Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article pr... more Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article presents a case of segmental cystic dilatation of the left ureter with proximal dilated upper left ureter and ipsilateral atrophied kidney, while the distal ureter with normal calibration. Case: Excision of the cyst with proximal ureter and kidney was done. Segmental cystic dilatation of the ureter should be considered in the differential diagnosis of intraabdominal cystic mass.
Introduction breast cancer (BC) mortality and morbidity burden in African countries is higher com... more Introduction breast cancer (BC) mortality and morbidity burden in African countries is higher compared to western countries due to late diagnosis produced by deficient screening. We aimed to assess the level of knowledge, attitude and practice regarding breast cancer screening among Sudanese female workers at a secondary-level hospital. Methods this is a cross-sectional study carried out at the largest governmental hospital of Ad-Damazin City (capital of Blue Nile State, south-eastern Sudan) in 2018. It surveyed female healthcare providers “group A” compared to the non-medical female staff at the same hospital “group B” to assess their awareness, beliefs and behavior concerning Breast Cancer Screening (BCS). Chi-squared and Student t-tests were used for analysis with a significant p value of <0.05. Results participants were 110, included 78 (70.9%), (“group A”) and 32 (29.1%) (“group B”) women. Good overall knowledge score (47.4%) vs (43.8%), for “group A” and “group B”, respectively, p=0.000. Positive attitude was scored by 63 (80.8%) vs. 23 (71.9%) participants in “group A” and “group B” respectively, p= 0.305. Obvious denial trend regarding susceptibility to this disease was noted in both groups. BCS practices were seriously unsatisfactory in both groups. As “group A” vs “group B” regarding breast self-examination, n=13 (16.7%) vs n=10 (31.3%); clinical breast examination n=4 (5.1%) vs n=4 (12.5%) and mammography was not performed by any woman in both groups. Conclusion the modest knowledge and poor BCS practices of our study groups strongly recommends appropriate official and educational actions.
Objective: Geophagia is defined as the craving and deliberate consumption of dirt, soil, or clay ... more Objective: Geophagia is defined as the craving and deliberate consumption of dirt, soil, or clay that is practiced sometimes by pregnant ladies, mentally handicapped, or people with iron deficiency anemia. This disorder is seen frequently in people who are native to Africa all around the world. A grave surgical complication can result from the presence of this foreign material inside the intestine notably intestinal perforation, and obstruction Case: A 34 years old female present with features of distal large bowel obstruction three weeks post-delivery underwent exploratory laparotomy were obstructing piece of clay was found, the patient confirmed after surgery a heavy consumption of river shore clay during the pregnancy. Conclusions: The patient experienced an uneventful postoperative course, oral intake allowed by the third postoperative day, and the patient was discharged home on the fifth postoperative day. Follow-up at one month after surgery show a clean healed wound with no c...
Background: The nurse plays a pivotal role in assisting the patient in facing many challenges tha... more Background: The nurse plays a pivotal role in assisting the patient in facing many challenges that are associated with renal transplantation, including the complications and long-term physical and psychosocial implications. Aim: The study aimed to assess the effects of a training program on nurses` knowledge regarding post-operative nursing care of renal transplantation patients.in the renal transplantation centers in Khartoum Sudan. Methods: An interventional, hospital-based study carried out, the total coverage method used to lay down the sample which reaches (72) nurses. The study conducted at the three main transplantation centers in the Khartoum State (Ahmed Gasim, Ibn Sina, and East Nile). Results: The total number of the participating nurses was 72 nurses their age between 20 and 30 years. The nurses' knowledge before the implementation of the program, 19 nurses (26.4%) was poor, 50 nurses (69.4%) was good, and 3 nurses (4.2%) was very good. after the program, The total n...
Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article pr... more Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article presents a case of segmental cystic dilatation of the left ureter with proximal dilated upper left ureter and ipsilateral atrophied kidney, while the distal ureter with normal calibration. Case: Excision of the cyst with proximal ureter and kidney was done. Segmental cystic dilatation of the ureter should be considered in the differential diagnosis of intra-abdominal cystic mass.
Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a soc... more Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a societal level, results in substantial health-care costs, economic losses and reduced health-related quality of life (HRQoL) 1-8. A biologically and clinically heterogeneous disease, NAFLD covers a broad spectrum of histological conditions that increase both hepatic and non-hepatic morbidity and mortality. The majority of people living with NAFLD have isolated steatosis (non-alcoholic fatty liver, NAFL) and a smaller proportion develop non-alcoholic steatohepatitis (NASH), with increasing hepatic fibrosis leading eventually to cirrhosis, liver cancer, end-stage liver disease and death 9,10. NASH is a leading cause of progression to cirrhosis and hepatocellular carcinoma 11,12 , and an increasingly common indication for liver transplantation 13,14. Liver cancer is now the second leading cause of years of life lost among all cancers globally 15. NAFLD is part of a multisystem disease and is considered the hepatic manifestation of metabolic syndrome 16-18. Although strongly associated with obesity, NAFLD also occurs in individuals with normal weight, especially in Asian populations 19,20. The causes of death in people living with NAFLD vary depending on disease state. Patients with cirrhosis predominantly have liver-related events, whereas those without cirrhosis have vascular events and non-hepatic cancer 21. Overall, cardiovascular disease (CVD) is the leading cause of death in patients with NAFLD; other common causes include extrahepatic
Abstract Introduction Modern liver surgery in the Sudan started at our institution, The National ... more Abstract Introduction Modern liver surgery in the Sudan started at our institution, The National Ribat University Hospital, in 2002. This study aimed to assess the perioperative events of hepatocellular carcinoma (HCC) resection in our institution during the period January 2002 to December 2013 compared to hepatectomies for benign liver pathologies. Methods The medical records of 114 patients subjected to hepatectomy were divided into the HCC group (cases), and benign group (controls). The characteristics and perioperative events of both groups were assessed and compared. Results The mean age of the HCC patients was 58.6 ± 7.7 years. The majority of liver resections in the HCC group were minor (72.7%). The mean intraoperative blood loss was 918.8 ml in the HCC group and 720 ml in benign resections group and the difference between them was not significant, p = 0.129. The mean operative duration of HCC resection was 4 hours. The major postoperative complications were encountered in 16 patients (36.4%) in the HCC group. HCC group thirty-day postoperative mortality was 9.1%, ( n = 4 patients) while no patient of the benign group ( n = 60) died within that duration, p = .030. Logistic regression multivariate analysis revealed massive bleeding as an independent predictor for major postoperative morbidity, Odds ratio [OR] = 5.899, 95%, Confidence Interval [95% CI], 1.129–30.830, p = .035. Discussion Our results revealed outcome parameters comparable with the international reports. Conclusion Further improvements in hepatic surgery in general, and HCC in particular is inevitable.
Introduction: The hypothalamic hormones are secreted in very small amount and directly targeting ... more Introduction: The hypothalamic hormones are secreted in very small amount and directly targeting to the pituitary gland. All stimulating hormones are secreted in the general circulation to reach their target glands. Could there be targeting of these stimulating hormones to their specific glands? If so then there would be differences between TSH level in thyroid artery, femoral artery and peripheral veins. No previous data was available concerning this question. Objectives: This study was designed to investigate the possibility of targeting the thyroid stimulating hormone towards the thyroid gland by evaluating the level of TSH in the thyroid artery and femoral artery, a peripheral vein and see if there is any difference. Methods: A cross sectional hospital based study was conducted in 2016 in the National Ribat Hospital in adult Sudanese. Blood Samples were taken from three euothyroid patients during thyroidectomy ,from the inferior thyroid artery, a peripheral vein and the femoral ...
BACKGROUND Rapid growth and invasiveness of hepatocellular carcinoma (HCC) largely depends on its... more BACKGROUND Rapid growth and invasiveness of hepatocellular carcinoma (HCC) largely depends on its vascularity and active angiogenic capacity. That feature was used to control the tumor in the past with some limitations. These deficiencies were addressed in our new procedure by hepatic artery ligation and extrahepatic collaterals division (HALED) of the liver lobe containing large HCC. This study tried to assess the feasibility, safety and the short term effects of HALED. MATERIALS AND METHODS This is a prospective stage 2a development IDEAL (Idea, Development, Exploration, Assessment and Long-term monitoring) case series. It included adult patients with large-sized HCC (diameter > 5 centimeters) subjected to HALED carried out in our center during five years` trial evaluating one-month postoperative outcomes. Patients will be reported prospectively in a sequential order with explanation of reasons for rejected cases and description of changes to technique or indication as the procedure evolved. This study registry number is NCT03129685 at the ClinicalTrials.gov. RESULTS The first HALED operation was carried out safely on 2013, followed by nineteen patients by 2018. Patients` mean age (±standard deviation) was 62·45 (±9·27), range 38 to 76 years. Eleven (55%) patients had tumors diameter > ten centimeters. 13 (65%) patients were advanced BCLC stage. Seven modifications were made on the technique and indications of the procedure towards stability. According to the modified response evaluation criteria in solid tumors, 13 patients (65%) attained complete response. Operative mortality was 5% (one patient) and major morbidity was 10% (two patients). Liver infarction and abscess formation were not noticed in this study. CONCLUSION Our forerunner study showed that HALED for large HCC is safe and induces tumor necrosis. Further long-term studies are suggested before starting the 2b stage.
Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a soc... more Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a societal level, results in substantial health-care costs, economic losses and reduced health-related quality of life (HRQoL) 1-8. A biologically and clinically heterogeneous disease, NAFLD covers a broad spectrum of histological conditions that increase both hepatic and non-hepatic morbidity and mortality. The majority of people living with NAFLD have isolated steatosis (non-alcoholic fatty liver, NAFL) and a smaller proportion develop non-alcoholic steatohepatitis (NASH), with increasing hepatic fibrosis leading eventually to cirrhosis, liver cancer, end-stage liver disease and death 9,10. NASH is a leading cause of progression to cirrhosis and hepatocellular carcinoma 11,12 , and an increasingly common indication for liver transplantation 13,14. Liver cancer is now the second leading cause of years of life lost among all cancers globally 15. NAFLD is part of a multisystem disease and is considered the hepatic manifestation of metabolic syndrome 16-18. Although strongly associated with obesity, NAFLD also occurs in individuals with normal weight, especially in Asian populations 19,20. The causes of death in people living with NAFLD vary depending on disease state. Patients with cirrhosis predominantly have liver-related events, whereas those without cirrhosis have vascular events and non-hepatic cancer 21. Overall, cardiovascular disease (CVD) is the leading cause of death in patients with NAFLD; other common causes include extrahepatic
Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article pr... more Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article presents a case of segmental cystic dilatation of the left ureter with proximal dilated upper left ureter and ipsilateral atrophied kidney, while the distal ureter with normal calibration. Case: Excision of the cyst with proximal ureter and kidney was done. Segmental cystic dilatation of the ureter should be considered in the differential diagnosis of intraabdominal cystic mass.
Introduction breast cancer (BC) mortality and morbidity burden in African countries is higher com... more Introduction breast cancer (BC) mortality and morbidity burden in African countries is higher compared to western countries due to late diagnosis produced by deficient screening. We aimed to assess the level of knowledge, attitude and practice regarding breast cancer screening among Sudanese female workers at a secondary-level hospital. Methods this is a cross-sectional study carried out at the largest governmental hospital of Ad-Damazin City (capital of Blue Nile State, south-eastern Sudan) in 2018. It surveyed female healthcare providers “group A” compared to the non-medical female staff at the same hospital “group B” to assess their awareness, beliefs and behavior concerning Breast Cancer Screening (BCS). Chi-squared and Student t-tests were used for analysis with a significant p value of <0.05. Results participants were 110, included 78 (70.9%), (“group A”) and 32 (29.1%) (“group B”) women. Good overall knowledge score (47.4%) vs (43.8%), for “group A” and “group B”, respectively, p=0.000. Positive attitude was scored by 63 (80.8%) vs. 23 (71.9%) participants in “group A” and “group B” respectively, p= 0.305. Obvious denial trend regarding susceptibility to this disease was noted in both groups. BCS practices were seriously unsatisfactory in both groups. As “group A” vs “group B” regarding breast self-examination, n=13 (16.7%) vs n=10 (31.3%); clinical breast examination n=4 (5.1%) vs n=4 (12.5%) and mammography was not performed by any woman in both groups. Conclusion the modest knowledge and poor BCS practices of our study groups strongly recommends appropriate official and educational actions.
Objective: Geophagia is defined as the craving and deliberate consumption of dirt, soil, or clay ... more Objective: Geophagia is defined as the craving and deliberate consumption of dirt, soil, or clay that is practiced sometimes by pregnant ladies, mentally handicapped, or people with iron deficiency anemia. This disorder is seen frequently in people who are native to Africa all around the world. A grave surgical complication can result from the presence of this foreign material inside the intestine notably intestinal perforation, and obstruction Case: A 34 years old female present with features of distal large bowel obstruction three weeks post-delivery underwent exploratory laparotomy were obstructing piece of clay was found, the patient confirmed after surgery a heavy consumption of river shore clay during the pregnancy. Conclusions: The patient experienced an uneventful postoperative course, oral intake allowed by the third postoperative day, and the patient was discharged home on the fifth postoperative day. Follow-up at one month after surgery show a clean healed wound with no c...
Background: The nurse plays a pivotal role in assisting the patient in facing many challenges tha... more Background: The nurse plays a pivotal role in assisting the patient in facing many challenges that are associated with renal transplantation, including the complications and long-term physical and psychosocial implications. Aim: The study aimed to assess the effects of a training program on nurses` knowledge regarding post-operative nursing care of renal transplantation patients.in the renal transplantation centers in Khartoum Sudan. Methods: An interventional, hospital-based study carried out, the total coverage method used to lay down the sample which reaches (72) nurses. The study conducted at the three main transplantation centers in the Khartoum State (Ahmed Gasim, Ibn Sina, and East Nile). Results: The total number of the participating nurses was 72 nurses their age between 20 and 30 years. The nurses' knowledge before the implementation of the program, 19 nurses (26.4%) was poor, 50 nurses (69.4%) was good, and 3 nurses (4.2%) was very good. after the program, The total n...
Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article pr... more Objective: Segmental cystic dilatation of the ureter is extremely rare in adults. This article presents a case of segmental cystic dilatation of the left ureter with proximal dilated upper left ureter and ipsilateral atrophied kidney, while the distal ureter with normal calibration. Case: Excision of the cyst with proximal ureter and kidney was done. Segmental cystic dilatation of the ureter should be considered in the differential diagnosis of intra-abdominal cystic mass.
Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a soc... more Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a societal level, results in substantial health-care costs, economic losses and reduced health-related quality of life (HRQoL) 1-8. A biologically and clinically heterogeneous disease, NAFLD covers a broad spectrum of histological conditions that increase both hepatic and non-hepatic morbidity and mortality. The majority of people living with NAFLD have isolated steatosis (non-alcoholic fatty liver, NAFL) and a smaller proportion develop non-alcoholic steatohepatitis (NASH), with increasing hepatic fibrosis leading eventually to cirrhosis, liver cancer, end-stage liver disease and death 9,10. NASH is a leading cause of progression to cirrhosis and hepatocellular carcinoma 11,12 , and an increasingly common indication for liver transplantation 13,14. Liver cancer is now the second leading cause of years of life lost among all cancers globally 15. NAFLD is part of a multisystem disease and is considered the hepatic manifestation of metabolic syndrome 16-18. Although strongly associated with obesity, NAFLD also occurs in individuals with normal weight, especially in Asian populations 19,20. The causes of death in people living with NAFLD vary depending on disease state. Patients with cirrhosis predominantly have liver-related events, whereas those without cirrhosis have vascular events and non-hepatic cancer 21. Overall, cardiovascular disease (CVD) is the leading cause of death in patients with NAFLD; other common causes include extrahepatic
Abstract Introduction Modern liver surgery in the Sudan started at our institution, The National ... more Abstract Introduction Modern liver surgery in the Sudan started at our institution, The National Ribat University Hospital, in 2002. This study aimed to assess the perioperative events of hepatocellular carcinoma (HCC) resection in our institution during the period January 2002 to December 2013 compared to hepatectomies for benign liver pathologies. Methods The medical records of 114 patients subjected to hepatectomy were divided into the HCC group (cases), and benign group (controls). The characteristics and perioperative events of both groups were assessed and compared. Results The mean age of the HCC patients was 58.6 ± 7.7 years. The majority of liver resections in the HCC group were minor (72.7%). The mean intraoperative blood loss was 918.8 ml in the HCC group and 720 ml in benign resections group and the difference between them was not significant, p = 0.129. The mean operative duration of HCC resection was 4 hours. The major postoperative complications were encountered in 16 patients (36.4%) in the HCC group. HCC group thirty-day postoperative mortality was 9.1%, ( n = 4 patients) while no patient of the benign group ( n = 60) died within that duration, p = .030. Logistic regression multivariate analysis revealed massive bleeding as an independent predictor for major postoperative morbidity, Odds ratio [OR] = 5.899, 95%, Confidence Interval [95% CI], 1.129–30.830, p = .035. Discussion Our results revealed outcome parameters comparable with the international reports. Conclusion Further improvements in hepatic surgery in general, and HCC in particular is inevitable.
Introduction: The hypothalamic hormones are secreted in very small amount and directly targeting ... more Introduction: The hypothalamic hormones are secreted in very small amount and directly targeting to the pituitary gland. All stimulating hormones are secreted in the general circulation to reach their target glands. Could there be targeting of these stimulating hormones to their specific glands? If so then there would be differences between TSH level in thyroid artery, femoral artery and peripheral veins. No previous data was available concerning this question. Objectives: This study was designed to investigate the possibility of targeting the thyroid stimulating hormone towards the thyroid gland by evaluating the level of TSH in the thyroid artery and femoral artery, a peripheral vein and see if there is any difference. Methods: A cross sectional hospital based study was conducted in 2016 in the National Ribat Hospital in adult Sudanese. Blood Samples were taken from three euothyroid patients during thyroidectomy ,from the inferior thyroid artery, a peripheral vein and the femoral ...
BACKGROUND Rapid growth and invasiveness of hepatocellular carcinoma (HCC) largely depends on its... more BACKGROUND Rapid growth and invasiveness of hepatocellular carcinoma (HCC) largely depends on its vascularity and active angiogenic capacity. That feature was used to control the tumor in the past with some limitations. These deficiencies were addressed in our new procedure by hepatic artery ligation and extrahepatic collaterals division (HALED) of the liver lobe containing large HCC. This study tried to assess the feasibility, safety and the short term effects of HALED. MATERIALS AND METHODS This is a prospective stage 2a development IDEAL (Idea, Development, Exploration, Assessment and Long-term monitoring) case series. It included adult patients with large-sized HCC (diameter > 5 centimeters) subjected to HALED carried out in our center during five years` trial evaluating one-month postoperative outcomes. Patients will be reported prospectively in a sequential order with explanation of reasons for rejected cases and description of changes to technique or indication as the procedure evolved. This study registry number is NCT03129685 at the ClinicalTrials.gov. RESULTS The first HALED operation was carried out safely on 2013, followed by nineteen patients by 2018. Patients` mean age (±standard deviation) was 62·45 (±9·27), range 38 to 76 years. Eleven (55%) patients had tumors diameter > ten centimeters. 13 (65%) patients were advanced BCLC stage. Seven modifications were made on the technique and indications of the procedure towards stability. According to the modified response evaluation criteria in solid tumors, 13 patients (65%) attained complete response. Operative mortality was 5% (one patient) and major morbidity was 10% (two patients). Liver infarction and abscess formation were not noticed in this study. CONCLUSION Our forerunner study showed that HALED for large HCC is safe and induces tumor necrosis. Further long-term studies are suggested before starting the 2b stage.
Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a soc... more Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver condition that, on a societal level, results in substantial health-care costs, economic losses and reduced health-related quality of life (HRQoL) 1-8. A biologically and clinically heterogeneous disease, NAFLD covers a broad spectrum of histological conditions that increase both hepatic and non-hepatic morbidity and mortality. The majority of people living with NAFLD have isolated steatosis (non-alcoholic fatty liver, NAFL) and a smaller proportion develop non-alcoholic steatohepatitis (NASH), with increasing hepatic fibrosis leading eventually to cirrhosis, liver cancer, end-stage liver disease and death 9,10. NASH is a leading cause of progression to cirrhosis and hepatocellular carcinoma 11,12 , and an increasingly common indication for liver transplantation 13,14. Liver cancer is now the second leading cause of years of life lost among all cancers globally 15. NAFLD is part of a multisystem disease and is considered the hepatic manifestation of metabolic syndrome 16-18. Although strongly associated with obesity, NAFLD also occurs in individuals with normal weight, especially in Asian populations 19,20. The causes of death in people living with NAFLD vary depending on disease state. Patients with cirrhosis predominantly have liver-related events, whereas those without cirrhosis have vascular events and non-hepatic cancer 21. Overall, cardiovascular disease (CVD) is the leading cause of death in patients with NAFLD; other common causes include extrahepatic
Uploads
Papers by Osa Elsa