Intestinal obstruction in children at El Obeid Hospital, Western Sudan

Intestinal obstruction is a common cause of childhood surgical emergency in the developing countries with considerable morbidity and mortality. To assess the magnitude, pattern and management outcomes of intestinal obstruction in children presenting to a General Surgical Unit at a rural setup, in Western Sudan. The clinical records of all children below 15 years of age admitted to the University General Surgical Unit at El Obeid Teaching Hospital, in Western Sudan with the diagnosis of intestinal obstruction during the period from 2006 to 2007 were retrospectively reviewed. The mean age, gender, causes of obstruction and management outcomes were studied and analyzed. There were 72 patients, 48 were males [66.7%]. Neonates and infants were 70% of patients. Hirschsprung's disease, intussusception, obstructed hernias and ano-rectal anomalies accounted for 21.8%, 19.4%, 16.7% and 13.9% respectively. Less common causes were pyloric stenosis 8.3% and gut atresia 6.9%. Lymphoma, adhesions, peritonitis and faecal impaction were 2% each. The overall mortality rate was 13.9%. The main causes of childhood intestinal obstruction at Western Sudan were congenital anomalies in neonates, intussusception in infants and obstructed hernias in elder children. The management was associated with high mortality due to poor hospital facilities and late presentations resulting in bowel ischaemia

Cancelled elective surgical operations at El Obeid Hospital, Western Sudan [revised article from Volume 44]

Cancellation of scheduled surgical operations on the day of surgery at hospitals upsets the patients and causes great concern to the relatives. It is also a major drain on health resources as the theatre costs increase and its efficiency decreases. The objective of this study is to estimate the frequency of cancellation of scheduled elective surgical operations on the day of surgery and to study the reasons for cancellation at El Obeid Teaching Hospital, Western Sudan. This is a prospective observational study. All the patients who had their major general surgical operations cancelled on the day of surgery during the year 2007 were included. The information were collected in a pre-formed questionnaire containing the patient characteristics, clinical diagnosis, intended operation, proposed anaesthesia and the exact reasons for cancellation. There were 1633 elective major general surgical operations performed during the study period. 162 cases [9.9%] were cancelled, eighty nine patients [55%] were females. The mean age was 46.5 years. The causes of cancellations were 34.6% patient related, 32.1% staff related and 33.3% procedural reasons. Cancellation of scheduled surgical operations on the day of surgery is a significant problem which annoys patients, increases the costs and decreases the efficiency of utilization of the theatre facilities. The reasons for cancellation were discussed. With better arrangements, the majority of the reasons can be avoided

Cancelled elective surgical operations at El Obeid Hospital, Western Sudan

Cancellation of scheduled surgical operations on the day of surgery at hospitals upsets the patients and causes great concern to the relatives. It is also a major drain on health resources as the theatre costs increase and its efficiency decreases. The objective of this study is to estimate the frequency of cancellation of scheduled elective surgical operations on the day of surgery and to study the reasons for cancellation at El Obeid Teaching Hospital, Western Sudan. This is a prospective observational study. All the patients who had their major general surgical operations cancelled on the day of surgery during the year 2007 were included. The information were collected in a preformed questionnaire containing the patient characteristics, clinical diagnosis, intended operation, proposed anaesthesia and the exact reasons for cancellation. There were 1633 elective major general surgical operations performed during the study period. 162 cases [9.9%] were cancelled, eighty nine patients [55%] were females. The mean age was 46.5 years. The causes of cancellations were 34.6% patient related, 32.1% staff related and 33.3% procedural reasons. Cancellation of scheduled surgical operations on the day of surgery is a significant problem which annoys patients, increases die costs and decreases the efficiency of utilization of the theatre facilities. The reasons for cancellation were discussed. With better arrangements, the majority of the reasons can be avoided

Emergency laparotomy for acute sigmoid volvulus in El Obeid hospital, western Sudan

To evaluate the role of emergency laparotomy in patients presenting with acute sigmoid volvulus at EI Obeid Teaching Hospital, Western Sudan. The records of 22 patients with acute sigmoid volvulus who were offered emergency laparotomy and admitted to the wards of the University Surgical Unit at EI Obeid Teaching Hospital, Western Sudan over 4 years, were studied. They were 18 males and four females. The mean age [[ +/- SD] was 59.7 [ +/- 14. 16] years. Patients had viable bowel for which detortion, deflation and colopexy were done. Eight patients had sigmoid colectomy later. Six patients had gangrenous bowel and underwent immediate resection and anastomosis, following which one patient died [4.5%]. Eight patients were lost in follow up. Emergency laparotomy for sigmoid volvulus may be overdone. A conservative decompression sigmoidoscopy with de rotation and tube deflation should be tried in such patients, with plans for colectomy later

Drug use among prisoners in three main prisons in Khartoum, Sudan

Drug use among prisoners in the three main prisons in Khartoum, Sudan in 1994 was studied. The results show variations in the use of drugs with regard to age, occupation, education, marital status and social status of inmates. Drug use was common among most prisoners, with alcohol and hashish being the most frequently used drugs. Alcohol use was more common among married prisoners; hashish use was more popular among single prisoners. Alcohol was frequently used with other drugs. Most prisoners started using drugs between the ages of 12 and 20 years. The principal reasons for drug use were temptation by friends and to escape social pressures