Effect of quinine therapy on plasma glucose and plasma insulin levels in pregnant women infected with Plasmodium falciparum malaria in Gezira state

To determine if quinine has a metabolic effect during treatment of severe or complicated malaria, we studied its effects on plasma glucose and plasma insulin levels in 150 pregnant women with malaria referred to Madani maternity teaching hospital, Gezira state and 50 healthy pregnant controls. Levels were determined at baseline [day 0] before the start of quinine treatment, after 2 days of treatment [2 hours after the 4th dose] and after 7 days of treatment [day 8]. There was a statistically significant increase in plasma insulin concentrations during the quinine infusion and fall in plasma glucose concentration [P<0.001]. Quinine administered at the recommended dose and rate can disrupt plasma glucose homeostasis although it is still the drug of choice for severe and complicated malaria in Sudan

Role of percutaneous radiofrequency ablation in patients with hepatocellular carcinoma

Radiofrequency ablation [RFA] is a promising technique for local control of liver malignancy such as primary hepatocellular carcinoma. This technique has become the main stream of the treatment of non-surgical modalities in clinical settings. A study was conducted to assess the therapeutic efficacy of percutaneous radiofrequency ablation for small and medium sized hepatocellular carcinoma [HCC]. Patients and Thirty five cirrhotic patients [M:F; 28:7, age; 57.4 +/- 7.8 years] each with solitary HCC mass lesion [mean size; 3.01 +/- 0.82cm] were consecutively recruited at Assiut University Hospital between August 2007 and November 2009. HCC was diagnosed by raised alpha-fetoprotein [AFF] and contrast-enhanced CT. Lesions were stratified into 2 groups; "Group A ". lesions <3cm [n=22] and "Group B ". lesions 3-5cm [n=13]. Single session RFA was done and all patients were followed-up with AFP and contrast-enhanced CT after one month and 6 months post-procedure. Complete ablation was achieved in 77.1% [27/35] of patients after one-month [81.8% [18/22] in group A and 69.2% [9/13] in group B; p=0.3] Local recurrence was noticed in 3 patients after 6 months [one in group A and 2 in group B]. AFP levels were significantly reduced in both groups after one month and 6-months follow-up. No major complications occurred in all patients treated by RFA. RFA is less effective in ablating medium sized HCC [3-5cm] than in ablating small sized HCC <3cm. The procedure is safe, effective and without major complications

Psychological distress and quality of life among diabetic pregnant women

Pregnant women may experience specific and intense fears such as fear of incompetence and concerns about pain and loss of control during delivery, fear for their own life and the life of their baby and worries about changes in their personal life due to pregnancy and childbirth. Diabetes is categorized into two groups, preexisting diabetes and gestational diabetes. This study is concerned with assessing and identifying psychological distress and quality of life among diabetic and nondiabetic pregnant women. It was conducted at the obstetric and gynecological department at Assiut university hospital. The study consisted 200 pregnant women, among the subjects, 100 were diabetics and 100 nondiabetics as a control group. Data were collected through two tools, depression anxiety stress scale and quality of life scale. The results of this study yielded that diabetic pregnant women had severe and extreme depression than nondiabetics [X[2] = 29. 32], Also they had severe and extreme anxiety and stress. Diabetic pregnant women had a moderate quality of life than nondiabetics. The study recommended developing strategies to improve quality of life and emotional support for diabetic pregnant women

Utilization of dephytinised rice bran for production oh highly nutrition value biscuits

Rice bran is a by-product obtained during rice milling. In the recent years with decreasing sources of foods there must be amaximum utilization of whole cereals. Therefore, in this presented study raw rice bran was extruded at 140°C and a screw speed of 150 r.p.m. for 20 seconds in order to inactivate lipase enzyme. After extrusion of the rice bran. phytic acid was removed by using hydrochloric acid and enzymes. The dephytinised rice bran [DRB] contained 14.6% protein, 19.2% oil and 22.5% total dietary fiber. Phytic acid decreased from 30.4 g/kg in raw rice bran to 4.37 g/kg in DRB. The protein digestibility increased from 66.9% in raw rice bran and reached 8 1.7% in DRB. Biscuits substituted with 10, 20 and 30% DRB were prepared and chemically analysied whereas biscuits contents from protein. fat, crude fiber and ash increased with increasing DRB substitute compared to control. The baking quality of biscuits showed an increase in weight, while volume, diameter and thickness slightly decreased with increasing DRB substitution compared to control. Sensory evaluation of biscuits suggested that the best additive was up to 20% DRB. Measurement of color biscuits by Hunter revealed little changes in color compared to control

Electrophysiological assessment in paint workers with chronic exposure to organic solvents

Exposure to organic solvents has been associated with many neurological deficits. However, not all solvents are equally neurotoxic. The association of clinically significant polyneuropathy with long term occupational exposure to organic solvents, alone or in combination, is controversial. The aim of this study was to assess the effects of chronic occupational exposure to a mixture of certain organic solvents upon the peripheral nervous system [PNS] in exposed painting workers and detection of sub-clinical affection. The population of this cross-sectional study included two groups. The exposed group comprised 40 male workers recruited from a paint factory. Twenty male workers, age matched, with no contact with the exposure environment, from the same factory were eligible as a control group. The exposed workers were further divided into two groups group [I] and group [II] according to frequency and the pattern of usage of personal protective equipment [PPE]. The materials frequently used in painting process were included; epoxy, calcium carbonate, barium sulfate, n-butanol, titanium dioxide, xylene and zinc oxide. All workers were subjected to a structured interview questionnaire about their exposure and medical history as well as complete general and neurological examinations. Bilateral nerve conduction studies [NCSs] for motor [common peroneal, median and ulnar] nerves and sensory [sural, median and ulnar] nerves were performed for all the study population using a standardized protocol. The diagnosis and classification of neuropathy was established using a combination of symptoms, signs, and NC measures consistent with standard clinical practice. Potential confounders of NC measures were examined. Mean values for nerve conduction velocities [NCVs] for all studied motor and sensory nerves were highly significantly slower in exposed workers compared to control group [p<0.01]. The same results were recorded for the mean values for SNAP amplitudes. Regarding motor nerves CMAP amplitudes, there was significant difference only for tibial nerve. There was no significant difference of distal latencies for any estimated nerve either sensory or motor. For whole exposed group [n=40], 19 workers [47.5%] had at least one abnormal NC measure in two or more of evaluated nerves; 11 workers [27.5%] fulfilled criteria for confirmed clinical neuropathy whereas 8 workers [20%] fulfilled the criteria for sub-clinical neuropathy. The results NCSs of exposed workers with regular and complete protection [group I], exposed workers with partial protection [group II] and controls demonstrated significant differences regarding all parameters of all studied nerves except sensory latency of ulnar sensory nerve and motor amplitudes of median motor and tibial motor nerve. Regarding the inter-group comparisons, there were significant differences between the three groups for all SNCVs and only the MNCV of tibial nerve [p<0.01]. Other evaluated parameters of both motor and sensory nerves were affected with different significant degrees except distal latency of ulnar sensory nerve and motor amplitudes of median motor and tibial motor nerves[p>0.05]. The median sensory nerve was the only nerve which showed highly significant differences between the 3 groups regarding all its evaluated parameters [p<0.05]. Also only ulnar motor nerve showed highly significant differences between workers of group I and workers in group II regarding its all evaluated parameters of [p<0.05]. In the studied population [n=60], exposure, age and smoking were found to have significant effects on some NC measurements on logistic regression analysis. In the exposed group [n=40] using of PPE, type of job [regarding the spray painters] and duration of exposure, in years, had significant effects on certain NC parameters based on the same model of logistic regression analysis. Chronic exposure to the mentioned organic solvents was associated with solvent induced toxic polyneuropathy [SITP] as proved by the results of abnormal electrophysiological parameters of the evaluated peripheral nerves for all exposed workers group. Appropriate medical strategies to reduce such morbidity as periodic medical evaluation and electrophysiological assessment should be implemented

Endoscopic management of benign biliary stricture

To present the experience of the Gastroenterology Department of the Riyadh Armed Forces Hospital, with endoscopic management of benign biliary strictures.Design: A retrospective study of patients diagnosed by endoscopic retrograde cholangiopancreatography [ERCP], as having benign biliary strictures. Thirty-seven patients with benign biliary strictures who were endoscopically diagnosed or treated over a 9-year period. Twenty-four of these patients had postoperative strictures and in the remaining 13 patients, the causes included sclerosing cholangitis, inflammation or benign neoplasm. The management in these patients was surgical in 18, combined surgical and endoscopic in ten and endoscopic only in nine. Nasobiliary drainage was performed in all ten cases of combined endoscopic and surgical approach before patients were referred to surgery. The last nine patients were managed by endoscopy alone, four had balloon dilatation and five had endoprostheses inserted [four of these were plastic stents and one was an expandable metal stent]. In benign biliary strictures, endoscopic management with stricture dilatation followed by stenting should be tried first before any surgical intervention is considered

Indications and results of the MAGPI Technique in minor forms of hypospadias

This study included 22 infants and children with a minor form of hypospadias. After clinical examination and appropriate preoperative investigations a MAGPI procedure was used to correct the malformation. The cosmetic and functional results were favorable in 86.3% of the cases with 3 complications. The comparison of the results to the original position of the meatus and anatomical state of the penis allows to redefine the indications of the MAGPI