Study of thyroid dysfunction in postpartum psychosis

Background Becoming a mother of newborn involves adaptation to may changes socially and physiologically. Some risk factors are responsible for the development of postpartum psychosis including postpartum hormonal changes. Objectives: was to study the role of thyroid dysfunction in development of early postpartum psychosis among a sample of Egyptian women. Subjects and Methods: A total of 60 female patients with postpartum psychosis during the first four weeks after delivery not suffering from any previous psychiatric disorders (Case Group) and 30 female patients within the first four weeks after delivery not suffering any psychiatric disorders (Control Group) were subjected to clinical psychiatric assessment using structured psychiatric interview of DSM -V, BPRS, HDRS and measuring plasma level of thyroid hormones e.g., free triiodothyronine, free tetra-iodothyronine and thyroid stimulating hormone. Results: There were higher significant difference regarding thyroid dysfunction in patients with postpartum psychosis than in controls. Patients with postpartum psychosis with thyroid dysfunction have a higher significant score on BPRS and HDRS than patients with postpartum psychosis without thyroid dysfunction. Conclusion: There is significant association between thyroid dysfunction in first four weeks after delivery and postpartumpsychosis

Evaluation of possible mechanisms of Cordia dichotoma fruits for hyperlipidemia controlling in Wistar albino rats

Objective: To investigate the antioxidant capacity of aqueous extract from Cordia dichotoma (C.dichotoma) fruits in-vitro and their effect on nutritional parameters in rats fed on high-fat diet.Methods: In-vitro antioxidant capacity of C. dichotoma extract were evaluated and compared to two standard materials, ascorbic acid and butylated hydroxytoluene. Metabolic experiments were set out using rats fed on high-fat diet. The extract was tested with two dosages: 0.5 and 1.0 g/kg body weight/ day for four weeks. Lipid constituents of diet and faeces and lipid profile of serum and liver were determined. Results: The administration of the C. dichotoma extract with two dosages caused a significant improvement in the lipid metabolism of rats, compared to the hyperlipidemic control which showed significant disturbance in lipid profile. C. dichotoma extract reduced total body weight gain and total feed intake, and enhanced the fresh and dry weight of faecal excretion. The superior effect was recorded with the high dosage of extract. C. dichotoma minimized fat and cholesterol intake significantly and maximized those in faecal excretions in comparison with hyperlipidemic control values, and low dosage was better than the high one. C.dichotoma extract at two dosages normalized the lipid profile of the serum and liver compared with hyperlipidemic control. Conclusions: The protective effect of C. dichotoma extract against hyperlipidemia may be attributed to the reduced ability of an animal to ingest and absorb fat and cholesterol, and enhanced ability to get rid of them in faecal excretion.

performance of candidates in the examinations of the otorhinolaryngology specialty, Sudanese national board of medical specializations

The Otorhinolaryngology, Head and Neck Surgery Council is one of the first established councils of the Sudanese National Board of Medical Specializations [SNBMS].This report covers the fourth rotation period from 2009-2013. It is meant to be in the form of an analytical study for more objectivity and transparency and to be a model for promotion of the general performance of other councils in administrative, examination and training issues. The main objective of this study is to analyze the trainees' results in part 1 and part 2 [final] examinations with regard to gender and pass rates and to draw relevant indices that help in planning for training and expansion of specialist services. This is an analytical retrospective study conducted at the [SNMSB] headquarters Khartoum, Sudan during the period from January 2009- December 2012 .This study covers the fourth rotation of the scientific council for the specialty. The study included all candidates sitting for both part 1 and part 2 examinations [265]. Candidates were classified according to gender and pass rates. Candidates who withdrew form the program after passing the part 1 examination were excluded. The total number of doctors sitting for part 1 examinant was 207. Females were 118 and males were 89. Female to male ratio was 1.3:1.0. Sixty nine [69] doctors passed the examination with over all pass percentage of 33.3%. The percentage of passed candidates among females was 31% and among males was 36%. The total number for trainees sitting for the final examination was 58. Females were 23 and males were 35. Female to male ratio was 1.0: 1.5. Thirty three [33] trainees passed the examination with over all pass percentage of 56.9%. The percentage of passed trainees among females was 52.2% and among males was 60%. The annual number of 69 in the first year to 48 in the fourth year although there was a steady increase in-between. The average annual pass rate for part 1 examination showed noticeable increase from 23% to 42% by the end of the fourth year. The annual number of trainees sitting for the final examination was fluctuating and the biggest number was in the first year. There was a minimal increase in the number of graduates. Applicants for part one examination are mostly females. Applicants numbers are generally decreasing. The pass percentages are increasing in both parts of the examination. Males performance in both part one and part two examinations is better than females. The number of graduates does not satisfy the national needs for specialist services provision and expansion

Common ear, nose and throat problems in the under- five Sudanese children

The health problems of children and especially the under-5 years are of great concern and impact on both medical and surgical practice. No wonder they attract political and administrative concern. This study aims to identify the common Ear, Nose and Throat [ENT] problems of under-5 Sudanese children and to study the frequency, admissions, available beds and operations and to compare this work load with the rest of the ENT wards. Furthermore, to outline what is needed to improve the services for this age group. This is a retrospective hospital-based study including all patients [n=21384] who presented to the ENT department, Wad-Medani Hospital, Gezira, Sudan, during a period of two years from the first of January 2010 to the thirty first of December 2011. The total number of the under-5 children was 2330; which contributed to 41.32% of total paediatric age group, up to 16 years, [n=:5639] and 10.90% of the total number of ENT patients who presented to the ENT department at Wad-Medani Hospital. The total number of admissions of under-5 children accounted for 32.72% of all paediatric patients and 20.66% of all ENT patients. Their commonest problems found in this study were; adenoiditis and tonsillitis [37.68%], otitis media [27.25%], Upper respiratory tract infections [URTIs] and allergy [12.31%], foreign body related [12.23%], otitis externa [5.45%], others [3.43%], epistaxis [0.75%], hearing and speech disorders [0.90%]. The total number of children under-5 requiring surgical operations constituted 55.46% of all paediatric patients and 33.98% of the total number of all ENT patients who were operated on. Of these operations 57.01% were elective and 42.99% were emergency operations. The main indications in 94.77% of the elective operations were adenoidectomy and tonsillectomy, while most of the surgical emergencies 91.32% were due to foreign body related problems. The ENT problems of the under-5 children in Wad-Medani General Hospital constitute an obvious high proportion of the work load. More attention is to be paid to this age group in terms of facilities, staff training and special requirements needed in settings and equipments. Thus, better handling and outcomes could be achieved for this important and delicate age group

lingual thyroid associated with congenital profound sensorineural hearing loss

This is a case report of an extremely rare case of a lingual thyroid associated with profound bilateral congenital sensorineural hearing loss in a Sudanese girl. To our knowledge this association has not been previously reported

Risk Factors of Viral Hepatitis B among Egyptian Blood Donors.

Background: Surveillance of infectious disease markers in the blood donor population is important in recognizing trends in prevalence and incidence of transfusion related infections in asymptomatic volunteer blood donors. Subjects & Methods: It is a community base cross sectional study. Subjects of study are volunteers to donate blood. Samples were collected from blood donors and questionnaire was designed to collect the risk factors data. The prevalence of hepatitis B surface antigen (HBsAg) among 1,000 apparently healthy blood donors was determined. Objective: To estimate the prevalence of virus B hepatic infection and to illustrate the various socioeconomic, demographic and medical factors related to infection with HBV among apparently healthy individuals. Results: The prevalence rate of HBV was 5%. Conclusion: This study provides comprehensive and reliable information on the possible risk factors affecting spread of Hepatitis B.

Primary tuberculosis of the maxillary sinus: a case report

Tuberculosis is up-to-date a leading cause of human suffering and loss of life. Although tuberculosis is a systemic disease, primary tuberculosis of the paranasal sinuses is rare. It should be kept in mind in any undiagnosed or atypical clinical infection or inflammation in this region. We present here a case of primary paranasal sinuses tuberculosis in an elderly Sudanese woman. Although Sudan is one of the highest three counties in the incidence of tuberculosis, this is the first case to be reported in Sudan

Epilepsy among Elderly Sudanese Patients

Objective: The aim of this study was to evaluate the clinical presentation and characteristics of elderly Sudanese patients with epilepsy. Methodology: This is a prospective study (from Feb. 2005 to Jun 2008). The study population included 240 elderly epileptic patients (age 60 years or above). Results: Cerebrovascular accident was found to be the most common cause of secondary epilepsy (31).Generalize epilepsy was seen in 120 (50) of patients. Abnormal neurological findings were more common (49) among patients with partial epilepsy. Fifty percent of our patients showed abnormal EEG. Abnormal CT brain findings were common among patients with partial epilepsy. Conclusion: The pattern of clinical presentation of epilepsy among elderly Sudanese epileptic patients is similar to what was mentioned in the literature except that the percentage of epilepsy following infections was more among our studied group (6

The Prevalence of Sickle Cell Anaemia in Northern Areas of Algadaref State; Sudan

Sickle cell anaemia is one of the major types of anaemia found in Sudan; especially in western Sudan in which the sickle cell gene is frequent. This study estimates the prevalence of sickle cell anaemia in other areas rather than western Sudan where it is more prevalent (Algadaref state). 100 blood samples of blood were taken from differenttribes (eleven tribes) living in the northern area of Algadaref state. 24 samples were collected from urban area; 76 from rural area; all tribes originated from Afro-Asiatic speaking regions. All samples were tested for complete blood count (CBC); and haemoglobin electrophoresis. The study revealed that the majority of sickle cell anaemia cases was found among the Masaleet tribe. 20 samples were (Hb-SS); 55 samples were (Hb- AS) and 25 samples were (Hb -AA)

Histopathological patterns of nasopharyngeal carcinoma in Sudan

To study the histological patterns of nasopharyngeal carcinoma NPC in Sudanese patients and to compare them with the internationally published series. A retrospective review for records of NPC patients treated in the Institute of Nuclear Medicine, Molecular Biology and Oncology INMO, Wadmedani, Sudan, during the period 2000-2005 was conducted. Parameters included in the review were histological types of NPC according to the World Health Organization WHO classification, age, gender, locality, ethnicity, and stage. All cases of NPC with positive histology were included while other types of histology lymphoma, sarcoma were excluded. The SPSS software was used for data entry and analysis. Total number of patients with NPC was 103. Age range from 11-82 years, median was 41 years, and mean was 45.5 years of age. Male:female ratio was 2:1. The WHO histology type-3 was 73.8% of cases, WHO type-2 was 26.2%, and there was no case of WHO type-1 found in this study population. Neck swelling is the most common presenting symptom 77.8%.Pattern of NPC classification resembles those seen in endemic areas like South China. Dominant histology was WHO type-3. Identifying risk factors for NPC in Sudan is required

Study on glucose tolerance in pregnancy as a screening test and diagnostic tool for gestational diabetes mellitus

GDM is a common medical problem that results from an increased severity of insulin resistance as well as an impairment of compensatory increase in insulin secretion. GDM is associated with a variety of maternal and fetal complications. Controversy surrounds the ideal approach for detecting GDM, and the approaches recommended for screening and diagnosis are largely based on expert opinion. This study enrolled 51 pregnant women aged between 20 and 39 years old. All women were invited to do fasting and two hours postprandial blood glucose every two weeks, 2 hr. 75g OGTT every trimester. Plasma glucose measurements were performed with glucose oxidase method using semi-automated spectrophotometer [Biosystems 310]. Both normal and GDM cases have normal glucose tolerance in early weeks of pregnancy. However, after 24 weeks of gestation progressive increment of hyperglycemia was obviously observed in GDM cases. Suitable cutoffs in diagnosis of GDM in third trimester are 97 mg/dl for fasting; 174 mg/dl for 1 hour; and 141 mg/dl for 2 hour

Laparoscope-assisted appendectomy in adults: the two-trocar techique

Open appendectomy is still the most common method of treating appendicitis. Laparoscopic procedures for removal of the appendix by the "in" technique as an alternative to conventional appendectomy have gained wide popularity, but have been criticized for their technical difficulty and high cost. We assessed the safety and efficacy of the laparoscope-assisted appendectomy [the two-trocar technique] in adults. We retrospectively studied 129 patients who had appendectomy using the laparoscope-assisted two-trocar technique between July 2002 to December 2003. The procedures were done by consultants and surgeons-in-training with experience in minimally invasive and open techniques. Locally modified endoloop and reusable trocars were used to reduce the cost Appendectomy was performed extra-abdominally after the appendix was identified by using a laparoscope through one port and then delivered outside through the second port using reusable laparoscopy instruments. The two-trocar technique was successful in 101 [78.3%] cases; 14 [10.8%] needed a third trocar to complete the operation extra-abdominally, 6 [4.6%] were converted to open surgery, and 5 [3.8%] had an intra-abdominal laparoscopic appendectomy. The mean operation time was 35 minutes [range, 30-90 minutes]. Six cases [4.6%] had infection. The mean hospital stay was 2.8 days [range, 2-7 days]. No case of port hernia was reported during the follow-up period [range, 14 -30 months]. The laparoscape-assisted two-trocar technique for removal of the appendix can be performed as safely and efficiently as the open technique, but at a lower cost than the complete laparoscopic "in" method and does not need much technical expertise. This method is recommended as an alternative procedure to open appendectomy or the complete laparoscopic "in" technique in adults

Emergence agitation after sevoflurane anesthesia in children: prophylactic effect of clonidine versus two doses of fentanyl

Sevoflurane anesthesia in preschool children has been associated with an increased incidence of emergence agitation. Many factors may be incriminated in this phenomenon, but most important of them [other than anesthetic technique] is postoperative pain. We designed a study that included a non-surgical procedure in order to eliminate pain and we compared the effects of different drugs to attenuate this anesthesia related complication. Eighty children undergoing examination under anesthesia between the ages of 18 months and 6 years were randomly assigned to receive fentanyl lug/kg, fentanyl 2 ug/kg, clonidine 2 ug/kg or placebo after receiving sevoflurane anesthesia. Blood samples were collected before discharge from the PACU to evaluate the hormonal part of stress response associated with agitation. The children's behavior was assessed with a special agitation scale in the PACU and total hospital discharge time was measured. Clonidine 2ug/kg and fentanyl lug/ kg were found to decrease much the incidence of postoperative agitation without increasing discharge time, vomiting or itching among preschool children exposed to sevoflurane anesthesia in nonpainful procedures

Streptococcal antibodies among rural school children in Bangladesh.

The upper limit of normal values of group A streptococcal antibodies should be known for a population concerned because it is influenced by many local conditions. As yet the reference value of the these antibodies has not been determined by using a quantitative method among Bangladeshi children. We determined the reference value of anti-streptolysin O and anti-deoxyribonuclease B among 361 apparently healthy rural Bangladeshi primary school children (aged 5 to 14 years, mean 9.2 years). Anti-streptolysin O was measured by an auto-analyzer and antideoxyribonuclease B was measured by microtitre method. The geometric mean titres for the entire group was 241 IU/ml and 222 IU/ml for anti-streptolysin O and anti-deoxyribonuclease B respectively. The upper limit of normal values (80th percentile) was 390 and 340 for anti-streptolysin O and anti-deoxyribonuclease B, respectively. These limits should be of value to physicians, epidemiologists and clinical laboratory personnel as well.

She wants it done

To compare ear piercing practices and complications arising there from in British and Sudanese children and to seek possible ethnic, cultural and environmental differences. Settings: Maelor, General Hospital, Wrexham, UK and Wad Medani Children Hospital, Wad Medani, Sudan. Parents of a hundred British children and an equal number of Sudanese parents were requested to fill a questionnaire on ear piercing. All children were examined for possible local or systemic complications. All parents answered the questionnaire. Eighty-eight [88%] of the British children were girls while all Sudanese children [100%] were girls. Eighty [80%,] of the British children had had their ears pierced before they were 6 years old while 90% of Sudanese children had had their ears pierced below that age. The procedure was performed in both groups by non-medical staff. Local inflammation and allergic contact reactions were the commonest complications in both groups. Keloids were only encountered in the Sudanese children. A case of tetanus was encountered in the Sudanese group. Conclusion and recommendations: Ear piercing in both communities is performed at a very early age. This procedure is not without complications and the medical profession should advise safety in this practice. Earrings selected should be of non- allergenic material. Regular application of an antiseptic to the site should be encouraged. The community should be made aware of the hazards and complications of ear piercing. With the awareness of these complications and guided with a set of rules, people may continue the practice [she may have it done]. Health authorities in Sudan should formulate guidelines that will ensure hygienic measures and reduce complications

Psychiatric manifestations in hair dye poisoning

To study the psychiatric manifestations in patients attempting suicide using paraphenylenediamine, a component of locally used hair dye. A prospective study of 50 successive patients who presented with acute hair dye poisoning was carried out after their recovery from the acute toxic phase. About 58% of the cases were attempted suicide as compared to 12% who completed suicide and 30% in whom the ingestion was accidental. Seventy per cent of the patients showed significant psychiatric manifestations. Psychiatric assessment and treatment is vital in these cases