Effect of pre-eclampsia on glomerular filtration rate in Sudanese women

Background: Creatinine clearance is safest method to measure glomerular filtration rate (GFR) in pregnancy. The objectives was to study a case-control study conducted in Omdurman Maternity Hospital aimed to assess GFR, using creatinine clearance and magnitude of changes of serum creatinine in pre-eclampsia.Methods: Pre-eclamptic were 70, normal pregnant 96 and non-pregnant 63. Investigations were done at St Hellier's hospital London. Serum and urine creatinine were measured using Jaffé reaction and spectrophotometer. 24-hour urine output was measured and creatinine clearance calculated to find GFR. GFR was calculated in ml/min/mm2 using John Hopkins’ method.Results: The mean serum creatinine in pre-eclamptic (68.6µmol/L) was less than non-pregnant (75.5µmol/L) (P=0.001) but was higher than normal pregnant (62.4µmol/L) (P=0.003). Mean GFR pre-eclamptic (68.6ml/min.1.73m2) was less than non-pregnant (87.0ml/min/1.73m2) (P=0.0001) and normal pregnant (89.0ml/min/1.73ml/min/1.73m2) (P =0.0001).Conclusions: GFR decreased at term in normal pregnancy and even more in pre-eclampsia. Serum creatinine levels increased and did not correlate with GFR changes in pre-eclampsia

Relationship between obesity, physical activity, sleeping hours and red blood cell parameters in adult Sudanese population: Effect of exercise and sleep hours on RBC parameters

Ideal body weight with proper physical activity and good sleep are essential parameters for good quality of life. This study is concerned with assessing the association of general obesity, physical activity and sleeping hours with hemoglobin (Hb) concentration and red blood cell (RBC) parameters in healthy adults in Sudan. In this cross sectional study, 1086 healthy adults between 20 and 60 years were included out of which 275 were males and 811 were females. A complete blood count (CBC) was performed for Hb, RBC count, PCV, MCH and MCHC using Sysmex KX-21 automated hematology analyzer. The median and 95 percentile (2.5th to 97.5th) range values for Hb and RBC count in underweight were 13.0 (Range: 9.6-16.7) g/dl and 4.6 (Range: 3.6-5.8) ×103/µL respectively, while Hb and RBC count in obese were 13.1 (Range: 10.4-17.0) g/dl and 4.6 (Range: 3.7-5.9) ×103/µL respectively, with no significant difference. The RBC count (p=0.004) and Hb (p?0.001) were significantly high in physically active compared to physically inactive participants; whereas the hemoglobin concentration (p=0.047), red blood cells (p=0.007) and hematocrit (p?0.001) values were significantly low in long-term sleep compared to normal sleeping hours. In conclusion, there were no significant differences in hemoglobin concentration, RBC count, PCV, MCH and MCHC between unde weight, normal weight, overweight and obese persons. Increased physical activity was associated with higher Hb levels and RBC counts, while long-term sleep showed lower Hb and RBCs

Role of neutrophil / lymphocyte ratio, uric acid / albumin ratio and uric acid / creatinine ratio as predictors to severity of preeclampsia

Abstract Background Pre-eclampsia (PE) is an intractable obstetric disorder with high mortality and morbidity, affecting 6–8% of pregnancies worldwide. As its etiology and pathogenesis remain unclear, there are no specific prevention or treatment options. This study aimed to determine the association between neutrophil to lymphocyte ratio (NLR), uric acid to albumin ratio (UAR) and uric acid to creatinine ratio (UA/Cr) and severity of pre-eclampsia. Methods A cross-sectional hospital-based study was conducted among pre-eclamptic women in Kosti Maternity Hospital from September to December 2022. Forty-five pre-eclamptic women were enrolled in this study and were classified according to the WHO classification of PE into mild PE (23 PE patients) and severe PE (22 PE patients). Data were collected using a semi-structured questionnaire covering medical history and clinical assessment. A blood sample was taken from each participant for measurements of the complete blood count (CBC), liver functions test (LFT) with enzymes, renal functions test (RFT) with electrolytes, and uric acid by standard techniques. Results NLR was found to be statistically significantly higher in mothers with severe PE (6.3–9.9) than in those with mild PE (2.2–1.5) (p-value 0.048). Alanine aminotransferase (ALT) was significantly higher in women with severe PE than in those with mild PE (p-value = 0.02). The total means of platelet-lymphocyte ratio (PLR), UA/Cr, and UAR were insignificantly higher in women with severe PE compared with those with mild PE (p-values 0.666, 0.427, and 0.525, respectively). The means of uric acid and serum creatinine showed insignificant statistical elevation in women with severe PE compared with mild PE (p-values of 0.27 and 0.44, respectively). Serum albumin was found to be insignificantly lower in mothers with severe PE (3.3 ± 0.6 g/dl) than in those with mild PE (3.6 ± 0.6 g/dl); p-value = 0.21. Conclusions PE showed a significant statistical increase in WBC, neutrophils, alanine transaminase (ALT), and NLR in severe PE compared to mild PE and a significant statistical decrease in lymphocyte count in severe PE compared to mild PE. The measurement of NLR may be a useful laboratory marker for predicting the severity of PE

Effects of Smoking on Intima-Media Thickness of the Common Carotid Artery Using Ultrasonography

Abstract Background Cigarette smoking is a causative factor in premature atherosclerosis, but the exact mechanism of smoking-induced damage to the arterial wall and its relationship to the atherosclerotic process are still largely unknown. Carotid ultrasound may help target treatment. The aim of this study was to measure carotid intima-media thickness (IMT) and carotid Doppler parameters in Sudanese smokers compared to non-smokers using ultrasound. Methods This was a retrospective, case–control, community-based study conducted between June 2021 and September 2021. The study was conducted on 100 Sudanese subjects (50 smokers as the case group and 50 non-smokers as the control group). The practical part was conducted in Khartoum State at Al Raqi University Hospital using the E-CUBE 8-ALPINION and at Yastbshroon Hospital using the Fukuda Denshi Sefius UF890AG with a high-frequency linear transducer (7–10 MHz). Scanning was performed in the supine position with the neck extended. Pulsed-wave (PW) Doppler spectral and IMT measurements were obtained. Results The mean age was 29.8 ± 4.5 years (range 24–40 years), and the mean IMT in smokers was 0.6 ± 0.06 mm, which was greater than the mean in non-smokers (0.462 ± 0.09 mm) (p = 0.000). Peak systolic velocity (PSV) was increased in smokers (40.0 ± 5.67 cm/s) compared to non-smokers (26.5 ± 5.6 cm/s) (p = 0.000), and end-diastolic velocity (EDV) was decreased in smokers (6.0 ± 1.2 cm/s) compared to non-smokers (9.8 ± 2.2 cm/s) (p = 0.000). In addition, the resistive index (RI) and the systolic-diastolic ratio (S/D) were not significantly different between smokers and non-smokers. The study showed that there was a significant positive correlation between IMT and the number of cigarettes per day in chronic smokers (p < 0.05), whereas peak systolic velocity (PSV) and end-diastolic velocity (EDV) were not affected in chronic smokers. Conclusions There was a statistically insignificant difference between the case (smokers) and control (non-smokers) groups in terms of age, body mass index (BMI), resistance index (RI), and systolic–diastolic ratio (S/D). While there were statistically significant differences in intima-media thickness (IMT), peak systolic velocity (PSV), and end-diastolic velocity (EDV), regular follow-up of individuals with a history of smoking is recommended to detect carotid intimal changes earlier

Comparative study of pulmonary functions test among different substances abusers

Abstract Background Substance use is a problem that affects people all over the world and is prevalent in different age groups. The lungs in particular, with their unique exposure to the environment and the bloodstream, are vulnerable to damage from substance use and can affect lung function. Efforts have generally focused on cigarettes, while there is little research on different substances of use. The study aimed to detect changes in pulmonary function tests in different substance users. Methods An analytical cross-sectional study was carried out among different substance users at the Abdalaal Elidridi Psychiatric Hospital. A total of 60 adults were included: 16 cannabis users, 16 heroin users, 16 methamphetamine users, and 12 alcohol users. Participants used only one substance. Height and weight were measured, and BMI was calculated. For each participant, pulmonary function tests (PFTs) including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio and peak expiratory flow rate (PEFR) were measured using an electronic spirometer, and the results were compared with normal reference values for Sudanese subjects matched for age, sex, and height. Results A high prevalence of lung function abnormalities (100.0%) is seen in all abusers. Obstructive lung disease is found in 80.0% of patients, and restrictive lung disease is found in 20.0% of cases. The measured FEV1/FVC ratio in different substance groups was lower than the expected normal values of (88.2 ± 2.9%). The mean FEV1/FVC ratio of alcohol was (83.6 ± 7.6%), for heroin, it was (77.3 ± 15.8%), for methamphetamine, it was (77.7 ± 17.8%) and for cannabis, it was (71.03 ± 11.3%), the latter was significantly lower than the other two groups (P < 0.001). Duration of substance use was inversely correlated with the FEV1/FVC ratio (r = -0.378, P 0.001), indicating that a longer duration of substance use correlates with lower FEV1/FVC ratios. Conclusions Obstructive lung abnormalities are frequent in substance abusers. All types of substances have a major deleterious effect on PFTs and harm the respiratory system. More action should be taken to address the effects of substances on the lungs. Awareness, early detection, and intervention are essential

Evaluation of renal functions tests among Sudanese healthy pregnant women attending antenatal care (ANC) at The National Ribat University Hospital in Khartoum State in 2019: Renal function tests in Sudanese pregnant women

Pregnancy involves remarkable physiological changes and the functional impact of pregnancy on the kidney physiology is widespread involving practically all aspects of kidney functions. The aim of this study was to evaluate the renal functions in Sudanese healthy pregnant ladies during different trimesters. A cross sectional study was carried out during July to October 2019 on Sudanese healthy pregnant ladies attending antenatal care at the National Ribat University Hospital in Khartoum State. The study covered 60 healthy pregnant ladies (20 for each trimester). The purpose of the study was explained to all participants and they were assessed after taking their consent. Blood pressure (BP) and body mass index (BMI) were measured by standard techniques. A sample of five ml venous blood was taken in a suitable blood container for measurement of urea and creatinine using a fully automated Mindray BS-300 Chemistry Analyzer (Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China). The data was analyzed using SPSS version 25 (IBM SPSS Inc., Chicago, IL, USA), t-test was used to compare the statistical significant (p value ? 0.05 was considered statistical significant). The mean age of participants was 26.6±5.3 years with the range of 18-37 years. The mean BMI was 25.7±3.6 with the range of 18-31. The mean urea in the first, second and third trimester was 13.4, 13.9 and 13.2 mg/dl respectively with no statistically significant variation. The mean creatinine in the first, second and third trimester was 0.6, 0.6 and 0.5 mg/dl respectively with no statistically significant variation. To conclude, there was no significant variation of serum urea and creatinine during three trimesters of pregnancy in healthy pregnant women

Medical students’ perceptions towards implementing case-based learning in the clinical teaching and clerkship training

Abstract Background Depending on the subject area and the ‘case’ used, many methods can be used to describe case-based learning (CBL). The majority of health professional education is patient-centered. As a result, clinical presentations and diseases are combined with social and clinical sciences, and student learning is linked to real-world applications. The purpose of this study was to evaluate how medical students at the Faculty of Medicine, National Ribat University, felt about the implementation of CBL. Methods This descriptive cross-sectional study was conducted on 171 final-year medical students (100 females and 71 males). Students were voluntarily invited to complete a self-administered questionnaire consisting of 15 closed-ended questions with 5-point Likert scale responses, covering data on perception, awareness, and barriers to CBL. Results The CBL satisfaction rate among medical students was 92.4%. The mean value of the medical student’s perception was 3.7 out of 5. Regarding perceptions of CBL, 65.5% of students agreed with the positive impact of CBL on their academic performance. “8.2%” (14/171) of students strongly concur that CBL improved teamwork, while “31.6%” (54/171) strongly disagree. “36.3%” of students strongly believe that CBL improved their ability to use clinical reasoning. Regarding CBL barriers, 53% of medical students considered a group of twenty participants per session to be a barrier. (69%) of students refused to consider physical presence as a barrier. “76.6%” of the students agreed that the moderator’s approach and style can have a big influence on the CBL session’s outcome. Conclusion Overall, students had positive perceptions of CBL. Academic performance, clinical reasoning, teamwork, and information retention and retrieval were all improved by incorporating CBL into training modules. Students agreed that the group size of 20 students per session was a barrier, despite their moderate to excellent knowledge of CBL. Preparation for CBL is both time-consuming and tiring. Despite this, students agree that CBL has a positive impact on the learning process