Economic Analysis on Crop Diversification of Farm households in the Selected Township, Southern Shan State

The purpose of this study was to identify the degree of crop diversification and socio-economic status of farm households to measure marginal analysis on crop diversification in Taunggyi district, Southern Shan State in 2013. A simple random sampling technique was used to sample size of 150 farm households with structured questionnaires. Herfindahl method (Hd) was employed to compute the diversification index. Data were analysed by using descriptive statistics and gross margin analysis to measure the profits of crop production. The results revealed 60% and 40% of farm households in specialized farming and diversified farming, respectively. Finding could be interpreted as decrease intensification of crop diversification among farm households. Crop diversification index showed that an average index was 0.81 and 0.39 in low and high diversified group, respectively. About 77.7% and 83.3% of household heads in low and high diversified groups were males. Average family size in both groups was 5 persons family-1. Most of low farm household heads (76.7%) had only primary education. High farm household heads (35%) had primary education as well as higher education. In addition, 31.3% of low and 29.7% of high farm households received formal credit and 13.1% of low and 9.4% of high farm households received credit from UNDP. Findings indicated that 68% of low farm households cultivated comparatively small land area than high diversified group. Rice-based and maize-based cropping patterns were mainly practiced in the study area. In Nyaung Shwe and Sesai Townships, 60% and 29% of low diversified group mostly practiced mono cropping. In Pindaya Township, 58% of high diversified group mostly practiced multiple cropping. Cropping intensity of low and high diversified groups was 109% and 133%, respectively. In gross margin analysis, the whole year round vegetables cultivation was the most profitable crop in low and high diversified groups (1.99 and 1.96 BCR). Paddy-Oilseed-vegetables cropping was the second profitable pattern with1.81 of BCR in high diversified group. Maize, the second most profitable crop, in mono cropping was the most efficient capacity in labour used

Health promoting behaviours of the elderly in Myanmar

Aging is a lifelong and inevitable process. As a human being, every person wants to have a long life. With the aim to promote active and healthy ageing, the Ministry of Health implemented the elderly health care project in Myanmar since 1992-1993. This programme is based on comprehensive health care; promotion, preventive, curative and rehabilitative care. Elderly health care programme has been implemented in 161 townships by the end of year 2013 but nationwide is not yet. Nurses in Myanmar involve in the elderly health care project as a significant contribution to the health of elderly population. There is a little research that demonstrates effectiveness in quantifiable measuring health promotion practices in the elderly. There is a definite need for the elderly population to practice health promotion to improve the quality of life as their life span lengthens. This study will also encourage the nurses to better help the elderly to move to increase health promotion practices. That is why it is needed to investigate the health promoting behaviors of elderly people. This cross sectional descriptive study was done to assess health promoting behaviors of the elderly in the community. 69 elderly people aged 60 years and above including males and females who live in Chan Mya Thar Si Township, Mandalay was conducted. The Health Promoting Lifestyle Profile II (HPLP II) developed by Walker, Sechrist, and Pender (1995) was used as a research instrument and analyzed manually. The findings of this study revealed that there were 62% (n = 43) of the elderly had healthy behavior in nutrition and 38% (n = 26) of the elderly had unhealthy behavior in nutrition. Regarding physical activity, 33% (n = 23) of the elderly had healthy behavior and 67% (n = 46) had unhealthy behavior. In managing stress, the majority of participants 93% (n = 64) had healthy behavior and only 7% (n=5) were unhealthy in stress management. Concerning interpersonal relations, 59% (n = 64) were healthy and 41% (n = 28) were unhealthy. 38% (n = 25) of healthy behavior of the elderly and 64% (n = 44) of unhealthy behavior of the elderly in health responsibility, 78% (n = 54) of healthy behavior of the elderly and 22% (n = 15) of unhealthy behavior of the elderly in spiritual growth. Overall, there were 55% (n = 38) in healthy behavior and 45% (n = 31) in unhealthy behavior in this community. This quantitative study showed that the overall behavior in their community was healthier. According to this study, the areas which needed to investigate and improve in their physical activities and their taking health responsibility

Omnious T-wave inversions: Wellens’ syndrome revisited

Wellens’ syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens’ syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI. Here, we report a case of an overweight man with 35 pack-year of smoking history who presented to Easton Hospital with intermittent pressing chest pain of 5/6 times within 10 day-period and was found to have type A Wellens’ sign, which was biphasic T-waves in precordial leads V2 and V3 during pain-free period with no cardiac enzymes elevation. He was given therapeutic lovenox and subsequently underwent coronary angioplasty and had 95–99% occlusion in proximal LAD artery. The unique feature of our case was that Wellens’ type B EKG changes were seen after reduction of stenosis with LAD artery stent, which was likely explained by the reperfusion of the ischemic myocardium. Therefore, it is important for physicians to recognize EKG features of Wellens’ syndrome in order to take appropriate therapy to reducing mortality and morbidity form impending MI

Omnious T-wave inversions: Wellens\u27 syndrome revisited.

Wellens\u27 syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens\u27 syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI. Here, we report a case of an overweight man with 35 pack-year of smoking history who presented to Easton Hospital with intermittent pressing chest pain of 5/6 times within 10 day-period and was found to have type A Wellens\u27 sign, which was biphasic T-waves in precordial leads V2 and V3 during pain-free period with no cardiac enzymes elevation. He was given therapeutic lovenox and subsequently underwent coronary angioplasty and had 95-99% occlusion in proximal LAD artery. The unique feature of our case was that Wellens\u27 type B EKG changes were seen after reduction of stenosis with LAD artery stent, which was likely explained by the reperfusion of the ischemic myocardium. Therefore, it is important for physicians to recognize EKG features of Wellens\u27 syndrome in order to take appropriate therapy to reducing mortality and morbidity form impending MI

Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease: Results From the CREDENCE Trial and Meta-Analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus.METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-analysis.RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (<45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]).CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02065791