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 severe 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. Objectives: 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.Methodology: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. Results: The most common age group affected was 18- 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 42.86exhibited sensory nerve dysfunction in the lower limbs. ""Gloves and stoking"" sensory impairment was the most common finding (30) while bilateral lateral popliteal sensory impairment was seen with the same percentage. Bilateral median and unilateral posterior tibial sensory impairment were found in 1.43each. Unilateral radial cutaneous sensory impairment was seen in 2.86. Approximately half (48.57) of the patients had upper limbs motor dysfunction. Bilateral ulnar distribution motor affection was seen in 40. 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 14.29while type 1 reaction in 7.14. Conclusion: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 dysfunctions. Signs related to cranial nerves involvement were less common. Leprosy reactions were present in one-fifth of the patients."

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

Prevalence of neurological manifestations of lung cancer among adult sudanese patients

The objective: is to study the prevalence of neurological manifestations among adults Sudanese patients with lung cancer seen in the Radiation and Isotope Centre in Khartoum. Methods: 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. The results: 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. Conclusion: The common neurological manifestations of lung cancer were found to be cranial nerves palsies; followed by lower limbs weakness; numbness; and sphincteric disturbances

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

Study of Knowledge; Attitude; Practice towards Epilepsy among Relative of Epileptic Patients in Khartoum State

People with epilepsy are suffering from a lot of un tolded negative impacts on their lives; due to misunderstanding of the disease and from the associated stigma. Objectives: The objective of this study is to assess the knowledge; attitude; and practice among relatives of Sudanese epileptic patients seen in Sheik Mohamed Kheir Neurological clinic and Elshaab Teaching Hospital. Methods: This is a descriptive cross- sectional community based study; 313 respondents were included; the duration of the study was from November 2008 to June 2009. Results: Most of the respondents knew the disease; and had witnessed an attack. One third mentioned a brain lesion as the underlying cause of epilepsy. Most of the respondents mentioned loss of consciousness as the major symptom. More than two thirds mentioned that it is not contagious. Most of the respondents claimed that it can be controlled; and two thirds preferred medical treatment. The study revealed that half of the respondents had shown favourable attitudes and practice. Conclusion: The study revealed that the level of knowledge; attitude; and practice towards epilepsy needs community educational programmes to fill the gaps; and minimize the stigma

The Patterns of Clinical Presentations of Cerebellar Syndromes among Adult Sudanese Patients

Cerebellar syndromes are one of the commonest neurological diseases.Objectives:To study the patterns of clinical presentations of cerebellar syndromes and to identify the possible causes.Methods:This is a prospective hospital based; cross-sectional study. One hundred adult Sudanese patients with cerebellar syndromes were included in the study during the period from January 2006 January 2007.Results:The most common age group affected was 18 - 25 years.Male to female ratio was 1.5:1unsteadiness on walking was the most common symptom (83).Gait-ataxia was the most common sign (83). Cerebrovascular disease was the most common etiology (25).Conclusion:Cerebellar syndromes are not rare in Sudan.However; they were diagnosed more commonly at the central regions of the country probably because of more awareness of patients and better facilities for diagnosis.The age of onset; the male predominance; the presentation and clinical findings were not different from reported literature.This also goes for the common causes apart from alcohol which is a strikingly rare as a cause in this study and could be accounted for the implementation of Elshariya (Islamic laws) Laws in Sudan

The 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. Methods: This is a descriptive cross sectional hospital based study; it was conducted at El Shaab Teaching Hospital; Khartoum; Sudan during the period from ebruary !!"" to #ctober !!$.esultset '!! diabe(c pa(ents were included in the study; $ were male and )* females. +ore than *;- were above the age of ); years and ;$- were in the age group );- $"". The pa(ents were from di/erent tribes and di/erent 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 diabetes mellitus and 7*.""- of them had diabetes for more than one year. Hypertension was found in *- of our pa(ents. The study revealed that $!- of the diabe(c pa(ents have neurological manifesta(ons. The main neurological complication found was peripheral sensory-motor neuropathy. Conclusion: There is significant positive correlation between age; duration of diabetes; glycaemic control and occurrence of the neurological complications."

A Study of Knowledge; Attitude; practice towards HIV/AIDS and Prevalence of HIV/AIDS among Tea Sellers women in Khartoum State (April 2004 - May 2005)

This was a descriptive community based study conducted to determine Tea seller's women risk behavior and factors towards AIDS in order to assist national planner to develop behavior change interventions. The study was carried out in Khartoum state during the period April 2004 - May 2005; 648 tea sellers women of age 15-49 were participated. It was found that they spend most of the day out of home; had high-risk sexual behavior. The majority of them are married; knowledge and behavior related to sexually transmitted disease and AIDS was generally satisfactory. Condom use was found to be not adequate; the tea sellers refer to pharmacies as a main source of obtaining condoms. The study showed a high level of misbelieves about mode of transmission of HIV / AIDS. Only little proportion of tea sellers has under gone voluntary testing for AIDS virus. The tea seller women are listening to radio and watching television; which make them potential sources for dissemination of information in the future. The tea sellers women when getting infected with ;sexually transmitted disease; used to seek treatment in governmental clinics and private pharmacies. The tea sellers women; like general population; are stigmatizing people living with AIDS. Although tea sellers women constitute a large proportion of the high risk population for HIV infection; no specific program to raise their awareness such as peer education; was designed for them