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The population of Myanmar comprises 8 major indigenous races (Bamar, Kayin, Kachin, Shan, Rakhine, Mon, Chin, and Kayah). The Bamar reside in the 7 central divisions of the country, and the others reside in the 7 peripheral states that border neighboring countries, including China, Laos, and Thailand in the east and India and Bangladesh in the west. Both malaria and HbE are endemic in Myanmar, although the actual prevalence of the latter in the different indigenous races is not yet known. Hemoglobin electrophoresis was performed in 4 malaria-endemic villages, each having a different predominating indigenous race. The overall prevalence of HbE was 11.4% (52/456 villagers), ranging from 2-6% in the Kayin-predominant villages to 13.1-24.4% in the Bamar-predominant villages. Although the overall HbE prevalence in the villages studied was not significantly different from that of the general Myanmar population, this study strongly documented the influence of racial differences on the prevalence of HbE in Myanmar. To prevent and control severe thalassemia syndromes in Myanmar, extensive prevalence studies of the country?s indigenous races are suggested.

A very rare case of echinococcus cysts of the heart and brain in a 27ﾝyear-old man who worked as a butcher, lived on a farm, and had a dog before disease onset. The initial manifestation of hydatid disease was anaphylactic shock, the etiology of which remained unknown on initial hospitalization. On rehospitalization, the diagnosis of cardiac hydatidosis was made and the patient underwent surgery. Two years later, reoperation was required for hydatid cyst of the brain and cardiac cyst recurrence. There was no other organ involvement from the disease onset, which is rarely reported. Based on this case, we suggest that echocardiography be performed as a standard method in the diagnosis of anaphylactic reaction of obscure etiology in the areas endemic for hydatidosis, even in the absence of symptoms indicative of cardiac involvement. This especially applies to individuals with occupational or epidemiological exposure to the infection.

Deficiency of glucose-6-phosphate dehydrogenase (G6PD) causes acute hemolytic anemia triggered by oxidative drugs such as primaquine. It is therefore essential in malaria-endemic areas for malaria patients to be confirmed for their G6PD activity before taking primaquine. The WST-8 method, a newly established screening method for G6PD deficiency, has been demonstrated to be suitable for field conditions, particularly for on-site malaria surveys. Here we report a laboratory evaluation by this method of the reactivity of blood-spotted filters. A time-course experiment was conducted to evaluate the reactivity of blood samples spotted onto 4 types of filter paper, Whatman 31ET Chr (ET), 3MM Chr (3MM), P81, and Advantec No. 2 (AD2). The rank of the relative reaction intensity was ET > 3MM = AD2 > P81. Blood-spotted filters stored at 4 degrees centigrade gradually decreased G6PD reactivity with the passage of storage time, whereas those stored at room temperature rapidly reduced their reactivity. Unexpectedly, saponin supplementation reduced the reactivity of blood-spotted filters. In conclusion, 1) ET is the most suitable filter for the WST-8 method ; 2) blood-spotted filters stored in cold condition can be assayed within 14 days, or those stored at room temperature should be tested within 3 days ; and 3) reaction mixtures should not contain saponin.

Histopathological investigations were carried out on five fatal cases of a type of polyneuritis of unknown etiology diagnosed as Landry-Guillain-Barre syndrome, which endemically occurred in children in the regions surrounding the Inland Sea of Japan. The most characteristic pathologic feature in the nervous system was pronounced patchy degenerative changes with slight or moderate degree of inflammatory cell response of focal type in the peripheral and cranial nerves, predominantly in the nerve fibers of the spinal and cranial roots. In the spinal cord, medulla, pons, and in some portions of the cerebrum and cerebellum, engorgement of the small blood vessels as well as edema and the less predominant scattered degenerative changes of ganglioncells and nerve fibers with extremely slight degree of glial response and sparse perivascular cell collections were encountered. The cerebrospinal meninges displayed edema and congestion of the pial blood vessels with focal collections of a small number of lymphocytes and/or monocytes. No advanced involvement of the anterior horn of the spinal cord in a strict sense of anterior poliomyelitis was, however, recognized. These changes may lead the histopathologic diagnosis of the present disease to infectious encephalomyelo-polyradiculoneuritis or a type of infectious polyneuritis. The main histopathologic changes in the visceral organs were a moderate degree of engorgement of the small blood vessels, degeneration of parencymatous organs such as the liver and kidney, hyperplasia or follicular atrophy of the lymphatic tissues, interalveolar pneumonia, focal myositis, and slight degree of round cell infiltrations in the interstitial tissues of the other viscera, such as the liver, heart, and gastrointestinal canal. Based upon the observations on the histopathological changes as well as clinical manifestations, discussions were made on the pathogenesis and etiologic factor of the present endemic disease with critique on the literatures.