Breaking Bad News for Patients with Gastro-Intestinal Malignancy: Experience at Ibn Sina Teaching Hospital

Background: Integrity, beneficence, non-maleficence and Justice are the pillars of the professional behaviour. Confidentiality is a serious issue governed by the law. However, in developing countries, patients’ relatives urge to know the diagnosis and often request the doctor not to mention the word cancer or malignancy to their patient.Objectives: To evaluate the communication skills for breaking bad news to Sudanese patients suffering of gastrointestinal cancer and to find out the patients’ responses on that matter.Materials and Methods: This is a hospital based non-randomized  prospective study, carried out at Ibn Sina Specialized Hospital in the period August through December 2011. The study involved113 patients of whom there were 56 males.Results: Doctors had talked about the disease to 75% of the patients  whereas the rest were told by either the psychologists and/or their  relatives. Only 25% of the patients were told the truth, the rest were told to have mass or lump without explaining its nature. Patients’ responses were as follows: 41.6% were felt terrified, 23.9% were shocked and became  anxious, while 33.6% were stable, but 0.9% became angry and frustrated. No patient was told about the prognosis and the chances of cure.Conclusion: Sympathy over-ride empathy in communicating bad news to Sudanese patients suffering of cancer. Patient education and training in breaking the bad news is needed.Key words: Communication skills, breaking bad news, truth telling, Sudan

Histological and body weight effects of Datura innoxia seeds and leaves extracts in rats

The study aim to determine the chemical compounds in aqueous and methanolic extracts of Datura innoxia seeds and leaves and to evaluate their toxic effects on experimental rats. Seeds and leaves were collected from El-Obied, North Kordofan State, Sudan, in October, 2016. The aqueous and methanol extracts were carried out by using maceration method and soxhlet apparatus respectively. Sixty five male Albino Wistar rats, three months old and with an average body weight ranged 110-120 g, were randomly divided into thirteen Groups, consisting of five rats in each Group. Group 1 served as control and fed with normal rats’ food and water for thirty days. Groups 2, 6 and 10 administered aqueous seeds extract, Groups 4, 8 and 12 received methanol seeds extract, Groups 3, 7 and 11 received aqueous leaves extracts, Groups 5, 9 and 13 received methanol leaves extract, all the Groups received the same type of extract were administered 40, 60 and 80 mg/kg body weight respectively. The extracts administered to the rats intra gastrically using cathodal tube daily for thirty days. The effects of oral administration of leaves and seeds extracts to 60 healthy rats over 30 days were evaluated by histological studies and body weight changes. The analysis by gas chromatography-mass spectrometry (GC-MS) of aqueous and methanolic extracts revealed the presence of alkaloids (Scopolamine, atropine and Hyoscyamine), fatty acids, esters, amides, amino acids, ketones, coummarins, terpinoids, phenols, alcohols and hydrocarbons compounds. The histological results showed that administration of extracts caused pathologic changes in the organs studied. The treated Groups had lower (p ≤ 0.05) body weight gains than control Group. The study concluded that the toxicity of seeds and leaves (methanolic and aqueous) extracts are nearly have the same toxic effects on rats due to their same active ingredients (alkaloids) and the oral administration of the extracts was found to be safe up to 40 mg/kg.</jats:p

Physicochemical properties of Roselle (Hibiscus sabdariffa L.) seeds oil (Elrahad-1) in North Kordofan, Sudan

The aim of this study was to clarify the physicochemical property evaluation of Roselle seed oil. Two samples (red and white calyces) of Roselle seeds (Elrahad-1) were obtained from El-obied Agricultural Research Station. The Roselle seed oil was extracted by soxhlet method. The standard procedure of the Association of Official Analytical Chemists (AOAC) was used to determine the physicochemical properties (oil%, specific gravity, refractive index, viscosity, saponification value, acid value, iodine value, peroxide value and fatty acids). The yield of the extracted oil for both red and white was found to be 21.1%. The oil had a refractive index (1.467, 1.466), saponification value (189.7, 189.1), iodine value (119, 119), peroxide value (4.6, 4.7), acid value (3.57, 3.55), viscosity (22.5, 22.5), specific gravity (0.90, 0.90). The main unsaturated fatty acids in the oil are Oleic (47.0555%, 47.8868%), Linoleic (30.5836%, 30.7931%) and Elaideic acid (14.359%, 15.1603%) and the saturated acids are Palmitic acid (3.9494%, 3.9198%) and Myristic acid (1.9609%, 1.9845%). These values were arranged for red and white calyces respectively. Comparing the study results with the standards and guideline of edible oils set by the FAO/WHO and the Sudanese standard and the metrology organization (SSMO) the study recommended that the Roselle seed oil can be an economic source of healthy edible fat and for other food industry applications and suggest further study on the effect of storage time on the physicochemical characteristic of the oil.</jats:p