Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertai...Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertain types of hearing loss among Sudanese rheumatoid arthritis patients attending rheumatology clinic in Omdurman military hospital and matching them with non-rheumatoid arthritis subjects. Methodology: This descriptive and analytic (comparative) hospital based cross sectional study conducted from October 2020 to April 2021 which include 66 RA patients with age range (21 - 60 years) matched with 41 non-rheumatoid arthritis group sharing same characteristics (nation, gender and age). Pure tone audiometry, tympanometry and acoustic reflexes were done for all RA patients and matched groups. Statistical analysis of the data was carried out using the association and correlation tests for associations and t-test for independent samples. Results: Thirty-six (54.5%) of RA patients had hearing impairment versus 9 (22%) non-RA in PTA test. Twenty-four RA cases (36.3%) showed asymmetrical hearing threshold and graph in PTA between right and left ears. Thirty-four (51.5%) right and 36 (54.5%) left ears were normal degree followed by 23 (34.8%) in the right and 24 (36.4%) in the left ears were mild degree hearing loss. Among hearing impaired RA patients;20 right ears (62.5%) and 19 left ears (65.5%) had sensorineural hearing loss (SNHL), conductive hearing loss 11 (34.4%) right ears and 9 (31%) left ears. Mixed HL was in 1 right ear (3.1%) and 1 left ear (3.5%). The most common degree of SNHL type was mild in (75%) and (78.9%) in right and left ears respectively, moderate and moderate severe were (20%) in the right and (15.7%) in the left ears. Fifty-eight right ears (87.9%) and 56 left ears (84.8%) had type A tympanogram while 7 (10.6%) right ears and 9 left ears (13.6%) were type As tympanogram, one right and one left ears had type Ad tympanogram. Acoustic reflex was impaired in 17 right ears and 17 left ears (25.8% for both). There were significant statistical differences in most of the specific frequency means between the study group and non-rheumatoid group in the right and left ears p-value 0.05). Also there was no significant statistical association between anti-rheumatic drugs used and hearing threshold of RA patients (p-value > 0.05). Conclusion: Hearing impairment especially sensorineural type is common in Sudanese rheumatoid arthritis patients. Conductive hearing loss is less common and most likely due to ossicles diarthrodial joint stiffness. No influence of the disease activity or used anti-rheumatic drugs on hearing threshold of the RA patients was detected in this study.展开更多
Background: Hypertension is a common chronic disease and an important public health problem. The prevention of complications depends on hypertension control. Aim: To assess blood pressure control, complication presenc...Background: Hypertension is a common chronic disease and an important public health problem. The prevention of complications depends on hypertension control. Aim: To assess blood pressure control, complication presence, and their influencing factors. Methods: This cross-sectional study was conducted on patients with hypertension attending a private medical facility, a governmental facility, and a primary health care center in Khartoum, Sudan, between September 2022 and February 2023. Statistical Package for Special Sciences version 25 was used for data analysis;frequency and percentage were used to describe the qualitative variables. A chi-square test was used for co-relation analysis;a P-value ≤ 0.05 was considered statistically significant, and the confidence interval was 95%. Results: The study included 250 participants;55.6% were males. Their age was 58.77 ± 6.80 years, and they had hypertension for 10.7 ± 8.51 years. The duration of the disease was 10.7 ± 8.51 years. Systolic blood pressure was 127.1 ± 11.3 mm hg, and diastolic blood pressure was 81.6 ± 7.1 mm hg. Of the participants, 76.4% had controlled hypertension, while 27.6% had complications due to hypertension. Controlled blood pressure was associated with females, age group 40 - 60 years, normal waist circumference, and high adherence level (P ≤ 0.05). The presence of complications was associated with males, participants older than 60 years, and a low adherence level (P ≤ 0.05). Conclusions: In Sudan, the level of control is good;nonetheless, not all patients achieve it. Availability and access to treatment facilities and medications should be improved. Proper patient counseling should be offered, as well as continuous care.展开更多
Background: Coronavirus disease 2019, otherwise known as COVID-19, emerged in December of 2019. COVID-19 spreads through an airborne transmission route. Preventive measures were described to help decrease the spread o...Background: Coronavirus disease 2019, otherwise known as COVID-19, emerged in December of 2019. COVID-19 spreads through an airborne transmission route. Preventive measures were described to help decrease the spread of COVID-19 worldwide. There were a number of preventive measures that were globally adopted: social distance of at least 1 meter, mask wearing, washing hands for 20 seconds, and covering the mouth and nose if the person sneezes or coughs. Methods: A descriptive cross-sectional study among 362 students from the International University of Africa, Sudan, was carried out between August 2021 and September 2022. Statistical Package for Social Sciences version 26 was used for data analysis;frequency and percentage were used to describe the qualitative variables. A chi-square test was used for association analysis;a P-value ≤ 0.05 was considered statistically significant. Results: Among study participants, the females were 70.9%;most were 20 - 23 years old (73.6%). 54.2% were vaccinated against COVID-19;83.6% had good knowledge regarding the mode of transmission, and 76.1% stayed in during quarantine. 80.6% of participants understood social distancing correctly. 76.1% of males and 45.1% of females started or completed vaccination (P ≤ 0.05). 51.4% of males and 81.3% of females adhered to preventive measures (P ≤ 0.05). Conclusions: It is important to target health education campaigns and interventions to improve adherence to preventive measures among university students. Although the pandemic is coming to an end, a lesson should be learned from it, and future preparation should be employed.展开更多
<strong>Background:</strong> Wilm’s tumour is a cancer of the kidneys that typically occurs in children younger than fifteen years of age and rarely in adults. With an early diagnosis and proper managemen...<strong>Background:</strong> Wilm’s tumour is a cancer of the kidneys that typically occurs in children younger than fifteen years of age and rarely in adults. With an early diagnosis and proper management of Wilm’s tumour by Multi-modal approach, excellent outcome can be obtained. This study was designed to reflect the clinical presentations and focus on different management modalities with an outcome of Wilm’s tumour in Sudan. <strong>Patients and methods:</strong> This descriptive, retro-prospective analytic study included all patients of Wilm’s tumour at Soba University Hospital, Gezira national paediatric surgery centre and Khartoum teaching Hospital from January 2014 to January 2016. <strong>Results:</strong> Thirty patients (pts) were included. Females were predominant in a ratio of 3: 1 to males. The mean age was 3.0 - 5.9 years. Those who came from central and western of Sudan were more affected. Most patients presented with abdominal mass 28 pts (93.3%), followed by abdominal distension in 16 pts (53.3%), while the less frequent presentation was haematuria seen only in 2 pts (6.7%). The multimodal approach: surgery and chemotherapy used in 21 pts (70%) and single modality was used in nine patients: surgery alone in 6 pts (20%), or chemotherapy alone in 3 pts (10%). The patients discharged uneventfully 23 pts (76%). Morbidity was seen in two patients. Deaths were occurred in five patients in the study (16.7%). <strong>Conclusion:</strong> The finding of this study reflected that Wilm’s tumour has an excellent outcome when patient was managed by multimodal approach.展开更多
Cytokines have been in focus of scientific in for more than decade now. Analyzing their expression has enabled a better understanding of pathogenesis of various diseases. Moreover, they are now for beyond their stage ...Cytokines have been in focus of scientific in for more than decade now. Analyzing their expression has enabled a better understanding of pathogenesis of various diseases. Moreover, they are now for beyond their stage when they were of interest for pathophysiological research. In the present study, we used an assay to anti-inflammatory cytokines. One hundred and thirty sera and urine from egg positive individuals and 42 samples of healthy individuals in Eldeum locality—an endemic area of S. haematobum and 28 healthy individuals from non-endemic area were tested. Concentration of IL5 and IL10 is reverse. IL5 is low in serum but high in urine before treatment and high in serum and low in urine after treatment. IL10 is high in serum, low in urine before treatment and low in serum, high in urine after treatment.展开更多
<strong>Background:</strong> The diverse modes in geographical locations, environmental factors, genetic and racial characteristics play a complex role in determining the pattern of neurological disorders ...<strong>Background:</strong> The diverse modes in geographical locations, environmental factors, genetic and racial characteristics play a complex role in determining the pattern of neurological disorders worldwide. Determining the pattern of neurological disorders enables health policymakers to plan evidently for service, training, and research priorities. Few prevalence studies in neurology were conducted in Sudan. <strong>Methods:</strong> This is a retrospective hospital-based study that reviewed the medical records of patients who attended a Dedicated Neurology Clinic (DNC) in Omdurman, the national Capital of Sudan, for 24 months, from January 2016 to January 2018. This study aimed to determine the DNC pattern of neurological disorders as a representative subset prevalence in Sudan. Neurologists conducted the medical workup for diagnosis after at least two visits. All patients have ethically consented. <strong>Results: </strong>The total number of patients was 1050. Only 749 patients (71.3%) fulfilled the inclusion criteria. The mean age was 46.5 ± 1.9, and males were 45.3%. 72% were from the Capital. The presenting symptoms were headache (16.6%), seizures (11.5%), limbs weakness (11.2%), and lower percentages for other neurological symptoms. The commonest diagnoses were Stroke 12.4%, Epilepsy 9.3%, Primary Headache 8.8%, Movement Disorders 7.3%, Peripheral Neuropathy 6%, Dementia 4% Neuroinfections 1.4%, Demyelinating Disorders 2.6%, Spinal Spondylotic Radiculopathy 2.6% and 1.7% for Cerebral Venous Thrombosis. <strong>Conclusion:</strong> The data from Sudan-DNC showed that the most common neurological disorders descendingly were Stroke, Epilepsy, Headache, Movement Disorders, Peripheral Neuropathy, Dementia, Infections, Demyelinating Disorders, Spinal Spondylotic Radiculopathy, and Cerebral Venous Thrombosis. The demyelinating disorders and peripheral neuropathy showed a higher percentage than our previous preliminary prevalence study in 2012 compared to the other conditions, which showed similar rates in that study.展开更多
Background: Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical i...Background: Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical interventions. Severely neglected clubfoot rarely exists today in developed countries, except in some emigrants from low- and middle-income countries. Acute surgical management with corrective mid-foot osteotomy and elongation of the Achilles tendon has an excellent functional outcome. Objective: To assess the functional outcome of acute correction of neglected Talipes-quinoa-varus deformity in adults. Methods: This is a cross-sectional, hospital–based multi-centric study. Forty patients were included in this study. Midfoot osteotomy and elongation of the Achilles tendon were performed on all patients. Data was collected using a questionnaire and the functional outcome has been assessed using the American Orthopedic Foot and Ankle Society Score (AOFAS). This score was measured before surgery and one year after surgery. Results: the mean age was 19.9 ± 4.7 years. Males were 25 (62.5%) and females were 15 (37.5%). The mean preoperative AOFAS score was 37.7 ± 7.1 (poor). This score improved to 80.7 ± 13.7 (good to excellent), two years after surgery. However, this indicates a significant change in the functional outcome after the operation (p value Conclusion: acute correction of neglected and relapsed TEV with elongation of the Achilles tendon and single midfoot osteotomy has excellent functional outcome as assessed by AOFAS Score. The satisfaction with this procedure is impressive. The younger age population showed better outcomes with this procedure.展开更多
Introduction: Rhabdomyolysis is severe and life threating condition in which skeletal muscles are damaged by dissolution of striped muscles. Acute kidney injury (AKI) has been widely reported (13% - 50%) as a complica...Introduction: Rhabdomyolysis is severe and life threating condition in which skeletal muscles are damaged by dissolution of striped muscles. Acute kidney injury (AKI) has been widely reported (13% - 50%) as a complication of Rhabdomyolysis in which the main pathophysiological mechanisms are intra-renal vasoconstriction, intraluminal cast formation (Tamm-Horsefall) and direct myoglobin toxicity. In this report we are going to describe the management of Acute Kidney Injury due to Rhabdomyolysis that is not responding to vigorous rehydration. Objective: Reporting about acute renal failure induced by Rhabdomyolysis due to Excessive Exercise and dehydration in young patient. Case Report: A 20 years male came to the outpatient clinic complaining of sever lower limb pain, back pain and vomiting. He was anuric and hypertensive (BP = 150/90 mmHg) with serum creatinine and urea levels of 15.72 mg/dl and 235 mg/dl, respectively. The diagnosis was based on the laboratory finding of creatine kinase = 3127 IU/l. The patient, then, has been referred to the emergency department. The Management plan was based on two arms: Emergency Management with Urgent Hemodialysis for AKI and high fluid replacement therapy. Patient started to recover after three hemodialysis sessions but the peak of recovery was noted after starting manual fluid replacement therapy with a target urine output of greater than 2 ml/kg, a urine pH of greater than 6. Manual fluid replacement therapy consisted of loop diuretics, intravenous fluids and intravenous sodium bicarbonate 1.26%. Full recovery was noted after one month of hospital admission with inpatient care and regular follow-up. A follow-up after one month has been set to assess the patient progression and monitor his kidney functions. Relevance and Impact: Home messages and lessons are;Firstly, young adults are vulnerable to Rhabdomyolysis, second, the diagnosis of Rhabdomyolysis can be made on the clinical bases but a confirmatory laboratory test of Creatine Kinase is mandatory, and lastly’ acute kidney injury needs to be treated urgently. Also, reducing the risk of infection is one of the management objectives to achieve recovery.展开更多
Background: Hindfoot fusion, is a fusion of the talonavicular, talocalcaneal, and calcaneocuboid joints and is commonly performed for patients complaining of pain, chronic instability and gross deformity as a result o...Background: Hindfoot fusion, is a fusion of the talonavicular, talocalcaneal, and calcaneocuboid joints and is commonly performed for patients complaining of pain, chronic instability and gross deformity as a result of hindfoot pathology. Objective: This study aimed to assess the functional outcomes of the patients underwent hindfoot fusion, the post-operative complications and patient’s satisfaction. Methodology: This study is a prospective cohort study was conducted in Future hospital, in Khartoum, Sudan. It involved 30 patients from July 2015-July 2022. Data was collected by the primary researcher using data collection sheet, then it was cleaned and entered into Microsoft excel data sheet and was analysed using SPSS version 28 software. Results: 33.3% of the patients are aged 51 - 60 years, and >60 years. Male: Female equals 1:1. 56.7% are for the left side, only 23.3% developed complications. 63.3% patients are fully satisfied. There is a significant correlation between the AOFAS score before and after the operation. Also, a significant correlation between the means of AOFAS score after with the complications and the satisfaction of the patients. Conclusion: Minimally invasive tibio-talo-calcaneal is an alternative procedure for the treatment of severe Charcot arthropathy of the ankle. The expected functional outcome is impressive and comparable with the open surgery. However, the post-operative complications are prevalent in 23.3% of patients. Most candidates are fully satisfied with the procedure.展开更多
Background: Cannabis can be associated with short-term and long-term adverse effects such as psychotic states, risk of dependence, provoking relapse and aggravating existing psychotic symptoms. Aim: The current study ...Background: Cannabis can be associated with short-term and long-term adverse effects such as psychotic states, risk of dependence, provoking relapse and aggravating existing psychotic symptoms. Aim: The current study is a descriptive cross-sectional hospital based study that aims to identify the prevalence and correlates of cannabis use among patients with mental illness. Methods: The study was conducted in two outpatient psychiatry clinics in Khartoum (Sudan). The sample size was 348 consecutive patients over 2 months’ study period. Clinical and sociodemographic characteristics were documented. Descriptive statistics was used to describe the data variables, and tabulated tables were used to calculate chi-square test for categorical data and the significance was set at p Results: A total of 96 participants (27.6%) had history of cannabis abuse;all of them were male patients. The majority (51%) started to use cannabis between 10 - 19 years of age, and most of them (86.6%) had a duration of less than five years of using cannabis. Psychiatric symptoms occurred after starting cannabis use in 17.7% of cases. We found a statistically significant difference related to age when comparing the age of cannabis users and non-users (p = 0.0239). The majority of patients with comorbid mental illness and cannabis abuse (89.5%) were below the age of 40 years. There was also statistically significant association between educational level achieved and history of using cannabis (p = 0.00001). Those with history of cannabis are more likely to be manual laborers (46.9%), and those with no history of cannabis were mostly unemployed (44%), indicating significant influence of employment history (p = 0.0064). The relation between using cannabis and the clinical psychiatric diagnosis was not statically significant (p = 0.125). Conclusion: Cannabis use is highly prevalent among people with mental illness. It is related to age, educational level and type of work.展开更多
Introduction: The burden of prostatic cancer is rising in Sudan. Usually, they present late in their disease with urinary tract obstruction, hematuria, bony pain, or cachexia because there is no screening program. Her...Introduction: The burden of prostatic cancer is rising in Sudan. Usually, they present late in their disease with urinary tract obstruction, hematuria, bony pain, or cachexia because there is no screening program. Here we present a patient with prostatic cancer who presented with left axillary mass as his main concern. Case Description: 82-year-old Sudanese male presented with a left axillary and left supraclavicular lymphadenopathy of a few months’ duration. He underwent a decisional biopsy which showed metastatic adenocarcinoma. Upper and lower GI endoscopy were performed but the latter was complicated by a sigmoid perforation with peritonitis. During laparatomy, multiple enlarged pelvic lymphnodes were encountered and a biopsy result suggested a metastatic prostatic neoplasm. Later, prostatic biopsy confirmed the diagnosis. The patient was treated with bilateral orchidectomy. Clinical discussion: Lymphatic metastasis to axillary lymph nodes is a very rare manifestation of prostate cancer and only a few cases have been reported in the literature. It can cause diagnostic difficulty since prostate cancer typically metastasis to the pelvic lymph node and very rarely involves he supradiaphragmatic lymph node. Conclusion: Metastatic prostatic carcinoma should be considered among the causes of supra-diaphragmatic lymph adenopathy. Careful physical and imaging examinations combined with PSA and pathological analysis are essential in the diagnosis of advanced prostate cancer with unusual presentation.展开更多
Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However,...Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.展开更多
文摘Background: Rheumatoid arthritis (RA) disease is one of the most common chronic autoimmune diseases that affect many body systems including the auditory system. Objectives: To assess hearing thresholds and to ascertain types of hearing loss among Sudanese rheumatoid arthritis patients attending rheumatology clinic in Omdurman military hospital and matching them with non-rheumatoid arthritis subjects. Methodology: This descriptive and analytic (comparative) hospital based cross sectional study conducted from October 2020 to April 2021 which include 66 RA patients with age range (21 - 60 years) matched with 41 non-rheumatoid arthritis group sharing same characteristics (nation, gender and age). Pure tone audiometry, tympanometry and acoustic reflexes were done for all RA patients and matched groups. Statistical analysis of the data was carried out using the association and correlation tests for associations and t-test for independent samples. Results: Thirty-six (54.5%) of RA patients had hearing impairment versus 9 (22%) non-RA in PTA test. Twenty-four RA cases (36.3%) showed asymmetrical hearing threshold and graph in PTA between right and left ears. Thirty-four (51.5%) right and 36 (54.5%) left ears were normal degree followed by 23 (34.8%) in the right and 24 (36.4%) in the left ears were mild degree hearing loss. Among hearing impaired RA patients;20 right ears (62.5%) and 19 left ears (65.5%) had sensorineural hearing loss (SNHL), conductive hearing loss 11 (34.4%) right ears and 9 (31%) left ears. Mixed HL was in 1 right ear (3.1%) and 1 left ear (3.5%). The most common degree of SNHL type was mild in (75%) and (78.9%) in right and left ears respectively, moderate and moderate severe were (20%) in the right and (15.7%) in the left ears. Fifty-eight right ears (87.9%) and 56 left ears (84.8%) had type A tympanogram while 7 (10.6%) right ears and 9 left ears (13.6%) were type As tympanogram, one right and one left ears had type Ad tympanogram. Acoustic reflex was impaired in 17 right ears and 17 left ears (25.8% for both). There were significant statistical differences in most of the specific frequency means between the study group and non-rheumatoid group in the right and left ears p-value 0.05). Also there was no significant statistical association between anti-rheumatic drugs used and hearing threshold of RA patients (p-value > 0.05). Conclusion: Hearing impairment especially sensorineural type is common in Sudanese rheumatoid arthritis patients. Conductive hearing loss is less common and most likely due to ossicles diarthrodial joint stiffness. No influence of the disease activity or used anti-rheumatic drugs on hearing threshold of the RA patients was detected in this study.
文摘Background: Hypertension is a common chronic disease and an important public health problem. The prevention of complications depends on hypertension control. Aim: To assess blood pressure control, complication presence, and their influencing factors. Methods: This cross-sectional study was conducted on patients with hypertension attending a private medical facility, a governmental facility, and a primary health care center in Khartoum, Sudan, between September 2022 and February 2023. Statistical Package for Special Sciences version 25 was used for data analysis;frequency and percentage were used to describe the qualitative variables. A chi-square test was used for co-relation analysis;a P-value ≤ 0.05 was considered statistically significant, and the confidence interval was 95%. Results: The study included 250 participants;55.6% were males. Their age was 58.77 ± 6.80 years, and they had hypertension for 10.7 ± 8.51 years. The duration of the disease was 10.7 ± 8.51 years. Systolic blood pressure was 127.1 ± 11.3 mm hg, and diastolic blood pressure was 81.6 ± 7.1 mm hg. Of the participants, 76.4% had controlled hypertension, while 27.6% had complications due to hypertension. Controlled blood pressure was associated with females, age group 40 - 60 years, normal waist circumference, and high adherence level (P ≤ 0.05). The presence of complications was associated with males, participants older than 60 years, and a low adherence level (P ≤ 0.05). Conclusions: In Sudan, the level of control is good;nonetheless, not all patients achieve it. Availability and access to treatment facilities and medications should be improved. Proper patient counseling should be offered, as well as continuous care.
文摘Background: Coronavirus disease 2019, otherwise known as COVID-19, emerged in December of 2019. COVID-19 spreads through an airborne transmission route. Preventive measures were described to help decrease the spread of COVID-19 worldwide. There were a number of preventive measures that were globally adopted: social distance of at least 1 meter, mask wearing, washing hands for 20 seconds, and covering the mouth and nose if the person sneezes or coughs. Methods: A descriptive cross-sectional study among 362 students from the International University of Africa, Sudan, was carried out between August 2021 and September 2022. Statistical Package for Social Sciences version 26 was used for data analysis;frequency and percentage were used to describe the qualitative variables. A chi-square test was used for association analysis;a P-value ≤ 0.05 was considered statistically significant. Results: Among study participants, the females were 70.9%;most were 20 - 23 years old (73.6%). 54.2% were vaccinated against COVID-19;83.6% had good knowledge regarding the mode of transmission, and 76.1% stayed in during quarantine. 80.6% of participants understood social distancing correctly. 76.1% of males and 45.1% of females started or completed vaccination (P ≤ 0.05). 51.4% of males and 81.3% of females adhered to preventive measures (P ≤ 0.05). Conclusions: It is important to target health education campaigns and interventions to improve adherence to preventive measures among university students. Although the pandemic is coming to an end, a lesson should be learned from it, and future preparation should be employed.
文摘<strong>Background:</strong> Wilm’s tumour is a cancer of the kidneys that typically occurs in children younger than fifteen years of age and rarely in adults. With an early diagnosis and proper management of Wilm’s tumour by Multi-modal approach, excellent outcome can be obtained. This study was designed to reflect the clinical presentations and focus on different management modalities with an outcome of Wilm’s tumour in Sudan. <strong>Patients and methods:</strong> This descriptive, retro-prospective analytic study included all patients of Wilm’s tumour at Soba University Hospital, Gezira national paediatric surgery centre and Khartoum teaching Hospital from January 2014 to January 2016. <strong>Results:</strong> Thirty patients (pts) were included. Females were predominant in a ratio of 3: 1 to males. The mean age was 3.0 - 5.9 years. Those who came from central and western of Sudan were more affected. Most patients presented with abdominal mass 28 pts (93.3%), followed by abdominal distension in 16 pts (53.3%), while the less frequent presentation was haematuria seen only in 2 pts (6.7%). The multimodal approach: surgery and chemotherapy used in 21 pts (70%) and single modality was used in nine patients: surgery alone in 6 pts (20%), or chemotherapy alone in 3 pts (10%). The patients discharged uneventfully 23 pts (76%). Morbidity was seen in two patients. Deaths were occurred in five patients in the study (16.7%). <strong>Conclusion:</strong> The finding of this study reflected that Wilm’s tumour has an excellent outcome when patient was managed by multimodal approach.
文摘Cytokines have been in focus of scientific in for more than decade now. Analyzing their expression has enabled a better understanding of pathogenesis of various diseases. Moreover, they are now for beyond their stage when they were of interest for pathophysiological research. In the present study, we used an assay to anti-inflammatory cytokines. One hundred and thirty sera and urine from egg positive individuals and 42 samples of healthy individuals in Eldeum locality—an endemic area of S. haematobum and 28 healthy individuals from non-endemic area were tested. Concentration of IL5 and IL10 is reverse. IL5 is low in serum but high in urine before treatment and high in serum and low in urine after treatment. IL10 is high in serum, low in urine before treatment and low in serum, high in urine after treatment.
文摘<strong>Background:</strong> The diverse modes in geographical locations, environmental factors, genetic and racial characteristics play a complex role in determining the pattern of neurological disorders worldwide. Determining the pattern of neurological disorders enables health policymakers to plan evidently for service, training, and research priorities. Few prevalence studies in neurology were conducted in Sudan. <strong>Methods:</strong> This is a retrospective hospital-based study that reviewed the medical records of patients who attended a Dedicated Neurology Clinic (DNC) in Omdurman, the national Capital of Sudan, for 24 months, from January 2016 to January 2018. This study aimed to determine the DNC pattern of neurological disorders as a representative subset prevalence in Sudan. Neurologists conducted the medical workup for diagnosis after at least two visits. All patients have ethically consented. <strong>Results: </strong>The total number of patients was 1050. Only 749 patients (71.3%) fulfilled the inclusion criteria. The mean age was 46.5 ± 1.9, and males were 45.3%. 72% were from the Capital. The presenting symptoms were headache (16.6%), seizures (11.5%), limbs weakness (11.2%), and lower percentages for other neurological symptoms. The commonest diagnoses were Stroke 12.4%, Epilepsy 9.3%, Primary Headache 8.8%, Movement Disorders 7.3%, Peripheral Neuropathy 6%, Dementia 4% Neuroinfections 1.4%, Demyelinating Disorders 2.6%, Spinal Spondylotic Radiculopathy 2.6% and 1.7% for Cerebral Venous Thrombosis. <strong>Conclusion:</strong> The data from Sudan-DNC showed that the most common neurological disorders descendingly were Stroke, Epilepsy, Headache, Movement Disorders, Peripheral Neuropathy, Dementia, Infections, Demyelinating Disorders, Spinal Spondylotic Radiculopathy, and Cerebral Venous Thrombosis. The demyelinating disorders and peripheral neuropathy showed a higher percentage than our previous preliminary prevalence study in 2012 compared to the other conditions, which showed similar rates in that study.
文摘Background: Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical interventions. Severely neglected clubfoot rarely exists today in developed countries, except in some emigrants from low- and middle-income countries. Acute surgical management with corrective mid-foot osteotomy and elongation of the Achilles tendon has an excellent functional outcome. Objective: To assess the functional outcome of acute correction of neglected Talipes-quinoa-varus deformity in adults. Methods: This is a cross-sectional, hospital–based multi-centric study. Forty patients were included in this study. Midfoot osteotomy and elongation of the Achilles tendon were performed on all patients. Data was collected using a questionnaire and the functional outcome has been assessed using the American Orthopedic Foot and Ankle Society Score (AOFAS). This score was measured before surgery and one year after surgery. Results: the mean age was 19.9 ± 4.7 years. Males were 25 (62.5%) and females were 15 (37.5%). The mean preoperative AOFAS score was 37.7 ± 7.1 (poor). This score improved to 80.7 ± 13.7 (good to excellent), two years after surgery. However, this indicates a significant change in the functional outcome after the operation (p value Conclusion: acute correction of neglected and relapsed TEV with elongation of the Achilles tendon and single midfoot osteotomy has excellent functional outcome as assessed by AOFAS Score. The satisfaction with this procedure is impressive. The younger age population showed better outcomes with this procedure.
文摘Introduction: Rhabdomyolysis is severe and life threating condition in which skeletal muscles are damaged by dissolution of striped muscles. Acute kidney injury (AKI) has been widely reported (13% - 50%) as a complication of Rhabdomyolysis in which the main pathophysiological mechanisms are intra-renal vasoconstriction, intraluminal cast formation (Tamm-Horsefall) and direct myoglobin toxicity. In this report we are going to describe the management of Acute Kidney Injury due to Rhabdomyolysis that is not responding to vigorous rehydration. Objective: Reporting about acute renal failure induced by Rhabdomyolysis due to Excessive Exercise and dehydration in young patient. Case Report: A 20 years male came to the outpatient clinic complaining of sever lower limb pain, back pain and vomiting. He was anuric and hypertensive (BP = 150/90 mmHg) with serum creatinine and urea levels of 15.72 mg/dl and 235 mg/dl, respectively. The diagnosis was based on the laboratory finding of creatine kinase = 3127 IU/l. The patient, then, has been referred to the emergency department. The Management plan was based on two arms: Emergency Management with Urgent Hemodialysis for AKI and high fluid replacement therapy. Patient started to recover after three hemodialysis sessions but the peak of recovery was noted after starting manual fluid replacement therapy with a target urine output of greater than 2 ml/kg, a urine pH of greater than 6. Manual fluid replacement therapy consisted of loop diuretics, intravenous fluids and intravenous sodium bicarbonate 1.26%. Full recovery was noted after one month of hospital admission with inpatient care and regular follow-up. A follow-up after one month has been set to assess the patient progression and monitor his kidney functions. Relevance and Impact: Home messages and lessons are;Firstly, young adults are vulnerable to Rhabdomyolysis, second, the diagnosis of Rhabdomyolysis can be made on the clinical bases but a confirmatory laboratory test of Creatine Kinase is mandatory, and lastly’ acute kidney injury needs to be treated urgently. Also, reducing the risk of infection is one of the management objectives to achieve recovery.
文摘Background: Hindfoot fusion, is a fusion of the talonavicular, talocalcaneal, and calcaneocuboid joints and is commonly performed for patients complaining of pain, chronic instability and gross deformity as a result of hindfoot pathology. Objective: This study aimed to assess the functional outcomes of the patients underwent hindfoot fusion, the post-operative complications and patient’s satisfaction. Methodology: This study is a prospective cohort study was conducted in Future hospital, in Khartoum, Sudan. It involved 30 patients from July 2015-July 2022. Data was collected by the primary researcher using data collection sheet, then it was cleaned and entered into Microsoft excel data sheet and was analysed using SPSS version 28 software. Results: 33.3% of the patients are aged 51 - 60 years, and >60 years. Male: Female equals 1:1. 56.7% are for the left side, only 23.3% developed complications. 63.3% patients are fully satisfied. There is a significant correlation between the AOFAS score before and after the operation. Also, a significant correlation between the means of AOFAS score after with the complications and the satisfaction of the patients. Conclusion: Minimally invasive tibio-talo-calcaneal is an alternative procedure for the treatment of severe Charcot arthropathy of the ankle. The expected functional outcome is impressive and comparable with the open surgery. However, the post-operative complications are prevalent in 23.3% of patients. Most candidates are fully satisfied with the procedure.
文摘Background: Cannabis can be associated with short-term and long-term adverse effects such as psychotic states, risk of dependence, provoking relapse and aggravating existing psychotic symptoms. Aim: The current study is a descriptive cross-sectional hospital based study that aims to identify the prevalence and correlates of cannabis use among patients with mental illness. Methods: The study was conducted in two outpatient psychiatry clinics in Khartoum (Sudan). The sample size was 348 consecutive patients over 2 months’ study period. Clinical and sociodemographic characteristics were documented. Descriptive statistics was used to describe the data variables, and tabulated tables were used to calculate chi-square test for categorical data and the significance was set at p Results: A total of 96 participants (27.6%) had history of cannabis abuse;all of them were male patients. The majority (51%) started to use cannabis between 10 - 19 years of age, and most of them (86.6%) had a duration of less than five years of using cannabis. Psychiatric symptoms occurred after starting cannabis use in 17.7% of cases. We found a statistically significant difference related to age when comparing the age of cannabis users and non-users (p = 0.0239). The majority of patients with comorbid mental illness and cannabis abuse (89.5%) were below the age of 40 years. There was also statistically significant association between educational level achieved and history of using cannabis (p = 0.00001). Those with history of cannabis are more likely to be manual laborers (46.9%), and those with no history of cannabis were mostly unemployed (44%), indicating significant influence of employment history (p = 0.0064). The relation between using cannabis and the clinical psychiatric diagnosis was not statically significant (p = 0.125). Conclusion: Cannabis use is highly prevalent among people with mental illness. It is related to age, educational level and type of work.
文摘Introduction: The burden of prostatic cancer is rising in Sudan. Usually, they present late in their disease with urinary tract obstruction, hematuria, bony pain, or cachexia because there is no screening program. Here we present a patient with prostatic cancer who presented with left axillary mass as his main concern. Case Description: 82-year-old Sudanese male presented with a left axillary and left supraclavicular lymphadenopathy of a few months’ duration. He underwent a decisional biopsy which showed metastatic adenocarcinoma. Upper and lower GI endoscopy were performed but the latter was complicated by a sigmoid perforation with peritonitis. During laparatomy, multiple enlarged pelvic lymphnodes were encountered and a biopsy result suggested a metastatic prostatic neoplasm. Later, prostatic biopsy confirmed the diagnosis. The patient was treated with bilateral orchidectomy. Clinical discussion: Lymphatic metastasis to axillary lymph nodes is a very rare manifestation of prostate cancer and only a few cases have been reported in the literature. It can cause diagnostic difficulty since prostate cancer typically metastasis to the pelvic lymph node and very rarely involves he supradiaphragmatic lymph node. Conclusion: Metastatic prostatic carcinoma should be considered among the causes of supra-diaphragmatic lymph adenopathy. Careful physical and imaging examinations combined with PSA and pathological analysis are essential in the diagnosis of advanced prostate cancer with unusual presentation.
文摘Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.
