Superior mesenteric artery syndrome and nutcracker phenomenon

The superior mesenteric artery [SMA] syndrome is a rare cause of proximal intestinal obstruction in which the third part of the duodenum is compressed between SMA and the aorta due to narrowing in aortomesenteric angle. High index of suspicion, in the presence of known risk factors, is the key to early diagnosis. We describe a case of SMA syndrome in a 17-year-old boy who admitted with a long history of abdominal pain and intermittent vomiting. The computed tomography [CT] features were diagnostic of SMA syndrome. The CT also showed partial compression of the left renal vein by SMA with more proximal dilatation [nutcracker phenomenon]. He received conservative medical treatment, with a favorable outcome. Our case is unique in that two rare syndromes which rarely coexist found together in our patient

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

study of knowledge, attitude, practice towards epilepsy among relative of epileptic patients in Khartoum state

People with epilepsy are suffering from a lot of un tolded negative impacts on their lives; due to misunderstanding of the disease and from the associated stigma. The objective of this study is to assess the knowledge, attitude, and practice among relatives of Sudanese epileptic patients seen in Sheik Mohamed Kheir Neurological clinic and Elshaab Teaching Hospital. This is a descriptive cross- sectional community based study, 313 respondents were included, the duration of the study was from November 2008 to June 2009. Most of the respondents knew the disease, and had witnessed an attack. One third mentioned a brain lesion as the underlying cause of epilepsy. Most of the respondents mentioned loss of consciousness as the major symptom. More than two thirds mentioned that it is not contagious. Most of the respondents claimed that it can be controlled, and two thirds preferred medical treatment. The study revealed that half of the respondents had shown favourable attitudes and practice. The study revealed that the level of knowledge, attitude, and practice towards epilepsy needs community educational programmes to fill the gaps, and minimize the stigma

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