Al-Ghad Medical Journal

Perinatal transmission is a common route for hepatitis B virus (HBV) during pregnancy, and often occurs when the pregnant women is hepatitis B e antigen (HBeAg) positive and/or has a high HBV DNA load. In this study, we determined markers of HBV (HBcAb, HBsAg, HBeAg, HBeAb) among the pregnant women in Al Fashir town, North Darfur State, Western Sudan).A total of 900 pregnant women in the age range 15 to 50 years were screened for the markers of HBV using the in vitro ELISA diagnostic kit (Beijing Wantai Biological Pharmacy Enterprise Co., Ltd. China) according to the manufacture’s recommendations. Among the HBsAg-positives, HBeAg and anti-HBe were tested. Overall, 162 pregnant women confirmed positive HBsAg (18%). HBeAg was detected in 2.6% (4 ̸ 153), where as HBeAb was found in 37.66% (58 ̸ 154) of the positive HBsAg pregnant women. Our study indicates a high prevalence of HBsAg with very low proportion of HBeAg among the pregnant women in Al Fashir town. Mostly perinatal transmission of HBV is effective when the mother is also HBeAg-positive, therefore our findings may indicate that perinatal transmissions play unsignificant role in HBV prevalence in Al Fashir town.

The placenta accrete spectrum, known before as morbidly adherent placenta refers to the varieties of adherence and invasiveness of the placenta into the uterine wall during pregnancy, including placenta increta, placenta percreta, and placenta accreta. Due to life-threatening bleeding, maternal mortality and morbidity can occur. The outcome differs across the placenta accrete spectrum, and women with placenta increta and percreta have the most morbidity and mortality risk. The reported prevalence of PAS differs between countries, the reason for this variation is still unclear. It occurs in 3.6 % of women diagnosed with clinical placenta previa without a history of caesarean section. The incidence of PAS has increased recently due to an increase in caesarean section rate worldwide. The article describes the case of a woman diagnosed with placenta accreta spectrum in Zawia Central Hospital and the clinical course of her birth.

The concept of Six Sigma is considered as one of the most important management concepts in total quality management, as it is based on the principle of focus efforts to provide manufacturing and services characterized by the highest levels of quality and compliance, at the lowest cost, and in standard time. With full commitment to avoid defects. This paper describes the theoretical and practical aspects of Six Sigma methodology and the advantages of its application in improvement and development. ‏ The paper also aimed at defining the DMAIC model for developing operations in order to encourage its adoption by local institutions to contribute to upgrading it towards globalization and moving it towards institutional excellence.

Background: Dexmedetomidine (Dex) is an alpha-2 adrenergic agonist that has increasing attention in clinical practice due to its role in sedation, analgesia, and hemodynamic regulation. Initially introduced as a sedative for critically ill patients, its uses have expanded to various perioperative and critical care settings. Aim: This article aimed to examine the pharmacological properties, clinical applications, and evolving roles of dexmedetomidine. Method: A search was conducted on the PubMed and Web of Science libraries for recent studies using different combinations of the words “dexmedetomidine”, “anaesthesia”, “analgesia”, “anti-“inflammatory” effect and “pharmacological effect”. Results: Dexmedetomidine has valuable effect in a variety of clinical settings. Its unique sedative response, analgesic, antioxidant, anti-inflammatory, and sympatholytic effects make it an excellent choice for sedation in critically ill patients, as well as an adjunct to anesthesia in the perioperative setting. The sympatholytic effect of dexmedetomidine also provide stable hemodynamics during the perioperative period.