Acanthamoeba keratitis in Sudan: outcome of ketoconazole treatment in six patients

In an exploration of the acanthamoebic aetiology of chronic keratitis cases (not responding to antibiotics, antiviral or antifungal therapy), 138 Sudanese patients were seen over a 2-year period at two teaching eye hospitals in Khartoum State. Six (4.3%) of these patients were found to be suffering from Acanthamoeba keratitis. The present study focuses on the good outcome of oral ketoconazole in four patients at 18 months follow up period. The drug oral route, convenient frequency of doses, minimal side effects and availability at reasonable price favour ketoconazole therapy. Sudan Journal of Medical Sciences Vol. 1(1) 2006: 34-3

Selection and Comlications of Donor Nephrectomy in Gezira Hospital for Renal Diseases and Surgery

Background: Though various renal replacement therapies are endorsed for the long treatment of ESRD yet the transplantation remains the gold standard. Objectives: generally  to assist in auditing of the programme of renal transplantation in Sudan and specifically to determine the degree of matching between donors and recipients ,to determine the effect of age, sex, relation, occupation and education in donor nephrectomy and to  estimate the incidence of complications in donor nephrectomy. Methods: In this study we reviewed open donor nephrectomy performed in GHRD and S from January 2005 to December 2011 in a descriptive retrospective and prospective study. Around 90 living kidney donors were enrolled in this study, followed for one year. Data concerning the work up, clinical strata, the thematic operative conditions and postoperative follow up sheets were recorded in the platform of the patient sheets and retrieved completely through the master sheet of the study and evaluated via SPSS package version 11.5, every complication was dealt with according to EUA guidelines, the mortality recorded was one patient in this study. Results: of these donors41 were males46% and (49) were females (54%) the minimum age was 18 years and maximum 57 and mean age 30,3years. We noted that donors were found satisfying the EAU criteria of donor’s selection. The complications recorded were anesthetic problems in 2.2%, vascular complications in 2.2%, wound infection in 6.6%, pneumonia in 4.4% and the mortality in the study was 1.1%. Conclusion: 1-selection for living donor nephrectomy is consistent with the international criteria and. 2-The incidence of complications in donors in GHRD and S was found to be comparable to the literature with slight inclination to upper limit

EVALUATION OF APPLICATION OF INTERNATIONAL PROSTATE SYMPTOMS SCORE IN SUDANESE PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Objectives: The purpose of the present study is to assess the reliability and validity of IPSS in pre- and treatment of Sudanese patients with BPH. Material and methods: In a descriptive prospective study, 350 Sudanese patients with LUTS attended the Urology department of Gezira Hospital for Renal Diseases and Surgery from September 2003 to April 2006. They were interviewed by urologists and answered the International Prostate Symptom Score (IPSS) questionnaire. Clinical work up was done for all only patients with benign hyperplasia were included in the analysis .Europeans guideline was adopted in the management and the out come was also subjected to IPSS evaluation. Results: The most common voiding symptoms was a weak stream (93% of subjects), followed by intermittency (57%) and hesitancy (54%). The most prevalence of storage symptoms was nocturia (87% of subjects), followed by frequency (73%) and urgency (64%). 64% of the study subjects   presented with severe IPSS, 33% with moderate IPSS, while only 3% of the patients presented with mild IPSS. Digital rectal examination (DRE) was done to all study subjects. There was no significant correlation between DRE and IPSS reported. The postoperative IPSS post treatment follow up was mild in 87%, moderate in 4% and sever in 9% of the patients.   Conclusion: Our study indicates that IPSS is informative and reproducible in assessment of patients with BPH. &nbsp

Erythrocytes alterations of monosex tilapia (Oreochromis niloticus, Linnaeus, 1758) produced using methyltestosterone

AbstractThe present study aims to investigate the effects of methyltestosterone on monosex farmed tilapia, Oreochromis niloticus by detection of apoptosis, micronucleus and alterations of erythrocytes. Fishes were obtained from four localities (Assiut as a control and Beheira, Alexandria and Kafr EL-Sheikh; three farms from each governorate as farmed monosex produced using methyltestosterone). Blood smears were processed for Hematoxylin and eosin technique. The major alterations recorded in the red blood cells were as swelled cells (Sc), tear drop-like cells (Tr), and sickle cells (Sk). Also, a significant difference (P⩽0.001) between three governorates and Assiut was recorded in the micronucleus test, apoptosis and altered erythrocytes. These alterations are considered as an indication for performance and health of fish in the monosex culture medium indicating the side effects of overdose induction of MT

Indications, outcome and complications of ureteroscopy, at Gezira Hospital for renal diseases and surgery, Sudan: a seven years ‘experience

Background: Ureteroscopy (rigid and flexible) with irrigating and working channels have expanded the capability of the urologist to diagnose and treat most abnormalities of the upper tracts.Objective: This study was conducted as a part of holistic auditing to the services provided by Gezira Hospital for Renal Disease and Surgery (GHRD&S), and specifically to evaluate ureteroscopy done in GHRD&S with emphasis on the indications, outcome and complications.Methods: Across-sectional- hospital-based study was adopted. All patients who underwent ureteroscopy since the inauguration of the hospital from 2005-2011 were included.Results: The total number of patients satisfying the inclusion criteria was 472 with a mean age of 40.6 years. Male to female ratio was 1.46:1. The mean hospital stay was 2.74 days.The commonest indication for ureteroscopy was ureteric stone amounting (74%) to a tangible share of ureteric stenting or removal as indication were found in (56.8%) . and therapeutic ureteroscopy for (92.3%). Ureteric stricture was not uncommon (24%). The success rate of therapeutic ureteroscopy was (93.7%) with definite correlation to the site of pathology been (91.75%), (92.3 %) and (87.5%) for the lower, mid and upper ureter respectively. The complications recorded were bleeding (3.3%), penetration (2.5 %), post-operative colic (13%) and infection (0.4%). Mortality rate was zeroConclusion: Because the experience of ureteroscopy in GHRD&S was auspiced by regular training from the SIU the outcome is really comparable to the literature.Keywords: Ureteroscopy, Gezira Hospital for Renal Disease and Surgery, Wad Medani, Success and safet

Urine Cytology for Detection of Bladder Carcinoma: Experience of Gezira Hospital for Renal Disease and Surgery(GHRDS)

Background: Urine cytology has been and remains the standard in the initial evaluation of lower urinary tract lesions to rule out bladder cancer. Objectives:  To evaluate the significance of urine cytology as a diagnostic tool for bladder cancer and a to assess the cytological pattern in voided and washed urine. Methodology: This was a cross-sectional descriptive hospital-based study. A total of 43 patients who were suspected to have bladder tumors based on both clinical and radiological findings. Pre-cystoscopy voided urine specimens and post-cystoscopy bladder wash specimens were collected. Three stains were used in preparation of cytological smears Hematoxylin / Eosin, Diff-Quik and May-Grünwald Giemsa, whenever possible equivalent histopathological diagnosis was obtained. Results: This study included 86 urine cytology specimens obtained from a total of 43 cases of suspected bladder cancer. Muscle invasive cases had the higher percentage (37.2%) with more prominent features of malignancy in cytology than the earliest stages. In 30.2% of voided urine specimens were excellent, while 79.1% of bladder wash specimens had excellent quality with more cellularity and preservation of cells in cytological smears. Conclusion: Urine cytology is a reliable method in the diagnosis of bladder cancer. The quality of washed urine is better than voided urine in cytological results

Surgical Complications of Arteriovenous Fistula as Permanent Vascular Access in Patients with End Stage Renal Disease at Gezira Hospital for Renal Disease and Surgery. Revisited

Background: Vascular access (VA) is a mainstay to perform an efficient hemodialysis (HD) procedure. Objectives: To evaluate the surgical complications of AV fistula as permanent vascular access in a patient of end stage renal disease (ESRDS) at Gezira hospital for renal diseases and surgery (GHRDS). Methods: Retrospective, prospective cross sectional hospital based study, done in 237 patients with end stage renal disease who underwent arteriovenous fistula.In 206 patients of the study sample done retrospectively and 31 patients of the study sample done prospectively,and they were followed for 1year. Study was conducted from September 2010 to September 2016. Data was collected using questionnaire.  Results: Sixty eight percent of study sample were males, with 42% above 50 years and 0.8% less than 10 years. Most of the patients (52.3%) were diagnosed as ESRD from the first presentation, 43.5% were diagnosed as chronic renal failure (CRF) on regular followup, while the minor rest of the patients were due to acute renal failure(ARF) which progressed to end stage renal disease.The complications rate was 32.8% (n=82), perioperative complications were 9.3% (n=22) represented as infections 3.8% (n=9), bleeding 3.0% (n=7), stenosis 1.7% (n=4), thrombosis 0.8% (n=2). The late complications were 23.18% (n= 60) the commonest was pseudo aneurysmal 19.4% (n=46) followed by venous HTN 0.8% (n=2) and steal syndrome 0.4%(n=1), skin necrosis 0.4%(n=1), idiopathic stop function 2.1% (n=5), thrombosis 0.4% (n=1). Conclusion: Permanent arteriovenous fistula is the best option for haemodialysis in patients with end stage renal disease. The commonest complication was puncture site pseudo aneurysm

Effects of ultraviolet A on the activity of two metabolic enzymes, DNA damage and lipid peroxidation during early developmental stages of the African catfish, Clarias gariepinus (Burchell, 1822)

Many ultraviolet-A (UVA)-induced biochemical and physiological changes are valid as biomarkers using aquatic species for detection of the degree of stress. Changes in the concentration and activities of enzymes, such as glucose-6-phosphate dehyderogenase (G6PDH), lactate dehyderogenase (LDH), DNA damage and lipid peroxidation (LPO), can be used as biomarkers to identify possible environmental contamination in fish. This study aimed to investigate the impact of UVA on the activity of the selected enzymes, DNA damage and LPO during early developmental stages of the African catfish Clarias gariepinus. Embryo hemogenates were used for measurements of G6PDH, LDH, DNA damage and LPO concentrations and activities spectrophotometrically at 37°C. The normal ontogenetic variations in enzyme activities, DNA damage and LPO of the early developmental stages (24–168 h-PFS; hours-post fertilization stage) were studied. There was a significant decrease in the activity of G6PDH till 120 h-PFS. Then after 120 h-PFS, the activity of such enzymes insignificantly increased toward higher stages. The LDH activity was recorded with a pattern of decrease till 96 h-PFS, followed by a significant increase toward 168 h-PFS. The polynomial pattern of variations in DNA damage and LPO was also evident. The patterns of the enzyme activities, corresponding DNA damage and LPO of the early ontogenetic stages under the influence of three different UVA doses (15, 30 and 60 min), were recorded. The pattern of variations in G6PDH activity in UVA-induced groups was similar to that of the control group with variation in the magnitude of such activity. In all treated groups, LDH activity decreased till 96 h-PFS, then increased till 168 h-PFS. Within each of the embryonic stages, the increase in UVA led to a significant increase in DNA damage. A significant increase in lipid peroxidation under UVA doses was recorded. The variability in number and molecular weight of proteins under exposure to UVA was evident, reflecting some of the genetic and transcriptional changes during exposure and development