Pattern of semen fluid abnormalities in male partners of infertile couples in Khartoum, Sudan

Normal semen is a mixture of spermatozoa suspended in secretions from the testis and epididymis, which at the time of ejaculation, are combined with secretions from the prostate, seminal vesicles, and pulbourethral glands. Many factors affect the quantity and quality of semen parameters such as cigarette smoking, excessive exercise and alcohol consumption. The objectives of the study were to determine the pattern of semen fluid abnormalities [volume of the ejaculate, sperm concentration, sperm motility, sperm morphology] in male partners of infertile couples in Khartoum, Sudan. This was a descriptive study, 100 records of couples who attended Sudan Assisted Reproduction Centre in Khartoum seeking fertility treatment from July - December 2008 were reviewed for the volume of the ejaculate, the concentration of the sperms, the motility and the morphology. Semen production was obtained in the centre or at home after 3-7 days of abstinence from intercourse. Production of semen was by masturbation in a sterile container. Evaluation of samples was made by a qualified andrology technician. Statistics was done by the computer using SPSS soft ware. Results showed that 41.5%, 53.9%, 3.1%, and 1.5% of men had a volume of < 2, 2-4, 5-7 and >8 ml respectively. 25%, 37% and 38% had normal, oligozoospermia and azoospermia respectively. As regards motility, 27.4% had normal motility 62.9% had sluggish motility and 9.7% their sperms were immotile. There were only 1.8% of men who had normal morphology. The study concluded that, few men had sperm profile that was consistent with reference values with regard to volume, concentration, motility and morphology. Morphology showed the least normality. Results showed that no subject in the cohort fulfilled the full criteria of normozoospermia

Maternal mortality in Ribat University Hospital, Khartoum, Sudan: seven years of experience

Maternal death is a tragedy that leaves an enormous negative impact on the family. The objectives of the study were to determine the rate and causes of maternal mortality in Ribat University Hospital This was a descriptive, hospital-based study conducted in Ribat University Hospital, Khartoum, Sudan. Maternal mortality records were reviewed for causes of maternal death. Data were collected by a check list and analysed by SPSS soft ware. The number of maternal deaths was 10 while the number of live births during the study period was 19604. The maternal mortality rate was 51:100000 live births. 40% of patients were below the age of 30 while 60% were 30 years of age and more. Rural and urban residence constituted 70% and 30% respectively. 60% of patients had a parity of more than four. Results showed that 62.5% delivered by emergency caesarean section. The study revealed that 20% of the patients died as a result of pregnancy induced hypertension [PIH] [Hellp syndrome and eclampsia], 20% of PIH [eclampsia], 10% of PIH [rupture liver], 10% of ante partum haemorrhage [placenta praevia], 10% of primary postpartum haemorrhage following twin vaginal delivery, 10% of puerperal sepsis and septic shock following emergency caesarean section, 10% of hypovolaemia due to hyperemisis gravidarum and 10% of septicaemia with acute renal failure following missed miscarriage, Maternal mortality rate was 51:100000 live births. Pregnancy induced hypertension constituted one half of the causes of maternal deaths, followed by haemorrhage and septicaemia

Contributing factors of vesico-vaginal fistula [WF] among fistula patients in Dr.Abbo's National Fistula and Urogynecology Centre - Khartoum 2008

Vesico-vaginal Fistula [VVF] is defined as an abnormal communicating tract extending between the bladder [vesico-] and the vagina resulting in continuous involuntary discharge of urine into the vaginal vault. Vesico-vaginal fistula is still a persisting scourge in the developing countries, including Sudan in which 5000 new cases of obstetric fistula were estimated to occur every year. The objectives of this work were to study the contributing factors of vesico-vaginal fistula in Sudanese patients. The design was descriptive, cross-sectional, community-based study. A total of 2 patients with vesicovaginal fistula presented to the Fistula Centre in Khartoum Teaching Hospital from July to August 2008 were investigated using an administrated, semi-structured questionnaire. The study revealed that 44.2% of patients were 18-24 years old 58.8% were teenagers when married [<18 yrs old]. While 7% of the patients were illiterates, 62.8% were married to illiterate husbands. [80.8%] were poor, [40.4%] were from western regions of Sudan. The study showed that labor was responsible for 90.4% of VVF of whom 59.6% were primiparous, 42.6% delivered at home. It was found that 40.4% of the total deliveries were by forceps as long as 27.7% were emergency caesarian sections. [53.2%] of the deliveries were attended by traditional birth attendants and 55.3% of cases stayed in labor for more than 24 hours, as long as 53.2% were not in regular antenatal care. The vesico-vaginal fistula in Sudan resulted mainly from obstructed labor. The victim was mostly a young woman, a primigravida, who was poor, illiterate, not on regular antenatal care and being in labor more than 24 hours. Most deliveries were carried at home, attended by Traditional Birth Attendants in most cases. The deliveries were mostly assisted by forceps, or conducted as emergency caesarian sections. To prevent VVF, the study suggested raising awareness of women at bearing age; improve transportation, besides inclusion of the issue in the curricula of schools and universities

Antibodies against merozoite surface protein 1 and 2 in Sudanese children

Malaria is a serious childhood disease causing high morbidity and mortality despite control measures. Immunological control against malaria was initiated early, and immunity acquired by children in endemic areas, which is age and exposure dependant, differs in different endemic settings. The objective of the study was to determine antibodies against Merozoite surface protein-1 [MSP-I] and Merozoite surface protein-2 [MSP-2], and to determine their relation to the age of Sudanese children. The study was descriptive, cross-sectional, conducted in Khartoum Children Emergency Hospital [KCEH]. 150 children with positive blood films for P. falciparum malaria were classified according to age, and a blood sample was taken from each one, and tested for antibodies against MSP-I and MSP-2. Antibodies to MSP-I and MSP-2 were 46% and 42% respectively. Sero-positivity and sero-negativity for both antigens were 26.6% and 42.7% respectively. Seropositivity to either MSP2 or MSPl antigen alone was present in 18.7% and 12% of patients respectively. High seropositivity [52.9%] was found in the age group 12-15 years of age. MSP-1 and MSP-2 antibodies in Sudanese children according to this study were age dependant, and findings were similar to what had been reported in some African countries