Oral Expulsion of Taenia saginata by a Sudanese Woman in Nyala, Western Sudan

A 43- year old woman vomited part of Taenia saginata (93 cm long) about two hours after she had a large meal at the end of a fasting day in Ramadan month. She expelled the rest of the worm per rectum the next day, after she took praziquantel tablet.Sudan Journal of Medical Sciences Vol. 3 (1) 2008: pp. 79-8

Diabetic Septic Foot in Omdurman Teaching Hospital

Objective: To audit the management of diabetic septic foot [DSF] lesions in Omdurman Teaching Hospital, usingWagner classification. Patients and methods: This is a retrospective study on 208 patients with DSF admitted to Omdurman Teaching Hospital, Sudan between June 2006 and May 2007. Data were analyzed manually Results: The male to female ratio was 2:1. The mean age± SD was 56 ± 12.35 year. 16.8% patients were grade 1. 33 (15.9%) patients were grade 2. grades 3, 4, 5 patients were 66 (37 %), 38 (18.3%) and 36 (17.3%) respectively. Major lower limb amputation and mortality were 19.2%, and 6.7% respectively.Conclusion: Preventive measures for patients at risk are highly needed as well early presentation isencouraged when ulcer develops in diabetic foot to avoid subsequent complications.Key words: Diabetes Mellitus, Diabetic septic foot, amputatio

Audit of laparoscopic cholecystectomy Omdurman teaching hospital

Objectives: To review and audit our experience in laparoscopic cholecystectomy [LC] at Omdurman Teaching Hospital, Sudan. Methods: A prospective study for patients who underwent laparoscopic cholecystectomy in the period, from January 2006 to October 2007. Demographic data, indications for surgery, rate of conversion to open cholecystectomy, morbidity, and mortality rates were noted. Results: A total of 114 patients underwent LC in 21 months, They were female 100 patients and 14 males, age range from 25 to70 years, mean age 44 years. Indications for surgery were biliary colic 65.8%, fatty dyspepsia 37.7%, and acute cholecystitis 3.5%. The range of operative time was 25-90 minutes. Conversion rate was (7.9%). The reasons for conversions were bleeding, extensive dense adhesions, severe inflammation. Conclusion: Our findings were consistent with the literature, demonstrating that LC is a safe minimal invasive technique Keywords: Laparoscopic, cholecystectomy, minimal invasive surgery, surgical audit, Sudan.Sudan Journal of Medical Sciences Vol. 3 (1) 2008: pp. 21-2

The group structure of non-Abelian NS-NS transformations

We study the transformations of the worldvolume fields of a system of multiple coinciding D-branes under gauge transformations of the supergravity Kalb-Ramond field. We find that the pure gauge part of these NS-NS transformations can be written as a U(N) symmetry of the underlying Yang-Mills group, but that in general the full NS-NS variations get mixed up non-trivially with the U(N). We compute the commutation relations and the Jacobi identities of the bigger group formed by the NS-NS and U(N) transformations.Comment: Latex, 11 pages. v2: Typos corrected; version to appear in JHEP

Morbidity and Mortality Pattern of Neonates Admitted into Nursery Unit in Wad Medani Hospital, Sudan

Background: Neonatal outcome is an important indicator of obstetrics and health care. Few or no published data are available concerning neonatal morbidity and mortality in Sudan. Objectives: To study morbidity and mortality pattern amongst inborn neonates admitted into nursery unit in Wad Medani Hospital, Sudan during the period Jan-June, 2009.Results: A total of 1211 (29.5%) out of 4098 in-born neonates were admitted during study period. The major indications for neonatal admission were; infections 300 (24.8%), low birth weight (LBW) 307(25.4%) and asphyxia 130(10.7). There were 133(11%) neonatal deaths; preterm delivery, LBW and birth asphyxia were the major causes of death among these neonates.Conclusion: neonatal infection, preterm birth and LBW were the common causes of neonatal morbidity and mortality. There is an urgent need for more research throughout the country concerning these common causes of morbidity and mortality.Key words: pregnancy, preterm delivery, low birth weight, asphyxi

Overuse of cesarean delivery at Al-Saudi Hospital, Hajjah, Yemen

Background: The prevalence of cesarean section delivery continues to rise in most of the settings including the developing countries. Different indications for cesarean delivery might be responsible for this rise.Methods: The study was conducted during one year period of first May 2012 through 30 of April 2013 at Al-Saudi Hospital in Hajjah city, Yemen to investigate incidence, indications and type of cesarean delivery. The medical files were reviewed and medical and obstetrics data were retrievedfrom the files (age, parity, education, and mode of delivery).Results: Out of 1728 deliveries, 1211 (70%) were vaginal (include 1.3% instrumental deliveries) and 517 (30%) were cesarean deliveries. The vast majority of the cesarean deliveries were emergency ones (410; 79.3%). The different indications of cesarean deliveries were; hypertensive disorder of pregnancy (27.1%); repeated cesareans (22.8%), antepartum  hemorrhage (14.5%), obstructed labor (10.6 %), cephalopelvic  disproportion (10.6 %), bad obstetric history (1.4 %), others (2.5 %) and combined indications ( 5%).Conclusion: There is a high incidence of cesarean deliveries in this setting. Measures have to be taken (increase instrumental delivery, trial of labour and trial of scar) to reduce this high incidence of cesarean deliveries.Keywords: pregnancy; cesarean delivery; indications; Yemen

Ultrasound- guided fine needle aspiration cytology and cell block in the diagnosis of focal liver lesions at Khartoum Hospital, Sudan

Background: The appropriate clinical management of various hepatic lesions depends on accurate diagnosis. Fine needle aspiration and cell block have gained popularity because they are convenient, minimally invasive, quick and have good performance profiles.Objective: To investigate the cytomorphological features of distinctive non-neoplastic and neoplastic lesions of the liver and to evaluate the sensitivity, specificity and diagnostic accuracy of ultrasound- guided (USG) fine needle aspiration cytology (FNAC) and cell block in the diagnosis ofliver diseases at Khartoum Teaching Hospital.Method: A cross-sectional study was conducted at Khartoum Teaching Hospital, Sudan during the period of November 2008 to October 2011. One hundred and five cytological materials were collected from patients with focal liver lesions who referred after initial clinical and radiologicalassessment for ultrasound–guided fine needle aspiration cytology (USG -FNAC).Results: The age of the patients ranged from 5- 60 years and 64 (61%) of these patients were males. Out of 105 investigated samples 76 (72.4%) and 41(39.0%) were malignant by cytology and cell block respectively. Out of these 105 samples, 71 were investigated by both cytology and cell blocks and were included in the final analyses of the FNAC in comparison to cell block. The sensitivity, specificity, positive predictive value and negative predictive value of the cytology were 100% (93.0 – 100%), 63.3% (45.2 – 79.0%), 78.8% (66.2 – 88.3%) and 0 (0 – 14.6%), respectively.Conclusion: Thus, USG -FNAC is a sensitive but not specific method in differentiating the benign and malignant focal liver lesions. Differentiation between primary liver malignant lesions and metastatic lesion needs adjunct techniqueKey words: neoplastic lesion, non-neoplastic lesio

The association between acute flaccid myelitis (AFM) and enterovirus D68 (EV-D68) – what is the evidence for causation?

© 2018, European Centre for Disease Prevention and Control (ECDC). All rights reserved. Background: Enterovirus D68 (EV-D68) has historically been a sporadic disease, causing occasional small outbreaks of generally mild infection. In recent years, there has been evidence of an increase in EV-D68 infections globally. Large outbreaks of EV-D68, with thousands of cases, occurred in the United States, Canada and Europe in 2014. The outbreaks were associated temporally and geographically with an increase in clusters of acute flaccid myelitis (AFM). Aims: We aimed to evaluate a causal association between EV-D68 and AFM. ?Methods: Using data from the published and grey literature, we applied the Bradford Hill criteria, a set of nine principles applied to examine causality, to evaluate the relationship between EV-D68 and AFM. Based on available evidence, we defined the Bradford Hill Criteria as being not met, or met minimally, partially or fully. Results: Available evidence applied to EV-D68 and AFM showed that six of the Bradford Hill criteria were fully met and two were partially met. The criterion of biological gradient was minimally met. The incidence of EV-D68 infections is increasing worldwide. Phylogenetic epidemiology showed diversification from the original Fermon and Rhyne strains since the year 2000, with evolution of a genetically distinct outbreak strain, clade B1. Clade B1, but not older strains, is associated with AFM and is neuropathic in animal models. Conclusion: While more research is needed on dose–response relationship, application of the Bradford Hill criteria supported a causal relationship between EV-D68 and AFM

The Phylogeography of MERS-CoV in Hospital Outbreak-Associated Cases Compared to Sporadic Cases in Saudi Arabia.

This study compared the phylogeography of MERS-CoV between hospital outbreak-associated cases and sporadic cases in Saudi Arabia. We collected complete genome sequences from human samples in Saudi Arabia and data on the multiple risk factors of human MERS-CoV in Saudi Arabia reported from 2012 to 2018. By matching each sequence to human cases, we identified isolates as hospital outbreak-associated cases or sporadic cases. We used Bayesian phylogenetic methods including temporal, discrete trait analysis and phylogeography to uncover transmission routes of MERS-CoV isolates between hospital outbreaks and sporadic cases. Of the 120 sequences collected between 19 June 2012 and 23 January 2017, there were 64 isolates from hospital outbreak-associated cases and 56 from sporadic cases. Overall, MERS-CoV is fast evolving at 7.43 × 10-4 substitutions per site per year. Isolates from hospital outbreaks showed unusually fast evolutionary speed in a shorter time-frame than sporadic cases. Multiple introductions of different MERS-CoV strains occurred in three separate hospital outbreaks. MERS-CoV appears to be mutating in humans. The impact of mutations on viruses transmissibility in humans is unknown

Severe anaemia is associated with a higher risk for preeclampsia and poor perinatal outcomes in Kassala hospital, eastern Sudan

<p>Abstract</p> <p>Background</p> <p>Anaemia during pregnancy is major health problem. There is conflicting literature regarding the association between anaemia and its severity and maternal and perinatal outcomes.</p> <p>Methods</p> <p>This is a retrospective case-control study conducted at Kassala hospital, eastern Sudan. Medical files of pregnant women with severe anaemia (haemoglobin (Hb) < 7 g/dl, n = 303) who delivered from January 2008 to December 2010 were reviewed. Socio-demographic and obstetric data were analysed and compared with a similar number of women with mild/moderate anaemia (Hb = 7-10.9 g/dl, n = 303) and with no anaemia (Hb > 11 g/dl, n = 303). Logistic regression analysis was performed separately for each of the outcome measures: preeclampsia, eclampsia, preterm birth, low birth weight (LBW) and stillbirth.</p> <p>Results</p> <p>There were 9578 deliveries at Kassala hospital, 4012 (41.8%) women had anaemia and 303 (3.2%) had severe anaemia. The corrected risk for preeclampsia increased only in severe anaemia (OR = 3.6, 95% CI: 1.4-9.1, <it>P </it>= 0.007). Compared with women with no anaemia, the risk of LBW was 2.5 times higher in women with mild/moderate anaemia (95% CI: 1.1-5.7), and 8.0 times higher in women with severe anaemia (95% CI: 3.8-16.0). The risk of preterm delivery increased significantly with the severity of anaemia (OR = 3.2 for women with mild/moderate anaemia and OR = 6.6 for women with severe anaemia, compared with women with no anaemia). The corrected risk for stillbirth increased only in severe anaemia (OR = 4.3, 95% CI: 1.9-9.1, <it>P </it>< 0.001).</p> <p>Conclusions</p> <p>The greater the severity of the anaemia during pregnancy, the greater the risk of preeclampsia, preterm delivery, LBW and stillbirth. Preventive measures should be undertaken to decrease the prevalence of anaemia in pregnancy.</p