Portal vein thrombosis in Sudanese children

Portal Vein Thrombosis [PVT] is one of the most common causes of portal hypertension among children in Sudan. To determine the incidence, aetiology and mode of presentation of PVT among children and find its relation to gastrointestinal bleeding in a Sudanese hospital. This is a prospective hospital based study conducted at a tertiary care paediatric hospital in Khartoum, Sudan [Gaffer Ibn Oaf Specialized Children Hospital [GIO]]. 350 children were diagnosed on clinical grounds [heamatemiss, splenomegaly] to have portal hypertension. After laboratory investigations [CBC, LFTs, coagulations profile and RFTs], abdominal sonography with Doppler, 275 patients turned to have portal vein thrombosis. Upper GI endoscopy was done for all patients and liver biopsy when indicated. Data were analysed, discussed and conclusion were reached. Out of 800 children presented with upper GI bleeding 350 were diagnosed as having esophageal varices bleeding due to portal hypertension [44%], out of these 250 [70%] children were found to have PVT as a cause of their portal hypertension, and another 25 children were diagnosed to have PVT without GI bleeding. Their ages ranged between 4 month and 16 years. Two hundred were males. Seventy five were below one year of age. History of risk factor for PVT was found only in 68 children. All the bleeders had sclerotherapy, band ligation or both beside propranolol and H2 blockers or PPI. Time for follow up was between 6 month to 4.5 years. 150 children cleared their varices with 4-6 cession of either sclerotherapy, banding or both, the rest of the children are still receiving sclerotherapy. Ten children received liver support for portal biliopathy, five children had splenectomy because of hypersplenism. Four children died. Propranolol was stopped in 50 children out of 150 children who cleared their varices after two years Conclusions: PVT in children is common in Sudanese children, and represents the second common cause of upper GI bleeding. Its aetiology is obscure in the majority of cases and more studies and facilities are needed to uncover the underlying cause. Simple clinical data, ultrasonography and upper GI endoscopy are quite adequate measures to reach accurate diagnosis. Combinations of endoscopic sclerotherapy and band ligations with propranolol are very effective in controlling the bleeding of the esophageal varices, though it has a remarkable effect on the quality of life of affected children. Thus appropriate medical alternative or surgical treatments are needed in order to reduce morbidity and mortality and improve the quality of life of these patients

Correlation between retinopathy, nephropathy and peripheral neuropathy among adult Sudanese diabetic in patients

Diabetes Mellitus is a worldwide common metabolic disorder. Increasing prevalence of diabetes, lack of proper education about the nature and course of the disease and necessary control are the main factors for an early onset of micro vascular complications. To correlate between retinopathy, nephropathy and neuropathy, among adult Sudanese diabetic patients at Elshaab Teaching hospital, Ahmed Gasim Teaching hospital and Gabber Abu Eleaz centre, from December 2006 to September 2008. This is a descriptive prospective cross sectional hospital based study, 71 patients were included. Male to female ratio was1.4:1.Common age group affected was 60-69 [32.4%].Common duration of diabetes mellitus was 20-24 years [23.9%].All patients who had diabetes for 25 years or more had developed complications [19.7%].The commonest long term microvascular complication was found to be retinopathy [71.2%], followed by neuropathy [69%] and nephropathy [50.7%].It was found that [47.6%] of our patients had the three complications. Long-term micro vascular complications affect male more than female, with average age of onset 60-69 years. All patients who had diabetes for 25 years or more had developed complications. Retinopathy is the most common micro vascular complication, followed by neuropathy. There is a significant correlation between retinopathy, nephropathy and neuropathy in association with the duration and control of blood glucose level

Knowledge of HBV risks and hepatitis B vaccination status among health care workers at Khartoum and Omdurman teaching hospitals of Khartoum state in Sudan

HBV infection is notorious and is endemic in Sudan. Health care workers are at particular increased risk for the infection. Their knowledge and acceptance of vaccination against the virus is of at most importance for the control of the disease. To study the knowledge and vaccination status among health care workers in some central hospitals in Sudan. Data from different categories of health workers were collected using structure questionnaire after taking informed consent. Data were analyzed using Chi-square and T-Test. Around 96.22% of surgeons knew their increased risk for infection, and 71.69% of them knew vaccine prevention. The overall screening for the virus was 32.2%. Only 26.19% of those who received the vaccination had completed the doses. None vaccination due to a none specified cause was the main reason among doctors and nurses. Knowledge about risk and vaccination was very low among cleaning staff and none of them had vaccination. Although knowledge about HBV risk in our health care workers was reasonable - apart from cleaning staff-, the vaccination among them was not satisfactory. Efforts have to be augmented and special care for cleaning staff is mandatory

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