Variations of Arterial Supply of the Liver: C.T. Angiographic Study Among Sudanese Adults

Hepatobiliary surgery through laparoscopic approach is becoming a routine. Knowledge of extrahepatic arterial tree is essential for surgical and imaging procedures. Anatomical complexity is expected since the liver is developed by mergingof lobules with its separate blood supply. This makes a wide range of variations in the pattern of vascular arrangement and so reinforces the need for an accurate understanding of full spectrum of variations. This study aimed to investigate the variations in origin and distribution of extrahepatic arterial supply. Fifty volunteers (32 males and 18 females) aged 20­70 years were randomly recruited from the department of CT scan in Al Amal Hospital, Khartoum North, Sudan. The patients were already candidates for CT angiography with contrast for conditions other than hepatobiliary diseases. The reported data is related to those who accepted to participate in the study. Patients with history of hepatobiliary disease were excluded. 3D views of the scans were treated and the extrahepatic arterial tree was traced in a computer-based software. Key findings suggest that Michel's classification was considered the standard template for description ­ 76% of them showed Michel's type I classification. Types III and V constituted about 2%. About 4% of the cases were represented by types VI and IX. Other types of variations constituted about 12%. To conclude, although type I classification which describes the textbook pattern of hepatic artery distribution was significantly detected among the Sudanese population, other variants were to be considered since they are related to major arteries like aorta and superior mesenteric.

Attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students in a Malaysian private medical college

INTRODUCTION@#This study explored attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students, and determined the association between their demographic characteristics, and attitudes and acceptance.@*METHODS@#A cross-sectional survey was conducted among clinical-year medical students from a Malaysian private medical college using a self-administered questionnaire.@*RESULTS@#There were 330 participants with a female preponderance and a mean age of 22.0 ± 1.1 years. The largest proportion of respondents were from Year 3. The vast majority were ethnically Malay (91.8%) and followed Islam (92.4%). Overall, 60.9% of participants had a positive attitude towards vasectomy and 76.0% showed good acceptance. Gender, academic year, ethnicity and religion variables were not associated with attitudes and acceptance (p > 0.05). A significantly higher proportion of male respondents thought that vasectomy was religiously forbidden and would give a bad impression. A significantly higher proportion of Year 5 students agreed to the statement 'I would recommend vasectomy to relatives, friends and people close to me' compared to Year 3 and 4 students.@*CONCLUSION@#Students' perception of vasectomy as a contraceptive method was encouraging. Our results suggest that their knowledge improved as medical training progressed, and attitudes evolved for the better irrespective of their traditional, cultural and religious beliefs - highlighting the importance of providing students with evidence-based learning about male sterilisation, which is more cost-effective and is associated with lower morbidity than female sterilisation. A qualitative study involving students from different ethnicities and religions would provide a better understanding of this subject.

The use of a documentary drama film to improve the knowledge, attitude and practice of an endemic village population towards mycetoma at Sennar State, Sudan

Background: Mycetoma is a badly neglected tropical disease, characterised by enormous deformities, disfigurement and disabilities if untreated early. Frequently, the majority of the mycetoma patients present late with advanced disease, and the only available treatment for them will be amputation of the affected part. Aim: This study aimed at producing a health promoting film to be used to improve the knowledge, attitude and practice (KAP) of a targeted population in one of the mycetoma endemic villages at Sennar State, Sudan.Materials and Methods : A 26 - minute drama film on a mycetoma patient journey from a small painless mass to advanced disease till lower limb amputation due to missinformation and negligence was performed. Professional actors and cinema work team were employed in the film production. It was filmed in one of the mycetoma endemic areas. A cohort of 250 individuals from two mycetoma endemic villages were included in this study. A closed ended pre-designed questionnaire was used to collect data from the targeted population. The collected data included demographic characteristics, knowledge, attitudes and practices towards mycetoma. The data was collected before and after the film was shown.Results: In this study, 218/250 responded to the questionnare with a response rate of 87%. Fifty-five percent of the respondents were males, 21.6% were farmers, 29.4% were students and 29.4% were unemployed.The film had improved the KAP of the targeted population hence it can be used as a health educational material in other mycetoma endemic areas in the Sudan

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

Bilateral ocular coloboma associated with nonsyndromic cleft lip and palate / 国际眼科杂志(Guoji Yanke Zazhi)

·The authors describe a 2-month-old boy with nonsyndromic cleft lip and palate. On examination, he had bilateral inferior iris colobomas, vitreous veils, optic disc and choroid colobomas. Magnetic resonance imaging(MRI) revealed bilateral colobomatous microphthalmia, retrobulber cysts and thinned optic nerves. Every infant with cleft lip and palate should be examined by an ophthalmologist to detect possible associated ocular abnormalities.

Chronic renal failure; Treatment of anemia with erythropoietin and iron

This study on anemia in chronic renal failure patients was aimed at evaluation and comparison of response to erythropoietin therapy in iron deficient groups treated with parenteral vs iron deficient group treated with oral iron; keeping iron replete patients as controls. Study design was case control study. The study was carried out at department of medicine Military hospital Rawalpidi and Armed forces institute of Urology; from 1997-1998. A total of 59 patients were recruited. Comparison of the change in hemoglobin, hematocrit, and reticulocyte count and serum ferritin levels was made. They were divided into three groups based on their serum ferritin levels. Group I [n=18] and group II [n=16] consisted of iron deficient patients. Group Ill [n=25] consisted of iron-loaded individuals and they were treated with erythropoietin alone. This group acted as the control group for the study. The hematocrit increased by an average of 6% in group I, 2% in group II and 5% in group Ill. The serum ferritin levels increased by an average of 147.51 microg/I in group I. Group II on oral iron showed an increment of only 77.1 mg/I. Group Ill that consisted of iron loaded patients showed a decrease of 594.2 mg/I in serum ferritin levels while on erythropoietin. [i] It was concluded that erythropoietin improved anemia in patients with chronic renal failure, parenteral iron having a definitive advantage over oral iron therapy. This response is augmented by supplementing iron in iron deficient patients. [ii] Conversely, functional iron deficiency, i.e. the inability to utilize iron in iron replete patients for erythropoiesis exhibit improvement with erythropoietin therapy