Assessment of anemia management in regular haemodialysis patients in Gezira hospital for renal diseases and surgery, Wad Medani

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

Prevalence and management of periodontal diseases in Gezira province [central Sudan]

This study aimed to assess the status of present periodontal diseases in Gezira Province, The facilities investigated included those in urban and rural areas including Wad Medani Dental hospital, Wad Medani Military Hospital, El Gadaiea Health Centre and Maringan Health Centre. The study tools were direct pre-coded questionnaires, and a checklist. The procedure involved dental clinical examinations of patients to estimate periodontal diseases assessed by measuring calculus, gingival bleeding and periodontal pockets [PI index]. The study sample was randomly selected to comprise 10% of patients attending Wad Medani Dental and Military Dental Hospitals during a week time period [6 days]. All patients attended El Gadaiea and Marinjan Health Centres [n = 201] and sampled patients at rural health institutions during the same period were recruited [n = 448]. Thirty study sites in the rural areas were chosen from five study councils including Alhosh, Wad Alnaeem, Alhag Abdalla, Almadina Arab and Hantoub. They comprise 418 towns, villages and camps, of the only 118 had health services, including only four dental units. This was the reason that most of rural populations seek oral health services for periodontal diseases and dental caries in Wad Medani health institutions. The result showed that the prevalence of gingivitis and periodontal diseases were more prominent in the rural areas, while the management of them were meager in both the urban and rural areas. From the results of the present study could be concluded that there was a high prevalence of periodontal diseases due to poor provision of dental services in both quantity and quality at Gezira Province

Malaria in pregnancy -Wad Medani Maternity Teaching Hospital

This is a prospective hospital - base study conducted in Wad Medani Maternity Teaching Hospital, during the period from 5[th] of October 2003 to 30[th] of December 2003. The objective of this study were to assess the status of malaria in the wards in Wad Malani Maternity Teaching Hospital, to determine the effects of malaria on the mother as well as on pregnancy outcome, and also to test the National Protocol for Treatment of Malaria during Pregnancy using Wad Madani Maternity Teaching Hospital. All pregnant women with malaria admitted to the hospital during that period were included in the study. Malaria was diagnosed by thick and thin blood film, Gimsa's stain. Severe falciparum malaria was diagnosed according to WHO criteria. National Protocol for Treatment of Malarial during Pregnancy was adopted in the management of all women. Patients were consider to be cure if symptoms and signs disappeared. The results were analysed using SPSS. The total number of pregnant women included in this study was 210. The main results of the study were: [i] severe falciparum malaria [73.4%], [ii] anaemia [98.6%] of whom 20%] was severe and [11%] was very severe, [iii] hyperparasitaemia [46.7%], [iv] dehydration [33.3%] and [v] jaundice [20.5%]. Complications on the fetus were: [i] preterm labour [44.1%], [ii] low Agars score < 7 [55.9%], [iii] low weight K 2.5 [44.1%] and [iv] perinatal death [5.5%]. Quinine was the main drugs used, Pregnant women admitted to the hospital need intensive care. Although there was no mortality but morbidity was high. The current protocol is adequate in reducing mortality. Intervention to reduce poor pregnancy outcomes must reduce the burden of malaria in pregnancy

Pseudomyxoma peritonei a rare case

This is a case report of a 55- year old male patient who presented with features of intestinal obstruction. The obstruction which was relieved surgically by removal of fibrous adhesions was found to be the result of Pseudomyxoma peritonei however, at operation the primary focus of the tumor was not found because of extensive local metastasis. The patient received parental chemotherapy in form of intravenous 5-fluorouracil [600mg/day 5 times/ week] for 6 month and was discharged from hospital in good condition