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

Determination of entrance skin dose from diagnostic X-ray of human chest at Federal Medical Centre Keffi, Nigeria

patient during x-ray examination in Federal Medical Centre, Keffi in Nasarawa state, Nigeria. Entrance skin doses (ESDs) for a common type of x-ray procedures, namely chest AP/PA (anterior/posterior) were measured. A total of 200 data were collected from patients who were exposed to diagnostic X-ray during their routine chest X-ray examinations. The age of the patients ranged from 15 to 68 years old while the weight and height of these patients ranged from 37.5kg to 98.5kg and 130.0cm to 175cm,  respectively. The patent’s skin dose were determined using Edmond’s formula, which is based on the X-ray tube and the radiographic exposure parameters of kVp, mAS, SSD and the total filtration of the beams. The calculated mean skin dose ranges from 0.013± 0.01mGy to 0.851±0.023mGy. In general, the ESDs measured for this type of x-ray procedures were found to be lower than or in agreement with the guidance level set by the Nigerian Basic Ionizing Radiation Regulation (NBIRR, 2003) standard and other international bodies and does not pose any significant health risk to the patience or the workers.Keywords: Entrance skin Dose, X-ray, Anterior-Posterior, Exposure, and Radiation

Genetic variation within and among five natural populations of endangered Sclerocarya birrea (A. Rich) subsp. Birrea in Sudan

Knowledge of genetic diversity is important for successful conservation and domestication of species. In order to determine genetic diversity within and among Sclerocarya birrea (A. Rich.) Htochst. subsp. birrea populations in Sudan, random amplified polymorphic DNA (RAPD) markers were used. Leaf materials from 75 seedlings from five populations (Rashad, Alfaid, Alkhwi, Aldamazin and Baw) of this species were used to compare the genetic diversity. A total of 37 bands were generated using four primers. Genetic variation within the populations as estimated by Shannon information index ranged from 0.343 to 0.272 with an overall diversity of 0.306. Analysis of molecular variance revealed that 46% of the variation was attributed to differences among the populations and 54% within the populations (P < 0.001). The gene flow among population was small (Nm = 0.297). UPGMA cluster and principal coordinate analyses (PCA) indicated Alfaid as the most distinct population. Since genetic variation was found to occur among and within the populations of S. birrea (A. Rich.) Hochst. Subsp. birrea, conservation of these populations would help in the maintenance of the species.Key words: Sclerocarya birrea subsp. birrea, genetic variation, conservation, random amplified polymorphicDNA (RAPD), Sudan

Multicentre study of Wilm’s tumours treated by different therapeutic strategies in two different countries

Background and purpose According to the treatment of Wilm’s tumours, two different therapeutic strategies were established in the second half of the last century. Both National Wilm’s Tumour Study (NWTS) group and the International Society of Paediatric Oncology (SIOP) have helped to improve the clinical management and outcome of patients with Wilm’s tumours. In this study, we compared three groups of patients with Wilm’s tumours from different racial backgrounds and therapeutic strategies.Patients and methods A clinicopathological review was carried out for 40 patients treated at Kyushu University Hospital in Japan from 1960 to 2006 according to NWTS, 79 patients treated at the South Egypt Cancer Institute from 2002 to 2009 according to the SIOP protocol and 33 patients treated at the Pediatric Surgery Department of Assiut University Hospital from 2000 to 2009 according to the NWTS protocol.Results In the Kyushu University group, a favourable histology was diagnosed in 80% of patients and an unfavourable histology in 20% of patients. The distribution of the clinical stage was as follows: I = 40%, II =22.5%, III = 22.5%, IV = 7.5% and V = 7.5%. The 5-year overall survival was 82.5%, with the 5-year stage-related survival as follows: I= 93.7%, II =83.3%, III= 62.5%, IV = 33.3% and V = 100%. In the South Egypt Cancer Institute group, favourable histology was diagnosed in 89.9% of patients, unfavourable histology in 8.8% of patients and benign disease in 1.3% of patients. The distribution of the clinical stage (before and after chemotherapy) was as follows: I = 25.3%-50%, II= 19%-20%, III= 35.4-15%, IV = 12.5%-5% and V = 7.6%-7.6%. No case of intraoperative tumour rupture was recorded. The overall 5-year survival rate of 84% with a 5-year stage-related survival was as follows: I= 92%, II =80%, III= 50%, IV = 31% and V = 30%. In the Assiut University group, a favourable histology was diagnosed in 79% of patients and an unfavourable histology in 9% of patients. The distribution of the clinical stage was as follows: I= 39.4%, II =21.2%, III = 21.2%, IV = 12% and V =6%. The overall 5-year survival rate was 77% and the 5-year stage-related survival was as follows: I= 85%, II= 75%, III = 52%, IV = 33% and V = 33%.Conclusion The Egyptian patients with Wilm’s tumour presented at a younger age and had less incidence of an unfavourable histology compared with Japanese patients. Preoperative chemotherapy increased the rate of stage I disease and decreased the incidence of intraoperative tumour rupture and relapse. However, there was a possibility that chemotherapy had been administered in the case of benign disease. Keywords: intraoperative tumour rupture, NWTS, SIOP, Wilm’s tumou

The Kinetics of the Silver(i)-induced Oxidation of Chromium(iii) by Peroxodisulphate

Chromium(III) and chromium(VI) compounds play an important role in natural oxidation processes in terrestrial and atmospheric water. During the oxidation of SO2, peroxodisulphate is formed as an intermediate. In acidic and neutral solutions, peroxodisulphate oxidizes chromium(III) very slowly. This reaction rate is markedly enhanced by silver ions, resulting in a reaction rate that allows the reaction to be studied conveniently under laboratory conditions. The kinetics of the Cr(III)/Ag(I)/S2O82– reaction system were studied as a function of different Cr(III), Ag(I) and S2O82– concentrations, temperature and pressure. The formation of Cr(VI) was observed as a first-order process at high [Cr(III)] and as a zero-order process at low [Cr(III)].Aninduction period was observed in both cases. For the first-order process, reaction rates were found to be independent of [Cr(III)], linearly dependent on [Ag+] and independent of [S2O82–]. The activation enthalpy (ΔH≠) was calculated as 56 ± 5 kJ mol–1, the activation entropy (ΔS≠) as –136 ± 16 J K–1 mol–1 and the activation volume as –5.8 ± 0.7 cm3 mol–1. At low [Cr(III)], the reaction rate was independent of [Cr(III)], linearly dependent on [S2O82–] and non-linearly dependent on [Ag+], reaching a limiting value at high [Ag+]. The activation enthalpy (ΔH≠) was calculated as 61±5kJmol–1, the activation entropy (ΔS≠) as –119±15 J K–1 mol–1 and the activation volume as –1.7±0.1 cm3 mol–1. A mechanism involving the reversible formation of a silver-peroxodisulphate complex that decomposes into oxidizing intermediates is proposed. The empirical observations can be adequately described by this mechanism.Keywords: Chromium(III), peroxodisulphate, oxidation, silver

Rare coding SNP in DZIP1 gene associated with late-onset sporadic Parkinson's disease

We present the first application of the hypothesis-rich mathematical theory to genome-wide association data. The Hamza et al. late-onset sporadic Parkinson's disease genome-wide association study dataset was analyzed. We found a rare, coding, non-synonymous SNP variant in the gene DZIP1 that confers increased susceptibility to Parkinson's disease. The association of DZIP1 with Parkinson's disease is consistent with a Parkinson's disease stem-cell ageing theory.Comment: 14 page

Spontaneous compartment syndrome in a patient with diabetes and statin administration: a case report

Compartment syndrome is a condition characterized by pressure increasing in the inextensible muscular compartments that leads to a decrease of capillary perfusion with consequent ischemic lesions of the logia elements. The authors report a case of an unusual compartment syndrome with spontaneous onset in a patient with type II diabetes and chronic therapy with statins (Atorvastatin). The condition was successfully treated by a fasciotomy and medical support. The importance of a correct anamnesis and a high level of suspicion is emphasized

Scheduling M2M traffic over LTE uplink of a dense small cell network

We present an approach to schedule Long Term Evolution (LTE) uplink (UL) Machine-to-Machine (M2M) traffic in a densely deployed heterogeneous network, over the street lights of a big boulevard for smart city applications. The small cells operate with frequency reuse 1, and inter-cell interference (ICI) is a critical issue to manage. We consider a 3rd Generation Partnership Project (3GPP) compliant scenario, where single-carrier frequency-division multiple access (SC-FDMA) is selected as the multiple access scheme, which requires that all resource blocks (RBs) allocated to a single user have to be contiguous in the frequency within each time slot. This adjacency constraint limits the flexibility of the frequency-domain packet scheduling (FDPS) and inter-cell interference coordination (ICIC), when trying to maximize the scheduling objectives, and this makes the problem NP-hard. We aim to solve a multi-objective optimization problem, to maximize the overall throughput, maximize the radio resource usage and minimize the ICI. This can be modelled through a mixed-integer linear programming (MILP) and solved through a heuristic implementable in the standards. We propose two models. The first one allocates resources based on the three optimization criteria, while the second model is more compact and is demonstrated through numerical evaluation in CPLEX, to be equivalent in the complexity, while it performs better and executes faster. We present simulation results in a 3GPP compliant network simulator, implementing the overall protocol stack, which support the effectiveness of our algorithm, for different M2M applications, with respect to the state-of-the-art approaches

Quantitative cardiovascular magnetic resonance for molecular imaging

Cardiovascular magnetic resonance (CMR) molecular imaging aims to identify and map the expression of important biomarkers on a cellular scale utilizing contrast agents that are specifically targeted to the biochemical signatures of disease and are capable of generating sufficient image contrast. In some cases, the contrast agents may be designed to carry a drug payload or to be sensitive to important physiological factors, such as pH, temperature or oxygenation. In this review, examples will be presented that utilize a number of different molecular imaging quantification techniques, including measuring signal changes, calculating the area of contrast enhancement, mapping relaxation time changes or direct detection of contrast agents through multi-nuclear imaging or spectroscopy. The clinical application of CMR molecular imaging could offer far reaching benefits to patient populations, including early detection of therapeutic response, localizing ruptured atherosclerotic plaques, stratifying patients based on biochemical disease markers, tissue-specific drug delivery, confirmation and quantification of end-organ drug uptake, and noninvasive monitoring of disease recurrence. Eventually, such agents may play a leading role in reducing the human burden of cardiovascular disease, by providing early diagnosis, noninvasive monitoring and effective therapy with reduced side effects