Prostate specific antigen versus digital rectal examination as screening for CA prostate in Sudanese patients

Objectives: The aim of this study is to compare the value of digital rectal examination (DRE) and prostate specific antigen (PSA) determination in the detection of prostate cancer among Sudanese patients presenting with lower urinary tract symptoms (LUTS). Material and Methods: A prospective study was carried out in Gezira Hospital for Renal Diseases and Surgery in the period of June 2003- May 2005. Patients presenting with LUTS, had been screened for prostate cancer using PSA and DRE examination.. Serum PSA and DRE were measured in all patients. Trans rectal biopsy was performed if the PSA was over 4ng and /or abnormal DRE. Results: A total of 194 elderly male pa3ents presen3ng with lower urinary tract symptoms (LUTS), 140 of them were at last diagnosed as benign prostate hyperplasia (BPH) and 54 pa3ents were been confirmed with prostate cancer (PCa). Their mean age was 65 years (range 45-90). Elevated level of PSA (> 4 ng/ml) was found in all the patients with prostate cancer (n= 54) and 68.6% (n= 96) of BPH patients. The rate of prostate cancer detection showed to be 25.7% for PSA > 4ng/ml, 13.31% for abnormal (positive) finding of DRE, and 27.8% for combination of the positive DRE and PSA > 4 ng/ml. The rate of BPH detec3on showed to be 68.6% for PSA > 4ng/ml, 28.6% for posi3ve finding of DRE, and 4.1% for combination of the positive DRE and PSA > 4 ng/ml. Conclusion: It was found that PSA determination detects a considerable proportion of tumors missed by DRE. And the combination of PSA and DRE escalates the probability of prostate cancer detection,

Assessment of clinical indicators for anaemiain the algorithm for integrated management of childhood illness [IMCI], Wad Medani paediatrics hospital, Sudan 2001-2002

The object of this study was to assess IMCI clinical indicators used for the assessment and classification of anaemia in underfines. A total of 500 children [aged 2-59 month] were selected by systematic random method from sick children attending to the outpatient department of the paediatrics hospital in Wad Medani, Sudan. The study doctors obtained a standardized history and carried out IMCI standard case management. Heamoglobin concentration and blood smear for malaria parasites were then performed for every enrolled child. Using the WHO Hb levels to diagnose anaemia, the sensitivity and specificity of IMCI guidelines to classify anaemia were examined. The sensitivity and specificity of" no palmar pallor" as a predictor of no anaemia were 60% and 50% respectively; and of "some pallor" as predictor of mild-moderate anaemia were 44%, 60%; whereas "severe pallor" showed a sensitivity of 52% and a very high specificity for 90% on detecting children with severe anaemia. Palmar pallor was not significantly associated with the presence of malaria as detected by a positive blood film for plasmodium falciparum. The study thus provides technical validation of IMCI algorithm for the assessment of anaemia. However, it did not provide proof of a significant association between palmar pallor and malaria, in the presence of fever