Sawsan M. Abdalla

Comparison between oxytocin, ergometrine and misoprostol in active management of the third stage of labour: a randomized controlled trial

Background: The aim of the present study was to compare the effectiveness of sublingual misoprostol, intravenous infusion of oxytocin, and intravenous infusion of Ergometrine in reducing blood loss during the third stage of labor. Methods: This is a no-random trial study conducted in in Ribat University Hospital, Khartoum among 150 laboring ladies with a healthy singleton pregnancy. After obtaining their written informed consent to participate in the study, they were randomly assigned to one of three possible treatment groups: 400 μg of sublingual misoprostol; 10 IU of intravenous infusion oxytocin; and 0.5 mg of intravenous infusion of Ergometrine. Blood loss was estimated by weighing the collected blood and converting the weight to milliliters. Results: The shortest mean duration of the third stage of labor was seen in patients who received misoprostol (3.89±0.37 min), followed by oxytocin (4.6±0.9 min), and Ergometrine (5.45±0.9 min). The lowest mean blood loss was seen in the patients who received 400 μg misoprostol (168.36±24.83 ml), followed by those who received 10 IU oxytocin (205.56±34.82 ml), and 0.5 mg Ergometrine (214.49±35.97 ml). Conclusions: Present study showed that 400 μg sublingual misoprostol was more effective than the conventional parenteral uterotonics in reducing the amount of the blood loss during the third stage of labor and has comparable effect to that of 10 IU intravenous oxytocin in shortening the duration of third stage of labor. It also showed that the use of misoprostol reduces the need for extra-uterotonics and blood transfusion.

Prevalence and Risk Factors of Metabolic Syndrome ( MetS ) in Primary Health Care Centers' Attendants in Majmaah , Saudi Arabia

Background: Metabolic syndrome (MetS) is a cluster of established cardiovascular risk factors that collectively increase predisposition to major chronic diseases, including heart diseases and diabetes mellitus. Population of Saudi Arabia is at risk for MetS as a result of industrialization and change in life style. The objectives of the current study were to determine the prevalence of metabolic syndrome in Majmaah area, to estimate its risk factors and to determine the relation between metabolic syndrome and the social factors. Methodology: The study was a cross-sectional and facility-based conducted in Majmaah city in Saudi Arabia. The sample size was calculated as 353. The data was collected by a pre-tested questionnaire. Weight, height and abdominal circumference were measured. Fasting blood samples were collected to ascertain fasting blood glucose and lipid profile. Components of full MetS as defined by the NCEP-ATP- III criteria were used for screening. Results: The prevalence of MetS among adults attending Primary Health Care Centers in Majmaah was 44.5%. MetS was significantly higher in males than in females (61.2 vs. 38.8%; P =0.001). Prevalence of MetS showed an increase trend with age from 20 years to 59 years, and inversely with educational status (illiterates 27% and university graduates 14.6%). MetS was associated with occupation; the housewives showed the highest prevalence of the syndrome followed by the government employees (36.3% and 34.3% respectively). Conclusions: Majmaah adult population has high prevalence of metabolic syndrome. Metabolic Syndrome is more prevalent among males, the low educated, the old age groups, the low income as well as among the employees and the housewives.

Knowledge, attitude and practices of evidence-based medicine among Sudanese medical doctors

Evidence‐based medicine (EBM) is defined as “the conscientious, explicit and judicious use of the best evidence in making decisions about the care of patients.” For some countries, it is a new area of expertise that all physicians ideally need to acquire to become more current in their daily practices. Most medical doctors working in Sudan have not received formal training in EBM. There is evidence that most physicians base their medical decisions on their own previous experience, consultation with colleagues or simply use common sense, and there is consistent evidence of physicians’ failure to translate research finding into clinical practice. Studies addressing medical doctors’ attitudes toward EBM are lacking in the Arab world and in developing countries in general. Sudan is not an exception, and there is a lack of information about the knowledge, attitudes and practices of its medical doctors of various specialties regarding EBM.