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ORIGINAL ARTICLES
Complications and management of hair dye poisoning in Khartoum
AA Elgamel, NO Ahmed
July-September 2013, 8(3):146-152
DOI:10.4103/1858-5000.132603  
Introduction: Paraphenylenediamine (PPD) is the major cause of intoxication in Sudan with high morbidity and mortality rate among the intoxicated victims. We here PPD poisoning studied in terms of mode of poisoning, case fatality rate, clinical presentation, management and complications. Methodology: This is a retrospective prospective study on 200 patients with hair dye poisoning who presented to Khartoum teaching hospital in the period from June 2008 to December 2008. Results: We reached to results that in the sample of 200 patients studied, (80.5%) were females and (19.5%) males. The ages of these patients ranged between 6 month - 57 years. Most of them were from Khartoum state (98.5%) and most of them were single (74%). About 51% had history of psychological problems. Most of them arrived immediately to the hospital (90%). Oral route is common route of administration of PPD (96%). The main causes of poisoning were suicidal attempts which occurred in (76%), accidental (22.5%) and homicidal (1.5%). The accessibility of dye to those patients was from local market accounts for about (47.9%), home (23.5%), relatives (22%) and other places (7.5%). Types of dye used were Indian (38.5%), Stone (42%) and Began account about (19.5%). PPD was detected in urine in (36%). There was impairment of renal function test using urea in (22%). Creatinine was abnormal in (23%). Serum electrolytes (sodium, potassium, Calcium) were abnormal in (11%).Uric acid was abnormal in (19.5%) and those who developed renal failure were (20.5%). The most common presentations were ingestion of dye (85.5%), tachycardia in (58%), tachypnea in (31.5%), vomiting in (31%), angioneuratic edema in (22.5%), abdominal pain (22%), enlarge tongue (18%), facial edema (14%) and loin pain in (7%) of the cases. The complications were respiratory distress in (22.5%), acute renal failure in (20.5%), cardiac problem in (1%) and liver problem in (0.5%). The medical treatment and emergency tracheostomy tend to decrease the mortality rate to only (3.5%). Relationship too many parameters were discussed. Recommendation: We recommended that may assist in decreasing the number of cases as health education about the danger of Hair dye that should be provided at the level of the community through all methods of mass media. Restriction should be made on the trade of Hair dye with more support analytical equipments in hospitals.
  7,958 365 -
The impact of continuous assessment on the final results a case study: College of Medicine, King Khalid University
Assad Ali Rezigalla, Asim Mohammed Abdalla, Syed Javed Haider, Qurashi Mohammed Ali, Muntaser Mohammed Alhassen
October-December 2014, 9(4):149-152
DOI:10.4103/1858-5000.153029  
Introduction: Assessment is a dynamic and multi-faceted process with variable aims. The assessment can be continuous, a final examination or a combination of both. The method of assessment per se is not the target, but its impact on student learning is the important. The method or the tool of assessment modulates the student's methodology of learning. Aims: The aim is to study the effect of the continuous assessment (CA) on the final result (FR) of students. Study Design and Type: Retrospective cross-sectional type. Materials and Methods: Student's scores were obtained from students' results of the CA, the final assessment (FA) and the FR. Statistical package for social sciences (SPSS, version 20) was used for data entry and analysis. Descriptive statistics and inferential statistics were applied. Results: Both CA and FA show a high level of correlation with the FR and it was higher with the CA. Correlation confident was higher between CA and FA than between FA and the FR. t-test showed a significant difference between the CA, FA and the FR. Conclusion: Continuous assessment has an impact on both the student's results and their methodologies of learning. Serious attention should be directed towards the tools that are used in the CA. Training of teachers in both exam settings and implementation is important as they have a direct effect on the methodology of assessment.
  6,009 1,025 -
Sagittal diameter of the lumbosacral spinal canal in normal (asymptomatic) adult Sudanese population 2014
Yasir Ahmed Mohamed Elhassan, Qurashi Mohamed Ali, Anas Osman Ahmed
October-December 2014, 9(4):153-158
DOI:10.4103/1858-5000.153030  
Background: Although spinal stenosis has been recognized for many years as a clinical diagnosis, it has yet to be exactly defined and agreed upon. This lack of definition leads to difficulties in comparing and interpreting studies of prevalence, incidence and treatment. This could in part be to difference in spinal canal dimensions that exist between population groups. This is essential for the rational design and development of spinal implants and instrumentation such as pedicle screws and, in particular, with the evolution towards robotic surgery. Objectives: This study aims to determine the normal Anteroposterior diameter of the spinal canal in lumbosacral region among the adult Sudanese population using the MRI and to determine whether there are any differences related to age, sex and race regarding this diameter. Material and Method: The study was descriptive cross-sectional analytical study. MRI measurements were performed in Ribat Teaching Hospital for 142 normal Sudanese subjects to study the lumbosacral region. The data was collected through check list, analyzed by SPSS. Results: The majority of the participants were male (57%), young between 20and 28 years of age with mean height 168cm and mean weight 66 kilogram. The results showed that the longest mean AP diameter was at L1 (17.5±2.0mm) in male while (18.1±2.7) in female. The shortest mean AP diameter was at S1 (15.9±3.2mm) in male and (15.4±3.2) in female. The AP diameter gradually decreased from L1 to S1.there is no significant difference between both sexes. There is significant difference between people live in different zones. There is association between age, height and weight and the AP canal diameter.
  4,871 385 -
Evaluation of the technical specifications of computerized tomography scanners in Jazan
Saeed Taha Mohamed Ali, Mahmoud Mohmed Hamad, Caroline Edward Ayad, Elsafi Ahmed Abdalla, Abdelmoneem Saeed Ahmed
July-September 2013, 8(3):159-166
DOI:10.4103/1858-5000.132611  
Introduction : good quality management for computerized Tomography (CT) scanners is essential to safe and efficient CT units, providing quality clinical images, maintaining patient and staff radiation doses as low as reasonably achievable. Aims : to evaluate the technical specifications of (CT) scanners in Jazan region in the period from 2011-2013. Materials and Methods : 13 CT scanners have been evaluated; 2 of them are in private sectors and the rest in public hospitals. The Technical specifications of CT scanners were assessed using template issued by ImPACT (Imaging Performance Assessment of CT scanners). Results : When comparing the 11 public scanners age with guidelines rules of European Coordination Committee of the Radiological and Electro medical Industries (ECCREI); it showed that scanners of Jazan region are within lifecycle guidelines, the total cumulative number of scanners since 1984 to 2013 are 15 scanners, 4 of them were replaced and the rest under use, multi detector CT scanners replaced most of the single detector scanners. for public CT scanners ; results show that all of the scanners are 3 rd generation, gantry bores are arranged between70-80cm, the x-ray tube inventory showed that there is no dual source CT scanner in the region and the anode storage heat capacity ranged from (3-8MHU) except Siemens 64slices and 20slices reached up to (30MHU). All of scanners in the region are built in solid state, image reconstruction time display per second is ranged from 1-40slice/seconds, advance clinical application software are available among the scanners. Jazan region CT scanners have a high capability and their technical specifications are in a rapid pace in developments that impacting on performance which depends on trade-off between image quality and patient dose.
  4,706 314 1
Structure and physical properties of flowering plants of the genus hibiscus
Nisreen Awad Eltahir, Mohamed A. Siddig, Abubaker A. Siddig, Hajer Adam
July-September 2013, 8(3):135-139
DOI:10.4103/1858-5000.132597  
Introduction: Hibiscus is a genus of flowering plants in the mallow family, Malvacease. It is quite large, containing several hundred species that are native to warm-temperate and have many medical benefits, for example, hibiscus drink lowers high blood pressure. Materials and Methods: Flowering plants of hibiscus were used in this study. X-ray fluorescence (XRF) and Fourier Transformation infrared spectroscopy (FTIR) were used as analytical techniques. The XRF results indicated that, hibiscus has contained Potassium (K), Calcium (Ca), Iron (Fe), Copper (Cu), Bromine (Br), and Strontium (Sr). Results: The FTIR spectra of hibiscus showed a broad and strong absorption band in the range1145-2926 cm -1 , and these absorptions were assigned to the different stretching vibrations. The conductivity and dielectric properties of hibiscus were measured as function of frequency. The conductivity was found to decrease with frequency while the opposite behavior was observed in case of dielectric. In order to investigate the optical properties, solutions with different concentration of hibiscus were prepared. Ultraviolet-visible spectroscopy (UV) was used to obtain the absorption for different samples with different concentration. Conclusion: The absorption was found to increase with the increase of concentration of hibiscus.
  4,659 275 1
Study of early pregnancy loss using Ultrasonography
Abdelmomem Saeed Ahmed, Caroline Edward Ayad, Ali Ahmed Altoom, Elsafi Ahmed Abdalla, Momen Abdou Elkhir, Qurashi M Ali
October-December 2014, 9(4):141-148
DOI:10.4103/1858-5000.153027  
Background: Vaginal bleeding is the most common cause of presentation to emergency department in the first trimester. Objectives: The objectives of the study were to review the value of ultrasound in assessing the vaginal bleeding and early pregnancy loss and to find out any related abnormalities. Design: This is community-based study. It was carried out in Khartoum State, Major teaching hospitals, during the period from July 2010 to October 2013. Materials and Methods: The sample of the study was 302 female patients, who referred to ultrasound departments for obstetric scanning, their ages ranged between 15 and 50 years, their mean age was 25.3 years old. Ultrasound machines with 3.5, 5 MHz convex and endovaginal probe were used. The type of abortion was correlated with socioeconomic, sac localization and shape, cervix and adenexea characters as well as the presence of fetal congenital abnormalities. Results: The abortion types were characterized as incomplete, missed, threatened, complete, blighted ovum, inevitable, septic, recurrent, ectopic and molar as: 29.47%, 16.88%, 12.58%, 7.94%, 5.62%, 19.02%, 1.83%, 4.3%, 1.98%, and 0.66% respectively and showed highly significant relations with: -low socioeconomic status, Intra gestational sac location and shape, fetal congenital abnormalities, competent cervix and abnormal Adnexa. Conclusion: Ultrasound provided unique information about vaginal bleeding causes and outcomes and is useful in the detection of early pregnancy complications.
  2,441 2,303 -
Pattern of eye diseases at the primary health centers in a Pakistani district
Khalil A. Lakho, Mohammad Babar Qureshi, Mohammad Aman Khan, Mohammad Daud Khan, Khabir Ahmad
October-December 2013, 8(4):171-173
DOI:10.4103/1858-5000.133001  
Introduction: Pakistan has an extensive network of public facilities aimed to provide primary health care including eye care. Yet no data exist on the number and purpose of eye visits to these facilities. Objective: This study aimed to describe the pattern of eye diseases in public primary care hospitals in a district in Pakistan's Sindh province. Materials and Methods: This study was conducted in 14 randomly selected government primary health care centers 10 Basic Health Units and 4 Rural Health Centers in district Nawab shah, a central district of Sindh province. Doctors in these centers were trained in diagnosis and management of common eye diseases at the primary level and requested to record data prospectively on the total number of patient visits, total number of eye consultations and reasons for eye consultation. Data were entered and analyzed using EPI Info Software. Results: Over a period of one month, 9759 visits were made to the 14 selected primary health care centers. Eye diseases accounted for 1.8% of the total visits. Adults were more likely to have an eye consultation compared with children (Odds Ratio: 2.96; P < 0.01). Conjunctivitis (34.1%), cataract (22.0%), and corneal problems (6.9%) were the most common reasons for eye consultations. Conclusion: Despite solid evidence of a high burden of eye diseases at the community level in Pakistan, eye diseases accounted for only a very small proportion of the total consultations in the primary health care facilities. Efforts are needed to assess barriers to optimal utilization of existing primary health care services for eye diseases.
  2,164 2,299 -
Assessment of creatinine and urea blood levels in healthy volunteers
Shaza M. Ahamed, Gad Allah Modawe, BadrEldin Elsanni, Mansaur A. Ballal
July-September 2013, 8(3):153-155
DOI:10.4103/1858-5000.132609  
Introduction: Endogenous creatinine and urea are protein metabolism. Their levels in the blood reflect status of kidney Function. Aim: This study aimed to assess the serum creatinine and urea levels normal Sudanese adults Females in the University of Gezira, to identify influence of age, tribe and menstrual cycle on the level of their parameters. Materials and Methods: The study population consisted of 270 females of ages ranged between 18-40 year's. Blood samples were collected from all of them after their consents. Serum samples were taken and creatinine and urea levels were analyzed using specterophotometeric methods. Results: The results showed that the (mean ± SD) serum creatinine and Urea levels were (0.82 ± 0.10 mg/dl) and (20.2 ± 4.7 mg/dl) respectively. Serum urea but not creatinine levels were significantly different (P = 0.04) for the different ages. Serum creatinine and urea levels varied with ethnic group and menstrual cycle. Conclusion: The results indicated that the mean levels of both these protein metabolites were within the ranges of their values for the normal kidney function.
  4,144 230 -
Electrical and optical properties of two types of Gum Arabic
Hajer Adam, Mohamed A. Siddig, Abubaker A. Siddig, Nisreen Awad Eltahir
October-December 2013, 8(4):174-178
DOI:10.4103/1858-5000.133006  
Introduction: Gum Arabic is most important commercial poly-saccharine and it is probably the oldest food hydro-colloid in current use. Gum Arabic is naturally obtained from Acacia Senegal and seyal trees which are known to grow in sub Sahara region of the Sudan. Materials and Methods: Two types of Gum Arabic namely; Acacia Senegal and Seyal were used. X-ray fluorescence (XRF) and Fourier Transformation infrared spectroscopy (FTIR) were used as analytical techniques. The conductivity and dielectric of both types of Gum Arabic were measured as function of frequency. Solutions with different concentration of Gum Arabic for both types were prepared and the Ultraviolet-visible spectroscopy (UV) was used to study the optical properties of these solutions. Results: The XRF results indicated that, Gum Arabic (Acacia Senegal and Seyal) contained Calcium (Ca), Iron (Fe), Copper (Cu), Lead (Pb), and Strontium (Sr). The FTIR spectra of both types of Gum Arabic showed broad and strong absorption band in the range of 600 to 3000 cm -1 . These absorptions were assigned to the different stretching vibrations. Conclusion: The conductivity was found to increase with frequency while the opposite behavior observed for the dielectric. The absorption was found to increase with the increase of concentration.
  3,435 895 2
Pattern of eye diseases presents at free outreach in rural community in the Northwestern Nigeria
Kehinde Fasasi Monsudi, Eletu Sadiat Saka, Richard Ifeanyi Azonobi
October-December 2015, 10(4):113-116
DOI:10.4103/1858-5000.171862  
Background: The lower socioeconomic status and long distance to eye care facility of the rural dwellers in many communities in developing countries accounts for the increase in the number of preventable and avoidable causes of blindness compare to developed countries of the world. It is widely believed that the best option to reduce blindness and visual impairment in these communities is to bring eye care services to their doorsteps in the form of outreach programs this has been practiced successfully in India and other Asian countries. Aims: To assess the pattern of eye diseases presenting at a free eye outreach in a rural community of Nigeria. Materials and Methods: A retrospective study was carried out on the findings of 3-day outreach programs at Zuru General Hospital, in Zuru Emirate of Kebbi State, Northwestern Nigeria. The following information was extracted from patient's folders: sociodemographics, diagnosis, treatment offered the patient, and distance of the patient house to the eye outreach center. The data were analyzed by SPSS version 18 (2006 Statistical Package for the Social Sciences, Chicago, Illinois, USA). Results: There were 458 patients seen at the outreach of which 197 (43%) were males and 261 (57%) were females. More than half of the patients 236 (52%) were 50 years and above, followed by age group of 34–50 years 99 (21.6%). The majority of the patients 128 (27.9%) were homemakers, followed by civil servants 125 (27.2%), and farmers 112 (24.5%). Most of the patients 188 (41%) covered a distance of 3–5 km before reaching the outreach center. The predominant ocular diseases seen were cataract 148 (32.3%), glaucoma 84 (18.3%), and refractive error 82 (17.9%). Conclusion: There were more females seen at our free eye outreach and majority of participants were 50 years and above. Cataract, glaucoma, and refractive error were the main reasons why patients presented at the outreach center. Efforts at improving the ocular health of this community should be focused on reducing the burden of cataract, glaucoma, and refractive error.
  1,889 2,321 2
Radiation dose measurements during hysterosalpingography
Mohamed Yousef, Jumaa Yousif Tambul, Abdelmoneim Sulieman
January-March 2014, 9(1):15-18
DOI:10.4103/1858-5000.144652  
Objectives: Hysterosalpingography (HSG) is an effective method to evaluate abnormalities of the uterus and fallopian tube using conventional X-ray or fluoroscopy. The aim of this study was to determine and evaluate the radiation dose for females undergoing HSG during the reproductive period. Materials and Methods: This study conducted in three radiology departments: Omdurman Teaching Hospital, Alneelain Diagnostic Center and Asia Specialized Hospital. A total of 50 patients was studied from three hospitals, 20 patients from Neelain Diagnostic Center in range of (25-40) years, 20 patients from Omdurman teaching Hospital in age range from (24 to 43) years. The study duration was carried out for a period of 3 months, from March 2011 to June 2011. Patient dose measurements were performed using unfors dosimeter. Organ dose and effective doses were estimated using National Radiological Protection Board software. Results: The mean patient dose was 20.1 and 28.9 and 13. 6 Omdurman Teaching Hospital, Neelain Diagnostic Center and Asia Specialized Hospital, respectively. Ovaries and uterus have the highest dose compared to other organs. Conclusion: The results of this study are higher compared with previous studies.
  3,814 258 2
Analysis of price discrepancies and its impact on rational use of medicines
Rayan K. Mahmoud, Hassan M. Ali
October-December 2013, 8(4):189-193
DOI:10.4103/1858-5000.133021  
Introduction: The concept of rational use of medicines requires that patients receive quality efficacious medicines appropriate to their needs, in doses that meet their individual requirements, for the adequate period of time and at the lowest cost to them and to the community. Objectives: The objectives of the study were to: 1) Analyze drug price differences between brands included in Sudan Drug Index (2009), 2) compare current drug prices with prices available in the international market (WHO drug price guide 2010), 3) assess the impact of price discrepancy on rational drug use by prescribers, dispensers and patients. Methodology: A descriptive, analytical, one time study was done in Khartoum capital, including 54 drugs selected via a pilot study. Questionnaire was designed to elect the perception, attitude, and behavior of prescribers and dispensers, toward price discrepancy and its impact on rational drug use. Information from patients was taken via a structured interview, using a probability value of 0.07; the sample size was 184 pharmacists, 196 doctors and 196 patients. Result: The discrepancy level was very high in Diclofenac Na 75 mg/3 ml inj with an H/L ratio of 73.7. Drug price comparison with the international guide reveled 92.31% of drug prices included in the study were higher than the guide. The impact of price discrepancy on rational drug use by prescribers, dispensers and patients is confusing, indicating a high degree of irrationality. Conclusion: Price discrepancies haven't been explained neither by the national regulatory authority nor by the local agents. The state of confusion on prescribers, dispensers, and patients would be a source of irrational practice with all its implications on rational use of medicines particularly on the end user having the current scarce financial resources. To ensure availability, accessibility and affordability of medicines establishment of a new drug policy becomes of paramount importance.
  3,548 207 -
Prescribing rationality in Khartoum state, Sudan: An update
Rayan Khalid Mahmoud, Salah Ibrahim Kheder, Hassan Mohammed Ali
April-June 2014, 9(2):61-66
DOI:10.4103/1858-5000.146575  
Aim: Rational prescribing is one of the essential components of good medical practice targeted to provide successful and relatively safe drug therapies. The present study was carried to assess the rationality of the current prescribing practices in Khartoum State. Methodology: A descriptive, observational, 1-time study was carried out in Khartoum State hospitals and community pharmacies, to evaluate the five main prescribing indicators adopted by the WHO. Data were collected using the WHO prescribing indicator form. Results: The total number of prescriptions collected and analyzed was 7377 prescriptions, 67% from Khartoum city, 22.5% from Khartoum North city and 10.5% from Omdurman city. The total number of drugs prescribed was 20,482, the average number of drugs per prescription: 2.776 drugs, percentage of generics: 37.3%, percentage of antibiotics: 54.3%, percentage of injections: 38.6% and the percentage of drugs on the essential drug list (EDL) was 72.8%. Discussion: The number of encounters included in this study is sufficiently large compared to other previously reported studies allowing us to consider the results obtained as an acceptable representative of the total population to describe the overall prescribing pattern. Except for the value obtained for the percentage drugs on the EDL, the values of the other four indicators are indicative of prescribing irrationality in the study population. Conclusion: The observed irrational prescribing behavior necessitates the development of certain policies as well as practical and effective implementation mechanisms to promote rational prescribing. We, therefore, recommend the conduction of one or more of three interventions namely, administrative, managerial and/or educational addressing the prescribers population.
  3,007 314 3
Evaluation of renal functions using isotopic renogram and biochemical tests
Mohamed Yousef, Suliman Salih, Abdelmoneim Sulieman, Naji Ali, Abdalla Ahmed
July-September 2013, 8(3):167-169
DOI:10.4103/1858-5000.132612  
Introduction: Radionuclide renography is now very important diagnostic tool comparable to other diagnostic modalities for the evaluation of renal diseases. Aim: This study was carried out to assess the role of radionuclide renography and biochemical test in the evaluation of the renal function. Materials and Methods: A total of 50 samples with a history of renal disease were included in this study. Out of a total 50, 31 were males and 19 were females, their age ranged between 9 and 79 years and most of the patients were in the age group above 46 years, weight ranged from 22 to 97 kg, mean (standard deviation [SD]) 67.32 (17.203). Height ranged from 125 to 185 cm, mean (SD) 163.07 (12.573). Radionuclide renography and biochemical test were done for all patients in the Radiation and Isotope Center of Khartoum in the period from March 2011 to October 2011. Results: In case of radionuclide renography, total glomerular filtration rate (GFR) ranged from 6.64 to 130.70, mean (SD) 65.87 (31.30) and the biochemical test showed that (10%) of patients with abnormal serum creatinine level and (12%) with abnormal serum urea level. The serum urea level was normal in 44 patients, but in the renogram 19 patients were abnormal (both kidneys GFR), 14 patients were abnormal (right kidney GFR) and 8 patients were abnormal (left kidney GFR). A total of 45 patients had normal serum creatinine level, but in the renogram 18 patients were abnormal (both kidneys GFR), 16 patients were abnormal (right kidney GFR) and 8 patients were abnormal (left kidney GFR). Conclusion: It is concluded that both isotopes renogram technique and biochemical test are very important in the evaluation of renal function.
  2,984 224 -
Phytochemical and antimicrobial screening of Capparis decidua stems
Amira M Nour, Y. M. A. El-imam
July-September 2013, 8(3):140-145
DOI:10.4103/1858-5000.132602  
Background: The chromatographic separation of aerial parts of Capparis decidua, a woody medicinal plant, afforded one shikimate derivative, two acyclic terpenoids, four fatty acids, two sterols and two lupare triterpenoids Methods: in the present study, qualitative chemical screening of ethyle ether, methanol and water extracts of Capparis decidua stems (family Cappariaceae) showed the presence of triterpenes, fatty acids, carotenoids, coumarins and basic alkaloids. The methanol extract revealed the presence of condensed tannins, alkaloids, cardiac glycosides and anthocyanins while the aqueous extract revealed the presence of saponins, polyurenoids, condensed tannins, alkaloids and anthocyanine. All extracts were devoid of anthracene glycosides, flavanoids and reducing compounds. The antimicrobial activity of chloroform, methanol and water extract were studied in vitro against two standard gram positive bacteria (Bacillus subtilis and Staphylococcus aureus), two standard gram negative bacteria (Escherichia coli and Pseudomonas aeruginosa) and two standard fungal organisms (Aspergillus niger and Candida albicans) using the cup-plate agar diffusion method. Results: The results showed that the extracts had antimicrobial activity against at least two of the tested standard organisms; methanol extract was found to be highly active against the standard gram positive bacteria and Candida albicans, followed by the chloroform extract. The least antimicrobial activity was associated with the aqueous extract. Ten fractions were obtained when the chloroform extract was fractionated by the Preparative Thin Layer Chromatography (PTLC), their antimicrobial activity was studied in vitro against two standard gram positive bacteria (Bacillus subtilis and Staphylococcus aureus). Conclusion: The methanol extract fractionation gave five fractions and their antimicrobial activity was studied against Staphylococcus aureus and Candida albicans.
  2,866 261 1
Cataract prevalence, etiology, and systemic association in children attending EI walidain Charity Eye Hospital from April to July 2015
Atif A. M Saad, Hind M. M Abusnina, Karimeldin M. A Salih
October-December 2016, 11(4):109-112
DOI:10.4103/1858-5000.202358  
Background: Childhood cataracts are responsible for 5%–20% of blindness in children worldwide and for an even higher percentage of childhood visual impairment in developing countries. This study is an attempt to evaluate the prevalence, etiology, and systemic association of cataract in Sudanese children attending El walidain Charity Eye Hospital. Materials and Methods: this is a cross-sectional, observational prospective study in the period between April and July 2015. Out of 783 children were enrolled in this study, 52 children aged ≤18 years presented with cataract to El walidain Charity Eye Hospital in Khartoum state in the period between April and July 2015. Diagnosis of cataract was made based on history and clinical examination using ophthalmoscope and slit lamp. Results: Prevalence was 6.6%. Nearly 63% of the patients were male, mostly were male, usually idiopathic and juvenile in nature, corneal opacity and photophobia in addition to lens opacity manifested were the usual presentation. Trauma, steroid therapy, congenital, Down syndrome, and other systemic diseases found to be a risk factor. Conclusion: The prevalence of cataract in children in El walidain Charity Eye Hospital was more than that of a hospital-based study done in Tanzania. The mean age of patients was 6.1 years. Corneal opacity and lens opacity were the most common symptoms and signs, respectively. Idiopathic cataract was the most common type and decreased vision was the most common complication.
  1,007 2,025 -
REVIEW ARTICLE
An overview of neonatal conjuctivitis
Mohammed Abdulsalam, M Ibrahim, MO Asani
July-September 2015, 10(3):91-98
DOI:10.4103/1858-5000.167868  
Neonatal conjunctivitis has been recognized for several centuries and it is one of the most common infections occurring in the 1 st month of life and remains an important cause of ocular morbidity of great health concern especially in developing countries. This article attempts to review the current epidemiology, etiology, risk factors, pathogenesis, investigations, and treatment and offer possible preventive measures to avert this potentially crippling disease. Most epidemiological reports have focused on gonococcal and chlamydial neonatal conjunctivitis because both are associated with sexually transmitted diseases and are therefore of general public health importance. The risk of conjunctivitis in newborns depends on frequencies of maternal infections, prophylactic measures, circumstances during labor and delivery, and postdelivery exposures to microorganisms. The etiological agents implicated as causes of Neonatal conjunctivitis can be classified into chemical and infective. Laboratory studies used in the diagnosis of neonatal conjunctivitis include smears, stains, cultures, and serological tests. Current World Health Organisation (WHO) guidelines for the management of sexually transmitted infections recommend that all cases of neonatal conjunctivitis be treated for both Neisseria gonorrhoeae and Chlamydia trachomatis. Four levels of intervention can be used to prevent childhood blindness and ocular morbidity from neonatal conjunctivitis. These strategies may reduce the prevalence of sexually transmitted disease, which in turn may reduce the risk to infants of exposure to agents that cause neonatal conjunctivitis.
  2,746 241 -
ORIGINAL ARTICLES
Hand-washing practices and techniques among clinical students of Bayero University Kano, Nigeria
Abdulsalam Mohammed, Ibrahim Aliyu
April-June 2015, 10(2):51-55
DOI:10.4103/1858-5000.160942  
Background: Hand-washing is an important and a single most cost-effective and practical measure that reduces the incidence of infection and cross infection among health-care providers and patients. However, compliance of health-care workers to hand hygiene guidelines are reportedly poor. It is important, therefore, to instill adequate knowledge and good attitudes and practices at the time of primary training of future health-care workers. Materials and Methods: This was a descriptive cross-sectional study carried out among randomly selected clinical students of Bayero University Kano. The questionnaires were administered to the students during their daily ward rounds and clinic sessions. Results: One hundred and thirty-seven medical and nursing students of Bayero University Kano, who were on clinical posting were studied. Sixty-three (46%) students were aware of the Global Hand-washing day (χ2 = 5.989, df = 2, P = 0.050). Only 16 (11.7%) students were able to state correctly the Global Hand-washing date. One hundred and thirty-one (96%) students believe that hand-washing if correctly done can reduce the risk of infection. One hundred and fourteen (83.2%) students were taught hand-washing technique (χ2 = 6.862, df = 1, P = 0.009). One hundred and twenty-two (89.1%) of the students use soap and water or hand rubs in washing their hands. One hundred and two (74.5%) students are not aware of the World Health Organization five moments of hand-washing hygiene. Only 13 (9.5%) students were able to mention the steps of hand-washing correctly (χ2 = 10.285, df = 2, P = 0.006). Eighty-six (62.8%) students adhere to the principles of hand-washing in their clinical postings (χ2 = 4.404, df = 1, P = 0.036). Seventy-two (52.6%) students wash their hands before handling patients (χ2 = 7.575, df = 1, P = 0.006), but the majority 130 (94.9%) of them wash their hands after handling patients. Conclusion: There is a need for continuous teaching of medical and nursing students on the correct hand-washing techniques and to inculcate in them the habit of hand-washing before and after touching patients. This will greatly improve the safety of the potential health-care providers and patients.
  2,560 242 1
Knee joint diseases diagnosed by ultrasound and magnetic resonance imaging
Elgeili Adam Yousif, Bushra Hussien Ahmed, Alsafi Ahmed Abdella, Qurashi Mohammed Ali
January-March 2014, 9(1):1-4
DOI:10.4103/1858-5000.144640  
Introduction: A great number of people all over the world suffer from knee joint problems. The benefits of ultrasound (US) when compared to magnetic resonance imaging (MRI) are that the US is noninvasive, freely available, well-accepted by patients, cheap and that it has the advantage of dynamic evaluation and real-time imaging. In this study, there is a comparison between uUS and MRI in characterization of knee joint diseases using. Materials and Methods: This is an observational cross-sectional study of 200 patients, who attended the Radiological Center, College of Applied Medical Sciences, King Khalid University, Saudi Arabia, from October 2011 to August 2013. The US technique has been carried out according to the protocol of American Institute of Ultrasound in Medicine, using a linear probe transducer with high frequency 7.5-12 MHz. Results: The range of the patients' age was 12-80 years. The most common presenting symptoms were painful swelling of the knee joint and inability to move. In 125 of them US and MRI revealed variable diseases: Effusion (81), loose body (2), synovial cyst (4), quadriceps tendon rupture (1), meniscus tear (6), tumor (1) bursitis (8), arthritis (5), baker cyst (4) deep vein thrombosis (3) diagnosed with both US and MRI, and anterior cruciate ligament tear (6), posterior cruciate ligament tear (4) seen with MRI only. Conclusion and Recommendations: The study suggested that US can evaluate cystic lesions, as well as menisci, ligaments, tendons, and muscles tear. Most of the knee joint disorders were degenerative in origin. Since MRI is not easily available in developing countries and rural areas. US can be used routinely for the diagnoses of most knee joint diseases, shortening the list of MRI indications.Introduction: A great number of people all over the world suffer from knee joint problems. The benefits of ultrasound (US) when compared to magnetic resonance imaging (MRI) are that the US is noninvasive, freely available, well-accepted by patients, cheap and that it has the advantage of dynamic evaluation and real-time imaging. In this study, there is a comparison between uUS and MRI in characterization of knee joint diseases using. Materials and Methods: This is an observational cross-sectional study of 200 patients, who attended the Radiological Center, College of Applied Medical Sciences, King Khalid University, Saudi Arabia, from October 2011 to August 2013. The US technique has been carried out according to the protocol of American Institute of Ultrasound in Medicine, using a linear probe transducer with high frequency 7.5-12 MHz. Results: The range of the patients' age was 12-80 years. The most common presenting symptoms were painful swelling of the knee joint and inability to move. In 125 of them US and MRI revealed variable diseases: Effusion (81), loose body (2), synovial cyst (4), quadriceps tendon rupture (1), meniscus tear (6), tumor (1) bursitis (8), arthritis (5), baker cyst (4) deep vein thrombosis (3) diagnosed with both US and MRI, and anterior cruciate ligament tear (6), posterior cruciate ligament tear (4) seen with MRI only. Conclusion and Recommendations: The study suggested that US can evaluate cystic lesions, as well as menisci, ligaments, tendons, and muscles tear. Most of the knee joint disorders were degenerative in origin. Since MRI is not easily available in developing countries and rural areas. US can be used routinely for the diagnoses of most knee joint diseases, shortening the list of MRI indications.
  2,519 241 -
CASE REPORTS
Charcot-Marie-Tooth disease type 5: A clinical and electrophysiological study
Moawia Elbalal Mohammed, Salih Mohamed Alawi Albasseri, Izzadin Elawad
January-March 2014, 9(1):49-51
DOI:10.4103/1858-5000.144667  
A young male presented to our hospital with a long standing history of spastic paraparesis with no cerebellar or sensory ataxia. He had no sensory level or sphencteric disturbances. There is no similar family history. He had normal magnetic resonance imaging of the cervical and dorsal regions. Electrophysiologic studies including electromyography and nerve conduction were consistent with Charcot-Marie-Tooth disease type 5. This case is being reported for its rarity.
  2,405 137 -
ORIGINAL ARTICLES
Prevalence of diabetes mellitus in a tertiary health institution in Gombe Metropolis, Nigeria
Mela Danjin, Nafisa Umar Usman, Danladi Adamu
October-December 2016, 11(4):113-118
DOI:10.4103/1858-5000.202357  
Aim: This study was aimed at determining the prevalence of diabetes mellitus (DM) among adult patients attending Specialist Hospital Gombe, Northern Nigeria. Materials and Methods: A 5-year (2010–2014) retrospective descriptive survey of cases of DM was conducted, using hospital record retrieved from the Record Department of Specialist Hospital Gombe. Diagnosed adult cases of DM were carefully identified and sorted from the general outpatient department morbidity register. Relevant data were then harvested on a specially designed data collection template. Results: A total of 40,083 medical cases were counted, out of which 2069 cases of DM were identified. This implies an overall prevalence rate of 5.16%. However, the yearly prevalence of the disease revealed as high as 12.55% in the year 2012 and a least value of 1.22% in the year 2010. Age-specific case count of the disease was found to be highest (1288; 62.25%) within the uppermost age range of 65–75, while the lowest age range of 25–34 was least affected (33, 1.60%). Overall, more females (1491; 72.06%) suffered from the disease than males (578, 27.94%). The sex difference was found to be significant (χ2 = 449.15521,P= 0.000). Furthermore, the case burden of the disease was found to be significantly (χ2 = 39.02524,P= 0.000) highest among individuals living in urban areas, 663 (80.38%) than those living in rural areas, 406 (19.62%). Conclusion: The disproportionately high case burdens of DM among females, urban dwellers, and the aged are useful information for the design of targeted diabetes prevention programs by government and other stakeholders.
  1,866 670 -
Evaluating medicines prices, availability, affordability and price components in Sudan
Salah Ibrahim Kheder, Hassan Mohamed Ali
January-March 2014, 9(1):19-30
DOI:10.4103/1858-5000.144655  
Background: The aim of this study to measure medicines prices, their availability, affordability and price structure carried out in different sectors in Sudan. Methods: A field study was undertaken in the public and private sector in Sudan from March 2012 to April 2013 using a standardized methodology developed by the (World Health Organization) and (health action international). Results: Based on median price ratio (MPR), the central medical store was procuring lowest priced generics (LPGs) at 1.2 times their international reference price (IRP), while they were selling generics at 2.34 times the IRP. The revolving drug fund was procuring LPGs at 1.55 times IRP, and selling generics at 5.13 times the IRP. In public pharmacies, the median MPR for LPG medicines was 2.99 and 8.03 for originator brands (OBs). In private retail pharmacies, the median MPR is 3.84 for LPGs and 19.37 for OBs. Generic medicines were the predominant products in public and private pharmacy sectors (39.5% and 56.6% respectively), while for OBs were 1.8% in public sector pharmacies and 9.3% for private pharmacy sector. The affordability of LPGs in the public sector was good for half of conditions, with standard treatment costing a days' wage or less for 53.3% of treatments. In the private sector, the affordability of LPGs was similar to the public sector. The government worker would have to work 2.5 days to pay for 1-month of treatment with OB Glibenclamide for diabetes when purchased from private pharmacies, for LPG Glibenclamide he has to pay about half-a day's salary to buy the medicines from public and private sectors. Conclusion: In Sudan, the availability of the surveyed medicines was low in all sectors as both OBs (<10%), and 40-50% as generics depending on the sector. LPGs have been accepted in the country as they are more available than OBs. In both the private and public sectors, considerable price differences were seen between OBs and LPGs. Medicines are often unaffordable for ordinary citizens.
  2,238 290 -
Comparative measuring between fresh and stored Drabkin's reagent preparations on hemoglobin estimation
Nadia Madani, Shamseldein M Ahmed, Tarig Guma, Gad Allah Modawe
January-March 2015, 10(1):7-10
DOI:10.4103/1858-5000.157502  
This pilot case control hospital base study was conducted to determine the effect of using stored Drabkin's reagent on hemoglobin estimation compared with freshly prepared Drabkin's reagent. Freshly 50 ethylenediaminetetraacetic acid venous blood samples were collected from volunteers from Omdurman Military Hospital, Sudan, the Hb estimation performed using manual method (Hemiglobincyanide or cyanmethemoglobin method), Drabkin's used was prepared in a manner (fresh, 4 days, 8 days and 12 days stored Drabkin's). Then the collected data were analyzed by SPSS computer program. The result shows that the mean concentration of Hb (g/dL) when estimated by prepared Drabkin's reagent for several interval, the fresh reagent result was 13.0 g/dL, 4 days was reagent 11.9 g/dL, 8 days reagent was 11.4 g/dL and 12 days reagent was 11.3 g/dL. The study reveals that the mean of Hb when measured by 4 days stored Drabkin's reagent were statically insignificant and significant when measured by 8 days and 12 days stored Drabkin's reagent (P = 0.05).
  2,344 178 -
Radiation doses from chest X-ray examinations for pediatrics in some hospitals of Khartoum State
N. O. Alatts, A. A. Abukhiar
October-December 2013, 8(4):186-188
DOI:10.4103/1858-5000.133018  
Introduction: Paediatrics patients deserve special attention because of the higher radiation risks compared with adults. Objective: The purpose of this study is to determine diagnostic reference level through entrance surface dose (ESD) calculations. The overall data consisted of patients doses collected from three major hospitals in Khartoum state. Results: 400 patients were subjected to this study. They are classified into four age groups, 0->1 year, 1->5 years, 5->10 years and 10->15 years old. Anteroposterior (AP) chest X-ray examination is done for them. The ESD calculated using Dose Cal software. The x-ray tube output for each equipment is measured using calibrated ionization chamber (RAD - Check Plus model 06-526). The results obtained are high compared to international diagnostic reference levels for chest. These results will also serve as a base line data for future settings.
  2,266 234 -
Cerumen auris in Abubakar Tafawa Balewa University teaching hospital Bauchi, North-eastern Nigeria
Abdullahi Musa Kirfi, Garba Mohammed Mainasara, Abubakar Tijjani Sa'idu, Mohammed Bello Fufore, Yohanna Joseph
April-June 2014, 9(2):75-80
DOI:10.4103/1858-5000.146579  
Background: Cerumen Auris (Ear Wax) is a naturally occurring normally extruded product of the External Auditory Canal (EAC). Despite lots of work on cerumen auris in other parts of Nigeria and the world at large, there was no documented prevalence study in North-eastern Nigeria. Objective: The study aimed to determine the prevalence of cerumen auris, evaluate the methods of its removal and to evaluate the possible complications of methods of cerumen removal in Abubakar Tafawa Balewa University Teaching Hospital Bauchi Northeastern Nigeria. Design: A 1-year retrospective study of all patients seen with cerumen auris at the study center. Materials and Methods: Patients case files were retrieved, and data on demography, clinical presentation, examination, intervention, as well as complications, were extracted. The data was analyzed using SPSS version 16. Results: A total of 442 patients' case notes was reviewed, consisting 218 males and 224 females, age ranges from 1-month to 93 years, mean age was 18.76 ± 1.78, most frequent affected age group was 0-9 years accounting for 43.7%. The calculated hospital prevalence was 4.6%. Ninety-five percent of the patients had their cerumen auris removed via ear syringing. Twenty-one (4.8%) of the patients had canal abrasion, 2.3% had bleeding in the EAC, 1.4% of the patients had vertigo. Conclusion: Cerumen auris, when untreated, can lead to hearing loss and loss of concentration hence its removal using a safe and effective method is paramount. Ear syringing is found to be safe and effective method of cerumen auris removal.
  2,256 200 -
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