April brings Thingyan (literal meaning = change), followed by the Myanmar New Year. This year will herald in the year 1385 BE. Accompanying the change-over to the new year are changes in the seasons, exotic display of flora and changing health concerns. Harsh weather in windy March, with cool night temperatures alternating with the heat in the daytime gives way to extremes of temperature and dry heat in April.
Many parts of the country will experience water shortages so personal hygiene will be difficult to practice and safe drinking water may be inaccessible. These hardships in the community will ultimately pose health problems. Extreme heat can cause heat exhaustion or heat stroke especially in the extremes of age. The Thirst Centre is not as sensitive and thermoregulation not as effective as in young adults. Carers need to ensure adequate hydration in infants and the elderly who are unable to communicate their discomfort. Nutritional deficiencies are often not carefully looked for, and may be more common than meets the eye. With rising costs of commodities and extremes of heat causing anorexia, nutritional deficiencies are not necessarily exclusive for the lower socioeconomic class of people.
Concerns about Covid had eased over the latter half of 2022, and the public has almost totally stopped wearing masks. People have become complacent and miss a Covid diagnosis as new variants of the Covid-19 corona virus no longer present with the classical symptoms of fever, cough, sore throat, difficulty in breathing but rather as myalgia, joint pains and fatigue. Furthermore, nobody bothers to test for Covid anymore. The reality is that Covid has not gone away and will not go away. The CDC has alerted that some people – especially those who had severe COVID-19-experience new health conditions after COVID-19 illness. They may experience multiorgan effects or autoimmune conditions with symptoms lasting weeks, months, or even years after COVID-19 illness. Multi-organ effects can involve many body systems, including the heart, lung, kidney, skin, and brain. As a result of these effects, people who have had COVID-19 may be more likely to develop new health conditions such as diabetes, heart conditions, blood clots, or neurological conditions compared with people who have not had COVID-19. General Practitioners need to be on the lookout for such presentations and enquire about Covid-19 infection in history – taking.
The picture quiz and case reports on Cushing and melisma should be of interest to young practitioners. You are invited to send such picture quizzes or case reports to the Journal. Your contributions to other categories (reflection, short communications, Letter to the Editors) are also most welcome.
We wish you a happy, healthy, peaceful year ahead.
– The Editors
