Mvcetoma of the eve lid

In this short communication, we report on a case of eye eumycetoma caused by M. Mycetomatis seen at Makkah eye complex and Mycetoma Research Centre, Khartoum, Sudan. The patient was a 13 year-old female student, from Central Sudan a Mycetoma endemic area. The patient had recurrent progressive left eye eumycetoma caused by M. Mycetomatis. The site was the left upper eye lid. The patient presented late with disease duration of two years. Lack of health education and financial constrain due to their low socio-economic status are the explanation of her late clinical presentation. She was treated with ketoconazole and wide local excision. The medical literature was reviewed and only eight documented patients with eye eumycetoma were reported; one due to M. mycetomatis, two caused by Dematiaceous Fungi and five caused by Allescheria boydii. Only three patients with eye Nocardia brasiliensis actinomycetoma were reported. Although eye Mycetoma is a rarity, in the tropical and subtropical subcontinent, Mvcetoma should be considered in the differential diagnosis of swellings with discharging in the eye region

Cell phenotypes, immunoglobulins and complement in lesions of eumycetoma caused by madurella mycetomatis

Mycetoma [maduromycosis] is a common health problem in Sudan. The causative organisms are either true fungi [eumycetoma] or actinomycetes [actinomycetoma]. The commonest eumycetoma in Sudan is caused by M mycetomatis. The cell phenotypes, immunoglobulins and complement in lesions of M mycetomatis were characterized by immunohistochemistry. In the HandE sections there were three types of inflammatory reactions. Type I reaction consisted of three zones: a neutrophil zone surrounding the grain, an intermediate zone of macrophages and giant cells and a peripheral zone consisting of lymphocytes and plasma cells. The neutrophils stained positively for CD15. The macrophages were positive for CD68. The majority of cells in the outermost zone were CD3 positive [T lymphocytes]; they were rimmed by CD20 positive cells [B lymphocytes]. In type II reaction there was no neutrophil zone, the grain being surrounded by macrophages and giant cells that stained positive for CD68. Type III reaction consisted of a discrete epithelioid granuloma without wellformed grains. IgG, IgM and C3 were found on the surface of the grain and the hyphae

Appendicular masses in Khartoum

Ninety patients with acute appendicular masses were studied. The peak incidence was between the ages of 11 and 30 years, with a male to female ratio of 2:1. All patients but 9 responded to conservative treatment. Seventy two patients were followed up for 6 months. The recurrence rate was 23.7% occurring during the first 3 months. Interval appendicectomy was performed in 62 patients. Histological examination of the appendices showed atrophy and fibrosis in 34 appendices, normal histological findings in 20 patients and evidence of chronic non-specific inflammation in eight appendices. Interval appendicectomy may not be necessary in the majority of patients with appendicular masses especially those who can be followed up closely for a minimal of 6 month period

Preoperative fasting state in patients undergoing elective surgery

Preoperative fasting and glycaemia states were studied in 77 patients undergoing elective surgery after 12:00 hours at Khartoum Teaching Hospital. Thirty one patients [40%] took their last oral feed before 16:00 hours the day before surgery and 14 patients [19%] were fasting for more than 18 hours. In six patients [7.8%] the preoperative blood sugar at the time of induction of general anaesthesia was less than 3 mmol/L and in one patient it was 1.6 mmol/L. Patients scheduled for elective surgery in the afternoon may be prone to latent hypoglycaemia and should therefore be encouraged to have their evening meal the day before surgery