A Sudanese Male with Jaccoud's Arthropathy: Case report

International audienc

Pattern and clinical phenotype of systemic lupus erythematosus among male patients: Hospital‐based study

Abstract Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown aetiology. SLE is mostly considered a disease of women, though men may also be affected, and this may lead to a delay in diagnosis in men. The result is a greater burden of inflammation and subsequent organ damage over time. This study aims to assess the pattern, clinical phenotype and organ damage in male patients with SLE. Methods A descriptive cross‐sectional study enrolled 30 male SLE patients in Omdurman Military Hospital, Khartoum, Sudan, during the period of December 2019 to May 2020. Data were collected by designated questioner containing demographics, age at diagnosis, clinical manifestations at onset and during the disease course and immunological assays. The data were analyzed by Statistical Package for Social Studies Program. Results The mean age of 35.7 years ranged and the mean age at diagnosis was 32 years, and a third of the patients were found in the age group (30–39 years). The origin distribution showed that 50% of the patients were from central areas, and most of the patients were university graduates, the mean SLE duration was 5 years. Constitutional symptoms were the major manifestation at the onset of SLE in 56.7% of the patients. SLE manifestations during the course of the disease were mainly musculoskeletal manifestations in 87.7% of patients. Conclusion The mean duration of the disease is 5 years, and the mean age of the patients is in the middle of their thirties, the constitutional symptoms were the major manifestation and musculoskeletal manifestations came second to that and almost all of them have positive antinuclear antibodies and anti‐dsDNA

AN ANALYTICAL, STATISTICAL STUDY OF THYROID CANCER INCIDENCE IN SUDAN DURING 2005-2015

Introduction: Sudan, the most diverse country in the African continent, is experiencing growing cancers problems. However, little is known about thyroid cancer epidemiology and patterns. the study aimed to analyse and describe the epidemiological characteristics and trends of thyroid cancer in, in the period1st January 2005 and 31st December 2015. Methods: This is retrospective population and hospital-based study. We analysed epidemiological data for digital medical records at both Radiation and Isotope Centre Khartoum (RICK), and Soba University Hospital, Khartoum, Sudan were reviewed. Results: In total, 1,062 cases were reported during 1st January 2005 and 31st December 2015. Of these, (360; 33.9%) were male and (702; 66.1%) were female. The highest number of cases was in the 25-54-year-old age group (451; 42.5%), and more than 65-year-old age (331; 31.2%). The most predominant type of thyroid cancer among the Sudanese population was Papillary carcinoma (734; 69.1%) followed by Follicular carcinoma 178(16.8%) and Medullary carcinoma (150; 14.1%). There were significant differences in gender, age groups and types of thyroid cancer (P=0.001). Based on geographical distribution thyroid cancer showed high prevalence in Khartoum, North Kurdufan, River Nile, Kassala, North Darfur, Northern, and south Kurdufan. Whereas, low distribution is seen in Red sea, West Darfur, West Kurdufan, East Darfur, Al Gadarif, and the Blue Nile. Conclusion: our results suggest that thyroid cancer continuous presenting alarming challenge with an increasing the prevalence in females. Papillary carcinoma is the most common type among Sudanese populations. Further epidemiological studies are required in policy strategies for control and prevention strategies of thyroid cancer in Sudan

Clinical presentation of psoriatic arthritis among sudanese: hospital based study

International audienc

THE ROLE OF HYDROXYCHLOROQUINE AS MONOTHERAPY IN MANAGING EARLY UNDIFFERENTIATED ARTHRITIS: A PROSPECTIVE HOSPITAL-BASED STUDY

Introduction: Early undifferentiated arthritis (EUA) is a common form of arthritis comprising, joint pain, stiffness and swelling with no definitive diagnosis. Patients of EUA can progress to other forms of rheumatic arthropathies such as rheumatoid arthritis or remain in the same form or spontaneously disappear. The main focus of this study is to explore the potential effect of hydroxychloroquine (HCQ) in management of EUA as a monotherapy treatment. Methods: This is a prospective hospital-based study which was conducted in Almwada hospital in Khartoum, Sudan. The study included thirty patients of EUA. Full clinical examination and history were done by a rheumatologist, and all the related investigations were obtained, and they all received HCQ after EUA diagnosis has been established. Result: The study shows that 96% of the patients responded well to the treatment and 10% had their duration of treatment doubled to show a favorable response. We also found that female patients weremore commonly affected than male ones with higher incidence among middle aged as compared to others. After treatment with HCQ, 86.6% of the patients showed average mean decrease in erythrocyte sedimentation rate (ESR) by 44%, the other 13.4%, even though they were symptoms free after treatment they showed increased level of ESR by 30% average. Conclusion: In the present study we found out most of the EUA patients are well responded to the HCQ treatment, and most of them respond from the first course of treatment, the study also shows higher incidence among female in compared to male

Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3-4.8), 3.9% (2.6-5.1) and 3.6% (2.0-5.2), respectively). Surgery performed >= 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9-2.1%)). After a >= 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms >= 7 weeks from diagnosis may benefit from further delay

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care