Spontaneous achilles tendon rupture in alkaptonuria

Spontaneous Achilles tendon ruptures are uncommon. We present a 46-year-old man with spontaneous Achilles tendon rupture due to ochronosis. To our knowledge, this has not been previously reported in Sudan literature. The tendon of the reported patient healed well after debridement and primary repairs

Why do people prefer traditional bonesetters in Sudan?

In Sudan as in other developing nations, traditional bonesetters play a significant role in primary fracture care. There is widespread belief in our society that TBS are better at fracture treatment than orthodox practitioners. Significant numbers of patients with fractures present first to the traditional bonesetters before coming to the hospital and therefore this mode of care delivery cannot be overlooked in Sudan. A prospective study designed to determine the reasons of why a considerable number of people prefer to go to the traditional bonesetters in Sudan. Patients and methods: This prospective two stages study was carried out in two different stages, 1st stage in 2006 targeted general population, and the 2nd stage in the period from May 2009 to September 2009 targeted traditional bonesetters and their patients. In the 1st stage of the study we distributed a predesigned questionnaire to general population, while in the 2nd stage of the study we visited different traditional bonesetter in order to interview them and their visitors and completing the early prepared Performa. We excluded the too elderly patients and children who have no decisions to choose TBS. In the 1st stage of study the participants were 199 of them, 192 participants responded well to the questionnaire. The reasons why they went to traditional bonesetters were; in 71 participants [37%] was their beliefs, in 27 [14.06%] was due to the low cost, and in 27 [14.06%] was due to fear of plaster. In the 2nd stage of the study 276 participants fulfilled the criteria of the research. The reason why they went to traditional bonesetters; in 63 candidates [22.8%] was their beliefs [P value < 0.003], in 53 [19.2%] was low cost [P value < 0.05], and in 46 [16.7%] was due to fear of cast or amputation. Study included sixteen traditional bonesetters, of them 14 were males and 2 were females. One of them has a bachelor graduation from faculty of sciences. 11 [68.8%] traditional bonesetters accepted the idea of regular training under medical supervision. Despite an adequate number of physicians practising in the region, traditional bonesetters continue to be consulted. Study showed that a belief is the most leading cause of consulting traditional bonesetters, other causes including fear of plaster or amputation and less cost. We recommend that the efficacy of their treatments have to be further assessed

Metastatic signet ring cell adenocarcinoma of proximal femur with uncertain primary site

Although bone metastases can be found commonly in some malignant tumours, diagnosing a primary malignancy site is not a usual event. Secondary signet ring cell carcinoma of the bone is a very rare tumour. We present a case with pure metastatlc signet ring cell carcinoma of the bone, with an uncertain primary site. A 48-year old man was admitted with Rt thigh swelling and inability to walk. One of first diagnostic effort performed was histopathological examination that revealed a metastatic signet ring cell carcinoma, compressing the regional lymphatics. To our knowledge, in Sudan literature, we believe that this case is the first report of metastatic signet ring cell carcinoma of the proximal femur. Because of the very short survival of many patients, all investigational procedures should be judged in view of their rationality, and should be focused on treatable primary tumours