Prevalence of asymptomatic bacteriuria in patients with preterm labor

Background: asymptomatic bacteriuria [ASB] during pregnancy is the primary cause of acute pyelonephritis, preterm labor, low birth weight fetus, etc., if left untreated. Adequate and early treatment reduces the prevalence of these obstetric complications

Objectives: this study aimed to determine the prevalence of ASB during pregnancy and determine the association between asymptomatic bacteriuria and spontaneous preterm birth

Patients Methods: this was a case control study of 120 preterm pregnancies and 40 term pregnancies among those attending El-Galaa Teaching Hospital, Obstetric Emergency Unit to evaluate the incidence of ASB and determine the association between asymptomatic bacteriuria and spontaneous preterm birth from March 2016 to March2017.Urine analysis and culture with antibiotic sensitivity were performed

Results: out of the 160 patients studied, ASB was observed in 7 patients [6 cases in preterm group [5%] and 1 case in full term group [2.5%] with no significant difference between the two groups [p-value. 0.05], the incidence of ASB in preterm labor was quite lower 5%. E. coli was the most common pathogen [55.14%] followed by proteus 28.57 followed by klebsiella [14.28%]

Conclusion: all pregnant women should be screened by urine culture to detect asymptomatic bacteriuria at their first visit to prevent overt urinary tract infections [UTI] and other complications in both mother and fetus

Assessment of level of satisfaction of national health insurance scheme enrolees with services of an accredited health facility in Northern Nigerian

Introduction: Consumer satisfaction is one of the driving goals of goods and service production. Patient satisfaction surveys, as a means of periodic evaluation of the quality of services offered by the National Health Insurance Scheme (NHIS) accredited facilities, is necessary to ensure that the goals of the scheme are achieved and sustained. Materials and Methods: This was a cross-sectional study of 202 respondents randomly selected from NHIS enrolees attending the Staff Clinic of Aminu Kano Teaching Hospital. It assessed respondents' perceived waiting time, level of satisfaction at the clinic's service units, and overall clinic satisfaction using a modified general practice assessment questionnaire. Results: The mean age of respondents was 36.4 ± 8.1 with a near equal sex ratio. They were predominantly civil servants (79.2%) with tertiary education (75.7%). Most respondents (70.3%) felt waiting time was too long; with 79.7% of those, feeling they spend at least 30 min after arrival at the registration unit to see their doctor. A majority of respondents: 90.1%, 86.8%, 79%, 76.8%, 75.9%, 77.5%, and 80.6% were satisfied with the consultation time, doctors' consultation, medical records, pharmacy, laboratory, accounts, and nursing services, respectively. However, 65.8% were satisfied with the overall clinic services. The perceived sufficiency of the consultation time was associated with overall satisfaction (χ2 = 6.199, P = 0.013). Conclusion: Although 65.8% of respondents were satisfied with the clinic services, the perceived clinic waiting time was dissatisfactory; therefore, further studies on the determinants of overall satisfaction may be required if improvement in the proportion of satisfied service consumers is desired by the clinic managers

Investigation of cryoprotection on the viability of freeze dried probiotics

Aims: The aim of the present work was to evaluate the effect of various cryoprotective agents on the survival of freezedried probiotic Lactobacillus rhamnosus. Methodology and results: Investigation was done on the viability and stability of probiotics L. rhamnosus. The effect of different cryoprotective agents (namely, sodium chloride, sucrose, dextran, sorbitol, monosodium glutamate, glycerol, skim milk and skim milk with malt extract) with modified De-Man Rogosa Sharpe (MMRS) medium were examined. Commercial De-Man Rogosa Sharpe (MRS) medium was proved to be more expensive than the modified MRS medium with relatively low yield of probiotics L. rhamnosus. Significantly high viable counts were achieved with monosodium glutamate, skim milk and skim milk with malt extract, with optimum concentration at 0.3% w/v. There was a reduction in cell viability at concentration above 0.5% w/v, which could be attributed to cell shrinkage associated with osmotic pressure changes. The cells were found to be stable at room temperature (28 °C) for eight weeks. A significant growth of probiotics was produced from skim milk. Conclusions: Modified MRS medium with skim milk is suggested for the remarkable growth and yield of probiotic lactobacilli.

Measurement of superior vena cava from changes in full term newborn with perinatal hypoxia

Background: Perinatal asphyxia is an important cause for neonatal morbidity and mortality which affects multiple body organs. Myocardium is one of the organs which could be severely affected and this can leads to compromise of the systemic blood flow. Recently Superior vena cava [SVC] flow is usecl to asses' systemic blood flow

Aim of the work: The aim of this work was to study cardiac output changes using SVC flow in neonates with perinatal hypoxia

Subjects and Methods: This observational prospective study was conducted between March 2015 and August 2[]15 at the Neonatal Intensive Care Unit [NICU] and the normal neonaral ward of Alexandria University Hospital [Al-Shatby] on 30 asphyxiated full term neonates [Group I] and 30 healthy full term neonates [Group Il].Superior yena cava [SVC] flow was measured in the first 3 days of life by Doppler echocardiography using Kluckow and Evans method

Results: Superior yena cava [SVC] flow at 12, 24, 48, 72 hours of Group I was significantly lower than that of Group II. The pattern of change in Superior vena cava[SVC] flow in Group l [asphyxiated] was the slow gradual increase over the period of the study in Superior vena cava [SVC] flow in Group II [normal] is the decrease in mean SVC flow from 91.4 ml/kg/min at Day 1 to 80.8 ml/kg/min at Day 3

Conclusion: In conclusion, the assessment Superior vena cava [SVC] flow changes in the early neonatal period is likely to be of great importance in predicting rnyocardial dysfunction. Developing a functional echocardiography [fEHO] service will provide the important hemodynamic information which is critical in the management of asphyxiated infants

Role of Mesenchymal Stem Cell Therapy in Cisplatin Induced Nephrotoxicity in Adult Albino Rats: Ultrastructural & Biochemical Study.

Objective: Mesenchymal stem cells (MSCs) have generated a great deal of excitement and promise as a potential source of cells for cell-based therapeutic strategies. These data provide the clue of using MSCs in the current work in correcting cisplatin-induced nephrotoxicity, the severest adverse effect of the well-known anticancer drug; cisplatin. Methods: MSCs of bone marrow origin of femora and tibiae of adult albino rats were separated, grown, propagated in culture then identified by both morphology and CD29 surface marker detection. MSCs were injected into the rats’’ tail veins one day after a single dose (5 mg/kg body weight) of intraperitoneal injection of cisplatin. Four weeks later kidney tissue was examined histopathologically and ultra-structurally. Renal functions s(urea, creatinine) as well as serum electrolytes levels (Na, K) were estimated Results: Cisplatin group demonstrated atrophied glomeruli, thickened glomerular basement membrane, dilated urinary space, loss of proximal convoluted tubules brush borders, loss of podocyte pedicels and collagen deposition. Tubular cells showed vacuolization and nuclear membrane degeneration. Serum levels of urea, creatinine, Na and K were significantly elevated. MSCs ameliorated cisplatin-induced nephrotoxicity to a great extent as evidenced histologically, ultra-structurally and biochemically. Conclusion: MSCs have a potential therapeutic effect against cisplatin induced nephrotoxicity.

Human Brucellosis in Khartoum State: a Commonly Underdiagnosed Disease

Back ground: Human brucellosis is a major debilitating zoonotic disease. It is caused by bacteria of the genus Brucella Methods: The serum antibody titres to Brucella melitensis and Brucella abortus of one thousand febrile patients; randomly selected from Khartoum; Khartoum North and Omdurman Teaching Hospitals; were estimated by the STAT. Results: Eighty nine (8.9) of the febrile patients had brucellosis. The average age of brucellosis patient was 43.9 years. Sixty three (70.8) of the brucellosis patients were males; and 26 (29.2) were females. Fifty four (60.7) of them had significant titres to Brucella melitensis while 23 (25.8) patients had significant titres to Brucella abortus. Twelve (13.5) patients had significant titres to both Brucella melitensis and Brucella abortus. The average diagnostic delay of brucellosis in this study was 88.6 days. Conclusion: Brucellosis was found to be misdiagnosed as malaria or typhoid fever. Animal contact was found to be a significant risk factor

Drug sensitivity pattern of salmonella thphi

To evaluate the susceptibility pattern of Salmonella typhi to different drugs in a tertiary care hospital at Karachi. Descriptive study. Clinical pathology laboratory of National Institute of Child Health, Karachi from May 2004 to June 2005. Eighty isolates of Salmonella typhi grown from blood cultures were included in the study. These isolates were identified by routine culture technique and later confirmed by slide agglutination method. Sensitivity for the following antibiotics ampicillin, chloramphenicol, cotrimoxazole, ciprofloxacin ceftriaxone and cefixime was measured by Kirby Baur method. The isolates were found to be resistant to ampicillin 52.5%, chloramphenicol 45%, cotrimoxazole 57.5%, ciprofloxacin 48.75%, ceftriaxone and cefixime 0%. Among 80 isolates, 38 [47.5%] were sensitive to first line of drugs, out of which, 11[28.94%] were resistant to ciprofloxacin. Among 80 isolates, 42 [52.5%] were resistant to first line of drugs. Out of 42 MDRS, 29[69.04%] were resistant to ciprofloxacin. It may be concluded that the trend of resistant strains of Salmonella typhi against newer drugs has reached to an alarming situation. Instead of waiting for newer drugs to come into market, we should use with care what we already have

Role of adhesion molecules in vascular complications of type 2 diabetes mellitus

The present study was undertaken to evaluate the plasma levels of soluble adhesion molecules [intercellular adhesion molecule-1 [ICAM-1] and vascular cell adhesion molecule-1 [VCAM-l] in type 2 DM to elucidate its potential involvement in pathogenesis of diabetic vascular complications and its association with other independent risk factors for diabetic atherosclerosis. The study was conducted on 60 patients with type 2 DM [27 with vascular complications Vs. 33 without vascular complications, assessed by fundus examinations] and 20 healthy controls, at Al-Azhar University Hospitals between March 2004 to August 2004. Serum levels of ICAM-l and VCAM-l in association with fasting blood sugar, fasting insulin and insulin resistance were measured, as wall as lipid profile, plasminogen activator inhibitor [PAl] and factor VII. Serum levels of ICAM-1 and VCAM-1 were significantly higher in type 2 diabetic patients with vascular complication than those without vascular complications, but no significant changes in their levels were found between patients without vascular complications and controls. Serum levels of ICAM- 1 and VCAM- I were significantly correlated with other studied parameters in patients with and without vascular complications except fasting serum insulin levels. Serum levels of insulin resistance [IR] and lipid profile were significantly higher in patients with type 2 DM than controls and in patients with vascular complications than those without vascular complications. Serum levels of fasting blood glucose, factor VII and PAl were significantly higher in diabetic patients with and without vascular complications than controls, on the other hand no significant changes was found between patients with and those without vascular complications. The present study suggested that the levels of soluble adhesion molecules in type 2 DM with dyslipidaemia, hyperinsulinemia and hypercoagulable state may be a marker of endothelial cell activation or dysfunction and may be related to the activity of multiple cell types in atherosclerotic lesion. Serum levels of ICAMs were closely related to vascular diabetic complications. Furthermore, they may serve as a tool for monitoring the impact of prevention and intervention on vascular damage

Diagnostic value of bone marrow examination in haematological and non haematological diseases

In this study, 223 bone marrow biopsies and / or aspirations were performed. The main indications for bone marrow examination were diagnosis and management of acute leukaemia [45-20.2%], staging of lymphoma [29-13.1%], evaluation of pancytopenia [31-14.1%], thrombocytopenia [26-11.7%], anaemia [16-7. 2%], pyrexia of unknown origin [PUO] [14-6.1%], lymphadenopathy [16-7. 3%], hepatosplenomegaly [12-5.3%], to exclude metastasis [7-3.2%] and miscellaneous [25-11%]. The most common diagnosis encountered were: acute lymphoblastic leukaemia [35-15.7 %], idiopathic thrombocytopenic purpura [13-5.7%], acute myeloid leukaemia [12-5.7%], hyper8plenism [12-5.7%], chronic myeloid leukaemia [12-5.7%], megaloblastic anaemia [7-3.1%] and multiple myeloma [3-1.3%]. It was concluded that bone marrow examination is an important investigation for establishing the diagnosis in many conditions especially haematological neoplasms. The most common indication in this study was to confirm and manage acute leukaemia and the most common diagnosis was acute lymphoplastic leukaemia