Khin Phyu Pyar | Defence Services Medical Academy (DSMA), Yangon, Myanmar (Burma) (original) (raw)
Papers by Khin Phyu Pyar
American journal of biomedical science & research, Jan 12, 2024
Journal of clinical images and medical case reports, Jun 21, 2023
A-39-year-old migrant worker coming back from Palatwa (Sagaing Division) and Myanmar-India border... more A-39-year-old migrant worker coming back from Palatwa (Sagaing Division) and Myanmar-India border area (Rakhine State) developed cerebral malaria, acute kidney injury and metabolic acidosis. He was treated with intravenous artemisinine followed by ACT (artemisinine combination therapy); Dihydroartemisinine-piperaquine, hemodialysis, fresh blood transfusion. He had early parasitological failure on Day 14; therefore, different ACT (Artemether-lumefantrine) was initiated. He had adequate clinical and parasitological response till Day 42.
Journal of clinical images and medical case reports, Oct 30, 2023
A 34 years old man, had increasing pain over grafted kidney with low urine output on post-operati... more A 34 years old man, had increasing pain over grafted kidney with low urine output on post-operative 'Day 7' following living donor kidney transplantation. He was a known case of IgA nephropathy with end stage renal disease and Myelodysplastic Syndrome (MDS). CT abdomen revealed perinephric hematoma; cast effect on graft kidney; and the density over grafted kidney was decreased suggestive of rejection. He also had disseminated multi-drug resistant Klebsiella pneumonia infections in urinary tract, gastrointestinal tract and orchitis. Multidisciplinary team's management which includes nephrologists, general physicians, hematologists, uro-surgeons, vascular surgeons, radiologists, microbiologists and anesthetists saves patient's life as well as transplant kidney.
International journal of medical science and clinical research studies, Dec 30, 2023
Background: Acute diarrhea is common in Myanmar. People are so used to diarrhea at least once a y... more Background: Acute diarrhea is common in Myanmar. People are so used to diarrhea at least once a year that they do not think diarrhea as an important problem. Acute diarrhea in early post-operative period in renal transplant recipient may result in pre-renal failure and delay graft function. This study aimed to identify the prevalence of diarrhea, its severity and response to treatment in early post-operative period (3 weeks after transplant) in living donor kidney transplant (LDKT) recipients. Patients and Methods: LDKT recipients having acute diarrhea in early post-transplant period at two transplant centers (Mingaladon and Nay Pyi Taw) in Myanmar were analyzed over 10 years period; from 2013 to 2023 September. Acute diarrhea is defined as three or more semisolid or liquid stools per day for a minimum of 1 day duration. It was a hospital based observational study. After obtaining diet history and physical examination, laboratory tests were done. Clinical parameters (diet, fever, features of oral candidiasis, features of dehydration, examination of abdomen), stool examination (stool inspection, stool examination for ova and cyst, stool for Clostridium difficle toxin, stool culture), blood tests (total WBC count, serum creatinine, liver function tests) and blood trough level for Tacrolimus and mycophenolate mofetil were done. Management was given according to algorithm and their response to treatment was recorded. Dose modification of immunosuppressants were done depending on full blood count and blood level of them. Results: A total of 230 LDKT recipients were observed; among them, thirteen percent (30/230) of recipients developed acute diarrhea in early post-operative period. The age ranged from 14 to 73 years. A majority of them had mild form; mild dehydration without significant changes in hemodynamic status. The peak onset of diarrhea was 4 to 5 days after transplant; majority resolved over one week. They did not have oral candidiasis. Abdominal examination was normal except mild tenderness over grafted kidney in all of them. Total WBC count and platelet count were normal except in two cases. Stool examination did not show trophozoite or cyst. Stool for Clostridium difficile toxin was not identified. With dietary modification and oral rehydration solution, their motion was back to normal in sixteen
A third-year medical student, 19 years, had multiple cold abscess at left posterior triangle with... more A third-year medical student, 19 years, had multiple cold abscess at left posterior triangle with systemic symptomspoor appetite and weight loss. Histopathology was consistent with tuberculous lymphadenopathy as it showed Langham's giant cells and caseation necrosis. Both systemic symptoms and local lesions were refractory to empirical treatment for tuberculosis standard anti-tubercular therapy: isoniazid, rifampicin, ethambutol and pyrazinamide. Pus for Gene Xpart was negative. Pus culture showed non-tuberculous mycobacteria (NTM); Mycobacterium fortuitum.
INTERNATIONAL JOURNAL OF MEDICAL SCIENCE AND CLINICAL RESEARCH STUDIES, 2022
Background: Sepsis is the first leading cause of death in Myanmar and complications are also diff... more Background: Sepsis is the first leading cause of death in Myanmar and complications are also difficult to solve. This study aimed to detect the effect of thiamine on lactate clearance and mortality in patients with sepsis. Method: A randomized controlled trial done in No.(1) Defence Services General Hospital, Yangon from October 2020 to June 2022. All patients > 18 years old admitted with suspected or documented infection and qSOFA score 2 or 3 were included but alcohol related cases were excluded. Total 80 patients were assigned 1:1 by block randomization. Intervention group was given IV thiamine 100 mg 6 hourly for 3 days. Primary outcome was lactate clearance and secondary outcomes, mSOFA score (both were assessed in day 1, day 3 and day 7), and mortality within 7 days. Intention to treat analysis with worst data imputation in missing value for expired cases. Results: Significant lactate clearance was seen in intervention group compared with control group, in day 3, [23.53% (34.37) vs 16.67% (43.30), z =-2.353, p = 0.019] and day 7, [53.85% (28.90) vs 30.22% (38.61), z =-3.186, p = 0.001]. Lactate clearance over time was well observed in the intervention group, [X 2 (2) = 29.356, p < 0.001] but not in the control group, [X 2 (2) = 3.152, p = 0.207]. Significant mSOFA score reduction over time was also observed in the intervention group, [X 2 (3) = 39.330, p < 0.001]. All-cause mortality within 7 days was not different, [X 2 (1) = 0.949, p = 0.330, OR 0.949, 95% CI (0.51-7.12)]. Conclusion: Thiamine supplementation in sepsis patient was benefit in lactate clearance starting from day 3 and reduction of mSOFA score starting from day 7. But it did not show the mortality benefit within 7 days period.
The "severe acute respiratory syndrome coronavirus type 2" (SARSCoV-2) is an en... more The "severe acute respiratory syndrome coronavirus type 2" (SARSCoV-2) is an enveloped, single-stranded, positive-sense RNA virus; it is known as "coronavirus disease 19" (COVID-19). It originated in Wuhan, Hubei province, People's Republic of China, in December 2019; then, it spread worldwide causing a global pandemic. Genetic variants of SARS-CoV-2 have been emerging and circulating around the world: original (wild-type),
Background: Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2... more Background: Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2 and developing severe COVID-19 infection because they have low innate immunity as well as poor antibody response to COVID-19 vaccine. This study aimed to assess the clinical and laboratory predictors for 5 th wave of COVID-19 infections in patients on maintenance hemodialysis. Methods: A hospital based, case control study was conducted in July 2022 to November 2022 among patients on MHD who had confirmed COVID-19 infection by nasopharyngeal swab PCR. Data were collected by using standardized forms and analysis was done. Results: A total of 22 patients out of 61 patients on maintenance hemodialysis (MHD) developed COVID-19 infection in same public hemodialysis (HD) center in Yangon. The comparison of clinical and laboratory parameters (age, BMI, vaccination history, type of vaccine, duration from last vaccination , smoking status, vaccination time, comorbid status, duration of hemodialysis, hemoglobin level, serum albumin level and anti-Spike antibody level) was made between infected group and non-infected group. Patients in both groups had 4 doses of vaccine: Covaxin, Sinovax, Sinopharm and Covishield. Baseline clinical characteristics were not significantly different between infected cases and non-infected cases; mean age was 49.77 ± 11.58 years vs 51.92 ± 13.6 years; BMI was 19.75 ± 3.00 kg/m 2 vs 20.03 ± 2.76 kg/m 2 ; duration from last vaccination was 37.64 ± 2.22 days vs 38.77 ± 3.62 days; number of current smokers was 4 vs 8 ; and vaccination time in the morning was 14 vs 29 patients. The proportion of patients with past COVID-19 infection was the same; 63.6% (14/22) in infected group and 66.7 % (26/39) in non-infected group. Hemoglobin level was lower in infected groups (8.26 ± 2.07 gm% vs 8.33 ± 2.02 gm%); and serum albumin level was lower in infected group (42.47 ± 4.82 gm/dl vs 43.17 ± 4.10 gm/dl) too. The
PubMed, Dec 1, 2000
Thalassaemics in Malaysia are poorly chelated because desferrioxamine is too expensive and cumber... more Thalassaemics in Malaysia are poorly chelated because desferrioxamine is too expensive and cumbersome for long term compliance. The efficacy and tolerability of the oral chelator deferiprone, and the effects of using a combination therapy in our patients were studied. Ten patients completed the study and the mean serum ferritin reduced from 7066.11 ug/L (2577-12,896 ug/L) to 3242.24 ug/L (955-6120 ug/L). The liver iron concentration did not show a significant drop (19.6 vs 18.2 mg/g dry weight) although 3 patients showed reductions ranging from 30-40%. Concomitant use of desferrioxamine increased the urinary excretion from a mean of 13.66 mg/day to 27.38 mg/day. Main side effects seen were nausea and rashes.
SunText review of virology, 2022
Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a ma... more Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world as it caused significant morbidity and mortality. Convalescent plasma therapy (CPT) has been one of the treatment options in
Journal of Anaesthesiology Clinical Pharmacology, 2014
We present a patient with known prothrombin gene mutation and a history of prior vascular events,... more We present a patient with known prothrombin gene mutation and a history of prior vascular events, who underwent living donor kidney transplantation. Given the presumed elevated risk of complication from known prothrombin mutation, clinical management was directed towards optimizing living donor allograft function.
International Journal of Infectious Diseases, 2012
Background: Various rickettsioses distribute worldwide. Scrub typhus and Japanese spotted fever a... more Background: Various rickettsioses distribute worldwide. Scrub typhus and Japanese spotted fever are known in Japan. Each rickettsiosis is reported about 400 cases and over 100 cases every year and has seasonal and geographical characteristics. In contrast, traveler's rickettsioses are febris acute diseases to need attention for all season and nationwide. In 2011, we experienced a laboratory diagnosis of various rickettsioses. Methods: In many time, untypical cases and imported cases are requested to perform laboratory diagnosis for our laboratory. We performed several PCR tests, targeted different reckettsial sequence regions, and measure antibody titer. We detected a rickettsial specific gene from acute phase samples (eschars, skin biopsy of rash and whole blood) and confirmed antibody titers elevation by paired sera. Results: Three African tick bite fever cases were diagnosed (case 1 traveled to Swaziland and case 2 to South Africa in January, and case 7 traveled to Zimbabwe and Botswana in December). Case 3 was forgrin traveler from South Africa, and diagnosed as Boutonnese fever. Case 5 was Scrub typhus who traveled to Malaysia in March. Case 6 was murine typhus, who stayed in Thailand and showed acute respiratory disorder syndrome in April. On the other hand, case 4 was suggested as the new spotted fever group Rickettsia by results of genetic sequence analysis of PCR products and showed antibody elevation against Rickettsia conorii. Conclusion: Antigenic cross-reactivity are high among spotted fever rickettsia group, there is a limit for differentiation of infected Rickettsia species by serologic diagnosis. In addition, members of spotted fever group Rickettsia have increased until now. Spotted fever rickettsioses show variety in clinical symptom, and have various outbreak situation and distribution. Therefore, history and episodes of the patients before onset are extremely important. In this presentation, we summarize traveler's rickettsioses and domestic rickettsioses in 2011 in Japan.
Zenodo (CERN European Organization for Nuclear Research), Dec 13, 2022
International Journal Of Medical Science And Clinical Research Studies
Background: Sepsis is a common life threatening medical problem and first leading cause of death ... more Background: Sepsis is a common life threatening medical problem and first leading cause of death in Myanmar. This study was aimed to determine the predictive values of initial mSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet count for mortality in patients with sepsis and septic shock. Method: A hospital based prospective observational study done in No.(1) Defence Services General Hospital, Yangon, from January 2021 to October 2022. All patients above 18 years old admitted with sepsis and qSOFA ≥ 2 were enrolled and sample size was 121 patients. The predictors were mSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet count, which were assessed within 24 hour of admission and the mortality was observed for 28 days. Logistic regression was used to find out the predictive value and the predictors were compared by receiver operating characteristic curve analysis.
International Journal Of Medical Science And Clinical Research Studies
Background: Sepsis is the first leading cause of death in Myanmar and complications are also diff... more Background: Sepsis is the first leading cause of death in Myanmar and complications are also difficult to solve. This study aimed to detect the effect of thiamine on lactate clearance and mortality in patients with sepsis. Method: A randomized controlled trial done in No.(1) Defence Services General Hospital, Yangon from October 2020 to June 2022. All patients > 18 years old admitted with suspected or documented infection and qSOFA score 2 or 3 were included but alcohol related cases were excluded. Total 80 patients were assigned 1:1 by block randomization. Intervention group was given IV thiamine 100 mg 6 hourly for 3 days. Primary outcome was lactate clearance and secondary outcomes, mSOFA score (both were assessed in day 1, day 3 and day 7), and mortality within 7 days. Intention to treat analysis with worst data imputation in missing value for expired cases. Results: Significant lactate clearance was seen in intervention group compared with control group, in day 3, [23.53% (3...
Korean Journal of Transplantation
Korean Journal of Transplantation
Journal of Clinical and Medical Images, Case Reports
A 50-year-old gentle man, coming back from Delta region, presented with, septic shock, ARDS and a... more A 50-year-old gentle man, coming back from Delta region, presented with, septic shock, ARDS and acute kidney injury following 8 days history of high fever. Eschar was noted on right forearm. His temperature was 105°F; very ill and toxic with SaO2 90% on air. He was hypotensive (80/50 mmHg), tachycardic (128/ min), tachypneic (respiratory rate 32/min) with low SaO2 (90% on air); crackles were audible in both lungs. Chest radiograph showed patchy opacities in both lungs. He had low Platelet count (34 x 109/mm3), raised serum creatinine (160 μmol/L), raised liver enzymes (SGOT 121 U/L & SGPT 86 U/L) and low serum albumin (22 mg%). Rapid test for Scrub Typhus IgM was positive. The patient recovered with oxygen therapy, fluid replacement, inotropes, cefopyrazone/salbactam and doxycycline.
Journal of Clinical Research and Reports
Background: Coronavirus disease 2019 (COVID-19) has been threatening the world for more than 2 ye... more Background: Coronavirus disease 2019 (COVID-19) has been threatening the world for more than 2 years. Breakthrough COVID-19 infection has clinical and public health significance. The health care workers have been working in front line; thus, acquiring greatest risks. Their family members are also at high risk being close contact to them. This study aimed to assess the prevalence and the severity of breakthrough COVID-19 infection (BTI) in fourth wave among health care workers (HCW) and their family members, and the protective effect of C OVID-19 vaccine in Myanmar. Methods: A cross-sectional descriptive study was conducted among health care workers (HCW) and their family members who developed confirmed COVID-19 infection either by rapid test or PCR test at least 14 days after receiving COVID-19 vaccine during the fourth wave from January 2022 to May 2022. Data were collected by using standardized forms and analysis was done. Results: A total of 1013 participants were included in thi...
Journal of medicine and therapeutics, 2020
American journal of biomedical science & research, Jan 12, 2024
Journal of clinical images and medical case reports, Jun 21, 2023
A-39-year-old migrant worker coming back from Palatwa (Sagaing Division) and Myanmar-India border... more A-39-year-old migrant worker coming back from Palatwa (Sagaing Division) and Myanmar-India border area (Rakhine State) developed cerebral malaria, acute kidney injury and metabolic acidosis. He was treated with intravenous artemisinine followed by ACT (artemisinine combination therapy); Dihydroartemisinine-piperaquine, hemodialysis, fresh blood transfusion. He had early parasitological failure on Day 14; therefore, different ACT (Artemether-lumefantrine) was initiated. He had adequate clinical and parasitological response till Day 42.
Journal of clinical images and medical case reports, Oct 30, 2023
A 34 years old man, had increasing pain over grafted kidney with low urine output on post-operati... more A 34 years old man, had increasing pain over grafted kidney with low urine output on post-operative 'Day 7' following living donor kidney transplantation. He was a known case of IgA nephropathy with end stage renal disease and Myelodysplastic Syndrome (MDS). CT abdomen revealed perinephric hematoma; cast effect on graft kidney; and the density over grafted kidney was decreased suggestive of rejection. He also had disseminated multi-drug resistant Klebsiella pneumonia infections in urinary tract, gastrointestinal tract and orchitis. Multidisciplinary team's management which includes nephrologists, general physicians, hematologists, uro-surgeons, vascular surgeons, radiologists, microbiologists and anesthetists saves patient's life as well as transplant kidney.
International journal of medical science and clinical research studies, Dec 30, 2023
Background: Acute diarrhea is common in Myanmar. People are so used to diarrhea at least once a y... more Background: Acute diarrhea is common in Myanmar. People are so used to diarrhea at least once a year that they do not think diarrhea as an important problem. Acute diarrhea in early post-operative period in renal transplant recipient may result in pre-renal failure and delay graft function. This study aimed to identify the prevalence of diarrhea, its severity and response to treatment in early post-operative period (3 weeks after transplant) in living donor kidney transplant (LDKT) recipients. Patients and Methods: LDKT recipients having acute diarrhea in early post-transplant period at two transplant centers (Mingaladon and Nay Pyi Taw) in Myanmar were analyzed over 10 years period; from 2013 to 2023 September. Acute diarrhea is defined as three or more semisolid or liquid stools per day for a minimum of 1 day duration. It was a hospital based observational study. After obtaining diet history and physical examination, laboratory tests were done. Clinical parameters (diet, fever, features of oral candidiasis, features of dehydration, examination of abdomen), stool examination (stool inspection, stool examination for ova and cyst, stool for Clostridium difficle toxin, stool culture), blood tests (total WBC count, serum creatinine, liver function tests) and blood trough level for Tacrolimus and mycophenolate mofetil were done. Management was given according to algorithm and their response to treatment was recorded. Dose modification of immunosuppressants were done depending on full blood count and blood level of them. Results: A total of 230 LDKT recipients were observed; among them, thirteen percent (30/230) of recipients developed acute diarrhea in early post-operative period. The age ranged from 14 to 73 years. A majority of them had mild form; mild dehydration without significant changes in hemodynamic status. The peak onset of diarrhea was 4 to 5 days after transplant; majority resolved over one week. They did not have oral candidiasis. Abdominal examination was normal except mild tenderness over grafted kidney in all of them. Total WBC count and platelet count were normal except in two cases. Stool examination did not show trophozoite or cyst. Stool for Clostridium difficile toxin was not identified. With dietary modification and oral rehydration solution, their motion was back to normal in sixteen
A third-year medical student, 19 years, had multiple cold abscess at left posterior triangle with... more A third-year medical student, 19 years, had multiple cold abscess at left posterior triangle with systemic symptomspoor appetite and weight loss. Histopathology was consistent with tuberculous lymphadenopathy as it showed Langham's giant cells and caseation necrosis. Both systemic symptoms and local lesions were refractory to empirical treatment for tuberculosis standard anti-tubercular therapy: isoniazid, rifampicin, ethambutol and pyrazinamide. Pus for Gene Xpart was negative. Pus culture showed non-tuberculous mycobacteria (NTM); Mycobacterium fortuitum.
INTERNATIONAL JOURNAL OF MEDICAL SCIENCE AND CLINICAL RESEARCH STUDIES, 2022
Background: Sepsis is the first leading cause of death in Myanmar and complications are also diff... more Background: Sepsis is the first leading cause of death in Myanmar and complications are also difficult to solve. This study aimed to detect the effect of thiamine on lactate clearance and mortality in patients with sepsis. Method: A randomized controlled trial done in No.(1) Defence Services General Hospital, Yangon from October 2020 to June 2022. All patients > 18 years old admitted with suspected or documented infection and qSOFA score 2 or 3 were included but alcohol related cases were excluded. Total 80 patients were assigned 1:1 by block randomization. Intervention group was given IV thiamine 100 mg 6 hourly for 3 days. Primary outcome was lactate clearance and secondary outcomes, mSOFA score (both were assessed in day 1, day 3 and day 7), and mortality within 7 days. Intention to treat analysis with worst data imputation in missing value for expired cases. Results: Significant lactate clearance was seen in intervention group compared with control group, in day 3, [23.53% (34.37) vs 16.67% (43.30), z =-2.353, p = 0.019] and day 7, [53.85% (28.90) vs 30.22% (38.61), z =-3.186, p = 0.001]. Lactate clearance over time was well observed in the intervention group, [X 2 (2) = 29.356, p < 0.001] but not in the control group, [X 2 (2) = 3.152, p = 0.207]. Significant mSOFA score reduction over time was also observed in the intervention group, [X 2 (3) = 39.330, p < 0.001]. All-cause mortality within 7 days was not different, [X 2 (1) = 0.949, p = 0.330, OR 0.949, 95% CI (0.51-7.12)]. Conclusion: Thiamine supplementation in sepsis patient was benefit in lactate clearance starting from day 3 and reduction of mSOFA score starting from day 7. But it did not show the mortality benefit within 7 days period.
The "severe acute respiratory syndrome coronavirus type 2" (SARSCoV-2) is an en... more The "severe acute respiratory syndrome coronavirus type 2" (SARSCoV-2) is an enveloped, single-stranded, positive-sense RNA virus; it is known as "coronavirus disease 19" (COVID-19). It originated in Wuhan, Hubei province, People's Republic of China, in December 2019; then, it spread worldwide causing a global pandemic. Genetic variants of SARS-CoV-2 have been emerging and circulating around the world: original (wild-type),
Background: Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2... more Background: Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2 and developing severe COVID-19 infection because they have low innate immunity as well as poor antibody response to COVID-19 vaccine. This study aimed to assess the clinical and laboratory predictors for 5 th wave of COVID-19 infections in patients on maintenance hemodialysis. Methods: A hospital based, case control study was conducted in July 2022 to November 2022 among patients on MHD who had confirmed COVID-19 infection by nasopharyngeal swab PCR. Data were collected by using standardized forms and analysis was done. Results: A total of 22 patients out of 61 patients on maintenance hemodialysis (MHD) developed COVID-19 infection in same public hemodialysis (HD) center in Yangon. The comparison of clinical and laboratory parameters (age, BMI, vaccination history, type of vaccine, duration from last vaccination , smoking status, vaccination time, comorbid status, duration of hemodialysis, hemoglobin level, serum albumin level and anti-Spike antibody level) was made between infected group and non-infected group. Patients in both groups had 4 doses of vaccine: Covaxin, Sinovax, Sinopharm and Covishield. Baseline clinical characteristics were not significantly different between infected cases and non-infected cases; mean age was 49.77 ± 11.58 years vs 51.92 ± 13.6 years; BMI was 19.75 ± 3.00 kg/m 2 vs 20.03 ± 2.76 kg/m 2 ; duration from last vaccination was 37.64 ± 2.22 days vs 38.77 ± 3.62 days; number of current smokers was 4 vs 8 ; and vaccination time in the morning was 14 vs 29 patients. The proportion of patients with past COVID-19 infection was the same; 63.6% (14/22) in infected group and 66.7 % (26/39) in non-infected group. Hemoglobin level was lower in infected groups (8.26 ± 2.07 gm% vs 8.33 ± 2.02 gm%); and serum albumin level was lower in infected group (42.47 ± 4.82 gm/dl vs 43.17 ± 4.10 gm/dl) too. The
PubMed, Dec 1, 2000
Thalassaemics in Malaysia are poorly chelated because desferrioxamine is too expensive and cumber... more Thalassaemics in Malaysia are poorly chelated because desferrioxamine is too expensive and cumbersome for long term compliance. The efficacy and tolerability of the oral chelator deferiprone, and the effects of using a combination therapy in our patients were studied. Ten patients completed the study and the mean serum ferritin reduced from 7066.11 ug/L (2577-12,896 ug/L) to 3242.24 ug/L (955-6120 ug/L). The liver iron concentration did not show a significant drop (19.6 vs 18.2 mg/g dry weight) although 3 patients showed reductions ranging from 30-40%. Concomitant use of desferrioxamine increased the urinary excretion from a mean of 13.66 mg/day to 27.38 mg/day. Main side effects seen were nausea and rashes.
SunText review of virology, 2022
Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a ma... more Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world as it caused significant morbidity and mortality. Convalescent plasma therapy (CPT) has been one of the treatment options in
Journal of Anaesthesiology Clinical Pharmacology, 2014
We present a patient with known prothrombin gene mutation and a history of prior vascular events,... more We present a patient with known prothrombin gene mutation and a history of prior vascular events, who underwent living donor kidney transplantation. Given the presumed elevated risk of complication from known prothrombin mutation, clinical management was directed towards optimizing living donor allograft function.
International Journal of Infectious Diseases, 2012
Background: Various rickettsioses distribute worldwide. Scrub typhus and Japanese spotted fever a... more Background: Various rickettsioses distribute worldwide. Scrub typhus and Japanese spotted fever are known in Japan. Each rickettsiosis is reported about 400 cases and over 100 cases every year and has seasonal and geographical characteristics. In contrast, traveler's rickettsioses are febris acute diseases to need attention for all season and nationwide. In 2011, we experienced a laboratory diagnosis of various rickettsioses. Methods: In many time, untypical cases and imported cases are requested to perform laboratory diagnosis for our laboratory. We performed several PCR tests, targeted different reckettsial sequence regions, and measure antibody titer. We detected a rickettsial specific gene from acute phase samples (eschars, skin biopsy of rash and whole blood) and confirmed antibody titers elevation by paired sera. Results: Three African tick bite fever cases were diagnosed (case 1 traveled to Swaziland and case 2 to South Africa in January, and case 7 traveled to Zimbabwe and Botswana in December). Case 3 was forgrin traveler from South Africa, and diagnosed as Boutonnese fever. Case 5 was Scrub typhus who traveled to Malaysia in March. Case 6 was murine typhus, who stayed in Thailand and showed acute respiratory disorder syndrome in April. On the other hand, case 4 was suggested as the new spotted fever group Rickettsia by results of genetic sequence analysis of PCR products and showed antibody elevation against Rickettsia conorii. Conclusion: Antigenic cross-reactivity are high among spotted fever rickettsia group, there is a limit for differentiation of infected Rickettsia species by serologic diagnosis. In addition, members of spotted fever group Rickettsia have increased until now. Spotted fever rickettsioses show variety in clinical symptom, and have various outbreak situation and distribution. Therefore, history and episodes of the patients before onset are extremely important. In this presentation, we summarize traveler's rickettsioses and domestic rickettsioses in 2011 in Japan.
Zenodo (CERN European Organization for Nuclear Research), Dec 13, 2022
International Journal Of Medical Science And Clinical Research Studies
Background: Sepsis is a common life threatening medical problem and first leading cause of death ... more Background: Sepsis is a common life threatening medical problem and first leading cause of death in Myanmar. This study was aimed to determine the predictive values of initial mSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet count for mortality in patients with sepsis and septic shock. Method: A hospital based prospective observational study done in No.(1) Defence Services General Hospital, Yangon, from January 2021 to October 2022. All patients above 18 years old admitted with sepsis and qSOFA ≥ 2 were enrolled and sample size was 121 patients. The predictors were mSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet count, which were assessed within 24 hour of admission and the mortality was observed for 28 days. Logistic regression was used to find out the predictive value and the predictors were compared by receiver operating characteristic curve analysis.
International Journal Of Medical Science And Clinical Research Studies
Background: Sepsis is the first leading cause of death in Myanmar and complications are also diff... more Background: Sepsis is the first leading cause of death in Myanmar and complications are also difficult to solve. This study aimed to detect the effect of thiamine on lactate clearance and mortality in patients with sepsis. Method: A randomized controlled trial done in No.(1) Defence Services General Hospital, Yangon from October 2020 to June 2022. All patients > 18 years old admitted with suspected or documented infection and qSOFA score 2 or 3 were included but alcohol related cases were excluded. Total 80 patients were assigned 1:1 by block randomization. Intervention group was given IV thiamine 100 mg 6 hourly for 3 days. Primary outcome was lactate clearance and secondary outcomes, mSOFA score (both were assessed in day 1, day 3 and day 7), and mortality within 7 days. Intention to treat analysis with worst data imputation in missing value for expired cases. Results: Significant lactate clearance was seen in intervention group compared with control group, in day 3, [23.53% (3...
Korean Journal of Transplantation
Korean Journal of Transplantation
Journal of Clinical and Medical Images, Case Reports
A 50-year-old gentle man, coming back from Delta region, presented with, septic shock, ARDS and a... more A 50-year-old gentle man, coming back from Delta region, presented with, septic shock, ARDS and acute kidney injury following 8 days history of high fever. Eschar was noted on right forearm. His temperature was 105°F; very ill and toxic with SaO2 90% on air. He was hypotensive (80/50 mmHg), tachycardic (128/ min), tachypneic (respiratory rate 32/min) with low SaO2 (90% on air); crackles were audible in both lungs. Chest radiograph showed patchy opacities in both lungs. He had low Platelet count (34 x 109/mm3), raised serum creatinine (160 μmol/L), raised liver enzymes (SGOT 121 U/L & SGPT 86 U/L) and low serum albumin (22 mg%). Rapid test for Scrub Typhus IgM was positive. The patient recovered with oxygen therapy, fluid replacement, inotropes, cefopyrazone/salbactam and doxycycline.
Journal of Clinical Research and Reports
Background: Coronavirus disease 2019 (COVID-19) has been threatening the world for more than 2 ye... more Background: Coronavirus disease 2019 (COVID-19) has been threatening the world for more than 2 years. Breakthrough COVID-19 infection has clinical and public health significance. The health care workers have been working in front line; thus, acquiring greatest risks. Their family members are also at high risk being close contact to them. This study aimed to assess the prevalence and the severity of breakthrough COVID-19 infection (BTI) in fourth wave among health care workers (HCW) and their family members, and the protective effect of C OVID-19 vaccine in Myanmar. Methods: A cross-sectional descriptive study was conducted among health care workers (HCW) and their family members who developed confirmed COVID-19 infection either by rapid test or PCR test at least 14 days after receiving COVID-19 vaccine during the fourth wave from January 2022 to May 2022. Data were collected by using standardized forms and analysis was done. Results: A total of 1013 participants were included in thi...
Journal of medicine and therapeutics, 2020