An Insight into the Practice of Iron Therapy: Contribution to the On-going Debate with Special Reference to Low- and Middle-income Countries

Background: Iron deficiency anemia is a public health problem of a sizable proportion in developing countries. Recently, emerging biochemical knowledge coupled with the discovery of Hepcidin have greatly advanced our understanding of iron metabolism and offered a better insight into its associated pathophysiology. This knowledge should be applied to iron-deficiency anemia therapy to avoid subsequent sequelae of tissue damage associated with reactive oxygen radicals that are catalyzed by iron, because current practices do not include these advances in the treatment guidelines. In the light of recent progress, the existing iron therapy program in many healthcare settings is controversial. This necessitates adjusting the magnitude of iron dose with respect to the very limited iron bioavailability, as gauged by Hepcidin. The current study was therefore aimed to incorporate newly emerging biochemical knowledge into the current iron-deficiency anemia treatment practice Methods: Literature relevant to iron-deficiency studies published in English between 1964 and 2020 and available online was covered. Conclusion: Evidently, the existing iron-therapy schedule is both inefficient and toxic. The intricate metabolism of iron should be translated into a more rational iron intervention program with special bias towards low- and middle-income countries requiring a more individualized approach. Key words: iron deficiency anemia, hepcidin, oxidative stress, iron therap

Exploring the Leadership Terrain: Reflections from Literature

This paper appraises the available literature on concept of leadership and proposes fresh imputes to the mainstream theory by highlighting five facets of leadership. First, leadership and management are interlinked yet distinctive set of knowledge and practice–which are not substitution to each other. Second, leadership gets instigated with making of leader’s self and its solicitation of authenticity by the followers. Third, an intimate relationship between leader and followers is deemed necessary for embarking on motivation and inspiration among followers to pursue established goals, even if they apparently seem unachievable. Fourth, contemporary organization study overwhelmingly posits leadership as individualistic domain, and thus fails to spot due diligence on the scope of co-leadership. Fifth, whilst talking high of leadership, we must not overlook the potential drawbacks that leadership might augment, because–like all other power corridors–leadership does have this tendency of fostering personal and sometimes ill-conceived agendas

Crossed testicular ectopia: a case report and review of the literature

Crossed testicular ectopia (CTE) is an extremely rare anomaly in which deviation of testicular descent results in unilateral location of both testes. It is usually associated with an inguinal hernia, with the spermatic cord of the ectopic testis originating from the appropriate side. Most often the diagnosis of CTE is not made until surgical exploration. We report a case of CTE in a 2-year-old boy who presented with left-sided inguinal hernia with concurrent nonpalpable right testis. Diagnosis was made during diagnostic laparoscopy followed by left open inguinal exploration during which high ligation of the left hernia and trans-septal orchiopexy, contralateral transposition tension-free for each testis was done

Urethral Stricture; Etiology, Presentation, Complications, and Outcome of Management at Gezira State, Central Sudan

Objectives: The objective is to evaluate urethral strictures in term of etiological factors, presentations and management at GHRDS, Gezira State, Central Sudan. Patients and Methods: One hundred sixty patients, who were diagnosed as urethral stricture, were enrolled in this study. All patients were dealt with through a scientific stratum of a thorough work up and managed according to the EAU guidelines. The bio-data, etiological factors of strictures, presenting symptoms and signs, the pathological types and modalities of treatment were recorded and analyzed. Results: The total number of patients was 160, only two females and the rest were males. The mean age was 46.2 ±2 years. The etiological factors were: post-surgical in 67 patients (41.9%), gonococcal urethritis in 48 patients (30%) followed by post traumatic stricture in 28 patients (17.5%). Concerning the sites 41 (25.6%) patients had bulbar urethral stricture and 24 (15%) with membranous urethra strictures. One hundred forty two (88.8%) patients were treated with visual internal urethrotomy (VIU) and the outcome of treatment was comparable to the literature Conclusion: The commonest etiological factors for urethral strictures in GHRDS were post-surgery followed by gonococcal urethritis. The outcome of management was comparable

CHEMICAL COMPOSITION OF URINARY STONES IN PATIENTS REFERRED TO GEZIRA HOSPITAL FOR RENAL DISEASES AND SURGERY IN GEZIRA STATE CENTRAL SUDAN

Objective: The purpose of this study was to perform the chemical analysis of stones to know the pattern of biochemical composition of stones in Sudanese subjects. Methods: 169 renal stones were analyzed during the period from February to December 2008. 96 patients were referred to Gezira Hospital for Renal diseases and Surgery (GHRDS), Gezira state, central Sudan. The stones were analyzed by semi quantitative method in the Gezira central laboratory. Kits were used for chemical analysis of stones. Calcium, phosphate, oxalate, uric acid, carbonate and cystine were determined. Results: Male to female ratio was 2:1. Calcium, oxalate and uric acid were the most common forms of stones (90.5%), followed by phosphate (4.7%), carbonate (3.0%) and cystine which accounted for 1.8% of the study subjects. Conclusion: The relative frequency of calcium oxalate stones in our study about 65.1%,outnumbers other types which is compatible with the international literature. While there is relative high percentage of uric acid stones which can be explained by the high animal protein consumption in Sudan together with the hot weather which can be a cause of a highly concentrated urine . Other types phosphates (4.7%), carbonate (3.0%), and cystine which account only ( 1.8%)

Whiter and Greener RP-HPLC Method for Simultaneous Determination of Dorzolamide, Brinzolamide, and Timolol Using Isopropanol as a Sustainable Organic Solvent in the Mobile Phase

A sustainable reversed-phase chromatographic method has been developed and validated for the simultaneous determination of three active pharmaceutical ingredients, dorzolamide, brinzolamide, and timolol, used to treat glaucoma. The eco-friendly solvent isopropanol has been used as an organic mobile phase constituent. According to the Hansen space green solvent selection tool, isopropanol has a G score of 6.5, comparable to ethanol, which has a G score of 6.6. The mobile phase consists of isopropanol: aqueous sodium acetate buffer (0.1 M, pH 4.25) in the ratio of 10:90 (v/v). The flow rate was maintained at 1 mL/min. Dorzolamide and brinzolamide were detected at 254 nm, and timolol was detected at 295 nm. A high-purity silica with a polymeric C18 modification column (150 × 4.6 mm, 5 µm particle size) was used for this separation. The three compounds were eluted within 8 min. The method was validated according to ICH guidelines. The calibration curves were linear in the range of 20–70 µg/mL, 40–140 µg/mL, and 20–70 µg/mL for dorzolamide, brinzolamide, and timolol, respectively. The LODs were found to be 1.61 µg/mL, 1.60 µg/mL, and 3.16 µg/mL for dorzolamide, brinzolamide, and timolol, respectively. Good accuracy and precision were obtained for the three compounds. The greenness and whiteness of the method were indicated using the AGREE, ChlorTox, and RGB12 tools

Greener and Whiter Analytical Chemistry Using Cyrene as a More Sustainable and Eco-Friendlier Mobile Phase Constituent in Chromatography

Cyrene (dihydrolevoglucosenone) was evaluated for the first time as a potential sustainable mobile phase solvent in reversed-phase chromatography. As a benign biodegradable solvent, Cyrene is an attractive replacement to classical non-green organic chromatographic solvents such as acetonitrile and a modifier, co-eluent to known green solvents such as ethanol. Compared to ethanol, Cyrene is less toxic, non-flammable, biobased, biodegradable, and a cheaper solvent. A fire safety spider chart was generated to compare the properties of Cyrene to ethanol and show its superiority as a greener solvent. Cyrene’s behavior, advantages, and drawbacks in reversed-phase chromatography, including the cut-off value of 350 nm, elution power, selectivity, and effect on the column, were investigated using a model drug mixture of moxifloxacin and metronidazole. A monolithic C18 (100 × 4.6 mm) column was used as a stationary phase. Different ratios of Cyrene: ethanol with an aqueous portion of sodium acetate buffer mobile phases were tested. A mobile phase consisting of Cyrene: ethanol: 0.1 M sodium acetate buffer pH 4.25 (8:13:79, v/v/v) was selected as the most suitable mobile phase system for separating and simultaneously determining metronidazole and moxifloxacin. The greenness and whiteness of the method were evaluated using the qualitative green assessment tool AGREE and the white analytical chemistry assessment tool RGB12. Further potentials of Cyrene as a solvent or modifier in normal phase chromatography, liquid chromatography–mass spectrometry, and supercritical fluid chromatography are discussed

Thyroid dysfunction in pregnancy

Timely treatment of thyroid disease during pregnancy is important in preventing adverse maternal and fetal outcomes. Thyroid abnormalities are very often subclinical in nature and not easily recognized without specific screening programs. Even mild maternal thyroid hormone deficiency may lead to neurodevelopment complications in the fetus. The main diagnostic indicator of thyroid disease is the measurement of serum thyroid-stimulating hormone and free thyroxine levels. Availability of gestation-age-specific thyroid-stimulating hormone thresholds is an important aid in the accurate diagnosis and treatment of thyroid dysfunction. Pregnancy- specific free thyroxine thresholds not presently available are also required. Large-scale intervention trials are urgently needed to assess the efficacy of preconception or early pregnancy screening for thyroid disorders. Accurate interpretation of both antepartum and postpartum levels of thyroid hormones is important in preventing pregnancy-related complication secondary to thyroid dysfunction. This article sheds light on the best ways of management of thyroid dysfunction during pregnancy in order to prevent any possible maternal or fetal complication

Effects of Perception of Organizational Politics on Employee’s Well-Being: The Mediating Role of Trust and Interpersonal Conflicts

Perception of organizational politics (POP) is a critical issue for all organizations. Most of the researchers indicate that it has a negative effect on employee’s performance. This study finds the relationship between POP and employee’s well-being (EWB) by using interpersonal conflicts at work (ICW) and interpersonal trust at work (ITW) as mediators. The well-being of employees is an important factor to be studied because it covers overall happiness of employees which includes job satisfaction, performance, job loyalty etc. Therefore, without concerning the employee’s well-being, no organization can compete or lead in the competitive environment. So there is a research gap which needs to conduct a research study on employee’s well-being with the reference to perception of organizational politics. The main focus of this study is to find out the relationship between employee’s well-being and perception of organizational politics with the mediating effect of interpersonal conflicts at work and interpersonal trust at work. The sample size of this study is in a number of 223 with cross-sectional study and conducted in the famous city Lahore, Pakistan