Updated on 2024/10/07

写真a

 
KARIYA Tetsuyoshi
 
Organization
Nagoya University Hospital Lecturer of hospital
Title
Lecturer of hospital
Contact information
メールアドレス
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Degree 1

  1. Doctor of Philosophy (Medical Science) ( 2018.1   Nagoya University ) 

Research Interests 3

  1. Internal medicine, Nephrology

  2. Healthcare Administration

  3. Nephrology

Research Areas 1

  1. Life Science / Nephrology

Research History 6

  1. Tokai National Higher Education and Research System, Nagoya University   Nagoya University Hospital, Hospital Strategy Office / Department of Nephrology, Graduate School of Medicine   Clinical Lecturer

    2023.10

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  2. National Health Policy Secretariat, Cabinet Office   Deputy Director

    2022.4 - 2023.9

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    Country:Japan

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  3. Ministry of Health, Labour and Welfare   Intractable/Rare Disease Control Division, Health Service Bureau   Assistant Director

    2021.3 - 2022.3

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    Country:Japan

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  4. Nagoya University   Asian Satellite Campuses Institute Division2   Designated assistant professor

    2018.10 - 2021.2

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  5. Nagoya University   Graduate School of Medicine Center for Research of Laboratory Animals and Medical Research Engineering Division   Designated assistant professor

    2018.4 - 2018.9

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  6. Nagoya University   Graduate School of Medicine Program in Integrated Medicine Social Life Science   Designated assistant professor

    2017.4 - 2018.3

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Education 3

  1. Nagoya University Graduate School of Medicine   Integrated Medicine

    2013.4 - 2017.3

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    Country: Japan

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  2. Nagoya City University   Faculty of Medicine

    2001.4 - 2007.3

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    Country: Japan

  3. Nagoya University   School of Agricultural Sciences

    1994.4 - 1998.3

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    Country: Japan

Professional Memberships 5

  1. The Japanese Society of Internal Medicine

  2. Japanese Society for Nephrology

  3. The Japanese Society for Dialysis Therapy

  4. The Japan Diabetes Society

  5. Japan College of Rheumatology

Awards 1

  1. Young Investigator Award

    2016.9   Japanese Society for Peritoneal Dialysis  

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    Award type:Award from Japanese society, conference, symposium, etc.  Country:Japan

 

Papers 50

  1. Characteristics of adverse drug reactions due to nonsteroidal anti-inflammatory drugs: a cross-sectional study. Reviewed

    Cholticha Sonsupap, Pattreya Pokhakul, Tetsuyoshi Kariya, Yunosuke Suzuki, Nobuyuki Hamajima, Eiko Yamamoto

    Nagoya journal of medical science   Vol. 85 ( 4 ) page: 668 - 681   2023.11

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    Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for treating pain and inflammation. Spontaneous adverse drug reaction (ADR) reports represent a rich data source for the detection of unknown and rare ADRs. This cross-sectional study aimed to analyze the characteristics of ADRs due to NSAIDs in Thailand. All ADR reports of NSAIDs for systemic use from 2015 to 2019 were extracted from the national database in Thailand. Patient characteristics, drug use information, adverse event information, and source of senders in 32,857 reports were analyzed. The annual number of ADR reports due to NSAIDs decreased from 7,008 in 2015 to 5,922 in 2019. The most frequently reported drug was ibuprofen (n=12,645, 38.5%) followed by diclofenac (n=7,795, 23.7%), most patients were 40-59 years old, and the major adverse reaction was angioedema (n=7,513, 22.9%). Serious reactions were recorded in 20.7% (n=6,801) of the total ADRs. Most patients (n=20,593, 62.7%) recovered without sequelae, but there were 5,420 patients (16.5%) who could not recover and 3,109 patients (9.5%) who were recovering. Eight patients (0.02%) died of Stevens-Johnson syndrome (n=3), toxic epidermal necrolysis (n=4), and anaphylactic shock (n=1), which were possibly related to ADRs. The number of ADR reports due to NSAIDs decreased from 2015 to 2019 in Thailand. Serious ADRs and death cases accounted for 20.7% and 0.02%, respectively. Most fatal cases exhibited severe drug-induced skin reactions.

    DOI: 10.18999/nagjms.85.4.668

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  2. Inhibition of Transglutaminase 2 Reduces Peritoneal Injury in a Chlorhexidine-Induced Peritoneal Fibrosis Model. Reviewed International journal

    Shunnosuke Kunoki, Hideki Tatsukawa, Yukinao Sakai, Hiroshi Kinashi, Tetsuyoshi Kariya, Yasuhiro Suzuki, Masashi Mizuno, Makoto Yamaguchi, Hiroyuki Sasakura, Masashi Ikeno, Kosei Takeuchi, Takuji Ishimoto, Kiyotaka Hitomi, Yasuhiko Ito

    Laboratory investigation; a journal of technical methods and pathology   Vol. 103 ( 4 ) page: 100050 - 100050   2023.4

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    Long-term peritoneal dialysis (PD) is often associated with peritoneal dysfunction leading to withdrawal from PD. The characteristic pathologic features of peritoneal dysfunction are widely attributed to peritoneal fibrosis and angiogenesis. The detailed mechanisms remain unclear, and treatment targets in clinical settings have yet to be identified. We investigated transglutaminase 2 (TG2) as a possible novel therapeutic target for peritoneal injury. TG2 and fibrosis, inflammation, and angiogenesis were investigated in a chlorhexidine gluconate (CG)-induced model of peritoneal inflammation and fibrosis, representing a noninfectious model of PD-related peritonitis. Transforming growth factor (TGF)-β type I receptor (TGFβR-I) inhibitor and TG2-knockout mice were used for TGF-β and TG2 inhibition studies, respectively. Double immunostaining was performed to identify cells expressing TG2 and endothelial-mesenchymal transition (EndMT). In the rat CG model of peritoneal fibrosis, in situ TG2 activity and protein expression increased during the development of peritoneal fibrosis, as well as increases in peritoneal thickness and numbers of blood vessels and macrophages. TGFβR-I inhibitor suppressed TG2 activity and protein expression, as well as peritoneal fibrosis and angiogenesis. TGF-β1 expression, peritoneal fibrosis, and angiogenesis were suppressed in TG2-knockout mice. TG2 activity was detected by α-smooth muscle actin-positive myofibroblasts, CD31-positive endothelial cells, and ED-1-positive macrophages. CD31-positive endothelial cells in the CG model were α-smooth muscle actin-positive, vimentin-positive, and vascular endothelial-cadherin-negative, suggesting EndMT. In the CG model, EndMT was suppressed in TG2-knockout mice. TG2 was involved in the interactive regulation of TGF-β. As inhibition of TG2 reduced peritoneal fibrosis, angiogenesis, and inflammation associated with TGF-β and vascular endothelial growth factor-A suppression, TG2 may provide a new therapeutic target for ameliorating peritoneal injuries in PD.

    DOI: 10.1016/j.labinv.2022.100050

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  3. Reporting system on mortality statistics in Lao People's Democratic Republic. Reviewed

    Souphalak Inthaphatha, Viengsakhone Louangpradith, Bounfeng Phoummalaysith, Bounbouly Thanavanh, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima

    Nagoya journal of medical science   Vol. 85 ( 1 ) page: 113 - 122   2023.2

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    The system to collect information on mortality statistics in Lao PDR is not well established, accurate and timely death information is therefore not available. This article reports the system and process to make the mortality statistical data of Lao PDR. The country has a paper-based resident registration system, using a death notification document, a death certificate, and a family census book. The death notification document is important as it provides the cause of death, which is issued from a health facility and the village office. In the event of a death occurring at home, the family representative needs to report to the village office verbally to obtain a death notification document. On the other hand, if the death occurred in a medical facility, a death notification document from a health facility is provided. The family representative should bring the death notification document to the district Home Affairs office to register the death and obtain a death certificate. After that, the family representative needs to bring the death certificate to the district Public Security office for an amendment in the family census book. ICD-10 is under development regarding death notification from health facilities under the Ministry of Health. However, it is unclear how death notification from village offices can adopt ICD-10 as the majority of deaths occur outside health facilities. A comprehensive and integrated mortality reporting system is necessary in order to create a holistic health policy and welfare for the country.

    DOI: 10.18999/nagjms.85.1.113

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  4. Children with neuro-developmental disorders at Center for Child and Adolescent Mental Health in Cambodia. Reviewed

    Sreyleap Moeun, Jegannathan Bhoomikumar, Puthy Pat, Tetsuyoshi Kariya, Yunosuke Suzuki, Nobuyuki Hamajima, Dearozet Sok, Eiko Yamamoto

    Nagoya journal of medical science   Vol. 84 ( 3 ) page: 593 - 606   2022.8

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    The Center for Child and Adolescent Mental Health (CCAMH) is one of the centers that have psychiatric specialists for children in Cambodia. This study aims to understand the characteristics of children with neuro-developmental disorders, especially autism spectrum disorder (ASD), at CCAMH. This study included 440 cases that were randomly chosen from 2,147 new patients at CCAMH in 2018-2019 and were aged 0-12 years. Socio-demographic factors, parent's information, obstetrical factors, and clinical data were collected from patients' records. A logistic regression analysis and Pearson's chi-square test were used to compare the characteristics between children who were finally diagnosed with ASD and the others (non-ASD). Of the 440 patients, most were male (75.2%), 0-4 years old (57.7%), and diagnosed with ASD (50.0%). Common symptoms were delay of speech, playing alone, and hyperactivity. ASD was significantly more prevalent in male patients compared to females and in the 0-4 years age group compared to the 5-12 years age group. Parents who lived in Phnom Penh and had high education were more likely to visit the CCAMH with their children who were diagnosed with ASD. Regarding treatment, approximately half of all 440 patients had family counselling and psychosocial education. ASD patients had more speech therapy, special education and structured teaching, and networking and coordination therapy compared to non-ASD patients. To provide education and therapy to children with ASD and their parents from the early stage, information about the center and ASD should be widely distributed to all parents in Cambodia.

    DOI: 10.18999/nagjms.84.3.593

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  5. Satisfaction With Health Care Services at the Pediatric Specialist Clinic of the National Referral Center in Malaysia: Cross-sectional Study of Caregivers' Perspectives. Reviewed International journal

    Thinakaran M Selvarajah, Eiko Yamamoto, Yu Mon Saw, Tetsuyoshi Kariya, Nobuyuki Hamajima

    JMIRx med   Vol. 3 ( 2 ) page: e33025   2022.5

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    BACKGROUND: The concept of customer satisfaction is gaining hold in all corporate sectors worldwide, and a satisfaction survey is used as a tool to discover service problems and as a chance for customers to rate their experience with health care services. A high degree of patient satisfaction with the services given has been found in numerous studies conducted in Malaysian public health care facilities. However, there is limited information available on caregiver satisfaction with pediatric clinics run by the Ministry of Health (MoH) of Malaysia. OBJECTIVE: This was the first research performed at a public hospital's pediatric clinic, which was the first hospital to adopt the public-private-partnership model under the MoH, with the aim of discovering the prevalence and factors affecting the satisfaction of caregivers at the national referral center. METHODS: Cross-sectional research using the standard self-administered SERVQUAL questionnaire was conducted among caregivers accompanying their children to the clinic. The questionnaire consists of 16 paired statements to evaluate their expectations and experiences with the clinic services. RESULTS: A total of 459 caregivers were involved in this study with a majority aged between 30 and 39 years (n=254, 55.4%). Caregivers from the Indian community (adjusted odds ratio [AOR] 2.91, 95% CI 1.37-6.18) and lower income groups (AOR 2.94, 95% CI 1.87-4.64), and those with lower educational backgrounds (AOR 3.58, 95% CI 1.19-10.72) were more likely to be satisfied with the quality of pediatric clinic services. Housewives/househusbands (AOR 0.48, 95% CI 0.25-0.90), on the other hand, appeared less likely to be satisfied with the services provided during their visit to the clinic. Looking at overall patient satisfaction, 50.5% (n=232) of caregivers demonstrated satisfaction with the quality of services, compared to 49.5% (n=227) of dissatisfied respondents. CONCLUSIONS: This paper suggests that, although most caregivers are satisfied with the services, greater emphasis must be placed on delivering reliable service in response to the MoH's mission to provide quality and integrated people-centered health services in Malaysia.

    DOI: 10.2196/33025

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  6. Development of a Vietnamese version of the Revised Hasegawa's Dementia scale. Reviewed

    Thi Phuong Tran, Duy Cuong Nguyen, Thi Van Quy Dang, Thi Khuyen Tran, Phong Tuc Vu, Minh Hoang Vu, Thu Hang Le, Thu Nandar Saw, Su Myat Cho, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima, Yu Mon Saw

    Nagoya journal of medical science   Vol. 84 ( 2 ) page: 402 - 417   2022.5

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    As the aging population grows worldwide, the problem of age-related health is becoming an important public health concern. Dementia is a devastating disease that places a significant physical, emotional, and financial burden on patients, their caregivers, and society. It is predicted to increase in developing countries. The Revised Hasegawa's Dementia Scale (HDS-R) has been used in many Asian countries to measure cognitive function. However, there is still no Vietnamese version of the HDS-R. Therefore, this paper describes the development of the HDS-R scale and manual in Vietnamese language. Two Vietnamese researchers translated the HDS-R from English to Vietnamese. To confirm the accuracy of the translation, two other Vietnamese researchers conducted a back-translation. Another pair of Vietnamese researchers compared the back-translated English version to the original one. All six researchers discussed the inconsistencies between English HDS-R scale and manual and derived the most suitable version for the Vietnamese context. In Questions 4 and Question 7, we changed the words from "cherry blossom" and "train" to "daisy flower" and "bicycle" for the first option, and from "plum blossom" to "rose" for the second option. We also changed the expressions in some places in the manual to fit the Vietnamese language. Future studies are needed to validate this version to be able to access cognitive function in both clinical and public healthcare settings.

    DOI: 10.18999/nagjms.84.2.402

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  7. Underlying cause of death at medical facilities in Xaiyabouli Province, Lao People's Democratic Republic. Reviewed

    Bounbouly Thanavanh, Singkham Hackpaserd, Souphalak Inthaphatha, Tetsuyoshi Kariya, Yunosuke Suzuki, Eiko Yamamoto, Nobuyuki Hamajima

    Nagoya journal of medical science   Vol. 84 ( 2 ) page: 448 - 461   2022.5

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    In Lao PDR, Ministry of Health introduced District Health Information Software 2 (DHIS2) in 2013. Although DHIS2 includes cause of death, Lao government did not request to report cause of death through DHIS2, resulting in no information on frequency of underlying cause of death even for the deaths at medical facility. This study aimed to collect the information on the underlying cause of death at all medical facilities in Xaiyabouli province, a rural area in Lao PDR. As well as the point estimate of the proportion, a 95% confidence interval (CI) based on a binomial distribution was calculated for each cause of death. According to the local government request, 226 deaths (128 males and 98 females) in 2019 were reported from all medical facilities in the province. Among them, infectious diseases were the most frequent (33.6%, 95% CI 27.5-40.2%); sepsis (16.8%, 95% CI 12.2-22.3%), pneumonia (8.8%, 95% CI 5.5-13.3%), and meningitis (4.9%, 95% CI 2.5-8.5%). Heart diseases were 15.9% (95% CI 11.4-21.4%) including heart failure and myocardial infarction. Injury was 10.2% (95% CI 6.2-14.4%) including brain injury. Neonatal death was 10.6% (95% CI 6.9-15.4%). Among those, preterm death was common (8.8%, 95% CI 5.3-13.3%). Renal failure was 8.0% (95% CI 4.8-12.3%). According to civil registration covering all deaths both at facilities and outside facilities, deaths at facilities were 16.8% of the whole deaths (1,372 deaths) in Xaiyabouli province. Although deaths outside facilities were not included, this is the first report demonstrating cause of death in one province in Lao PDR.

    DOI: 10.18999/nagjms.84.2.448

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  8. Rates and Factors Associated With Serious Outcomes of Patient Safety Incidents in Malaysia: An Observational Study. Reviewed International journal

    Khairulina Haireen Khalid, Eiko Yamamoto, Nobuyuki Hamajima, Tetsuyoshi Kariya

    Global journal on quality and safety in healthcare   Vol. 5 ( 2 ) page: 31 - 38   2022.5

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    INTRODUCTION: This study aimed to examine the reporting rate and the factors associated with serious outcomes of patient safety incidents at public hospitals in Malaysia. METHODS: All patient safety incidents reported in the e-Incident-Reporting System from January to December 2019 were included in the study. A descriptive study was used to describe the characteristics of incidents, and logistic models were used to identify factors associated with low reporting rates and severe harm or death outcomes of incidents. RESULTS: There were 9431 patient safety incidents reported in the system in 2019. The mean reporting rate was 2.1/1000 patient bed-days or 1.5% of hospital admissions. The major category of incidents was drug-related incidents (32.4%). No-harm incidents contributed to 56.1% of all the incidents, while 1.1% resulted in death. More hospitals in the eastern (odds ratio [OR], 12.1) and southern regions (OR, 6.1) had low reporting rates compared to the central region. Incidents with severe harm or death outcomes were associated with more males (OR, 1.4) than females and with the emergency department (OR, 10.6), internal medicine (OR, 5.7), obstetrics and gynecology (OR, 2.4), and surgical department (OR, 5.0) more than the pharmacy department. Compared to drug-related incidents, operation-related (OR, 3.0), procedure-related (OR, 3.5), and therapeutic-related (OR, 4.8) incidents had significantly more severe harm or death outcomes, and patient falls (OR, 0.4) had less severe harm or death outcomes. CONCLUSION: The mean reporting rate was 2.1/1000 patient bed-days or 1.5% of hospital admissions. More hospitals in the eastern and southern regions had low reporting rates. Certain categories of incidents had significantly more severe outcomes.

    DOI: 10.36401/JQSH-21-19

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  9. Patient delay and health system delay of patients with newly diagnosed pulmonary tuberculosis in Mongolia, 2016-2017. Reviewed

    Batmunkh Batbayar, Tetsuyoshi Kariya, Tsolmon Boldoo, Enkhtamir Purevdorj, Naranzul Dambaa, Yu Mon Saw, Eiko Yamamoto, Nobuyuki Hamajima

    Nagoya journal of medical science   Vol. 84 ( 2 ) page: 339 - 351   2022.5

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    Although diagnosis and treatment of tuberculosis (TB) have been improved in many countries, delays in the diagnosis and treatment remain problematic in resource-limited countries. This study aimed to identify factors affecting delays in TB care in Mongolia. Data on TB cases registered from January 2016 to December 2017 were obtained from the national registry of TB at the Department of TB Surveillance and Research in National Center for Communicable Disease. The total number of TB cases registered in these two years was 8,166, including 3,267 cases of newly diagnosed pulmonary TB. Pulmonary TB cases (1,836 males and 1,431 females) were analyzed to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Patient delays longer than the median (28 days) were significantly associated with patient age >32 years (aOR=1.31, 95%CI: 1.14-1.51), residence in areas other than Ulaanbaatar (aimags) (aOR=1.38, 95%CI: 1.20-1.59), and smear-negative (aOR=0.57, 95%CI: 0.47-0.69). Health system delays longer than the median (7 days) were significantly associated with patient age >32 years (aOR=1.16, 95%CI: 1.00-1.33), residence in aimags (aOR=0.82, 95%CI: 0.71-0.95), special facilities including a prison hospital (aOR=4.40, 95%CI: 2.42-7.83), registration in 2017 relative to 2016 (aOR=0.83, 95%CI: 0.71-0.95), and smear-negative (aOR=1.72, 95%CI: 1.42-2.07). Total delays longer than the median (45 days) were significantly associated with patient age >32 years (aOR=1.39, 95%CI: 1.21-1.60), residence in aimags (aOR=1.27, 95%CI: 1.11-1.47), and smear-negative (aOR=0.74, 95%CI: 0.62-0.90). To shorten the total delay, improvement of the access to medical facilities in aimags is necessary.

    DOI: 10.18999/nagjms.84.2.339

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  10. Factors associated with severe dengue in Savannakhet Province, Lao People's Democratic Republic. Reviewed

    Phetvilay Senavong, Eiko Yamamoto, Phouvilay Keomoungkhoune, Nouda Prasith, Virasack Somoulay, Tetsuyoshi Kariya, Yu Mon Saw, Tiengkham Pongvongsa, Nobuyuki Hamajima

    Nagoya journal of medical science   Vol. 83 ( 4 ) page: 749 - 763   2021.11

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    This study aimed to describe the socio-demographic and clinical characteristics of dengue inpatients at a provincial hospital, and to identify factors associated with severe dengue. This is a retrospective study involving 402 dengue patients admitted to the Savannakhet Provincial Hospital, Lao People's Democratic Republic (Lao PDR), between January 2018 and April 2019. Socio-demographic factors, clinical signs and laboratory data on admission, final diagnosis, use of health care services before admission, admission date, and hospitalization period were collected from patient records. The number of dengue inpatients was higher in the rainy season than in the dry season. Of the 402 patients, 205 patients (51.0%) were finally diagnosed with severe dengue. Children aged <15 years had more symptoms, higher proportion of severe dengue (69.8% vs. 35.9%), and longer hospitalization (3.5 days vs. 3.0 days) than adults aged ≥15 years. In multivariable analyses, factors associated with severe dengue were nausea on admission (adjusted odds ratio=3.57, 95% CI=1.05-12.09, P=0.04) in children and persistent vomiting on admission (adjusted odds ratio=3.82, 95% CI=1.23-11.92, P=0.02) in adults. In adults, the creatinine level on admission was significantly higher in patients with a final diagnosis of severe dengue compared to the others. The proportion of severe dengue in our study was higher than that in other countries. Nausea and persistent vomiting on admission were suggested to be predictive factors for severe dengue. To reduce the incidence of severe dengue in Lao PDR, improvements in access to health care, referral system, and training of health care workers are needed.

    DOI: 10.18999/nagjms.83.4.749

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  11. Prevalence and risk factors of anxiety and depression among the community-dwelling elderly in Nay Pyi Taw Union Territory, Myanmar. Reviewed International journal

    Su Myat Cho, Yu Mon Saw, Thu Nandar Saw, Thet Mon Than, Moe Khaing, Aye Thazin Khine, Tetsuyoshi Kariya, Pa Pa Soe, San Oo, Nobuyuki Hamajima

    Scientific reports   Vol. 11 ( 1 ) page: 9763 - 9763   2021.5

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    Providing elderly mental healthcare in Myanmar is challenging due to the growing elderly population and limited health resources. To understand common mental health problems among Myanmar elderly, this study explored the prevalence and risk factors of anxiety and depression among the elderly in the Nay Pyi Taw Union Territory, Myanmar. A cross-sectional study was conducted among 655 elderly by face-to-face interviews with a pretested questionnaire. Descriptive analysis and multiple logistic regression analyses were performed. The prevalence of anxiety and depression were 39.4% (33.5% for males and 42.4% for females) and 35.6% (33.0% for males and 36.9% for females), respectively. The adjusted odds ratio of having anxiety was significant for having low education level, having comorbidity, having BMI < 21.3, poor dental health, no social participation, and having no one to consult regarding personal problems, while that of having depression was significant for having comorbidity, having BMI < 21.3, poor vision, and having no one to consult regarding personal problems. The reported prevalence of anxiety and depression indicate the demand for mental healthcare services among Myanmar elderly. Myanmar needs to improve its elderly care, mental healthcare, and social security system to reflect the actual needs of its increasing elderly population. Screening for anxiety and depression among elderly with comorbidities should be promoted. Raising community awareness of mental health, encouraging social participation, and supportive counselling are also essential in combating anxiety and depression among Myanmar elderly.

    DOI: 10.1038/s41598-021-88621-w

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  12. Rate of achievement of therapeutic outcomes and factors associated with control of non-communicable diseases in rural east Malaysia: implications for policy and practice. Reviewed International journal

    Zhi Yi Keng, Yu Mon Saw, Senk Chung Thung, Woon Wee Chong, Amanda Albert, Tetsuyoshi Kariya, Eko Yamamoto, Nobuyuki Hamajima

    Scientific reports   Vol. 11 ( 1 ) page: 3812 - 3812   2021.2

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    Non-communicable diseases (NCDs) are an increasing problem worldwide, including in Malaysia. National surveys have been performed by the government but had poor coverage in east Malaysia, particularly in rural regions. This study aimed to describe the achievement of target therapeutic outcomes in the control of diabetes mellitus (DM), hypertension (HPT), and dyslipidemia (DLP) among diabetic patients in rural east Malaysia. A cross-sectional study was conducted among DM patients who visited the NCDs clinic in Lundu Hospital, Sarawak, Malaysia, from Jan to March 2016. In total, 214 patients (male, 37.9%; female, 62.1%) were recruited using a systemic sampling method. Multiple logistic regression models were applied to estimate the adjusted odds ratio (AOR) and confidence interval (CI) for the target therapeutic achievement in the control of DM, HPT, and DLP. Compared to the national average, therapeutic target achievement in Lundu was higher for DM (43.0% vs. 23.8%), equal for DLP (35.8% vs. 37.8%) but lower for HPT (30.9% vs. 47.9%). DM patients who had at least yearly HbA1c monitoring (AOR 2.30, 95% CI 1.04-5.06, P = 0.039), and those 58.7 years or older (AOR 2.50, 95% CI 1.32-4.74, P = 0.005) were more likely to achieve the therapeutic target for DM. Health promotion and public education regarding HPT needs to be emphasized in rural Malaysia. HbA1c monitoring at least once a year was one of the important factors associated with achieving DM control in rural east Malaysia. Accessibility to HbA1c tests and monitoring should be ensured for diabetic patients.

    DOI: 10.1038/s41598-021-83168-2

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  13. Factors associated with neonatal mortality in a tertiary hospital in Phnom Penh, Cambodia. Reviewed

    Ponloeu Leak, Eiko Yamamoto, Pisey Noy, Dane Keo, Sidonn Krang, Tetsuyoshi Kariya, Yu Mon Saw, Meng Siek, Nobuyuki Hamajima

    Nagoya journal of medical science   Vol. 83 ( 1 ) page: 113 - 124   2021.2

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    This study aimed to identify hospital neonatal mortality rate (NMR) and the causes of neonatal deaths, and to understand risk factors associated with neonatal mortality in a national tertiary hospital in Cambodia. The study included all newborn infants, aged 0-28 days old, hospitalized in the Pediatrics department of Khmer-Soviet Friendship Hospital between January 2016 and December 2017. In total, 925 infants were included in the study. The mean gestational age was 35.9 weeks (range, 24-42 weeks). Preterm infants and low birth weight accounted for 47.5% and 56.7%, respectively. With respect to payment methods, the government (53.5%) and non-governmental organizations (NGO) (13.7%) paid the fees as the families were not in a financial position to do so. The hospital NMR at the Pediatrics department was 9.3%. Respiratory distress syndrome (37.2%) was the main cause of deaths followed by hypoxic-ischemic encephalopathy (31.4%) and neonatal infection (21.0%). Factors associated with neonatal mortality were Apgar score at 5th minute <7 (adjusted odds ratio (AOR) = 3.57), payment by the government or NGO (AOR = 11.32), admission due to respiratory distress (AOR = 11.94), and hypothermia on admission (AOR = 9.41). The hospital NMR in the Pediatrics department was 9.3% (95% confidence interval 7.50-11.35) at Khmer-Soviet Friendship Hospital; prematurity and respiratory distress syndrome were the major causes of neonatal mortality. Introducing continuous positive airway pressure machine for respiratory distress syndrome and creating neonatal resuscitation guidelines and preventing hypothermia in delivery rooms are required to reduce the high NMR.

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  14. Trends and risk factors for infant mortality in the Lao People's Democratic Republic. Reviewed International journal

    Viengsakhone Louangpradith, Eiko Yamamoto, Souphalak Inthaphatha, Bounfeng Phoummalaysith, Tetsuyoshi Kariya, Yu Mon Saw, Nobuyuki Hamajima

    Scientific reports   Vol. 10 ( 1 ) page: 21723 - 21723   2020.12

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    A high infant mortality rate (IMR) indicates a failure to meet people's healthcare needs. The IMR in Lao People's Democratic Republic has been decreasing but still remains high. This study aimed to identify the factors involved in the high IMR by analyzing data from 53,727 live births and 2189 women from the 2017 Lao Social Indicator Survey. The estimated IMR decreased from 191 per 1000 live births in 1978-1987 to 39 in 2017. The difference between the IMR and the neonatal mortality rate had declined since 1978 but did not change after 2009. Factors associated with the high IMR in all three models (forced-entry, forward-selection, and backward-selection) of multivariate logistic regression analyses were auxiliary nurses as birth attendants compared to doctors, male infants, and small birth size compared to average in all 2189 women; and 1-3 antenatal care visits compared to four visits, auxiliary nurses as birth attendants compared to doctors, male infants, postnatal baby checks, and being pregnant at the interview in 1950 women whose infants' birth size was average or large. Maternal and child healthcare and family planning should be strengthened including upgrading auxiliary nurses to mid-level nurses and improving antenatal care quality.

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  15. Factors associated with postpartum depression among women in Vientiane Capital, Lao People's Democratic Republic: A cross-sectional study. Reviewed International journal

    Souphalak Inthaphatha, Eiko Yamamoto, Viengsakhone Louangpradith, Yuki Takahashi, Alongkone Phengsavanh, Tetsuyoshi Kariya, Yu Mon Saw, Nobuyuki Hamajima

    PloS one   Vol. 15 ( 12 ) page: e0243463   2020.12

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    Postpartum depression is a worldwide public health concern. The prevalence of postpartum depression is reported to be greater in developing countries than in developed countries. However, to the best of our knowledge, no papers on postpartum depression in the Lao People's Democratic Republic have been published. In order to strengthen maternal and child health, the current situation of postpartum depression should be understood. This study aims to determine the prevalence of postpartum depression and identify factors associated with postpartum depression in Vientiane Capital, Lao People's Democratic Republic. Study participants were 428 women 6-8 weeks postpartum who visited four central hospitals in Vientiane Capital for postnatal care from July to August 2019. Structured questionnaires were used to collect socio-demographic, obstetrical and infant, and psychiatric data about the women and their partners. The Edinburgh Postnatal Depression Scale (EPDS) was used to identify suspected cases of postpartum depression with the cut-off score of 9/10. Multivariable logistic regression was used to examine independent factors that were associated with suspected postpartum depression (EPDS ≥10). The mean age of the 428 women was 28.1 years, and the prevalence of suspected postpartum depression was 31.8%. Multivariable logistic regression using variables that were statistically significant on bivariate analyses indicated that three variables were associated with suspected postpartum depression: unintended pregnancy (AOR = 1.66, 95% CI 1.00-2.73, P = 0.049), low birth satisfaction (AOR = 1.85, 95% CI 1.00-3.43, P = 0.049), and depression during pregnancy (AOR = 3.99, 95% CI 2.35-6.77, P <0.001). In this study, unintended pregnancy, low birth satisfaction, and depression during pregnancy were independent risk factors for postpartum depression. These results suggest that the mental health of pregnant women should be monitored, and that health care services, especially family planning and supportive birth care, should be strengthened to prevent postpartum depression.

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  16. Assessment of nutritional status and risk factors for malnutrition among the elderly in Loikaw, Myanmar. Reviewed

    Noe MTN, Saw YM, Saw TN, Kyaw YP, Zin PE, Cho SM, Kariya T, Yamamoto E, Win HH, Wann T, Hamajima N

    Nutrition (Burbank, Los Angeles County, Calif.)   Vol. 79-80   page: 110933   2020.11

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    Objectives: Malnutrition among the elderly is an important health concern in Myanmar. The country is chal-lenged by both an aging population and poor nutritional status. The aim of this study was to estimate the prevalence of malnutrition and elucidate its associated factors among the elderly in Loikaw, Myanmar.Methods: A cross-sectional study was conducted from July to August 2019. Using a multistage sampling method, 747 elderly individuals (313 men and 434 women) were recruited. The nutritional status of these participants was assessed using the Mini-Nutritional Assessment tool, with a face-to-face interview method. Body mass index, mid-upper arm and calf circumference, blood pressure, and random blood sugar levels were also assessed. Multinomial logistic regression analysis was performed.Results: The prevalence of malnutrition and at risk for malnutrition were 21.7% and 59.4%, respectively. In the multivariate model, dental problem (adjusted odds ratio [aOR], 2.18; 95% confidence interval [CI], 1.24-3.83), low level of education (aOR, 3.13; 95% CI, 1.44-6.81), aged >70 y (aOR, 3.55; 95% CI, 1.83-6.88), current betel chewing (aOR, 2.82; 95% CI, 1.64-4.87), and having heart disease (aOR, 8.04; 95% CI, 2.29-18.13) were positively associated with malnutrition.Conclusion: One in five elderly study participants were malnourished and 50% were at risk for malnutrition. Malnutrition was associated with being >70 y of age, having a low educational level, chewing betel, having a history of heart disease, and having dental problems. These findings may alert policymakers to develop and implement effective interventions for improving nutritional status of the elderly population. (c) 2020 Elsevier Inc. All rights reserved.

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  17. Assessment of quality of life among elderly in urban and peri-urban areas, Yangon Region, Myanmar. Reviewed International journal

    Zin PE, Saw YM, Saw TN, Cho SM, Hlaing SS, Noe MTN, Kariya T, Yamamoto E, Lwin KT, Win HH, Hamajima N

    PloS one   Vol. 15 ( 10 ) page: e0241211   2020.10

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    BACKGROUND: In the context of an aging population, quality of life (QOL) is an important consideration for the well-being of the elderly. However, there is limited information on the QOL of the elderly in Myanmar. This study aimed to explore the risk factors for low QOL among the elderly in urban and peri-urban areas of the Yangon Region, Myanmar. METHODS: A community-based, cross-sectional study was conducted among the elderly aged 60 years or older in two urban and two peri-urban townships in the Yangon Region from July to September 2019. A multi-stage sampling method was used to recruit study participants using a pre-tested questionnaire. A total of 616 (305 males and 311 females) elderly people were interviewed using a face-to-face interview technique. Multiple linear regression analysis was performed on the four domains (physical health, psychological health, social relationship, and environment) of QOL measured with the WHOQOL-BREF. RESULTS: Income level and having intimate friends influenced the QOL scores of the elderly in all domains, while education level and marital status influenced psychological health, social relationship, and environment domains. Social interaction with neighbors increased the QOL scores for physical health, social relationship, and environment domains. Living in peri-urban areas was associated with lower QOL scores for physical health, psychological health, and environment, while participation in group activities increased QOL scores in these domains. Having comorbidities affected the QOL for psychological health and environment domains, while the frequency of going out affected physical health, and the frequency of religious performance affected social relationship. CONCLUSION: Residential location, education level, marital status, income, comorbidities, social interactions with neighbors and friends, participation in group activities, and frequencies of going out and religious activities should be considered in planning and implementing programs for the elderly in Myanmar. Peri-urban development, strengthening healthcare and social security systems, and encouraging social interaction and participation in group activities play critical roles in improving the QOL for elderly residing in Myanmar.

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  18. Geographic distribution and utilisation of CT and MRI services at public hospitals in Myanmar. Reviewed International journal

    Khaing M, Saw YM, Than TM, Mon AM, Cho SM, Saw TN, Kariya T, Yamamoto E, Hamajima N

    BMC health services research   Vol. 20 ( 1 ) page: 742 - 742   2020.8

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    BACKGROUND: Diagnosis by computed tomography (CT) and magnetic resonance imaging (MRI) is important for patient care. However, the geographic distribution and utilisation of these machines in countries with limited resources, such as Myanmar, have not been sufficiently studied. Therefore, this study aims to identify the geographic distribution and utilisation of CT and MRI services at public hospitals in Myanmar. METHODS: This nationwide, cross-sectional study was conducted at 43 public hospitals in Myanmar. Data were collected retrospectively using a prepared form from 1st January 2015 to 31st December 2017 at public hospitals in Myanmar. A descriptive analysis was performed to calculate the number of CT and MRI units per million population in each state and region of Myanmar. The distribution of CT and MRI units was assessed using the Lorenz curve and Gini coefficient, which are indicators of inequality in distribution. RESULTS: In total, 45 CT and 14 MRI units had been installed in public hospitals in Myanmar by 2017. In total, 205,570 CT examinations and 18,981 MRI examinations have been performed within the study period. CT units per million population in 2017 varied from 0.30 in Rakhine State to 3.22 in Kayah State. However, MRI units were available only in public hospitals in five states/regions. The Gini coefficient for CT and MRI was 0.35 and 0.69, respectively. An upward trend in the utilisation rate of CT and MRI was also observed during the study period, especially among patients aged between 36 and 65 years. CONCLUSIONS: Throughout Myanmar, CT units were more equally distributed than MRI units. CT and MRI units were mostly concentrated in the Yangon and Mandalay Regions, where the population density is higher. The geographic distribution and utilisation rate of CT and MRI units varied among states, regions, and patients' age group. However, the utilisation rates of CT and MRI increased annually in all states and regions during the review period. The Ministry of Health and Sports in Myanmar should consider the utilisation and population coverage of CT and MRI as an important factor when there will be procurement of those medical equipment in the future.

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  19. Determinants of diarrhea in children under the age of five in Afghanistan: a secondary analysis of the Afghanistan Demographic and Health Survey 2015 Reviewed

    Nasir Wasiq Ahmad, Saw Yu Mon, Jawidh Sultani, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 82 ( 3 ) page: 545 - 556   2020.8

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    Diarrhea is the second leading cause of under-five mortality and globally accounts for 526,000 child deaths every year. Afghanistan, with 33,000 child deaths in 2012, was ranked 8th among nations, with the highest under-five deaths being from pneumonia and diarrhea. This study aimed to identify the determinants of diarrhea in children under the age of five in Afghanistan. A secondary data analysis of the Afghanistan Demographic and Health Survey (AfDHS) 2015 was focused on diarrhea in children under the age of five. The dataset of the AfDHS 2015 was used for the analysis. The subjects for this study were 30,238 under-five children. A logistic regression model was applied to examine the determinants of childhood diarrhea. This study found that 7,921 (26.2%) out of 30,238 under-five children had diarrhea within the two weeks preceding the survey. Higher maternal education accompanied a lower risk of childhood diarrhea with an adjusted odds ratio (AOR) of 0.70 (P<0.01) than did no education. Flush toilets (AOR=0.84, P<0.01) and traditional dry vaults (AOR=0.83, P<0.001) were less likely associated with diarrhea compared with pit latrines. Tube wells, public taps, and unprotected wells and springs were sources of drinking water with a higher risk of diarrhea than piped water. This study identified that the type of toilet facility, source of drinking water, age of the child, and maternal education were important determinants of under-five diarrhea. Intervention programs concerning improved sanitation facilities, sources of drinking water, and raising women's level of education and health awareness are important.

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  20. Estimation of the unvaccinated among those aged less than 25 years according to aimag and its association with incidence of measles outbreak 2015-2016 in Mongolia Reviewed

    Sereenen Enkhbold, Saw Yu Mon, Erkhembayar Ryenchindorj, Volodya Baigal, Otgonbayar Dashpagma, Orsoo Oyunchimeg, Kariya Tetsuyoshi, Ochir Chimedsuren, Yamamoto Eiko, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 82 ( 3 ) page: 437 - 447   2020.8

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    Mongolia had an epidemic of measles in 2015-2016, even though more than 90% of the population have been vaccinated since 1997. This study aimed to examine the associations between unvaccinated proportion and measles incidence according to aimag. Mongolia has 21 provinces (aimag) with Ulaanbaatar as the capital city. Vaccination coverage between 1991 and 2014 and measles incidence according to aimag were obtained from the National Center for Communicable Diseases of Mongolia database. Accumulated unvaccinated proportion (AUP) among those aged 1 to 24 years in 2015 was estimated from the unvaccinated at the 1st dose of 1991 to 2014. From 1991 to 2014, unvaccinated proportion among those aged 1 to 24 years in the whole country has been reducing from 28.0% in 1991 to 1.8% in 2014. The AUP in 2015 varied from 2.7% (Selenge) to 21.8% (Govisumber). The incidence was remarkably higher in only two aimags with a large density of the unvaccinated aged 1 to 24 years (Ulaanbaatar and Darkhan-Uul) than in the other aimags. The incidence had no significant correlation with the AUP, although the correlation between the incidence and the density of unvaccinated aged 1 to 24 years was significant when the two aimags were included. In conclusion, the AUP between 2.7% and 21.8% had no correlation with the incidence according to aimags in Mongolia measles epidemic 2015-2016.

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  21. Cognitive impairment and its risk factors among Myanmar elderly using the Revised Hasegawa's Dementia Scale: A cross-sectional study in Nay Pyi Taw, Myanmar Reviewed International journal

    Saw Yu Mon, Saw Thu Nandar, Than Thet Mon, Khaing Moe, Soe Pa Pa, Oo San, Cho Su Myat, Win Ei Mon, Mon Aye Myat, Fuchita Etsuko, Kariya Tetsuyoshi, Iriyama Shigemi, Hamajima Nobuyuki

    PLOS ONE   Vol. 15 ( 7 ) page: e0236656   2020.7

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    BACKGROUND: Globally, elderly population with impaired cognitive function, such as dementia, has been accelerating, and Myanmar is no exception. However, cognitive function among elderly in Myanmar has rarely been assessed. This study aimed to identify the rate of cognitive impairment and its risk factors among the elderly in Myanmar. METHODS: This cross-sectional study was conducted at rural health centers in Nay Pyi Taw Union Territory, Myanmar, from December 2018 to January 2019. In total, 757 elderly individuals aged 60 years or over (males: 246 [32.5%], females: 511 [67.5%]) were interviewed using a face-to-face method with a pre-tested questionnaire. Descriptive statistics and multivariable logistic regression analyses were performed. RESULTS: The rate of impaired cognitive function among participants was 29.9% (males: 23.6%; females: 32.9%). The following participants were more likely to present cognitive impairment: those aged 70-79 years (adjusted odds ratio [AOR] = 1.8; 95% confidence interval [CI]: 1.19-2.70) and 80 years or older (AOR = 3.9; 95% CI: 2.25-6.76); those who were illiterate (AOR = 9.1; 95% CI: 3.82-21.51); and those dependent on family members (AOR = 1.6; 95% CI: 1.04-2.44). The elderly livening with their families and those who reported having good health (AOR = 0.7; 95% CI: 0.44-0.99) were less likely to have cognitive impairment. CONCLUSION: Using the HDS-R Myanmar version, this study reported that there out of five elderly participants had cognitive impairment, and its risk factors, altering policy makers that Myanmar needs to prepare for adequate healthcare services and social support for elderly with cognitive impairment. Future research should be performed not only to detect general cognitive impairment but also to differentiate specific cognitive domains impairments among Myanmar elderly. Longitudinal studies are needed to observe the causal and protective factors associated with cognitive impairments in Myanmar.

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  22. Etiologic agents of acute diarrhea in sentinel surveillance sites in Vientiane Capital, Lao People's Democratic Republic, 2012-2015 Reviewed International journal

    Houattongkham Souphatsone, Yamamoto Eiko, Sithivong Noikaseumsy, Inthaphatha Souphalak, Kariya Tetsuyoshi, Saw Yu Mon, Vongduangchanh Arounnapha, Keosavanh Onechanh, Hamajima Nobuyuki

    EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES   Vol. 39 ( 6 ) page: 1115 - 1122   2020.6

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    This study aims to identify the pathogens of diarrhea in Vientiane Capital, Lao People's Democratic Republic (Lao PDR). The data of 2482 patients who visited eight health facilities due to diarrhea in 2012-2015 were retrospectively reviewed. Stool or rectal swabs collected from all patients were tested for bacteria. Children who were under 5 years old were additionally tested for rotavirus. Of 2482 cases, 1566 cases were under 5 years old, and at least one enteropathogen was detected in 475 cases (19.1%). Salmonella species was the most commonly detected bacterial pathogen. Enteropathogenic Escherichia coli (EPEC) and Salmonella species was the major pathogen in the dry season and the wet season, respectively. Eighty-seven patients tested positive for multiple bacteria. Rotavirus was detected in 291 children under 5 years old (32.4%), mostly from October to April. The major bacteria of coinfection with rotavirus were EPEC followed by Salmonella species. Salmonella species was the predominant bacterial pathogen of diarrhea of all ages, and rotavirus was the predominant pathogen among children under 5 years old. Further studies examining other types of pathogens for diarrhea and the introduction of a rotavirus vaccine for children are needed in Lao PDR.

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  23. Prevalence of alcohol consumption and its risk factors among university students: A cross-sectional study across six universities in Myanmar Reviewed International journal

    Htet Hein, Saw Yu Mon, Saw Thu Nandar, Htun Nang Mie Mie, Mon Khaing Lay, Cho Su Myat, Thike Thinzar, Khine Aye Thazin, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    PLOS ONE   Vol. 15 ( 2 ) page: e0229329   2020.2

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    BACKGROUND: Globally, alcohol consumption is a significant public health concern and it is one of the most important risk behaviours among university students. Alcohol consumption can lead to poor academic performance, injuries, fights, use of other substances, and risky sexual behaviours among students. However, the study explored the prevalence of alcohol consumption and the associated risk factors among university students since these have not been fully examined in previous research. Therefore, the aim of this study was to explore the prevalence of alcohol consumption and the associated risk factors among university students in Myanmar. METHODS: The present cross-sectional study was conducted using a sample of 15-24-year-old university students who were selected from six universities in Mandalay, Myanmar, in August 2018. In total, 3,456 students (males: 1,301 and females: 2,155) were recruited and asked to respond to a self-administered questionnaire. Multiple logistic regression analysis was used to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for alcohol consumption among university students. RESULTS: The prevalence of alcohol consumption in the previous 30 days was 20.3% (males: 36.0%, females: 10.8%). The alcohol consumption was significantly higher among males (AOR = 2.3, 95% CI; 1.9-2.9), truant students (AOR = 2.1, 95% CI; 1.3-3.3), smokers (AOR = 7.0, 95% CI; 5.1-9.7), students who reported feeling of hopelessness or sadness (AOR = 1.4, 95% CI; 1.2-1.8), peers' alcohol consumption (AOR = 7.5, 95% CI; 4.8-11.7). CONCLUSION: The present study revealed that males, smokers, peer alcohol consumption, and truant students had higher odds of alcohol consumption among the students. Therefore, effective campus-based counselling, peer education, and national surveillance systems that can monitor risky drinking behaviours among university students should be implemented. Further, government regulations that control the production, sale, promotion, advertising, and restriction of alcohol should be well developed and strengthened, as in the case of other Southeast Asian countries.

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  24. Association between body mass index and ready-to-eat food consumption among sedentary staff in Nay Pyi Taw union territory, Myanmar Reviewed International journal

    Thike Thin Zar, Saw Yu Mon, Lin Htin, Chit Khin, Tun Aung Ba, Htet Hein, Cho Su Myat, Khine Aye Thazin, Saw Thu Nandar, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    BMC PUBLIC HEALTH   Vol. 20 ( 1 ) page: 206 - 206   2020.2

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    BACKGROUND: Ready-to-eat (RTE) food consumption has become popular in the working community with the increase in full-time jobs and the limited time to prepare food. Although RTE food is essential for this community, its consumption causes obesity. In Myanmar, obesity is a modifiable risk factor for non-communicable diseases, causing increases in morbidity and mortality. This study aimed to identify the association between body mass index (BMI) and RTE food consumption among sedentary staff in Nay Pyi Taw Union Territory, Myanmar. METHODS: A cross-sectional study was conducted in 2018, in which 400 respondents participated in face-to-face interviews. The study area was selected using simple random sampling and drawing method. Measuring tape and digital weighing scale were used to measure the height and weight of the respondents. BMI was calculated by dividing the weight by height squared (kg/m2). Overweight and obesity were categorized by World Health Organization cut-off points. The collected data were analyzed using multiple logistic regression to estimate the adjusted odds ratio (AOR), and the 95% confidence interval (CI). RESULTS: This study revealed that sedentary staff who consumed RTE food once or more per month were nearly five times more likely to be overweight and obese (AOR = 4.78, 95% CI 1.44-15.85) than those who consumed RTE food less frequently. In addition, five factors namely being older than 32 years (AOR = 3.97, 95% CI 1.82-8.69), preference for RTE food (AOR = 8.93, 95% CI 2.54-31.37), light-intensity of physical exercise (AOR = 3.55, 95% CI 1.63-7.73), sedentary leisure activities (AOR = 3.32, 95% CI 1.22-9.03), and smoking (AOR = 5.62, 95% CI 1.06-29.90) were positively associated with overweight and obesity. CONCLUSION: Frequent consumers of RTE food and less physically active sedentary staff were more likely to be overweight and obese. This study highlights the urgent need to raise awareness regarding healthy lifestyle behaviors among the working community to reduce the burden of obesity-related chronic diseases. Moreover, sedentary workers should be aware of the food-based dietary guidelines of the country. Policy makers should strictly enforce nutritional labeling of RTE food, and strictly prohibit over-branding of RTE food.

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  25. Estimating cost of hospitalization for childbirth at a tertiary hospital in Mongolia Reviewed

    Taazan Bolorchimeg, Yamamoto Eiko, Baatar Bayart, Amgalanbaatar Avirmed, Kariya Tetsuyoshi, Saw Yu Mon, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 82 ( 1 ) page: 47 - 57   2020.2

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    Health services for pregnancy and delivery at public health facilities are fully subsidized by the government in Mongolia. However, it has been reported that health financing, budget planning, and implementation processes are weak. Therefore, this study aims to estimate the costs per inpatient of vaginal delivery and cesarean section (C-section) by using data gathered from a tertiary hospital in Ulaanbaatar. Inpatient and financial data were collected from the Statistics and Finance, Economics Department of National Center for Maternal and Child Health. A top-down method was used for the calculation of unit costs. The total number of deliveries in 2016 were 11,033, including 7,777 vaginal deliveries and 3,256 C-sections. The cost per inpatient stay for vaginal delivery and C-section were USD 255 and USD 592, respectively. The average cost per bed-day of the six departments of the obstetrics and gynecology hospital was USD 80. The percentage that represents employees' salary in the cost per inpatient was as low as 12.4% for vaginal delivery and 18.5% for C-section, although the cost for salaries accounted for 51.2% of the total expenditure of the hospital. Results show that the cost per inpatient of C-section was two times higher than that of vaginal delivery. The cost of childbirths may account for approximately 9% of total health expenditure of the country. These results may be advantageous to the government in instituting a policy and controlling the health care budget to improve cost-effectiveness and equal access to all in health care services in Mongolia.

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  26. Disease frequency among inpatients at a tertiary general hospital in Lao PDR Reviewed

    Louangpradith Viengsakhone, Phoummalaysith Bounfeng, Kariya Tetsuyoshi, Saw Yu Mon, Yamamoto Eiko, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 82 ( 1 ) page: 113 - 121   2020.2

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    In Lao People's Democratic Republic (Lao PDR), reports on disease frequency are very limited. This study aimed to report frequencies of the main cause of admission among inpatients of a tertiary general hospital (Mittaphab Hospital) in Vientiane. Subjects were inpatients who were admitted from January 3 to February 2 in 2017. The dataset were made as a pilot run to establish hospital statistics. The data on sex, age, address (province), dates of admission and discharge, and main diagnosis were collected from paper-based medical charts. International Classification of Diseases 10 was applied for classifying the main diagnosis. During the 1-month period, 1,201 inpatients (637 males and 564 females) were admitted, including 171 (14.2%) aged <20 years and 254 (21.1%) aged ≥60 years. About 20% patients were from outside of Vientiane. Among them, 67.5% (62.5% in males and 73.8% in females) were admitted within 7 days. The main causes with more than 10% in males were injury and poisoning S00-T98 (49.8%), while those in females were injury and poisoning S00-T98 (25.2%), pregnancy and childbirth O00-O99 (19.0%), and diseases of genitourinary system N00-N99 (13.7%). Injury and poisoning S00-T98 among inpatients aged <20 years was 81.8% in males and 59.0% in females. Among those aged 20-59 years, it was 49.9% and 22.4%, and among those aged ≥60 years it was 22.3% and 16.9%, respectively. This is the first report on the frequencies of main diseases among inpatients in Lao PDR. Injury was the first main cause of admission at the tertiary hospital.

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  27. Cross-sectional study on tobacco advertising, promotion and sponsorship (TAPS) and violations of tobacco sale regulations in Myanmar: do these factors affect current tobacco use among Myanmar high school students? Reviewed International journal

    Cho Su Myat, Saw Yu Mon, Latt Nyi Nyi, Saw Thu Nandar, Htet Hein, Khaing Moe, Than Thet Mon, Win Ei Mon, Aung Zaw Zaw, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    BMJ OPEN   Vol. 10 ( 2 ) page: e031933   2020.2

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    OBJECTIVES: To examine the associations of current tobacco use with tobacco advertising, promotion and sponsorship (TAPS), and illicit tobacco sales exposures among Myanmar high school students. DESIGN: A quantitative, cross-sectional study. SETTING: Seven high schools from both urban and rural areas of four states and regions in Myanmar. PARTICIPANTS: In total, 1174 high school students (482 males and 692 females) were interviewed using a self-administered questionnaire. MAIN OUTCOME MEASURE: Current tobacco use of participants, defined as using any kind of smoked or smokeless tobacco product at least one occasion within the past 30 days. RESULTS: The prevalence of TAPS exposure was 90.9% among high school students in Myanmar. Current tobacco use was positively associated with being over 14 years old (adjusted OR (AOR) 9.81; 95% CI 4.54 to 21.19), being male (AOR 28.06; 95% CI 13.29 to 59.25), exposure to any kind of TAPS (AOR 6.59; 95% CI 2.33 to 18.64), having seen any smoked tobacco product for sale inside or within 100 feet of the school premises (AOR 4.17; 95% CI 1.65 to 10.58), having seen the sale or gifting of any smoked tobacco product to minors (AOR 6.46; 95% CI 2.18 to 19.12) and having seen the sale or distribution of any smoked tobacco product by minors (AOR 2.42; 95% CI 1.42 to 4.10). Having ever received health education about tobacco use (AOR 0.45; 95% CI 0.27 to 0.78), or having a higher perception score of tobacco use (AOR 0.17; 95% CI 0.10 to 0.30) were negatively associated with current tobacco use. CONCLUSIONS: There was an alarming prevalence of TAPS exposure among Myanmar high school students. TAPS exposure and violations of tobacco sale regulations were strong risk factors for current tobacco use among Myanmar high school students, while health education about tobacco products was reported as an effective protective factor. Specific smokeless tobacco sale regulations for minors are needed immediately in Myanmar.

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  28. Assessing risk factors and impact of cyberbullying victimization among university students in Myanmar: A cross-sectional study Reviewed International journal

    Khine Aye Thazin, Saw Yu Mon, Htut Zaw Ye, Khaing Cho Thet, Soe Htin Zaw, Swe Kyu Kyu, Thike Thinzar, Htet Hein, Saw Thu Nandar, Cho Su Myat, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    PLOS ONE   Vol. 15 ( 1 ) page: e0227051   2020.1

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    BACKGROUND: Cyberbullying is a global public health concern with tremendous negative impacts, not only on the physical and mental health of students but also on their well-being and academic performance. However, there are very few studies on cyberbullying among university students, especially in Myanmar. This study aims to determine the percentage of university students who suffered cyberbullying victimization in the last 12 months, and the association between students' socio-demographic characteristics, adverse events following cyberbullying and cyberbullying victimization. METHODS: A cross-sectional study was conducted among university students aged 18 years and older at one medical university in Magway, Myanmar. A total of 412 students (277 males and 135 females) participated in the study. Data were collected from August to September, 2018 using a self-administered questionnaire. Multiple logistic regression analyses (models I and II) were performed to estimate the unadjusted (UOR) and adjusted odds ratios (AOR), and 95% confidence intervals (CI). RESULTS: In total, 40.8% of males and 51.1% of females in the study had suffered cyberbullying victimization in the past 12 months. In model I, students who had been studying at the university for 3 years or less (AOR = 1.81; 95% CI 1.14-2.85), and who had witnessed psychological, physical or sexual violence, or cyberbullying in their neighborhoods, (AOR = 2.95; 95% CI 1.48-5.91) were more likely to have suffered cyberbullying victimization in the past 12 months. In model II, being a victim of cyberbullying was associated with difficulties in concentrating and understanding lectures (AOR = 3.96; 95% CI 1.72-9.11), and substance abuse (AOR = 2.37; 95% CI 1.02-5.49). Non-resident students were at a higher risk of being cyberbullying victims than their resident peers (AOR = 1.86; 95% CI 1.04-3.34). CONCLUSION: Two out of five students had suffered cyberbullying victimization in the past 12 months, and only half of the victims discussed their experience(s) with someone else. Students who suffered cyberbullying victimization faced academic difficulties and started or increased smoking, betel chewing or alcohol drinking. Counter measures to prevent and mitigate the adverse events related to cyberbullying victimization are urgently needed among university students in Myanmar. Periodic screening for cyberbullying, counseling services, cyber-safety educational programs, and awareness raising campaigns should be implemented.

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  29. Factors associated with HIV testing among the general male population in Cambodia: A secondary data analysis of the Demographic Health Survey in 2005, 2010, and 2014 Reviewed

    Piseth Narin, Eiko Yamamoto, Yu Mon Saw, Ny Net, Souphalak Inthaphatha, Tetsuyoshi Kariya, Nobuyuki Hamajima

    PLOS ONE   Vol. 14 ( 7 ) page: e0219820 - e0219820   2019.7

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  30. Outbreak detection of influenza-like illness in Prey Veng Province, Cambodia: a community-based surveillance Reviewed

    Long-Hay Puthik, Yamamoto Eiko, Bun Sreng, Savuth Thai, Buntha So, Sokdaro Soy, Kariya Tetsuyoshi, Saw Yu Mon, Sengdoeurn Yi, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 81 ( 2 ) page: 269 - 280   2019.5

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    On June 4, 2016, the Prey Veng Provincial Health Department reported a total of 107 patients with influenza-like illness (ILI) from Chakhlanh village to the Cambodian Ministry of Health. To confirm the outbreak and evaluate its clinical and epidemiological characteristics, the investigation team visited the village and reviewed the case-based surveillance (CBS) data on severe respiratory infection (SRI) and patients' records in health facilities. The team interviewed all households in the village from May 1 to June 5, 2016 and obtained the following data: age, medical history, date of onset, treatment, symptoms, and history of contact with patients or dead poultry. Nasal swab samples were collected from suspected ILI cases to test for influenza virus by RT-PCR. The investigation detected 498 suspected ILI cases, including 288 females. Although the incidence of suspected ILI cases who visited health centers was 63.0 per 1,000 persons per month, the attack rate was 27.1 per 100 population. The major age group was 5-14 years followed by 0-4 years. Major symptoms were cough, fever, runny nose, and headache. Six of seven nasal swab samples were positive for influenza A/H1N1 pdm09 virus. Most children with flu symptoms had contact with previous cases. This study showed that the ILI outbreak might be caused by seasonal influenza A/H1N1 pdm09 spread from person to person. Poor living conditions and poor hygiene and sanitation practices were environmental factors that caused the outbreak. As the CBS system was unable to identify this epidemic, it needs to be improved.

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  31. Cognitive function measured with the Revised Hasegawa's Dementia Scale among elderly individuals in Lao PDR Reviewed

    Kounnavong Sengchanh, Ratsavong Kethmany, Soundavong Khouanchay, Xayavong Syda, Kariya Tetsuyoshi, Saw Yu Mon, Yamamoto Eiko, Horibe Kentaro, Toba Kenji, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 81 ( 2 ) page: 281 - 290   2019.5

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    In Lao PDR, measurement of cognitive function has rarely been conducted among elderly individuals. This study aimed to investigate the cognitive function among elderly individuals who lived at their homes with family in Lao PDR. Participants were elderly individuals aged 60 years or over registered with the local government in urban (Vientiane capital; VC) and rural areas (Khammouane province; KP). Those with serious mental/physical diseases, those who could not walk by themselves, or those who could not speak the Lao language were excluded. The information was collected through interviews with the participants and their family members. A newly developed Lao version of the Revised Hasegawa's Dementia Scale (HDS-R) was applied to measure cognitive function. The participants were 414 elderly individuals (224 males and 190 females) aged 60 to 98 years. The average HDS-R score was 23.0 among 115 men in VC, 22.7 among 92 women in VC, 20.3 among 109 men in KP, and 17.5 among 98 women in KP. The main caregiver was a daughter (40.6%) followed by a spouse (31.4%). Among 414 elderly individuals, 42 (10.0%) stated the necessity of support. Those with HDS-R < 20 accounted for 38.8% in men and 48.9% in women. The adjusted odds ratio of HDS-R < 20 was significant for those in rural areas (3.83) relative to those in urban areas. Among superficially healthy elderly individuals residing with their families, those with reduced cognitive function were more common among women and in rural areas.

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  32. Consumption of foods containing prohibited artificial colors among middle-school children in Nay Pyi Taw union territory, Myanmar Reviewed

    Nwe Oo, Yu Mon Saw, Hnin Nwe Ni Aye, Zaw Zaw Aung, Hnin Nandar Kyaw, Ae Mon Tun, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima

    BMC Public Health   Vol. 19 ( 1 ) page: 344   2019.3

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  33. Survival rate and mortality risk factors among TB–HIV co-infected patients at an HIV-specialist hospital in Myanmar: A 12-year retrospective follow-up study Reviewed

    Zaw Zaw Aung, Yu Mon Saw, Thu Nandar Saw, Nwe Oo, Hnin Nwe Ni Aye, Sithu Aung, Htun Nyunt Oo, Su Myat Cho, Moe Khaing, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima

    International Journal of Infectious Diseases   Vol. 80   page: 10 - 15   2019.3

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    DOI: 10.1016/j.ijid.2018.12.008

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  34. Antibiotic prescription for under-fives with common cold or upper respiratory tract infection in Savannakhet Province, Lao PDR Reviewed

    Bounxou Keohavong, Manithong Vonglokham, Bounfeng Phoummalaysith, Viengsakhone Louangpradith, Souphalak Inthaphatha, Tetsuyoshi Kariya, Yu Mon Saw, Eiko Yamamoto, Nobuyuki Hamajima

    Tropical Medicine and Health   Vol. 47 ( 1 ) page: 16   2019.2

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  35. Free and universal access to primary healthcare in Mongolia: the service availability and readiness assessment Reviewed

    Altantuya Jigjidsuren, Tumurbat Byambaa, Enkhjargal Altangerel, Suvd Batbaatar, Yu Mon Saw, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima

    BMC Health Services Research   Vol. 19 ( 1 ) page: 129   2019.2

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  36. Epidemiological characteristics and trends of a Nationwide measles outbreak in Mongolia, 2015–2016 Reviewed

    Oyunchimeg Orsoo, Yu Mon Saw, Enkhbold Sereenen, Buyanjargal Yadamsuren, Ariunsanaa Byambaa, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima

    BMC Public Health   Vol. 19 ( 1 ) page: 201   2019.2

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  37. Patient satisfaction on the utilization of traditional and complementary medicine services at public hospitals in Malaysia Reviewed

    Jaspal Kaur, Nobuyuki Hamajima, Eiko Yamamoto, Yu Mon Saw, Tetsuyoshi Kariya, Goh Cheng Soon, Ariyani Amin, Adilla Nur Halim, Farhana Abdul Aziz, Suraya Hani Sharon

    Complementary Therapies in Medicine   Vol. 42   page: 422 - 428   2019.2

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  38. Factors associated with antenatal care visits in Afghanistan: secondary analysis of Afghanistan Demographic and Health Survey 2015 Reviewed

    Azimi Mohammad Walid, Yamamoto Eiko, Saw Yu Mon, Kariya Tetsuyoshi, Arab Ahmad Shekib, Sadaat Said Iftekhar, Farzad Fraidoon, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 81 ( 1 ) page: 121 - 131   2019.2

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    Afghanistan is one of the countries with the poorest maternal mortality ratio in the world. Inadequate utilization of antenatal care (ANC) services increases the risk of maternal mortality. This study aimed to identify the factors associated with ANC visits in Afghanistan. The dataset of the Afghanistan Demographic and Health Survey (AfDHS) 2015 were used for taking the socio-demographic factors, cultural factors, and the number of ANC visits. The subjects of this study were 18,790 women who had at least one live birth in the last five years, and 10,554 women (56.2%) had availed of at least one ANC visit. Most women were 20-29 years old (53.3%), poor (41.7%), had 2-4 children (43.9%), lived in rural areas (76.1%), and had no education (85.0%) or no job (86.7%). Most women answered that husbands made a decision about their healthcare and that getting permission from their husbands was a major challenge. Multivariate analysis showed that age, ethnicity, area of residence, parity, women's education, husband's education, literacy, having a job, wealth, the decision maker for healthcare, and difficulty in getting permission from the husband were significantly correlated with availing of the ANC visits. This study showed that not only the socio-demographic factors but also the cultural factors were associated with ANC visits. The Afghanistan government should improve the education programs at schools and healthcare facilities, for both men and women. To augment women's propensity to take a decision, the programs for women's empowerment need to be supported and extended across the country.

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  39. Healthcare waste management at primary health centres in Mon State, Myanmar: the comparisons between hospital and non-hospital type primary health centres Reviewed

    Win Ei Mon, Saw Yu Mon, Oo Kyi Lwin, Than Thet Mon, Cho Su Myat, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 81 ( 1 ) page: 81 - 91   2019.2

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    Improper healthcare waste management (HCWM) poses a serious public health problem worldwide. Primary health centres (PHCs) provide public health and medical care services as the basic structural and functional units of healthcare services in Myanmar. However, no study has been conducted in Myanmar about HCWM at PHCs. This study aims to assess the practice of HCWM at PHCs in Mon State, Myanmar. A cross-sectional study was conducted in all ten townships in Mon State, Myanmar. In total, 93 PHCs (71 non-hospitals and 22 hospitals) were selected using simple random sampling. The observational checklist which was developed based on the World Health Organization's standard guideline procedure of HCWM was used to determine the practice of HCWM at PHCs. Binary logistic regression was used for final data analysis. The burning in pits method was used as the final disposal method of healthcare waste in 78.5% of PHCs. Non-hospital type PHC were more likely not to have colour coding system for HCWM (odds ratio [OR] 7.54; 95% confidence interval [CI] 2.15-26.52), did not have equipment for accidental spillage of healthcare waste (OR 3.92; 95% CI 1.3-11.77) and did not have separate staff for HCWM (OR 8.27; 95% CI 2.77-24.64), relative to hospitals. Non-hospital type PHCs practices poorly on the colour coding for waste segregation, assigning separate staff for HCWM, and possessing equipment for accidental spillage of healthcare waste than hospital type PHCs. The Ministry of Health and Sports should issue technical guidelines of safe HCWM as a compulsory policy for both hospitals and non-hospital type PHCs.

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  40. Increase of Eosinophil in Dialysate During Induction of Peritoneal Dialysis Reviewed

    Shigemoto Emi, Mizuno Masashi, Suzuki Yasuhiro, Kobayashi Kazuma, Sakata Fumiko, Kariya Tetsuyoshi, Katsuno Takayuki, Maruyama Shoichi, Ito Yasuhiko

    PERITONEAL DIALYSIS INTERNATIONAL   Vol. 39 ( 1 ) page: 90 - +   2019.1

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  41. Assessing the operational costs of routine immunization activities at the sub-center level in Myanmar: What matters for increasing national immunization coverage ? Reviewed International journal

    Aye Hnin Nwe Ni, Saw Yu Mon, Thar Aye Mya Chan, Oo Nwe, Aung Zaw Zaw, Tin Htun, Than Thet Mon, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    VACCINE   Vol. 36 ( 49 ) page: 7542 - 7548   2018.11

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    BACKGROUND: Myanmar's national immunization program was launched in 1978. Routine immunization is mainly provided at sub-center level with midwives assigned as main vaccinators. The vaccinators at the sub-centers have to obtain vaccines from their designated township health department's cold room for immunization services. This study aimed to calculate the operational costs of routine immunization at sub-centers in Myanmar. METHODS: A cross-sectional study was conducted among 160 sub-centers throughout the country. Face-to-face interviews were conducted with the main vaccinator at each sub-center using a pre-tested questionnaire. The study analyzed the operational costs per facility and the associations between sub-center characteristics and operational costs. RESULTS: In Myanmar, the average operational costs of routine immunization per sub-center ranged from 434,700-990,125 MMK for rural areas and 235,875-674,250 MMK for urban areas. The operational costs increased by 8,749.50 MMK (95% CI: 6,805.79-10,693.21; p < 0.001) per mile and 5,752.50 MMK (95% CI: 914.22-10,590.79; p < 0.05) per working day. CONCLUSION: This study indicated that the operational costs at sub-centers were high and varied significantly among the different geographical areas. The operational costs could be reduced by additional support for the resources, for example, installing cold chain facilities at sub-centers and opening new sub-centers throughout the country.

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  42. Myanmar language version of the Revised Hasegawa's Dementia Scale Reviewed

    Saw Yu Mon, Than Thet Mon, Win Ei Mon, Cho Su Myat, Khaing Moe, Latt Nyi Nyi, Aung Zaw Zaw, Oo Nwe, Aye Hnin Nwe Ni, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 80 ( 4 ) page: 435 - 450   2018.11

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    Reduced cognitive function among the elderly is an important issue not only in developed countries, but also in developing countries. As a test to measure cognitive function, the Revised Hasegawa's Dementia Scale (HDS-R) has been used in Asian countries including Japan, Korea, and China. Since there was no HDS-R version in Myanmar language, a questionnaire and manual for the HDS-R were developed. The translation from English to Myanmar language was done by two Myanmar researchers. Back-translation was conducted to confirm the accuracy of the translation by two other Myanmar researchers. Back-translated English was compared to the original by two Japanese researchers, and inconsistencies were discussed by all six researchers to reach consensus. Five Myanmar researchers independently read the questionnaire and manual to verify the expressions are familiar in Myanmar language. The modified points were as follows. 1) The date order in Question 2 is day/month/year. 2) The words to be memorized in Questions 4 and 7 are padauk tree, cat, and bullock cart for the first set, and tamarind tree, dog, and car for the second set. 3) The objects to be memorized in Question 8 are shown with pictures, not actual objects. 4) Like the Lao version, we introduced two new rules; a clear time definition for no reply (10 seconds), and repeating questions twice for those with hearing problems. The revised version of the HDS-R has been prepared to be an applicable standard questionnaire for use on assessment of cognitive function in suspected dementia cases in Myanmar, both in the clinical and public healthcare setting.

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  43. Tobacco Control Law awareness, enforcement, and compliance among high school students in Myanmar Reviewed

    Latt Nyi Nyi, Saw Yu Mon, Cho Su Myat, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 80 ( 3 ) page: 379 - 389   2018.8

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    In Myanmar, the Control of Smoking and Consumption of Tobacco Products Law (Tobacco Control Law; TCL), which covers the prohibition of sale of tobacco to minors and all forms of tobacco advertisement, was enacted in 2006. This study aimed to examine the awareness of the TCL among high school students. A cross-sectional study was conducted in November 2015. Participants were 1,339 high school students (554 boys and 785 girls) from two regions and two states of Myanmar. Data were collected using anonymous self-administered questionnaires and revealed that 78.0% of boys and 86.5% of girls responded the sale of tobacco products in or within 100 feet from school, and 83.4% of boys had ever seen someone selling tobacco products to minors. More than half of the students had ever seen minors selling or distributing tobacco products, and had knowledge about the TCL, while only 9.7% knew about the penalties. The adjusted odds ratio (95% confidence interval) of awareness of the TCL was 2.12 (1.35-3.31) for students who had ever received tobacco products free of charge, or seen/heard about their distribution free of charge, 1.86 (1.20-2.89) for current smokeless tobacco users, and 0.58 (0.43-0.77) for students who had ever seen someone selling tobacco products to minors. The majority of high school students did not know that the violation of the TCL could be punished with a fine and/or imprisonment. These findings suggest that awareness of the TCL was very low among high school students, highlighting that TCL enforcement and compliance, and tobacco-related health education programs are not satisfactory in Myanmar.

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  44. Associations of treatment completion against drug addiction with motivational interviewing and related factors in Afghanistan Reviewed

    Rasekh Bakhtar, Saw Yu Mon, Azimi Sayed, Kariya Tetsuyoshi, Yamamoto Eiko, Hamajima Nobuyuki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 80 ( 3 ) page: 329 - 340   2018.8

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    Despite the increase in the number of drug treatment centers, patients with drug addicts have been increasing without the improvement of treatment in Afghanistan. This study aimed to examine the associations of the completion of drug addiction treatment with motivational interviewing (MI) and other factors among male drug users in Afghanistan. Subjects were patients admitted to Jangalak Hospital in Kabul, Afghanistan in 2014 and 2015. Systematic sampling and supplementary sampling were applied. The records of 327 males aged 18 to 54 years were collected from those of 3,373 male inpatients. Completion of treatment was defined as presence and receiving treatment in the hospital for at least 45 days. Multiple logistic regression models were applied to estimate the adjusted odds ratio (AOR) and 95% confidence interval (CI) for the completion of drug addiction treatment. Among the patients, heroin was the most commonly used drug, followed by opium, crystal, hashish, and other drugs. Patients with treatment history for drug addiction (AOR 2.46; 95% CI 1.14-5.30), those attended MI before admission (AOR 43.98; 95% CI 17.21-112.39), and those used heroin (AOR 4.74; 95% CI 1.32-16.97) were more likely to complete the drug addiction treatment. Among the factors examined in this study, attending MI was most strongly associated with the completion of drug addiction treatment. Amendments to policies to include compulsory MI in standard operational procedures of drug addiction treatment before hospitalization may be recommended.

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  45. Waiting time in the outpatient clinic at a national hospital in Vietnam Reviewed

    Suong Thi Thao Nguyen, Eiko Yamamoto, Mai Thi Ngoc Nguyen, Huy Bao Le, Tetsuyoshi Kariya, Yu Mon Saw, Cong Duc Nguyen, Nobuyuki Hamajima

    Nagoya Journal of Medical Science   Vol. 80 ( 2 ) page: 227 - 239   2018.5

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    Vietnam is facing a problem of over-crowding in public hospitals. Long waiting time is a major dissatisfaction for patients. Reducing waiting time benefits not only patients but also hospitals in decreasing overall workload. To identify factors contributing to long waiting time in outpatient clinics, a cross-sectional study was conducted at a national hospital in Vietnam. The time for each process of 7,931 patients who visited the outpatient clinics within Thong Nhat Hospital from 5 to 9 September 2016 was collected from the computerized clinical database. Characteristics of patients (age, sex, address, day of visit, registration time, visited department and test) and waiting times were studied at the outcome measures. Multivariate analyses using the linear regression model was carried out to evaluate the contribution of these factors to the total waiting time. Among 7,931 patients, 52.3% were women, 46.3% were 60-80 years, and 64.8% registered between 5:30 and 9:30. The mean total waiting time was 104.1 minutes. The analysis on total waiting time among 4,564 patients who visited one department without any test showed that department group and registration time were significantly associated with a total waiting time. In 1,259 patients who visited one department with one test, early registration and undergoing blood tests were significantly associated with a longer total waiting time. These results showed that old age, visiting internal medicine departments, early registration time, and undergoing blood tests were factors contributing to a longer total waiting time in the outpatient clinics within Thong Nhat Hospital.

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  46. TGF-beta 1-VEGF-A pathway induces neoangiogenesis with peritoneal fibrosis in patients undergoing peritoneal dialysis Reviewed

    Kariya Tetsuyoshi, Nishimura Hayato, Mizuno Masashi, Suzuki Yasuhiro, Matsukawa Yoshihisa, Sakata Fumiko, Maruyama Shoichi, Takei Yoshifumi, Ito Yasuhiko

    AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY   Vol. 314 ( 2 ) page: F167 - F180   2018.2

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  47. Medical facility statistics in Japan Reviewed

    Nobuyuki Hamajima, Takuya Sugimoto, Ryo Hasebe, Su Myat Cho, Moe Khaing, Tetsuyoshi Kariya, Yu Mon Saw, Eiko Yamamoto

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 79 ( 4 ) page: 515 - 525   2017.11

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    Medical facility statistics provide essential information to policymakers, administrators, academics, and practitioners in the field of health services. In Japan, the Health Statistics Office of the Director-General for Statistics and Information Policy at the Ministry of Health, Labour and Welfare is generating these statistics. Although the statistics are widely available in both Japanese and English, the methodology described in the technical reports are primarily in Japanese, and are not fully described in English. This article aimed to describe these processes for readers in the English-speaking world. The Health Statistics Office routinely conduct two surveys called the Hospital Report and the Survey of Medical Institutions. The subjects of the former are all the hospitals and clinics with long-term care beds in Japan. It comprises a Patient Questionnaire focusing on the numbers of inpatients, admissions, discharges, and outpatients in one month, and an Employee Questionnaire, which asks about the number of employees as of October 1. The Survey of Medical Institutions consists of the Dynamic Survey, which focuses on the opening and closing of facilities every month, and the Static Survey, which focuses on staff, facilities, and services as of October 1, as well as the number of inpatients as of September 30 and the total number of outpatients during September. All hospitals, clinics, and dental clinics are requested to submit the Static Survey questionnaire every three years. These surveys are useful tools for collecting essential information, as well as providing occasions to implicitly inform facilities of the movements of government policy.

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  48. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting? Reviewed

    Thet Mon Than, Yu Mon Saw, Moe Khaing, Ei Mon Win, Su Myat Cho, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima

    BMC HEALTH SERVICES RESEARCH   Vol. 17 ( 1 ) page: 669   2017.9

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    Background: Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately.
    Methods: A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010.
    Results: The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals.
    Conclusion: The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the available resources.

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  49. Successful Treatment of Cryptococcus laurentii Peritonitis in a Patient on Peritoneal Dialysis Reviewed

    Marina Asano, Makoto Mizutani, Yasuko Nagahara, Koji Inagaki, Tetsuyoshi Kariya, Daijiro Masamoto, Makoto Urai, Yukihiro Kaneko, Hideaki Ohno, Yoshitsugu Miyazaki, Masashi Mizuno, Yasuhiko Ito

    INTERNAL MEDICINE   Vol. 54 ( 8 ) page: 941 - 944   2015

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:JAPAN SOC INTERNAL MEDICINE  

    A 32-year-old man on peritoneal dialysis (PD) was hospitalized for seven days due to fever. A diagnosis of yeast-like fungal peritonitis was made by Gram staining. The patient was started on intravenous micafungin and oral fluconazole therapy following removal of the PD catheter. A fungal pathogen was isolated from the peritoneal fluid and identified as Cryptococcus species. Based on antifungal susceptibility testing, the treatment was changed to voriconazole and continued for 3 months. A genetic analysis identified the isolate as Cryptococcus laurentii (C. laurentii). This patient was diagnosed with C. laurentii PD-related peritonitis and was successfully treated with voriconazole and removal of the PD catheter.

    DOI: 10.2169/internalmedicine.54.3586

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  50. Evaluation for hypoperfusion distal to arteriovenous vascular access using skin perfusion pressure in fingers Reviewed

    Akihito Tanaka, Masaki Sakakibara, Hayato Nishimura, Marina Asano, Tetsuyoshi Kariya, Daijiro Masamoto, Makoto Mizutani, Hideki Ishii, Toyoaki Murohara

    JOURNAL OF VASCULAR ACCESS   Vol. 15 ( 1 ) page: 29 - 32   2014.1

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:WICHTIG EDITORE  

    Purpose: The usefulness of skin perfusion pressure (SPP) measurement in the assessment of critical ischemia of the lower limb has previously been established. This study investigated whether finger SPP measurement is useful to evaluate hypoperfusion distal to arteriovenous vascular access in dialysis patients.
    Methods: Seventeen asymptomatic hemodialysis patients with upper extremity arteriovenous access and 17 non-dialysis control patients were prospectively examined. SPP in the thumb, the middle finger and the little finger of both hands was measured. The bilateral difference of the mean SPP of the three fingers was evaluated.
    Results: The mean difference of SPP between the contralateral and the arteriovenous access sides among hemodialysis patients (33 +/- 2 5 mmHg) was significantly larger than the mean difference of SPP between the left and the right hands among control patients (1.0 +/- 6.0 mmHg, p&lt;0.01).
    Conclusions: This report shows the potential usefulness of SPP measurement to evaluate hypoperfusion distal to arteriovenous vascular access.

    DOI: 10.5301/jva.5000170

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Books 1

  1. 小児科診療 2022年 Vol.85 No.秋増刊号 今考える,移行期医療 「指定難病」

    狩谷哲芳( Role: Contributor ,  Ⅲ自立支援に欠かせない社会保障制度と就労支援 社会保障制度と就労支援 指定難病)

    診断と治療社  2022.10 

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    Language:Japanese

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MISC 2

  1. TGF-β-VEGF-A PATHWAY INDUCES NEOANGIOGENESIS IN PERITONEAL FIBROSIS OF PERITONEAL DIALYSIS

    Kariya, T; Ito, Y; Mizuno, M; Suzuki, Y; Sakata, F; Terabayashi, T; Ishii, T; Tawada, M; Iguchi, D; Maruyama, S; Matsuo, S

    NEPHROLOGY DIALYSIS TRANSPLANTATION   Vol. 31   page: 35 - 35   2016.5

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  2. 腹膜透析の腹膜線維症においてTGF-β-VEGF-A pathwayが血管新生を誘導する

    狩谷 哲芳, 伊藤 恭彦, 水野 正司, 鈴木 康弘, 坂田 史子, 丸山 彰一, 松尾 清一

    日本腎臓学会誌   Vol. 58 ( 3 ) page: 258 - 258   2016.5

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    Language:Japanese   Publisher:(一社)日本腎臓学会  

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Presentations 1

  1. TGF-β-VEGF-A PATHWAY INDUCES NEOANGIOGENESIS IN PERITONEAL FIBROSIS OF PERITONEAL DIALYSIS International conference

    Kariya T, Ito Y, Mizuno M, Suzuki Y, Sakata F, Terabayashi T, Ishii T, Tawada M, Iguchi D, Maruyama S, Matsuo S

    The 53rd ERA-EDTA Congress 

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    Event date: 2016.5

    Language:English   Presentation type:Oral presentation (general)  

    Country:Austria  

KAKENHI (Grants-in-Aid for Scientific Research) 1

  1. lucidation of the mechanisms which cause deterioration of peritoneal function in peritoneal dialysis and development of a novel treatment by inhibiting neoangiogenesis.

    Grant number:18K15997  2018.4 - 2020.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Early-Career Scientists

    KARIYA TETSUYOSHI

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    Authorship:Principal investigator 

    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    The purpose of this study is to reveal the mechanisms how TGF-beta1 induces VEGF-A, and VEGF-A causes peritoneal dysfunction in peritoneal dialysis. Sixty-six human peritoneal tissues and 136 peritoneal dialysis fluid were analyzed with microscopic examinations, immunological stains and protein measurements. Compared to the control groups, samples with peritoneal dysfunction had significantly (1) higher levels of VEGF-A and TGF-beta1 protein in peritoneal dialysis fluid, (2) increased number of CD-31-positive vascular vessels in submesothelial compact zone of peritoneal tissues, and (3) higher level of VEGF-A mRNA expression in peritoneal tissues. It was suggested that TGF-beta1-VEGF-A induction and subsequent loss of vascular integrity causes peritoneal dysfunction in peritoneal dialysis. Peritoneal fibrosis in animal model revealed that hypoxic change in macrophages of peritoneal membrane induces by TGF-β1 causes VEGF-A, resulting in increased angiogenesis and vascular permibility.

 

Teaching Experience (On-campus) 19

  1. Outline of Clinical Medicine

    2024

  2. Special Lecture TOKURON

    2023

  3. Distinctive Educational Program, Health Care Administration course

    2020

     詳細を見る

    Role of health center (hokejo)
    Tuberculosis controls
    Quarantine
    Dialysis therapy in Japan

  4. Outline of Clinical Medicine

    2020

     詳細を見る

    Dialysis therapy in Japan

  5. Hospital Administration

    2020

  6. Administrative Regulations for Health

    2020

  7. Distinctive Educational Program, Medical English

    2020

  8. Distinctive Educational Program, Health Care Administration course

    2019

     詳細を見る

    Role of health center (hokejo)
    Tuberculosis controls
    Dialysis therapy in Japan

  9. Outline of Clinical Medicine

    2019

     詳細を見る

    Dialysis therapy in Japan

  10. Administrative Regulations for Health

    2019

  11. Distinctive Educational Program, Medical English

    2019

  12. Distinctive educational program, Health Care Administration course

    2018

     詳細を見る

    Role of health center (hokejo)
    Tuberculosis controls
    Dialysis therapy in Japan

  13. Outline of Clinical Medicine

    2018

     詳細を見る

    Dialysis therapy in Japan

  14. Administrative Regulations for Health

    2018

  15. Distinctive Educational Program, Medical English

    2018

  16. Distinctive educational program, Health Care Administration course

    2017

     詳細を見る

    Dialysis therapy in Japan

  17. Administrative Regulations for Health

    2017

  18. Outline of Clinical Medicine

    2017

  19. Medical English

    2017

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Teaching Experience (Off-campus) 1

  1. Essential Writing a Scientific Research Paper

    2017.12 University of Medicine 1)

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    Level:Other  Country:Myanmar