Clinical presentation, treatment and outcome of paraphenylene-diamine induced acute kidney injury following hair dye poisoning: a cohort study

Introduction: in Africa and Asia hair dye is applied together with henna to decorate the hands and feet. Paraphenylene-diamine (PPD), a highly toxic constituent of hair dye can lead to acute kidney injury (AKI). Methods: a cohort study was conducted during the period from April 2012 to March 2013 in Khartoum Teaching Hospital, Sudan. It targeted adults presenting acutely with an evident history and clinical  features of hair dye poisoning, together with AKI as per the RIFLE criteria. Analysis of data was done using SPSS. Results: 30 adults were included, their mean age was 25.6 ± 4.2 years, 93.3% were females. Exposure to PPD was suicidal in 86.7%. The mean duration to onset of renal symptoms was 34.8 ± 7.6 hours,  maximum median serum creatinine was 8.6 ± 2.3 mg/dl, 86.7% had loss of kidney function as per the RIFLE  classification and required dialysis. Initial renal recovery was seen after a mean duration of 9.8 ± 2.2 days. One patient died, 3.3%; all others, 96.7%, recovered normal kidney function. The amount of ingested PPD correlated significantly to the severity of symptoms, number of dialysis sessions required and time for renal recovery with P values < 0.05. Conclusion: hair dye poisoning was associated with prolonged hospital stay, requirement of dialysis and increased morbidity. The severity of symptoms directly correlates to the dose of PPD ingested, with the kidney damage being reversible in almost all survivors.Key words: Hair dye poisoning, paraphenylene-diamine, acute kidney injur

Diagnosing Pilgrimage Common Diseases by Interactive Multimedia Courseware

في هذه الدراسة، نحاول تقديم خدمة الرعاية الصحية للحجاج. تصف هذه الدراسة كيف يمكن استخدام مناهج الوسائط المتعددة في جعل الحجاج على علم بالأمراض الشائعة الموجودة في المملكة العربية السعودية أثناء موسم الحج. كما سيتم استخدام البرامج التعليمية للوسائط المتعددة في توفير بعض المعلومات حول أعراض هذه الأمراض، وكيف يمكن علاج كل منها. يحتوي البرنامج التعليمي للوسائط المتعددة على تمثيل افتراضي للمستشفى، وبعض مقاطع الفيديو للحالات الفعلية للمرضى، وأنشطة التعلم الأصيلة التي تهدف إلى تعزيز الكفاءات الصحية أثناء الحج. تم فحص المناهج الدراسية لدراسة الطريقة التي يتم بها تطبيق عناصر المناهج الدراسية في التعلم في الوقت الحقيقي. أكثر من ذلك، في هذا البحث، يتم تقديم مناقشة حول أخطر الأمراض التي قد تحدث خلال موسم الحج. إن استخدام دورة الوسائط المتعددة قادر على توفير المعلومات بشكل فعال وفعال للحجاج حول هذه الأمراض. تؤدي هذه التقنية هذه المهمة باستخدام المعرفة المتراكمة من التجارب السابقة، لا سيما في مجال تشخيص الأمراض والطب والعلاج. تم إنشاء المناهج الدراسية باستخدام أداة تأليف تُعرف باسم مدرب ToolBook لتزويد الحجاج بخدمة عالية الجودة.In this study, we attempt to provide healthcare service to the pilgrims. This study describes how a multimedia courseware can be used in making the pilgrims aware of the common diseases that are present in Saudi Arabia during the pilgrimage. The multimedia courseware will also be used in providing some information about the symptoms of these diseases, and how each of them can be treated. The multimedia courseware contains a virtual representation of a hospital, some videos of actual cases of patients, and authentic learning activities intended to enhance health competencies during the pilgrimage. An examination of the courseware was conducted so as to study the manner in which the elements of the courseware are applied in real-time learning. More so, in this research, a discussion on the most dangerous diseases which may occur during the season of pilgrimage is provided. The use of the multimedia course is able to effectively and efficiently provide information to the pilgrims about these diseases. This technology performs this task by using the knowledge that has been accumulated from past experience, particularly in the field of disease diagnosis, medicine and treatment. The courseware has been created using an authoring tool known as ToolBook instructor to provide pilgrims with quality service

Quality of life among gastric cancer patients in one center in Baghdad, Iraq in 2021.

Background: In Iraq, gastric cancer is the ninth most frequent cancer. health-related quality of life (HRQOL) encompasses a person's physical, mental, emotional, and psychological well-being, as well as their social and functional status. These aspects are crucial in assessing the long-term health consequences of stomach cancer. The purpose of this study is to summarize the quality of life among gastric cancer patients and how it affects their daily activity. Methods:A descriptive cross-sectional study was done in an oncology teaching hospital in Baghdad Iraq in 2021. 30 patients with gastric cancer diagnosed using endoscopic biopsy were recruited. Participants were asked to answer questions in a structured interview. The questionnaire included questions about the quality of life including symptoms, treatment, and activities of daily living. Results:Half of the sample were males. 46.66% were in their sixth decade or older. 33% had poor quality of life during the recent 3 months and 80% had worse quality of life than before. 50% had worse economic status than before. 30% had a lack of energy almost every day and 80% had a low mood at least once a day. Diabetes is the most frequent co-morbidity. Conclusion: The majority of patients had a good or acceptable lifestyle, but worse than before with half having worse economic status than before. Most participants have bad moods and lack of energy, and the majority have limited social activities. Keywords: quality, life, gastric cancer, Iraq.

Correlations of complete blood count, liver enzyme and serum uric Acid in Sudanese pre-eclamptic cases

Background: Pre-eclampsia is a serious disorder of pregnancy with unknown ethological factors that may occur at any stage of second or third trimester of pregnancy. The objectives of the present study were to assess changes in complete blood counts including platelets, liver enzymes and serum uric acid in pre-eclamptic cases compared to second-half normal pregnant and non-pregnant Sudanese women and their correlations to other biomarkers.Methods: This was a cross-sectional, case-control study performed from December 2008 to December 2010; in Omdurman Maternity Hospital, in concomitance with other studies in pre-eclampsia. The sample size included three groups, 72 up pre-eclamptic cases in their recent pregnancies, 96 normal pregnant in their second half of pregnancy and 63 non- pregnant (control) women; a total of 231 subjects. Questionnaire Interviews and clinical examination were done for all participants. Laboratory investigations were done including complete blood picture, liver enzymes and uric acid.  Results: The mean Hb concentration of the pre-eclamptic (11.3g/dl±1.7) was statistically significantly lower than that of the non-pregnant (12.1g/dl±0.2) (P=0.01) but not from that of the normal pregnant (11.4g/dl±0.1) (P=0.882) .There was no statistical significant difference in the mean WBC count between the pre-eclamptic (7.4x103/mm3±0.3) and non-pregnant (7.3x103/mm3±0.3) (P=0.797) and between the pre-eclamptic and normal pregnant (7.7x103/mm3±0.2) (P=0.270). There was a considerable statistical significant decrease in the mean platelets count of the pre-eclamptic (236.4/mm3±8.3) compared to the non-pregnant group (322.0/mm3±10.4) (P=0.0001) s well as to the normal pregnant (275.0/mm3±8.9) (P = 0.003). In the pre-eclamptic cases, serum ALT correlated significantly with TWCC (r=0.26, P=0.03) and serum AST (r=0.65, P=0.000). In the pre-eclamptic cases, serum AST correlated significantly with Hb (r=0.26, P=0.03), serum ALT and serum uric acid (r=0.36, P=0.01).Conclusions: There was a considerable statistical significant decrease in mean platelets count of the pre-eclamptic compared to the non-pregnant group and to the normal pregnant may be explained by hemodilution; whereas further decrease was due to pre-eclampsia. ALT and AST are strong prognostic indicators of pre-eclampsia

CA72-4 as a Promising Prognostic and Diagnostic Biomarker in Iraqi Patients with Colorectal Cancer

Colorectal cancer (CRC), the second most fatal cancer and the 3rd most common cancer is expected to cause 0.9 million deaths globally in 2025. Carcinoembryonic antigen (CEA) is currently used in the follow-up of patients with colorectal cancer, and in this study, we are trying to find a better marker than CEA in following up on patients' health and knowing the effectiveness of the treatment used and as a diagnostic marker for colorectal cancer. To determine the significance of Cancer antigen 72-4 (CA72-4) as a prognosis predictor in patients with colorectal cancer, compare its prognostic validity to the CEA biomarker. this case-control study includes (150) participants, 100 patients (59 males and 41 females), and 50 healthy controls (26 males, 24 females). Blood samples were collected from all participants to measure the serum concentrations of CA72-4 and CEA using an enzyme-linked immunosorbent assay (ELISA). Between November 2020 and February 2021 in Baghdad, Iraq, this investigation was conducted at the oncology teaching hospital's gastrointestinal consulting clinic. There was a strong positive relation between CA242 and CEA (R = 0.953, p <0.001) and participants with colorectal cancer had considerably greater levels of CA72-4 than healthy controls (p <0.001). AUC was 0.944, sensitivity was 86%, specificity was 94%, and the cutoff value was 50 U/ml for the CA72-4. while AUC was 0.919, sensitivity was 91%, specificity was 80%, and the cutoff value was 5 ng/ml for the CEA.CA72-4 can serve as a potential prognostic and diagnostic biomarker for colorectal cancer

Pattern and outcome of acute kidney injury among Sudanese adults admitted to a tertiary level hospital: a retrospective cohort study

Introduction: Little is known about the pattern and outcome of Acute Kidney injury (AKI) in Sudan. This study aimed to determine the etiology and outcome of AKI among Sudanese adults. Methods: A retrospective cohort study was conducted in a tertiary level hospital, Soba University Hospital, Sudan. The medical records of all adults admitted to hospital from the 1st of January to 31st of December 2014 were reviewed. The diagnosis and severity of AKI was defined as per the Kidney Disease Improving Global Outcomes (KDIGO) recommendations. Results: The medical records of 6769 patients were reviewed. AKI was diagnosed in 384 patients (5.7%); being community acquired in 82.6% of cases. Sepsis, volume depletion, obstructive uropathy, heart failure, acute glomerulonephritis and severe malaria were the commonest causes of AKI diagnosed in 44%, 38.5%, 8.9%, 5.7%, 4.7% and 3.1% of patients, respectively. Following treatment complete renal recovery was seen in 35.7% of patients; whereas 31.2% of patients died. Predictors of increased risk of death were old age [OR 1.03, 95% CI (1.01-1.057); P=0.003], presence of chronic liver disease [OR 2.877, 95% CI (1.5-5.5); P=0.001], sepsis [OR 2.51, 95% CI (1.912-4.493);P=0.002] and the severity of AKI [OR 3.873, 95% CI(1.498-10.013);P=0.005]. Conclusion: AKI was diagnosed in 5.7% of adults admitted to hospital. Most patients were having community acquired AKI. Old age, the presence of chronic liver disease, sepsis, and the severity of AKI as per KDIQO staging were significant predictors of mortality

Association of Higher Defensin β-4 Genomic Copy Numbers with Behçet’s Disease in Iraqi Patients

Objectives: Behçet’s disease (BD) is an immune-mediated small vessel systemic vasculitis. Human β-defensins are antimicrobial peptides associated with many inflammatory diseases and are encoded by the β-defensin family of multiple-copy genes. However, their role in BD necessitates further investigation. The aim of the present study was to investigate the possible association of BD in its various clinical forms with defensin β-4(DEFB4) genomic copy numbers. Methods: This case-control study was conducted from January to September 2011 and included 50 control subjects and 27 unrelated Iraqi BD patients registered at Baghdad Teaching Hospital, Bagdad, Iraq. Copy numbers of the DEFB4 gene were determined using the comparative cycle threshold method by duplex real-time polymerase chain reaction technology at the Department of Dermatology of Jena University Hospital, Jena, Germany. Results: DEFB4 genomic copy numbers were significantly higher in the BD group compared to the control group (P = 0.010). However, no statistically significant association was found between copy numbers and clinical variables within the BD group. Conclusion: The DEFB4 copy number polymorphism may be associated with BD; however, it is not associated with different clinical manifestations of the disease

Implementing an efficient expert system for services center management by fuzzy logic controller

Expert System (ES) is considered to be the prominent reasoning practices which are commonly employed towards various application domains. Considering expert systems, human understanding regarding specific proficiency in accomplishing specific tasks could be signified as facts and rules towards their knowledge base, which finds and employs the data delivered by means of a manipulator. Reasoning procedure has been further employed towards the specified expertise by means of heuristic methods for formulating the elucidation. Mechanisms which employ knowledge based approaches are considered to be more candid when compared to other conservative approaches. Knowledge could be signified clearly towards knowledge base, thereby capable in alteration with comparative easiness, which commonly employs the concept of rules. Inference engines employ knowledge base subjects for solving specific problems based on user responses by means of interface (for instance, specify the situations needed for car assessment). This inference unit deeds with knowledge for applying this knowledge for specific problems. There are numerous approaches for control systems that are applied in all the major areas in industry. In all these approaches for controlling the systems, fuzzy has been deemed to be the best methodology, mainly because of its increased speed and cost-efficiency. For machine regulation, fuzzy logic is found to be vividly employed. This paper mainly focuses in designing the simulation model for fuzzy logic regulator in advising the supervisor of service center in maintaining definite delay in service towards acceptable limit

The Association of Lymphocyte count, CRP, D-Dimer, and LDH with Severe Coronavirus Disease 2019 (COVID-19): A Meta-Analysis

Background: The rapid progression of Coronavirus disease 2019 (COVID-19) and its increasing burden on health systems necessitate the identification of parameters of severe infection to help in monitoring, prognoses and development of treatment algorithms. Objectives: This review aims to investigate the association of lymphocyte count, CRP, LDH, and D-Dimer with the severity of COVID-19. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), and ScienceDirect were used for the systematic search. Random effects model was used to estimate the pooled standardized mean differences (SMD) with the corresponding 95% confidence interval (CI), using OpenMeta Analyst software. Results: A total of 11 studies, with 2437 COVID-19 patients, which fulfilled the eligibility criteria were included in the meta-analysis. The analysis revealed that lymphocyte count was significantly lower in patients with the severe form of COVID-19 (SMD = - 1.025, P value &lt;.001). Also, the analysis of SMD showed that patients with severe COVID-19 have a significantly higher serum levels of CRP (SMD = 3.363, P value &lt;.001), D-Dimer (SMD = 1.073, P value &lt;.001), and LDH (SMD = 3.345, P value &lt;.001). Conclusion: Low lymphocyte count and high levels of CRP, LDH, and D-Dimer are associated with severe COVID-19. These laboratory markers could be used as clinical indicators of worsening illness and poor prognosis of COVID-19

Unilateral, trifocal, diaphyseal fracture of the radius with ipsilateral mid-shaft ulna fracture in an adult: a case report

<p>Abstract</p> <p>Introduction</p> <p>To the best of our knowledge, a trifocal, diaphyseal fracture of the radius associated with ipsilateral mid-shaft fracture of the ulna in an adult has not been reported in the literature to date. The AO classification system does not include such a fracture configuration.</p> <p>Case presentation</p> <p>We report a case of trifocal, diaphyseal fracture of the radius with a mid-diaphyseal fracture of the ulna in a 53-year-old Caucasian, British, right-hand dominant woman involved in a head-on collision with another vehicle. The management of this rare fracture configuration is described and alternative treatment options discussed.</p> <p>Conclusions</p> <p>We describe an unusual, complex fracture, which with prompt surgical treatment resulted in a rapid, full and satisfactory functional recovery for our patient.</p