Women and epilepsy: Sudanese experience

Epilepsy is equally prevalent in men and women. However; for women there are unique concerns related to hormone effects on seizures and the effects of seizures and antiepileptic drugs (AEDs) on reproductive health. Some AEDs reduce the efficacy of oral contraceptive agents; increasing the probability of unplanned pregnancies. Seizure frequency may change during pregnancy; seizures may cause pregnancy complications; and the treatment of a woman with epilepsy must consider all these issues. Objective: To study the clinical presentation of epilepsy among adult Sudanese females and to verify aspects of epilepsy specific to women. Methods: This is a cross sectional descriptive non intervention clinical based study; it was carried out in Elshaab Teaching Hospital and El-shiekh Mohamed Kheir charity clinic; from February-2008 to June- 2008. 630 female patients with epilepsy were included in the study. Results: The study showed that 72of the patients had generalized epilepsy and 28had partial epilepsy; primary epilepsy is more common than secondary epilepsy; 54of our patients had warning symptoms and 39.7had triggering factors; irregular menstrual cycle was observed in 28; 22of our patients had catamenial seizures; 7.1had increased frequency of seizures during pregnancy. Obstetric complications were common among our studied group. The incidence of infertility increased among our studied group. Conclusion: Women had differences in presentation and control of epilepsy that must be understood and considered when treating women with epilepsy

Modified shoelace technique for repair of large midline incisional hernia

Operations for large and recurrent abdominal hernia have a high associated recurrence rate although it is lower when prosthetic material is used. Many techniques were prescribed for repair of such hernia with varying degree of success. We present in this study a modification of the old shoelace technique used for repair of large midline incisional hernia discussing the results and the complications associated with such modification especially infection, respiratory complications and recurrence. We concluded that modified shoelace technique is a good method for repair of large midline incisional hernia as it is associated with low incidence of respiratory complications and recurrence

Tuberculosis in patients with chronic renal failure under dialysis

In the present work 150 uremic patients under regular dialysis treatment were studied to find out the incidence of tuberculosis. The methods used in this work included: history, clinical examination, PPd skin test, ESR, WBCs counts, renal function tests, microscopic examination by Z.N stain for sputum, urine, pleural, pericardial and ascitic fluids, radiological examinations, and pathological studies of specimens from lymph node and pericardium. Three patients were proved to have definite tuberculosis. Another three patients though did not show bacteriological or histological evidence, they responded remarkably to therapeutic trials of anti T.B treatment. The total incidence of T B among dialysis patients was found to be 4% which is 2-4 times that of the general population in Egypt. Three of our cases were extra pulmonary T.B [50%]. Tuberculosis was the cause of renal failure in [0.6%]