Neurological manifestations of dural sinus thrombosis

Dural sinus thrombosis is a clinical syndrome that has a diversity of signs and symptoms that can be easily misinterpreted with other common neurological diseases such as brain infections. To study the clinical presentation of dural sinus thrombosis among Sudanese patients seen at Elshaab Teaching Hospital. This is a prospective, descriptive, cross sectional, hospital based study conducted in Elshaab Teaching Hospital- Khartoum Sudan, in the period from November 2008 to July 2010. All adult Sudanese patients with dural sinus thrombosis who were admitted to the hospital and accepted to participate in the study during the period from November 2008-July2010 [50 patients] were enrolled. History, clinical examination and relevant investigations including MRI were done for all patients. Data were collected, analyzed, conclusions drawn and recommendations stated. Females [98%] in child bearing age were mostly affected. Delivery and pregnancy were the common risk factors; head ache, neck pain and stiffness were the frequent neurological symptoms. Papilledema was the commonest neurological finding. Saggital sinus thrombosis was found to be the major radiological finding and great majority of patients showed remarkable improvement with treatment. Dural sinus thrombosis is uncommon neurological problem, however the diagnosis should always be considered in the right clinical setting, as it is a treatable condition

Correlation between retinopathy, nephropathy and peripheral neuropathy among adult Sudanese diabetic in patients

Diabetes Mellitus is a worldwide common metabolic disorder. Increasing prevalence of diabetes, lack of proper education about the nature and course of the disease and necessary control are the main factors for an early onset of micro vascular complications. To correlate between retinopathy, nephropathy and neuropathy, among adult Sudanese diabetic patients at Elshaab Teaching hospital, Ahmed Gasim Teaching hospital and Gabber Abu Eleaz centre, from December 2006 to September 2008. This is a descriptive prospective cross sectional hospital based study, 71 patients were included. Male to female ratio was1.4:1.Common age group affected was 60-69 [32.4%].Common duration of diabetes mellitus was 20-24 years [23.9%].All patients who had diabetes for 25 years or more had developed complications [19.7%].The commonest long term microvascular complication was found to be retinopathy [71.2%], followed by neuropathy [69%] and nephropathy [50.7%].It was found that [47.6%] of our patients had the three complications. Long-term micro vascular complications affect male more than female, with average age of onset 60-69 years. All patients who had diabetes for 25 years or more had developed complications. Retinopathy is the most common micro vascular complication, followed by neuropathy. There is a significant correlation between retinopathy, nephropathy and neuropathy in association with the duration and control of blood glucose level

Correlation between Retinopathy; Nephropathy and Peripheral Neuropathy among Adult Sudanese Diabetic Patients

Diabetes Mellitus is a worldwide common metabolic disorder. Increasing prevalence of diabetes; lack of proper education about the nature and course of the disease and necessary control are the main factors for an early onset of micro vascular complications. Objective: To correlate between retinopathy; nephropathy and neuropathy; among adult Sudanese diabetic patients at Elshaab Teaching hospital; Ahmed Gasim Teaching hospital and Gabber Abu Eleaz centre; from December 2006 to September 2008. were included. Result: Male to female ratio was1.4:1.Common age group affected was 60-69 (32.4).Common duration of diabetes mellitus was 20-24 years (23.9).All patients who had diabetes for 25 years or more had developed complications (19.7).The commonest long term microvascular complication was found to be retinopathy (71.2); followed by neuropathy (69) and nephropathy (50.7).It was found that (47.6) of our patients had the three complications. Conclusion: Long-term micro vascular complications affect male more than female; with average age of onset 60-69 years. All patients who had diabetes for 25 years or more had developed complications. Retinopathy is the most common micro vascular complication; followed by neuropathy. There is a significant correlation between retinopathy; nephropathy and neuropathy in association with the duration and control of blood glucose level

Prevalence of neurological manifestations of lung cancer among adult Sudanese patients

Is to study the prevalence of neurological manifestations among adults Sudanese patients with lung cancer seen in the Radiation and Isotope Centre in Khartoum. 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. 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. 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. To study the clinical presentation of epilepsy among adult Sudanese females and to verify aspects of epilepsy specific to women. 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. The study showed that 72% of the patients had generalized epilepsy and 28% had partial epilepsy, primary epilepsy is more common than secondary epilepsy, 54% of our patients had warning symptoms and 39.7% had triggering factors, irregular menstrual cycle was observed in 28%, 22% of our patients had catamenial seizures, 7.1% had increased frequency of seizures during pregnancy. Obstetric complications were common among our studied group. The incidence of infertility increased among our studied group. Women had differences in presentation and control of epilepsy that must be understood and considered when treating women with epilepsy

Correlation between serum level of antiepileptic drugs and their side effects

The aim of the study is to investigate the relation between serum levels of anticonvulsants and their side effects. This is a prospective cross sectional hospital based study conducted at Al Shaab Teaching Hospital. 120 patients were included in the study. The AEDs used were phenytoin, phenobarbitone, carbamazibine, and sodium valproate. The results showed that the side effects among the studied group were not uncommon. There was no relationship between serum levels of AEDs and their side effects

patterns of clinical presentations of cerebellar syndromes among adult Sudanese patients

Cerebellar syndromes are one of the commonest neurological diseases. To study the patterns of clinical presentations of cerebellar syndromes and to identify the possible causes. 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. The most common age group affected was 18-25 years. Male to female ratio was 1.5: 1; unsteadiness on walking was the most common symptom [83%]. Gait-ataxia was the most common sign [83%]. Cerebrovascular disease was the most common aetiology [25%]. 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

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. This is a descriptive cross sectional hospital based study, it was conducted at El Shaab Teaching Hospital, Khartoum, Sudan during the period from February 2004 to October 2006. 100 diabetic patients were included in the study, 62 were male and 38 females. More than 85% were above the age of 35 years and 56% were in the age group 35- 64. The patients were from different tribes and different 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 2 diabetes mellitus and 78.4% of them had diabetes for more than one year. Hypertension was found in 28% of our patients. The study revealed that 60% of the diabetic patients have neurological manifestations. The main neurological complication found was peripheral sensory-motor neuropathy. There is significant positive correlation between age, duration of diabetes, glycaemic control and occurrence of the neurological complications

prevalence of neurological complications among adult Sudanese patients with chronic liver disease

We aimed to study the prevalence of neurological complications among adult Sudanese patients with chronic liver disease [CLD] seen in Ibn Sina Hospital [Sudan] [February 2005 - February 2006]. This is a prospective descriptive cross sectional hospital based study. Ninety six adult Sudanese patients with CLD were included in the study. All patients had been subjected to full detailed history, proper clinical examination and necessary investigations including EEG, Brain CT, MRI, NCS and EMG. Male to female ratio was [2.5:1]. Splenomegally was observed in 71 patients [74%], shrunken liver in 83 [86.5%], 74 [77.1%] had ascites. Sixty percent had liver cirrhosis, 24% had cirrhosis with periportal fibrosis [PPF]. Hepatocellular Carcinoma [HCC] was detected in 12 patients. Out of 96 patients with CLD, neurological complications were detected in 44 [45.8%], acute hepatic encephalopathy ranging from grade I to grade IV was found to be the most common neurological complication [29 patients]. Neurological complications were common among adult Sudanese patient with chronic liver disease

Diabetic autonomic neuropathy

The diabetic autonomic neuropathy is a poorly studied subject in our medical literature. This study is aimed at investigating the presence of diabetic autonomic neuropathy in a group of Sudanese diabetic patients and its relationship to factors like glycemic control, duration of diabetes and presence of peripheral neuropathy. During one year we examined 120 diabetic patients and an age-matched control group of 42 by applying a battery of 5 cardiovascular autonomic tests, beside a full history and clinical examination. The patients were also tested for glycemic control and presence of peripheral neuropathy. Diabetic autonomic neuropathy was diagnosed in 48 patients [40%] of a mean age of 48.411 + 12.50 years, type 1/2 diabetes was 10/38, mean duration of diabetes 16.2 + 7.3 years, 41 with poor glycemic control [81%] and peripheral neuropathy was present in 32 patients [66%]. We found a significant association between diabetic autonomic neuropathy and prolonged duration of diabetes [P<0.001], poor glycemic control [0.01>P>0.001] and presence of peripheral neuropathy [0.02>P>0.01]. Diabetic autonomic neuropathy [both asymptomatic and symptomatic] is a common problem among our diabetic patients. It is significantly associated with prolonged duration, poor control of diabetes and presence of peripheral neuropathy. We need to augment the awareness of diabetes care providers to the occurrence, and peculiar features and tests of this syndrome