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Ultrasonic evaluation in the patients in whom fat is lacking may prove rewarding order 45 mg midamor overnight delivery blood pressure chart british heart foundation, whereas examination of obese patients may be less productive safe midamor 45 mg blood pressure medication and weight loss, since ultrasound is not particularly well transmitted through fat generic 45 mg midamor visa arteria3d elven city pack. In summary, selection of an appropriate radiographic imaging requires consideration of the area and organ system to be examined, the body habitus of the patients and the skill of the examiner. Meticulous history and thorough physical examination was done uisng abdominal pain chart. Diagnosis was made after clinical examination and was correct in 57 overall patients. Diagnostic 197 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar accuracy with this pain chart was 57%. Specificity was high in biliary stone disease and relatively low in acute appendicitis. The prevalence of bacterial and parasitic - enteropathogens were investigated at Bacteriology Section, National Health Laboratory; Yangon. Bacterial pathogens were isolated in 46% and parasitic agents were detected in 12% of children with acute diarrhoea. Prevalence of pathogen was the same with that reported from other developing countries. Vibrio cholerae O1 strains were resistant to ampicillin (100%), cotrimoxazole (100%), polymyxin B (100%) and tetracycline (50%). Resuscitation and replacement therapy is the initiative management for emergency life saving. Early endoscopy offers definitive diagnosis and provides proper institution oftreatment. The development of multidisciplinary protocols for management has significantly influenced outcome. Compared to other four studies, the outcome of bleeding peptic ulcer was not much differed. The authors analyzed the long-term survival rate and complications of the procedure in children operated on at The University of Hong Kong Medical Centre between 1979 and 2000. The patients were divided into groups according to postoperative bile flow, decade of operation, and age at operation. Esophageal variceal bleeding occurred in 13 patients and was a prognostic indicator for end-stage liver failure (P=. Esophageal hemorrhage is not an absolute indication for urgent liver transplantation in patients with good bile drainage. One of the components of the strategy is improving family and community practices. Families need knowledge, skills, motivation and support in order to care for their children. Ten Focus Group Discussions were conducted with 88 mothers of two age groups (below 30 years and above 30 years) residing at a randomly selected rural area of Gyobingauk Township. Some positive responses were pointed out by some mothers but not including chest indrawing. There were favourable health seeking pattern as health care facilities were easily accessible in this study area. But there were indiscriminate usage of western as well as traditional medicines in their first home treatment. Mothers continued to feed their sick children but the restricted feeding were also observed among mothers. Mothers followed the preventive practices which were related to perceived causes like coldness and indigestion. In the study area we also observed the risk behaviours that cause indoor air pollution. Only few mothers could tell the danger signs as majority of mothers did not have serious experience of diarrhoea. There were positive knowledge (such as avoid feeding unsuitable fruits, giving cool boiled water, avoiding food contaminated by flies, using sanitary pit latrines and washing hands properly) about preventive practices of diarrhea but inadequate practices of sanitation and preparation of safe water were observed. Most of the mothers could not express the correct immunization schedule but they accepted to receive immunization as they believed immunization would prevent most of the diseases of their children. The controls were free from diarrhoea 48 hours prior to and 24 hours after collection of stool specimens. Stool specimens were collected as freshly as possible in screw-capped clean bottles from cases as well as controls. Stool specimens were inoculated into appropriate media for isolation and identification of enteric bacteria. Enteric bacteria that were searched for, included Salmonella species, Shigella species, enterotoxigenic. Enteropathogenic and enteroadherent Escherichia coli and Vibrio species employing standard bacteriological techniques. Stool specimens were also examined microscopically for protozoa namely Entamoeba histolytica, Giardia intestinalis, Microsporidium species, Cryptosporidium species and helminth ova and larva using routine and Kinyoun acid fast stains. Rotavirus was not detected in the stool specimens of 114 patients tested, 54 cases and 60 controls. Intestinal parasites in the stool specimens of 54 patients with diarrhoea included Cryptosporidium parvum in 23 cases (42. Thus both cases and controls haboured these enteric organisms in the gastrointestinal tract and probably only when the immune status of the patient was lowered to a certain level that these organisms become diarrheogenic. In children under 1 year of age, the changes are more marked proximally and become less marked distally, perhaps reflecting exposure to the causative agent(s) in early life. Fifty professional traditional medical health practitioners who were working general practice in their own clinics within Yangon area were included in this study. Among 50 practitioners, 56% use the single plant therapy alternative to formulations and 44% use only formulation therapy. Regarding the treatment of dysentery with single plant therapy, Euphorbia hirta (uGsJausmif;rifap;) was the most commonly recommended one; recommended by 35. The result of this study provided certain contribution on promising traditional medicine to be utilized in Standard Treatment System of Myanmar Traditional Medicine and traditional knowledge resources for the development of scientific preparations of traditional drugs for diarrhea and dysentery. It studied 29 patients who underwent oesophagectomy, examined biopsy for the celiac lymph node involvement. The study showed that tumour length of invasion varied from 2cm to 8cm, the average tumour length was found to be 5. In histological type, squamous cell carcinoma was 69% and the adenocarcinoma was 31%. There were no significant association between celiac lymph node involv- ment and tomour depth, length, histological type, site of involvement and histological grading. This study found that, 222 (M: F=127: 95) out of 252 patients had acute appendicitis at operation, which was confirmed by histology. Some facts for clinicopathological correlation are similar with previous research findings but others are not. This paper adds more information on causal agents of stomach cancer in Myanmar and includes information for future clinical tumor vaccine trial and immunotherapy of cancer. Peptic ulcer was the only non-infective medical condition which was studied in some detail.

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Male children who suffered from diarrhoea were more than females and peak incidence of acute and persistent diarrhoea occurred in the 2-11 month age group discount midamor 45 mg without prescription pulse pressure of 20. Fever and vomiting were found more frequent in persistent than acute diarrhoea during second week of illness and differences were statistically significant purchase midamor 45 mg without a prescription arrhythmia associates of south texas. The presence of leucocytes and reducing substances in the stool was equally frequent discount midamor 45mg on-line blood pressure bottom number is high. Ninety eight male children aged 4 months to 10 years presenting with watery diarrhoea of less than 72 hours prior to hospitalization were studied. Ninety eight male children aged 4 months to 10 years presenting with watery diarrhoea of less than 72 hours prior to hospitalization ware studied. Stool for routine examination was done on each children and base line assessment on lactose absorption and small bowel bacterial overgrowth status were done. The results indicate that parasitic infections hinder the lactose absorption and favour the small bowel bacterial overgrowth; thus deworming could improve the lactose absorption status in children. Intestinal mucosal integrity was assessed by measurement of permeability index using dual sugar lactulose and L-rhamnose. Significantly decreased L-rhamnose excretion was observed in all of the clinical groups, in comparison to controls reflecting decreased absorption through enterocytes and villous atrophy. Raised lactulose urinary excretion was observed in all clinical groups except in children with persistent diarrhea, suggesting increased paracellular spaces and mucosal injury. It is concluded that major changes in intestinal permeability occurred in children with persistent diarrhea. There were lesser degree of damage in acute diarrhea and recovered persistent diarrhea groups. Only minor changes was observed on those who recovered from acute diarrhoeal illness. As a result persistent diarrhoeal group had lowest value of nutritional indices and grater proporation of malnourished children in comparison to acute and recovered diarrhoeal illness. The study included 20 days to 10 years old children and 239 were males and 149 were females. Faecal leukocytes were identified under a high power (40 X) field microscope by mounting of methylene blue staining method. The bacterial pathogens and protozoa pathogens were identified by standard methods. The association between the presence of faecal leukocytes and isolated pathogens from the stools were isolated in association with Shigella alone (25. They all were grown at both 37C and 42C and they were resistant to polymyxin B sulphate. This study was also carried out to describe some epidemiological features of giardiasis in these children and to monitor the efficacy of metronidazole. A total of 308 stool samples from children attending the Diarrhoeal unit were examined for the presence of Giardia lamblia cysts or trophozoites. The infected children were treated with standard regimen of metronidazole (Myanmar Pharmaceutical Industry) and their stools were again examined at the end of treatment. To have a better understanding of public health importance of domestic and personal hygienic measures on acute diarrhoea, mothers were asked to answer some variables by using a standard questionnaire forms. It was carried out on 100 patients who were under 4 months old of age, diagnose as acute diarrhoea and admitted for treatment to Yangon Children Hospital, Myanmar, during June 1997 to May 1998. It was isolated from 28 cases who had some dehydration and 20 cases who had severe dehydration. Exclusion breast feeding was only seen in age group of less than one and more than one to two months age group. It was not statistically significant when severity of dehydration with other types of feeding compared to exclusive breast feeding among less than one and more than one to two months old children. In our study most of the mothers wash their hands with water only after cleaning her child s defecation and before and after feeding her child. The severity of dehydration was statistically significant in hand washing practice and indicating a need for appropriate intervention programmes aimed at promoting exclusive breast feeding and hand washing practices with soap and water after cleansing her child s defecation, and before and after feeding her child. The study was conducted during 1993-1994 to determine the association of the pathogen with the disease. The seasonal, age and sex distribution, serotyping and susceptibility of these isolates to antibiotics were investigated, V. Dysenteric stool samples were collected from the laboratory of Infectious Diseases Hospital, Yangon during January-June 1993. Four hundred and sixty stool samples containing blood and mucous were collected in this study, and Shigella spp. The increasing antimicrobial resistance of shigellosis from 1980 to 1993 in this community was also discussed. A number of factors, including poultry farming, consumption of food and iced drinks from street venders, drinking unboiled water and lack of hygienic habits were found to be significantly associated with choler transmission. The gastroenteritis caused by these bacteria is accompanied by pain in abdomen, nausea and vomiting, fever and a mild degree of 102 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar dehydration. It is anticipated to facilitate the epidemiological study in order to provide an effective control of disease. One hundred and fifty mothers and guardians of severely malnourished children were interviewed regarding the epidemiologic, demographic, socio-economic, cultural and environmental risk factors. Routine H & E stain and two tissue special staining methods, modified carbol-fuchsin and modified Giemsa, were introduced in this study. From June 1997 to December 1997, total of (58) gastroscopic biopsy were taken and examined, including (8) of gastric adenocarcinoma cases. Comprising changes were chronic superficial gastritis 19 (38%), chronic atrophic gastritis 20 (40%), chronic gastritis with aberrant pancreatic rest 5 (10%), and chronic regenerative gastritis 6 (12%) respectively. They were pseudocysts of pancreas (14 cases), pancreatic phlegmon (14 cases), and pancreatic abscess (8 cases). Overall mortality rate of inflammatory pancreatic masses following acute pancreatitis was 19. Sex difference, serum amylase, urinary amylase and serum calcium could not be used as prognostic factors in these cases. However, when positive factors was 3 or more than 3, mortality rate became increased, along with increased number of positive factors. Serum amylase and urinary amylase levels were raised above normal in majority of cases but not that much as in early phase of acute pancreatitis. Means and standard deviations for serum amylase and urinary amylase levels were 544. Serum and urinary amylase levels in those cases remained high in blood longer than those of uncomplicated acute pancreatitis. Six cases underwent trangastric cystogastrostomy and no mortality as well as no recurrences were encountered. Seven responded well to non- operative treatment and achieved spontaneous regression. All of the spontaneous resolution started between two to six weeks from the onset of appearance of mass.