Objective: to determine the distribution of various idiopathic inflammatory center dot myopathies (IIM) and their profile at the largest university hospitals in Yangon, Myanmar. Method: It was a hospital based prospective study recruiting IIM patients admitted to Neurology and Rheumatology ward over a 1.5 year period from September 2017 to February 2019. Results: Among total 51 IIM patients recruited, 62.7% presented to Neurology ward and 373% to Rheumatology ward. Overlap myositis (OM) was the commonest (43%), followed by immune-mediated necrotizing myopathy (IMNM) 27%, dermatomyositis (DM) 24%, polymyositis (PM) 6%. Among OM, anti-synthetase syndrome (ASS) was 23%, and among IMNM, anti-SRP positive was 79%. IMNM and PM patients presented more to neurologists while OM/ASS and DM more to rheumatologists; 82% were females (F:M= 4.6:1). Mean age of onset of myositis was 40.2 +/- 17.8 years, and duration of symptoms before presentation was 10-3,600 days (shortest in anti-SRP and longest in anti-ILMGCR myopathy). Myositis antibodies were positive in 67%. CK range was 40-25,690 U/l, highest in INLNM and lowest in DM. Associated connective tissue diseases among OM in order of descending frequency were 47% systemic lupus erythematosus, 24% Sjogren syndrome, 41% scleroderma and 12% rheumatoid arthritis. Associated cancer identified were one lung cancer in DM, one breast cancer in OM, one buccal cancer in IMNM cases. Conclusions: With recent availability of myositis antibody panel and MHC staining in Myanmar, we have applied current updated classification to describe the first Myanmar data on IIM cases.

INTRODUCTION:Factors predictive for death from snake envenomation vary between studies, possibly due to variation in host genetic factors and venom composition. This study aimed to evaluate predictive factors for death from snake envenomation in Myanmar. METHODS:A prospective study was performed among adult patients with snakebite admitted to tertiary hospitals in Yangon, Myanmar, from May 2015 to August 2016. Data including clinical variables and laboratory parameters, management, and outcomes were evaluated. Multivariate regression analysis was performed to evaluate factors predictive for death at the time of presentation to the hospital. RESULTS:Of the 246 patients with snake envenomation recruited into the study, 225 (92%) survived and 21 (8%) died during hospitalization. The snake species responsible for a bite was identified in 74 (30%) of the patients; the majority of bites were from Russell's vipers (63 patients, 85%). The independent factors predictive for death included 1) duration from bite to arrival at the hospital >1 h (odds ratio [OR]: 9.0, 95% confidence interval [CI]: 1.1-75.2; P=0.04); 2) white blood cell counts >20 ×103 cells·μL-1 (OR: 8.9, 95% CI: 2.3-33.7; P=0.001); and 3) the presence of capillary leakage (OR: 3.7, 95% CI: 1.2-11.2; P=0.02). A delay in antivenom administration >4 h increases risk of death (11/21 deaths). CONCLUSIONS:Patients who present with these independent predictive factors should be recognized and provided with early appropriate intervention to reduce the mortality rate among adults with snake envenomation in Myanmar.

Snakebite-related acute kidney injury (AKI) is a common community-acquired AKI in tropical countries leading to death and disability. The aims of this study were to (1) determine the occurrence of snakebite-related AKI, (2) assess factors at presentation that are associated with snakebite-related AKI, and (3) determine the outcomes of patients with snakebite-related AKI.

The World Federation of Medical Education encourages the teaching of generic skills including communication skills, together with technical skill training in medical schools. Medical Universities in Myanmar started teaching communication skills as a formal content in the curriculum five years ago. But it was included in the assessment as an Objectively Structured Clinical Examination (OSCE) station, starting only from 2012. The underlying philosophy is that improving the communication between doctor and patient will improve the ability to gather the information needed to solve the problems of a particular patient and in presenting the formulated problem list and management plan. The aim of this study is to determine the pass rate of the Communication Skills (CS) station and association between communication skills score and Objectively Structured Long-case Assessment Record (OSLAR) score. It was a retrospective cross-sectional descriptive study analyzing the scores of the last three completion tests of 363 final-year medical students, in University of Medicine 2, in Yangon, Myanmar. In the communication skills station, 290 out of 363 (79.9%) passed. For OSLAR, the pass rate was 288 out of 363 (79.3%), and for OSCE it was 279 out of 363 (76.9%). There was a significant association between passing communication skills and OSLAR ( ? 2 = 10.2, p = .001). Especially, there was correlation between the history taking part of OSLAR scores and CS scores ( r = .257, p = 0.000). To test whether it was because of the phenomenon that good students will pass whatever station it is and poor students will fail, association between communication skills score and OSCE (the station where the students do not need to speak and are tested for manual skills only) was analyzed. There was no association between those two skill stations.