Maternal age and miscarriage: A unique association curve in Sudan

This study's aim was to estimate the prevalence and maternal age and other risk factors of miscarriage among Sudanese women. Across-sectional study was conducted at the Saad Abuelela Tertiary Hospital in Khartoum, Sudan, from February to December 2019. Sociodemographic, obstetric and clinical data were collected. A multivariate logistic regression analysis was performed. Four hundred thirteen (20.5%) women reported experiencing a miscarriage. Risk factors included older age, high parity, histories of caesarean delivery, and obesity. Logistic regression showed that the lowest risk for women aged less than 20 years (adjusted odds ratio [AOR], 0.33) or 20 to 24 years (AOR, 0.57), primiparas (AOR, 0.42) and women educated below the secondary level (AOR, 0.78). Unlike the global age-associated risk of miscarriage, the risk of miscarriage among Sudanese women follows a unique curve in relation to maternal age. Interestingly, the curve showed a lower risk for women less than 20 years and at 40 years. (Afr J Reprod Health 2022; 26 [7]: 15-21).

Predictors of success of shock wave lithotripsy for ureteral stones based on computed tomography scan parameters

Background: For shock wave lithotripsy has proven to be an effective, safe and truly minimally invasive option for the treatment of nephrolithiasis. Various technical factors as well as patient selection can impact the success of the procedure. Objective: The aim of this study was to identify the parameters on NCCT that may predict the success of shock wave lithotripsy (SWL) in ureteral stones. Patients and Methods: 102 patients who underwent SWL for ureteral stones at sayed Galal University Hospital from January 2015 to August 2018 diagnosed by non-contrasted computed tomography were studied. The failure was defined as remnant stones ﻞ4 mm. We assessed age, sex, body mass index, stone size, location, skin-to-stone distance (SSD), presence of JJ and the presence of secondary signs (hydronephrosis, renal enlargement, perinephric fat stranding, and tissue rim sign). Results: 102 patients with success rate 61.8%, stone size, stone density were significantly associated with outcome of SWL. While SSD, JJ and secondary signs (hydronephrosis, perinephric fat stranding and tissue rim sign) were insignificant. On multivariate analysis, stone size and stone density were the independent factors affecting the outcome of SWL. Conclusions: The study demonstrated that stone size and density are significant and independent predictors of outcome in patients with upper ureteral stones. However SSD and signs of impaction still have to be evaluated

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Treatment outcomes among human immunodeficiency virus and tuberculosis co-infected pregnant women in resource poor settings of South-Western Nigeria

The complex interactions between Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) infections may be magnified, in the presence of another potentially stressful condition like pregnancy. Though co-infection among pregnant women is rare, treatment outcomes may depend on accessibility to comprehensive treatment modalities. The objective of this study is to determine treatment outcomes among pregnant HIV and TB co-infected pregnant women in Lagos, South-western Nigeria. This retrospective, analytical study was carried out among ninety four (94) eligible pregnant women co-infected with HIV and TB at selected health-care facilities in Lagos state between January, 2008 and December, 2009. A standard checklist for data collection was used and analysis was carried out using the EPI info software. Mean age of respondents was 30.8 (±3.9) years. Sixteen (17.1%) TB cases were clinically diagnosed for tuberculosis. Among tuberculosis cases identified through sputum microscopy, 60(63.8%) were acid fast bacilli (AFB) positive and 21(22.3%) were identified in the first trimester. The mean percentage adherence to anti-retroviral drugs was 95.9% (±5.3). None of the participant smoked cigarette. Seventy three {73 (77.7%)} had contact with TB infected or suspected person in the last three months. Treatment outcome in mother showed that 74(78.7%) were cured, 8(8.5%) relapsed while 12 (12.8%) had treatment failures. Among the babies, 83(88.3%) were born alive. Women with both poor adherence (<90%) and with positive TB contact, but neither factor alone, were half-fold less likely to be cured compared with women with both good adherence (>95%) and no TB contact (OR=0.59, CI=0.45-0.95 and p=0.014). Cure rate was substantially lower in this study. This calls for extra strategies such as routine TB screening in antenatal clinics, strict adherence to national guidelines in the treatment of HIV/TB co-infections, focused antenatal care and comprehensive Prevention of Mother to Child Transmission (PMTCT) care and treatment

Seroprevalence of hepatitis C virus antibodies amongst blood donors in Ahmadu Bello University Teaching Hospital (ABUTH) Kaduna

Background: Hepatitis C virus (HCV) is one of the most common transfusion transmissible infections hence the introduction of routine screening for its antibodies in blood donors in most blood banks. Methods: This was a retrospective study in which the blood donor screening register for all intending donors were reviewed and analyzed. Results: There were 4;731 potential donors with age range 20-41years. Eighty six (1.8) were sero-positive to HCV antibodies with a decreasing incidence over the period under review. The highest incidence was recorded the age group 31-40 years. Aim: To determine the sero-prevalence of HCV among blood donors in ABUTH Kaduna. Conclusion: HCV infection is not uncommon in our environment hence the need to emphasize it's routine screening among all potential donors

Women and epilepsy: Sudanese experience

Epilepsy is equally prevalent in men and women. However; for women there are unique concerns related to hormone effects on seizures and the effects of seizures and antiepileptic drugs (AEDs) on reproductive health. Some AEDs reduce the efficacy of oral contraceptive agents; increasing the probability of unplanned pregnancies. Seizure frequency may change during pregnancy; seizures may cause pregnancy complications; and the treatment of a woman with epilepsy must consider all these issues. Objective: To study the clinical presentation of epilepsy among adult Sudanese females and to verify aspects of epilepsy specific to women. Methods: This is a cross sectional descriptive non intervention clinical based study; it was carried out in Elshaab Teaching Hospital and El-shiekh Mohamed Kheir charity clinic; from February-2008 to June- 2008. 630 female patients with epilepsy were included in the study. Results: The study showed that 72of the patients had generalized epilepsy and 28had partial epilepsy; primary epilepsy is more common than secondary epilepsy; 54of our patients had warning symptoms and 39.7had triggering factors; irregular menstrual cycle was observed in 28; 22of our patients had catamenial seizures; 7.1had increased frequency of seizures during pregnancy. Obstetric complications were common among our studied group. The incidence of infertility increased among our studied group. Conclusion: Women had differences in presentation and control of epilepsy that must be understood and considered when treating women with epilepsy

Severe Depression Following a-interferon Usage in a Patient with Chronic Myeloid Leukemia

Background: Chronic myeloid leukaemia (CML); with a median age of 40 years; is one of the commonest haematological malignancies in Nigeria. Cytoreductive agents; which were hitherto the mainstay of treatment; neither induce cytogenetic nor haematologic remission. Alpha-interferon (a-IFN); an endogenous glycoprotein with cytotoxic and natural killer cell enhancer effects has been found to induce haematologic and cytogenetic remission in patients with CML; but neuro- psychiatric complications of a -interferon (a-IFN) usage were not reported in Nigeria. Objective: To report a case of deliberate self-harm in University Lecturer as a side effect of a-IFN in the treatment of CML. Method: Clinical and laboratory follow up of a patient receiving a-IFN in the management of CML from the time of diagnosis of CML to the point of loss of contact. Result: Severe depression is a complication that may adversely influence the clinical outcome of a-IFN usage Conclusions/Recommendations: Although interferon related depression is uncommon; it is suggested that pre-therapy interferon assays and neuro-psychiatric assessment are carried out in prospective users of a-IFN

Morbi-mortalite des accidents vasculaires cerebraux hemorragiques apres prise en charge en reanimation a Djibouti

Les donnees prospectives sur la prise en charge et l'evolution des accidents vasculaires cerebraux (AVC) en Afrique sont pauvres. Le but de ce travail etait de decrire les aspects epidemiologiques; cliniques et e volutifs d'une serie d'AVC hemorragiques a Djibouti. Une etude prospective descriptive a ete realisee pendant 18 mois de tous les patients admis dans le service de reanimation du Groupement Medico-Chirurgical Bouffard pour hemorragie cerebrale diagnostiquee par scanner cerebral. Dix-huit patients dont seize hommes ont ete inclus. L'agemedian etait de 51;5 ans [20-72]. La duree mediane de sejour en reanimation etait de 3 jours [1-38]. Le score de Glasgow moyen a l'entree etait de 9 [3-14]. Cinq patients ont beeeficie d'unee evacuation sanitaire aerienne. Les principaux facteurs de risque retrouvse etaient l'hypertension arterielle (HTA); le tabagisme et la consommation reguliere de Khat. Dix patients (55;5) ont beneficie de ventilation artificielle avec une survie de 40. La mortalite en reanimation etait de 33; la mortalite hospitaliere a 1mois de 39et la mortalite a 6 mois et 1 an de 44;4. La survie a un an des patients ayant un Glasgow . 7 a l'entree etait de 33. L'hypertension arterielle; le khat; et le tabagisme apparaissent comme des facteurs de risque importants pour les hommes djiboutiens. Les mesures medicales de neuroreanimation permettent d'obtenir des taux de mortalite hospitaliere proches de ceux des pays occidentaux. Le pronostic fonctionnel apparait bon pour les survivants autochtones malgre l'absence de reeducation fonctionnelle. Ces donnees plaident contre la passivite et le fatalisme dans la prise en charge en reanimation des hemorragies cerebrales; et pour la prevention primaire en luttant contre les facteurs de risque cardio-vasculaires

Prevalence of Diabetes in a Semi-Urban Community in Northern Nigeria

Background: Diabetes mellitus is a growing public health problem both in developing and developed nations. The prevalence of diabetes globally is projected to rise from 2.8in 2000 to 4.4in 2030.This study was conducted to assess the prevalence of diabetes in Dakace village; near Zaria Method: This study was part of a larger study to assess the prevalence of cardiovascular disease risk factors among adults in Dakace village; near Zaria. Out of a total of 492 eligible respondents for the study; a subsample of 199 persons was recruited using a systematic sampling technique had their fasting blood glucose levels determined. Body mass indices of the participants were also determined. Results: A total of 199 subjects (94 males and 105 females) participated in this segment of the study. Three subjects had fasting blood glucose (FBG) of more than 7.0mmol/L; one participant a previously known diabetic on medication had a good glycaemic control. The overall prevalence of diabetes was 2.0.Five participants (2.5) had impaired fasting glucose (IFG). Among the diabetics; one was overweight (BMI= 27.43Kg/m2) and one was obese (BMI=31.55Kg/m2); while among those with impaired fasting glucose two were overweight. Fortythree subjects (21.6) were overweight and 15 (7.5) were obese. Conclusion: The prevalence of diabetes mellitus in this semi-urban community is keeping with what had been reported earlier from across the country

Analgesic and Anti-Inflammatory Activities of Asparagus Africanus Root Extract

The methanolic extract of the roots of Asparagus africanus Lam (Liliaceae) which contains mainly saponins and carbohydrate showed significant analgesic and anti-inflammatory activities (P0.05) in the tail-flick/hot-plate test and egg albumen-induced rat paw oedema tests that were comparable to the test drugs (morphine 20mg/kg and indomethacin 50mg/kg respectively). These results indicate that the extract possesses analgesic and anti-inflammatory properties

Cutaneous leishmaniasis in Sudan: an update

Cutaneous leishmaniasis due to L.major is now endemic in many parts of the northern Sudan. In this up-date we discuss the clinical manifestations of cutaneous leishmaniasis; its diagnosis and treatment. The most common clinical forms are nodular; noduloulcerative and ulcerative lesions. Less common forms are sporotrichoid lesions; leishmanial dactylitis; leishmanial cheilitis; mycetoma- and residivans-like types. In a suspected case the diagnosis is made by demonstration of leishmania parasites in slit smears or biopsy; isolation of the parasite by culture in appropriate media and by the polymerase chain reaction (PCR) using specific primers. The majority of lesions heal spontaneously. Criteria for local or systemic treatment are given