Factors associated with patient delay in accessing pulmonary tuberculosis care, Gezira State, Sudan, 2009

Analyses of patient delays in seeking treatment for tuberculosis [TB] provide useful evidence for national TB control programmes. The objectives of this study in Gezira State/ Sudan were to estimate the extent of, and factors associated with, pulmonary TB patient delay in accessing care. A cross-sectional phase was conducted to determine the length of delay, followed by a nested case-control phase comparing patients delaying above or below the median time. The mean patient delay was 27.2 days, median 4 days [range 0-365 days]. There were no significant differences between case and control groups in terms of age/ sex, marital status, educational level or smoking status. However, patients living in urban areas, with low income status and who were housewives or unemployed were more likely to delay. Also patients with a history of contact with a TB patient, those who suspected TB and those with a history of chronic obstructive pulmonary disease were more likely to delay

Total versus subtotal abdominal hysterectomy influence on the urinary bladder function

To evaluate lower urinaiy tract flinctions in asymptomatic patients after subtotal abdominal hysterectomy and total abdominal hysterectomy. Forty mtdtiparous premenopausal patients, subjected to subtotal and total abdominal hysterectomy for non malignant causes, and with no urinary complains, were divided into two groups: Group A: Twenty patients in whom subtotal abdominal hysterectomy was performed. Group B: Twenty patients in whom total abdominal hysterectomy was undertaken. Urodynamic data [cystometry, uroflowmeny, and abdominal detrusor leak point pressure] were collected preoperatively, at the 4[th] week, and at the 4[th] month postoperative in both groups. The mean age of group A and B were 42.58 +/- 12.09 years and 43.9 +/- 13.21 years respectively. The mean parity of group A and B were 2.01 +/- 1 1.08 deliveries and 2.61 +/- 1 1.36 deliveries respectively. The mean body mass index of group A and B were 31.25 +/- 12.85 kg/m[2] and 30.7 +/- 1 3.01 kg/m[2] respectively. There were no statistically significant differences between both groups as regards the age, parity, and body mass index. Four weeks postoperative, patients of group A and B complain of frequency [in 20% and 40%], urgency [in 5% and 25%], urge incontinence[in 5% and 20%] respectively. After 4 months of the operation, frequency persisted in [10% and 25%]; urgency persisted in [5% and 20%], However, urge incontinence disappeared in the only one case of group A, which suffered from, while diminished in group B to 10% of the cases. Stress incontinence had never occurred in both studied groups postoperatively. No statistical significant differences were found in the bladder capacity and detrusor muscle activity preoperatively compared with follow up at 4 weeks and at 4 months postoperatively in both groups. Also, No statistical sign[ficant difference was found in residual urine volume preoperative compared with follow up at 4 weeks and at 4 months postoperatively of group [A]. However, significant postoperative increase in the residual urine volume is observed in patients of group [B]. Insignificant urinary complainsand functions changes, except, urgency and residual urine volume are significantly complicating total hysterectomy more than subtotal hysterectomy, with improvement occurred 4 months after the operation