Intestinal obstruction in Khartoum.

The pattern of intestinal obstruction at Khartoum Teaching Hospital was reviewed in this study which included 239 patients. 170 of them were males and 68 were females. Their ages ranged from two days to 95 years (mean 31.4 +/- 5.3 years). The commonest causes of intestinal obstruction were strangulated external hernias (27.7%), intestinal adhesions (21%), intussusception (12%) and sigmoid volvulus (11%). Less frequent causes were paralytic ileus, large bowel tumours, peritoneal bands and Hirschsprung's disease. Of the strangulated hernias, inguinal hernia (70%) was the most frequent type of hernia seen, followed by paraumbilical hernia (20%). Previous appendicectomy (40%) and laparotomy for abdominal trauma (20%) were the commonest causes of adhesive intestinal obstruction. The mortality rate of intestinal obstruction was 19.7%. This high mortality is attributed to delayed presentation, fluid and electrolyte imbalance, intestinal ischaemia and gangrene. This could be minimised by health education, adequate preoperative preparation, meticulous surgical technique and good postoperative care.

Gastrointestinal tract cancer in association with hepatitis and HIV infection.

One hundred and fifty patients with histologically proven gastrointestinal tract (GIT) cancer, 150 patients with a variety of other malignancies and 150 normal subjects were screened for human immunodeficiency virus (HIV) and hepatitis B sero-markers. Only one patient with nasopharyngeal carcinoma proved to be HIV seropositive. Hepatitis B surface antigen (HBsAg) was detected in 18% (n = 26) of the GIT cancer patients, in 16% (n = 24) of the other cancers group and in 12% (n = 20) of the control. There was no significant difference between the three groups (P > 0.1). The HBsAg was detected mainly in patients with primary hepatocellular (25%), gastric (12%), rectal (10%) and colonic carcinoma (8%). Hepatitis B core antibody (HBc AB) was detected in 12% of the GIT cancer patients, in 11% of the other cancers patients and in 13% of the control. In this study, there was no association between HIV, hepatitis B infections and GIT cancer.

PIP: 150 patients with histologically proven gastrointestinal tract (GIT) cancer, 150 patients with a variety of other malignancies and 150 normal subjects were screened for human immunodeficiency virus (HIV) and hepatitis B sero-markers. Only 1 patient with nasopharyngeal carcinoma proved to be HIV seropositive. Hepatitis B surface antigen (HBsAg) was detected in 18% (n = 26) of the GIT cancer patients, in 16% (n = 24) of the other cancer cases, and in 12% (n = 20) of the control group. There was no significant difference between the three groups (P 0.1). The HBsAg was detected mainly in patients with primary hepatocellular (25%), gastric (12%), rectal (10%), and colonic carcinoma (8%). Hepatitis B core antibody (HBcAB) was detected in 12% of the GIT cancer patients, in 11% of the other cancer patients, and in 13% of the control group. In this study, there was no association between HIV infection, hepatitis B infection, and GIT cancer.

Thyroid function in patients with mycetoma.

Thyroid function was assessed in seventy two patients with various types of mycetoma. There was no evidence of clinical or biochemical thyroid dysfunction in these patients. The symptoms encountered in some of the mycetoma patients mimic those of hypothyroidism should be attributed to other factors possibly mental depression and apathy.

The aetiology of a keratoconjunctivitis occurring in goats in the Sudan.

An infectious keratoconjunctivitis occurring in goats in the Sudan is described. Experimental transmission using infective ocular discharges resulted in a conjunctivitis in young kids and a severe keratoconjunctivitis in an adult goat. A pleomorphic organism which resembled Rickettsia spp was found in conjunctival smears from naturally and experimentally infected animals. Neither Mycoplasma nor Chlamydia spp were isolated in microbiological cultures.

Gastric emptying and secretion in the milk-fed calf.

1. For a few weeks, immediately post-natally, the abomasum of the ruminant stomach can be regarded as the analogue of the simple stomach for at this time food passes directly to the abomasum because of closure of the oesophageal groove.2. Using standard fractional and serial test meal techniques discussed by Hunt (1956) and adapted for use in the calf, abomasal emptying, acid and pepsin secretion have been examined. Phenol red was used as a marker to measure volume changes of the test meal.3. Abomasal emptying is exponential in character whether large or small volumes of fluid are instilled into the abomasum. The initial and end phase of emptying shows variable rates between animals.4. Glucose and lactose solutions inhibit abomasal emptying as well as acid production.5. Sodium chloride and sodium bicarbonate of low concentration, near isotonic with blood plasma, stimulate abomasal emptying but the bicarbonate is most effective. Hypertonic solutions of these salts inhibit abomasal emptying.6. Pepsin secretion in the abomasum of the calf is not affected by test meals of glucose, lactose, sodium chloride or sodium bicarbonate.7. These results shows a great similarity between the physiology of the abomasum of the milk-fed calf and the simple stomach. This suggests that the same duodenal receptors, discussed by Hunt & Knox (1968), which control gastric movement in man are also effective in controlling gastric emptying in the milk-fed calf.

The effect of some molecules and ions on gastric function in the milk-fed calf.

1. The abomasum of the milk-fed calf has been examined using an adaptation of the Serial Test Meal method devised by Hunt & Spurrell (1951). The emptying process, acid secretion and pepsin secretion were studied.2. Using serial test meals of simple solutions instilled into the abomasum via a cannula, our investigation leaves no doubt that the osmolarity of the abomasal contents significantly modifies the rate of abomasal emptying.3. Hypotonic and isotonic solutions of sodium chloride and sodium bicarbonate increase abomasal emptying but bicarbonate is most effective.4. Increasing the concentration of solutes in the abomasal contents slows abomasal emptying. Sodium chloride, sodium bicarbonate, ammonium chloride and urea do not delay abomasal emptying until hypertonic concentrations are attained. Hypotonic solutions of potassium chloride, calcium chloride, glucose, lactose, hydrochloric acid and acetic acid delay abomasal emptying.5. The results obtained in the calf show that the abomasum is under restraint probably from duodenal receptors as is the simple stomach (Hunt & Knox, 1968) and that an osmoreceptor as postulated by Hunt (1956) is an important factor in this mechanism.6. Acid secretion is inhibited when hypertonic solutions are instilled into the abomasum.7. Pepsin secretion is not affected by simple solutions in the abomasum.8. Gastric function in the milk-fed calf appears to be controlled by mechanisms essentially similar to those already demonstrated in the simple stomach.