Drugs use during pregnancy at Medani Maternity Hospital, Sudan

Background: There is a limited knowledge on use of drugs during pregnancy including beneficial and possible adverse effects of drugs on both the mother and the fetus.Objective: To investigate epidemiology of use of drugs during pregnancy.Methods: A cross sectional hospital based study at Medani Hospital during the period December 2011. After signing an informed consent, a pre-tested questionnaire was used to gather data from each parturient mother on her age, parity, level of education, antenatal care visits and use of drug during the index pregnancy.Results: The vast majority (334; 98.2%) of the interviewed women used drugs during the index pregnancy. Around ten percent (35; 10.5%) of these women used the drugs in the first trimester of pregnancy. The majority (266; 78.2%) used the drugs in third trimester and the rest used it in the second trimester. The most common drugs used were antibiotics, tonics, antimalarials and antiemetic.Conclusion: There is a very high rate of drug use in this setting. Antibiotics and antimalarials drugs were the most used drugs.Keywords: drugs, pregnancy, antibiotics, antimalarials, Sudan

Plasmodium vivax cerebral malaria in an adult patient in Sudan

BackgroundPlasmodium vivax infection is rising in sub-Saharan Africa, where Plasmodium falciparum is responsible for more than 90% of malaria cases. While P. vivax is identified as a major cause of severe and cerebral malaria in South east Asia, the Pacific and South America, most of the severe and cerebral cases in Africa were attributed to P. falciparum. Cases of severe malaria due to P. vivax are emerging in Africa. A few severe P. vivax cases were reported in Eastern Sudan and they were underestimated due to the lack of accurate diagnosis, low parasitaemia and seldom use of rapid diagnostic tests (RDTs).Case presentationA 60-year-old Sudanese male presented to the Al Kuwaiti hospital in the Sudan capital Khartoum. On admission, the patient was complaining of fever (measured temperature was 38 °C), sweating, chills, vomiting and confusion in the past 2 days prior to his admission. He rapidly deteriorated into a coma state within 48 h of the admission, with significant neck stiffness. He was admitted to the intensive care unit and was suspected of meningitis. Lumbar puncture was not performed since the patient was suffering from spinal cord disc. Brain CT scan was unremarkable. Several biochemical, haematological tests, and blood film for malaria were performed. The results of the laboratory tests were within the normal range except of mild elevation of the total white blood cell count and a significant decrease in the platelets count. Malaria parasites were seen in the blood film with high parasitaemia (quantified as 3 +++). The patient was diagnosed as P. vivax cerebral malaria based on the positive blood film and the amplification of P. vivax specific 499 bp amplicon using Plasmodium multi-species multiplex Polymerase Chain Reaction (PCR). The patient was treated with quinine 10 mg/kg body weight for 10 days followed by primaquine 15 mg/days PO for 2 weeks. The symptoms subsided within 48 h and the patients was cured and released from the hospital.ConclusionsPlasmodium vivax is an emerging cause of cerebral malaria in adults in Sudan and should be considered in the differential diagnosis of cerebral malaria for proper management of patients

Occurrence and spatial distribution of legacy and emerging organic pollutants in marine sediments from the Atlantic coast (Andalusia, SW Spain)

Contamination of aquatic systems by no longer used but very persistent compounds (e.g., organochlorine pesticides) and newly detected chemicals, such as personal care products (PCPs), represents a raising concern. In this study, we carried out one of the first comparisons of both types of contaminants, legacy and emerging, in two coastal systems (Cadiz Bay and Huelva Estuary). A wide range of analytes were selected to this end, including hydrocarbons, UV filters, fragrances, and antimicrobials. Analysis of surface sediments revealed the occurrence of 46 out of 97 target analytes, most of them predominantly accumulated in depositional areas with high organic carbon content. Polycyclic aromatic hydrocarbons (PAHs), fragrances (e.g., octahydrotetramethyl acetophenone or "OTNE"), UV filters (e.g., octocrylene), and nonylphenol had the highest concentrations (up to 1098, 133.5, 72 and 575ngg-1, respectively). Several inputs were detected, from atmospheric deposition after combustion to wastewater discharges and recreational activities. However, an environmental risk assessment performed for those chemicals for which ecotoxicological data were available, indicated that legacy compounds still pose the highest potential risk towards benthonic organisms (individual hazard quotients up to 580 for dichlorophenyldichloroethylene or "DDE") compared to PCPs

Of PCOS Symptoms, Hirsutism Has the Most Significant Impact on the Quality of Life of Iranian Women

INTRODUCTION:Polycystic ovary syndrome is a common endocrine disorder affecting women both physically and psychologically and can lead to a poor quality of life compared to their normal counterparts. The aim of the present study was to assess the impact of various clinical features of polycystic ovary syndrome on the health-related quality of life of Iranian women diagnosed with this syndrome. MATERIALS AND METHODS:A total of 796 women diagnosed with polycystic ovary syndrome, aged 15-49 years, completed the questionnaires, interviews, and medical assessments required for this study. A reliable and validated Persian version of the health-related quality of life questionnaire for polycystic ovary syndrome patients was used. Linear regression models were used to assess the association between the symptoms of polycystic ovary syndrome and health-related quality of life. RESULTS:The mean age of participants was 28.02 years. 35.4% of the subjects were classified as overweight or obese. Hirsutism, was reported to have the strongest impact on the patients' health-related quality of life, followed in descending order by body mass index, irregular menses and infertility. The relative level of hirsutism was directly proportional to decrease in health-related quality of life score (p<0.001). CONCLUSIONS:The results of the study found that hirsutism had the strongest impact on the health-related quality of life measures in Iranian women diagnosed with polycystic ovary syndrome. Health care officials need to evaluate in depth the effect of each clinical feature of polycystic ovary syndrome separately and design management strategies, keeping in mind the psychological and physical manifestations