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 Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج (Re: بهاء الدين سليمان)
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بعض اﻻوراق العلمية بخصوص المﻻريا و نقص الجلوكوز ( و ورقة 2011 من السودان عن طبيعة المﻻريا فى الحوامل )
Hypoglycaemia and severe Plasmodium falciparum malaria among pregnant Sudanese women in an area characterized by unstable malaria transmission.
Ali AA, Elhassan EM, Magzoub MM, Elbashir MI, Adam I.
Source
Faculty of Medicine, Kassala University, Sudan.
Abstract
BACKGROUND:
Pregnant women are more susceptible to severe Plasmodium falciparum malaria, which can lead to poor maternal and fetal outcomes. Few data exist on the epidemiology of severe P. falciparum malaria in pregnant women.A hospital-based study was carried out to assess the pattern of severe P. falciparum malaria among pregnant women at the Kassala and Medani maternity hospitals, which are located in areas of unstable malaria transmission, in eastern and central Sudan, respectively. Pre-tested questionnaires were used to gather socio-demographic, clinical and obstetrical data. Suitable tests were performed for clinical and biochemical investigations.
RESULTS:
Among 222 pregnant women diagnosed with malaria at the two hospitals, 40 (18.0%) women at mean (SD) gestational age of 29.3 (6.7) weeks fulfilled one or more of the WHO criteria for severe P. falciparum malaria. These were hypoglycaemia (14; 35.5%), severe anaemia (12; 30%), hypotension (10; 25%), jaundice (9; 22.5%), cerebral malaria (6; 15%), repeated convulsions (4; 10%), hyperparasitaemia (4; 10.0%) and more than one manifestation (9; 22.5%). While the mean (SD) presenting temperature was significantly lower for women presenting with hypoglycaemia [38.2(0.6) versus 38.8(0.7) °C, P = 0.04], other clinical and biochemical characteristics were not significantly different among women with different manifestations of severe P. falciparum malaria.
CONCLUSION:
Preventive measures for pregnant women such as insecticide-treated bednets and chemoprophylaxis may be beneficial in areas of unstable malaria transmission. Early detection and prompt treatment of severe malaria, especially in pregnant women with hypoglycaemia, are needed.
2. Hypoglycaemia in severe malaria, clinical associations and relationship to quinine dosage.
Ogetii GN, Akech S, Jemutai J, Boga M, Kivaya E, Fegan G, Maitland K.
Source
Centre for Geographic Medicine Research, Kenya Medical Research Institute- Wellcome Trust Programme, PO Box 230, Kilifi, Kenya.
Abstract
BACKGROUND:
Hypoglycaemia is an independent risk factor for death in severe malaria and a recognized adverse treatment effect of parenteral quinine
. In 2006 our hospital changed quinine treatment policy from 15 mg/kg loading (plus 10 mg/kg 12-hourly) to 20 mg/kg loading (plus 10 mg/kg 8-hourly) to comply with new WHO guidelines. This presented us with the opportunity to examine whether there was any dose relationship of quinine and hypoglycaemia occurrence.
METHODS:
Retrospective case notes review of all children admitted to hospital with severe falciparum malaria between April 2002 - July 2009, before and after the introduction of the new WHO quinine regimen. Four-hourly bedside glucose levels were measured until intravenous quinine was discontinued. Clinical events immediately preceding or concurrent with each episode of hypoglycaemia (glucose < = 3.0 mmol/l) were recorded.
RESULTS:
954 children received the old quinine regime and 283 received the new regime. We found no evidence of an increased prevalence of hypoglycaemia (< = 3.0 mmol/L) on the new regime compared to former (15% vs. 15%); similar findings were noted for profound hypoglycaemia (< 2.2 mmols/L) 8% v 5%, P = 0.07. Episodes were co-incident with disease severity markers: coma (57%), circulatory failure (38%) and respiratory distress (21%) but less commonly with seizures (10%). Disruption of maintenance fluids and/or blood transfusion concurred with 42% of the hypoglycaemia episodes. Post admission hypoglycaemia increased odds of fatal outcome (24%) compared to euglycaemic counterparts (8%), odds ratio = 3.45 (95% confidence interval = 2.30-5.16) P < 0.01.
CONCLUSION:
There was no evidence to indicate a dose relationship between quinine and occurrence of hypoglycaemia. Hypoglycaemia concurred with severity features, disruption of glucose infusion and transfusion. Careful glucose monitoring should be targeted to these complications where resources are limited.
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| العنوان |
الكاتب |
Date |
 أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-17-12, 11:48 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-17-12, 09:07 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | الفاتح سليمان | 03-17-12, 10:18 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-18-12, 06:55 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | جمال الباقر | 03-17-12, 11:06 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | تبارك شيخ الدين جبريل | 03-17-12, 11:27 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-18-12, 07:09 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-18-12, 07:04 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | أيمن دياب | 03-18-12, 07:08 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-18-12, 07:22 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Magdi Is'hag | 03-18-12, 07:49 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-18-12, 09:02 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | محمد مختار جعفر | 03-18-12, 08:02 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Magdi Is'hag | 03-18-12, 09:22 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-18-12, 10:35 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Magdi Is'hag | 03-18-12, 10:56 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-18-12, 10:38 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | وضاحة | 03-18-12, 10:51 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | حاتم محمد حاج المهدي | 03-19-12, 00:31 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Dr.Elsadig Abdalla | 03-19-12, 01:36 AM |
 Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | داليا الكباشى | 03-19-12, 04:43 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | عارف الركابي | 03-19-12, 07:20 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 09:25 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 08:58 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 08:50 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 08:33 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 08:27 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 09:31 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Hisham Osman | 03-19-12, 09:43 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 09:16 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 10:13 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | وائل فاروق | 03-19-12, 09:51 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 10:37 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-19-12, 10:43 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | وائل فاروق | 03-19-12, 11:26 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Hisham Osman | 03-20-12, 07:19 AM |
 Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | وائل فاروق | 03-19-12, 11:10 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-20-12, 00:22 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-20-12, 00:28 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | حاتم محمد حاج المهدي | 03-20-12, 00:28 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Abureesh | 03-20-12, 00:40 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | حاتم محمد حاج المهدي | 03-20-12, 00:47 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | محمد فضل محمد | 03-20-12, 11:32 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 03-21-12, 01:35 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | وائل فاروق | 03-20-12, 07:31 PM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | بهاء الدين سليمان | 04-07-12, 00:01 AM |
| Re: أطباء السودان غباء فى الداخل ودهاء فى الخارج | Magdi Is'hag | 04-07-12, 06:51 AM |
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