Al Neelain Medical Journal - VOL - 04
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Item Primary thrombophilia(جامعة النيلين, 2012) Amani HashimI.Elgadal; Faroug Yasin; Sumia Elasad; Sawsan Abdelmonem; Hiba AbdurrahmanWe would like to present an early age of presentation of primary Thrombophilia with progressive course due to Protein C deficiency type 1 with a lot of challenges in the treatment options. M.A.M, 9years old, female from small village near Eldweem, White Nile state, Sudan. 3rd grade primary school admitted in Omdurman pediatric emergency hospital on 12th April 2011 with convulsions five hours before admission. The condition started one month before presentation with blurred vision of progressive course started in the RT eye, then it became bilaterally till she became completely blind ,parents seek medical advice at private ophthalmology clinic, medications was prescribed but she regained vision after two days without starting the treatment. A week later the mother noticed that her baby developed squint , bilateral ptosis and She was sleepy also there is severe frontal headache on &off with no aggravating or relieving factor associated with difficulty in walking and slurred speech, seen by a doctor at health centre and diagnosed as malaria based on investigations received oral anti-malarial with no response, Three days later she developed low grade fever not relieved by paracetamol not associated with rigor or sweating then she developed convulsions started in her hands then became generalized last for less than 5 minutes not followed by loss of conscious or sphintric disturbance so parents brought her to Omdurman Pediatrics Emergency Teaching Hospital.Item Tuberous sclerosis… the future(جامعة النيلين, 2012) Amani.H.I.ElgadalTuberous sclerosis is genetic inherited disease as autosomal dominant .In the past it is thought to be a rare, but recently been found to be more common. Many people have mild symptoms; many remain asymptomatic for a long time before the diagnosis was made. The disease affects many organs: the brain, eyes, skin, kidneys, and in females the lungs as well as the heart may be involved, its progression is unpredictable. Many people think that: when seizures starts, couldn’t even with aggressive treatment, bother yourself waste time and recourses. Now tuberous sclerosis become a model genetic disease having new treatment opportunities like the mTOR inhibitors which has the potentiality to treat and/or improve symptoms and signs of the disease. Many researches had FDA approval, others in the process of approval which is the great hope. In this case I would like to refresh you about the disease, the future options regarding mainly neurological manifestations. The challenge in our situation is the availability feasibility, accessibility and sustainability.Item Teacher’s perception of the first implemented OSCE mock as a reference for perfection in the final clinical exam for medical students(جامعة النيلين, 2012) Sara Lavinia Fatah El Rahman Ibrahim Brair; Ahmed Babiker AliIntroduction: Teacher’s perception is important for improvements in exam methodology and organization. The aim of the study was to find out what teachers thought of the exam and therefore improve the quality, credibility and validity of the final OSCE. Methodology: Cross sectional study facility based study was carried out on the teachers who participated in the execution and preparation of the exam. A questionnaire was designed and filled in by the staff. The questionnaire tackled five domains. Results: 91.6% of teachers agreed that exam was fair, 83.3% of teachers agreed that more time was needed at each station and 75% agreed that more staff was needed for supervision. 66.7% thought that instructions for moving about stations were clear. The mean results showed that perception of the exam, organisation, atmosphere, real patients & simulator patients and perception of the students were good. Conclusion: Time needed to be increased at each station. The number of staff was not enough. Recommendation: Increase time at each station, or make double and linked stations. Increase the number of staff participating in the exam.Item Assessment of Knowledge, Attitude and Practice about Sandfly and Visceral Leishmaniasis Control Activities in Rural Area of Gedarif State, Sudan in May 2008(جامعة النيلين, 2012) Moawia M. Hassan; Anwr O. Banaga; Ehab AM. Frah; Bakri Y. M. NourControl of visceral leishmaniasis (VL) in Sudan remains a subject of interest because the disease threats lives of many populations in endemic areas. Success of the disease control programme depends on improving of knowledge attitude and practice (KAP) of the community towards kala-azar in the endemic areas. No data have previously been published on the KAP of the community towards kala-azar in Sudan. A cross-sectional study was carried out in Tabarakallah and Barbar elfugara villages (Gedarif State; eastern Sudan) during May 2008 to assess the KAP towards sand fly and leishmaniasis control activities by households. Heads of 388 of households from the two villages were interviewed using a well designed socio-economic questionnaire. Most of the respondents in the area (95.6%) were aware of Kala-azar. However, fever, weight loss (28.1%) and hepato-splenomegaly (31.4%) were the most commonly known symptoms. The infectious NMJ March مجلة النيلين الطبية-العدد الرابع 2012 2012 Al Neelain Medical Journal vol.2 No.4 ISSN 1858-6279 nature of the disease was only known to 19.6% whereas 51% of the respondents believed that transmission is by other insects (e.g. mosquitoes) rather than sand flies. Most of the respondents (76.8%) preferred specialize VL treatment centres than health centres (19.1%) or public health sectors (0.5%) for treatment. Approximately, 33.2% of the respondents thought that sand flies breed in hospitals and only 17.7% knew that sand flies biting occur during night. The majority of the respondents (85.5%) believed that ITNs can be a good choice for control of VL rather than insecticide spraying (5.7%) or applying of mosquito repellents (2.7%). Poor knowledge of the respondents in the study area about symptoms of KA, nature of the disease transmission, breeding sites of the vector and control measures underline the urgent need of intensive health educational campaigns in the area to help future plan to control the disease.Item Family and Community Support of TB Patients -Jebel Awleyah Locality-Khartoum Sudan -2011(جامعة النيلين, 2012) Mustafa Khidir Mustafa Elnimeiri; Ahmed BoladFamily and community support are always considered as essential factors need to facilitate coping of the patients with their disease and its outcome. In Sudan the family and ties are still firm. However family and community support for TB patients may not always be encountered to the same extent especially among urban populations. The design was facility-based descriptive. The study was conducted in Gebel Awleyah Locality, which is geographically located in the South of the National Capital of Sudan. The study population was composed of 348 TB patients (pulmonary and extra-pulmonary) in the TBMUs receiving DOT in the intensive phase. A Standardized pre-coded and pre tested administered questionnaire was used for data collection from the TB patients. 99% of the TB patients were supported by their families as they became sick. The family support was expressed in accompanying to the TBMU (96%) and in provision of extra food (99%). The family support in cash was encountered for about 73% of the TB patients. About 31% of the TB patients were supported by the community and 69% of them were not supported. For those TB patients, who were subjected to community support, were mainly supported by their neighbors (98%). The TB patients of both genders were supported by their families mainly by their bothers. The family support was marked in accompanying to the TBMUs and provision of extra food.Item Comparison of different diagnostic methods of Helicobacter pylori infection in Sudanese patients(جامعة النيلين, 2012) Nazar Abdalazeem Osman Abdalsadeg; Adam Ahmed Adam; Hassan Abdul-Aziz; Waleed Hussein Omer; Hassan Abdalsalam Osman; Ahmed Kamal BoladThis study aimed at comparing a PCR method of direct detection from biopsy and two other methods: culture and (campylobacter like organism) CLO test for the diagnosis of H. pylori in Sudan. A total of 100 biopsies were taken from 100 patients presenting with various gastro-duodenal symptoms after obtaining an informed consent. The biopsies were analyzed using the culture method, CLO test kit and the PCR test using the 23S rRNA gene (Jene bioscience kits). With culture 48% (48 out of 100) were positive, CLO test 53% (53 of 100) were positive, 58 out of 100(58%) were patients by using PCR. Sensitivity and specificity of culture technique was (78%) and (94%) respectively while PCR showed a sensitivity of 94% and a specificity of 75% and CLO test showed (96% & 86.5%) for sensitivity and specificity when culture was the golden method and (88%, 95%) when PCR was the golden method. The PCR test appears to be the most reliable test for diagnosis of H. pylori in Sudan especially where culture is difficult. Keywords: Helicobacter pylori, biopsies, PCR, CLO test, culture.Item Investigation of Iron Deficiency Anemia among Infants In Omdurman (albuluk hospital)-Sudan. (August 2008 to August 2011(جامعة النيلين, 2012) Rehab Omer Adam Mohammed Gibla; Babiker Ahmed MohamedIron deficiency anemia (IDA) is widespread among adults and children particularly those below 5 years of age. Nutritional deficiency predominates. This is a cross sectional study in which 350 blood specimen of anemic children admitted to Omdurman (Albuluk hospital), aged from two months to two years. The samples were collected and analyzed in the period from August 2008 to august 2011. Tests performed in all specimens are the mean + SD of haemoglobin (Hb) concentration, packed cell volume (PCV), mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), white blood cells counts(WBC) ,platelet counts ,reticulocyte counts ,red cell distribution width (RWD), serum iron concentration and serum ferritin concentrations. Parents of these children were also interviewed about nutrition of their children and whether they have symptoms. Results of blood analysis showed significant drop in all age groups in children’s parameters compared with normal values (P value <0.05). Morphology showed microcytic hypochromic and target cells. As for nutrition, 81% had poor nutritional history indicating low income. Other causes of microcytic morphology such as thalassaemia are not completely ruled out and we need to do haemoglobin electrophoreses.Item The Impact of malaria disease on Socio – Economic Development in the Gezira Scheme – Sudan(جامعة النيلين, 2012) M. A. M. Elnur; M. S. EltahirThis study was carried out in the Gezira scheme to identify the impact of (Malaria on socio- economic development in Gezira scheme. The study was established on the assumption that malaria disease has a drastic effect on the farmer income due to his absence from work. A simple random multistage stratified sample was taken from farmers in the villages of the scheme (180) farmers to represent the research community. Statistical packages for social sciences (SPSS, version 11) were used to display and interpret the data; chi-square was also used to identify the significant or non-significant relations.Chi-square has confirmed the following findings: There is significant relation between each of the following: Malaria infection and income level. Malaria infection and its affect on agricultural activities of the farmer. Malaria infection and the disease communicators existent.