Effect of delay in diagnosis on the rate of tuberculosis among close contacts of tuberculosis patients

Few studies have explored diagnosis delay by tuberculosis [TB] patients and its effects on the rate of infection among their close contacts. A cross-sectional study of the close contacts of 505 newly diagnosed TB patients was conducted in a TB referral centre in Sana'a, Yemen from 2008 to 2010. Only the close contacts of 89 new TB patients agreed to participate and completed the tuberculin skin test [TST]. Of the 239 close contacts investigated, 133 [55.6%] had a positive TST result. Index patients were classified as long or short diagnosis delay [above or below the median]. There was no significant difference in the number of infected close contacts between long and short delay index patients [Mann-Whitney U-test]. A larger sample size, with more incentives for patients to participate and the use of other investigative tools could provide a better picture of the pattern of TB transmission among all contacts

Selection of Proton Pump Inhibitors (PPIs) for Formulary Inclusion Using an Objective Scoring System in Malaysia.

The main aim of this study was to develop an objective Drug Evaluation Scoring System (DESS) by determining criteria for differentiation among 5 PPI drugs available in the market i.e. esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole. Secondly, was to assign weightage according to its importance of the criteria. Thirdly, was to determine the scores and rank the PPI drugs. In developing DESS, 200 points was assigned for the clinical documentation criterion, 300 points for the clinical efficacy criterion, 200 points for the safety criterion and 300 points for the cost criterion. The higher the assigned score, the higher importance the criterion is. The criteria were designed in the format of questionnaire to enable participants to allocate scores according to their perception on the importance of the criteria. Self-administered questionnaires were distributed to 165 specialists and medical officers. Study findings from the scoring system found that all PPI drugs have very negligible difference in clinical efficacy and clinical safety. Omeprazole was found to be the most cost economical PPI in the government hospitals. The DESS was able to compare and rank PPI drugs based on the scoring system and also assist in the selection of PPI drugs into the drug formulary.

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

Presentation of colorectal cancer in Khartoum teaching hospital

To determine the age and gender distribution in Sudanese patients with colorectal cancer, as seen in Khartoum Teaching Hospital, and to study its emergency presentation. This retrospective study was conducted in Khartoum Teaching Hospital [Sudan]. Two hundred and seventy seven [277] patients who presented in the period 1[st] January 2000 to 31[st] December 2006 were included. Data were collected from their hospital records and analyzed using SPSS computer program. More than 100 [34.5%] of the study population [n=277] were below the age of 40 years, and 17.3% were below 30 years. The male to female ratio was 1.5:1. Intestinal obstruction was the most common cause of emergency presentation of colorectal cancer [94%]. Colorectal cancer in this study was found in young age groups. Intestinal obstruction is the main mode of its emergency presentation

Study of the analgesic efficacy of epidural ketamine with and without bupivacaine in normal labour

There are several methods to alleviate pain during normal labor, ketamine given epidurally may be a reasonable technique. Sixty parturients ASA I or II were selected, epidural catheter was inserted and the patients were allocated into three groups [20 patients each]. Group I received 50 mg ketamine, group II received 10 ml of 0.125% bupivacaine, group III received a combination of ketamine 50 mg and bupivacaine 10 ml of 0.125%. Pain was assessed by visual analogue pain score. Arterial blood pressure, heart rate and ECG were monitored. Duration of analgesia, cervical dilatation, induction delivery interval and Apgar score were assessed. Half the initial dose of analgesics was given either on the patient request and /or during the second stage of labor. Ketamine produced significant analgesia which was prolonged by the use of combination of ketamine and bupivacaine. No patient developed respiratory depression, motor blockade or hypotension. Three patients were sleepy and detached from the environment with the use of ketamine

Comparison between pethidine and fentanyl for pain relief during labour

The aim of this study was to compare a standard analgesic which is pethidine with a more recent one; namely, fentanyl as regard the analgesic efficacy as well as the incidence of possible materno-fetal side-effects. Forty full term primigravidae in active labor with cervical dilatation 3 to 4 cm were included. They were enrolled into two groups each consisting of 20 cases to receive intravenously either pethidine or fentanyl. Both medications induced a significant analgesia in late first stage or second stage. Side effects were minimal with both medication and they did not induce any adverse effect in the mother or her fetus

Intra-articular bupivacaine versus morphine for postoperative analgesia after arthroscopic knee surgery

Sixty adult patients were randomly collected and divided into two equal groups. One group received general anesthesia using thiopentone sodium, halothane and nitrous oxide in oxygen and spontaneous ventilation, the other group received spinal analgesia [2 ml of 0.5% bupivacaine]. Each group was subdivided into three equal groups [10 patients each]. Group A received intra-articular saline, group B received intra-articular morphine, and group C received intra-articular bupivacaine. Analysis of the results revealed that both morphine and bupivacaine provided a better analgesic effect when compared with saline group. They also prolonged the duration first analgesic use and reduced the analgesic requirements. The effect of morphine was significant when compared with that of bupivacaine

study of convulsions in childhood

This prospective study was performed on 400 children, between the ages of 1 month and 13 years with a history of convulsions, admitted during a 2-year period. There were more males than females, with more children admitted in the winter season than in the summer. The largest group suffered febrile convulsions [77%], followed by afebrile convulsions and epilepsy [11.2%], hypocalcaemia with or without rickets [5.7%], central nervous system infections [4.4%] and lead intoxication [0.8%]. In nearly 40% of the children, the laboratory investigations were normal, while polymorphonuclear leucocytosis [37.5%] was the most common laboratory finding. Central nervous system infections were found in all age groups, and hypocalcaemia and lead intoxication were found to be significant causative factors for convulsions in children under 2 years of age