Long-Standing Asymptomatic Inguinoscrotal Hernia

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Pattern of Anorectal malformations in Gzira National Center for Pediatric Surgery (GNCPS)

Background: Anorectal malformations (ARM) are one of the common clinically and socially demanding problems in the world especially in the poorly resourced countries. Patients and Methods: It is a cross-sectional descriptive hospital based study, in the period from June 2009 to December 2011 of 80 patients of ARM in Gezira National Center for Pediatric Surgery (GNCPS). History and examination in addition to invertogram and distal loopogram were the tools of assessment. Results: Eighty children with ARM were studied, 64 males and 16 females. Sixty six patients have delayed presentation. More than 61% presented from rural areas. Twenty-one (26%) patients had one or more associated congenital anomalies, with cardiac and limb anomalies being the most common associated malformation. High anomaly was found in 48.75% of patients, intermediate type was found in 5%, while 43.75% of patients had low anomaly. Conclusion: Delayed presentation entails suboptimal training of midwives and resident doctors in obstetric hospitals and nurseries to evaluate congenital defects in the newborn

FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) IN DIAGNOSIS OF TUMORAL CALCINOSIS, A REPORT OF THREE CASES

Introduction: Tumoral calcinosis (T.C.) is very rare and generally of unknown aetiology characterized by calcific deposits in the soft tissues. Commonly seen in the second decade of life (reported age range 15 months to 83 years). We are reporting 3 cases of T. C. who were initially diagnosed by FNAC. Two of the 3 cases were female siblings who were referred to us as possible cases of recurrent fibrosarcomas following surgical excision. Case reports:  (1) Two female siblings aged 17 and 14 years  complaining of large swelling in the upper   outer right thigh and the left outer upper thigh around the hip joints respectively. There was no limitation of movement. The masses recurred within a short period after total excision. Neither specimen was subjected to histopathology. Clinical examination showed two masses each approximately 30cm maximum diameter and 10 cm width. In addition the younger sister showed an additional mass 4.5 cm in the outer aspect of her right elbow. (2) 18 months old female child, unrelated to the above two cases, presented with an egg-sized mass in the mid-lateral aspect of her right thigh  cystic and mobile.There is a history of quinine injection in the same area. No positive family history of a similar condition. All three cases showed normocalcaemia and hyperphosphataemia with specks of calcification on x - ray and cysts in ultrasound. FNAC showed structureless gung , calcium granules and inflammatory cells including foreign body type multinucleated giant cells. Histopathology confirmed the diagnosis of T. C. Discussion: Described the three types of T. C. (familial, idiopathic, and that in patients of chronic renal failure on dialysis). The differential diagnoses were also discussed as well as lines of management such as Ca++ supplementation, phosphate restriction, acetazolamide, parathyroidectomy and the treatment of choice is total surgical excision. To our best knowledge this is the first time to report the use of fine needle aspiration cytology in the diagnosis of T. C. in Sudan.&nbsp

Endemic Vesical Stones in Sudanese Children Seen at Gezira National Center for Pediatric Surgery

Objectives: To determine the pattern, demographic features, clinical features, the common types of vesical stones and diagnostic tools accuracy of endemic vesical stone in children. Materials and Methods: In this study the records of 73 patients with endemic vesical stones were reviewed at Gezira National Center For Pediatric Surgery (GNCPS). The data were analyzed for age, sex, locality, clinical features the diagnostic tools, the treatment offered and outcomes. Results:  A total of 73 patients were included in this study, males were 64  (87.7%), < 5 years were  54 cases ( 74%), the majority from rural areas of low socio-economic status.  Conclusion: Endemic vesical stones in children is common in males below  5 years  and low socio-economic status, with UTI like symptoms and penile itching

Esophageal perforation following foreign body ingestion in children: report of three cases

We report three cases of foreign body esophagus, in two of them the foreign body was a coin, and the third child ingested a disc battery. In all three cases the foreign body was impacted in the mid esophagus. All were initially  evaluated by chest X ray which confirmed the diagnosis.One underwent flexible endoscopic extraction initially followed by rigid esophagoscope later and in the other two extractions was performed using rigid esophagoscope, two of them ended with perforation of the esophagus and treated  conservatively with only chest tube insertion and supportive management.In the third child who ingested a disc battery, esophagoscopy revealed  necrosis and perforation at the site of impaction with formation of trachea-esophageal fistula, extraction was performed but the fistula necessitated surgical closure which failed and therefore underwent stent placement to end with complete cure.Keywords: Foreign body; esophageal perforation; children; rigid endoscope

An Unusual Presentation of Jejunal Stenosis: A Case Report

Late presentation of jejunal atresia or stenosis is very rare. All patients present within the 1st to 5th day of life. They present with symptoms and signs of intestinal obstruction. Bilious vomiting is one of the most important and diagnostic feature. Other symptoms and signs of intestinal obstruction are very rare. In patients with duodenal stenosis the presentation is usually late and their main presenting symptom is failure to thrive with or without symptoms of intestinal obstruction. Here we present a thirty one month female who was seen with symptoms and signs of chronic intestinal obstruction. Her main symptoms were bilious vomiting, abdominal distension and constipation. The condition started since birth. Pregnancy was uneventful and she was an outcome of spontaneous vaginal delivery with birth weight of 3kg

Ethical, legal and social aspects of the approach in Sudan

The global malaria situation, especially in Africa, and the problems frequently encountered in chemical control of vectors such as insecticide resistance, emphasize the urgency of research, development and implementation of new vector control technologies that are applicable at regional and local levels. The successful application of the sterile insect technique (SIT) for the control of the New World screwworm Cochliomyia hominivorax and several species of fruit flies has given impetus to the use of this method for suppression or elimination of malaria vectors in some areas of Africa including Northern State of Sudan. The research and development phase of the Northern State feasibility study has been started. Sudanese stakeholders are working side-by-side with the International Atomic Energy Agency in the activities of this important phase. Several ethical, legal and social issues associated with this approach arose during this phase of the project. They need to be seriously considered and handled with care. In this paper, these issues are described, and the current and proposed activities to overcome potential hurdles to ensure success of the project are listed

Field site selection: getting it right first time around

The selection of suitable field sites for integrated control of Anopheles mosquitoes using the sterile insect technique (SIT) requires consideration of the full gamut of factors facing most proposed control strategies, but four criteria identify an ideal site: 1) a single malaria vector, 2) an unstructured, relatively low density target population, 3) isolation of the target population and 4) actual or potential malaria incidence. Such a site can exist in a diverse range of situations or can be created. Two contrasting SIT field sites are examined here: the desert-flanked Dongola Reach of the Nile River in Northern State, Sudan, where malaria is endemic, and the island of La Reunion, where autochthonous malaria is rare but risk is persistent. The single malaria-transmitting vector at both sites is Anopheles arabiensis. In Sudan, the target area is a narrow 500 km corridor stretching from the rocky terrain at the Fourth Cataract - just above the new Merowe Dam, to the northernmost edge of the species range, close to Egypt. Vector distribution and temporal changes in density depend on the Nile level, ambient temperature and human activities. On La Reunion, the An. arabiensis population is coastal, limited and divided into three areas by altitude and exposure to the trade winds on the east coast. Mosquito vectors for other diseases are an issue at both sites, but of primary importance on La Reunion due to the recent chikungunya epidemic. The similarities and differences between these two sites in terms of suitability are discussed in the context of area-wide integrated vector management incorporating the SIT