Periconceptional folic acid usage and its associated factors in eastern Sudan: A cross-sectional study.

BACKGROUND: Several countries poorly adhere to the World Health Organization's recommendation of folic acid supplementation in the periconceptional period, especially in limited-resource settings. OBJECTIVE: The objective of this study was to investigate the prevalence of and the factors associated with folic acid usage in the periconceptional period among pregnant women at Gadarif Maternity Hospital in eastern Sudan. STUDY DESIGN: This is a cross-sectional study. METHODS: This study was conducted in eastern Sudan from April to September 2022. A total of 720 pregnant women in their first trimester were enrolled. The sociodemographic characteristics and clinical and obstetrical data of pregnant women in their first trimester were assessed using a face-to-face questionnaire. In addition, multivariate regression analysis was performed. RESULTS: In this study, the median (interquartile range) of the age and gravidity of the enrolled women was 26.3 (24.14-29.52) years and 2 (1-4), respectively. Of these 720 women, 423 (58.8%) used folic acid during the periconceptional period, while 27 (3.7%) women used folic acid in the preconceptional period. None of the investigated factors (age, residence, education, employment, body mass index, or gravidity) were associated with periconceptional use of folic acid. CONCLUSION: The study revealed a low prevalence of folic acid usage in preconceptional period among pregnant women in eastern Sudan. Additional efforts are needed to promote folic acid usage in the preconceptional period as well as in the first trimester.

Multimorbidity and its associated risk factors among adults in northern Sudan: a community-based cross-sectional study.

BACKGROUND: Multimorbidity (having two or more coexisting long-term conditions) is a growing global challenge. However, data on multimorbidity among adults in Africa, including Sudan, are scarce. Thus, this study aimed to investigate the prevalence of multimorbidity and its associated risk factors among adults in Sudan. METHODS: A community-based cross-sectional study was conducted in northern Sudan from March 2022 to May 2022. Participants' sociodemographic characteristics were assessed using a questionnaire. Multimorbidity was defined as having two or more coexisting long-term conditions, including diabetes mellitus (DM), hypertension, obesity, anaemia and depression-anxiety. Multivariate logistic regression analyses were performed to determine the associated factors. RESULTS: The participants included 250 adults: 119 (47.6%) males and 131(52.4%) females. The median interquartile range (IQR) of the enrolled adults of the age was 43.0 (30.0‒55.0) years. Of the 250 adults, 82(32.8%), 17(6.8%), 84(33.6%), and 67(26.8%) were normal weight, underweight, overweight, and obese, respectively; 148(59.2%), 72(28.8%), 63(25.2%), 67(26.8%), and 98(39.2%) had hypertension, DM, anaemia, obesity, and depression-anxiety, respectively. A total of 154 adults (61.6%) had multimorbidity: 97(38.8%), 49(19.6%), and 8(3.2%) had two, three, and four morbidities, respectively. The remaining 21 (8.4%), and 75 (30.0%) adults had no morbidity, and one morbidity, respectively. In amultivariate logistic regression analysis, increasing age (adjusted odd ratio [AOR] = 1.03, 95% CI = 1.01‒1.05), and female sex (AOR = 2.17, 95% CI = 1.16‒4.06) were associated with multimorbidity. CONCLUSIONS: The high prevalence of multimorbidity revealed in this study uncovers a major public health problem among Sudanese adults. Our results show that increasing age and female sex are associated with multimorbidity. Additional extensive studies are necessary to evaluate the magnitude of multimorbidity for improved future planning and establishing effective health systems.

Prevalence and factors associated with hypertension among adolescents in Sudan: a cross-sectional school-based study.

OBJECTIVES: There is an increasing rate of elevated blood pressure, or hypertension, in children and adolescents worldwide, including Sub-Saharan Africa (SSA). Only a few data on adolescent hypertension in SSA, including Sudan, have been published. The aim of the present study was to investigate the prevalence and associated factors of hypertension among adolescent schoolchildren (within the ages of 10 to 19 years) in Sudan. DESIGN: A cross-sectional school-based study was conducted from June to September 2022. SETTINGS: Six randomly selected schools in Almatamah, River Nile State, Sudan. PARTICIPANTS: Adolescent schoolchildren (within the ages of 10 to 19 years). MAIN OUTCOME MEASURES: Sociodemographic information. Anthropometric and blood pressure measurements were performed in accordance with the standard procedures. An adjusted logistic regression analysis was performed. RESULTS: Of the 384 enrolled adolescents, 166 (43.2%) and 218 (56.8%) were boys and girls, respectively. The median (IQR) age and body mass index (BMI) were 15.2 years (14.0‒16.4 years) and 18.5 kg/m2 (16.4‒21.5 kg/m2), respectively. Of the 384 adolescents, 240 (62.5%) and 255 (66.4%) had educated mothers and fathers (≥secondary), respectively. 38 adolescents (9.9%) had hypertension (≥95th percentile). The multivariable logistic regression analysis revealed that age, sex and maternal educational level were not associated with hypertension. Paternal educational level according to secondary education attainment (adjusted OR (AOR), 2.72; 95% CI 1.36‒5.46) and increasing BMI (AOR, 1.12; 95% CI 1.02‒1.20) were associated with hypertension. CONCLUSION: 1 in 10 adolescents in northern Sudan was hypertensive. Low paternal educational level and increasing BMI were significantly associated with hypertension. The introduction of interventional nutritional programmes at early ages is needed to ensure that adolescents are healthy in their present and later lives. To sustain such programmes, involving all educational parties at early stage is essential.

The association between blood groups, Rhesus factors, body mass index and obesity among pregnant women at Gadarif Maternity Hospital, Eastern Sudan.

BACKGROUND: The existing evidence regarding the link between blood groups and obesity remains inconclusive, and there is a noticeable lack of data on the potential association between blood groups and obesity during pregnancy. Consequently, this study aimed to investigate the association between blood groups, body mass index (BMI), and obesity among pregnant women receiving care at Gadarif Maternity Hospital in eastern Sudan. METHODS: This cross-sectional study was conducted in eastern Sudan during the period from April to September 2022. A questionnaire was employed to gather sociodemographic information from pregnant women. BMI was computed based on weight and height. Blood groups determinations were made using the agglutination method which is commonly used in the study's region. Multinominal and multiple linear regression analyses were performed, and adjusted for covariates in the regression models. RESULTS: Eight hundred and thirty-three pregnant women were enrolled with a median (interquartile range, IQR) gestational age of 10.0 (9.3‒11.0) weeks. The median (IQR) BMI of the women was 26.3(24.2‒29.4) kg/m2. Of these women, 11(1.3%) were underweight, 268(32.2%) were of normal weight, 371(44.5%) were overweight, and 183(22.0%) were obese. One hundred eighty-three (22.0%) women had blood group A, 107 (12.8%) had blood group B, 56 (6.7%) had blood group AB, and 487(58.5%) had blood group O. While 798 (95.8%) of the women were Rhesus factor positive, only 35 (4.2%) were Rhesus factor negative. Multinominal regression showed that only urban residency (adjusted odds ratio, AOR = 2.46, 95% confidence interval, CI = 1.47‒4.13) was associated with overweight. Blood groups and Rhesus factors were not associated with overweight. Age (AOR = 1.06, 95% CI = 1.01‒1.11), urban residence (AOR = 2.46, 95%, CI = 1.47‒4.13), and blood group O (AOR = 1.60, 95%, CI = 1.06‒2.40), were associated with obesity. Rhesus factors were not associated with obesity. In the multiple linear regression, age (coefficient = 0.07, P = 0.028), gravidity (coefficient = 0.25, P = 0.014), urban residence (coefficient = 1.33, P = 0.001), and blood group O (coefficient = 0.68, P = 0.035) were associated with BMI. CONCLUSIONS: Blood group O was associated with obesity and high BMI among pregnant women in eastern Sudan. Rhesus factors were not associated with obesity.

Epidemiology of pre-pregnancy body mass index (BMI) among mothers in Abu Dhabi, the United Arab Emirates.

Pre-pregnancy obesity is a risk factor for several health problems such as gestational diabetes, preeclampsia, labor induction, postpartum hemorrhage, and neonatal hypoglycemia. Being underweight is a risk factor for fetal growth restriction. Despite the negative impact of abnormal pre-pregnancy body mass index (BMI) (over and underweight) on pregnancy outcomes, a limited amount of studies has been conducted on the prevalence of pre-pregnancy over and underweight and associated factors in the United Arab Emirates (UAE). Thus, the aim of this study was to investigate the prevalence and factors associated with underweight, overweight, and obesity among mothers with children under the age of 2 years in Abu Dhabi, the UAE. A cross-sectional multicenter study was conducted in 2017 and included data from seven government health care centers in Abu Dhabi. Maternal pre-pregnancy BMI was calculated as the weight in kilograms (kg) divided by the square of the height in meters (m), (kg/m2). A total of 1,622 mother-child pairs were included in this study. Out of the 1,622 mothers, 43 (2.7%) were underweight, 1,068 (65.8%) were normal weight, 412 (25.4%) were overweight, and 99 (6.1%) were obese. Mothers with advanced maternal age (AMA) (≥35 years) were more likely to be overweight, odds ratio [OR] = 1.93, (95% confidence interval [CI] 1.52-2.3), p ≤ 0.001, and obese OR = 2.15 (95% CI 1.32-3.39), p = 0.001. Mothers with lower family income were more likely to be obese OR = 2.72 (95% CI 1.44-5.93), p = 0.002. Mothers with high parity (≥2) were more likely to be overweight OR = 1.91 (95% CI 1.49-2.50), p ≤ 0.001; obese OR = 1.76 (95% CI 1.06-2.92), p = 0.024; and less likely to be underweight OR = 0.52 (95% CI 0.27-0.94), p = 0.037. Obese mothers were more likely to deliver via cesarean section (CS) OR = 1.95 (95% CI 1.27-2.96), p = 0.002. This study provides valuable baseline information on the epidemiology of pre-pregnancy BMI in the UAE. The sociodemographic factors identified in the study can be used to target at-risk women. The study findings can also be used to develop contextualized strategies to prevent and manage complications associated with abnormal pre-pregnancy BMI in Emirati women.

Autoaugmentation Brachioplasty: An Arm Contouring Method in Women with Massive Weight Loss.

BACKGROUND: Brachioplasty of deflated arms following massive weight loss (MWL) often results in too slim arms. These slimmer arms lack the natural proportion and contour. This study presents a novel method for such arms through standard skin excision and autoaugmentation by dermofat flap. PATIENTS: During a period of 2 years, 21 women complaining of severe deflation deformity of upper arms following MWL were operated. At time of surgery, the BMI ranged from 20.5 to 33. 4 with a mean of 26.2 kg/m2. The mean value of weight loss was 47.8 kg over a mean period of 18 months. METHODS: A de-epithelialized dermofat flap was preserved underneath the dissected and advanced anterior and posterior arm skin flaps. The bulk of the flap was tailored as to give an appropriate girth with balanced proportion and contour of the upper arm. RESULTS: During 14 months of follow-up, all patients reported a high satisfaction. Objective evaluation was based on measurement of the mid-upper arm circumferences (MUAC) and its ratio with the mid-forearm circumferences (MFAC) which was compared with those of arms of healthy volunteers with normal BMIs. CONCLUSION: Augmentation of the upper arm by autologous dermofat flap provides a well arm contour in appropriate balance with the forearm in women having severe arm deflation deformity following MWL. The findings were supported by the objective anthropometric measurements of the MUAC/MFAC of a normal weight healthy women which reached to a mean value of 1.366. The normal girth of upper arm should equal 1[Formula: see text] that of the forearm. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Prevalence and factors associated with overweight and central obesity among adults in the Eastern Sudan.

BACKGROUND: A global epidemic of obesity has been documented, particularly among African countries. While central obesity and overweight have been reported for many countries, very limited information exists about the prevalence of these health problems in Sudan, and these data are nonexistent for Eastern Sudan. The present study aimed to determine the prevalence of obesity and central obesity, as well as the factors associated with both, among adults in Gadarif, Eastern Sudan. METHODS: A cross-sectional study was conducted in Gadarif, Eastern Sudan, during the period of January through May 2018. Sociodemographic and health characteristics data were collected through a questionnaire. Body mass index (BMI) and waist circumference (WC) were measured using the standard methods. Both descriptive and inferential statics were applied to analyze the data. RESULTS: A total of 594 adults participated in the study; 70.4% of them were female. The mean (standard deviation) age was 44.98 (16.64) years. Of the 594 enrolled participants, 33.7%, 7.4%, 26.8%, and 32.2% were normal weight, underweight, overweight, and obese, respectively. The prevalence of central obesity was (67.8%). Approximately, one-third of the participants (29.29%) were obese and had central obesity. In the multinomial regression, being married was the main risk factor associated with overweight, and older age, female sex, being married and hypertension were significantly associated with obesity. In the binary regression, the main risk factors associated with central obesity were female sex and being married. CONCLUSION: The prevalence rates of both obesity and central obesity among the study participants were high. Older age and hypertension were only associated with obesity. Obesity and central obesity were significantly associated with female sex and being married. This study provided valuable baseline information to develop appropriate strategies for the prevention and control of obesity in Eastern Sudan.

Are there paternal components in human milk?

Breastfeeding is indeed the foundation for life and gives growing children a once-in-a-lifetime opportunity to grow and develop to their full potential. There are considerable studies on the role of maternal contribution to human milk components. It would be very important and interesting to explore the existence of a paternal contribution into the composition of human milk. Proceeding on this track, there is an abundant evidence that supports the hypothesis of paternal contribution in human milk composition. This evidence could be strengthened by the fact that a small population of the fetal cells migrate during pregnancy and stay for long time in the maternal body. This phenomenon is known as microchimerism. It has been well documented that some of these cells are of mature immunological and hematopoietic stem cells character. As the fetal parts contain 50% from each parent, any fetal parts in the maternal body (i.e., fetal microchimerism) should contain paternal components as well. The paternal genetic material is more responsible for the determination of the fetal sex (female XX or male XY). The variations in maternal human milk component that was clearly understood as related to child sex will substantially provide a solid basis for the investigation of the new hypothesis. In this short report, we conclude by briefly foregrounding the proposed role for paternal contribution on human milk composition for consideration and suggesting new directions for future research that would shed light on this subject.

Comparison of different serum sample extraction methods and their suitability for mass spectrometry analysis.

Mass spectrometry has been widely used, particularly in pharmacokinetic investigations and for therapeutic drug monitoring purposes. Like any other analytical method some difficulties exist in employing mass spectrometry, mainly when it is used to test biological samples, such as to detect drug candidates in mammalian serum, which is rich in proteins, lipids and other contents that may interfere with the investigational drug. The complexity of the serum proteome presents challenges for efficient sample preparation and adequate sensitivity for mass spectrometry analysis of drugs. Enrichment procedures prior to the drug analysis are often needed and as a result, the study of serum or plasma components usually demands either methods of purification or depletion of one or more. Selection of the best combination of sample introduction method is a crucial determinant of the sensitivity and accuracy of mass spectrometry. The aim of this study was to determine the highest serum protein precipitation activity of five commonly used sample preparation methods and test their suitability for mass spectrometry. We spiked three small molecules into rabbit serum and applied different protein precipitation methods to determine their precipitation activity and applicability as a mass spectrometry introductory tool.