Antibacterial Activity and Preliminary Phytochemical Screening of Four Medicinal Plants

       The present study was undertaken to investigate the antibacterial activity and to find the biologically active functional groups of four medicinal plants. The ethanolic extracts which were obtained by maceration were tested against in vitro five bacterial strains, using cup-plate agar diffusion method. Preliminary phytochemical screening techniques were also used to test for the presence and nature of the active constituents in these plant extracts.      Extracts of the plants; Adansonia digitata, Eucalyptus globulus and Trigonella foenum graecum showed a remarkable antibacterial activity against all tested bacterial strains. Meanwhile, the ethanolic extract of Ficus sycomorous exhibited a considerable antibacterial activity against Proteus mirabilis, Pseudomonas aeuroginosa and Staphylococcus aureus. The preliminary phytochemical screening revealed the presence of terpenes, tannins and saponins in all tested plant extracts, whereas alkaloids and cardiac glycosides were found in appreciable amounts in extracts Trigonella foenum graecum and Adansonia digitata respectively.       It can be concluded that the tested plants demonstrating broad spectra of activity which may help to discover new chemical classes of antibiotics that could serve as selective agents for the maintenance of health

Investigation of anti -nociceptive activity of Zingabeel (Zingiber officinale) on acetic acid induced writhing in rats

This study was carried out to test for antinociceptive effect of the methanolic extract of ginger using acetic acid induced writhing in rats and compared to morphine and diclofenac sodium as standard drugs. The methanolic extract of ginger, showed dose dependent responses whereas 50 and 100mg/kg produced 100%protection against writhing  induced  by  acetic acid (0.6 %  i.p.) .  This protection supersedes the effect of diclofenac sodium (25, 50 and 75 mg/kg). On the other hand morphine (2.5- 10 mg/kg), exhibited 100% protection against writhing induced by acetic acid. Therefore we can conclude and recommend that, ginger is a potential source of new and effective anti-nociceptive agent(s). Bioassay guided fractionation for the methanolic extract of ginger should be investigated for the determination of active ingredient(s), and to elucidate their mechanism of action.  الخلاصة: أجريت هذ الدراسة  لإختبار تأثيرالخلاصة الميثانولية  للزنجبيل كمسكن للألم باستخدام حمض الاستيك الذي يحفز الانقباضات ألبطنيه المسببة للألم ومقارنته بالمورفين و الدايكلوفيناك صوديوم  كأدوية مرجعية. أظهر  المستخلص الميثانولي للزنجبيل إستجابات إعتمادا على  الجرعات حيث إنه في الجرعات  50 و 100مجم/كجم نتجت حماية بنسبة 100% ضد الانقباضات المسببة  بواسطة حمض الأسيتيك (0,6%)˛ حيث يعتبر أفضل تأثيرا من الدايكلوفيناك صوديوم (25، 50، 75مجم/كجم) ومن ناحية أخرى فإن المورفين (2.5 -10 مجم/كج) قد أعطى حماية بنسبة 100% ضد الانقباضات المسببه بواسطة حمض الأسيتيك.  لذا نستنتج   ونوصي بأن الزنجبيل مصدر متوقع  جديد فعال كمسكن للآلام. كما نوصي  بأن تجرى الاختبارات الحيوية الموجهه للتجزئة للزنجبيل لتحديد المادة الفعالة و توضيح آلية عملها.    &nbsp

Pattern of Mental Disorders among the Students of the University of Gezira- Sudan

This retrospective study was conducted in the University of Gezira (U of G) - Sudan, in the year 2009. The objective of the study was to describe the pattern of mental disorders among the students of (U of G) and to assess the services provided for them. The data of 200 students suffering from mental disorders, total coverage, was obtained by reviewing the records of the health services of the university, interview with the Director General of Psychiatry and Mental Health Hospital and with the psychologist responsible for dealing with students suffering from mental disorders.  The results revealed the following: the prevalence of mental disorders among the students of (U of G) was found to be (0.8%), more than half (51.5%) were females, male students were (48.9%), (57.5%) of them were residing outside Medani. Regarding their tribes the majority were from Galli tribe the other tribes were all represented with different rates. The following types of mental disorders described among the students, depression (42%), dissociative (23%), Schizophrenia (13%), Mania (6.5%), Epilepsy (9%), Anxiety (3%), Headache (2.5%).The faculty of Computer and Mathematic of sciences showed a big number of mental disorder students compared to the other faculties.  The study also showed lack of close follow up from the students themselves and their families. A problem of continuation of the treatment was observed. The study recommended; special mental health unit in the different faculties, Free drugs for mental disorders, Provision of mental health promotional services at the university including mental health education and screening services

SUCCESSFUL TWO PREGNANCIES IN ACHONDROPLASIC MOTHER, A CASE REPORT

The word achondroplasia is derived from Greek and means "without cartilage formation," although individuals with achondroplasia do have cartilage. In genetics, dominance describes the effects of the different versions of a particular gene on the phenotype of an organism. Many animals (including humans) and plants have two copies of each gene in their genome, one inherited from each parent

EPIDEMIC OF RIFT VALLEY FEVER IN SUDAN, GEZIRA, 2007; GEZIRA EXPERIENCE

In the last 3 months of 2007, an acute episode of an ill-defined severe febrile illness presented to Medani hospital isolation words, with severe hemorrhagic manifestations. This initially did not harbor any attention as other possibilities were thought of like severe malaria , septicaemia but by the end of the same week the number of patients increased dramatically and the suspicion was put and the whole case was addressed officially in an epidemical paradigm. This study was conducted in Wad Medani Teaching Hospital. From the beginning of 41st week of the year 2007, the Gezira state in Sudan was tremendously affected by an epidemic of Rift valley fever as declared by the WHO authorities (11).all the districts of the estate were involved with a total number of patients was around 392. During the period of epidemic of RVF, (week 41.2007 - up to the 1st week of January 2008) total number of patients admitted were about 392 and total number of patients died were 158 patients .The main presenting symptoms were fever, epistaxsis, haematemesis and vaginal bleeding, and the main complication was acute renal failure and death

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries. Funding: Bill & Melinda Gates Foundation

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income. Conclusion At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised