Pattern and Risk Factors of Urinary Bladder Neoplasms in Sudanese patients in Khartoum State, Sudan

Background: Urinary bladder neoplasm (UBN) is associated with high morbidity and mortality rate. It poses biologic and clinical challenges. Objectives: To evaluate the pattern as regards frequency, age, sex, occupation, local geographical distribution, clinical presentations and risk factors of UBN in Sudanese patients in Khartoum State. Patients and Methods: This study was conducted in the period from January 2004 through December 2005 at three centres in Khartoum State. One hundred and six patients with urinary bladder neoplasms were included in the study. Results: The commonest affected age group was 60-80 years with male to female ratio 4.6:1. Urinary bladder neoplasms have some ethno-geographic variations in Sudan. The majority of these patients were from the Northern and Western regions. Conclusion: There is significant relationship between urinary schistosomal infestation and the development of squamous cell carcinoma of the urinary bladder among Sudanese patients. Keywords: Urinary Bladder, Transitional Cell Carcinoma, Squamous Cell CarcinomaSudan Journal of Medical Sciences Vol. 3 (3) 2008: pp. 211-21

Impact of caloric and dietary restriction regimens on markers of health and longevity in humans and animals: a summary of available findings

Considerable interest has been shown in the ability of caloric restriction (CR) to improve multiple parameters of health and to extend lifespan. CR is the reduction of caloric intake - typically by 20 - 40% of ad libitum consumption - while maintaining adequate nutrient intake. Several alternatives to CR exist. CR combined with exercise (CE) consists of both decreased caloric intake and increased caloric expenditure. Alternate-day fasting (ADF) consists of two interchanging days; one day, subjects may consume food ad libitum (sometimes equaling twice the normal intake); on the other day, food is reduced or withheld altogether. Dietary restriction (DR) - restriction of one or more components of intake (typically macronutrients) with minimal to no reduction in total caloric intake - is another alternative to CR. Many religions incorporate one or more forms of food restriction. The following religious fasting periods are featured in this review: 1) Islamic Ramadan; 2) the three principal fasting periods of Greek Orthodox Christianity (Nativity, Lent, and the Assumption); and 3) the Biblical-based Daniel Fast. This review provides a summary of the current state of knowledge related to CR and DR. A specific section is provided that illustrates related work pertaining to religious forms of food restriction. Where available, studies involving both humans and animals are presented. The review includes suggestions for future research pertaining to the topics of discussion

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

Nazik Elmalaika Husain,1 Sufian K Noor,2 Wadie M Elmadhoun,3 Ahmed O Almobarak,4 Heitham Awadalla,5 Clare L Woodward,6 Dushyant Mital,6 Mohamed H Ahmed7 1Department of Pathology, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Khartoum, 2Department of Medicine, 3Department of Pathology, Faculty of Medicine and Health Sciences, Nile Valley University, Atbara, 4Department of Pathology, Faculty of Medicine, University of Medical Sciences and Technology, 5Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan; 6Department of HIV and Genitourinary Medicine, Milton Keynes University Hospital, NHS Foundation Trust, Milton Keynes, UK; 7Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, UK Background: The current challenge in managing people living with human immunodeficiency virus (PLWHIV) includes the identification and monitoring for comorbid health risks associated with HIV and its treatment and longer survival. Dyslipidemia, diabetes mellitus and metabolic syndrome are increasingly seen in PLWHIV. Objective: In this narrative review, we aimed to summarize the current knowledge about diabetes, dyslipidemia and metabolic syndrome in PLWHIV in Africa and also to discuss the challenges that patients as well as health authorities in Africa may face. Methods: PubMed and Google scholar published-English literatures concerning earlier mentioned entities regardless of time limit were critically reviewed. Results: The prevalence of metabolic disorders in HIV population in Africa was estimated to range from 2.1% to 26.5% for diabetes and 20.2% to 43.5% for pre-diabetes, 13% to 58% for metabolic syndrome and 13% to 70% for dyslipidemia. Conclusion: The management of metabolic disorders and cardiovascular disease risks related to HIV is complex especially in Africa due to healthcare resources, but our experience suggests that metabolic clinic is beneficial to patients and staff and should be an important part of HIV services especially as the older HIV population is increasing. In this context, cardiovascular risk assessment of HIV-infected patients will become an important component of care in developing countries in Africa and strategies are needed to deal with progressive increase in the epidemic of type 2 diabetes, dyslipidemia and metabolic syndrome. Keywords: dyslipidemia, diabetes mellitus, metabolic syndrome, cardiovascular, NAFLD, HIV services, Africa, metabolic clini