Publications by authors named "Mohammed Elhassan"

18 Publications

  • Page 1 of 1

Rings Flying Around: A rare complication of Transjugular Intrahepatic Portosystemic Shunt.

Respir Med Case Rep 2022 3;36:101586. Epub 2022 Feb 3.

Internal Medicine, Saint Agnes Medical Center, 1303 East Herndon Avenue, Fresno, CA, 93725, USA.

We present a rare case of TIPS stent migration. TIPS is considered a relatively safe procedure with a high success rate. We present a case of 58 year old male with decompensated alcoholic liver cirrhosis requiring TIPS stent, which fractured and migrated into the pulmonary artery. Our case represents a rare complication, reported only 4% of the population.

Rings Flying Around: a rare complication of Transjugular Intrahepatic Portosystemic Shunt.
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http://dx.doi.org/10.1016/j.rmcr.2022.101586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8866153PMC
February 2022

Real-Time Human Recognition at Night via Integrated Face and Gait Recognition Technologies.

Sensors (Basel) 2021 Jun 24;21(13). Epub 2021 Jun 24.

School of Informatics, Xiamen University, Xiamen 361005, China.

Human recognition technology is a task that determines the people existing in images with the purpose of identifying them. However, automatic human recognition at night is still a challenge because of its need to align requirements with a high accuracy rate and speed. This article aims to design a novel approach that applies integrated face and gait analyses to enhance the performance of real-time human recognition in TIR images at night under various walking conditions. Therefore, a new network is proposed to improve the YOLOv3 model by fusing face and gait classifiers to identify individuals automatically. This network optimizes the TIR images, provides more accurate features (face, gait, and body segment) of the person, and possesses it through the PDM-Net to detect the person class; then, PRM-Net classifies the images for human recognition. The proposed methodology uses accurate features to form the face and gait signatures by applying the YOLO-face algorithm and YOLO algorithm. This approach was pre-trained on three night (DHU Night, FLIR, and KAIST) databases to simulate realistic conditions during the surveillance-protecting areas. The experimental results determined that the proposed method is superior to other results-related methods in the same night databases in accuracy and detection time.
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http://dx.doi.org/10.3390/s21134323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8272095PMC
June 2021

The Conundrum of Volume Status Assessment: Revisiting Current and Future Tools Available for Physicians at the Bedside.

Cureus 2021 May 26;13(5):e15253. Epub 2021 May 26.

Internal Medicine, Saint Agnes Medical Center, Fresno, USA.

Assessment of patients' volume status at the bedside is a very important clinical skill that physicians need in many clinical scenarios. Hypovolemia with hypotension and tissue under-perfusion are usually more alarming to physicians, but hypervolemia is also associated with poor outcomes, making euvolemia a crucial goal in clinical practice. Nevertheless, the assessment of volume status can be challenging, especially in the absence of a gold standard test that is reliable and easily accessible to assist with clinical decision-making. Physicians need to have a broad knowledge of the individual non-invasive clinical tools available for them at the bedside to evaluate volume status. In this review, we will discuss the strengths and limitations of the traditional tools, which include careful history taking, physical examination, and basic laboratory tests, and also include the relatively new tool of point-of-care ultrasound.
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http://dx.doi.org/10.7759/cureus.15253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231469PMC
May 2021

Small bowel obstruction secondary to primary enterolith: A rare and delayed complication of radiation enteritis.

Clin Case Rep 2021 Mar 16;9(3):1783-1784. Epub 2021 Jan 16.

Department of General Surgery George Eliot Hospital NHS Trust Nuneaton UK.

Primary enteroliths as a result of pelvic radiotherapy are a rare cause of intestinal obstruction.
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http://dx.doi.org/10.1002/ccr3.3700DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981604PMC
March 2021

Feel It, See It, Get It: Is Internal Medicine Residents' Use of Ultrasound in Lumbar Puncture Associated With Higher Success Rate?

Cureus 2020 Nov 18;12(11):e11545. Epub 2020 Nov 18.

Clinical Research Center, University of California San Francisco Fresno, Fresno, USA.

Introduction:  Multiple emergency medicine and anesthesiology research studies suggest that ultrasound (US) is potentially useful in assisting with needle insertion in a lumbar puncture (LP). However, little is known about its value when utilized by internal medicine (IM) residents. The objective of this study is to examine whether the use of ultrasound in LPs performed by internal medicine residents is associated with a higher success rate than the traditional palpation method.

Materials And Methods:  We reviewed all LP procedure notes in our hospital's records written by IM residents from June 2017 to December 2018 in a single community teaching hospital. We examined the association between the US use and success using the Chi-squared test and logistic regression model.

Results: Among the 152 lumbar punctures documented, 130 specified whether US was used or not. Among these, 39 were ultrasound-assisted and 91 were not. Use of ultrasound was associated with a higher success rate compared to the non-ultrasound-use (87% vs 73%; p=0.1). The association was strengthened using logistic regression but did not reach statistical significance (OR 3.5; CI: 0.9 -13.8; p=0.07). Success was significantly associated with a fewer number of attempts (p<0.001). No statistically significant association was found between success and patients' body mass index (BMI; p=0.57), or level of training (p=0.11).

Conclusions:  Use of ultrasound for needle insertion in lumbar punctures performed by internal medicine residents was associated with a higher success rate compared to the palpation method but without statistical significance. Ultrasound is a non-invasive, quick, and safe tool. Our study favors its use as an aid during lumbar puncture when performed by internal medicine residents. Larger studies are needed to gather more evidence in support of this conclusion.
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http://dx.doi.org/10.7759/cureus.11545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748586PMC
November 2020

Internal medicine residents' point-of-care ultrasound skills and need assessment and the role of medical school training.

Adv Med Educ Pract 2019 31;10:379-386. Epub 2019 May 31.

Department of Internal Medicine, UCSF Fresno Medical Education Program, Fresno, CA, USA.

Point-of-care-ultrasound (POCUS) as a useful bedside tool is growing. Few studies have examined residents' attitude towards POCUS or compared POCUS image interpretation skills between residents with and without POCUS training in medical school. We distributed an anonymous survey and image interpretation test to assess residents' attitude towards POCUS, confidence, and skills in interpreting POCUS images and videos. Using independent samples t-tests, we compared mean confidence levels and test scores between residents with and without prior POCUS training. Fifty-two residents responded to survey (response rate 68%) and 59 took the image interpretation test (77%). Most residents (90%) reported being interested in POCUS. Residents with prior POCUS training (n=13) were either PGY-1 (9) or PGY-2 (4). No PGY-3 resident had prior training. Most residents (83%) thought POCUS could be extremely useful in the inpatient setting compared to 29% for outpatient setting. PGY-1 residents with prior training had a higher mean confidence level than PGY-1 residents without prior training, but the difference was not statistically significant (3.26 vs 2.64; =0.08). PGY-1 with prior training had a mean confidence level that was close to that of PGY-3 residents. PGY-1 residents with prior training scored significantly higher than PGY-1 residents without prior training in image interpretation test (10.25 vs 7; =0.01). Residents felt most confident in interpreting inferior vena cava images (mean 3.7; max. 5), which also had the highest score in image interpretation test (correct response rate of 88%). Our residents seem very interested in POCUS. PGY-1 residents with prior POCUS training in medical school seem to have higher confidence in their POCUS skills than PGY-1 residents without prior training and outperformed them in image interpretation test. The study is very instructive in building our future POCUS curriculum for residents.
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http://dx.doi.org/10.2147/AMEP.S198536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6549795PMC
May 2019

Quality Aspects of Insects as Food-Nutritional, Sensory, and Related Concepts.

Foods 2019 Mar 12;8(3). Epub 2019 Mar 12.

Department of Molecular Sciences, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden.

In the search for another appealing source of future food to cover the increasing need for nutrients of a growing global population, this study reviewed the potential of insects as human food. Most previous reviews have dealt with insects as a group, making it difficult to evaluate each individual insect species as food because of the generalized data. This study assessed some common edible insects, but concentrated on mealworms. Insects, especially mealworms, have a similar or higher nutritional value than many conventional food sources. For example, the protein content of mealworm larvae is reported to be almost 50% of dry weight, while the fat content is about 30% of larval dry weight. Mealworms can be cooked by different methods, such as hot air drying, oven broiling, roasting, pan frying, deep frying, boiling, steaming, and microwaving. Oven broiling in particular gives a desirable aroma of steamed corn for consumers. Changes in the flavor, taste, and texture of mealworm products during storage have not been studied, but must be determined before mealworms can be used as a commercial food source. Factors controlling the shelf-life of mealworms, such as their packaging and storage, should be identified and considered with respect to the feasibility of using mealworms on a commercial scale.
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http://dx.doi.org/10.3390/foods8030095DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463183PMC
March 2019

Patterns, treatments, and outcomes of pediatric central nervous system tumors in Sudan: a single institution experience.

Childs Nerv Syst 2019 03 4;35(3):437-444. Epub 2019 Jan 4.

Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.

Purpose: Studies of epidemiology, treatment modalities, and outcomes of childhood central nervous system (CNS) tumors in Sudan are scarce. To address this shortcoming, we evaluated baseline information about the epidemiology, treatment types, and outcomes of childhood CNS tumors at the National Cancer Institute, University of Gezira (NCI-UG) in Wad Madani, Sudan.

Methods: We performed a retrospective health facility-based study of children with CNS tumors who were treated at the NCI-UG from January 2000 to December 2015.

Results: A total of 62 (5.4% of all childhood cancers) pediatric patients with CNS tumors were identified over the study period. Tumors were more common among male children and involved the infratentorial compartment in 58% of cases. The median age at diagnosis was 9 years (range, 2-14 years). Approximately 60% (n = 37) of the study population had histology-determined diagnoses. Astrocytomas and medulloblastomas were the most common tumors in these cases. The mean time to diagnosis was 6 months (SD, 9). During the study period, the number of children with CNS tumors who were referred for treatment at the NCI-UG increased every year. Of the 37 patients who received surgical interventions, 8 received gross total resections, 20 received partial resections, and 24 received postoperative radiotherapy. The treatment abandonment rate was 11%. The 2-year and 5-year survival rates were 33% and 13%, respectively.

Conclusion: Our findings reveal a high incidence of poor outcomes for patients with CNS tumors in Sudan, which is most likely due to many distinct factors.
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http://dx.doi.org/10.1007/s00381-018-04032-9DOI Listing
March 2019

Spontaneous renal artery dissection associated with sexual intercourse: a case report.

Int Med Case Rep J 2018 12;11:221-223. Epub 2018 Sep 12.

Department of Internal Medicine, Division of Hospital Medicine, University of California San Francisco (UCSF) Fresno Medical Education Program, Fresno, CA, USA,

Spontaneous renal artery dissection is a rare cause of renal infarction and can be a diagnostic challenge at times, necessitating high index of suspicion. Other common underlying causes, especially thromboembolic phenomena, need to be considered and investigated first before making this uncommon diagnosis with vascular imaging studies. Very few cases did report strenuous exercise as a predisposing factor for the development of spontaneous renal artery dissection, but we believe that sexual intercourse has not been reported before as an underlying precipitating etiology. We report a case of a young male who presented with renal infarction that started during sexual intercourse and was found to have an angiographically proven renal artery dissection.
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http://dx.doi.org/10.2147/IMCRJ.S171645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143129PMC
September 2018

Management of anaphylaxis in children: a survey of parents and school personnel in Qatar.

BMJ Paediatr Open 2017 25;1(1):e000077. Epub 2017 Oct 25.

Department of General Pediatrics, Hamad Medical Corporation, Doha, Qatar.

Background: Allergies are a growing health concern with a significant impact on quality of life and healthcare costs. It is critical to develop an appropriate care plan to deal with children's allergies. This study aimed to assess and compare the knowledge and perception of families and school personnel caring for children with history of anaphylaxis who were prescribed the epinephrine autoinjector (EpiPen). The study also examined the underlying reasons for any observed knowledge gaps.

Methods: A cross-sectional study of 128 families and 50 corresponding school personnel caring for children at risk of anaphylaxis who had been prescribed the EpiPen was conducted. The primary outcome was to identify any knowledge deficiency within family and school personnel and the reasons behind knowledge gaps.

Results: Of the 128 screened schools, 30 (23%) were not informed by parents about their pupils' risk of anaphylaxis. Importantly, 113 (88%) of families and 42 (84%) of schools were unable to recognise the symptoms of anaphylaxis. Also, 67 (52%) of families and 22 (44%) of schools were not aware that a child should ideally have two EpiPen in case of a severe allergic reaction. The EpiPen had been used by 18 (14%) families and 5 (6%) schools.

Discussion: Communication among families and school personnel regarding anaphylaxis was suboptimal. Both parents and school personnel lacked key information in allergy management. Managing a child at risk of anaphylaxis requires effective communication among healthcare professionals, families and schools. There is an urgent need to improve knowledge of anaphylaxis and its management among families and school caregivers.
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http://dx.doi.org/10.1136/bmjpo-2017-000077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862213PMC
October 2017

In with acute bronchitis; out with duodenal perforation: the potentially harmful cascade of over-testing. A case report.

J Community Hosp Intern Med Perspect 2018 6;8(1):26-28. Epub 2018 Feb 6.

Department of Internal Medicine, UCSF/Fresno Internal Medicine Residency Program, Fresno, CA,USA.

Overutilization of diagnostic imaging can lead to unnecessary interventions and subsequently can jeopardize patient safety. When ordered, the results of these images should always be interpreted in the appropriate clinical context taking into consideration the patient clinical presentation and the natural history of the diseases which are being investigated. We presented a case that demonstrates for the practicing physicians how violating these two notions can lead ultimately to patient harm.
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http://dx.doi.org/10.1080/20009666.2018.1424486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804681PMC
February 2018

The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education.

Adv Med Educ Pract 2017 6;8:785-789. Epub 2017 Dec 6.

Department of Internal Medicine, Division of Hospital Medicine, UCSF/Fresno Center for Medical Education and Research, Fresno, CA, USA.

Background: The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine.

Materials And Methods: The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A survey disseminated at the end of the first year of its implementation examined the residents' perception of the educational value of this new teaching activity.

Results: Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching.

Conclusion: The survey results support the notion that teaching and learning with flat hierarchies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents' satisfaction.
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http://dx.doi.org/10.2147/AMEP.S149450DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5724516PMC
December 2017

Placental malaria and its effect on pregnancy outcomes in Sudanese women from Blue Nile State.

Malar J 2017 09 16;16(1):374. Epub 2017 Sep 16.

Sudanese National Academy of Sciences, Khartoum, Sudan.

Background: Malaria infection during pregnancy can result in placental malaria and is associated with adverse pregnancy outcomes particularly among primigravidae. The aim of this study was to assess the prevalence and risk factors for placental malaria and its effect on pregnancy outcomes in Blue Nile state, Sudan.

Methods: A cross-sectional hospital-based study was conducted consecutively during January 2012-December 2015 in three main hospitals in Blue Nile State, Sudan. At delivery, peripheral and placental blood samples were collected from consenting women. Finger prick blood was used for preparation of peripheral smears and for haemoglobin measurement. Smears were stained with Giemsa and examined microscopically for malaria parasites. Pregnancy outcomes in association to placental malaria were investigated.

Results: A total of 1149 mothers and their newborns were recruited. The mean (SD) of the age was 23.3 (5.2) years. Detection of malaria parasites was confirmed in 37.8% of the peripheral blood films and 59.3% of the placental films with Plasmodium falciparum as the only species detected. In multivariate analysis, younger age ≤23.2 years old (AOR = 3.2, 95% CI 1.9-5.5; P < 0.001), primiparae (AOR = 3.9, CI 2.1-7.6; P < 0.001), secundiparae (AOR = 2.8, 95% CI 1.5-5.1; P < 0.001, no antenatal care (ANC) visits (AOR = 11.9, 95% CI 7.8-18.1; P < 0.001) and not using bed nets (AOR = 3.5, 95% CI 1.7-6.8; P < 0.001) were risk factors for placental malaria. Education and residence were not associated with placental malaria infection. Placental malaria was significantly associated with maternal anaemia (AOR = 41.6, 95% CI 23.3-74.4; P < 0.001) and low birth weight (LBW) (AOR = 25.2, 95% CI 15.1-41.3; P < 0.001).

Conclusion: During the study, there was a high prevalence of placental malaria in Blue Nile State-Sudan, as the enhanced control activities were not practiced, leading to adverse pregnancy outcomes, such as maternal anaemia and LBW.
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http://dx.doi.org/10.1186/s12936-017-2028-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603062PMC
September 2017

Formation and properties of viscoelastic masses made from kafirin by a process of simple coacervation from solution in glacial acetic acid using water.

Food Chem 2018 Jan 22;239:333-342. Epub 2017 Jun 22.

Institute for Food, Nutrition and Well-being and Department of Food Science, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa. Electronic address:

Stable viscoelastic masses have been formed from kafirin in a mainly aqueous system. Kafirin was dissolved in glacial acetic acid (GAA) and simple coacervation was performed by rapid addition of 15°C water under low shear. Kafirin precipitated out as a network of hydrated fibrils which could be hand-kneaded into a viscoelastic mass. These could be formed from a very wide range of kafirins, including those where β- or γ-subclass expression was suppressed. Kafirin composition influenced the appearance of the masses but did not fundamentally affect stress-relaxation behaviour. Fresh kafirin masses exhibited similar elasticity and viscous flow balance to gluten. They maintained functionality when stored for several days at 10°C but their elastic component increased. FTIR showed that when kafirin was dissolved in GAA its α-helical conformation increased substantially. Dissociation of the kafirin molecules in GAA, assuming a α-helical conformation may have enhanced water binding, enabling viscoelastic mass formation.
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http://dx.doi.org/10.1016/j.foodchem.2017.06.114DOI Listing
January 2018

Success and survival conference: a novel idea to resonate an underutilized concept in medical education.

Int J Med Educ 2017 Jul 20;8:273-275. Epub 2017 Jul 20.

Department of Internal Medicine, Division of Hospital Medicine, UCSF/Fresno Center for Medical Education and Research, USA.

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http://dx.doi.org/10.5116/ijme.5969.c8ecDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572100PMC
July 2017

Physical examination checklist for medical students: can less be more?

Int J Med Educ 2017 Jun 12;8:227-228. Epub 2017 Jun 12.

UCSF Fresno Center for Medical Education and Research, Fresno, CA, USA.

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http://dx.doi.org/10.5116/ijme.591b.3022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5511743PMC
June 2017

Giant Ovarian Cyst Masquerading as Massive Ascites in an 11-Year-Old.

Case Rep Pediatr 2015 5;2015:878716. Epub 2015 Jul 5.

Hamad Medical Corporation, P.O. BOX 3050, Doha, Qatar.

We are presenting a unique case of an 11-year-old girl admitted for investigation of progressive abdominal distention of more than one-year duration. Due to the complete cystic nature of the mass and its enormous size, it was not visualized by the ultrasound and was reported as massive ascites. MRI and postoperative histopathology confirmed a diagnosis of giant serous cystadenoma of the right ovary. She underwent a right ovarian cystectomy with complete preservation of both ovaries and fallopian tubes and is doing well on outpatient follow-up.
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http://dx.doi.org/10.1155/2015/878716DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4506805PMC
August 2015

Fluorescence microscope (Cyscope) for malaria diagnosis in pregnant women in Medani Hospital, Sudan.

Diagn Pathol 2011 Sep 24;6:88. Epub 2011 Sep 24.

Federal Ministry of Health, P O Box 325, Khartoum, Sudan.

Background: Accuracy of diagnosis is the core for malaria control. Although microscopy is the gold standard in malaria diagnosis, its reliability is largely dependent on user skill. We compared performance of Cyscope fluorescence microscope with the Giemsa stained light microscopy for the diagnosis of malaria among pregnant women at Medani Hospital in Central Sudan. The area is characterized by unstable malaria transmission.

Methods: Socio-demographic characteristics and obstetrics history were gathered using pre-tested questionnaires. Blood samples were collected from febrile pregnant women who were referred as malaria case following initial diagnosis by general microscopist.

Results: During the study period 128 febrile pregnant women presented at the hospital. Among them, Plasmodium falciparum malaria was detected in 82 (64.1%) and 80 (62.5%) by the Giemsa-stained light microscopy and the Cyscope fluorescence microscope, respectively. The sensitivity of the Cyscope fluorescence microscope was 97.6% (95% CI: 92.2%-99.6%). Out of 46 which were negative by Giemsa-stained light microscopy, 5 were positive by the Cyscope fluorescence microscope. This is translated in specificity of 89.1% (95% CI: 77.5%-95.9%). The positive and negative predictive value of Cyscope fluorescence microscope was 94.1% (95% CI: 87.4% -97.8%) and 95.3% (95% CI: 85.4% - 99.2%), respectively.

Conclusion: This study has shown that Cyscope fluorescence microscope is a reliable diagnostic, sensitive and specific in diagnosing P. falciparum malaria among pregnant women in this setting. Further studies are needed to determine effectiveness in diagnosing other Plasmodium species and to compare it with other diagnostic tools e.g. rapid diagnostic tests and PCR.
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http://dx.doi.org/10.1186/1746-1596-6-88DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189106PMC
September 2011
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