Stock enhancement activities in the Union of Myanmar

Presented in the paper are the stock enhancement programs of the Union of Myanmar which is being implemented by the Department of Fisheries. The State’s vision is to assist the national economy by promoting livelihood programs for rural people through the development of the fisheries sector. To achieve such goal, one of the major activities is to undertake a stock enhancement program which has been implemented since 1983. The DOF subsidizes the annual seeding of freshwater fish and prawns into natural waters. Species used in seeding include common carp (Cyprinus carpio), tilapia (Oreochromis), rohu (Labeo rohita), catla (Catla catla), and featherbacks fish (Notopteridae), freshwater prawn Macrobrachium and tiger shrimp Penaeus monodon. Activities include annual stocking of seeds in the Ayeyarwaddy River and its tributaries, lakes, reservoirs, dams and other bodies of water

Health literacy - is it useful in prevention of behavioral risk factors of NCDs?

Background: Health literacy means cognitive and social skills of a person that determine his or her ability to access, understand and use health information to maintain and promote health. People need to understand and use health information in order to choose a healthy lifestyle or to take advantage of preventive measures. The occurrence and consequences of NCDs are related to unhealthy life styles. Insight into the relationship between health literacy and modifiable behavioral risk factors of NCDs may support the prevention and control of these diseases.Methods: A cross-sectional study was conducted among 1367 adults. Multi-stage random sampling was used. Data entry and analysis was done using Stata 11.0 statistical package. Multiple logistic regression analysis was applied to assess the association between health literacy and behavioral risk factors.Results: The proportion of participants who reported ever smoking, ever alcohol drinking and not-practicing daily-exercise was 19.8%, 16.2% and 85.2%, respectively. The prevalence of satisfactory level of health literacy was 31.5%. Health literacy was significantly related to behavioral risk factors even if age, sex, education status and monthly household’s expenditure were adjusted. By improving the health literacy status of adults up to satisfactory level, the prevalence of ever smoking, ever drinking and not-practicing daily exercise among them would be reduced by 34%, 32.1% and 38.9%, respectively.Conclusions: Health literacy status of community should be assessed, monitored and improved. Health literacy may be an effective tool in prevention and control of NCDs because of its preventive effect on modifiable behavioral risk factors.

Nuclear Expression of Pygo2 Correlates with Poorly Differentiated State Involving c-Myc, PCNA and Bcl9 in Myanmar Hepatocellular Carcinoma

In Myanmar, hepatocellular carcinoma (HCC) is commonly seen in young adult and associated with poor prognosis, while the molecular mechanisms that characterize HCC in Myanmar are unknown. As co-activation of Wnt/β-catenin signaling and c-Myc (Myc) are reported to associate with malignancy of HCC, we immunohistochemically investigated the expression of Pygo2 and Bcl9, the co-activators of the Wnt/β-catenin signaling, Myc and PCNA in 60 cases of Myanmar HCC. Pygo2 expression was confirmed by in situ hybridization. The signal intensity was measured by image analyzer and then statistically analyzed. As a result, the expression of Pygo2 was significantly higher in HCC compared to normal liver tissue and the nuclear signal was the most intense in poorly differentiated HCC. Cytoplasmic Bcl9 was expressed in the normal liver tissue but decreased in HCC with the progression of histopathological grade. Myc was significantly higher in poorly differentiated HCC, whereas PCNA labeling index increased with the progression of histopathological grade. Nuclear Pygo2 showed strong correlation with nuclear Myc (P < 0.01) and PCNA (P < 0.001), and inversely correlated with cytoplasmic Bcl9 (P < 0.01). Our results suggested Wnt/β-catenin and Myc signaling is commonly activated in Myanmar HCC and that the correlative upregulation of nuclear Pygo2 and Myc characterizes the malignant features of HCC in Myanmar

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 &ge; 2). In the first six hours of hospitalisation patients received a mean 1.7 ml/kg/hour (range: 1.3&ndash;2.2) of intravenous fluid and were able to drink a mean of 0.8 ml/kg/hour (range: 0&ndash;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 &lt; 60mmHg). Plasma lactate was elevated (&gt; 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 (&gt; 120 &mu;mol/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 &lt; 0.001).ConclusionsA conservative fluid resuscitation strategy appears safe in adults hospitalised with malaria

Prevalence and Risk Factors of Eye Problems among Older People in Central Tropical Region, Naypyitaw Union Territory, Myanmar

Purpose:Vision is essential one and it is proximately linked with their quality of life. In the meantime, older populations are increasing rapidly in the whole world and thus, age-related macular degeneration, glaucoma, cataract and diabetic retinopathy are becoming common. Hot and dusty environment, inadequate access to water and poor facial hygiene are risk factors for blindness. Design: Lewe Township was purposively selected due to its high prevalent on eye problems. This cross-sectional study was conducted and simple random sampling was applied to achieve desired sample size. The structured questionnaires were used to collect data including screening of eye problems from 414 older population. Frequency, percentage, mean, SD and other descriptive analysis were determined and chi-square test for associations was constructed. Findings: Cataract was the highest prevalence rate with 40.8% followed by refractive error (27.3%) and pterygium (12.8%) among older people population in research area. While knowledge level indicated good level (88.4%), good attitude level (21.3%) and good practice level (27.1%) were noticeably low among older people. In the meantime, there were significantly associations between age (p=0.003) and education level (p=0.001) with knowledge level of older people while age (p=0.001), education level (p=&lt;0.001), occupation (p=0.038) showed statistically association with attitude level. Originality:The study noticed that higher prevalence of eye problems while relatively poor level of eye care seeking practice and unawareness on risk factors in targeted community. Knowledge and awareness for changing attitude about eye problems, eye care seeking behavior and preventive practices should be accomplished more

Real-world experience of metformin 1000 mg/day in patients with type 2 diabetes mellitus and comorbidities from Myanmar

Background: The study was conducted to assess the efficacy and safety of 1000 (mg/day) metformin in patients with type 2 diabetes (T2DM) with comorbidities and special reference to elderly people in Myanmar.Methods: This was a retrospective, post surveillance study conducted in patients diagnosed with T2DM receiving treatment of metformin (1000 mg/day). Baseline characteristics, comorbidities, random blood sugar level (RBS) and RBS changes pre- and post-therapy were retrieved from patient’s medical records. A paired sample t-test was used for comparing the pre- and post-treatment RBS levels.Results: A total of 303 patients with T2DM were included. A total of 88, 115 and 100 patients belonged to age groups ≤50, >50-≤60 and >61 years, respectively. Duration of T2DM was significantly higher in elderly patients (>61 years) compared to ≤50 and >50-≤60 age group. Hypertension was the most common comorbid condition observed in all age groups followed by cardiovascular disease. However, both hypertension and cardiovascular disease were significantly higher among elderly patients (>61 years) compared to ≤50 and >50-≤60 age group (p50-≤60 years, 86.2 mg/dL and >61 years, 97.2 mg/dL). Metformin was well tolerated with minimal gastrointestinal adverse events (n=27).Conclusions: In this post marketing surveillance study, metformin (1000 mg/day) was found to be effective in reducing RBS in T2DM patients with comorbidities especially older adults and well tolerated with no risk of hypoglycemia

Bcl9の異なるエピトープを認識する二つの抗体を用いた免疫組織化学的マッピングによるミャンマー国若年性発症肝細胞がんの特徴付け

B-cell lymphoma 9 (Bcl9) is the core component of Wnt/β-catenin signaling and overexpressed in nuclei of various tumors, including hepatocellular carcinoma (HCC). However, the extent of Bcl9 expression relative to HCC differentiation stage and its functional aspects are poorly understood. In this study, we examined the expression pattern of Bcl9 immunohistochemically, using two anti-Bcl9 antibodies; one was a conventional polyclonal-antibody (anti-Bcl9ABC) against amino acid no.800?900 of human-Bcl9, while the other (anti-Bcl9BIO) was against amino acid no.50?200, covering Pygopus-binding sites of Bcl9. Immunohistochemistry using anti-Bcl9BIO demonstrated distinctive staining in the cytoplasm, while the anti-Bcl9ABC signal was detected in both cytoplasm and nuclei of HCC cells, reflecting different states of Bcl9 function because Pygopus-binding to Bcl9 is essential to exert its function together with β-catenin in nucleus. Quantitative analysis revealed a significantly higher immunohistochemical-score by anti-Bcl9BIO in normal liver comparing various differentiation grades of HCC (P < 0.004), whereas no significant difference was noted with anti-Bcl9ABC. Interestingly, immunohistochemical-score of anti-Bcl9BIO in patients aged < 40 years was significantly lower than that of ? 40 years group (P < 0.01). The results indicated that anti-Bcl9BIO detected cytoplasmic Bcl9, which does not bind to Pygopus suggesting it could be a useful indicator for development of HCC in young Myanmar patients.長崎大学学位論文 学位記番号:博(医歯薬)甲第1129号 学位授与年月日:平成31年3月20日Author: Myat Thu Soe, Yasuaki Shibata, Myo Win Htun, Kuniko Abe, Kyaw Soe, Nay Win Than, Thann Lwin, Myat Phone Kyaw and Takehiko KojiCitation: Acta Histochemica et Cytochemica, 52(1), pp.9-17; 2019Nagasaki University (長崎大学)課程博

High rate of virological failure and low rate of switching to second-line treatment among adolescents and adults living with HIV on first-line ART in Myanmar, 2005-2015.

BACKGROUND: The number of people living with HIV on antiretroviral treatment (ART) in Myanmar has been increasing rapidly in recent years. This study aimed to estimate rates of virological failure on first-line ART and switching to second-line ART due to treatment failure at the Integrated HIV Care program (IHC). METHODS: Routinely collected data of all adolescent and adult patients living with HIV who were initiated on first-line ART at IHC between 2005 and 2015 were retrospectively analyzed. The cumulative hazard of virological failure on first-line ART and switching to second-line ART were estimated. Crude and adjusted hazard ratios were calculated using the Cox regression model to identify risk factors associated with the two outcomes. RESULTS: Of 23,248 adults and adolescents, 7,888 (34%) were tested for HIV viral load. The incidence rate of virological failure among those tested was 3.2 per 100 person-years follow-up and the rate of switching to second-line ART among all patients was 1.4 per 100 person-years follow-up. Factors associated with virological failure included: being adolescent; being lost to follow-up at least once; having WHO stage 3 and 4 at ART initiation; and having taken first-line ART elsewhere before coming to IHC. Of the 1032 patients who met virological failure criteria, 762 (74%) switched to second-line ART. CONCLUSIONS: We found high rates of virological failure among one third of patients in the cohort who were tested for viral load. Of those failing virologically on first-line ART, about one quarter were not switched to second-line ART. Routine viral load monitoring, especially for those identified as having a higher risk of treatment failure, should be considered in this setting to detect all patients failing on first-line ART. Strategies also need to be put in place to prevent treatment failure and to treat more of those patients who are actually failing

Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar.

BACKGROUND: Myanmar has a high burden of Human Immunodeficiency Virus (HIV) and second-line antiretroviral treatment (ART) has been available since 2008 in the public health sector. However, there have been no published data about the outcomes of such patients until now. OBJECTIVE: To assess the treatment and programmatic outcomes and factors associated with unfavorable outcomes (treatment failure, death and loss to follow-up from care) among people living with HIV (aged ≥ 10 years) receiving protease inhibitor-based second-line ART under the Integrated HIV Care Program in Myanmar between October 2008 and June 2015. DESIGN: Retrospective cohort study using routinely collected program data. RESULTS: Of 824 adults and adolescents on second-line ART, 52 patients received viral load testing and 19 patients were diagnosed with virological failure. However, their treatment was not modified. At the end of a total follow-up duration of 7 years, 88 (11%) patients died, 35 (4%) were lost to follow-up, 21 (2%) were transferred out to other health facilities and 680 (83%) were still under care. The incidence rate of unfavorable outcomes was 7.9 patients per 100 person years follow-up. Patients with a history of injecting drug use, with a history of lost to follow-up, with a higher baseline viral load and who had received didanosine and abacavir had a higher risk of unfavorable outcomes. Patients with higher baseline C4 counts, those having taken first-line ART at a private clinic, receiving ART at decentralized sites and taking zidovudine and lamivudine had a lower risk of unfavorable outcomes. CONCLUSIONS: Long-term outcomes of patients on second-line ART were relatively good in this cohort. Virological failure was relatively low, possibly because of lack of viral load testing. No patient who failed on second-line ART was switched to third-line treatment. The National HIV/AIDS Program should consider making routine viral load monitoring and third-line ART drugs available after a careful cost-benefit analysis