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A look into the correlation between Major Depressive Disorder (MDD) and physical activity
(International Journal of Research Publications (IJRP.ORG), 2022) Hassan I. Osman; Shahd Salaheldeen
Depression is an issue that faces humanity. It carries a high suicide rate as well as a very high morbidity rate. Combating depression is a deed that is bestowed upon metal health workers. A plethora of approaches to depression exist. Many of them being pharmaceutical in nature. The authors of this paper understand that these options are not always available to everyone and, ergo, decided to conduct a review article which explores the effects of exercise on depression. This research has showed that physical activity has significant positive effects on mental health in general (namely, depression and anxiety). This effect seems rather comparable to that of SSRIs. This is of importance as it illustrates the need for the immediate implementation of physical activity in their treatment modules to combat depression in our mental health institutes.
A rare diagnostic case of angioimmunoblastic T-cell lymphoma
(Science Progress and Research, 2021-12-22) Mujahed Nooraldaem Mirghani Adam; Mohammed NooraldaemMirghani Adam; Alkhair Abd Almahmoud Idris; Ali Seedahmed Mohamed Ali; Ismail Osman Khalid
Angioimmunoblastic T-cell lymphoma is a malignancy of mature T-cells. A 45 years old Sudanese female with generalized lymphadenomegalyreferred from Tayba hospital to Al-tayseer reference medical centre in histopathology and cytology laboratory department (Sudan) for her lymph node histopathology analysis. A surgical lymph node biopsy for histopathology analysis stained by H&E was performed and sections showed effacement of normal architecture of lymph node with disappearance of follicles and germinal center composed of polymorphic infiltrate of small tumour cells and large tumour cells. The small tumour cells showed irregular nuclei and clear cytoplasm. In this case report, we state that the delay of diagnosis was mainly a consequence of an insufficient clinical history, which led to an incomplete histological analysis, delay of reporting and need for second opinions for interpretation.
A review on SARS-CoV-2: the origin, taxonomy, transmission, diagnosis, clinical manifestations, treatment and prophylaxis
(GSC Biological and Pharmaceutical Sciences, 2020-06-11) Hilmi Zahir Abbas; Aloufi Bandar H; Ibrahim Husam MA
Coronavirus disease 19 (COVID-19) pandemic, caused by highly contagious SARS-CoV-2 that infects the respiratory system. COVID-19 started in Wuhan, south China, in December 2019, and spread to all other parts of the world. SARS-CoV-2 has +ssRNA genome (29,844bp) enclosed in an enveloped capsule (60 to 140 nm) and showing high genome homology (96%) with coronavirus of its potential natural reservoir Horseshoe bats. Two types of SARS-CoV-2 were detected: type L (70%) and type S (30%). SARS-CoV-2 spikes have very high binding affinity with all cells expressing ACE2 receptor. Nasal swabs and bronchoalveolar lavage samples were used by reverse transcriptase rtPCR for detection of SARS-CoV-2. ELISA can detect anti-SARS-CoV-2 IgM and IgG antibodies five days post infection. COVID-19 infection is confirmed by clinical signs and symptoms and CT thoracic images. Patients typically present with fever (87.3%), cough (58.1%), dyspnea (38.3%), muscle soreness or fatigue (35.5%), chest distress (31.2%) and expectoration (29.4%). The fatality rate of the infection approaches 7%. Hundreds of lungs micro clots were reported to occur causing heart failure and death. Fatal consequences were reported in older patients and those with chronic diseases. There is no specific medicine, but supportive treatment and anticoagulants are in use. Chloroquine and azithromycin have fatal consequences in 50% of patients, while Remdesivir did not show significant clinical or antiviral effects. Plasma convalescence clear the infection within three days. There is no vaccine for SARS-CoV-2 due to its mutations. Social isolation and countries lockdown measures exert catastrophic negative impact on health and economy worldwide.
A review on SARS-CoV-2: the origin, taxonomy, transmission, diagnosis, clinical manifestations, treatment and prophylaxis
(2020-01-11) Hilmi Zahir Abbas; Aloufi Bandar H; Ibrahim Husam MA
Coronavirus disease 19 (COVID-19) pandemic, caused by highly contagious SARS-CoV-2 that infects the respiratory system. COVID-19 started in Wuhan, south China, in December 2019, and spread to all other parts of the world. SARS-CoV-2 has +ssRNA genome (29,844bp) enclosed in an enveloped capsule (60 to 140 nm) and showing high genome homology (96%) with coronavirus of its potential natural reservoir Horseshoe bats. Two types of SARS-CoV-2 were detected: type L (70%) and type S (30%). SARS-CoV-2 spikes have very high binding affinity with all cells expressing ACE2 receptor. Nasal swabs and bronchoalveolar lavage samples were used by reverse transcriptase rtPCR for detection of SARS-CoV-2. ELISA can detect anti-SARS-CoV-2 IgM and IgG antibodies five days post infection. COVID-19 infection is confirmed by clinical signs and symptoms and CT thoracic images. Patients typically present with fever (87.3%), cough (58.1%), dyspnea (38.3%), muscle soreness or fatigue (35.5%), chest distress (31.2%) and expectoration (29.4%). The fatality rate of the infection approaches 7%. Hundreds of lungs micro clots were reported to occur causing heart failure and death. Fatal consequences were reported in older patients and those with chronic diseases. There is no specific medicine, but supportive treatment and anticoagulants are in use. Chloroquine and azithromycin have fatal consequences in 50% of patients, while Remdesivir did not show significant clinical or antiviral effects. Plasma convalescence clear the infection within three days. There is no vaccine for SARS-CoV-2 due to its mutations. Social isolation and countries lockdown measures exert catastrophic negative impact on health and economy worldwide.
Active Tuberculous Infection among Adult Sudanese Patients on Long Term Peritoneal Dialysis
(2012-09) Hasan Abu-Aisha; Mazin Shigidi; Nazik Farouk; Ramy Ibrahim Abulikailik; Rabab Tag Alsir
Introduction: The prevalence of tuberculosis in Sudan is 209 cases per 100,000 populations. There are no reports available regarding the prevalence of tuberculosis among the end-stage kidney disease and dialysis populations. Methods: We reviewed the medical records of all adults who were on peritoneal dialysis (PD) in the Sudan Peritoneal Dialysis Program, during the period from June 2005 to December 2011. Those diagnosed as having active tuberculous infections were retrospectively studied regarding their demography, clinical presentation and outcomes. Results: Out of 350 patients in our program, 19 were diagnosed as having active tuberculosis (5.4%). All patients were diagnosed during their first year on peritoneal dialysis, 74% were males; the mean age was 37 ± 11 years, extrapulmonary tuberculosis was seen in 16/19 (84%) patients and it was abdominal in nine of the 16 (47%) patients. In addition to high clinical suspicion, the diagnosis of active tuberculosis was supported by tissue biopsy findings in 16%, positive polymerase chain reaction in 26%, exudative ascites with suggestive radiological features in 21%, strongly positive tuberculin test in 21% and a favourable response to empirical antituberculous therapy in 26% of patients. HIV test was negative in all 19 patients and only one patient tested positive for hepatitis B viral infection. Antituberculous drugs side effects were seen in 68% of patients. Forty seven percent of patients showed complete recovery and continued on peritoneal dialysis. Our case fatality was 32%. Conclusion: Abdominal tuberculosis is common among PD patients and its diagnosis should always be considered in suspected patients.
Adherence of Health‑Care Providers to Hypertension Management Guidelines in Khartoum, Sudan, 2020
(Wolters Kluwer ‑ Medknow, 2020-10-09) Ali Awadallah Saeed; Lamees Abdelrhman; Lamiaa Saad; Marah Omran; Inas Osman
Introduction: Hypertension has the highest prevalence among the major non‑communicable diseases in Sudan (prevalence 27.6%) due to high amount of salt intake in foods, lack of exercise, obesity, stress, smoking, and increase in age. Different guidelines have been proposed from time to time to increase the number of patients with controlled blood pressure. It is a well‑established fact that poor disease control is largely related to the poor patient compliance to medical advice and medications. However, the other important aspect of the same problem is the physician’s adherence to evidence‑based management of hypertension, but, unfortunately, this has not been studied adequately. Objective: The objective is to investigate adherence practices of health care providers to the use of clinical practice guidelines in Khartoum, Sudan. Materials and Methods: An observational cross‑sectional study was carried out from February to April 2020 among health‑care providers which include prescribing doctors and community pharmacists in Khartoum locality. Data were collected using electronic delivery validated questionnaire. Results: A total of 200 health‑care professionals (HCPs) voluntary participated, 51% were pharmacists, while 49% were prescribing doctors. As overall 86.125% of participated health‑care provider aware about hypertension as a health problem as a mean of their correct responses. In the area of measurement and management of a new case of hypertension, the mean of the responses (mean of correct answers) which follow guidelines was 55.75%. In the area of selection of anti‑hypertensive treatment in comorbid conditions the mean responses of correct responses was 58.88%. Conclusions: Our study observed that the majority of HCP adhere to guidelines for hypertension in Khartoum locality. The study showed a lack of knowledge among HCPs in managing hypertension in patients with the comorbid condition.
Alien Hand Syndrome: Introduction, l iterature review and overview
(Napata College, 2022) Hassan I. Osman; Rudaina I. Osman
Few disorders/syndromes are surrounded by as much mystery as Aline Hand Syndrome (AHS) – a rare neurological disorder of connection which ergo results in misinterpretation and a loss of ownership of a limb (usually upper). In this paper, we aim to bring forth enough light on AHS so that more clinicians can correctly diagnose AHS, research efforts increase and awareness. It is, undoubtedly, misdiagnosed en masse on a daily basis as a result of our failure to properly introduce it in medical literature. A phenomenon of which we have a fair amount of understanding, yet have yet to teach it in medical references. In our search for AHS in medical references, we came across a total of only 1 reference which discussed AHS. It is important that we note that the number of references we searched was 16 and that these were well-known references which medical students and practitioners read on a daily basis all around the globe.
An overview of aortic stenosis (AS): what we know and when should we intervene?
(International Journal of Research, 2021) Rudaina I. Osman; Hassan I. Osman; MBBS
Introduction: A condition in which there is a continuous state of fibrosis, thickening as well as calcification of the leaflets that’ll eventually impede the amount of blood reaching the heart, which, if left untreated/maltreated, will eventually lead to death (1). AS does not only have an impact on the aforementioned valve, but on the LV and the entirety of the systemic vasculature (2). The most commonly encountered heart valve lesion, AS is believed to affect 2- 5% of older adults (3). It is estimated that 4-7% of individuals aged 65 years or older have been diagnosed with severe AS (3). Etiology of AS: It is believed that there are 3 major causes of AS, these are: 1) Degenerative (Calcific), 2) Rheumatic (4,5), and 3) Congenital Clinical Manifestations & Underlying Etiology: First articulated in 1968 by Ross and Braunwald (8), it is now commonly accepted amongst professionals that the development of symptoms (such as exertional dyspnea, angina, and syncope) is a poor prognostic sign as it clearly signifies left ventricular decompensation (1,8). Diagnosis: The diagnosis of calcific aortic stenosis is initially suspected if a systolic ejection murmur is present; be that as it may, the clinically significant question is normally whether the aortic stenosis is to be classified as ‘severe’ (5). The three most useful signs when it comes to diagnosing severe aortic stenosis are: 1) Late peaking systolic murmur, 2) Single second heart sound or paradoxical splitting of S2, and 3) ‘cooing’ murmur (5). Current guideline-recommended treatment strategies and their limitations: In a general sense, contemporary clinical rules suggest aortic valve intervention when stenosis seriousness is considered extreme and there is confirmation of left ventricular decompensation, via the direct even-handed or proxy representative measures (1). Conclusion: Aortic stenosis is a common cardiac disease that is of the upmost importance, deserves our undivided attention, and a crucial part in decreasing any morbidity and mortality is generally through a very careful follow-up. The gold standard investigation for suspected cases is echocardiography (5), currently the only treatment available would be a valve replacement therapy which is proven to have a good outcome and increases the patient’s life span (4). In asymptomatic patients on the other hand aortic valve replacement is considered only after symptoms have developed or if the exercise test results are worrying (4,14). We are hoping that in the future there’ll be more treatment options available that would suit the different ages and health statuses of the patients. Recommendations: 1) The initiation, funding, and publication of further studies on AS, ergo permitting for decreased morbidity and mortality, 2)The initiation of awareness programs amongst the public that would result in a decreased likelihood of lifestyle-caused AS, 3) The initiation of awareness programs amongst the public that would result in patients being overall better surgical candidates if it must take place, 4) The initiation of nation-wide (in Sudan and elsewhere around the world) geriatric services that would result in the monitoring of those most likely to fall ill with AS.
Angiotensin 1-7: A Second Window of Protection in Hypertensive Patients
(2019-04-18) Mazin Salaheldin Abdalla Mohamed; Muntaser Ibrahim; Muhanad S. Abdelwhab
The effects of the renin-angiotensin-aldosterone system on the human body are so diverse and our knowledge about them is ever growing. Angiotensin 1-7 has been proven to play protective roles in patients with cardiovascular disorders including but not limited to hypertension. As is the case with Africa, the prevalence of hypertension in Sudan is rising, and its complications could be delayed by pharmacologically manipulating the levels of renin-angiotensin system metabolites. The aim of this review is to compare the advantageous and deleterious effects of Angiotensin 2 in contrast to those of Angiotensin 1-7 and to assert the well-established protective effects of Angiotensin 1-7 (systemically and locally) in hypertensive patients
Aquaporin 5 promotes tumor migration and angiogenesis in non‑small cell lung cancer cell line H1299
(Elkhider, 2020-01-07) Abdalkhalig Elkhider; Bing Wang; Xunli Ouyang; Mahmoud AL‑Azab; Williams Walana; Xiaotong Sun; Han Li; Yawei Tang; Jing Wei; Xia Li
Non‑small cell lung cancer (NSCLC) constitutes the majority of all lung‑cancer cases. Aquaporin 5 (AQP5) may be involved in NSCLC by promoting lung‑cancer initiation and progression. The present study aimed to determine the role of AQP5 in migration and angiogenesis using NSCLC cells and HUVECs. AQPs 1, 3, 4, 5, 8 and 9 were screened in the NSCLC cell line H1299, and the present results showed that AQP5 mRNA was upregulated compared with the other AQP genes. At the protein level, AQP5 was significantly increased in H1299 cells compared with 16HBE cells. AQP5 knockdown in H1299 cells significantly decreased cell migration compared with untransfected cells, as demonstrated by both Transwell and wound closure assays. The present study further investigated H1299 ability to promote HUVEC vascularisation. The supernatants of both transfected and untransfected H1299 cells were used as conditioned medium for HUVECs, and tube formation was measured. The supernatant of AQP5‑downregulated cells exhibited significantly low tube formation potential compared with untransfected cells. Similarly, vascular endothelial growth factor was significantly increased in control cells (si‑NC) compared with cells transfected with small interfering RNA targeting AQP5. The present study found that AQP5 downregulation significantly decreased the phosphorylation level of epidermal growth factor receptor and the activity of the ERK1/2 pathway. In summary, the present study suggested that AQP5 influenced migration and angiogenesis in NSCLCs in vitro and may potentially exhibit similar in vivo effects.
Arabic Translation, Adaptation, and Validation of The Kidney Disease Quality of Life Short-Form 36
(Saudi Center for Organ Transplantation, 2019) Hasan Abu-Aisha; Sarra Elamin; Abdelbagi H. E. Elbasher; Shima E. E. Ali
The Kidney Disease Quality of Life Short Form 36 (KDQOL-36) is a self-reported measure of health for patients with chronic kidney disease. Our goal was to develop an Arabic version of KDQOL-36 that is linguistically and conceptually equivalent to the original English version. We translated KDQOL-36 into formal Arabic language using forward and backward translation. To assess conceptual equivalence, we administered the Arabic and English versions simultaneously to a group of 10 bilingual patients. To assess test–re-test reliability, we administered the instrument twice to a group of 10 hemodialysis (HD) patients. To assess internal reliability, convergent validity, and discriminate validity, we administered the instrument to 62 HD patients and 82 kidney transplant patients asking them to simultaneously fill the Depression, Anxiety and Stress Scale (DASS-21). The intraclass correlation coefficient (ICC) between the Arabic and English versions indicated excellent conceptual equivalence. The ICC between test and re-test scores revealed good reliability in the burden of kidney disease subscale and excellent reliability in the remaining four subscales. The translated version of KDQOL-36 had a Cronbach’s alpha of 0.81, indicating good internal reliability. We found significant negative correlations between the five subscales of the instrument and DASS-21, indicating good convergent validity. Kidney transplant recipients had significantly better scores than HD patients in the five subscales of the instrument, indicating excellent discriminate validity. The current Arabic version of KDQOL-36 has excellent conceptual equivalence with the original English version. It is a reliable and valid instrument for Arab kidney disease patients.
ASPARTAME SWEETENER
(2020) Ali Awadallah Saeed; Ahmed Mustafa Khidir
Artificial sweeteners have increasingly become an area of controversy in the world of food and nutrition. Consumers are oftenly barraged with a number of contradictory opinions and reports regarding the safety and efficacy of sweeteners. Artificial sweetener consumption may cause migraines or headache, skin eruptions, muscle dysfunction, depression, weight gain, liver and kidney effects, multiple sclerosis and blurred vision. On the other hand natural sweeteners like stevia and its products are safe and do not cause any health problem. Therefore, it is important for the consumer to choose sweeteners with great care. Aspartame (APM)) is composed of methyl ester of the dipeptideL-L-aspartyl-L-phenylalanine with molecular weight of 294.3 and a source of 4 kcal/g of energy (Food and Drug Administration, 2006).
Assessment of Community Pharmacist’s Involvement in Health Promotion and Education Activities of Patients in Khartoum, 2020
(Wolters Kluwer - Medknow, 2020-11-30) Ali Awadallah Saeed; Naira Saeed; Fatima Mahmoud; Marina Ezzat; Mohamed El Mojtaba; Ola Hamza; Mai Abdallah Humaida
Introduction: Health promotion enables people to gain better control and improve their health and overall well‑being. An important aspect of health promotion is community action and participation through health education which encourages socioeconomic and cultural activities and improves environmental determinants of health. Justifications: Sudan national guidelines for good pharmacy practice in community pharmacy 2016 state that community pharmacists should have a role in health promotion in community, so researches must be done to assess achievement in this issue. Objectives: The objective was to assess the extent of the pharmacists’ involvement in counseling patients about health promotion and education topics, their preparation to counsel patients in health promotion and education topics, and their perceived success in changing the patients’ health behavior. Materials and Methods: An observational cross‑sectional study was carried out from March to April 2020 among community pharmacists in Khartoum locality. Results: A total of 150 community pharmacists who participated in the study showed that the most important purpose of consumers’ visits to community pharmacy was related to seeking pharmaceutical advice about drug dosage, indication, availability, and side effects which were ranked first, second, third, and fourth, respectively. In the area of the pharmacists’ perceptions on their preparedness to counsel patients on health‑related behaviors, the perceived preparedness was highest for counseling on taking drugs as prescribed/directed (mean [standard deviation (SD)]; 4.5 [0.9]) and knowledge about drug contents and side effects (mean [SD]; 4.2 [1.1]). The community pharmacists perceived success in helping patients to change their health‑related behaviors. Conclusion: The majority of participants have a positive attitude toward counseling the population on health behaviors and indicated their willingness to learn more about health promotion.
ASSESSMENT OF RATIONAL USE OF ASTHMA MEDICATIONS AMONG ASTHMATIC PATIENTS IN BAHRI AND ALSHAAB TEACHING HOSPITALS
(2019) Hala Tajelsir Ahmed; Hassan Mohamed Ali; Sahar Mamoun Mohamed Ali; Ali Awad Allah Ali Moh. Saeed; Ahmed Mustafa Khidir; Mohammed Jalalaldin
Introduction: Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. It is usually characterized by shortness of breath, chest tightness, wheezing and coughing. Objective: The main objective of this study was to assess rational use of asthma medications among asthmatic patients in two teaching hospitals. Method: A descriptive cross sectional hospital based study, data was collected during October and November 2014, using close-ended questionnaire included demographic data of patients, question to assess clinical control of asthma, clinical indication regarding inhaled corticosteroid preventer therapy, adherence to treatment, regular review, and PMDI technique assessment. Data was analyzed using statistic package for social sciences (SPSS-V15) and Microsoft Excel 2010. Results: The result obtained showed that, asthma symptoms was uncontrolled in 60.35%, ICS is indicated for 76.4, 45.8% were regular users of ICS, 35.5% have regular review, 19.8% have correctly performed full PMDI technique and 41.3% of the studied sample performs the entire essential steps of inhaler technique correctly. Conclusion: Asthma is uncontrolled among the studied sample, lack of optimal medication use and regular review and PMDI is widely miss used by asthmatics in this study.
Assessment of Sex knowledge and Sexual Education of Sudanese women with Cervical Cancer
(International Journal of Academic Pedagogical Research, 2021-08) Alkhair Abd Almahmoud Idris; Alla Hashim Sidig
The main objective was to investigate the level of sex knowledge, sexual education of women diagnosed with cervical cancer in Khartoum State. Methods: This descriptive, cross sectional based study has been conducted in Khartoum State. Samples of 200 Sudanese women, 100 of them were diagnosed with cervical cancer (cases) and the remainder (100) were haven't got symptoms or signs of cervical cancer (control group). Primary data were collected using a questionnaire. Secondary sources of data related to the topic of the current study were books, previous researches, Internet, and other related published and non-published articles. The data collected were analyzed by using SPSS programme V. 12.0. Results: The findings revealed that cervical cancer and satisfaction by sexual education as well as sufficiency of the studied courses and importance of studying sexual education were significantly associated with cervical cancer (P < 0.05). Conclusion: This study was successful in raising awareness about the importance of sexual education as preventive means against STIs and cervical caner. The study highly recommends continuing sexual education and awareness campaigns among high risk group in the community.
ASSESSMENT OF THE RISK OF TYPE 2 DIABETES AMONG HEALTHY WITHOUT DIABETES IN SUDAN USING THE FINDRISC TOOL
(2020-09-15) Osman Abdalrhman Osman; Ali Awadallah Saeed; Mohamed Awad Mousnad; Azza Hamid
Background and objective: Diabetes is increasingly recognized as a serious public health concern worldwide. The risk assessment of type 2 diabetes can be done through a risk questionnaire that provides an accurate, low-cost, educational and time-effective method for this. By early identification of people at risk of developing diabetes and if it is confirmed that they are in the pre-diabetes stage, adequate care is provided to them through lifestyle interventions or even hypoglycemic drugs if needed, thus delaying or preventing their progression to diabetes. Therefore, this study aimed to assess the risk of developing type 2 diabetes (T2DM) among healthy Sudanese without diabetes in Khartoum. Methods: A cross-sectional study from Nov 2016-March 2017 comprising 122 adult participants, age (>20 yrs) visiting the garden yard located at airport street at Khartoum district without a diagnosis of T2DM was carried out. The risk of developing T2DM was assessed using the validated and widely used Finish diabetes risk score (FINDRISC) Total Risk Score of each participant was analysed and compared. Knowledge assessment tool and Anthropometric measurements were also used. Results: 122 participated in the study, the mean age of the participants was 31.55±10.122, the mean BMI was 25.718±5.813 and the mean of waist circumstances 90.2±16.63. Estimated risk of developing T2DM in 10 years of study for participants according to FINDRISC, only 3.3% have a high risk. The risk factors for the participants in the study for developing DM type 2 were 66.4% has positive family history, 44.3% were overweight or obese, has 41.8% limited physical activity and 27.9% has central obesity. The pattern of vegetables and fruits daily intake according to FINDRISC only 36.1% from participants. Significant positive correlation (r= 0.395, p=0.000) High risk score of FINDRISC is >14, Estimated age: Y=24.1+ (0.9x15) = 37.9≈38years.Significant positive correlation (r= 0.6, p=0.000) High risk score of FINDRISC is > 14, Estimated BMI: Y= 19.24+ (0.8x15) = 31 Kg/ m2. Conclusion: The knowledge about diabetes risk factors, classical symptoms and common complication was not satisfactory. None of the “at high” risk had their risk further investigated. While 25% adapted health their lifestyle. Large scale studies to test the validity of FINDRISC in Sudanese population should be conducted. Development of Sudanese population specific risk score that take into count the local risk factors is warranted.
ASSESSMENT ORTHOPEDIC PATIENTS AT HIGH RISK FOR VENOUS THROMBOEMBOLISM DESPITE THROMBOPROPHYLAXIS IN MILITARY HOSPITAL
(2019) Ahmed Alamin Kazzam; Ahmed Mustafa Khidir; Ali Awad Allah Ali Moh. Saeed
Introduction: Venous thromboembolism, including both deep-vein thrombosis and pulmonary embolism, is an important complication of major orthopedic surgery, and is associated with significant morbidity and mortality. A variety of factors related to the clinical setting and patient influence the risk of venous thromboembolism in orthopedic surgery patients. Objective: To assess orthopedic patients at high risk for venous thromboembolism despite thromboprophylaxis in military hospital. To evaluate risk factors for venous thromboembolism, Prevalence, Risk factors, Doses, Interaction, role of the clinical pharmacists, type of anticoagulation used, Compliance and Cost effectives. Material and method: This study was carried in military hospital Omdurman by a questionnaire for patients in December 2013 – January 2014 Study was conducted among Patients in risk of DVT in military hospital in Khartoum state. A pre designed and tested questionnaire were used for collect the data. Results: 40% from the patient’s undergone orthopedic surgeries were in age above 60 years, while 35% from patients were aged between 30-60 years. 76% from the patients were male while 73% from the patients were married. 97% from the patients were governmental employed. About their residence, 64% from the patients were rural. More than half from patients (67%), the orthopedic surgery was hip arthoplasty. The majority from the patients (82%) have surgical factors while 9% from the patients have patient’s related factors and the remaining have the both. 42% from patient has undergone orthopedic surgery, the thrombophrophylaxis drug given to them for less than 14 days. In the study, 38% from them the prophylaxis done by aspirin only while 4% done by physical prophylaxis (elastic stoking) and enoxaparin and this regimen does not match the guidelines. Only 52% from the orthopedic surgeries patients were given enoxaparin as thromboprophylactic agent, which matches the guidelines. Conclusion: Despite the availability of effective thromboprophylaxis, the prevention of venous thromboembolism in orthopedic surgery patients remains an important clinical problem. Because the increased risk of venous thromboembolism after orthopedic surgery can persist for several weeks, and discontinuation of anticoagulation therapy can lead to a second wave of thromboembolic complications, extended-duration thromboprophylaxis may be required during this period. Accurate prediction of thromboembolic risk in orthopedic patients should also facilitate the appropriate use of extended-duration thromboprophylaxis, thereby reducing the burden of venous thromboembolism. Improved risk-assessment models are therefore required to identify patients who will benefit from extended-duration thromboprophylaxis. The higher a patients risk of VTE, the greater the reliance on pharmacologic prophylaxis.
Association of Plasma Zinc and Prostate‑Specific Antigen in Patients with Prostatic Cancer in Khartoum
(Wolters Kluwer - Medknow, 2022-01-25) Nafisa Mohammed; Ali Awadallah Saeed; M. A. Mahdi
Background: Prostate cancer is the most common visceral cancer in males, ranking as the second most common cause of cancer‑related deaths in men older than 50 years of age, after carcinoma of the lung. It is predominantly a disease of older males, with a peak incidence between the ages of 65 and 75 years. This study aimed to estimate the plasma zinc level and plasma prostate‑specific antigen (PSA) level in patients suffer from prostate cancer. Materials and Methods: A case–control study was conducted in Khartoum on 100 males aged more than 50 years old which were divided into 50 apparently healthy as control and 50 with prostate cancer as case. A 5 ml of blood specimens was collected in lithium heparin anticoagulants for the estimation of plasma zinc level using Buck model 210 VGP Atomic Absorption Spectrophotometer (East Norwalk, CT 06855) made in the USA and the plasma total PSA that was measured by immunoassay Sandwich principle HITACHI ROCHE COBAS E 411 (serial number 04641655190 V 13.0). Results: The mean level of plasma zinc was 0.35 mg/L ± standard deviation [SD] 0.14 in case and in control was 0.68mg/L ± SD 0.13, so the P value was 0.002 and PSA was 43.08 ng/ml ± SD 20.08 in case and 3.53 ng/ml ± SD 3.90 in control, so the P value was 0.000, the correlation between the level of plasma PSA with plasma zinc in patients with prostate cancer give R was 0.01 and R2 was 0.001. Conclusion: This study concluded that PSA is significantly increased in patients with prostate cancer and plasma zinc level is significantly decreased in patients with prostate cancer. However, it is statistically significant.
ASYMPTOTIC PROPERTIES OF COLLOCATION PROJECTION NORMS
(Pergamon Press plc, 1990) A. H. A. AHMED
This paper is concerned with the behaviour of certain eoUocation projection norms. It is shown that the norms of the piecewise collocation projection and the usual piecewise interpolating projection are asymptotically the same. A similar result is shown for the global ease if the collocation points are chosen as Tchebycheff zeros with some restrictions on the coefficients of the differential operator.
AWARENESS OF INTERACTIONS OF NSAIDS WITH SOME DISEASES AMONG PHARMACISTS IN KHARTOUM STATE
(2019) Fahad Gasim Alsiddig Alabass; Ahmed Mustafa Khidir; Ali Awad Allah Ali Moh. Saeed
Introduction: Drug- Disease interactions may cause deterioration in the patient’s clinical status, resulting in additional treatment, hospitalization, and/ or an extended hospital stay. NSAIDs inhibit the enzymatic production of prostaglandins. In Sudan and prescribing are more than other drugs or may be used routinely by more patient by them self without sufficient know –how the effect of (NSAIDs) if they have other diseases e.g., Asthma, gastrointestinal upset (peptic ulcer). Objectives: To assess the extent of awareness of drug-diseases interactions of NSAIDs among Pharmacists and Doctors in Khartoum state pharmacies and hospitals. Materials and methods this study was conducted in Khartoum state pharmacies and hospitals during the period of May to 15Th October 2011, it is cross-sectional study. Sample size 120 of pharmacists and 50 doctors working in Khartoum state hospitals will be selected randomly. Structured pre tested questionnaire will be developed to collect the data. Moreover, the information was collected from books, international journals. BNF and scientific websites. The analyzing of data using SPSS program. Results: 76% of doctor expected that there will be drug-drug or drug-disease interaction between asthmatic patients and NSAIDs. 75.5% from the pharmacists stated that NSAIDs may interact with asthmatic patients by worsening the asthma. 91.67% of doctors expected that there will be drug-disease interaction between ulcerative patients and NSAIDs. 88% stated that the interaction by increasing gastric acid secretion and worsening of the ulcer in these patients. 55.5% from the doctors did not ask the patients about the period of using NSAIDs when they come to take NSAIDs. Conclusion: More than half of the practicing pharmacists and medical doctors are aware about the interaction between NSAIDs and asthma, hypertension and patients having ulcer. Unfortunately in spit of that, they dispense and prescribe NSAIDs to these patients respectively. Half of the doctors did not ask the patients about the period of using NSAIDs when they come for treatment. Half of the pharmacists are reluctant to ask the patients about the medical history when they are taking NSAIDs.

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