Transdiaphragmatic intercostal hernia (TDIH) is a rare condition involving simultaneous disruption of the diaphragm and intercostal muscles, allowing abdominal organs to herniate into the chest wall. It is usually traumatic and spontaneous cases are uncommon and can be easily overlooked. We report the case of a man in his late 60s with six years of progressive right chest wall swelling and recent vomiting and breathlessness. Initial imaging was misinterpreted as pleural effusion, but a computed tomography confirmed a five cm diaphragmatic defect with bowel herniation through the 7th –8th intercostal space. Prompt recognition is vital, as delayed diagnosis may lead to bowel obstruction, strangulation, and life -threatening complications

Transdiaphragmatic intercostal hernia (TDIH) is a rare condition involving simultaneous disruption of the diaphragm and intercostal muscles, allowing abdominal organs to herniate into the chest wall. It is usually traumatic and spontaneous cases are uncommon and can be easily overlooked. We report the case of a man in his late 60s with six years of progressive right chest wall swelling and recent vomiting and breathlessness. Initial imaging was misinterpreted as pleural effusion, but a computed tomography confirmed a five cm diaphragmatic defect with bowel herniation through the 7th –8th intercostal space. Prompt recognition is vital, as delayed diagnosis may lead to bowel obstruction, strangulation, and life -threatening complications

BACKGROUND: Particulate matter (PM) is recognized as the most harmful air pollutant to the human health. The Yangon city indeed suffers much from PM-related air pollution. Recent research has interestingly been focused on the novel subject of changes in the air quality associated with the restrictive measures in place during the current coronavirus disease-2019 (COVID-19) pandemic. The first case of COVID-19 in Myanmar was diagnosed on March 23, 2020. In this article, we report on our attempt to evaluate any effects of the COVID-19-restrictive measures on the ambient PM pollution in Yangon. METHODS: We measured the PM concentrations every second for 1 week on four occasions at three study sites with different characteristics; the first occasion was before the start of the COVID-19 pandemic and the remaining three occasions were while the COVID-19-restrictive measures were in place, including Stay-At-Home and Work-From-Home orders. The Pocket PM RESULTS: The results showed that there was a significant reduction (P < 0.001) in both the PM CONCLUSIONS We concluded that the restrictive measures which were in effect to combat the COVID-19 pandemic had a positive impact on the ambient PM concentrations. The changes in the PM concentrations are considered to be largely attributable to reduction in anthropogenic emissions as a result of the restrictive measures, although seasonal influences could also have contributed in part. Thus, frequent, once- or twice-weekly Stay-At-Home or Telework campaigns, may be feasible measures to reduce PM-related air pollution. When devising such an action plan, it would be essential to raise the awareness of public about the health risks associated with air pollution and create a social environment in which Telework can be carried out, in order to ensure active compliance by the citizens.
Air Pollution/analysis* ; COVID-19/epidemiology* ; Humans ; Myanmar/epidemiology* ; Pandemics ; Particulate Matter/analysis* ; SARS-CoV-2

Objective: To understand the pattern and burden of neurological disorders at Department of Neurology, Yangon General Hospital (YGH), Myanmar. Method: All patients admitted to Department of Neurology had been prospectively registered and then analyses were performed on one year data from 1st January to 31st December 2019. Results: Among study population of total 17606 cases, 65.5% attended to neurology out-patient clinics, 20.1% were seen as referral cases and 14.4% were inpatients at neurology ward. When analyzed the inpatients, 58% were male. Mean age was 47.2 ±19.1 years and 41-65 year age group was most commonly affected. The most common inpatient neurological diseases were cerebrovascular diseases (CVD)(40.8%), central nervous system (CNS) infections (15.2%) and peripheral nerve lesions (9.4%). Autoimmune diseases and headache disorders were more common in women. Mortality rate in inpatients was 4.6%, among which stroke occupied for 55.1% and CNS infection was 23.7%. Three most common neurological diseases in out-patient clinic were seizure disorders (21.9%), CVD (20.7%) and headache disorders (11.2%). Among the referral cases, 43.7% were CVD, 17.8% were CNS infections and 11% had seizures disorders. The most referred patients (93.3%) came from general medical wards. Conclusions: Entire range of neurological disorders was present in YGH. CVD and CNS infections were the most common cause of incidence as well as the mortality. Knowing the burden can raise the awareness about it and point out the prioritizing provision of essential health services. As similar in controlling the communicable diseases, the importance of health education, preventive measures on non-communicable disorders should be considered as national concern.

BACKGROUND: Constrictive pericarditis is an uncommon condition that could be easily confused with congestive heart failure. In symptomatic patients, septal "wobble" on echocardiography may be an important sign of constrictive physiology. This study was planned to investigate the effects of constriction on septal motion as identified by echocardiography. METHODS: In this retrospective observational study, nine consecutive patients with constriction underwent careful echocardiographic analysis of the interventricular septum (IVS) with slow motion 2-dimensional echocardiography and inspiratory manoeuvres. Six patients who had undergone cardiac magnetic resonance imaging underwent similar analysis. Findings were correlated with haemodynamic data in five patients who had undergone cardiac catheterisation studies. RESULTS: In mild cases of constriction a single wobble of the IVS was seen during normal respiration. In more moderate cases a double motion of the septum (termed "double wobble") was seen where the septum bowed initially into the left ventricle (LV) cavity in diastole then relaxed to the middle only to deviate again into the LV cavity late in diastole after atrial contraction. In severe cases, the septum bowed into the LV cavity for the full duration of diastole (pan-diastolic motion). We describe how inspiration also helped to characterize the severity of constriction especially in mild to moderate cases. CONCLUSION: Echocardiography appears a simple tool to help diagnose constriction and grade its severity. Larger studies are needed to confirm whether the type of wobble motions helps to grade the severity of constrictive pericarditis.
Classification* ; Constriction ; Diastole ; Echocardiography* ; Heart Failure ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Observational Study ; Pericarditis, Constrictive* ; Physiology ; Respiration ; Retrospective Studies