Anatomical Variations Of The Cystic Duct And Their Surgical Implications In Sudanese Population: A Cadaveric Study

Background: Anatomic variations of cystic ducts are common and continuously encountered during Surgical andradiological interventions. Failure to identify these clinically important variations may result in complicationsduring surgical or endoscopic procedures.Patients and methods: This is an observational descriptive cross-sectional study. 65 cadavers in the dissectingrooms of the medical colleges, in which the length and mode of insertion of cystic duct (CD) into common bileduct (CBD) were observed.Results: The mean length of the CD in the cadavers examined was (2.06 ± 1.03) with a minimum length of d” 0.5 cmand a maximum of 5 cm. Regarding the mode of insertion of CD into the CBD; 53.8% were found to have a lowjunction between the CD and common hepatic duct (CHD) which is considered the normal insertion. 46.2% foundto be abnormal variations of insertion; short CD (d”0.5 cm) observed in 10.8%; whereas in 13.8% of cadavers wefound that the CD is adherent to the CHD and runs in parallel to it. In 7.8% there was a high junction between theCD and CBD and in 9.2% we found that CD courses anterior or posterior to CBD and joins it medially.Conclusion: CD variations are not uncommon and it is important to identify these anatomical variations. Adetailed knowledge of the extra hepatic biliary tract, as well as of its variations, is important for the diagnosticand therapeutic success in many clinical situations since they allow the surgeon prompt identification ofcertain pathologies, making surgical procedures more accurate and affective.

Testing of cellulose papers [cement papers] as growth media instead of acer to germinate and growth of pea embryos in vitro

Cells and embryos culture are new, important and useful methods in plant science scope. This method moved out from research to application scientific circuit. The technique of tissue culture uses the rapid propagation to produce large number of plants this cannot be actualize by classical propagation method which needs to specific time in the year and effort. Large number of scientific researchers have done that leaded know how can parts of plant differentiate and develop to organisms in artificial media. In order to, grow part of the plant. It should be capable of mitosis division where testing of used part of the plant and the growth stage of this part are important. In any case, should sterilize the used plant part before agriculture start then provide it with growth media. This requires that all equipment used in creating a cell and embryos culture must be sterilized to ensure contamination does not occur. In plant tissue culture researchers faces many problems as kind of nutrition media, high quality of sterilization that the. In addition to stimulation of embryos growth and activation of embryos to grow. This study was conducted in order to study possibility for alteration ager media to cellulose media [cement papers] for germination and growth of peas plant embryos. The mature embryos separated, sterilized then germinated in ager and cellulose media, in order to compare their growth in both media. Embryos left to grow in dark incubator at 26°C for four days. Growth parameters recorded then ail seedlings exposed to hardness stage by transferring them to the small pots. Seedlings left to grow four days under controlled conditions. Results of this study revealed that cellulose papers media is the best for embryos growth especially during the first four days [Incubation stage] where highly significant increases in total plant length; leaves formation had noted. In contrast, embryos that germinated in ager media did not showed any response in their length and weight .Treatment of embryos that grown on cellulose papers media by Gebberelic acid concentration of Ippm significantly increased their lengths; fresh weight and water content, while, treatment of embryos, that grown on ager media, with the same concentration of Gibberellic acid was useless during the first four days [Incubation stage]. After transfer the seedling to hardness stage, it had noted that seedlings grown in cellulose papers media improved their growth when they compared with seedlings that grown on ager media, also, the seedling slants to show an increase especially in the length of root. Treatment of seedlings by Gibberellic acid during the stage of hardness was not usefulness because it did not note any significant increases between controlled plants and the treated plants. The result of this study revealed to that cellulose papers can be used instead of ager media because embryos of peas plants improved their growth parameters

Ruptured ileocolic artery aneurysm: An unusual cause of hemoperitoneum

Ruptured aneurysm of a branch of ileocolic artery is a rare finding and is an unusual cause of haemoperitoneum. Rapid diagnosis, and surgical or endovascular intervention are necessary to avoid devastating consequences and high mortality rates following an emergency operation after rupture. Resection is a good choice for surgical intervention for some aneurysms that are not suitable for endovascular repair. This report describes the case of a middle-aged man with a ruptured superior mesenteric artery branch aneurysm and his subsequent surgical management.

Quality of work life and organizational commitment among nurses in a health care setting

The quality of work life is about the development oF organizational programs that support the of employees' welfare and commitment to their organizations. The study aim was to explore the relation between quality of work life and organizational commitment among those nurses working at a military hospital. Using a descriptive- correlational design on 140 nurses working in various units. Data were collected through two self-administered questionnaire sheets, which include the Quality of work life questionnaire, and the Organizational Commitment questionnaire. Pilot testing showed a high reliability of the tools. The results showed that only 20.7% of nurses had high QWL, while 90% of them had high total commitment to their job. A moderate statistically significant positive correlation was detected between nurses' scores of organizational commitment and QWL [r=0.47, p=0.01]. Multivariate analysis showed that the score of QWL and nurse's age were the statistically significant positive independent predictors of the commitment score. It was concluded that nurses in the military hospital have high levels of organizational commitment, but their QWL is quite low. The scores of QWL and organizational commitment are closely correlated. Nurses' age and QWL score can predict positively the score of organizational commitment. It was recommended to improve the QWL of nurses in the study setting through on-service training programs for nurse leaders in leadership and management, continuing education sessions for nurses, and reviewing the system of incentives. Further study is suggested to compare the QWL and organizational commitment between military and civilian hospitals

study of nurses' job satisfaction and motivate the relationship to nurse managers' leadership style

A leader's behavior or leadership style may influence the subordinates' level of job satisfaction; many studies concluded that effective leadership is associated with better individual and organizational performance. Recently, it has been shown that successful leadership is the result of the interaction between leaders and their subordinated in a particular organization situation, additionally, it was found that the employees' immediate supervisor had more impact on the employee than overall company policies or procedures. Leadership is the use of one's skills to influence others to perform the best of their ability. In an attempt to answer the question" Is there a relationship between the nurse manager's leadership style and the nurses' job satisfaction and motivation to work?" This study was conducted aiming at investigating the relationship between the nurse managers' leadership styles and the nurses' job satisfaction and motivation to work. Sample size was 41 nurse managers and 306 nurses chosen from four educational hospitals. Finding of the study indicated that the majority of the nurse managers [85.4%] adopted mixed leadership style, and the highest percent of the nurses were job dissatisfaction and motivated, with no significant relationship between leadership style and job satisfaction and motivation. Monitoring the work climate, is recommended to identify factors that may increase or decrease job satisfaction

clinico-epidemiological study of falciparum malaria in a cluster of villages in the eastern bank of the River Nile in Northern Sudan

A cross sectional descriptive study was conducted during the period from September 1997 to February 1998 in Tragma area; a part of an irrigation scheme located on the Eastern bank of the River Nile, 200 km North of Khartoum, in order to determine point prevalence and clinical characteristics of malaria in the area. The study consisted of two household surveys followed by a hospital-based study. Prevalence of malaria was 0.09% [1/1053] during September and 16.7% [119/711] during December survey. Plasmodium falciparum was detected in 120 [9.2%] of 1300 patients who reported to hospital during the study period. Both infection rate and mean parasite count/Mu l of Plasmodium falciparum decreased significantly with age [P<0.05]. Fever and low haemoglobin were found to be associated with Plasmodium falciparum infection [P <0.05]. No associations were observed between Plasmodium falciparum and digestive system symptoms or leucocyte count

Cryptosporidiosis among patients with diarrhoea attending Nyala Hospital

Cryptosporidiosis is a parasitic zoonotic non-bloody diarrhoeal disease that affects all people. Children and the immunosuppressed are more at risk than immunocompetent adults. It occurs in an epidemic as well as sporadic forms. Stool examination for Cryptosporidium oocysts has to be considered in non-bloody diarrhoea stools. The objective of this study is to determine the prevalence of Cryptosporidiosis among patients presenting with non-bloody diarrhoea to Nyala medical laboratory. This is a descriptive cross-sectional study including non-bloody diarrhoeal stool specimens of 72 patients. The stool specimens were examined for Cryptosporidium oocysts by using Safranine/ Methylene blue stain technique. Eleven [15.3%] out of 72 patients were positive for Cryptosporidium oocysts. Seven of them were below five years of age. Cryptosporidiosis is a common cause of non-bloody diarrhoea especially among children. This study enrolled a small number of patients. Nevertheless we recommend inclusion of Cryptosporidium in laboratory examination of non-bloody diarrhoeal stools in certain locations

Outcome of double burr-hole craniotomy in patients with chronic subdural haematoma

Chronic subdural haematoma [CSDH] is a common condition in late stages of life. Most of the patients are subjected to minor trivial trauma which will end up with a collection of altered blood in the subdural space. This necessitates immediate surgical drainage, with the aim to reduce the mass effect on the brain to alleviate the symptoms and to reverse the condition. To report the experience and outcome of double burr-holes craniotomy in treatment of chronic subdudal haematoma. This study was conducted on 70 patients with CSDHs managed at Omdurman Teaching Hospital Sudan, during the period from November 2004 to November 2006. All patients after clinical assessment and CT scan of the brain proved to have CSDH. The haematoma was removed surgically by double burr-holes craniotomy, irrigation and close system drainage. The study included 70 patients, 50 males and 20 females. The mean age was 69 years. Computed tomography scan, showed unilateral collection in 60% of patients and bilateral in 40%, only 1.8% showed conning of the brain. Unilateral double burr-hole craniotomy was performed in 60% of the patients, while bilateral was done in 35.7%. In the postoperative follow up 87.1% of the patients showed uneventful recovery. Seven patients developed complications in the form of pneumocephallus or postoperative recurrence. The mortality rate was 2.9%. Burr holes craniotomy, irrigation and close system drainage, is effective and favor rapid regression of residual subdural collection and associated with fewer recurrences

Cutaneous myiasis due to Dermatobia hominis: a case report from Eastern Sudan

Cutaneous myiasis [CM] is invasion of human skin by larvae of dipterous flies CM is encountered world-wide and is endemic in several tropical countries, mainly in central and south American. Cases have been reported in non-tropical countries such as USA, UK, Germany, and Japan. Patients with CM due to Dermatobia hominis usually suffer from painful pruritic furuncular skin lesion with a serous or seropurulent discharge accompanied by a crawling sensation. The disease may resolve spontaneously, however conservative and/or surgical treatment may be indicated. Fatal CM due to D. hominis was reported from Brazil where a scalp lesion had disseminated into the brain. In Sudan, CM seems uncommon, unreported or probably underdiagnosed. In this communication we describe a case of CM due to D. hominis which seems to have been acquired from an indigenous source

Expression of both Albumin and Cytokeratin of Small Epithelial Cells in Human Hepatocellular Carcinoma / 上海第二医科大学学报

ObjectiveTo investigate whether small epithelial cells (SEC) exist in human hepa- tocellularcarcinoma (HCC) and if so, whether they exhibit immunolabelling for both albumin and cytokeratin 7 (CK7). MethodsThirty cases of human HCC from operative specimens were investi- gated by immunohistochemistry with antibody against albumin, a marker of hepatocyte differentiation and CK7, a marker of biliary differentiation. Ten cases were investigated by electron microscopy and by immuno- electron microscopy. ResultsThe SEC were found in 20 of 30 cases that located around the edges of the tumors and appeared as proliferative small biliary ductules. Under electron microscopy they were of small size, contained sparse cytoplasm, few free ribosomes, intracellular tonofilarnents, and intercellular junctions. Immunoelectron microscopically the SEC exhibited labelling for both albumin and CK7 in 5 out of 10 cases. ConclusionSEC in human HCC are found that represent the same mor- phology like those seen in hepatoblastoma and biliary atresia, co- expressed markers for hepatocytic and biliary differentiation.