Sero-molecular Epidemiology of Hepatitis E Virus in Blood Donors, Gezira State, Sudan: A Cross-sectional Study

Background: Hepatitis E virus (HEV) is a hepatotropic pathogen that causes significant morbidity and mortality in humans. It is an important causative agent of viral hepatitis outbreaks. This study investigates the serological and molecular prevalence of HEV in blood donors attending the Central Blood Bank in Wad Medani City in Gezira State, Sudan. Methods: The study adopted a cross-sectional descriptive design. A structured questionnaire was used to collect data concerning demographic information and risk factors associated with HEV transmission. All enrolled participants (N = 300) were screened for HEV IgG antibodies using commercial ELISA kits, then strong positive samples (N = 84) were selected and rescreened for HEV IgM and HEV RNA by RT PCR. SPSS version 24.0 was used for analysis. Results: Out of 300 male participants, 36.3% (109/300) were positive for HEV IgG. However, only one participant was IgM positive, while the HEV RNA was negative. The highest prevalence rates of the virus were 42 (44.6%) among the age group of 31­40 years, 20 (48.8%) in those who consumed food from outside, 13 (50%) in three to four multiple blood donations, and 5 (62.5%) in those who consumed water from the river source. A significant association of HEV IgG prevalence concerning the occupation of the participants being students or farmers was detected using univariate and multivariate analysis (P-value = 0.007).

Assessment of the prevalence of abnormal hysteroscopic findings in infertile women undergoing ART

Background: The endometrium plays an important role in implantation of good quality embryos in ART. Many studies have proved the negative impact of intra uterine pathologies on reproductive outcome whether spontaneous pregnancy or ART, because uterine anomalies may be associated with many obstetric complications such as miscarriage, preterm birth, premature rupture of membrane, malpresentation, postpartum bleeding and retained placenta. Aim of the work: This study aims to assess the prevalence of abnormal hysteroscopic findings among infertile women undergoing ART at Ain Shams Maternity University Hospital over the period from January 2007 to January 2017. Patients and Methods: This descriptive retrospective study was carried out on infertile couples planned for ART who were sent to ECDU for hysteroscopy in Early Cancer Detection Unit (ECDU), Ain Shams University Maternity Hospital. Case reports From January 2007 to January 2017 were reviewed. Results: The most prevalent congenital abnormality was endometrial polyp (18.4%) followed by uterine septum (6.9%). Conclusion: This study concluded that the most common uterine abnormality was endometrial polyp (18.4%), followed by uterine septum in 6.9% of patients. Also, thick endometrium was very common with a prevalence of 12.9%. Therefore, based on this high prevalence of abnormalities, this study is in agreement with the opinion that all women should be offered hysteroscopy, even if they have normal vaginal ultrasound and hysterosalpingography, because this is supposed to increase the detection rate of minor abnormalities, which theoretically will improve the reproductive outcome. Still, further interventional randomized controlled trials (RCT) are needed to verify the positive impact of routine use of hysteroscopy prior to ART

Périchondrites aiguës du pavillon de l'oreille. A propos de 23 cas

Objectifs : Notre objectif était d'évaluer les facteurs étiologiques, les agents pathogènes, le traitement et les séquelles des périchondrites. Patients et méthodes : Il s'agit d'une étude rétrospective, sur une période de 8 ans (janvier 2009 à décembre 2016), portant sur les cas de périchondrite aiguë au service d'ORL du CHNU de Fann. Résultats : Vingt-deux dossiers ont été colligés avec un cas de périchondrite bilatérale. Le sex-ratio était de 0.37 ; l'âge moyen de 27 ans. La durée d'évolution moyenne était de 23 jours. La circonstance de survenue était un piercing dans 36% des cas. Dix-neuf de nos patients présentaient une périchondrite collectée, soit 86% des cas. Quinze de nos patients avaient bénéficié d'un examen bactériologique de pus, soit 68% des cas. Le Pseudomonas aeruginosa était retrouvé dans 66.6% des cas, sensible dans 90% des cas à la ciprofloxacine et dans 10% des cas aux aminosides. La culture était négative dans 26.6% des cas. La durée moyenne d'hospitalisation était de 7 jours ; la durée moyenne du traitement de 13 jours. L'évolution était satisfaisante chez tous nos patients, avec une absence de séquelles dans 72.7% des cas. Conclusion : La périchondrite aiguë du pavillon de l'oreille se développe souvent suite à un traumatisme externe mineur. Le Pseudomonas aeruginosa représente le principal agent causal d'où l'intérêt d'une antibiothérapie probabiliste active sur ce dernier. Un traitement précoce permet de prévenir les séquelles morphologiques inesthétiques

The use of a documentary drama film to improve the knowledge, attitude and practice of an endemic village population towards mycetoma at Sennar State, Sudan

Background: Mycetoma is a badly neglected tropical disease, characterised by enormous deformities, disfigurement and disabilities if untreated early. Frequently, the majority of the mycetoma patients present late with advanced disease, and the only available treatment for them will be amputation of the affected part. Aim: This study aimed at producing a health promoting film to be used to improve the knowledge, attitude and practice (KAP) of a targeted population in one of the mycetoma endemic villages at Sennar State, Sudan.Materials and Methods : A 26 - minute drama film on a mycetoma patient journey from a small painless mass to advanced disease till lower limb amputation due to missinformation and negligence was performed. Professional actors and cinema work team were employed in the film production. It was filmed in one of the mycetoma endemic areas. A cohort of 250 individuals from two mycetoma endemic villages were included in this study. A closed ended pre-designed questionnaire was used to collect data from the targeted population. The collected data included demographic characteristics, knowledge, attitudes and practices towards mycetoma. The data was collected before and after the film was shown.Results: In this study, 218/250 responded to the questionnare with a response rate of 87%. Fifty-five percent of the respondents were males, 21.6% were farmers, 29.4% were students and 29.4% were unemployed.The film had improved the KAP of the targeted population hence it can be used as a health educational material in other mycetoma endemic areas in the Sudan

Paralysie récurrentielle bilatérale : l'aryténoïdopexie est-elle toujours compétitive ?

Introduction : La Paralysie Récurrentielle (PR) bilatérale en adduction est une situation clinique dramatique. Le traitement repose sur la chirurgie par voie endoscopique couplée au laser. Ce procédé thérapeutique est inaccessible dans beaucoup de pays en développement. La chirurgie par voie externe peut-elle constituer une alternative ? Matériel et méthodes : Nous avons mené une étude rétrospective portant sur 20 patients, porteurs d'une PR bilatérale en adduction post-thyroïdectomie, sur une période de 12 ans. Tous les malades ont été traités par abord chirurgical cervical externe. L'appréciation des résultats se faisait sur la possibilité de décanulation et la qualité de la voix.Résultats : Tous les malades étaient de sexe féminin avec un âge moyen de 43 ans. La PR était une complication de la thyroïdectomie totale dans 85% des cas et subtotale dans 15% des cas. L'abord latéral du larynx nous a permis de réaliser 16 aryténoïdopexies selon King et 2 aryténoïdectomies associées à une cordopexie selon Graaf Woodman. L'abord antérieur par thyrotomie, effectué dans 4 cas, a permis de réaliser une aryténoïdectomie dans 1 cas et une cordo-aryténoïdectomie dans 3 cas. La décanulation a été effective chez tous les malades après un délai moyen de 30 jours. Après analyse perceptuelle, chez 11 patients, la qualité de la voix était jugée bonne dans 4cas (36.63%), passable dans 2 (18.18%) et mauvaise dans 5 (45.46%).Conclusion : Nos résultats sont satisfaisants et comparables à ceux des séries des pays développés, usant des procédés endoscopiques au laser

Relationship between Age; Radiographic Normal Heart Size and Cardio-Thoracic Ratio in a Nigerian Population

Background: Cardio-vascular disease (CVD) is now on the increase. The precise diagnosis of CVD is of immense clinical importance to the cardiac surgeons; pathologist and also for cardiologists. However; information on normal values for various cardio-vascular structures in Nigeria; a country with the highest population of blacks in the world is sparse. In this regard the age-related radiographic sizes of a Nigerian cohort of patients with non-cardiogenic complaints or consultations were therefore assessed.Objectives: To evaluate the limits of normal cardiac size in our environment ; determine if there was a relationship between the age and size of the heart and to evaluate the relationship between sex and cardiac size and cardio-thoracic ratio.Design: A cross-sectional study.Setting: The Radiology department of University of Ilorin Teaching Hospital; Ilorin; North Central Nigeria between January to June 2012.Subjects: One Hundred patients were consecutively recruited and their chest radiographs examined after fulfilling the inclusion criteria.Results: Males accounted for 55% of the study population. The age range was 1 month to 73 years; (Mean = 29.3; SD =2.41668). The mean cardiac size was 11.7cm. The average cardiac size for adult males and females; were 11.6cm and 11.5cm respectively while that of thoracic size was 29.0cm and 26.8cm respectively. Correlation between age and cardiac size was 0.66; age and thoracic size was 0.64 and between cardiac size and thoracic size was 0.89. The paired sample t-test for age and cardiac size was less than 0.05 (p value 0.05).Conclusion: knowing the average values of cardiac size for adult males and females (11.6cm and 11.5cm) and thoracic size (29.0cm and 26.8cm) respectively from this study presents a base line for early detection of variation from normal cardiac measurements in this environment

Morphological Variation of Third Ventricle Using Computerized Tomography among Different Gender and Age Groups: A 5-Year Retrospective Study in Usmanu Danfodiyo University Teaching Hospital; Sokoto; North - West Nigeria

Background: Many methods have been described for measurements of the third ventricle as a means of evaluating brain atrophy during the normal aging process and disease. Enlargement of the cerebral ventricles is one of the most frequently replicated neurobiological findings in schizophrenia. The aim of this morphological study was to examine the range in the normal size of the third ventricle of individuals living in Sokoto and to assess its association with gender and age. Materials and Methods: All available brain CT in the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto; Nigeria; from 2007 to 2012 (a 5-year period) and reported as normal by the radiologist were recruited for the study. Films were viewed on the computer monitor. Measurements were made with Dragon V 3.1.1 Philips and Neusoft Medical System Company Limited software; the software provides a meter rule with which measurements were done. Results: A total of 252 CT scan images where used in the study. Of this number; 156 (61.9) were CT scan images of males and 96 (38.1) were CT scan images of females. The mean width was 8.38 mm and mean anteroposterior length was 12.16 mm. These differences were statistically significant; P = 0.0209 (0.05). Conclusion: Our findings provide a base line data for the measurement of the third ventricles using CT scans in our environment and this may be applied in various clinical conditions involving the third ventricle

Paediatrics HIV/AIDS: Clinical Presentation and Practical Management Challenges in Sokoto; Nigeria

Background: Implications of continuing HIV/AIDS pandemic in Nigeria is very grave for children. Lack of financial resources means care of children with HIV/AIDS is exceedingly difficult to provide. We described the clinical pattern and highlight the problems in the management of HIV/AIDS in children seen in Usmanu Danfodiyo University Teaching Hospital (UDUTH); Sokoto; Nigeria over a two-year period. Methods: This prospective study was carried out between 1st January 2001 and 31st December 2002. The clinical presentation of each patient satisfying the WHO diagnostic criteria for paediatrics HIV/AIDS; admitted consecutively into our Emergency Paediatrics Unit (EPU) was documented. Laboratory diagnosis was by Enzyme linked immunosorbent assay (ELISA) for HIV- I and HIV- II in affected children and their mothers while confirmatory test was by Western blot. Treatment of each patient was individualised. Results: A total of 41 children with HIV/AIDS were admitted into EPU over the study period. There were 22 males and 19 females with ratio of 1.2:1. Age ranged from 0.25 years to 14 years with mean (SD) of 1.5 (2.2) years. Forty - one (97.6) patients were aged 5 years and below. Modes of transmission were vertical in 40 (97.6); while 1 (2.4) was by homosexual abuse. The commonest clinical feature was weight loss in 41 (100); followed by fever (one month) 39 (95); chronic diarrhoea 39 (95); recurrent cough 37 (90) and oro-pharyngeal candidiasis 35 (85) in that order. Thirty- six (87.8) patients had protein - energy malnutrition (PEM); marasmus constituting 58. Thirtytwo (78) patients were in WHO clinical stage 3 while the remaining 9 (22) patients were in stage 4. The main types of infections were oral candidiasis; pneumonia; malaria; septicaemia; urinary tract infections; and tuberculosis. Case fatality rate was 91. Highly active antiretroviral therapy (HAART) was not freely available to children during the period of our study. Conclusion: The mortality of these antiretroviral naive HIV/AIDS children was very high. It is anticipated that current availability of HAART to children free of charge would improve the outcome of HIV/AIDS in this group

Isolation and Identification of E-Coli 0157:H7 amongst Sudanese Patients with Bloody Diarrhea and in Animals

E.coli 0157:H7 is present as a commensal in the intestine of animals and as a pathogen in human beings. It causes bloody diarrhoea due to the secretion of a verotoxin which may lead to lethal complications. Objective: This study is aimed at determining the presence of this organism in animals and patients. Methods: Rectal swabs were collected from 250 cows. Stool specimens were obtained from 200 patients presenting with macroscopically or microscopically bloody diarrhoea. All specimens were cultured on sorbitol MacConkey agar and incubated at 37oC overnight. Non-sorbitol fermenting colonies were identified by different biochemical and serological tests as E.coli 0157:H7. Antibiotic sensitivity was done for the isolates using ampicillin; cephalexin; ciprofloxacin; co-trimoxazole; gentamicin; and tetracycline. Results: Patients (n = 10; 5) with bloody diarrhoea were found to harbour E.coli 0157:H7 in their stools. All isolates (in humans) were resistant to ampicillin. Eight (80) were resistant to tetracycline and cephalexin; six (60) to co-trimoxazole; and four (40) to gentamicin. All isolates were sensitive to ciprofloxacin. Sixty percent of the human isolates were resistant to three antibiotics and 40to four antibiotics. Twenty of the cows (8) were found to be carriers of E.coli 0157:H7. All isolates (in animals) were resistant to ampicillin; five (25) to tetracycline and cephalexin and four (20) to co-trimoxazole. All animal isolates were sensitive to gentamicin and ciprofloxacin. Thirty five percent of the animal isolates were resistant to two antibiotics and 25to three antibiotics. Conclusion: The isolation of E.coli 0157:H7 from animals and patients should direct the attention of physicians and paediatricians to consider the possibility of infection and complications by this organism

A comparison study of histochemical staining of various tissues after Carnoy's and formalin fixation

Background: The potential problems related to the use of formalin in histopathology; such as health hazards; deterioration of nuclei acids are well-known. The aim of this study was to evaluate the utilization of a Carnoy's solution fixation in comparison with formalin on subsequent tissue sectioning and histochemical staining. Materials and Methods: Corresponding sections of 25 tissue biopsies of rabbit's different organs were fixed in Carnoy's solution and in 10neutral buffered formalin. Samples were processed using the conventional method and then stained applying five histochemical methods. The degree of the quality of the staining was assessed for each method by scoring system (1-10) depending on comparison of the stained tissue sections with illustrated photomicrographs. Results: For the quality of cutting; the best quality was obtained by Formalin (mean = 4.76) then Carnoy's fixative (mean =3.84). The best quality of Haematoxylin and Eosin staining was obtained by formalin (mean =5.28) then Carnoy's (mean = 4.00). For Alcian blue and Perl's Prussian blue; the best staining qualities were obtained by Formalin (mean = 4.76 and 5.64 respectively) followed by Carnoy's (mean = 2.88 and 3.92 respectively). For periodic Acid Schiff's the best staining quality was obtained following Carnoy's fixation (mean = 4.52) then; the formalin (mean = 3.76). Conclusion: Although; Carnoy's fluid is a safe fixative and can rapidly penetrate the tissues; but it can't be a substitute for formalin

Malignant Phylliodes Tumours: Results of Breast Conserving Surgery and Immediate Reconstruction

Background: Malignant phylliodes tumour (MPT) is a rare breast tumor. Surgery is the mainstay in treatment but varies from local resection to modified radical mastectomy. In this study; we present our experience using wide local excision or subcutaneous mastectomy and immediate breast reconstruction in the management of MPT. Methods and Results: Twenty-three recurrent MPT and ten patients with histological evidence of MPT were included. All patients with recurrent MPT (n=23) had subcutaneous mastectomy; tow centimeter wide excision of the scar and immediate breast reconstruction with either Latissimus Dorsi (LD) myocutaneous flap (n= 10) or Latissimus Dorsi muscle flap (n=13). Seven of the newly diagnosed patients had wide local excision of the tumor; reconstruction with LD muscle flap; tow had wide local excision and reduction of contra lateral breast; and one had subcutaneous mastectomy and silicon implant. The margin resection varied between five and fifteen centimeter in wide local resection group and subcutaneous mastectomy group respectively and the size of tumors varied between five and fifteen centimeters in diameter. Discussion: During the follow up period; which ranged between twenty-four and eighty-four months one local recurrence; was recorded (3.03) and none of the patients had distant metastasis or regional lymph nodes involvement. This approach has secured wider excision of MPT; offered breast reconstruction; and has reduced the chances of recurrence in our patients

Evaluation of preoperative predictive values of serum CA15-3 and CEA within Sudanese women with breast cancer

Objectives: Early detection of cancer comprises early diagnosis in symptomatic and screening of asymptomatic individuals.Our aim was to evaluate the significant values of carbohydrate antigen 15-3 (CA15-3) and/or carcinoembryonic antigen (CEA) in women with breast cancer.Design and setting: This case control study was conducted in Khartoum Teaching Hospital; Khartoum; Sudan. Application of such measurement may be helpful within screening and early detection efforts in such a country like Sudan with poor resources.Methods: We examined by serological radioimmuno-assay methods; significant elevation of CA15-3 and CEA serum samples obtained from 100 women of whom 40and 35were patients with histopathologically confirmed breast cancer and benign breast lumps respectively and the remaining 25were apparently healthy controls. Statistical analysis: Data were analyzed by using a computer SPSS program.Results: Among the 75 patients with breast lumps; 33 (44) and 31(37.3) showed high CA15-3 and CEA levels respectively. Of the 40 carcinomas; high expressions of CA15-3 and CEA were found among 28(70) and 24(60) respectively. Notably; only 2(8) of the controls showed lightly elevated CEA. Conclusions: The obtained Specificity of 85.7; 80and sensitivity of 70; 60for CA15-3 and CEA correspondingly; support the combined application of both markers in screening for breast cancer

Plain radiographic cephalometry of the sella turcica: an overview

Background: The simplest of the parameters in anthropometry; including; height; weight; length; thickness and widths of various parts of the body vary from tribe to tribe and from one race to the other; and measurements of these parameters also differ amongst different age groups and between the two sexes as well. Method: A review composed via Medline Internet search; literature search and contributions from our experiences as well as experiences from colleagues. Results: Studies on measurements of the Sella turcica have revealed variations in the size of the fossa with certain parameters such as age; sex e.t.c. Conclusion: It is concluded that complete study of the Sella turcica requires multidirectional tomography