Epilepsy among Elderly Sudanese Patients

Objective: The aim of this study was to evaluate the clinical presentation and characteristics of elderly Sudanese patients with epilepsy. Methodology: This is a prospective study (from Feb. 2005 to Jun 2008). The study population included 240 elderly epileptic patients (age 60 years or above). Results: Cerebrovascular accident was found to be the most common cause of secondary epilepsy (31).Generalize epilepsy was seen in 120 (50) of patients. Abnormal neurological findings were more common (49) among patients with partial epilepsy. Fifty percent of our patients showed abnormal EEG. Abnormal CT brain findings were common among patients with partial epilepsy. Conclusion: The pattern of clinical presentation of epilepsy among elderly Sudanese epileptic patients is similar to what was mentioned in the literature except that the percentage of epilepsy following infections was more among our studied group (6

Monitoring and stratification of renal functions in patients with chronic hepatitis c virus infection: an immunohistochemical study

Hepatitis C virus [HCV] infects more than 170 million people worldwide and around 20% of blood donors are seropositive by ELIZA to HCV Ab in Egypt. Renal manifestations may be the presenting features of chronic HCV infection. This work was carried out on 200 patients with chronic HCV in order to study the relationship between HCV and chronic kidney Disease and to stratify HCV patients according to the degree of albuminuria and to know the histopathological changes in kidney and liver by immunohistochemical study. II showed that screening for proteinuria in patients with chronic HCV is necessary due to high prevalence of renal affection in these patients. Assessment of microalbuminuria should be done in these patients as an early indicator for renal affection. Albumin creatinine ratio ACR] had a good reliability as a surrogate measure for routine screening of urine albumin excretion. Awareness of chronic kidney disease [CKD] stage in patients with HCV and renal affection help prediction and early management of renal disease. There was a documented link between cryoglobulinemic and non-cryoglobulinemic membrano-proliferative glomerulonephritis and HCV infection

Monitoring and stratification of renal functions in patients with chronic hepatitis C virus infection

Hepatitis C virus [HCV] infects more than 170 million people worldwide and around 20% of blood donors are seropositive by ELIZA to HCV Ab in Egypt. Renal manifestations may be the presenting features of chronic HCV infection. This work was carried out on 200 patients with chronic HCV in order to study the relationship between HCV and chronic kidney disease and to stratify HCV patients according to the degree of albuminuria. It showed that screening for protenuria in patients with chronic HCV Is necessary due to high prevalence of renal affection in these patients. Assessment of microalbuminuria should be done in these patients as an early indicator for renal affection. Albumin creatinine ratio [ACR] had a good reliability as a surrogate measure for routine screening of urine albumin excretion. Awareness of chronic kidney disease [CKD] stage in patients with HCV and renal affection help prediction and early management of renal disease. There was a documented link between cryoglobulinumic and non-cryoglobulinumic membrano-proliferative glomerulonephritis and HCV infection

Peak Expiratory Flow Rates Among Gujjar and Non-Gujjar Population of Kashmir Valley

Peak expiratory flow rates of 506 healthy adults from a rural area of Kashmir consisting of 252 Gujjars and 254 non-Gujjars are reported. There is paucity of literature an ventilatory measurements of such populations living at high attitudes and this study is first of this kind from Kashmir valley. Gujjars were found to have lower peak expiratory flow rates than non-Gujjars. Role of domestic smoke pollution (measured as time spent near fire place) and smoking in lowering the peak expiratory flow rates has also been documented.

Smith - Lemli - Opitz Syndrome

This is a very rare autosomal recessive disorder characterised by short stature, microcephaly,low set ears, hypospadias (in males), pyramidal signs in addition to several other features as described.

Role of Intraperitoneal Antibiotic Lavage in Peritonitis

Although mortality and morbidity associated with generalized peritonitis has been brought down markedly, postoperative complications like wound sepsis, intra-abdomlnal collections, paralytic ileus and septicemia do occur in some cases. To minimize such complications different measures have been tried so far, including intraperitoneal lavage with saline solutions and antibiotics. We conducted a study involving fifty patients over a period of two years using the third generation cephalosporin, cefotaxime intraperitoneally with encouraging results.

Cockayne syndrome.

We report four cases of Cockayne Syndrome in a family of seven children. Apart from the usual clinical and laboratory features, sparse eye lashes and high arched palate in two patients, conjunctival and corneal edema in one, and proximal muscle weakness in one patient were noticed as additional findings.

Hyperhomocysteinemia and the risk of cardiovascular disease in hemodialysis patients and renal transplant receipients

The aim of this work was to study serum total homocysteine [tHcy] in dialysis dependent end stage renal disease [ESRD] patients as well as in renal transplant recipients [RTR] in relation to the established cardiovascular disease [CVD] risk factors. The study included 20 ESRD patients on hemodialysis [HD, group I], 20 RTR [group II] as well as 15 healthy age and sex matched controls. In HD patients, the mean fasting tHcy was significantly higher than that of the controls and hyperhomocysteinemia occurred in 90% of the patients. In RTR, mean tHcy level was significantly lower than in HD patients, yet still significantly higher than the controls and hyperhomocysteinemia occurred in 60% of the patients. None of the studied CVD risk factors [blood lipids, smoking, and hypertension] was significantly correlated to tHcy. In RTR, tHcy was not correlated to blood cyclosporine trough level. It was concluded that hyperhomocysteinemia was a common characteristic of HD patients and a frequent finding in RTR. The results indicated that hyperhomocysteinemia was associated with the occurrence of cardiovascular disease in both patient groups as an independent risk factor

Early detection of radio contrast media induced nephropathy

Radio contrast media [RCM] induced nephropathy has been defined as an acute impairment of renal function following exposure to radiographic contrast materials after excluding other causes of renal impairment [Bersketh and Kjellstrand, 1984]. The aim of the present work is early detection of asymptomatic radio-contrast media associated nephrnpathy and its possible effect on glomerular-and tubular functions. The study included 35 subjects divided into two groups: Group I: 20 patients received RCM urographin l ml/kg body weight and Group II: 15 healthy persons as normal control who received normal saline as a placebo. Both groups were subjected to thorough clinical examination and the following laboratory investigations: urinary microalbuminuria before as well as 24 hours after RCM to test glomerular function urinary alkaline phosphatase before RCM administration as well as 5 hours. 24 hours as well as 5 days after as a test for tubular function. The results of the present study showed significant increase in microalbuminuria in group I patients after administration of RCM, also there was statistically significant increase in the mean values of urinary alkaline phosphatase observed 5 hours. 24 hours, and 5 days after RCM

endogenous antioxidant enzymes in end-stage renal disease

This study was done to evaluate the plasma endogenous antioxidant enzymes activity [glutathione peroxidase, catalase and superoxide dismutase] in patients with end stage renal disease. Sixty patients were studied. They were divided into two groups: group I [30 patients with chronic renal failure on maintenance hemodialysis] and group II [30 patients with different degrees of renal impairment on conservative drug managemen]. Thirty healthy volunteers with normal kidney function were taken as a control group [group III]. For all of them the following was done: full medical history, complete clinical examination, hemoglobin concentration and hematocrit value, serum urea, creatinine, uric acid, calcium, phosphorus, fasting and 2 hours postpr and ial blood sugar, creatinine clearance, and blood levels of super-oxide dismutase, glutathione peroxidase and catalase. We found that the blood level of superoixde dismutase was significantly lower in group I than group III [P. < 0.0001] and it was significantly lower in group II than group III [P < 0.0001] and there was no significant difference between group I and group II [P < 0.3720]. The blood level of glutathione peroxidase was significantly lower in group I than group III [P < 0.0001] it was significantly lower in group II than group III [P < 0.0001] and significantly lower in group I than group II [P < 0.0117]. The plasma level of catalase was significantly lower in group I than group III [P < 0.001] and it was significantly lower in group II than group III [P < 0.0165] and there was no significant difference between group I and group II [P < 0.7002]. There was positive correlation between hemoglobin concentration and whole blood superoxide dismutase [r= 0.5767-P<0.0001] and also plasma catalase [r=0.2348 P<0.05]. It can be concluded that impaired activity of endogenous antioxidant enzymes occurs early in the course of chronic renal failure and is further exacerbated by hemodialysis resulting in permenant oxidative stress that can be an important mediator contributing to the progression of renal failure and to associated complications such as anemia consequently, it may be possible to propose that some antioxidant substances may be useful for such patients

Study of intercellular adhesion molecule-I in patients with liver cirrhosis and chronic hepatitis: association with disease severity and activity

This study was carried out in Benha University hospital on 20 patients with liver cirrhosis [Group I], 25 patients with chronic hepatitis [Group II] and 20 healthy controls. Thorough history and clinical examination was done to all subjects. Abdominal ultrasonography and the following laboratory investigations were performed to every subject: AST, ALT, serum albumin, serum bilirubin, Prothrombin time [PT], HCV Ab, HBs Ag, HBc Ab [IgG]. HBe Ab and serum level of intercellular adhesion molecule- 1 "sICAM- 1". Liver biopsy was done to patients only. Assessment of disease severity was judged by Child-Pugh classification. Assessment of disease activity was done by histopathological staging and by ALT and AST levels. Our work showed that serum level of sICAM- 1 was significantly high in both patient groups compared to controls, and this elevation was attributed to both increased hepatic production and defective hepatic clearance. The serum level of sICAM-1 correlated significantly with both disease severity and activity. Our study showed that serum level of sICAM-1 can be used as a screening non-invasive test with high specificity [100%] and sensitivity [94.6%] to detect patients with chronic liver diseases. On the other hand we failed to find a significant difference in the serum level of sICAM-1 between the two patient groups. Therefore, serum level of sICAM-1 has a poor diagnostic value with low specificity [78.6%] and sensitivity [43.5%] to differentiate patients with chronic hepatitis from patients with cirrhosis