Surgical complications of peptic ulcer disease in Wad Madani teaching hospital June 2013 to june 2017

Background:peptic ulcer disease is a common curable disease but still refractory and complicated disease  frequently seen. This study was done to identify the surgical complications of peptic ulcer disease, their clinical presentation , management and  outcome  . Objective: This study was carried out to identify types of surgical complications (bleeding, perforation and obstruction) , their clinical presentation ,site of the ulcer , intraoperative findings ,surgical procedure , postoperative complications and mortality   . Patients and methods: This was a cross-sectional  ( prospective and retrospective)  descriptive hospital based study of surgical complications of peptic ulcer disease  carried out at the departments of  surgery in Wad Medani Tteaching Hospital , Wad Medni, Sudan,  from June  2013 to June  2017. Data was collected from patients and hospital records using a designed questionnaire and analysed using SPSS version 21. Results: Ninety eight patients had surgical complications of peptic ulcer disease  were included in the study 71.4% (n=70) of them were males and 29.6% (n=28) were females with the male to female ratio 2.5 : 1   49%(n=48) were middle age group,73.5%(n=72) were from a rural areas the commonest clinical symptoms was epigasrtic pain 99% followed by vomiting 90.8% and heart burn 42.9% heamatemeisis was seen in 25.5% and the OGD showed that gastritis was the most common finding 46.4% followed by multiple ulcers and single ulcer and most of them were gastric , 42.9% were using NSAID and 72.4% had used antiulcer treatment the most common  surgical complication  was  perforation (84.7%) followed by gastric outlet obstruction 9.2% . and  bleeding  (6.1%) . (68 patient )   were treated with omental batch  ,15  with excision of the ulcer and repair, 9  with gastrojujenostomy and vagotomy,   4 with dudeonotomy and over sewing of bleeding vessel  and only  two patients were treated with partial gastrectomy. 23% developed complications of which sepsis was the commonest 55% and the mortality was 5.1% . Conclusion: Surgical complications of peptic ulcer  predominantly occurs in middle  age group  and males of rural area residents who were mostly  not diagnosed previously as peptic ulcer disease (PUD). The most common  complication seen was perforation  , GOO and bleeding. Outcome and mortality was greatly influenced by age , type of complication ,haematemesis,site of the ulcer , late presentation and the presence of sepsis . ملخص البحث                                                                                                   أجريت هذه الدراسة لإيضاح المضاعفات الجراحية للقرحة الهضمية  تناولت الأعراض السر يريه نوع المضاعفات  وطرق العلاج الجراحي التي اتبعت في مستشفى مدني التعليمي في الفترة من يونيو 2013 إلي يونيو 2017. تم تضمین 98 مريض  مضاعفات جراحیة لمرض القرحة الهضمية في الدراسة 71.4٪ (ن = 70) منھم ذکور و 29.6٪ (ن = 28) کانوا من الإناث وكان معدل الذکور إلی الإناث 2.5: 1  49٪ (ن = 48) كانت من الفئة العمرية المتوسطة، 73.5٪ (ن = 72) كانت من المناطق الريفية كانت الأعراض  السريرية الأكثر شيوعا ألم البطن 99٪ تليها القيء 90.8٪ وحرق القلب كان في 42.9٪  وجد القي الدموي  في 25.5٪ وأظهر منظار المعدة أن التهاب المعدة كان الأكثر شيوعا (46.7٪) تليها قرحة متعددة وقرحة واحدة، ومعظمهم في المعدة، و 42.9٪ كانوا يستخدمون مضادات الالتهاب غير الستيروئيدية، و 72.4٪ كانوا يستخدمون العلاج المضاد للقرحة   المضاعفات الجراحية الأكثر شيوعا هو ثقب القرحة (84.7٪) يليه انسداد مخرج المعدة 9.2 ٪. والنزيف (6.1٪). 68 مريضا تم علاجهم مع دفعة الأثينية، 15 مع استئصال القرحة  والإصلاح، 9 مع توصيل المعدة مع الصائم وقطع العصب الحائر ، 4 مع فتح ألاثني عشر والإفراط في الشريان النازف وتم علاج اثنين فقط من المرضى مع استئصال المعدة الجزئي  و 23٪ حدثت لهم مضاعفات ما بعد العملية التي كان الإنتان الأكثر شيوعا 55٪ وكان معدل الوفيات 5.1٪

The contribution of centrifugal partition chromatography to the phytochemical study of three plants used in traditional Sudanese medicine

Ce travail de thèse est une contribution à l’étude phytochimique par Chromatographie de Partage Centrifuge (CPC), de trois plantes utilisées en médecine traditionnelle au Soudan : Aristolochia bracteolata (plante entière), Ziziphus spina-christi (feuilles) et Hydnora abyssinica (rhizomes). Ce travail a permis de mettre au point trois méthodologies de purification par CPC, applicables au fractionnement des acides aristolochiques, des flavonoïdes ou des proanthocyanidols (PAC). Dans ce contexte, la première partie de ce manuscrit est consacrée aux notions générales portant sur la CPC. La deuxième partie porte sur l’étude d’Aristolochia bracteolata. Cette plante est utilisée en médecine traditionnelle, malgré la présence d'acides aristolochiques qui confèrent une néphrotoxicité élevée. Ce travail a permis de mettre au point une méthode innovante pour l’isolement et la purification, avec un très haut niveau de pureté, des acides aristolochiques I, II et IIIa à partir d’un extrait brut, en une étape par CPC en mode d’échange d’ions forts (SIX-CPC). L’acide aristolochique IIIa n’avait jamais été décrit dans cette plante auparavant. Ces résultats ont fait l’objet d’une publication en 2015 dans Separation and Purification Technology. Dans la troisième partie de cette thèse, la CPC a été appliquée à l’isolement de flavonosides présents dans Z. spina-christi. Nous appuyant sur l’expérience du laboratoire dans l’extraction par CPC des flavonosides du Ginkgo biloba, nous proposons une méthodologie de purification utilisant les systèmes de solvant biphasiques EtOAc/n-BuOH/MeOH/H2O et EtOAc/n-BuOH/H2O à différents ratios en fonction de la polarité des flavonosides. Dans la dernière partie, l’étude phytochimique de Hydnora abyssinica a mis en évidence la présence de PACs, polymères de hauts poids moléculaires de flavanols. La méthodologie de fractionnement CPC, précédée d’un pré-fractionnement sur résine LH-20, a permis l’isolement pour la première fois dans cette plante de la katsumadine et du rhodioloside.This work was a contribution to the phytochemical study of three Sudanese medicinal plants: Aristolochia bracteolata (Whole plant), Ziziphus spina-christi (Leaves) and Hydnora abyssinica (Rhizomes). The specificity of this research program was to emphasize the application of Centrifugal Partition Chromatography (CPC) for the fractionation of these plants. Three specific CPC methodologies were developed for the purification of either aristolochic acids, flavonoids or proanthocyanidins (PACs). In this context, the first part of this manuscript was devoted to the presentation of the CPC methodology. The second part focused on the fractionation of crude extract of Aristolochia bracteolata. This plant is used in traditional medicine, in spite of the presence of aristolochic acids that confer a high nephrotoxicity. In this work was developed an innovating procedure for the isolation and purification in high purity of aristolochic acids I, II and IIIa, in one step from crude extract, using Strong Ions eXchange CPC (SIX-CPC). These results were published in 2015 in Separation and Purification Technology. In the third part, the flavonosides present in Z. spina-christi were isolated using CPC, either in normal or reverse elution mode, using two phases solvent systems EtOAc/n-BuOH/MeOH/H2O or EtOAc/n-BuOH/H2O with different ratios. In the last part, the phytochemical study of Hydnora abyssinica led to the fractionation of PACs, polymers of high molecular weight of flavanols. The CPC fractionation methodology, preceded by LH-20 resin pre-fractionation, allowed the isolation of katsumadine and rhodioloside

Traditional Uses of Herbal Medicines in Khartoum and Gezira state (Central Sudan)

Background: Traditional medicine is a folk medicine or herbalism practice based on the use of plants and plant extracts. The diversity of the climate of Sudan is responsible for its very rich flora.Purpose: The aims of this work are to determine habitat, folkloric and current medicinal uses and the active constituents of the studied plants.Study design: The type of study design used in this work is observational and descriptive study design.Methodology: Method used is face-to-face interviews of herbal shops in Khartoum and Gezira state. The language used is Arabic language. The interviews involved 15 from 50 herbal shops; 10 in Khartoum state and 5 in Gezira state. The study also contains information about current uses and newly active constituents of some plants species therein were cited.Conclusion: Eighty-six plants and herbs are reported in this study. They are distributed in Forty-three families. The popularly used species by natives were found to include Solenostemma argel, Trigonella foenum-graecum, Acacia spp, Nigella sativa and Hibiscus sabdariffa. All of which known to contain mixture of phenolic, flavonoids, terpenoids and sterols phytoconstituents. The highest numbers of plants are found belong to family Lamiaceae (Seven species), Fabaceae (Seven species), Apiaceae (Six plant species) and Asteraceae (Five plant species)

One-step preparative isolation of aristolochic acids by strong ion‐exchange centrifugal partition chromatography

Poster Session Monday : Theme 2: Sources of bioactive compoundsOne-step preparative isolation of aristolochic acids by strong ion‐exchange centrifugal partition chromatography. 9. Joint Natural Products Conference 201