Hirschisprung's disease: Factors Affecting the Outcome at The National Ribat University Hospital, Khartoum, Sudan, 2007 to 2011

Hirschsprung's disease [HSD] remains the most frequent cause of child intestinal obstruction. to evaluate the effect of different factors at the final outcome, postoperative complications and the hospital stay of children with HSD. It is a retro-prospective analytical observational hospital based study, involving all the cases presented initially to the Paediatric Surgery Centre at the National Ribat University Hospital and confirmed to be a case of HSD. The data were collected using a questionnaire and analyzed by the software SPSS version 17. Sixty four patients were involved in this study with male to female ratio of 5:1. The mean age at the first time of presentation was 9 days and the bulk of the patients seen from the center of Sudan. The emergency presentation accounted for 21.9% of the cases with the delayed passage of meconium and constipation as the main presenting symptoms. Complications occur mainly at day 13 post operatively with colostomy prolapse as the commonest type of complications. The age of the patients at the time of Pull Through Procedure [PTP] was range between 7 to 72 months and the mean body weight found to be 11.94 kg. Complications following PTP occur in 18.8% of the cases, with wound infection accounting for 15.6% of the cases. The total duration of hospital stay post operatively after reversal of colostomy was found to range between 6 and 60 days with a mean of 8.77 days and SD of [+/-] 6.657. The average hospital frequency of HSD in our study is compared to that encountered in European countries and Northern American countries. Early diagnosis and treatment is essential for better outcome. Emergency presentation, age and the weight at Pull Through Operation and at the time of closure of colostomy, significantly affect the outcome and prolong the hospital stay

Congenital lower limb biphasic synovial sarcoma in a male newborn - Khartoum teaching hospital: a case report

Synovial sarcoma is a malignant mesenchymal neoplasm which commonly occurs in extremities of adults. We report on a 12-days-old boy who presented to the department of paediatric surgery at Khartoum teaching hospital with a biphasic synovial sarcoma in the lateral aspect of his left ankle. The tumor was treated with total excision and adjuvant chemotherapy.Histopathologic examination of the excised tumor revealed a biphasic synovial sarcoma. There was no evidence of local recurrence or distant metastasis of the tumor at follow-up examination 24 months postoperatively

Teenage cigarette smokers with schistosoma mansoni: Effect of multifacet management on hepatic and bronchio-alveolar disposition

Schitosomiasis and cigarette smoking are among the common health hazards in young Egyptians worthy of concern. The present study aims to investigate the influence of cigarette smoking and management strategy on serum and branchioalveolar lavage [BAL] parameters in teenage male cases with and without S.mansoni. Certain indices of immuno-inflammatory response, oxidative stress, lipid peroxidation, vasoactive mechanisms and anti-oxidant defense capacity would be evaluated. The study included forty selected cigarette smoker male cases [mean age 15.9 +/- 2.6 years] who were sub-classified equally into two groups involving cases with S.mansoni [G I] and without S.mansoni [G II]. Ten age-matched non Schistosomal individuals non-smokers were included as a control [G Ill]. Biochemical assessment of serum and BAL included the evaluation of cotinine, total thiols, ceruloplasmin, uric acid, lipid peroxidation product, interleukin-5, eotaxin, RANTES, surfactant proteins A and D, procollagen Ill, trace elements and hepatocyte growth factor. Management strategy was evaluated after six months of quitting smoking and treatment with praziquantel, Nigella sativa, Garlic extract and antioxidants. The result showed that alterations in assessed parameters were greatly influenced by cigarette smoking more profoundly in cases with S mansoni. The management strategy identified the alleviation of reactive oxygen species [ROS] determinants on immuno-inflammatory response with beneficial outcome in assessed parameters. In conclusion, the proposed strategy for management of smoking in teenagers especially those with liver disposition was effective and identified the greater benefits of early intervention alongside smoking cessation

Presentation of colorectal cancer in Khartoum teaching hospital

To determine the age and gender distribution in Sudanese patients with colorectal cancer, as seen in Khartoum Teaching Hospital, and to study its emergency presentation. This retrospective study was conducted in Khartoum Teaching Hospital [Sudan]. Two hundred and seventy seven [277] patients who presented in the period 1[st] January 2000 to 31[st] December 2006 were included. Data were collected from their hospital records and analyzed using SPSS computer program. More than 100 [34.5%] of the study population [n=277] were below the age of 40 years, and 17.3% were below 30 years. The male to female ratio was 1.5:1. Intestinal obstruction was the most common cause of emergency presentation of colorectal cancer [94%]. Colorectal cancer in this study was found in young age groups. Intestinal obstruction is the main mode of its emergency presentation

Effect of fasting of Ramadan on bacteriuria of pregnancy

Significant bacteriuria was found in 18 [18%] out 100 fasting pregnant women attending the antenatal clinic at Al-Zahraa Hospital at the first week of Ramadan. All infected patients received treatment according to culture and sensitivity. Re-examination of bacteruria patients at the end of the month indicated a 4.2% increase of prevalence, which is of no statistical significance. The incidence of bacteriuria was found to be higher in the 31-40 years age group and in multigravidae than in primigravidae. The maximum incidence of bacteriuria was found during the last trimester, while, none of the pregnants at the first trimester had bacteriuria. This clarifies the importance of re-culture of urine in cases proved to be sterile during the first trimester. Our results showed that 72.3% of the patients who had bacteriuria, were asymptomatic. The predominant infecting organisms was found to be E. coli in 77.7% of cases