Virtual clinics progress and outcome during the Covid-19 pandemic.

AIM: To assess progress and outcome of the Virtual clinics during the Covid-19 Pandemic. METHODS: We used Excel sheet to collect and anlyse data including number of call attempts for answer, duration of the calls, success in talking to the carers and the outcome of consulttion. RESULTS: One-hundred-sixty-seven calls were made for 117 patients. Average of 1.3 calls per patient. 94/115 (81.7%) calls were eventually answered. 65% (71) parents answered the call from a single attempt (71/110). 18% (21/110) of parents answered the call on the second attempt. The average call duration was 9 min (range 21-5 min). We discharged 11% (11/103) of patients, while 33% (34/103) patients required a face-to-face physical review. A follow-up appointment was scheduled for 54% patients (58/103). DISCUSSION/CONCLUSION: With careful patients' selection, virtual outpatient clinics represent a feasible means of delivering outpatient care from a clinician perspective.

Infantile onset ascending hereditary spastic paralysis.

A 3½-year-old girl, presented with delayed motor development and increased tone in lower limbs along with tight tendoachilles, toe walking and bilateral clonus. There were normal antenatal and perinatal period, however, after birth there was twitching of her lower limbs. Examination showed lower limb spasticity.Brain and spinal MRI along with EEG were normal. Serum amino acids revealed hyperprolinemia type 1. Hereditary spastic paraplegia gene panel confirmed a homozygous pathogenic variant in ALS2 gene, confirming a diagnosis of infantile onset ascending hereditary spastic paraparesis. She was fitted with ankle-foot orthotics, uses a Kaye walker and is on baclofen and diazepam as she can experience spasticity and painful muscle cramps. She is being managed by a multidisciplinary team involving paediatrician, paediatric neurologist, physiotherapist, occupational therapist, speech and language therapist, dietitian and social worker. Infantile onset ascending hereditary spastic paraplegia represents a rare cause of early onset spasticity with a progressive prognosis.

Association between serum lipid profile, body mass index and osteoporosis in postmenopausal Sudanese women

Background: Epidemiological observations suggest links between osteoporosis and the risk of acute cardiovascular events. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. The reduction of bone density and osteoporosis in postmenopausal women contributes to elevated lipid parameters and body mass index (BMI). Objective: To investigate the relationship between serum lipid profile, BMI and osteoporosis in postmenopausal women. Materials and Methods: A prospective analytical case control-study conducted in Khartoum north hospital at Khartoum city, capital of the Sudan from April 2017 to March 2018 after ethical approval obtained from the local Research Ethics Committee of Faculty of Medical Laboratories, Alzaeim Alazhary University on the committee meeting number (109) on Wednesday 15th February 2017. A written informed consent was obtained from all participants to participate in the study.Two hundred postmenopausal women were enrolled in the study. The age was studied in one hundred osteoporosis postmenopausal women as a case group and one hundred non-osteoporosis postmenopausal women as control group. The serum lipid profiles were estimated using spectrophotometers (Mandry) and BMI calculated using Quetelet index formula. The data were analysed using SPSS version 16. Results: The BMI, serum total cholesterol, triglyceride, HDL and LDL in case group respectively were (24.846±2.1647, 251.190±27.0135 mg/dl, 168.790 ±45.774 mg/dl, 50.620 ± 7.174 mg/dl, 166.868 ±28.978 mg/dl). While the BMI, serum total cholesterol, triglyceride, HDL and LDL in control group respectively were (25.378 ±3.8115, 187.990 ± 26.611 mg/dl, 139.360±20.290 mg/dl, 49.480 ±4.659 mg/dl, 111.667 ±28.0045 mg/dl). All serum lipid profiles significantly increased (p=0.000) in the case group compared to the control group, except serum HDL was insignificant different between the case and control group and also BMI was insignificant different between the case and control group. There was a positive Pearson's correlation between BMD and serum total cholesterol (r= 0.832, P<0.01), serum LDL (r = 0.782, P<0.01) and serum triglyceride (r = 0.72, P<0.01). Conclusions: Osteoporotic postmenopausal women had a significant increase in serum lipid profile and BMI. Moreover, we found a positive link between women with cardiovascular diseases and stroke