Workplace Violence Toward Doctors Working in Obstetrics and Gynecology Emergency Units in Khartoum North Locality, Sudan: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Workplace violence (WPV) is any action, incident, or behavior that deviates from appropriate conduct and results in a person getting assaulted, threatened, harmed, or injured at work. This research aimed at studying the current state of WPV among doctors working in obstetrics and gynecology (OBGYN) emergency departments (EDs) in Khartoum north locality (KNL), Sudan   Methods: A descriptive cross-sectional study that included 128 doctors from six governmental hospitals in KNL. A self-administered questionnaire assessing the prevalence and outcomes of WPV was distributed. The descriptive statistics and frequency tables were generated using the Statistical Package for Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY).   Results: The respondents' mean age was 28.3±6.6 years (range: 21-70 years). Approximately half of the respondents (49.2%) experienced WPV. Verbal WPV was the most common type (93.3%), followed by physical (10%) and sexual (3.2%) type. Patients' relatives and friends are the most common group to commit WPV (92.9%). Night shifts were the time most WPV (58.6%) took place. The effect of WPV on respondents was mainly psychological (95.8%) compared to physical (4.2%).   Conclusion: WPV prevalence among health care workers (HCWs) working in the OBGYN EDs is alarming with detrimental effects. Evaluating the current state of WPV, outcome, and associated factors will help not only address the current problem but also guide future related research.

Methanol-induced parkinsonism and cerebral vasculopathy due to perfume inhalation.

Background: Methanol (methyl alcohol) is a form of toxic alcohol that is found in illicit alcohol as well as household products such as solvents and paint removers. The most common cause of methanol poisoning is through ingestion of adulterated alcohol; however, other routes of poisoning may also occur including cutaneous exposure and, rarely, inhalation. Methods/results: We are reporting a case of a young woman with vision loss, parkinsonism and widespread cerebral artery spasms due to methanol inhalation from domestically made perfume. Conclusion: Our case highlights the increased need for awareness on the part of the public and health authorities with regard to the manufacturing and use of homemade perfumes produced with poorly processed alcohol having a high methyl alcohol content.

Application of equine herpesvirus-1 vaccine inactivated by both formaldehyde and binary ethylenimine in equine.

BACKGROUND AND AIM: Equine herpesvirus-1 infection in horses causes a wide range of manifestations affecting the respiratory tract. The virus can cause serious economic losses through sporadic abortion in pregnant mares, perinatal death, respiratory disease in young foals. This study was designed to prepare inactivated equine herpesvirus-1 (EHV-1) vaccine using both 0.005 M binary ethylenimine (BEI) and 0.0006% formaldehyde (FA) to decrease the use of BEI and provide a good immunological response. The efficacy, safety, and duration of immunity of the prepared inactivated EHV-1 vaccine were evaluated. MATERIALS AND METHODS: The prepared FA/BEI-inactivated EHV-1 vaccine was adjuvanted with Alhydrogel and then evaluated by inoculation into guinea pigs, followed by comparison with the commercial inactivated EHV-1 vaccine. These two vaccines were evaluated by testing the safety and immunogenicity in horses classified into two groups. Group A was vaccinated with two doses of the prepared vaccine at a 4-week interval, while Group B was vaccinated with two doses of the commercial vaccine only. Anti-EHV-1 antibodies were detected in horse serum using enzyme-linked immunosorbent assay (ELISA) and virus neutralizing test (VNT). RESULTS: Regarding the time required to inactivate EHV-1 vaccine, this was decreased using 0.005 M BEI and 0.0006% FA from 24 to 8 h. ELISA in Group A horses demonstrated a significant increase in EHV-1 antibody titer at 2 weeks after the booster dose compared with that for the pre-booster one, from 485 to 855 antibody titer, which then peaked at 1240 in the 3rd month post-vaccination; after that, it began to decline gradually until the 6th month. Meanwhile, in Group B, the ELISA reading increased from 420 to 790 and then peaked at 1215. The VNT mean in Group A increased from 1.1 to 2.5 within 2 weeks after administration of the booster dose, while in Group B it increased from 0.8 to 2.1. Moreover, ELISA in Group A pigs indicated mean antibody titers at the 3rd week post-inoculation of 576 for Group A and 554 for Group B. CONCLUSION: The inactivated EHV-1 vaccine, with fewer chemicals, was prepared in a shorter time. It is safe and also more potent to protect horses for up to 6 months against EHV-1 infection than the commercially produced vaccine.

Carvedilol induces the antiapoptotic proteins Nrf2 and Bcl2 and inhibits cellular apoptosis in aluminum-induced testicular toxicity in male Wistar rats.

The present study was carried out to explore the protective effect of carvedilol (CARV) on aluminum chloride-induced testicular damage in Westar rats. Forty adult male rats, aged 8 weeks, were randomly divided into 4 groups (10 rats each). Group I (control group) received normal saline; whereas group II animals were supplemented with CARV in a dose of 10 mg/kg/day. Group III received AlCl3 (30 mg/kg/day) whereas group IV was co-administered CARV and AlCl3 as the same doses in group II and III respectively. The route of the application was oral gavage for CARV and I.P for AlCl3 for 20 successive days. Exposure of rats to AlCl3 for 20 consecutive days resulted in a significant decrease in serum and testicular superoxide dismutase and catalase activities, serum testosterone level, and sperm count and motility; on the other hand, an increase in nitric oxide, malondialdehyde, aluminum, and serum tumor necrosis factor-alpha levels. Furthermore, histopathological changes in the testis exhibited marked testicular damage. In addition, it revealed a significant up-regulation in the level of the expression for the apoptotic marker; Caspase-3, and down-regulation in antiapoptotic marker Bcl2 and Nrf2 genes. On the other hand, the co-administration of CARV modulated the biochemical parameters, saved sperm count and motility, and the histopathological findings, also, restored the observed changes in Caspase-3, Bcl2, and Nrf2 transcriptional genes. These data suggested that administration of CARV protects against AlCl3 induced testicular oxidative, inflammatory, and apoptosis damage.

Evaluation of myocardial function in neonatal sepsis using tissue Doppler imaging.

Background: Neonatal sepsis is an important cause of neonatal morbidity and mortality especially in developing countries. Cardiac dysfunction is a major complication of severe sepsis and occurs as a part of multiple organ failure.Objective: To asses right and left ventricular functions in neonates with sepsis using tissue Doppler imaging (TDI).Methods: A total of 50 neonates fulfilling the diagnostic criteria for sepsis and 25 healthy neonates were enrolled in our study. Myocardial function and pulmonary systolic pressure were assessed using conventional echocardiography and tissue Doppler imaging techniques.Results: Septic neonates had a lower E/A ratio of the mitral valve when compared to healthy neonates (p = .048), indicating left ventricular diastolic dysfunction. Pulmonary systolic pressure was significantly higher in septic neonates compared to control group (p < .001). Left ventricular systolic function (left ventricular fractional shortening and S wave mitral annulus) was not significantly different between septic and healthy neonates. Left ventricular fractional shortening (LVFS) was found to be significantly higher in the survived than the nonsurvived septic neonates (p = .0387).Conclusions: Neonates with sepsis have evidence of left ventricular diastolic dysfunction and elevated pulmonary systolic pressure. Reduced left ventricular fractional shortening is associated with poor prognosis.

Cross sectional study to determine chloroquine resistance among Plasmodium falciparum clinical isolates from Khartoum, Sudan.

Background:  Malaria continues to present a global health threat; the World Health Organization (WHO) reported 214 million cases of malaria by the year 2015 with a death rate of 438000. Sudan is endemic to malaria with over 95% of malaria cases due to Plasmodium falciparum. Chloroquine is a well-established drug in the treatment of P. falciparum malaria although its use has declined since its introduction as the drug of choice in treatment of malaria in Sudan. The mechanism of resistance has been attributed to mutations in P. falciparum Chloroquine resistance transporter gene coding for a key food vacuole proteins. In current study we aimed at verifying the genetic cause of resistance to Chloroquine in field isolates of P. falciparum. Methods: Twenty P. falciparum cases were diagnosed from East Nile hospital in Khartoum and recruited in the investigation. Nested PCR was conducted to isolate mutation region in the PfCRT gene and the amplicons were sequenced using Sanger sequencing technique (Macrogen, Soule Korea). Results: 16/20 (80%) of the field isolates contained base pair mutation of codon 76 in the pfcrt gene thus being resistant to chloroquine treatment and only 4/20 (20%) did not contain such mutation. Conclusions: High treatment failures associated with Chloroquine treatment is evident of the high prevalence of mutant strains of P. falciparum field isolates thus suggesting the reduced relevance of Chloroquine as a treatment choice in the management of P. falciparum malaria.

Low-dose Spironolactone: Treatment for Osteoarthritis-related Knee Effusion. A Prospective Clinical and Sonographic-based Study.

OBJECTIVE: To evaluate the effectiveness of spironolactone as a treatment for osteoarthritis (OA)-related knee effusion in comparison to ibuprofen, cold compresses, and placebo. METHODS: This study was carried out on 200 patients, aged 40 years or older, attending the outpatient clinic of the Rheumatology Department of Sohag University Hospital with unilateral knee effusion related to OA based on clinical examination, musculoskeletal ultrasonography (US), and synovial fluid analysis. In group 1, 50 patients received spironolactone 25 mg daily for 2 weeks; in group 2, 50 patients took ibuprofen 1200 mg daily for 2 weeks; in group 3, 50 patients used cold compresses 2 times daily for 2 weeks; and in group 4, 50 patients received placebo for the same duration. Fluid > 4 mm was considered as effusion. Decrease in fluid to reach below 4-mm thickness was considered complete improvement, and any decrease that did not reach below 4 mm thickness was considered partial improvement. RESULTS: The mean age of the participants was 51.2 ± 8.1 years. The mean duration of effusion was 16.5 ± 3.6 days. In group 1, 66% had complete improvement, 20% partial improvement, and 14% no response. In group 2, 24% had complete improvement, 12% partial improvement, and 64% no response. In group 3, 28% had complete improvement, 14% partial improvement, and 58% no response. In group 4, only 6% had complete improvement, 10% partial improvement, and 84% no response. CONCLUSION: Low-dose spironolactone is a safe and effective medical treatment for OA-related knee effusion.