Hypospadias in Sudan, clinical and surgical review.

BACKGROUND: Hypospadias is one of the commonest penile abnormalities in new born males, and occurs as a result of a birth defect resulting in a urethral opening anywhere from the glans penis along the ventral aspect of the shaft of the penis up to the scrotum or the perineum in extreme cases. The condition has a huge impact on the patient's psychological, emotional and sexual well being. This study aimed to evaluate the current trend in the treatment of hypospadias in Sudan. MATERIALS AND METHODS: The was a retrospective study done in Elribat university hospital, department of Paediatrics surgery, for patients who underwent hypospadias surgical repair in the period January 2006 to June 2007. RESULTS: There were 50 patients in this study. Regional distribution of the patients showed that 52% of the patients live in Khartoum state, the capital, while 48% were from the peripheries; 12% of patients had family history of similar condition (Hypospadias) and 54% were of low socioeconomic status. Anterior hypospadias was the commonest type (46%), and associated chordee occurred in most of the patients (88%). The most common associated anomalies found were undescended testicles (20%) and inguinal hernia only in 2%. The most common type of repair was MAGPI (meatal advancement and glanuloplasty) with 42% of cases, anterior hypospadias commonest type with 46% of cases, 12% of cases had a family history of the condition and an overall complication rate of 26%. Chordee was the most prevalent association in 88% of cases. CONCLUSION: There is a high familial tendency for hypospadias in Sudan. Associated chordee and other anomalies are in keeping with other reports. Corrective surgery for hypospadias is associated with high complication rate in our setting. Collaboration between surgical specialties such as plastic surgeons, paediatrics urologist and general surgeons may improve the present complication scenario.

Safety of artemisinins during early pregnancy, assessed in 62 Sudanese women.

Between June 2006 and October 2008, the safety of artemisinins during early human pregnancy was assessed in central-eastern Sudan. Pregnant women in the first or second trimester who were attending antenatal-care clinics at the Wad Medani, Gadarif and New Halfa hospitals were interviewed. Each was asked if they had had malaria in the first trimester of the index pregnancy and, if so, what treatment they had received. The women who had received artemisinins were then followed-up until delivery and their babies were followed-up until they were 1-year-olds. Overall, 62 of the pregnant women reported receiving artemisinins - artemether injections (48), artesunate plus sulfadoxine-pyrimethamine (11) or artemether plus lumefantrine (three) - during the first trimester. Medical records were available for 51 (82%) of these 62 women, and, in each case, these records showed the reported treatment and that malaria had been confirmed. Only nine (15%) of the 62 women given artemisinins had not known that they were pregnant when treated. Two of the treated women (both given artemether injections in the first trimester) had miscarriages, one at 20 weeks of gestation and the other at 22 weeks, each while receiving quinine infusions for a second attack of malaria. The other 60 women who had received artemisinins delivered apparently healthy babies at full term. No congenital malformations were detected, there was no preterm labour, no maternal deaths were recorded during the follow-up, and none of the babies died during their first year of life. It therefore appears that artemisinins may be safe to use during early pregnancy, although further study is clearly needed.

Electrophysiological evidence for the inhibition of potassium permeability in pancreatic beta-cells by glibenclamide.

The effects of glibenclamide on the electrical activity of the beta-cells of the islets of Langerhans of normal mice have been investigated in the absence and presence of glucose (11.1 mM). Glibenclamide depolarized the cell membrane and this has been interpreted in terms of an increase in the ratio of the Na+ and K+ permeabilities, PNa/PK. This ratio increased from 0.05 to 0.24 in the presence of 4 microM glibenclamide and zero glucose. The input resistance of the beta-cells also increased. These observations indicate a decrease in K+ permeability. The effect is only slowly reversed after removal of glibenclamide. Uncouplers of oxidative phosphorylation do not reverse the depolarization induced by glibenclamide. It is suggested that glibenclamide is acting directly to inhibit the [Ca2+]i-gated K+ permeability in the beta-cell membrane.