Objective. Malaria during pregnancy is a priority area for malaria research and control as pregnant women represent a high risk group for severe malaria, and the presentation of malaria during ...pregnancy varies according to the level of transmission in the area; so the aim of this study is to determine the prevalence rates of malaria parasite among pregnant women attending to Saudi Kassala Teaching hospital in Kassala state, 2022. Methods. A cross-sectional study was carried out in Saudi Kassala Teaching hospital in Kassala State. This study involved one hundred and eighty-five blood samples collected from pregnant women who was then examined by using blood films and ICT for malaria, and the data were collected by a structured questionnaire and analyzed using SPSS version 21. Results. The prevalence of malaria among pregnant women was 2.2% (95% CI: 0.006–0.054). There was no significant difference among the different age groups with respect to the prevalence of malaria (P value = 0.483). The prevalence of malaria in rural residency was 2.2%, and this was significantly more common than the urban residency (P value = 0.021). When compared across the gestational trimesters, there was no significant difference between them (P value = 0.518). The number of gravidity is not related to malaria infection (P value = 0.737). The presence of symptom compliant of malaria during pregnancy does not suggest the presence of malaria (P value = 0.152). No difference was found between the different educational levels with respect to the prevalence of malaria (P value = 0.362). The result showed that there was 1 (0.5%) negative result in ICT which was positive in blood film for malaria (BFFM) and there were 3 (1.6%) positive malaria parasites by both methods in all 185 samples with statistically insignificant differences (P = 0.703). Conclusion. Plasmodium falciparum was only species detected in this study. Malaria among pregnant women was more prevalent in rural areas. However, other factors such as age, gestational age, gravidity, and educational level do not affect the prevalence of malaria in pregnant women. The presence of symptomatic compliant of malaria during pregnancy does not suggest the presence of malaria. The use of ICT or BFFM has similar diagnostic outcome for malaria in pregnancy.
Objective
To evaluate diagnostic performance and inter-reviewer agreement (IRA) of the Gynecologic Imaging Reporting and Data System (GI-RADS) for diagnosis of adnexal masses (AMs) by pelvic ...ultrasound (US).
Patients and methods
A prospective multicenter study included 308 women (mean age, 41 ± 12.5 years; range, 15–73 years) with 325 AMs detected by US. All US examinations were analyzed, and AMs were categorized into five categories according to the GI-RADS classification. We used histopathology and US follow-up as the reference standards for calculating diagnostic performance of GI-RADS for detecting malignant AMs. The Fleiss kappa (
κ
) tests were applied to evaluate the IRA of GI-RADS scoring results for predicting malignant AMs.
Results
A total of 325 AMs were evaluated: 127 (39.1%) were malignant and 198 (60.9%) were benign. Of 95 AMs categorized as GI-RADS 2 (GR2), none was malignant; of 94 AMs categorized as GR3, three were malignant; of 13 AMs categorized as GR4, six were malignant; and of 123 AMs categorized as GR5, 118 were malignant. On a lesion-based analysis, the GI-RADS had a sensitivity, a specificity, and an accuracy of 92.9%, 97.5%, and 95.7%, respectively, when regarding only those AMs classified as GR5 for predicting malignancy. Considering combined GR4 and GR5 as a predictor for malignancy, the sensitivity, specificity, and accuracy of GI-RADS were 97.6%, 93.9%, and 95.4%, respectively. The IRA of the GI-RADS category was very good (
κ
= 0.896). The best cutoff value for predicting malignant AMs was >GR3.
Conclusions
The GI-RADS is very valuable for improving US structural reports.
Key Points
• There is still a lack of a standard in the assessment of AMs.
• GI-RADS is very valuable for improving US structural reports of AMs.
• GI-RADS criteria are easy and work at least as well as IOTA.
Bardet-Biedl syndrome: a case series Elawad, Omer Ali Mohamed Ahmed; Dafallah, Mumen Abdalazim; Ahmed, Mohammed Mahgoub Mirghani ...
Journal of medical case reports,
04/2022, Letnik:
16, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Bardet-Biedl syndrome is a rare multisystem autosomal recessive disorder that falls under the spectrum of ciliopathy disorders. It is characterized by rod-cone dystrophy, renal malformations, ...polydactyly, learning difficulties, central obesity, and hypogonadism. Many minor features that are related with Bardet-Biedl syndrome might aid in diagnosis and are crucial in clinical management. Bardet-Biedl syndrome is diagnosed on the basis of clinical signs and symptoms, which can be confirmed by genetic testing. Here we present four cases of Bardet-Biedl syndrome. To our knowledge, these are the first cases of Bardet-Biedl syndrome reported from Sudan.
Here, we report four Sudanese patients who presented with a variety of clinical manifestations of Bardet-Biedl syndrome (two males, 50 and 16 years old; two females, 38 and 18 years old). The first two patients presented with features of chronic kidney disease. The third patient had recently been diagnosed with type 1 diabetes and diabetic ketoacidosis. The fourth patient showed signs of retinal dystrophy early on. Case 1: a 38-year-old female presented with vomiting and irritability; the patient was diagnosed with Bardet-Biedl syndrome as she fulfilled six items of the primary features (obesity, retinitis pigmentosa, post-axial polydactyly, renal abnormalities, learning disabilities, and genitourinary malformations), as well as one secondary feature (cardiovascular involvement, that is, left ventricular hypertrophy). Case 2: a 50-year-old male presented with fatigability; the patient was diagnosed with Bardet-Biedl syndrome as he fulfilled four items of the primary features (obesity, retinitis pigmentosa, post-axial polydactyly, and renal abnormalities) in addition to two secondary features (diabetes mellitus and cardiovascular involvement, that is, left ventricular hypertrophy). Case 3: an 18-year-old female presented with polyuria, polydipsia, weight loss, and epigastric pain for 2 days; the patient was diagnosed with Bardet-Biedl syndrome because he had four major features (retinal dystrophy, post-axial polydactyly, obesity, and learning disabilities) in addition to three secondary features (developmental delay, diabetes mellitus, and strabismus). Case 4: a 16-year-old male presented with a blurring of vision; the patient was diagnosed with Bardet-Biedl syndrome as he exhibited four major features (retinal dystrophy, post-axial polydactyly, obesity, and learning disabilities) plus two secondary features (developmental delay and cataract).
The scarcity of Bardet-Biedl syndrome necessitates a high index of suspicion to diagnose this syndrome. Increased awareness among physicians is required for the early diagnosis and treatment of Bardet-Biedl syndrome and to avoid complications and mortality.
Background: The fact that bacteria have no geographical boundaries has made bacterial resistance to antibiotics a worldwide issue that requires collaboration and unity to address. Aim: evaluate the ...effect of nursing-based intervention to optimize the self-prescribed and the misuse of antibiotics among mothers of children less than 5 years. Methods: A quasi-experimental design was used to conduct this study. The study was conducted in Maternal Child Health Centers in Mansoura City & Beni-Suef City, Egypt, 100 participants were included in the study. A structured interview questionnaire was used to collect the data, which consisted of five parts; socio-demographic data, knowledge questions about antibiotics and their resistance, attitude scale towards self-prescribed antibiotics, questionnaire on safe use of antibiotics, and patterns of self-prescribed antibiotic use. Results: 41 % of the study group used self-prescribed antibiotics more than 6 times in the previous 6 months and 100 % of them used them to treat fever and sore throat, followed by 76 % for vomiting and diarrhea. There were significant improvements in participants' knowledge, attitudes towards self-prescribed antibiotics, and safe use of antibiotics after implementing the nursing intervention. Conclusion: The nursing-based intervention was successful in attaining its objectives in improving the total knowledge, attitudes and practices of the studied group. Recommendation: Health education about appropriate antibiotic use should be approved as a part of the preventive services obtained for the mothers.
The current work presents a detailed investigation for the effect of a wide range friction stir welding (FSW) parameters on the dissimilar joints’ quality of aluminum alloys. Two groups of dissimilar ...weldments have been produced between AA5083/AA5754 and A5083/AA7020 using tool rotational rates range from 300 to 600 rpm, and tool traverse speeds range from 20 to 80 mm/min. In addition, the effect of reversing the position of the high strength alloy at the advancing side and at retreating side has been investigated. The produced joints have been investigated using macro examination, hardness testing and tensile testing. The results showed that sound joints are obtained at the low heat input FSW parameters investigated while increasing the heat input results in tunnel defects. The hardness profile obtained in the dissimilar AA5083/AA5754 joints is the typical FSW hardness profile of these alloys in which the hardness reduced in the nugget zone due to the loss of the cold deformation strengthening. However, the profile of the dissimilar AA5083/AA7020 showed increase in the hardness in the nugget due to the intimate mixing the high strength alloy with the low strength alloy. The sound joints in both groups of the dissimilar joints showed very high joint strength with efficiency up to 97 and 98%. Having the high strength alloy at the advancing side gives high joint strength and efficiency. Furthermore, the sound joints showed ductile fracture mechanism with clear dimple features mainly and significant plastic deformation occurred before fracture. Moreover, the fracture in these joints occurred in the base materials. On the other, the joints with tunnel defect showed some features of brittle fracture due to the acceleration of the existing crack propagation upon tensile loading.
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•Ultrasensitive and green-adapted spectrofluorimetric approach.•Simultaneous analysis of alfuzosin HCL and solifenacin succinate at nanogram scale.•The proposed approach was assessed ...for its greenness using eco-scale and GAPI tools.
Alfuzosin hydrochloride (AZH) is co-formulated with solifenacin succinate (SOS) in Solitral® capsules for treating prostate hyperplasia in patients with overactive bladder syndrome. Herein and for the first time, an ultrasensitive synchronous spectrofluorimetric approach coupled with first-order derivative signal processing was designed for simultaneous determination of AZH and SOS in their pure forms, newly-released pharmaceutical capsules, and human biological fluids. AZH and SOS showed their conventional emission spectra in bi-distilled water at 382 nm and 294 nm after excitation at 325 nm and 250 nm, respectively. The native fluorescence intensities of AZH and SOS were greatly enhanced through micellar formation using sodium dodecyl sulfate surfactant (2%). The proposed approach included the use of synchronous mode at Δλ of 60 nm where the overlap between the studied analytes’ fluorescence spectra wasn't completely resolved. The complete resolution was achieved by derivatization of the synchronized spectra to the first-order yielding two zero-crossing points which allowed the determination of AZH and SOS simultaneously without interference at 408 nm and 321 nm, respectively. Under optimum experimental circumstances, good linearities were accomplished over the concentration ranges of (1–24) ng/mL and (4–250) ng/mL with LOD of 0.26 ng/mL and 1.31 ng/mL for AZH and SOS, respectively. The proposed approach was validated successfully according to guidelines adopted by the ICH and compared statistically with the reported LC method with no discernible differences concerning accuracy or precision at p = 0.05. Successful application of the proposed approach achieved with excellent recovery percentages for analysis of the studied analytes in different matrices (pharmaceutical capsules and biological fluids) confirms its suitability for use in QC laboratories and other bioanalytical applications. The proposed approach’s greenness was evaluated using two tools namely; penalty points scoring system and green analytical procedure index (GAPI) divulging excellent greenness of this approach relative to the reported LC method. The proposed approach relied chiefly on water as the cheapest and greenest solvent.
Sydenham Chorea in Sudan; Presentation Panorama A Ibrahim, Etedal Ahmed; Mohamed, Rogia Hussein; Abbasher Hussien Mohamed Ahmed, Khabab ...
Neuropsychiatric disease and treatment,
01/2023, Letnik:
19
Journal Article
Recenzirano
Odprti dostop
Sydenham's chorea (SC) is the most common form of acquired chorea in childhood, it is considered a neurological complication of streptococcal pharyngitis. In this study, we aimed to determine the ...clinical pattern, association of Sydenham's chorea with other manifestations of acute rheumatic fever, and the laboratory findings of Sydenham's chorea among Sudanese patients.
A prospective cross-sectional study involving fifty patients of various ages diagnosed with Sydenham's chorea and followed up at The National Center for Neurological Sciences from January 2017 to November 2019. Data were obtained after patients' consent through personal interviews or personal review of patients' records via a structured questionnaire composed of demographic data, symptoms, co-morbid illness, risk factors, physical examination, and related investigations.
About 50 patient was enrolled in this study with a median age of 13.7 years. Females were (n=35) (70%) and (30%) (n=15) s were males. Generalized chorea was seen in 33 (66%) and hemichorea in 17 (34%) patients. Weakness (38%) and hypotonia (46%) were common, such as behavior change (44%), dysarthria (70%), gait change (18%), and deterioration of handwriting (12%). Arthritis occurred in (36%), carditis in 30 (60%), both arthritis and carditis in 18 (36%), and pure chorea in 14 (28%). Erythema marginatum and subcutaneous nodules were not observed in our patients. Only 13 patients (26%) gave a history of pharyngitis.
Sydenham chorea is more common in young female Sudanese, with a familial predominance and a tendency towards mitral valve disease. All pediatric Patients with chorea should be screened for Sydenham's chorea.
Transesophageal Doppler (TED) is a minimally invasive monitor that allows continuous hemodynamic variables monitoring. Non-invasive electrical cardiometry (EC) and TED methods added an additional ...facility to monitor cardiac output (CO) continuously and guide fluid management. The aim of this study was to correlate hemodynamic monitoring between non-invasive EC and Esophageal Doppler (ED) in cases undergoing major abdominal surgery.
This prospective observational study was carried out on 35 adult cases, American Society of Anesthesiologists (ASA) physical status II or III, undergoing major abdominal surgery. Esophageal Doppler and EC were attached to the same patient. Parameters measured were hemodynamic parameters.
Comparison of CO with ICON and ED showed that the ICON mean value ranged from 5.6 to 6.2 l/min, and the ED mean value always ranged from 5.7 to 7.6 l/min with the non-significant difference between the two methods. The precision for the ICON ranged from 15.19 to 17.99% and the precision for ED ranged from 13.39 to 17.08%. At a 15% change in ICON, the ED values' sensitivity was 72.6% and specificity was 30.9% with AUC 0.505.
The agreement between CO measured by EC and ED is acceptable. Both monitored trend changes and guided fluid administration in the operation theater. The EC is as accurate as ED in measuring hemodynamics during major abdominal surgery.
Acute hypoxia impairs left ventricular (LV) inotropic function and induces development of pulmonary edema (PE). Enhanced and uneven hypoxic pulmonary vasoconstriction is an important pathogenic ...factor of hypoxic PE. We hypothesized that the potent vasodilator relaxin might reduce hypoxic pulmonary vasoconstriction and prevent PE formation. Furthermore, as relaxin has shown beneficial effects in acute heart failure, we expected that relaxin might also improve LV inotropic function in hypoxia. Forty-two rats were exposed over 24 h to normoxia or hypoxia (10% N
2
in O
2
). They were infused with either 0.9% NaCl solution (normoxic/hypoxic controls) or relaxin at two doses (15 and 75 μg kg
−1
day
−1
). After 24 h, hemodynamic measurements and bronchoalveolar lavage were performed. Lung tissue was obtained for histological and immunohistochemical analyses. Hypoxic control rats presented significant depression of LV systolic pressure by 19% and of left and right ventricular contractility by about 40%. Relaxin did not prevent the hypoxic decrease in LV inotropic function, but re-increased right ventricular contractility. Moreover, hypoxia induced moderate interstitial PE and inflammation in the lung. Contrasting to our hypothesis, relaxin did not prevent hypoxia-induced pulmonary edema and inflammation. In hypoxic control rats, PE was similarly distributed in the apical and basal lung lobes. In relaxin-treated rats, PE index was 35–40% higher in the apical than in the basal lobe, which is probably due to gravity effects. We suggest that relaxin induced exaggerated vasodilation, and hence pulmonary overperfusion. In conclusion, the results show that relaxin does not prevent but rather may aggravate PE formation.
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