Prevalence of neurological manifestations of lung cancer among adult Sudanese patients

Is to study the prevalence of neurological manifestations among adults Sudanese patients with lung cancer seen in the Radiation and Isotope Centre in Khartoum. This is a prospective cross sectional hospital based study, conducted at Radiation and Isotope Centre in Khartoum. Sample of 52 adults Sudanese patients with lung cancer were included in the study. The period of the study was from February 2006 to July 2006. Data were collected by self administered questionnaire; this was constructed in sections to address the different aspects of the study as follows: personal data, presentation, physical examination, and investigations. Showed that 41 patients were males. Most of the patients were above 50 years of age. Fifty percent of our patients' were from Khartoum state. All of our patients had chest findings except one. The most common symptoms observed were of cranial nerves involvement, headache, limb weakness, numbness, and sphincteric disturbance. More than half of the patients were smokers. Other extrapulmonary manifestations noticed include: clubbing, lymph node enlargement, bone metastasis or fracture, gynaecomastia, superior vena cava obstruction, hepatomegaly, and ascites. Chest X-ray abnormalities showed pleural effusion, consolidation, hilar lymphadenopthy, collapsed lung, and fibrosis in the majority of patients. Most of our patients had adenocarcinoma, followed by squamous cell carcinoma, poorly differentiated carcinoma, and small cell carcinoma. The common neurological manifestations of lung cancer were found to be cranial nerves palsies, followed by lower limbs weakness, numbness, and sphincteric disturbances

Frequency of neurological deficits in Sudanese lepromatic patients

Leprosy has been a major burden on humanity over thousands of years. Perhaps no other disease in the history of mankind has been associated with such a strong social stigma as leprosy. Failure in early detection often leads to serve disability in spite of eradication of mycobacteria at a later date. Untreated the disease is progressive and results in permanent damage to the skin, nerves, limbs and eyes. To study the pattern of neurological manifestations among adult Sudanese leprosy patients seen in Khartoum Dermatology hospital in the period from March 2006 to August 2006. This is a prospective cross-sectional hospital-based study. Seventy adult Sudanese leprosy patients were studied using simple, direct standardized questionnaire including history and neurological examination, during the period from March to August 2006. The most common age group affected was 19-27 years. Male to female ratio was 3:1. Numbness was the most common neurological symptom seen in 77.14%. Each of visual disturbance, headache and bilateral ulnar sensory impairment was detected in 7.14%. Half of the patients had upper limbs sensory nerve dysfunction while 42.86% exhibited sensory nerve dysfunction in the lower limbs. "Gloves and stoking" sensory impairment was the most common finding [30%] while bilateral lateral politeal sensory impairment was the most common finding [30%] while bilateral lateral politeal sensory impairment was seen with the same percentage. Bilateral median and unilateral posterior tibial sensory impairment ware found in 1.43% each. Unilateral radial cutaneous sensory impairment was seen in 2.86%. Approximately half [48.57%] of the patients had upper limbs motor dysfunction. Bilateral ulnear distribution motor affection was seen in 4%. A significant number [41.43] had upper limbs muscle wasting. Impaired olfaction was the most common cranial nerve sign seen in 12.86%. Leprosy reactions were detected in 21.43%; type 2 reaction in 14.27% while type 1 reaction in 7.14%. Numbness and limbs weakness were the most common neurological symptoms in leprosy patients. Peripheral nerve sensory impairment was found in half of the patients with "Gloves and stokes" peripheral sensory neuropathy being the most common sensory disturbance. Motor dysfunction was found in 48.57%. Ulnar and median nerves motor affection was the most common motor dysfunction. Signs related to cranial nerves involvement were less common. Leprosy reactions were present in one-fifth of the patients

Women and epilepsy: Sudanese experience

Epilepsy is equally prevalent in men and women. However, for women there are unique concerns related to hormone effects on seizures and the effects of seizures and antiepileptic drugs [AEDs] on reproductive health. Some AEDs reduce the efficacy of oral contraceptive agents, increasing the probability of unplanned pregnancies. Seizure frequency may change during pregnancy, seizures may cause pregnancy complications, and the treatment of a woman with epilepsy must consider all these issues. To study the clinical presentation of epilepsy among adult Sudanese females and to verify aspects of epilepsy specific to women. This is a cross sectional descriptive non intervention clinical based study; it was carried out in Elshaab Teaching Hospital and El-shiekh Mohamed Kheir charity clinic, from February-2008 to June-2008. 630 female patients with epilepsy were included in the study. The study showed that 72% of the patients had generalized epilepsy and 28% had partial epilepsy, primary epilepsy is more common than secondary epilepsy, 54% of our patients had warning symptoms and 39.7% had triggering factors, irregular menstrual cycle was observed in 28%, 22% of our patients had catamenial seizures, 7.1% had increased frequency of seizures during pregnancy. Obstetric complications were common among our studied group. The incidence of infertility increased among our studied group. Women had differences in presentation and control of epilepsy that must be understood and considered when treating women with epilepsy

prevalence of neurological complications among adult Sudanese diabetic patients

The objective of this study was to identify the prevalence of neurological complications among adult Sudanese diabetic patients attending the outpatient clinics of El Shaab Teaching Hospital in Khartoum. This is a descriptive cross sectional hospital based study, it was conducted at El Shaab Teaching Hospital, Khartoum, Sudan during the period from February 2004 to October 2006. 100 diabetic patients were included in the study, 62 were male and 38 females. More than 85% were above the age of 35 years and 56% were in the age group 35- 64. The patients were from different tribes and different states. Sixty percent of the patients were from the northern Sudanese states while the rest of patients were from eastern and western states. Seventy seven percent of the patients had type 2 diabetes mellitus and 78.4% of them had diabetes for more than one year. Hypertension was found in 28% of our patients. The study revealed that 60% of the diabetic patients have neurological manifestations. The main neurological complication found was peripheral sensory-motor neuropathy. There is significant positive correlation between age, duration of diabetes, glycaemic control and occurrence of the neurological complications

Clinical presentation of Parkinson's disease among sudanese patients

Parkinson Disease [PD] is a neurodegenerative disorder affecting motor system. It is a chronic progressive disorder leading to long standing disability. To study the clinical presentation of PD among Sudanese patients seen at Elshaab Teaching Hospital during the period from May 2004 - April 2008. In this descriptive prospective, cross sectional hospital based study, 94 patients were studied using standardized questionnaire including history and clinical examination. The total number diagnosed to have PD was 94 patients. Male to female ratio was found to bel .5:1. Common age group affected was 70-80 years [24.47%]. The common presenting symptom was found to be poverty of movement [93.6%] followed by tremor [82.9 8%]. On neurological examination; rigidity, dyskinesia and festinate gait were the common signs. Primitive reflexes were found in significant number of patients. Idiopathic PD was found to be the common type [75.53%]. Of the side effects of benzhexol, 66.67% of our patients developed dry mouth. Postural hypotension was seen in 10.42% of the patients who were taking levodopa. The clinical presentations of our patients does not differ from what was mentioned in the literature

patterns of clinical presentations of cerebellar syndromes among adult Sudanese patients

Cerebellar syndromes are one of the commonest neurological diseases. To study the patterns of clinical presentations of cerebellar syndromes and to identify the possible causes. This is a prospective hospital based, cross-sectional study. One hundred adult Sudanese patients with cerebellar syndromes were included in the study during the period from January 2006 -January 2007. The most common age group affected was 18-25 years. Male to female ratio was 1.5: 1; unsteadiness on walking was the most common symptom [83%]. Gait-ataxia was the most common sign [83%]. Cerebrovascular disease was the most common aetiology [25%]. Cerebellar syndromes are not rare in Sudan. However, they were diagnosed more commonly at the central regions of the country probably because of more awareness of patients and better facilities for diagnosis. The age of onset, the male predominance, the presentation and clinical findings were not different from reported literature. This also goes for the common causes apart from alcohol which is a strikingly rare as a cause in this study and could be accounted for the implementation of Elshariya [Islamic laws] Laws in Sudan

Clinical pattern of partial epilepsy in Sudanese patients

To study the pattern of clinical presentation of partial epilepsy among Sudanese epileptic patients attending Elshaab Teaching Hospital from May 2005 to March 2006. Seizures are categorized as partial [with the initial activation of a limited number of neurons in a part of one hemisphere] or generalized [with the initial activation of neurons throughout both hemispheres]. The study was conducted at Elshaab Teaching Hospital May 2005- March 2006. Fifty patients with partial were included in a prospective cross- sectional hospital-based-study. The mean age is 35.96 years. Male to female ratio was 1.4:1. Abdominal aura predominates in 12%, followed by autonomic symptoms in 8%, fear in 6%, anxiety and visual hallucination in 4%, olfactory hallucination, auditory hallucination and automatism in 2%. Postictal confusion was found in 16% followed by post ictal sleep and Todd's paralysis in 8%, headache in 6% and amnesia in 4%. Abnormal neurological signs found in 30%. Space occupying lesions in 22% and cerebrovascular accident in 20% are the commonest causes for partial epilepsy, followed by brain atrophy in 6%, and arterioveneous malformation in 2% as detected by MRI. EEG was found abnormal in 56% i.e. 42% focal discharge, 10% focal discharge with secondary generalization and 4% generalized discharge. Prodromal symptoms like abdominal pain nausea and vomiting were the commonest symptoms in partial epilepsy. Confusion, sleep, Todd's paralysis, headache and amnesia were the commonest post ictal symptoms. Brain MRI detected space-occupying lesions in most of the patients. Interictal epileptic focal discharges [IEDs] were detected in more than half of the studied population

Cervical cord compression secondary to mycetoma infection

Mycetoma is a chronic granulomatous subcutaneous infection caused by actinomycetes [actinomycetoma] or by true fungi [eumycetoma]. Clinically the disease is characterized by swelling, and sinuses in the affected part. Another characteristic feature of mycetoma is the formation of aggregates of the organism [grains] in the tissues, which are visible to the naked eye and are discharged through sinuses in the skin. The grains vary in colour, size and consistency depending on the causative agent [1, 2]. These features are helpful in making a tentative diagnosis of the causative organism. We report a 75 year's Sudanese female with spastic paraplegia of gradual onset, she has discharging sinuses in her neck. Cervical X-RAY and cervical MRI showed destruction of cervical vertebrae. Identification of the agent was established by the histological examination of the grains, by culture and serologic techniques. Mycetoma is a local chronic and progressive infection of the skin, subcutaneous tissues and bone. It is characterized by swelling that is often grotesque and disfiguring and by multiple sinus tracts that drain granule-containing pus [3]

pattern of clinical presentation and etiology of non-traumatic quadriparesis in Sudanese patients

Quadriparesis is a major disabling health problem. Its importance is due to the incapacitating disability that often persists despite treatment. The study was aimed at detecting the etiologies and clinical presentation of Sudanese patients with quadriparesis, as there was no available documented information about quadreparesis in Sudan. This is a descriptive hospital based cross-sectional study of 100 patients admitted to Elshaab Teaching Hospital [ETH] from January 2002 to October 2003, who presented with four limbs weakness. Out of 100 patients 55 were males and 45 were females. 55% were in the age group of 18-44. Patients were originally from different states and different racial groups. Weakness was the presenting complains in all patients. 75% of the patients presented with gradual onset weakness. MRI detected the lesion in all patients with cervical cord compression. Cervical cord compression, acute inflammatory demyelinating polyradiculopathy, motor neuron disease and muscular dystrophy constituted the etiological bulk of quadriparesis in the Sudan