Awareness and practice of patients' rights among hospitalized patients at Wad-Medani Teaching Hospital, Sudan

Patients' rights are a fundamental human right and an important part of modern health care practice. This is a cross-sectional descriptive analytic study, conducted amongst 263 patients at Wadi-Medani Teaching Hospital, Sudan, in March-April 2015. Most patients [95.2%] did not know about the Bill of Rights and most of them [92.8%] were not able to mention any of the patients' rights. The most practiced rights were: the right to be asked for permission before examination [88.1%], proper handling [87.8%], safety of the hospital [87%], presence of a third person when examining a female by a male doctor [85.6%], and admission file confidentiality [75.5%]. The awareness of Sudan FMOH Patients' Bill of Rights was very low among patients at Wad-Medani Teaching Hospital, yet they showed a high satisfaction rate probably due to their low socioeconomic status, educational level and expectations. Therefore, awareness of patients' rights must be increased

Effects of iron chelating therapy and / or HBV-vaccination on beta-thalassemia major patients

Thalassemia is a genetic inherited blood disorder in which the body makes abnormal hemoglobin with excessive destruction of red blood cells, which leads to anemia. For many years, hepatitis B virus was a major problem for patients with thalassemia substantially contracted from blood transfusions. The development of effective vaccine has further reduced the magnitude of the problem of hepatitis B. Iron chelators are used to remove excess iron that accumulates due to repeated blood transfusion. To compare thalassemic patients either have or haven't HCV with healthy persons as regards biochemical indices taking in consideration effect of vaccination against HBV or not and using iron chelating therapy or not by the studied persons. A case control study in which 40 thalassemic, blood transfusion dependent patients were chosen randomly to act as a case group from thalassemic patients attending the VACSERA Company. The cases [40 patients] they were classified to patients having HCV, patients were HBV vaccinated, other non vaccinated, using iron chelating therapyor don't use it. Another 10 healthy and non thalassemic persons were chosen randomly among persons attending the same company as a control group to be matched with the case group. 50% of studied thalassemic patients had HCV seropositivity. Biochemical blood indices which were found to be significantly elevated among thalassemic patients than controls were ALT, AST, ALP, GGT and LDH enzymes in addition to serum iron, ferritin and globulin mostly in HBV non-vaccinated and iron chelating therapy non dependent patients while, other biochemical indices which were significantly decreased among thalassemic patients compared to controls included: total cholesterol, total protein, albumin and albumin/globulin ratio mostly in HBV vaccinated and iron chelating non dependent patients. This study illustrated the effectiveness of iron chelators agentsand the importance of vaccination for reduction of morbidity and mortality

Urinary cystine calculi and detection of polymorphism in the SLC3A1 gene in Sudanese children

To investigate polymorphism in exon 8 of the SLC3A1 gene in children with urinary cystine calculi in Khartoum. A semi-quantitative chemical method was used to analyse 175 urinary calculi removed surgically from paediatric patients at Soba Teaching Hospital in Khartoum between October 2005 and May 2009. DNA was extracted with phenol chloroform isoamyl alcohol, and exon 8 of the SLC3A1 gene was amplified in a thermocycler and sequenced with an AB3130 genetic autoanalyser. Of the 175 stones, 10 were cystine calculi [5.7%]. The sex ratio of the patients was 2.3:1 [boys to girls], and the mean age at cystine stone onset was 31.1 +/- 28.2 months [range, 3-125 months]. Of the 10 patients, 8 had a positive family history of calculi formation, 4 had bilateral calculi, 3 had both renal and urinary bladder calculi, and 2 had obstructive acute renal failure. All patients required more than one surgical operation. One patient had a missense mutation M467K in exon 8 of the SLC3A1 gene. The prevalence of cystine calculi among urinary calculi in Sudanese children was 5.7%. A family history was found in 80% of children. A mutation [M467T] was identified at exon 8 of the SLC3A1 gene in one child

Frequency of gestational diabetes mellitus and impaired glucose tolerance in urban Sudanese pregnant women in the third trimester

Impaired glucose tolerance may be defined as intermediate group of individuals whose carbohydrate metabolism does not constitute diabetes but is not entirely normal. It carries a higher risk of developing microvascular disease and a significant percentage of these patients eventually become diabetics. Of the study was to estimate the frequency of gestational diabetes mellitus [GDM] and impaired glucose tolerance [IGT] in urban Sudanese pregnant women in the third trimester. The study also showed the effect of age and parity on IGT. The study was carried out on hundred pregnant women in the third trimester. The frequency of gestational diabetes was 2% and it was 6% for the IGT incidence whereas, 92% of the pregnant women revealed normal fasting plasma levels. The IGT pregnant women were older than the control pregnant women but, the age difference was not significant [28.7 +/- 5.5 years [mean +/- S.D] vs. 27.3 +/- 4.8 respectively, p>0.05]. Also, the IGT pregnant women were found to have mean parity significantly greater than that of the control group [6.7 +/- 2 [mean +/- S.D.] vs. 3.9 +/- 2.1 respectively, p<0.001]. The frequency of GDM and IGT in Sudanese pregnant women is within the universal estimates and parity is an important risk factor that affects impaired glucose tolerance incidence in pregnancy

Alternative versus traditional medicine use among adults: Sharja -United Arab Emirates, 2009

Alternative medicine is increasing interest and acceptance among the general population. Although usage is thought to be widespread among patients, little studies have been done. The current study aimed to identify the types of alternative medicine, determine the medical problems for uses of alternative medicine and study the alternative medicine and its relation to some sociodemographic factors. A cross sectional study was carried out in the Alternative Medicine Clinic of Sharja. All the attended patients to the clinic during two months [March and April], 2009 was included in the study, the total number reached was 725 patients. The data was collected through interviewing questionnaire. It included the socio-demographic: age, gender, educational level, monthly income, and occupation. Also types and reasons for use of alternative medicine. The results showed that the males outnumbered females [56.7% and43.3% respectively], their mean age was 38.51 +/- 10.66 year. Arabic constituted 56.1%of the sample while local represented 31.0%. University or higher level of education was detected for almost half of the participants, and more than two-thirds of the participants are married, The most common medical problems for using alternative/ complementary medicine was chronic pain [40.1%] followed by headache [15.5%], general weakness and fatigue [12.2%], hypertension [7.3%], diabetes mellitus [5.5%] and the lowest percentage of use was observed among patients with cancers or eye diseases [1.1% for each]. The present study point to alternative medicine use more prevalent among young male who are more educated. Alternative medicine users are more likely to have chronic medical conditions e.g. chronic pain followed by headache. The increasing use of Alternative medicine may necessitate a need for the implementation of a surveillance system to report and monitor possible adverse events of all types of alternative medicine

Clinical and experimental study of acute intoxication as a result of ingestion of stone hair dye containing paraphenylenediamine

Hair dyes containing para-phenylenediamine were used in some communities for criminal purposes and more frequently for attempted suicide and sometimes accidentally ingested. The aim of the present work to analyze the various aspects of poisoning fatalities as a result of stone hair dye [SHD] ingestion through a retrospective study of fatalities investigated by Assiut Chemical Laboratory of Medico-legal Department, Ministry of Justice in four governorates in Upper Egypt and to detect the systemic effects on experimental animals as a result of its ingestion and if there is dose-effect relationship. The records of acute poisoning cases of hair dye ingestion investigated by Assiut Medicolegal Laboratory in the period from January 2002 to December 2009 were examined as regarding type of poison, pattern, incidence, sex, geographical distribution and mode of poisoning. The studying of the systemic effects on ingestion of hair dye was conducted on 30 albino rats divided into five groups each contain 6 animals. The first group was the control and the other groups were subjected to oral administration of either stone hair dye or para-phenylenediamine [PPD] in two doses [10 and 20 mg each]. The animals were sacrificed after 24 hours and haematological, histopathological [liver and kidney] and biochemical examinations were performed. The results obtained from the records revealed that 72.29% of the cases were from Qena, 14.45% from Aswan, 12% from Sohag and 1.2% from Assiut. The highest incidence of poisoning was found in 2006 [19.3%] followed by 2008, 2009 [15.7%] each, then 2004 and 2005 [13.3%], 2007 [12%], 2002 [7.2%] and lastly 2003 [3.6%]. The majority of victim's were females and most of cases were suicides. There were insignificant changes in RBCs count in all groups and insignificant decrease of Hb concentration while WBCs count was very significantly increased. The levels of AST and ALT showed a significant increase in all treated groups while serum level of creatinine was insignificantly decreased. There was significant increase in the plasma enzymes AST, GPT, the liver tissues showed many degenerative changes in the form of vacuolated cytoplasm and irregular deeply stained nuclei of the hepatocytes with vascular congestion and lymphocytic infiltration. The same results were obtained with both SHD and PPD. They were more obvious with high doses of both. The results confirmed that Para-phenylenediamine is the main toxic ingredient in stone hair dye, and the experimental study revealed that the liver is the target organ of para-phenylenediamine and SHD toxicity, also that toxic manifestations were dose related. This compound is highly toxic when taken by mouth and the outcome depends mainly on the dose taken. The study recommends that the sale and use of PPD containing dyes, SHD and henna should be prohibited

Retinopathy of prematurity; a study of frequency and risk factors

Retinopathy of prematurity [ROP] is a serious complication of prematurity treatment and extension of survival in premature infants and can lead to blindness unless recognized and treated early. The aim of this prospective study was to estimate the incidence of ROP in our country and to identify the risk factors which predispose to ROP in the Neonatal Intensive Care Unit [NICU] graduates. An ROP prospective screening survey was performed enrolling all premature admitted to the NICU from 1st September 2007 to 31st August 2008, with a gestational age [GA]of 32 weeks or less at birth and those of birth weight [BW] of 1500gm or less. Infants whom GA was>32 week or BW was>1500 gm were included if they were exposed to high oxygen [FiO2>21%].A total of 175 infants had retinal evaluation by indirect ophthalmoscopy at 4 weeks of gestation and followed up periodically. All clinical and epidemiological data were statistically analyzed. ROP was diagnosed in 34 [19.4%] infants; one of whom was diagnosed as threshold ROP and underwent Laser Ablative therapy. Out of the 175 neonate, 86 [49.1%] were males and 89 [50.9%] were females. The mean gestational age was 33.01 +/- 1.73 weeks; 25 were less than 32 weeks and 150 were>32 weeks. The birth weight ranged from 0.67 to 2 kg with a mean of 1.5 +/- 0.24 Kg. Using univariate comparison between the risk factors in neonates who developed ROP and those who didn't we found a statistically significant correlation between the occurrence of ROP and gestational age, supplemental oxygen therapy and frequency of packed RBC transfusions. However insignificant correlation was found with sepsis, respiratory distress syndrome [RDS], intraventricular hemorrhage [IVH], patent ductus arteriosus [PDA] and the use of phototherapy. The incidence of ROP in our study was 19.4%.Short gestation, supplemental oxygen administration and frequency of packed RBC transfusions were significant risk factors for ROP. Laser was effective in regressing ROP

ultrasound findings of complications of Schistosoma haematobuim

Ultrasound had been utilized for detection of infections and evaluation of mass chemotherapy programs for Schistosoma mansoni, with few studies concentrating on S. haematobium. The objectives were to determine the frequency of ultrasound findings of complications of Schistosoma haematobium in infected patients in El Kiryab and El Rahad area. 83 urine samples were selected from El Kiryab Agricultural Scheme, Khartoum State, and 80 ones from the El Rahad area, Kordofan State, 20 patients were sporadic cases from Khartoum East of Blue Nile, while 50 samples were taken as a control group. Urine microscopic examination and ultrasound was used to scan for residual effects of Schistosoma haematobium. The frequency of positive microscopic findings of S. haematobium was 63.9% and 62% in El Kiryab and El Rahad areas respectively. The frequency of the urinary bladder changes were wall thinking 85.5%; wall fibrosis in 29%; calcification in 87.4%; Polyps in 72% and ureteric dilatation in 41.7% of the scanned candidates

Health status assessment among population in Al Khawneej region, Dubai: chronic conditions and some associated factors

Assessment of the population health status is required to determine priority population health needs, identify populations most at-risk and refine health service planning Aim of the study: to assess the health status of the population in Al kawaneej region [Dubai] in terms of some chronic conditions [diabetes mellitus, hypertension, hpercholestelemia and overweight and obesity] and to determine some associated factors. A cross sectional study was conducted in Al Khawneej region. Household survey was conducted to compromise all available adult individual aged 18 years or more at the time of the survey. The total number O participants reached 210. The participants were subjected to the following tools: interview questionnaire, measurement of weight and height, blood pressure, laboratory investigations which include the fasting blood sugar, blood cholesterol level, and triglyceride level and low density lipoprotein. The ordering of the studied health problems as follow, the overweight and obesity came first in the health problems of the people of this region, it was 71.4%[44.3% and 27.1%], 60.5% had a high level of Low density lipoprotein, high blood cholesterol level was detected in 40.5% of the participants, it was found that 25.7% suffered from hypertension, while the diabetes mellitus was accounted for 13.3%. Stepwise logistic regression revealed that age 40 years or more was the predictor for diabetes mellitus, hypercholesterolemia and hypertension, furthermore obesity was also the predictor for hypercholesterolemia, while the low 'educational level was associated with overweight and obesity. The survey pointed out that the problem of the overweight and obesity came first in the health problems of the people of this region, followed by a high level of Low density lipoprotein, high blood cholesterol level, hypertension, and then diabetes mellitus. We are in crucial need for an intervention program to reduce these risk factors and to enhance healthy life style which including dietary pattern and physical activity

Knowledge, attitude and practice of breast cancer screening among women visiting primary health care centers in Dubai

Breast cancer continues to be a major public health problem. Globally, breast cancer is the most common malignant neoplasm among women. The cornerstones of breast cancer prevention are early detection and prompt treatment. A breast self-examination [BSE], clinical examination, and mammography make up the conventional early detection approach. Knowledge, attitude and practices are crucial factors in breast cancer early detection and treatment. Is to evaluate knowledge, attitude and practice of women towards breast cancer screening and to identify potential barriers to screening among women users of health centers. A cross sectional study was conducted in four primary health care centers [PHC] which were selected randomly out of eleven. Systematic random sample was used for selection of the women attending these centers above 40 years by choosing of every other one to be included. The visits carried out daily over 2 months period [September - October] in 2008, some clients refused to participate in the interview, the final sample eligible for analysis was 532 clients out of 560, with the response rate of 95%. The participants were subjected to the following tools: interview questionnaire including the following: socidemographic data, obstetric data, data on menopause, knowledge, attitude about breast cancer disease and breast cancer screening and practice of breast cancer screening methods and barriers of practicing. The present study displayed that an overall, 6.2% of the women had good knowledge and 73.9% of the women had poor knowledge level about the breast cancer and its screening methods. Regarding the attitude, it was found that 59.8% of positive attitude, while 35.5% and 4.7% of the women had neutral and negative attitude respectively. By studying the practice the breast cancer screening methods, it was found that 59.8% of the studied women didn't practice breast self-examination, [58.5%] didn't practice clinical breast examination and 80.8% of the women didn't practice mammography. This study has revealed poor knowledge and attitude of breast cancer and its screening methods as well as low level of practice of breast cancer screening among local women. Women must be educated regarding the importance of breast self-examination, clinical breast examination and mammography after the appropriate age. Doctors need to be more proactive in suggesting regular screening tests. Demonstrations of correct technique of breast self-examination using audio and ' visual aids should be done while a clinical breast examination as part of routine physical checkup might help in making women more "breast health aware". Breast cancer awareness education should be integrated into existing health education programs within hospital settings and at government level

Burdens of animal environment on human health

Our environment is affected by a great variety of pollutants and emerging infectious diseases. The public health threats are affected by the relationship between people and the physical, chemical, and biological nature of our natural environments .Vector-borne and zoonotic diseases, water contamination, airborne contaminants, bioaccumulative contaminants in the food chain, and environment threat to public health. Workers, area residents, and the communities located downstream or down-wind of the animals may find themselves with a lot of problems on their hands. Zoo animals, backyard wildlife, pets, and livestock, all serve the public as valuable "First Alert" systems for emerging infectious diseases. Animal symptoms and responses to conditions around them can serve as an early warning system for potential threats to human health .Arthropods, such as fleas, ticks, or mosquitos, are common vectors that transfer disease from an infected individual to others, be they wild or domestic animals or people. Ticks can carry pathogens that are the causes of Lyme disease, ehrlichiosis or babesiosis, Earthworms, swallows, bats, other wildlife, and even our pets are all animal sentinels alerting us to disease, allergens, and contaminants in our environment. Bats have long served informally as public health surveillance systems for rabies. Prairie dogs are also valuable wildlife informants, alerting us to the occurrence and spread of plague. Rodents, commercially bred or trapped in the wild, may be infected with a number of zoonotic infections, including Salmonella, lymphocytie choriomeningitis virus [LCMV], Machupo virus hemorrhagic fevers, murine typhus, tularemia, and plague. Free-living amoebae are natural reservoirs of many types of bacteria such as Legionella spp., Burkholderia pickettii, Vibrio cholerae, Myobacterium avium and Listeria monocytogenes. Amoebae in cooling towers and water treatment facility bioflims are considered the primary reservoir for pathogenic legionellae

Neurotransmitters - a biochemical view

The neurotransmission at most if not all synapses is chemical and is of great biochemical, physiological and pharmacological importance. Neurons communicate with each other at synapses by a process called synaptic transmission which is the release of small quantities of chemical messengers, called neurotransmitters that alter the electrical activity of neurons after they interact with receptors on post-synaptic cell surfaces. This review gives a biochemical view on the nature of neurotransmitters and presents the biochemical chart and the medical relevance of the most important neurotransmitters

Metabolic aspects of skeletal muscles

Differences in the metabolic patterns of the skeletal muscles are biochemically important. Muscle performance declines during intense activity due to changes in some metabolic and physiological events. This review illustrates how biochemical knowledge illuminates the response of muscular tissues to such changes

Lactic acid- the innocent culprit of muscle fatigue

What causes muscle fatigue? Is lactic acid considered to be a major culprit in the underlying mechanisms of muscle fatigue? These are very important questions and the answers are difficult and sophisticated. For decades, lactic acid was the major culprit of muscle fatigue. This review reveals that muscle fatigue would occur more badly if lactic acid was not produced in anaerobic cellular conditions to regenerate NAD[+] required for continuation of glycolysis, the major pathway for generation of energy needed for muscle performance

Use of the Internet by Sudanese doctors and medical students

Patterns of use of the Internet were investigated by a questionnaire survey of 102 hospital doctors and 123 medical students in Khartoum, Sudan, in January 2005. More doctors [84.3%] had used the Internet than had students [78.9%]. Half of consultants [55.0%] used the Internet daily, compared with only 18.2% of junior doctors. Many consultants and junior doctors rated their abilities as poor [60.0% and 53.1%]. One-third of students [33.3%] used the Internet only for personal and not for academic purposes. Barriers to greater use of the Internet by doctors included: time constraints [80.2%], poor skills [54.6%], no access to full texts of journal articles [53.4%], difficulty in verifying the quality of information [47.6%] and high costs [41.8%]. Students faced similar barriers but also listed poor knowledge of the English language

Patterns of lipid changes among type 2 diabetes patients in Sudan

This study investigated the patterns and determinants of lipid disorders among a group of 250 type 2 adult diabetic patients and 60 age- and sex-matched healthy controls in Sudan. Demographic and clinical data, body mass index and waist circumference, and fasting blood samples were taken to estimate the glucose and lipid profile. The mean duration of diabetes was 9.4 years and 46.0% of patients had poor glycaemic control. Compared to controls we detected a statistically significant increase in triglycerides level and a decrease in HDL-C levels. Other lipid values showed a slight increase compared to controls. There was a statistically significant association of triglycerides and HDL-C with increasing age, female sex, obesity, physical inactivity and poor glycaemic control of diabetes

ATP-sensitive potassium channel blockers, glimepiride and glibenclamide reduces ischemia reperfusion-induced renal injury in rats by inhibition of neutrophil aggregation: comparative study of glimepiride versus glibenclamide and diazoxide

Renal ischemia is a complex neutrophils-mediated syndrome in which ATP-sensitive potassium channels are involved. Fall in intracellular ATP concentration induces opening of these channels resulting in massive influx of neutrophils .This exerts a crucial role in the patho-physiology of post-ischemic renal failure. Our study has used the ischemia reperfusion [I/R] model to asses the role of ATP-dependant potassium channel modulation, comparing the protective effects of glimepiride and glibenclamide on renal I/R inflammatory injury and neutrophil aggregation. As this protective effect in renal I/R stands in sharp contrast to the harmful effects on the cardiac tissues, our study evaluates the harmful effects of both sulfonylurea drugs on normal hearts and on ischemic reperfused hearts subjected to ischemic preconditioning protection afforded by diazoxide. One hundred and fourteen [114] adult albino rats were used; 72 of them were used for the in renal I/R study and 42 rats for the cardiac I/R experiment. In renal I/R study, rats were unilaterally nephrectomized, then all rats except the Sham operated control group, were subjected to renal I/R by ischemia 45 min and reperfusion 4 and 24 h, then divided into five groups: [1] renal ischemia-reperfusion, [2] renal I/R + solvent control, [3] renal I/R + diazoxide, [4] renal I/R + glibenclamide, [5] renal I/R + glimepiride. At the end of each reperfusion period, mean arterial pressure, urine volume, serum creatinine and urea, were measured. Then kidneys and lungs were taken for histological examination and determination of TNF-alpha levels, superoxide anion production and myloperoxidase activity. Cardiac I/R study, cardiac ischemia reperfusion model by left coronary artery ligation was used for evaluating the side effects of both sulfonylureas on both normal and ischemic preconditioning rat's hearts. Renal ischemia reperfusion induced marked renal dysfunction associated with significant increase in arterial pressure, TNF-alpha levels, superoxide anion production, and myloperoxidase activity. Treatment with glibenclamide or glemipiride, illustrated significant improvement in the reperfusion-induced injury in both kidney and lung, but glemipiride has no effect on superoxide anion production. However glibenclamide induced a significant improvement in these measurements as compared to glimepiride group. Before coronary artery ligation, neither diazoxide nor glimepiride pretreatment influenced significantly the electrocardiographic parameters [heart rates, T-waves voltages and ST segment elevation] in comparison with control group. On the other hand, glibenclamide supplementation induced a significant elevation in all these parameters. After left coronary artery ligation, reperfusion of the ischemic hearts caused a significant elevation in the measured electrocardiographic parameters. These elevations were significantly ameliorated by pretreatment with diazoxide. Administration of glibenclamide significantly abolished the protective effects of diazoxide, while pretreatment with glimepiride didn't abolish it. In conclusion, glimepiride offered some promise for therapy of renal I/R with minimizing the undesirable cardiac side effects

effect of some maternal risk factors in glucose tolerance impairment among Sudanese pregnant women in the third trimester

To show the effect of some maternal risk factors in glucose tolerance impairment in pregnancy, a study was carried out on thirty pregnant women with gestational diabetes mellitus, thirty ones with impaired glucose tolerance and thirty control ones with normal glucose tolerance. Age and parity of the GDM and the IGT groups were significantly greater than that of the control group: 32.77 +/- 5.08 years [mean +/- S.D.], 31.1 +/- 6.04 vs 23.93 +/- 4.46 respectively, p<0.0001 and 5.23 +/- 2.69, 5.6 +/- 3.07 vs 2.77 +/- 1.48 respectively, p< 0.0001. Also, The GDM and the IGT groups were found to have a family history of diabetes and previous heavy babies, incidence significantly higher than that of the control group. Finally, it was concluded that Age, parity, previous heavy babies' incidence and family history of diabetes are very important maternal risk factors that affect glucose tolerance in pregnancy

Human placental lactogen and glucose intolerance in pregnancy: a study on Sudanese pregnant women

To stand on the role of human placental lactogen and its interconnection with cortisol in augmentation of glucose intolerance in pregnant women, a study was carried out on Sudanese pregnant women in the third trimester. There were no significant differences among the mean levels of fasting serum insulin of the studied groups [12.29 +/- 0.83 micro lU/ml [mean +/- S. E.], 14.93 +/- 2.17 and 12.39 +/- 2.52 for the GDM, IGT and control groups respectively, p = 0.27]. The 2h-serum insulin mean level of the IGT group was not significantly higher than that of the control group but significantly higher than that of the GDM group [68 +/- 6.71 vs 54.88 +/- 8.15 and 36.5 +/- 3.06 for the IGT, control and GDM groups respectively, p < 0.002]. Also, it was found that the GDM and the IGT groups have significantly higher mean levels of serum cortisol than that of the control group [33.71 + 2.86 [micro g/dl], 28.57 +/- 2.18 vs 21.48 +/- 1.11 respectively, p < 0.0003]. Results of serum hPL of the GDM and that of the IGT groups were not significantly higher than that of the control group [6.85 +/- 0.58 [micro g/ml] and 7.15 +/- 0.49 vs 5.73 +/- 0.24 respectively, p = 0.2]. Finally, it was concluded that insulin resistance in pregnancy is augmented by the effect of hPL and cortisol. When the insulin resistance is so large that pregnant women can not overcome it, glucose deterioration develops and some women become with impaired glucose tolerance while others develop gestational diabetes mellitus

Ammonia stress and histopathological changes of broiler internal organs under closed environment

The current experiment established to figure out the effect of ammonia exposure for two intermittent periods [1st at 22-26 days old with 120-ppm and 2nd at 31-35 days old with 150 ppm] / 24 hours, on the bird internal organs [liver, spleen,lung,air sac and bursa fabricus from the histo-pathological aspect under controlled broiler ecosystem through summer. The micrographs of Control birds were remarked by the moderate features, that shown on liver at 28 and 42 days old .Spleen revealed mild features along 4-6 weeks old, moderate ones were only at 21 days. Bursa fabricius showed mild changes at 21 and 42 days .moderate ones at 28 and 42 days .while the severe changes were few at 28,35 and 42 days old that were contributed to the normal growth regressive behavior of this lymph organs, with age. Lung and air sacs showed mild changes at 3-6 weeks old and the moderate changes were only on lung at 2-5 weeks old. The micrographs of ammonia stressed birds revealed that liver post 1st exposure showed moderate histological changes at 26 days old with no remarked changes at both 35 and 42 days old except the mild changes. On regard to spleen, the moderate changes were at 26 and 35 days old while mild changes were at all ages .Bursa fabricius showed mild changes at 30 and 35 days old,the moderate changes were at 26 .35 and 42 days old, in addition the severe changes were shown at all ages. Lung micrographs revealed, mild changes at 26 days old .moderate changes were at 26,30 and 35 days old and the Severe changes were noticed at 35 days old,the effects looked cumulative and related to growth stage. Air sacs, remarked by mild changes at 26, 30 and 42 days old, moderate and severe changes were at 35 days old .Lung and air sacs were the most affected internal organs post 2nd period of ammonia exposure [26,30 and 35 days old] with moderate and severe histological changes with regard to the difference in degree of affections. Conclusively, ammonia gas was detrimental to broiler internal organs tissues architectures either due to the unexpected elevated level in control birds [8 ppm at 11 and 16 days old] or the experimental levels [120-150 ppm / 2 exposures] with regard to the birds age lesions intensity, organ specificity, environment kind and management,The results confirmed the harsh effect of ammonia exposure on lung and air sac tissues that were more prominent post 2nd exposure. The reversible effects on hem tissues [liver and spleen].The complex responses of BF to ammonia for its nature as lymph organ and involvement in immune responses and natural growth regressive behavior. Proper environmental management especially sources of indoor ammonia generation and emission could properly enable bird to recover and restore its normal tissues morphology and functions as shown during rest period to a great extent