Myanmar

Objectives: To investigate the association between the single nucleotide polymorphism (SNP) rs7903146 in the transcription factor 7-like 2 (TCF7L2) gene and type 2 diabetes mellitus (T2DM) and to examine the impact of this variant on pancreatic beta-cell function in the Myanmar population. Methodology: A case-control study was undertaken in 100 subjects with T2DM and 113 controls. The SNP rs7903146 was genotyped using the allele-specific polymerase chain reaction method. Plasma glucose and serum insulin levels were determined using the enzymatic colorimetric method and ELISA respectively. Beta-cell function was calculated by the HOMA-β formula. Results: The frequencies of carrier genotypes (CT and TT) were higher in subjects with T2DM than in controls. The minor T alleles of rs7903146 were found to statistically increase type 2 diabetes risk than the C allele with an allelic odds ratio of 2.07 (95% CI 1.39-3.09, p=0.0004). The mean HOMA-β level of the group with non-carrier genotype (CC) was significantly higher than that of the groups with carrier genotypes (CT and TT) in subjects with T2DM and controls with a p-value of 0.0003 and less than 0.0001, respectively. Conclusion The rs7903146 variant of the TCF7L2 gene was found to be associated with T2DM and low β-cell function among Myanmar subjects.
TCF7L2 ; Myanmar

Cardiovascular disease is a significant cause of morbidity and mortality in patients with diabetes mellitus (DM). According to the IDF Diabetes Atlas 2013, the prevalence of diabetes in Myanmar is 5.7%.(1) Diabetes is recognized as a risk equivalent for coronary heart disease. The lipid profile in patients with type 2 DM is characterized by elevated triglycerides, low high-density lipoprotein cholesterol and raised small dense low-density lipoprotein cholesterol (LDL-C) particles. This is believed to be a key factor in promoting atherosclerosis in these patients. There is ample evidence that aggressive statin therapy reduces cardiovascular end points in patients with DM in both primary and secondary prevention studies. In all persons with DM, current treatment guidelines recommend reduction of LDLC to less than 100 mg/dL, regardless of baseline lipid levels. In very high risk patients with DM and coronary heart disease lowering of LDL-C to less than 70 mg/dL may provide even greater benefits. Treatment for hypertriglyceridaemia is recommended only if TG levels is very high (>500 mg/dL).
Myanmar ; Practice Guideline

ASEAN Neurology Association (ASNA) consists of 9 member countries, Brunei, Indonesia, Lao, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam. Among them 2 countries are considered lower middle income, 4 as upper middle income, and 3 as high income by World Bank criteria. The life expectancy is above 75 years in Brunei and Singapore, below 60 years in Lao and Myanmar. There are a total of 1,871 neurologists in ASNA member countries which has a total of 540 million populations. This constitutes 2.2% of the world neurologists, although ASNA member countries accounts for 8.3% of the world population. Myanmar and Lao in particular, has lowest ratio of neurologist, with one neurologist serving 5 million populations in Myanmar, and 2 million populations in Lao.
Myanmar ; member ; Neurology ; Income ; Neurologist

Neurological services in Myanmar began in 1969 in the Yangon General Hospital. Presently the country has 10 neurologists and 13 neurosurgeons serving the 54 million populations in 4 neurological centers. The ratio of population per neurologist is 5.4 million. All of the centers have CT scan, 2 have MRI and EEG, and one has electromyography. The pattern of neurological diseases is largely similar to elsewhere, with stroke, epilepsy and headache as the main illnesses treated. There is a training program for neurologists in the Yangon General Hospital. The Myanmar Neurology Society was founded in 2000. It is affiliated to World Federation of Neurology and ASEAN Neurological Association.
Myanmar ; seconds ; Neurologic ; Neurology ; Hospitals, General

The aims of the Myanmar CPG for Diabetes in Pregnancy were to provide a framework to assist healthcare professionals in the management of diabetes in pregnancy and to aid primary care physicians in referrals to specialists, when necessary, in an appropriate manner. This article summarizes clinical practice guidelines developed for assisting Myanmar healthcare providers (physicians, endocrinologists, obstetricians, general practitioners) to better diagnose and effectively manage diabetes in pregnancy. It recommends a multidisciplinary approach in the management of diabetes in pregnancy in Myanmar.
Diabetes, Gestational ; Pregnancy ; Practice Guideline ; Myanmar

Objective: The aim of the study was to evaluate the beta cell function, insulin sensitivity and low grade systemic inflammation in different categories of glucose tolerance in Myanmar. Methodology: A cross-sectional study was conducted on 202 Myanmar subjects of both sexes, aged between 45-65 years old. Fasting blood glucose, insulin, C-peptide and hs-CRP levels were measured. A 75g oral glucose tolerance test was performed. Insulin resistance and beta cell function were assessed by homeostasis-model-assessment (HOMA). Results: The subjects were categorized as normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus (DM) according to WHO-2006 criteria. Fasting serum insulin, C-peptide and hs-CRP levels and insulin resistance index (HOMA-IR) progressively increased from NGT through prediabetes (IFG, IGT) to DM (p<0.01). Beta-cell function did not change significantly in any other group as compared to normal group. Conclusion After multivariate analysis, increases in fasting C-peptide, hs-CRP and HOMA-IR index were significantly associated with diabetes. It was also found that insulin resistance was a predominant feature in deterioration of the glucose tolerance in Myanmar subjects.
Diabetes Mellitus ; Insulin Resistance ; Glucose Intolerance ; Myanmar

Peripheral artery disease (PAD) broadly encompasses vascular diseases caused primarily by atherosclerosis and thromboembolic pathophysiologic processes that alter the normal structure and function of the aorta, its visceral arterial branches, and the arteries of the lower extremity. The aims of the Myanmar clinical practice guidelines for the management of patients with PAD are to assist physicians in selecting the best management strategies for an individual patient with peripheral artery disease with main focus on lower extremity artery disease (LEAD) due to atherosclerosis, to help the physician to make decisions in their daily practice, and to aid in appropriate referrals to specialists. Early detection and treatment guidelines for the treatment of PAD are important to reduce the morbidity and mortality of patients with vascular problems in Myanmar.
Peripheral Arterial Disease ; Practice Guideline ; Myanmar

BACKGROUND: Tuberculosis (TB) is one of the most serious health problems in Myanmar. Because TB drug resistance is associated with genetic mutation(s) relevant to responses to each drug, genotypic methods for detecting these mutations have been proposed to overcome the limitations of classic phenotypic drug susceptibility testing (DST). We explored the current estimates of drug-resistant TB and evaluated the usefulness of genotypic DST in Myanmar. METHODS: We determined the drug susceptibility of Mycobacterium tuberculosis isolated from sputum smear-positive patients with newly diagnosed pulmonary TB at two main TB centers in Myanmar during 2013 by using conventional phenotypic DST and the GenoType MTBDRplus assay (Hain Lifescience, Germany). Discrepant results were confirmed by sequencing the genes relevant to each type of resistance (rpoB for rifampicin; katG and inhA for isoniazid). RESULTS: Of 191 isolates, phenotypic DST showed that 27.7% (n=53) were resistant to at least one first-line drug and 20.9% (n=40) were resistant to two or more, including 18.3% (n=35) multidrug-resistant TB (MDR-TB) strains. Monoresistant strains accounted for 6.8% (n=13) of the samples. Genotypic assay of 189 isolates showed 17.5% (n=33) MDR-TB and 5.3% (n=10) isoniazid-monoresistant strains. Genotypic susceptibility results were 99.5% (n=188) concordant and agreed almost perfectly with phenotypic DST (kappa=0.99; 95% confidence interval 0.96-1.01). CONCLUSIONS: The results highlight the burden of TB drug resistance and prove the usefulness of the genotypic DST in Myanmar.
Drug Resistance* ; Genotype ; Humans ; Myanmar* ; Mycobacterium tuberculosis* ; Rifampin ; Sputum ; Tuberculosis

Malaria, tuberculosis, and hepatitis are common and notorious infectious diseases in Myanmar. Despite intensive efforts to control these diseases, their prevalence remains high. For malaria, which is a vector-borne disease, a remarkable success in the reduction of new cases has been achieved. However, the annual number of tuberculosis cases has increased over the last few decades, and the prevalence of chronic viral hepatitis infection has been high in Myanmar and other nearby countries. Early detection and prompt treatment are crucial to control these diseases. We have devoted our research efforts to understanding the status of these infectious diseases and working towards their eventual elimination for the last four years with the support of the Korea International Cooperation Agency. In the modern era, an infection that develops in one geographical area can spread globally because national borders do not effectively limit disease transmission. Our efforts to understand the status of infectious diseases in Myanmar will benefit not only Myanmar but also neighboring countries such as Korea.
Communicable Diseases ; Hepatitis* ; International Cooperation ; Korea ; Malaria* ; Myanmar* ; Prevalence ; Tuberculosis*