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

Chronic pain after inguinal hernia repair

Hernia repair is one of the most common surgical procedures, and some patients suffer from chronic pain after hernia surgery. Chronic pain was believed to be a recognized but infrequent complication after inguinal hernia repair. Although it is usually mild, its exact cause and lack of evidence-based treatment path present problems in the effective management of this surgical complication. It has significant variable degrees of effects on work and social activities. The aim of the present study was to evaluate chronic post-herniorrhaphy pain in patients who underwent Darn or modified Bassinis' repair. We evaluated the patients over the subsequent 3 months, using a telephone filled questionnaire. The questionnaire included the chronic pain grading scale [CPG] questionnaire to focus on chronic pain and its limitations to their quality of life. The results show that the majority of patients were successfully treated by therapeutic injection into the point of maximal tenderness. It was concluded that chronic pain following open inguinal hernia repair can be disabling, sometimes seriously affecting quality of life. It is, therefore, very important to discuss the possibility of resulting chronic severe pain when obtaining preoperative informed consent. This paper highlights the importance of education of junior trainees about the appropriate issues and skills needed to get informed consent. We believe that each patient must be informed about the possibility of chronic, severe pain and its impact on their quality of life should it occur. The present findings indicate that identification and preservation of nerves during open inguinal hernia repair reduce chronic incapacitating groin pain and that, in the majority of patients with chronic pain at 6 months, the pain at 1 year is resolved only with conservative or medical treatment

Metabolic aspects of skeletal muscles

Differences in the metabolic patterns of the skeletal muscles are biochemically important. Muscle performance declines during intense activity due to changes in some metabolic and physiological events. This review illustrates how biochemical knowledge illuminates the response of muscular tissues to such changes

Adiponectin

Adipose tissue is not considered anymore as a passive depot for storing excess energy in the form of triglycerides but as an active organ secreting several hormones or adipokines. This review gives some knowledge about history of discovery, ways of measurements, and biochemical and pathophysiological effects of adiponectin

Neurotransmitters - a biochemical view

The neurotransmission at most if not all synapses is chemical and is of great biochemical, physiological and pharmacological importance. Neurons communicate with each other at synapses by a process called synaptic transmission which is the release of small quantities of chemical messengers, called neurotransmitters that alter the electrical activity of neurons after they interact with receptors on post-synaptic cell surfaces. This review gives a biochemical view on the nature of neurotransmitters and presents the biochemical chart and the medical relevance of the most important neurotransmitters

study of the hospital stay in laparoscopic cholecystectomy versus open cholecystectomy

Each year, large numbers of Sudanese have gallbladder surgery. Surgery options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy. While elective cholecystectomy now carries extremely low morbidity and mortality rates, the operation does incur sizable expense in terms of hospitalization and time lost from work. The advantages of hospital stay in laparoscopic cholecystectomy versus open cholecystectomy were questioned because the recovery from open cholecystectomy is brief

Pemphigus in Khartoum skin teaching hospital

This study was conducted in Khartoum Skin Teaching Hospital to determine the profile of the disease and the most common variant in the Sudan. The study included 50 patients [38 females and 12 males]. Pemphigus vulgaris was found to be the predominant variant in the Sudan [88%] as compared to pemphigus vegetans [12%]

Case of Sigmoid volvulus associated with Hypothyroidism

This case report focuses on the features of sigmoid volvulus and Gastrointestinal manifestations of hypothyroidism with a conclusion that any patient with dynamic or adynamic intestinal obstruction must be searched for signs and symptoms of hypothyroidism to start thyroid hormone replacement therapy promptly if thyroid function test revealed hypoactive thyroid

effect of some maternal risk factors in glucose tolerance impairment among Sudanese pregnant women in the third trimester

To show the effect of some maternal risk factors in glucose tolerance impairment in pregnancy, a study was carried out on thirty pregnant women with gestational diabetes mellitus, thirty ones with impaired glucose tolerance and thirty control ones with normal glucose tolerance. Age and parity of the GDM and the IGT groups were significantly greater than that of the control group: 32.77 +/- 5.08 years [mean +/- S.D.], 31.1 +/- 6.04 vs 23.93 +/- 4.46 respectively, p<0.0001 and 5.23 +/- 2.69, 5.6 +/- 3.07 vs 2.77 +/- 1.48 respectively, p< 0.0001. Also, The GDM and the IGT groups were found to have a family history of diabetes and previous heavy babies, incidence significantly higher than that of the control group. Finally, it was concluded that Age, parity, previous heavy babies' incidence and family history of diabetes are very important maternal risk factors that affect glucose tolerance in pregnancy

Human placental lactogen and glucose intolerance in pregnancy: a study on Sudanese pregnant women

To stand on the role of human placental lactogen and its interconnection with cortisol in augmentation of glucose intolerance in pregnant women, a study was carried out on Sudanese pregnant women in the third trimester. There were no significant differences among the mean levels of fasting serum insulin of the studied groups [12.29 +/- 0.83 micro lU/ml [mean +/- S. E.], 14.93 +/- 2.17 and 12.39 +/- 2.52 for the GDM, IGT and control groups respectively, p = 0.27]. The 2h-serum insulin mean level of the IGT group was not significantly higher than that of the control group but significantly higher than that of the GDM group [68 +/- 6.71 vs 54.88 +/- 8.15 and 36.5 +/- 3.06 for the IGT, control and GDM groups respectively, p < 0.002]. Also, it was found that the GDM and the IGT groups have significantly higher mean levels of serum cortisol than that of the control group [33.71 + 2.86 [micro g/dl], 28.57 +/- 2.18 vs 21.48 +/- 1.11 respectively, p < 0.0003]. Results of serum hPL of the GDM and that of the IGT groups were not significantly higher than that of the control group [6.85 +/- 0.58 [micro g/ml] and 7.15 +/- 0.49 vs 5.73 +/- 0.24 respectively, p = 0.2]. Finally, it was concluded that insulin resistance in pregnancy is augmented by the effect of hPL and cortisol. When the insulin resistance is so large that pregnant women can not overcome it, glucose deterioration develops and some women become with impaired glucose tolerance while others develop gestational diabetes mellitus