Face and brow presentation in northern Jordan, over a decade of experience

BACKGROUND: Malpresentation is a deviation from the normal presentation, which occurs in approximately 5% of labours (Seeds and Cefalo in Clin Obstet Gynaecol 25:145-156, 1982). The commonest form of malpresentation at delivery is breech presentation followed by face and brow presentation. OBJECTIVES: To review the incidence and management of face and brow presentation in north of Jordan. MATERIALS AND METHODS: This was a retrospective review of the experience of face and brow presentation deliveries in the two main civil hospitals in north of Jordan between 1995 and 2005. RESULTS: The incidence of face and brow presentation was 1 in 813 and 1 in 1,689 deliveries, respectively. There was no significant increase in the incidence of prematurity nor very low birth weight and no higher incidence of postmaturity among those delivered by face or brow in the same period. All the foetuses presenting by the brow and by face (mentoposterior) and only 16.7 % of foetuses presenting by face (mentoanterior) were delivered by caesarian section. CONCLUSION: The incidence of face and brow presentation was 1 in 813 and 1 in 1,689 deliveries, respectively. All the babies presenting by brow presentation did undergo caesarean section. The management of face and brow presentation is heading towards a safe delivery and not merely to accomplish vaginal delivery.     

Synthesis,SAR studies,and insecticidal activities of certain N-heterocycles derived from 3-((2-chloroquinolin-3-yl)methylene)-5-phenylfuran-2(3H)-one against Culex pipiens L. larvae

An acid hydrazide derivative was synthesized and transformed into a variety of valuable N-heterocycles such as pyridazinone, oxadiazole, triazolopyridazinone, and triazole derivatives via reactions with certain carbon electrophiles such as 4-methoxybenzaldehyde, indole-3-carbaldehyde, pentan-2,4-dione, and carbon disulfide. The chemical structures of all prepared compounds were verified via their analytical and spectroscopic data. The insecticidal activity of the N-heterocycles was evaluated against field and lab strains of the third larval instar of Culex pipiens. All tested compounds exhibited higher larvicidal activity against the lab strains compared to the field strains, with dissimilar ratios. The obtained results demonstrate that the high toxicity achieved by oxadiazole followed the order of furanone, pyridazinone and hydrazide, with lower LC₅₀ values of the hydrazone and N-acetylpyridazinone derivatives compared to that of imidacloprid. Interestingly, these compounds are promising agents for insect pest control, especially since they are insoluble in water and can overcome the disadvantages of neonicotinoid applications in pest management programs.

A new series of N-heterocycles including pyridazinone, oxadiazole, triazolopyridazinone, and triazole derivatives were synthesized from the acid hydrazide via its reaction with certain carbon electrophiles.     

Risk factors for hospital admission among COVID-19 patients with diabetes: A study from Saudi Arabia

Objectives:To elucidate the risk factors for hospital admission among COVID-19 patients with type 2 diabetes mellitus (T2DM).Methods:This retrospective study was conducted at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia between May 2020 and July 2020. Out of 7,260 COVID-19 patients, 920 were identified as T2DM. After the exclusion process, 806 patients with T2DM were included in this analysis. Patients’ data were extracted from electronic medical records. A logistic regression model was performed to estimate the risk factors of hospital admission.Results:Of the total of 806 COVID-19 patients with T2DM, 48% were admitted in the hospital, 52% were placed under home isolation. Older age between 70-79 years (OR [odd ratio] 2.56; p=0.017), ≥80 years (OR 6.48; p=0.001) were significantly more likely to be hospitalized compared to <40 years. Similarly, patients with higher HbA1c level of ≥9% compared to <7%; (OR 1.58; p=0.047); patients with comorbidities such as, hypertension (OR 1.43; p=0.048), cardiovascular disease (OR 1.56; p=0.033), cerebrovascular disease (OR 2.38; p=0.016), chronic pulmonary disease (OR 1.51; p=0.018), malignancy (OR 2.45; p=0.025), chronic kidney disease (CKD) IIIa, IIIb, IV (OR 2.37; p=0.008), CKD V (OR 5.07; p=0.007) were significantly more likely to be hospitalized. Likewise, insulin-treated (OR 1.46; p=0.03) were more likely to require hospital admission compared to non-insulin treated patients.Conclusion:Among COVID-19 patients with diabetes, higher age, high HbA1c level, and presence of other comorbidities were found to be significant risk factors for the hospital admission.     

Kawasaki disease with Glucose-6-Phosphate Dehydrogenase deficiency,case report

Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in infants and children younger than 5 years of age. Coronary artery abnormalities are the most serious complication.Based on the literatures infusion of Intravenous Immunoglobulin of 2 g/kg and a high dose of oral aspirin up to 100 mg/kg/day are the standard treatment for Kawasaki disease in the acute stage, and should be followed by antiplatelet dose of aspirin for thrombocytosis. Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is an inherited X-linked hereditary disorder, and aspirin can induce hemolysis in patients with G6PD deficiency. We report a case of a 5 year and 8 month old male with KD and G6PD deficiency.     

A novel de novo heterozygous pathogenic variant in the SDHA gene results in childhood onset bilateral optic atrophy and cognitive impairment

Metabolic Brain Disease - Isolated defects in the mitochondrial respiratory chain complex II (CII; succinate-ubiquinone oxidoreductase) are extremely rare and mainly result from bi-allelic...     

Evaluation of Spironolactone Solid Dispersions Prepared by Co-Spray Drying With Soluplus® and Polyvinylpyrrolidone and Influence of Tableting on Drug Release

Solid dispersions of spironolactone with Soluplus^® and polyvinylpyrrolidone were prepared by spray drying according to a mixture experimental design and evaluated for moisture content, particle size, drug solubility, crystallinity (powder X-ray diffraction and differential scanning calorimetry), and physicochemical interactions (Fourier-transform infrared spectroscopy, Raman). In vitro dissolution was evaluated for the spray dried product itself and after compression into tablets, and prediction models were derived using multiple linear regression analysis. The spray dried products consisted of amorphous drug, indicated by the absence of crystalline powder X-ray diffraction peaks. Amorphization and interactions impacted changes in the Fourier-transform infrared spectroscopy spectra in the ranges 2900-3000 cm^?1 (C-H) and 1600-1800 cm^?1 (C=O) and caused merging at 1690 cm^?1 (C=O of lactone) and 1670 cm^?1 (C=O of thioacetyl group). In the Raman spectra, amorphization and interactions resulted in disappearance of peak at 1690 cm^?1 (C=O) and merging of peaks at 582 and 600 cm^?1 (C-S). Hydrogen bonding between the thioacetyl group of the drug with the hydroxyl groups of Soluplus^® caused marked suppression of the peak at 1190 cm^?1 (R-C(=O)-S vibration). Amorphization and interactions resulted in improved solubility and dissolution which was greatest for drug/Soluplus^® ratio 1:4 and was also demonstrated in the corresponding tablets.