Pattern of Endoscopic Findings of Upper Gastrointestinal Tract in Omdurman Teaching Hospital, Sudan

Background: The pattern of endoscopic findings of upper gastrointestinal tract (UGT) including gastro esophageal reflux (GERD), peptic ulcer diseases (PU), and upper gastrointestinal malignancies was not studied recently in Sudan.Objectives: The aim of this study is to know the pattern of endoscopic findings of upper gastrointestinal tract.Materials and Methods: This is a cross-sectional descriptive study which was conducted during the period from March to September 2013, at endoscopy unit in Omdurman Teaching Hospital. All patients referred for upper gastrointestinal endoscopy were included in the study.Results: A total of 390 subjects was enrolled in the study.56.4% were females; the male to female ratio was 1.3:1, their ages ranged from 11 to 80 years old with a mean age of 50.2 years. The most common endoscopic findings in the study group was Gastritis 54.9% followed by esophagitis 42%, peptic ulcer diseases 21%, esophageal varices 13.8% and upper gastrointestinal tumors (esophageal and gastric) 13.2 %. Normal findings were found in 3% of all patients in the study group.Conclusion: Upper gastrointestinal disorders are more common in Sudan compared to other countries. Esophageal varices and upper gastrointestinal malignancies are increasing compared to previous studies. Further studies are required to characterize abnormalities of upper gastrointestinal tract.Key words: Upper gastro-intestinal endoscopy, Gastritis, Esophagitis, Peptic ulcer, Sudan

Non-obstructive patterns of spirometry among obese patients presenting with symptoms and signs of mild to moderate asthma

Background: Asthmatic patients typically show obstructive pattern on spirometry; with positive response to bronchodilators. However, there is paucity of data regarding presentation of obese patients with non-obstructive patterns of spirometry.Methods: A sample of 295 known asthmatic patients (74% over-weights or obese and 26% nonobese) was selected from those attending respiratory clinic of Yastabshiron Hospital for follow up. A portable spirometer (All flow, Clement Clarke International, UK) was used for measurement ofFEV1, FVC, FEV1/FVC ratio and PEF for each patient. Measurements were carried out on presentation and then 15 minutes following inhalation of 0.5 mg salbutamol using a spacer.Results: Typical obstructive pattern was found in only 17.4% of obese patients, normal pattern in 18.3%, restrictive in 45.9% and combined pattern in 18.3%. The relation between obesity and patterns of spirometry was found to be statistically insignificant (P= 0.808). Significant proportionsof all patterns showed positive reversibility tests (P= 0.000).Conclusion: It is concluded that all patterns of spirometry are expected in obese patients with mild to moderate asthma. Reversibility tests are highly significant among asthmatic patients, irrespective to their spirometric pattern.Key words: Obesity, Reversibility, FEV1, FV

Changes in plasma IL4, TNF-α and CRP in response to regular passive smoking at home among healthy school children in Khartoum, Sudan

Background: Regular exposure to tobacco smoke at home causes airway inflammation and altered cytokine regulation; however, there is variation between individuals of different countries. Objective: To determine effects of passive smoking on plasma IL4, TNF-α, and CRP in healthy male school-children in Khartoum. Methods: A total of 135 male school-pupils (69 passive smokers and 66 non-smokers) were selected randomly from three primary schools for boys in Khartoum. Information about smoking history was collected from each pupil and his parents using a questionnaire. Plasma CRP, IL4 and TNFá were measured using commercially available ELISA kits. Results: Plasma IL4 and TNF-α in the passive smokers (mean ± SEM) is at 2.92 ± 0.93 and 19.78 ± 4.67 pg/ml respectively; whereas in the non-smokers . It is at 0.45 ± 0.28 and 5.05 ± 1.54 pg/ml respectively. The difference between the two groups is statistically significant (p < 0.05). The mean plasma IL4 and TNF-α were lowest with no exposure, higher with moderate exposure, and highest with heavy exposure (P < 0.05). Plasma CRP showed insignificant difference between the two groups. Conclusion: Passive smoking causes significant rise in plasma TNF-α and IL4 with a dose dependent effect among school pupils in Khartoum

Changes in plasma IL4, TNFá and CRP in response to regular passive smoking at home among healthy school children in Khartoum, Sudan

Background: Regular exposure to tobacco smoke at home causes airway inflammation and altered cytokine regulation; however, there is variation between individuals of different countries.Objective: To determine effects of passive smoking on plasma IL4, TNF&aacute;, and CRP in healthy male school-children in Khartoum.Methods: A total of 135 male school-pupils (69 passive smokers and 66 non-smokers) were selected randomly from three primary schools for boys in Khartoum. Information about smoking history was collected from each pupil and his parents using a questionnaire. Plasma CRP, IL4 and TNF&aacute; were measured using commercially available ELISA kits.Results: Plasma IL4 and TNF&aacute; in the passive smokers (mean &plusmn; SEM) is at&nbsp; 2.92 &plusmn; 0.93 and 19.78 &plusmn; 4.67 pg/ml respectively; whereas in the non-smokers . It is at 0.45 &plusmn; 0.28 and 5.05 &plusmn; 1.54 pg/ml respectively. The difference between the two groups is statistically significant (p &lt;0.05). The mean plasma IL4 and TNF&aacute; were lowest with no exposure, higher with moderate exposure, and highest with heavy exposure (P &lt; 0.05). Plasma CRP showed insignificant difference between the two groups.Conclusion: Passive smoking causes significant rise in plasma TNF&aacute; and IL4 with a dose dependent effect among schoolpupils in Khartoum