High prevalence of urinary schistosomiasis in two communities in South Darfur: implication for interventions.

BACKGROUND: There are few data on the prevalence of schistosomiasis in Darfur. We conducted this study in response to reports of 15 laboratory confirmed cases of schistosomiasis and visible haematuria among children from two communities in South Darfur. The aim of the study was to estimate the prevalence of schistosomiasis in the area and to decide on modalities of intervention. METHODS: A cross-sectional survey involving 811 children and adults from schools and health facilities was conducted in two communities of South Darfur in March 2010. Urine samples were collected and examined for ova of Schistosoma haematobium using a sedimentation technique. A semi-structured format was used to collect socio-demographic characteristics of the participants. RESULTS: Eight hundred eleven (811) urine samples were collected, 415 from Alsafia and 396 from Abuselala. Of the collected samples in 56.0% (95% Confidence Interval (CI); 52.6-59.4) Schistosoma eggs were found. The prevalence was high in both Abuselala 73.3% (95% CI; 68.9-77.6) and Alsafia 39.5% (95% CI; 34.8-44.2). More males (61.7%, 95%CI; 56.5-64.9) were infected than females (52.1%, 95%CI; 48.2-56.0). Children in the age group 10-14 has the highest (73.0%, 95%CI; 68.7-77.2) infection rate. School age children (6-15 years) are more likely to be infected than those >15 years (Adjusted Odds Ratio (AOR) = 2.70, 95% CI; 1.80-4.06). Individuals in Abuselala are more likely to be infected than those who live in Alsafia (AOR = 4.3, 95% CI; 3.2-5.9). CONCLUSION: The findings of this study indicate that S. hematobium is endemic in Alsafia and Abuselala South Darfur in Sudan with a high prevalence of infection among older children. This signifies the importance of urgent intervention through Mass Drug Administration (MDA) to halt the infection cycle and tailored health messages to targeted groups. Based on the findings MDA was conducted in the villages.

Prevalence of anxiety and depression among medical students of private university.

OBJECTIVE: To assess anxiety and depression levels among medical students of a private university by using a self-administered anxiety and depression questionnaire. METHODOLOGY: A cross sectional study was done on the students of Ziauddin Medical University, who had spent more than six months in the medical school. A self-administered questionnaire was given to the students, present in the class and willing to participate in the study. During the survey students of 5th year were not available. The instrument used to asses the anxiety and depression levels was the, Aga Khan University Anxiety and Depression Scale (AKUADS). Additional questions regarding socioeconomic variables were also included in the survey instrument, such as student's birth order, monthly income, number of siblings, and monthly expenditure on education. Data analysis was done on Epi info version 6. RESULTS: There were 252 students in 4th year MBBS to 1st year MBBS. Of these 189 were present during the survey. Using anxiety and depression scale it was found out that 113 (60%) students had anxiety and depression. Prevalence of anxiety and depression in students of 4th year, 3rd year, 2nd year and 1st year was 49%, 47%, 73% and 66% respectively. It was significantly higher in 1st year and 2nd year, as compared to 3rd and 4th year (p < 0.05). It was seen that birth order, monthly income, number of siblings and monthly expenditure on education did not affect the prevalence of anxiety and depression. CONCLUSION: This study suggests that medical students experience anxiety and depression, the finding is consistent with other western studies, however there is no local data available to support our findings. The study finding highlights the need of psychiatric counseling and support services available to vulnerable students. These findings should be further explored in longitudinal studies to identify the stressors leading to these outcomes and appropriate interventions.

Selection procedure as predictor of performance in university examination.

OBJECTIVE: To determine the correlation of SSC, HSC, ZMU achievement test and interview scores with the scores achieved in MBBS 1st, 2nd and 3rd Professional Examinations. METHOD AND PROCEDURE: The SSC, HSC, ZMU admission test and interview scores of 159 MBBS students admitted in 1995, 1996 and 1997 were correlated with the scores of the 1st, 2nd and 3rd professional examinations. Data analysis was done on SPSS Software. RESULTS: No significant relationship was found between the SSC, HSC, ZMU admission test and interview scores and the scores obtained in the professional examinations. SSC scores did not correlate with any variables/matrices, whereas for batches 1 and 2 the HSC school leaving examination scores correlated significantly with ZMU interview score (p < 0.05). No correlation was found between ZMU test and ZMU interviews. Results showed significant relationship (p < 0.01) between all 1st, 2nd and 3rd professionals of all three batches. CONCLUSION: None of the admission criteria (SSC, HSC, ZMU admission test and interview scores) predict the performance of medical students in the professional examinations.

Two weeks triple therapy with lansoprazole, amoxycillin and roxythromycin is better than dual therapy with lansoprazole and amoxycillin for H. pylori infection: a randomised, clinical trial.

AIMS: To compare the efficacy of 2 weeks of dual therapy of Lansoprazole and Amoxycilline with triple therapy of Lansoprazole, Amoxycilline and Roxythromycin for H. pylori eradication. SUBJECTS: Twenty-five suffering from dyspepsia and found H. pylori positive (CLO) during upper GI endoscopy. METHODS: Patients were divided into 2 groups, one group received Lansoprazole (30 mg) once a day, and amoxycilline (500 mg) three times a day (group I), while the second group received Lansoparazole and amoxycillin in similar dosage with the addition of Roxythromycin (150 mg) twice a day (group II). H. pylori status was confirmed on endoscopy using CLO test at entry to the protocol and then at 4 weeks. RESULTS: H. pylori eradication was 57% in group I and 86% in group II with healing of lesions in all cases. CONCLUSION: Better response with triple therapy (group II) indicates enhanced eradication of the pathogens with triple therapy while using roxythromycin (JPMA 50:157, 2000).

Oesophageal carcinoma in Karachi.

Between January, 1979 to August, 1990, 107 histologically proven cases of oesophageal carcinoma were seen. The ages of the patients ranged from 19-85 years (mean 55 +/- 14 years) with a male to female ratio of 1.2:1. Majority (70%) of the cases belonged to lower socioeconomic group and 56% were migrants from India. History of tobacco chewing or smoking was present in 78% cases. In 54%, the lesion was located in the middle third of the oesophagus, followed by lower third in 44%. Histology showed squamous cell carcinoma in 86% and adenocarcinoma in 10% cases. Of the 19 cases followed, 16 underwent surgery and 3 received chemotherapy. Two cases died within 7 months following surgery and in 6 carcinomas recurred. All cases receiving chemotherapy died within 8 months of treatment.

H2 receptor antagonist or H. pylori eradication?

To assess the healing and relapse rate of duodenal ulcer (DU) treated with H2 receptor antagonists in helicobacter pylori (HP) positive vs negative cases, we analysed 95 cases of endoscopically proven duodenal ulcer. H. pylori colonization was found in 73 (77%) patients before treatment. No difference was observed in the pre-treatment characteristics between patients with HP positive and HP negative duodenal ulcers. Healing rates with H2 receptor antagonist at 8 weeks were 90% and 91% respectively (NS). No difference in HP colonization was found between patients with and without healed ulcerie, 77% and 78% respectively. Relapse rate within 1 year was 50% in patients with HP positive vs 73% with HP negative cases. We conclude that duodenal ulcer healing and relapse rate is related to acid inhibition rather than HP colonization.

[Fibroma of the tunica albuginea. Apropos of a case]. / Fibrome de la tunique albuginée. A propos d'un cas.

Fibroma of the tunica albuginea is a rare, benign lesion. Only twenty cases have been published. We have observed one case a solitary testis of a 40 years old patient. The treatment performed was enucleation. The interest of this case consists in the rarity of the case and the operative solution proposed. After a review of the literature, we summarise the characteristics of this disease.

A double-blind study of misoprostol (SC-29333) in the healing of duodenal ulcer.

In a double-blind randomized placebo controlled trial, 50 patients with endoscopically confirmed duodenal ulcer were treated with either misoprostol 200 micrograms or placebo in q.i.d. doses for 4-8 weeks. Of 25 patients in the placebo group, four defaulted and two were withdrawn due to worsening of symptoms. Of 25 misoprostol-treated cases, 17 cases (68%) and 21 cases (84%) healed at 4 and 8 weeks respectively, compared with three (14%) and five (24%) of the 21 placebo-treated cases (P less than 0.001). Except for diarrhoea in 2 patients in each group and itching in one with misoprostol, no serious side effects were noted.

Efficacy of oral propranolol and injection sclerotherapy in the long-term management of variceal bleeding.

Three treatment regimens were tried in 145 portal hypertensives with bleeding oesophageal varices to test the efficacy of each regimen in the prevention of rebleeding. Forty-seven cases received oral propranolol, 57 sclerotherapy, while 41 who did not receive any treatment except conservative management served as controls. Patients were followed up at 6 weeks, 6 months, 1 and 2 years to see the frequency of bleeding with each regimen. No significant difference was seen at 6 weeks with either of the three regimens but at 6 months and 1 year the frequency of bleeding was significantly less (p less than 0.05) in the propranolol group than in the other two groups while at 2 years results were significantly better with both propranolol (p less than 0.05) and sclerotherapy (p less than 0.001) than in controls. Efficacy of propranolol when compared with sclerotherapy showed similar results. The results of the present study are different from most of the western reports where sclerotherapy was found to be superior to propranolol. Variations in the results are likely to be due to differences in the etiology of portal hypertension in different countries.

Clinical features, course, viral markers and follow-up in young versus adult nonalcoholic cirrhotics--a retrospective study.

To determine the presenting features and prognosis of nonalcoholic cirrhosis, retrospective analysis was done in 145 cases. Of the total, 48 patients (33%) belonged to the young (less than or equal to 35 years), and 97 (67%) to the adult age group (greater than 35 years) with no predominance of either sex. The etiology of cirrhosis and the positivity of viral markers were similar in both groups. Adults had on presentation a higher frequency of anorexia while hematemesis was more frequent in the young group (p less than 0.001). During a mean follow-up (+/- SE) of 31.7 +/- 5.5 and 16.3 +/- 2.2 months in the young and adult group, respectively, 68 and 63% cases survived 5 years. Liver failure (53.8 and 44.4%) and variceal bleeding (23 and 11.1%) were the main causes of death in both groups, accounting for 27% mortality in each group.