The North Okkalapa General Hospital is an affiliated teaching hospital of the University of Medicine 2, Yangon, located in North Okkalapa Township in the eastern part of Yangon, Myanmar.
Background:Donor selection strategies for allogeneic hematopoietic cell transplantation (HCT) have evolved with the increasing use of haploidentical transplantation. However, contemporary patterns of donor and stem cell source selection according to disease category in the Asia-Pacific (AP) region remain insufficiently characterized. Methods:Aggregated data from the APBMT Activity Survey 2022-2023 were analyzed to evaluate donor type and stem cell source distributions for allogeneic HCT. Donors were categorized as HLA-identical sibling, haploidentical (including other related donors), or unrelated donor. Stem cell sources were classified as bone marrow (BM), peripheral blood (PB), cord blood (CB), or mixed graft sources. Malignant and non-malignant diseases were compared, and disease-specific analyses were performed for acute myeloid leukemia, myelodysplastic syndrome/myeloproliferative neoplasms, severe aplastic anemia, and hemoglobinopathy. Sensitivity analyses excluding data from China were conducted. Results:Donor selection differed between malignant and non-malignant diseases, with haploidentical donors accounting for approximately 45%-60% of allogeneic HCTs, followed by unrelated donors (20%-30%) and HLA-identical sibling donors (15%-25%). Regarding stem cell source, PB was the predominant source across disease categories, accounting for approximately 60%-70% of allogeneic HCTs. BM accounted for approximately 5%-17% of transplants, with somewhat higher use in non-malignant diseases. CB accounted for approximately 10%-12% of transplants in malignant diseases and 3%-4% in non-malignant diseases. These patterns were consistent in disease-specific analyses; however, exclusion of China resulted in a relative decrease in haploidentical transplantation and an increase in unrelated donor use, particularly in malignant diseases, as well as a marked reduction in mixed graft sources with a corresponding increase in bone marrow use. Despite these shifts, the overall predominance of peripheral blood as the stem cell source and the disease-specific trends were maintained. Conclusions:Across AP region, donor and stem cell source selection for allogeneic HCT demonstrates modest but consistent disease-specific differences, reflecting adaptation of transplantation strategies to disease context in contemporary clinical practice.
OBJECTIVES:Staphylococcus aureus is one of the leading causes of nosocomial infections. This study aimed to clarify the recent trend of molecular epidemiological features of methicillin-resistant and susceptible S. aureus (MRSA/MSSA) isolates from a tertiary care hospital in Myanmar. METHODS:S. aureus clinical isolates from various specimens were genetically classified by the schemes of MLST and other genotypings. Antimicrobial resistance determinants and virulence factors were detected by uniplex/multiplex PCR, along with antimicrobial susceptibility testing by broth microdilution method. RESULTS:A total of 319 S. aureus (65 MRSA and 254 MSSA) and 7 S. argenteus isolates were collected during a 19 month-period (Sep. 2023 to Mar. 2025), with an MRSA rate of 20.4%. Panton-Valentine leukocidin (PVL) genes were detected in 30.4% of all the isolates, with almost similar rates in MRSA and MSSA. Among MRSA, ST6 (CC5) with SCCmec-IV (ST6-IV) was the most dominant (31%), followed by ST772 (CC1)-V, ST2885 (CC1)-IV, ST22 (CC22)-IV, and ST672 (CC361)-V. PVL-positive rate was highest in ST22 (75%) and ST121 (84%) among MRSA and MSSA, respectively. PVL-positive ST22 MRSA also harbored TSST-1 gene (ST22-PT clone). Characteristic virulence factors were detected in other MRSA clones; enterotoxin A (SEA) in ST6, exfoliative toxin A (ETA) in ST2885, and exfoliative toxin E (ETE) in ST2990. PVL-positive ST22 and ST772 MRSA showed multiple antimicrobial resistance harboring some resistance genes. MSSA isolates were differentiated into 33 STs, among which ST2990 (CC1) was the most common (24%), followed by ST121, ST1156 (CC12), ST6 (CC5) and ST1930 (CC96). All the S. argenteus were mecA-negative and belonged to ST2250. CONCLUSIONS:The present study revealed the recent clonal trend and change of MRSA/MSSA isolates in Myanmar, identifying some notable clones with characteristic virulence factors (ST6-SEA, ST22-PT, ST2885-ETA, and ST2990-ETE).
Craniopharyngiomas are benign sellar and suprasellar tumors that frequently cause visual field defects due to compression of the optic chiasm, which are usually considered permanent. We report a rare case of reversible visual field loss in a 29-year-old woman with a partially calcified craniopharyngioma. The patient presented with left temporal hemianopia on Humphrey visual field testing, despite normal visual acuity in both eyes. Neuroimaging revealed an old, partially calcified sellar and suprasellar mass consistent with craniopharyngioma. Review of prior medical records showed a similar episode of right temporal hemianopia two years earlier, which had resolved spontaneously. This case demonstrates that visual field defects associated with craniopharyngioma may be reversible, possibly due to reduced mass effect from tumor regression or calcification. Awareness of this potential for recovery is important when evaluating visual prognosis and planning long-term follow-up in patients with craniopharyngioma.
Antiemetic therapy is an essential component of supportive care following hematopoietic stem cell transplantation (HSCT). Chemotherapy and irradiation used in conditioning regimens frequently induce severe nausea and vomiting, which can significantly impair patients' quality of life. Although recent guidelines recommend a triple combination of a 5-hydroxytryptamine-3 (5-HT3) receptor antagonist, dexamethasone, and an neurokinin 1 (NK1) receptor antagonist, antiemetic practices vary widely across countries and regions. This study aimed to investigate current antiemetic policies among the Asia-Pacific Blood and Marrow Transplantation (APBMT) centers. A web-based questionnaire survey using SurveyMonkey was distributed via email from the APBMT office between December 7, 2021, and January 21, 2022. The survey addressed antiemetic strategies used in HSCT conditioning regimens. Responses were received from 28 centers across 14 countries. Among the participating centers, 93% reported that physicians were primarily responsible for antiemetic decision-making, with limited involvement from pharmacists or multidisciplinary teams. The most commonly used conditioning regimens for allogeneic HSCT were busulfan and cyclophosphamide (Bu-CY) (72%) and fludarabine and busulfan (Flu-Bu) (62%), whereas high-dose melphalan (83%) and carmustine (BCNU), etoposide, cytarabine arabinoside, and melphalan (BEAM) (69%) were predominant for autologous HSCT. Despite guidelines recommending olanzapine as an additional antiemetic in highly emetogenic chemotherapy, its routine implementation remains limited, even in high-risk settings. Notably, dexamethasone is frequently avoided in allogeneic HSCT, likely due to concerns about its immunosuppressive effects. The incidence of vomiting varied, with 36% of centers reporting rates of 10% or higher, even among those with institutional antiemetic policies. In conclusion, this survey highlighted substantial variation in antiemetic strategies across the APBMT centers. The limited use of olanzapine reflects ongoing concerns regarding its side effects, while the frequent avoidance of dexamethasone in allogeneic HSCT represents a deviation from current guideline recommendations. Given the complexity of HSCT and the varying side effect profiles of antiemetic agents, a multidisciplinary approach to treatment planning, including that of pharmacists and dietitians, could optimize supportive care. Future prospective studies are warranted to evaluate the safety, efficacy, and feasibility of olanzapine- and steroid-sparing antiemetic strategies to improve patient outcomes.
Background: Premature birth continues to be a major factor in perinatal illness and death worldwide. Inflammatory markers such as C-reactive protein (CRP) have been proposed as predictive biomarkers for preterm birth, yet their predictive utility remains inconclusive. This study aimed to assess the relationship between maternal serum CRP levels evaluated in advance before 22 weeks of gestation and the happenings of spontaneous preterm delivery. Methods: A prospective study conducted at Central Women’s Hospital, Yangon period between January to December in 2016. A total of 253 pregnant women with singleton pregnancies of less than 22 weeks’ gestation were recruited. Maternal serum CRP was measured at enrollment. Women were followed up until delivery. Exclusion criteria included previous preterm delivery, pre-existing medical conditions, obstetric complications, and later development of systemic infection. Final analysis was conducted on 234 participants. Statistical analysis included chi-square and Fisher's exact test, with significance set at p < 0.05. Results: The overall preterm delivery rate was found to be 3.4% (n = 8). CRP levels > 4 mg/L were observed in 75% of those who delivered preterm. However, when analyzed using a cut-off value of > 6 mg/L, the association between elevated CRP and preterm delivery did not reach statistical significance (p = 0.087). Conclusion: High level of maternal serum CRP levels in early pregnancy not evidenced significant association with spontaneous preterm delivery in this cohort. CRP may not serve as a reliable standalone biomarker for predicting preterm birth, underscoring the need for further large-scale studies incorporating multiple markers.
