Anticonvulsant activity of some vanilloid receptor agonists

Vanilloid receptors 1 [VR 1], a group of transient receptor potential channels family was cloned in 1997. They were found to be a potential target for treatment of different acute and chronic pain disorder. Recently these receptors were reported to be involved in several pathological conditions. The present study aimed to investigate the potential anticonvulsant activity of five vanilloidal agonists [capsaicin, nonivamide, zingerone, dehydrozingerone and 6-gingerol]. Experimental animal model of pentylenetetrazole [PTZ] induced seizure was used to investigate the potential anticonvulsant activity of capsaicin, nonivamide, zingerone, dehydrozingerone and 6-gingerol. The data obtained showed that, all tested compounds [capsaicin, nonivamide, zingerone, dehydrozingerone and 6-gingerol] possess dose dependant anticonvulsant activity. The five vanilloidal agonists; capsaicin, nonivamide, zingerone, dehydrozingerone and 6-gingerol exhibit anticonvulsant activity and may find clinical application

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 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

Clinical presentation of epilepsy among adult Sudanese epileptic patients seen in Sheik, Mohamed Kheirs Friday epileptic clinic-Sudan

To study the pattern of clinical presentation of epilepsy among adult Sudanese epileptic patients. 120 patients with epilepsy were included in a prospective cross-sectional study. The study was conducted at Sheik Mohamed Kheir Friday Epileptic Clinic. May 2003- Oct 2006. Males were [54.15%] while females were [45.85%]. In 80 patients [67%] no cause was identified. Cerebrovascular accident was found to be the commonest risk factor, 24 patients [20%] had a family history of epilepsy. 103 patients had generalized epilepsy while 18 patients had focal epilepsy. The prodromal symptoms and neurological signs were common among patients with partial epilepsy. 78 patients [64.8%] showed abnormal EEG. 12 patients [10%] with generalize epilepsy had abnormal CT of the brain, while 50% of those who had focal epilepsy had abnormal CT of the brain. Generalized epilepsy is more common than partial epilepsy. Prodromal symptoms and neurological signs were common among patients with partial epilepsy. EEG and CT Brain play an important role in supporting the diagnosis of epilepsy

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]

rare case of myopathy

A young Saudi lady presented with gradual worsening of muscle weakness and skeletal stiffness. Her sister has a similar condition. The clinical picture was very consistent with diagnosis of Rigid Spine Syndrome. This impression was further substantiated by the result of muscle biopsy. This syndrome was not clearly understood and probably not so rare either. This negative picture was basically imposed by under reporting and lack of large studies

Psychiatric disturbance associated with epilepsy in a tertiary health service in Sudan

Co morbid psychiatric Disorders are common in epileptic patients. This relationship had not been studied before in Sudanese patients. To study the common psychiatric disturbances and their correlates among epileptic patients attending a tertiary health service in the Sudan. Sixty two patients with idiopathic epilepsy were submitted to psychiatric assessment using the General Health Questionnaire [GHQ], a semi-structured questionnaire and direct clinical assessment. Thirty patients [48.4%] of them emerged as probable psychiatric cases. Severity of epilepsy showed a slightly less strong correlation with the GHQ score. Social class [P<0.05], together with vocational, educational [P<0.05] and social relations difficulties [p<0.07] showed significant correlation with the GHQ score. The study showed that psychiatric co-morbidity is a common complication of epilepsy that is related to severity of epilepsy and social stress of being epileptic

Urinary tubular enzyme excretion in children with nephrolithiasis and urolithiasis with hydronephrosis

Objective: Nephrolithiasis and urolithiasis are recurrent conditions associated with significant morbidity and economilc impact. Previous studies have suggested that cell- crystal interactions lead to tubular damage and/or dysfunction. To find further proof for these observations, a metabolic evaluation [including serum and urine biochemistry and urinary enzyme excretion] was done in children with nephrolithiasis and urolithiasis with hydronephrosis

Patients and Methods: This study included two groups: 10 normal children [controls] and 32 children with calcium oxalate urinary tract stones. The latter group was further subdivided into those with nephrolithiasis [n=12] and urolithiasis with hydronephrosis [n=20]. Levels of uric acid, oxalate, calcium, magnesium and inorganic phosphorus in 24-hour urine and serum were determined. Urinary N-acetyl-beta-D-glucosaminidase [NAG], beta-galactosidase [beta-GAL], beta-hexosaminidase [beta-Hex], angiotensin converting enzyme [ACE] and gamma glutamyl transferase [y-GT] levels were also determined colorimetrically

Results: Increases in urinary excretion of oxalate, calcium, magnesium and inorganic phosphorus were the major abnormalities found in stone forming patients. Elevated urinary NAG, beta-GAL, beta-Hex and ACE levels were also noted in patients compared with controls. Urinary excretion of oxalate, NAG, beta-GAL and ACE was significantly elevated in children with nephrolithiasis compared to those with urolithiasis and hydronephrosis

Conclusion: Abnormal urine biochemistry seems to have a role in the risk for urinary-tract stone formation in children. Hyperoxaluria can induce tubular cell injury mainly in proximal tubules, which is more pronounced in children with nephrolithiasis. The tubular injury manifested by enzymuria occurs before alteration of renal functions and blood biochemistry. Urinary tubular enzymes should be screened in children with urinary tract stones

Flaccid paralysis [guillian barre like syndrome] in Sudanese patients

To study clinical presentation of 24 Sudanese patients who had flaccid paralysis. The study was conducted in Elshaab Teaching Hospital [Sudan] in the period from January 2005 to November 2005, 24 patients were included in the study. A full detailed history and proper clinical examinations were performed by the authors. A list of investigations were done including urine, stool analysis, complete haemogram, urea and electrolytes BFFM, liver function test, Lumbar, Dorsal or Cervical MRI if needed, Brain M.R.I, nerve conduction study and C.S.F analysis. The study for viral infection revealed no evidence of circulating antibodies. Out of 24 patients 12 were males and 12 were females, fever was the commonest prodromal symptoms. Weakness of upper or lower limbs occurred either 24 or 48 hours following the prodromal symptoms. The facial nerve was the commonest cranial nerves affected. Four patients had sphincteric disturbances. Twelve patients had sensory disturbances. Two patients had respiratory muscles involvement and one patient had autonomic nervous system involvement. CNS showed an evidence of demylination in 16 patients while four had both demylination and axonal degeneration. CSF analysis revealed heigh proteins in eight patients. All patients showed remarkable improvement. This was acute paralysis which mimics G.B.S

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

Turner's syndrome variant with three cell line mosaicism and ring X chromosome [45, X /46,X r [X] [p21 q25] /46,Xx] in a Saudi patient

A case of Turner's Syndrome with three cell line mosaicism associated with ring X Chromosome, which is an extremely rare condition. Perhaps this is the first case report, with such chromosomal abnormality, from Saudi Arabia. The phenotypical changes are comparable with classical Turner's Syndrome of 45, X complement. The other findings are also discussed

place of laparoscopy in acute abdomen

Laparoscopy offers a simple safe and rapid mean of evaluation and diagnosis of intrabdominal diseases when the indications for laparotomy are equivocal. In this study laparoscopy was employed in 60 patients with acute abdomen. Three categories of patients were included, those with queery acute appendicitis [40 patients], those with blunt abdominal trauma [10 patients] and those with a provisional diagnosis of acute cholecystitis [10 patients]. Laparoscopy was done for every case for diagnosis and proceed accordingly.It was concluded that, laparoscopy is a very useful procedure in managing the patient who complained of acute abdominal pain and indication for laparotomy is equivocal. So the main value of laparoscopy in such cases were either avoiding unnecessary laparotomy or proceeding laparoscopically or ending into laparotomy

Autogenous superficial femoral vein graft in trauma to large - sized arteries in dogs

The long saphenous vein [LSV] is the preferred vascular graft for arterial trauma to small- and medium-sized vessels. However, there may be a mismatching between LSV diameter and that of large-sized injured arteries. In such cases an alternate graft should be used instead. We had tried to evaluate the use of the autogenous superficial femoral vein [SFV] graft in arterial trauma in 11 dogs. In each dog we had excised a 4-cm segment from the femoral artery at one side and replaced it by an equal segment taken from the contralateral SFV after its reversal and irrigation with heparinized saline. Postoperative follow-up was done for one month when patency was confirmed by angiography. There was neither venous insufficiency in the donor limb nor infection in the recipient limb. We could conclude that the early results showed the SFV to be an acceptable and a feasible arterial substitute in vascular trauma to large-sized arteries without significant morbidity or mortality. However, we recommend a longer period of follow-up to detect any possible late complications such as aneurysmal dilatation or neointimal hyperplasia in the vein graft or late chronic venous insufficiency in the donnor limb