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which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Use of family planning methods in Kassala, Eastern Sudan
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Maternal age and intracytoplasmic sperm injection outcome in infertile couples at Khartoum, Sudan [version 1; referees: 1 approved, 2 approved with reservations]
Background Intracytoplasmic sperm injection (ICSI) was considered as the mainstay of treatment for male infertility. Nowadays, the scope of ICSI has been widened to include other causes of infertility. There are few published data on ICSI in countries with low incomes. Aims A cross-sectional study was conducted at Saad AbuAlla and Banoun Centers, Khartoum, Sudan to investigate outcomes of ICSI and to determine the parameters that might predict pregnancy success rate following ICSI. Methods The study included 191 infertile couples who underwent 296 ICSI cycles between 1st April 2013 and 31 March 2014. Results One hundred and ninety one couples (comprising 296 cycles of ICSI) were enrolled to the study. The mean (SD) number of retrieved oocytes was 9.7 (7.5). The mean (SD) number of transferred embryos was 2.9 (1.0). Out of these, 50 (26.2%) and 40 (20.9%) had chemical and clinical pregnancy, respectively. Thirty–six couples (18.8%) and five couples (2.6%) had miscarriage and had ectopic pregnancy, respectively. Under logistic regression, younger age (OR = 0.8, 95% CI= 0.81 ─ 0.96, P = 0.004) and endometrial thickness (OR = 1.3, 95% CI= 1.07─1.60, P = 0.009) were the significant predictors for the success of ICSI in inducing pregnancy. Conclusion The rates of successful fertilisation and pregnancy-to-term rates in this setting depend mainly on the maternal age
Histopathological pattern of gynaecological malignancies: National Health Laboratory (NHL), Sudan
Gynaecological malignancies (GM) is a common cancer problem in both developing and developed countries .The burden of GM is more critical in developing countries, this is due to lack or deficient screening and late clinical presentation. The aim of this study is to study the histopathological pattern of GM in the NHL (National Health Laboratory) Sudan. Material &Methods: Clinical data, histopathological reports, stained tissue slides of patients diagnosed histologically as GM were revised from the archive of the department of histopathology and cytology at the NHL .Results: 372 patients diagnosed histologically as GM from 1st Jan 2009-31st Dec to the 1st Jan 2013 were studied. The commonest GM histological type was cervical malignancies, followed by ovarian, endometrial, vaginal, vulvar, choriocarcinoma and tubal cancer respectively .Conclusion: There is an urgent need for screening, early detection and prompt management for GM.Keywords: ,
Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan
Abstract Background Anaemia during pregnancy is major health problem. There is conflicting literature regarding the association between anaemia and its severity and maternal and perinatal outcomes. Methods This is a retrospective case-control study conducted at Kassala hospital, eastern Sudan. Medical files of pregnant women with severe anaemia (haemoglobin (Hb) 11 g/dl, n = 303). Logistic regression analysis was performed separately for each of the outcome measures: preeclampsia, eclampsia, preterm birth, low birth weight (LBW) and stillbirth. Results There were 9578 deliveries at Kassala hospital, 4012 (41.8%) women had anaemia and 303 (3.2%) had severe anaemia. The corrected risk for preeclampsia increased only in severe anaemia (OR = 3.6, 95% CI: 1.4-9.1, P = 0.007). Compared with women with no anaemia, the risk of LBW was 2.5 times higher in women with mild/moderate anaemia (95% CI: 1.1-5.7), and 8.0 times higher in women with severe anaemia (95% CI: 3.8-16.0). The risk of preterm delivery increased significantly with the severity of anaemia (OR = 3.2 for women with mild/moderate anaemia and OR = 6.6 for women with severe anaemia, compared with women with no anaemia). The corrected risk for stillbirth increased only in severe anaemia (OR = 4.3, 95% CI: 1.9-9.1, P Conclusions The greater the severity of the anaemia during pregnancy, the greater the risk of preeclampsia, preterm delivery, LBW and stillbirth. Preventive measures should be undertaken to decrease the prevalence of anaemia in pregnancy.</p
Use of family planning methods in Kassala, Eastern Sudan
Abstract Background Investigating use and determinants of family planning methods may be instructive in the design of interventions to improve reproductive health services. Findings Across sectional community-based study was conducted during the period February-April 2010 to investigate the use of family planning in Kassala, eastern Sudan. Structured questionnaires were used to gather socio-demographic data and use of family planning. The mean ± SD of the age and parity of 613 enrolled women was 31.1 ± 7 years and 3.4 ± 1.9, respectively. Only 44.0% of these women had previously or currently used one or more of the family planning methods. Combined pills (46.7%) and progesterone injection (17.8%) were the predominant method used by the investigated women. While age, residence were not associated with the use of family planning, parity (> five), couple education (≥ secondary level) were significantly associated with the use of family planning. Husband objection and religious beliefs were the main reasons of non-use of family planning. Conclusion Education, encouragement of health education programs and involvement of the religious persons might promote family planning in eastern Sudan.</p
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.</jats:p
A Higher Rate of Iron Deficiency in Obese Pregnant Sudanese Women
AIM: To assess the association between obesity and iron deficiency (ID).MATERIAL AND METHODS: Pregnant women were recruited from Saad Abualila Hospital, Khartoum, Sudan, during January–April 2015. Medical history (age, parity, gestational age) was gathered using questionnaire.  Weight and height were measured, and body mass index (BMI) was calculated. Women were sub-grouped based on BMI into underweight (< 18.5 kg/m^2), normal weight (18.5–24.9 kg/m^2), overweight (25–29.9 kg/m^2) and obese (≥ 30 kg/m^2). Serum ferritin and red blood indices were measured in all studied women.RESULTS: Two (0.5%), 126 (29.8%), 224 (53.0%) and 71 (16.8%) out of the 423 women were underweight, normal weight, overweight and obese, respectively. Anemia (Hb <11 g/dl), ID (ferritin <15µg/l) and iron deficiency anemia (IDA) were prevalent in 57.7%, 21.3% and 12.1%, respectively. Compared with the women with normal BMI, significantly fewer obese women were anemic [25 (35.2%) vs. 108 (85.7%), P < 0.001] and significantly higher number of obese women [25 (35.2) vs. 22 (17.5, P = 0.015] had iron deficiency. Linear regression analysis demonstrated a significant negative association between serum ferritin and BMI (– 0.010 µg/, P= 0.006).CONCLUSION: It is evident from the current findings that prevalence of anaemia and ID showed different trends about BMI of pregnant women
Maternal Heart Rate Variability during the First Stage of Labor
Labor necessitates continuous adjustments of cardiac autonomic reflexes by alternate activation of the sympathetic and parasympathetic nervous systems. The division of the autonomic nervous system (ANS) that predominates during the first stage of labor is unclear and needs to be further investigated. The study aimed to compare heart rate variability (HRV) in pregnant women in the third trimester with those during the first stage of labor. We conducted a case–control study at Saad Abul Ela Maternity Hospital, Khartoum, Sudan. Forty-five women with singleton, live neonates in the first stage of labor and 45 women in the third trimester (but not in labor) were enrolled as case and control groups, respectively. Data on the medical history, obstetrics history, and clinical examinations that were performed in all of the studied women were obtained using prearranged questionnaires. Cardiac autonomic modulation (CAM) of the heart was examined in both groups based on time and frequency domain HRV indices. There were no significant differences in age, parity, body mass index, and hemoglobin levels between the two groups. Pregnant women in labor had significantly higher LnSDNN, LnRMSSD, LnTP, LnVLF, LnLF, LnHF, LF Norm, and LnLF/HF ratio, but lower HF Norm compared with controls (P < 0.001). These findings remained unchanged when possible confounders were controlled for using regression analysis. Our findings suggest a significant increase in indictors of sympathetic CAM, namely LF Norm and LnLF/HF, during labor. Sympathetic hypertonia associated with labor is unlikely to increase the risk of cardiac events because sympathetic CAM simultaneously increases with global HRV. Increased HRV during labor may be explained by parasympathetic activation as indicated by higher LnHF and LnRMSSD at the time of delivery
