Editorial Problem based learning in medical education, where we are?

No Abstract. Sudan Journal of Medical Sciences Vol. 1(1) 2006: 11-1

Minimally Invasive Surgery: Can We See Inside the Future

The substantial developments in surgery, over the last century with the advent of antiseptic substance, anesthetic agents, antibiotics, surgical nutrition, and organ transplantation, haven’t  changed neither the basic surgical tools nor the surgical techniques. Minimally invasive surgery (MIS), was first proposed by Wickham in 1986 because of the radical changes in the treatment of kidney stones between 1979 and 1983. This new concept of (MIS) has revolutionized the management of surgical disorders in a very short period of time.  It has moved the focus of surgery towards reducing the morbidity without compromising on the quality of healthcare(1). (MIS) is getting in more and more in all fields of surgery, laparoscopic and endoscopic surgery are no exception(2). It basically entailed entering the body cavities or lumina through the skin or through a natural orifice incurring the least damage to those organs or structures. . Collectively called minimal access surgery it has developed so much to the extent of being impossible to halt or withdraw it back. Recently computerized designing of laparoscopic instrument is introduced and microprocessor controlled safety features are added.  MIS has proved a boom for patients over the last 25 years. It has significantly reduced  hospital stay, grossly reduced the  patients’ recovery time, and greatly improved the cosmetic consequences of operations with less pain and  less strain of the organism. Despite the improvement in outcomes with laparoscopy, the technique still has some limitations.  Apart from grand cost and training needs, there is definite loss of tactile perception and of course the surgeon’s eyesight is limited by the two dimensional view(3)

Effect of dilution of Red Sea water on survival and seedling growth of two geographical sources in Sudan of Acacia tortilis sub species tortilis

Acacia tortilis is an important woody species in Sudan with regard to protection and production. Its distribution is limited to the northern, north-eastern and central Sudan. It tolerates salinity and drought stresses. The objective of this study is to investigate the tolerance of A. tortilis seedlings from two geographical sources to saline condition with regard to survival, mineral content and vegetative growth. Two geographical sources were selected as seed sources according to soil types (Rufaa and Port Sudan). The seeds were sown in silt loam soil on polyethylene bags and irrigated every two days. The irrigation water consists of five levels of salinity EC: (0.4 as control, 4, 8, 12 and 16dSm-1) and survival, plant mineral content and vegetative growth were measured. The results showed that both sources can tolerate salinity but Port Sudan source had significantly higher survival percent, potassium content and growth values than Rufaa source. It was concluded that A. tortilis, from Port Sudan can be included in the Red Sea refforestation program. XII Effect of dilution of Red Sea water on survival and seeding growth of two geographical sources in Sudan of Acacia tortilis sub specie

Bariatric surgery outcomes: a single-center study in the United Arab Emirates

BACKGROUND: Bariatric surgery has become an attractive treatment for severe obesity over the last decade, due to its impacts on weight loss and remission of type 2 diabetes and metabolic syndrome. In the United Arab Emirates, a country where the rate of obesity is dramatically increasing bariatric surgery has gained popularity in recent years; however, published data on its outcomes in the Emirati population are lacking. METHODS: We retrospectively reviewed the medical records of 95 patients who underwent bariatric surgery (ie, laparoscopic Roux-en-Y gastric bypass [RYGB] or laparoscopic sleeve gastrectomy) at the Rashid Center for Diabetes and Research in Ajman, United Arab Emirates. Weight outcomes and metabolic marker data were abstracted at baseline and at 3, 6, and 12 months postoperatively. RESULTS: Laparoscopic RYGB was the main procedure performed by our bariatric unit. All variables demonstrated postoperative improvement. An average excess weight loss of 68% was observed at 12 months. Fat mass was the body component that decreased the most, with an average reduction of 46%. Additionally, lipid profiles were significantly different (P<0.01) at 12 months, with triglyceride levels improving by 27% and low-density lipoprotein levels improving by 21%. Similarly, glycated hemoglobin (HbA1c) levels decreased significantly (P<0.001) in patients with type 2 diabetes, with an average reduction of 73%. CONCLUSION: Our results show that a substantial short-term reduction in weight and significant improvements in metabolic markers followed bariatric surgery in severely obese Emirati patients. Our results are consistent with the outcomes of other internationally published studies. Additional studies are warranted to determine whether the favorable impacts of bariatric surgery can be sustained over the long term

Numerical Study of Low Salinity Water Flooding in Naturally Fractured Oil Reservoirs

Due to the increase of the activities in the oil industries, higher interest has been given to enhance the recover the trapped oil and produce more oil from the matured reservoirs. Worldwide, enhanced oil recovery (EOR) is implemented in most reservoirs to recover additional amounts of oil that are not recovered during secondary recovery by water flood or gas injection. Recently, a numerous techniques such as thermal, miscible, immiscible and chemical has proposed to enhanced oil recovery and to increase the producible oil from oil reservoirs. The suitability and the success of a specific EOR process are highly sensitive to reservoir and fluid characteristics, recovery efficiency, availability of injected fluids, and costs. One of the common techniques which have been proposed recently is low salinity water flooding where the sea water with a controlled salinity and salt content is used to alter the rock wettability or enhance the fine migration and resulted in higher oil production. This study aims to investigate the possibility of using low salinity water flooding in naturally fractured reservoirs. The wettability changes are taking into account in terms of oil/water relative, saturation and capillary pressure as these parameters play a key role during the simulation of brine injection. The results show that the oil recovery significantly increases specially for water wet reservoirs as the reason behind is the decreasing water production after the breakthrough of the low saline brines

Hypolipidemic Effect of Hyphaene thebaica (Doum-palm) in Induced Hypercholestrolemic Wistar Albino Rats

Abstract This study is designed to investigate the effect of feeding the whole bulb (mesocarp) of Hyphaene thebaica fruit, as 3% of the diet, on lipid profile in Diet-induced hypercholesterolemic Wistar albino rats. Various dietary rations were prepared by addition of H. thepaica, to assess their impact on the serum triglycerides, total cholesterol and its fractions the LDL-C, HDL-C and VLDL-C in normal and induced hypercholestrolemic rats. The rats were divided into four groups and fed for three-weeks as follows: Group 1 fed basal rat diet, group 2 fed the basal rat diet mixed with H. thebaica, group 3 fed high fat diet (the basal rat diet mixed with, calculated amount of, egg yolk to formulate a diet of 1% cholesterol) and group 4 fed the high fat diet mixed with H. thebaica. By the end of the experiment a significant (P=0.03) increase in serum triglycerides and the VLDL-C was observed in groups (3 and 4) compared to the control group. Also the level of LDL-C increased significantly (P=0.04) in group 3 but decreased numerically in group 4. Moreover, the lowest level of the total cholesterol was recorded in group 2 compared to the other groups. However, feeding H. thebaica when mixed with high fat in the diet, resulted in significantly (P=0.02) decreased HDL-C levels. In conclusion this study suggested that H. thebaica contains active ingredients that can manipulate blood lipids and can protect from an increase of the bad cholesterol in the blood, even if a high fat diet is consumed. The present experiment also showed that, the increase of serum triglycerides and VLDL-C levels due to feeding high fat diet in group 3, was augmented by adding H. thebaica to the diet in group 4, so the study of the fatty acid composition of these lipid fractions is recommended

Modeling Short-Term Deflection of Reinforced Concrete Slabs using the Layered Approach

This paper examines the short-term deflection of reinforced concrete slabs taking the tension-stiffening phenomenon into account. The main goal of this study is to develop a model that predicts the deflection of one-way slabs made of reinforced concrete. The model takes into account concrete contribution in carrying tension between cracks thoroughly considering the stress-strain relationship material model. The model has been developed using MATLAB Program incorporating a numerical technique known as the layered approach. The developed layered approach model was validated using experimental deflection results reported in a previous study. Based on the experimental validation, the model showed its tendency in predicting the real-case deflection of one-way concrete reinforced slabs. It was concluded that different types of tension stiffening models can be added to the program to model deflection and crack propagation

On the influence of biodiesel feedstock on compression ignition particulate emissions

Particulate emissions from compression ignition engines are a major health concern, especially in underground mine environments where limited ventilation during the operation of diesel powered equipment can exacerbate the problem. Clearly strategies are required to address the diesel particulate matter problem, with alternative fuels, such as biodiesel, having been recently considered to ameliorate the problem. This study considers a physico-chemical characterisation of particulate emissions from an underground coal mine compression ignition engine to determine the effect of using 3 biodiesel feedstocks at 4 different blend percentages. Particle physical properties measured included particle number size distributions and the lung deposited surface area, and particle chemical properties measured included particle and vapour phase polycyclic aromatic hydrocarbons (PAHs) and also the measurement of reactive oxygen species (ROS), which are believed to play an important role in the human body’s inflammatory response after exposure to diesel emissions. The particle number size distributions showed strong dependency on both feedstock and the blend percentage employed, with the canola feedstock yielding higher particle number emissions than diesel (followed by tallow), whereas the soy feedstock showed significant particle number reductions. Both particle and vapour phase PAHs were generally reduced with biodiesel, although the results did not exhibit dependence on blend percentage. The ROS concentrations increased monotonically with biodiesel blend percentage but the data did not suggest strong feedstock dependency. It was also shown that ROS emissions correlate quite well with the organic volume percentage of particles which was calculated using unheated and heated particle volume distributions. Whilst biodiesel fuels might be effective at reducing particle mass emissions, some feedstocks increase the number of particles emitted, and all feedstocks increase the oxidative capacity of particles and also emit particles that have a much smaller median diameter than ultra-low sulphur diesel

Blood pressure gradients and cardiovascular risk factors in urban and rural populations in Abia State South Eastern Nigeria using the WHO STEPwise approach

Background: Developing countries of sub-Saharan Africa (SSA) face a double burden of non-communicable diseases (NCDs) and communicable diseases. As high blood pressure (BP) is a common global cardiovascular (CV) disorder associated with high morbidity and mortality, the relationship between gradients of BP and other CV risk factors was assessed in Abia State, Nigeria. Methods: Using the WHO STEPwise approach to surveillance of chronic disease risk factors, we conducted a populationbased cross-sectional survey in Abia state, Nigeria from August 2011 to March 2012. Data collected at various steps included: demographic and behavioral risk factors (Step 1); BP and anthropometric measurements (Step 2), and fasting blood cholesterol and glucose (Step 3). Results: Of the 2983 subjects with complete data for analysis, 52.1% were females and 53.2% were rural dwellers. Overall, the distribution of selected CV disease risk factors was diabetes (3.6%), hypertension (31.4%), cigarette smoking (13.3%), use of smokeless tobacco (4.8%), physical inactivity (64.2%) and being overweight or obese (33.7%). Presence of hypertension, excessive intake of alcohol, smoking (cigarette and smokeless tobacco) and physical inactivity occurred more frequently in males than in females (p,0.05); while low income, lack of any formal education and use of smokeless tobacco were seen more frequently in rural dwellers than in those living in urban areas (p,0.05). The frequency of selected CV risk factors increased as BP was graded from optimal, normal to hypertension; and high BP correlated with age, gender, smokeless tobacco, overweight or obesity, annual income and level of education. Conclusion: Given the high prevalence of hypertension in this part of Nigeria, there is an urgent need to focus on the reduction of preventable CV risk factors we have observed to be associated with hypertension, in order to effectively reduce the burden of NCDs in Africa.http://dx.doi.org/10.1371/journal.pone.0073403IS

Self-rated health and factors influencing responses among young Egyptian type 1 diabetes patients

<p>Abstract</p> <p>Background</p> <p>Patients diagnosed with type 1 diabetes mellitus (T1DM) face major daily challenges. Self-rated health (SRH) is a global measure of an individual's health related quality of life (HRQoL) and is based on the question, "In general, how would you rate your health?" Subjects rate their health as excellent, very good, good, poor or very poor. Our objective was to determine the HRQoL using the SRH measure and determine factors influencing responses. We hypothesized that better SRH responses were associated with shorter diabetes duration, better compliance and better glycemic control.</p> <p>Methods</p> <p>The standardized SRH measure was the instrument used for health related quality of life assessment. Logistic regression analysis was used to examine the association between SRH responses and selected variables.</p> <p>Results</p> <p>124 subjects, 64 females (51.6%) and 60 males (48.4%) were included. Average age was 13.08 (±3.19) and average diabetes duration was 5.82 (±1.60), while the mean HbA₁C was 8.02 (±1.60). The majority rated their health as good (31%), 29% rated it as excellent, 11% as very good, 14% as poor and 15% as very poor. Regression analysis showed that regular exercise was the only predictor that was independently and significantly associated with a "better" self-health rating, with an OR of 12.84, CI of 1.425-115.727 and a <it>p </it>value of 0.023.</p> <p>Conclusion</p> <p>Regular exercise among Egyptian children with T1DM is strongly associated with a "better" overall health related quality of life and should be repeatedly encouraged.</p