RESUMEN
Syphilis is a sexually transmitted disease found only in humans, which is caused by a spirochete [Treponema pallidum]. It infects the genital area, lips, mouth, or anus of both men and women. Patients usually get syphilis from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy. The early stage of syphilis usually causes a single, small, painless sore. Sometimes it causes swelling in nearby lymph nodes. If you do not treat it, syphilis usually causes a non-itchy skin rash, often on your hands and feet. Many people do not notice symptoms for years. Symptoms can go away and come back. The sores caused by syphilis make it easier to get or give someone HIV during sex. If you are pregnant, syphilis can cause birth defects, or you could lose your baby. In rare cases, syphilis causes serious health problems and even death. Syphilis is easy to cure with antibiotics if you catch it early. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading syphilis
RESUMEN
This study was conducted to evaluate the status of anemia and its management in regular haemodialysis patients attending Gezira Hospital for Renal Diseases and Surgery [GHRDS], compared to the international guidelines, in order to know where we are standing relative to what should be done, and to try to put our own guidelines according to our situation. So 140 patients [70% of them were males] representing all End Stage Renal Disease patients who are in regular haemodialysis during December 2005. The data was collected from all patients. The data included: age, sex, hemoglobin, Urea Reduction Ratio [URR], is she/he on intravenous iron and erythropoietin. The mean hemoglobin [Hb] level was 7.5g/dl, with a minimum Hb of 2.4g/dl and a maximum of 14.5g/dl. Most of females [95%] of females were anemic and all males have Hb less than 13.5g/dl. About 24% of patients were on intravenous iron supplements, and only 30% of them were taking it regularly, while 20% of patients were on subcutaneous erythropoietin, 50% of them taking it regularly. The main cause for not taking these drugs is poverty. The majority [93%] of patients were receiving two sessions of haemodialysis per week, and the mean URR was 62.5, there was only 41% of patients with URR more than 65%. Despite that anemia in Chronic Kidney Disease [CKD] is multifactorial; however this study indicated that the most important reasons for low Hb level in our patients are: the inadequate assessment of anemia with failure of taking iron and erythropoietin, lack of information about the disease and its complications including anemia and the lines of management among patients and inadequate dialysis. So it is recommended to establish an anemia management team in GHRDS to do proper assessment of anemia and to follow the management, to provide free erythropoietin and intravenous iron for patients, increase dialysis dose to three sessions [12 hours] per week and to establish our own guidelines for management of anemia in CKD in Sudan according to our situation and parameters