quality of care provided by PMTCT ser- vices. However, they encountered social and financial access barriers to attend the PMTCT clinic regularly. Mothers had concerns about community stigma from the disclosure of their HIV status and the potential consequences for their infants. While medical care at the PMTCT clinics was free, caregivers sometimes experienced financial difficulties associated with out-of-pocket expenses for childbirth and transportation. Some caregivers had to choose not to attend work (impacting their income) or the adult antiretroviral clinic in order to attend the paediatric PMTCT clinic appointment. The acceptability of the Xpert testing pro- cess was high among the caregiver participants and more than half received the Xpert result on the same day as testing. Short turnaround time of the near POC EID testing enabled the caregivers to find out their infants’ HIV status quicker, thereby shortening the stressful wait- ing time for results. Conclusion: Our study identified important access challenges facing caregivers of HIV exposed infants and high acceptability of near POC EID testing. Improving the retention rate in the PMTCT and EID programs necessitates careful attention of program managers and policy makers to these challenges, and POC EID represents a potential solution

Research and Development of Feature Extraction from Myanmar Palm Leaf Manuscripts for the Myanmar Character Recognition System

This paper proposed Myanmar palm leaf manuscript handwriting OCR system. Each text area in the Myanmar palm-leaf manuscript is segmented. This segmented character text image is needed to be recognized to transform to Myanmar handwritten characters which express Myanmar’s precious historical and invaluable information. This paper involves two essential steps: preprocessing and feature extraction. The preprocessing is carried out to extract the attractive palm-leaf manuscript region from the Images automatically are taken by the camera and to support the enhanced images for subsequence processes of Myanmar character recognition from Myanmar palm leaves. The one-dimensional segmentation approach is used to crop leaf area in the image which is taken with high resolution. Line count analysis is also done to extract the region for using enough line count. After that, line segmentation is carried out using Object Frequency Histogram along the horizontal lines which can find the best optimal points between the lines. Similarly, the same technique but vertically is used to get each character or smallest group of characters. Totally 18 features are extracted to recognize the Myanmar palm-leaf manuscript characters. Although the experimental results are good enough but some difficulties are still needed to take account related to the connected components.

Performance Test and Structural Analysis of Cross-Flow Turbine

Myanmar is a developing country, the annual consumption of electricity has been increasing rapidly throughout the country.  The main source of energy for generating electricity is hydropower because of her hilly regions with rivers and water-falls.  Myanmar, where 75% of the populations live in rural area, has a low level of access to electricity.  Small-scale hydropower production may be the most cost-effective way to supply electricity to remote villages that are not near transmission lines.  The objectives of this research is to design low cost with high efficient cross-flow turbine especially for low head, to analyze the blade structural and modal of the turbine runner by using ANSYS 14.5 software, to construct the designed cross-flow turbine and test the performance of constructed cross-flow turbine in selected site location.  The designed cross-flow turbine is capable of producing up to 300 watts AC power at the head of 6m and water flow rate of 0.009 m3/s.

Caregiver experience and perceived acceptability of a novel near point-of-care early infant HIV diagnostic test among caregivers enrolled in the PMTCT program, Myanmar : a qualitative study

Background The majority of HIV infection among children occurs through mother-to-child transmission. HIV exposed infants are recommended to have virological testing at birth or 4–6 weeks of age but challenges with centralized laboratory-based testing in Myanmar result in low testing rates and delays in result communication and treatment initiation. Decentralized point-of-care (POC) testing when integrated in prevention of mother-to-child transmission of HIV (PMTCT) services, can be an alternative to increase coverage of early infant diagnosis (EID) and timely engagement in HIV treatment and care. Aim This paper aims to explore experiences of caregivers of HIV-exposed infants enrolled in the PMTCT program in Myanmar and the perceived acceptability of point-of-care EID testing compared to conventional centralised laboratory-based testing. Methods This is a sub-study of the cluster randomised controlled stepped-wedge trial (Trial registration number: ACTRN12616000734460) that assessed the impact of near POC EID testing using Xpert HIV-1 Qual assay in four public hospitals in Myanmar. Caregivers of infants who were enrolled in the intervention phase of the main study, had been tested with both Xpert and standard of care tests and had received the results were eligible for this qualitative study. Semi-structured interviews were conducted with 23 caregivers. Interviews were audio recorded, transcribed verbatim and translated into English. Thematic data analysis was undertaken using NVivo 12 Software (QSR International). Results The majority of caregivers were satisfied with the quality of care provided by PMTCT services. However, they encountered social and financial access barriers to attend the PMTCT clinic regularly. Mothers had concerns about community stigma from the disclosure of their HIV status and the potential consequences for their infants. While medical care at the PMTCT clinics was free, caregivers sometimes experienced financial difficulties associated with out-of-pocket expenses for childbirth and transportation. Some caregivers had to choose not to attend work (impacting their income) or the adult antiretroviral clinic in order to attend the paediatric PMTCT clinic appointment. The acceptability of the Xpert testing process was high among the caregiver participants and more than half received the Xpert result on the same day as testing. Short turnaround time of the near POC EID testing enabled the caregivers to find out their infants’ HIV status quicker, thereby shortening the stressful waiting time for results. Conclusion Our study identified important access challenges facing caregivers of HIV exposed infants and high acceptability of near POC EID testing. Improving the retention rate in the PMTCT and EID programs necessitates careful attention of program managers and policy makers to these challenges, and POC EID represents a potential solution

Survey on Emotion Recognition Using Facial Expression

Automatic recognition of human affects has become more interesting and challenging problem in artificial intelligence, human-computer interaction and computer vision fields. Facial Expression (FE) is the one of the most significant features to recognize the emotion of human in daily human interaction. FE Recognition (FER) has received important interest from psychologists and computer scientists for the applications of health care assessment, human affect analysis, and human computer interaction. Human express their emotions in a number of ways including body gesture, word, vocal and facial expressions. Expression is the important channel to convey emotion information of different people because face can express mainly human emotion. This paper surveys the current research works related to facial expression recognition. The study attends to explored details of the facial datasets, feature extraction methods, the comparison results and futures studies of the facial emotion system

Penicillin resistance in Streptococcus pneumoniae: Threat, Treatment, and Future trends in Management

Emergence of antibiotic resistance is a global concern in this era to combat infectious diseases. Streptococcus pneumoniae is one of the most common causes of communityacquired respiratory tract infections and the drug of choice for treatment was penicillin. However, the first clinically significant penicillin-non-susceptible pneumococcus (PNSP) was documented in 1967. Since then, penicillin resistance strain had been identified in different continents of the world. Among 94 serotypes of S. pneumoniae, ―paediatric serotypes‖ (6A, 6B, 9V, 14, 15A, 19A, 19F and 23F) were found to have the highest resistance to penicillin and erythromycin globally. The mechanism of penicillin resistance in S. pneumoniae is conveyed by the alternation of the structure of penicillin binding proteins (PBPs), which leads to reducing the affinity for penicillin. There is a relationship between antibiotic consumption and dissemination of antibiotic resistant pneumococcal clones in Southern and Eastern Europe, America, and Asia. Therefore, rational use of antibiotics is important in order to decrease the development and spread of resistant strains. After the introduction of Pneumococcal conjugate vaccine (PCV) 7 vaccines, non-vaccine serotypes like 6C, 11A, 15A, and 15B/C have increased in prevalence. Since the changes in serotype prevalence due to selective pressure have been observed, it is necessary to monitor the prevalent serotypes. Optimal coverage may be achieved by using vaccines with a wide range of serotype coverage in the future. In managing pneumococcal infections, sensitivity tests are important to choose the appropriate antibiotics. In severe pneumonia or hospital-acquired pneumonia patients at the area of high prevalence of PNSP, the initial antibiotics must include intravenous carbapenems, ceftriaxone, cefotaxime or newer quinolones, meanwhile, penicillin-resistant pneumococcal meningitis (≥ 2 µg/ml) is vancomycin and ceftriaxone or cefotaxime. Judicious use of antibiotics, modification of the treatment duration and encouragement for adherence by patients are recommended to prevent antibiotic resistance. Development of new classes of drugs and novel therapeutic regimen is essential to overcome the hazard of penicillin resistance pneumococcal infection in future. Keywords: Penicillin resistance, β-Lactams, Streptococcus pneumoniae, Communityacquired respiratory tract infections

Domain-Specific Sentiment Lexicon for Classification

Nowadays people express their opinions about products, government policies, schemes and programs over social media sites using web or mobile. At the present time, in our country, government changes policies in every sector and people follow with the eyes or the mind on these policies and express their opinion by writing comments on social media especially using Facebook news media pages. Therefore, our research group intends to do sentiment analysis on new articles. Domain-specific sentiment lexicon has played an important role in opinion mining system. Due to the ubiquitous domain diversity and absence of domain-specific prior knowledge, construction of domain-specific lexicon has become a challenging research topic in recent year. In this paper, lexicon construction for sentiment analysis is described. In this work, there are two main steps: (1) pre-processing on raw data comments that are extracted from Facebook news media pages and (2) constructing lexicon for coming classification work. The word correlation and chi-square statistic are applied to construct lexicon as desired. Experimental results on comments datasets demonstrate that proposed approach is suitable for construction the domain-specific lexicon