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Penetrating Abdominal Injuries: Pattern and Outcome of Management in Khartoum

International Journal of Clinical Medicine 2014年第1期5卷 18-22页

作者： maha yassin omer Aamir Abdullahi Hamza Mohammed Toum Musa Department of Surgery College of Medicine & Health Sciences Bahri University Khartoum Sudan Department of Surgery Faculty of Medicine Al Neelain University Khartoum Sudan Department of Surgery Faculty of Medicine Khartoum University Khartoum Sudan

Background: The pattern and presentation of penetrating abdominal trauma vary according to places and the structure of the present health system. As well controversies in management exist ranging from mandatory exploration to selective non-operative management. Objectives: To determine the pattern of penetrating abdominal trauma, current management practiced and outcome in Khartoum. Patients and Methods: The study was prospective, descriptive and hospital-based. It was carried out at the main three hospitals in Khartoum State. It was conducted over a period of one year from 2012 Mar to 2013 Mar. All patients who presented penetrating injury to their abdomen were included. Results: The study included 85 patients with a mean age of 28 years (SD ± 10). The male to female ratio was 11:1. Most of the patients (89.4%) were in the first four decades of their life. Twenty-three patients (27.1%) presented shock. Stab wound is the commonest mode of trauma seen in 83.5% of our patients. The majority of our patients were managed by exploratory laparotomy (81.2%), however 16 (18.8%) underwent conservative measures. Of the operated group, solid organ injuries were found in 22.9%, yet hollow viscous injuries were reported in 86.9% of the patients. Registrars operated on 78.26% of the patients. The rate of negative laparotomy of this study was 8.7%. Complications and mortality were encountered in 25.9% and 4.7% respectively. The mean hospital stay was 8.47 days (SD ± 10.6). Conclusion: This study demonstrates no difference in the pattern of intra-abdominal injuries. The rate of operative treatment is acceptable, but more laparotomies can be avoided if the haemodynamic stable patients without features of peritonitis were given a period of observation. The overall outcome was satisfactory.

关键词： Mandatory Laparotomy Mortality Non-Operative Management Penetrating Abdominal Injuries

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Incidence of Oxa23 and Oxa51 Genes Associated with Bacterial Isolated from Patients with Urosepsis: Single Centre Prespective

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American Journal of Molecular Biology 2022年第3期12卷 85-96页

作者： Salma omer Ibrahim Elimam M. A. Mohammed Sami Mahjoub Taha Sanaa Mohammed Yousif Hajir omer omer omer Mirghani Seif-Elnasr Seitelbanat yassin Yousif Abdelhameed Mohammed omer Abu Elhasan Mohamed Taj-Eldin Adam Dawoud Abakar Elhadi Abdalla Ahmed Salaheldein G. Elzaki Department of Medical Microbiology Faculty of Medical Lab Sciences University of Gezira Wad Medani Sudan Department of Urology Faculty of Medicine University of Gezira Wad Medani Sudan National Blood Bank Ministry of Health Khartoum Sudan University Hospital Galway Galway Ireland Department of Urology Gezira Hospital for Renal Disease and Surgery Wad Medani Sudan Department of Pharmaceutics Faculty of Pharmacy University of Gezira Wad Medani Sudan Department of Clinical Chemistry National Cancer Institute University of Gezira Wad Medani Sudan Department of Medical Microbiology Wad Medani College for Medical Science and Technology Wad Medani Sudan Department of Medical Parasitology Faculty of Medical Laboratory Sciences University of Gezira Wad Medani Sudan Department of Epidemiology Tropical Medicine Research Institute Khartoum Sudan

Background: Urosepsis is one of the most common infections that require empirical broad spectrum antibiotics immediately after diagnosis. This has led to development of bacterial resistance by acquiring the capability to destroy the β-lactam ring. Methodology: This is a cross-sectional hospital-based study. The study was conducted from 2019 to 2020 at Gezira Hospital for Renal diseases and surgery (GHRDS). A hundred patients were diagnosed clinically with urosepsis and the isolated organisms were Escherichia coli, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumonia and Pseudomonas aeruginosa. The susceptibility test was conducted by Kirby Bauer disc diffusion technique according to clinical laboratory standard institute (CLSI) guidelines. Seventy eight samples of bacterial genomic DNA were confirmed by 16srRNA and multiplex PCR, were performed for genotypic blaOXA-51 and blaOXA-23 gene characterization of isolated bacteria. Then gel electrophoresis was used to identify the presence or absence of (blaOXA-51 and blaOXA-23) genes. Results: 88.5% (69/78) in 16srRNA detected. Using multiplex PCR, the frequencies of blaOXA-51 and blaOXA-23 genes were 13% and 10.1%, respectively. The percentages of isolates which yielded both blaOXA-51 and blaOXA-23 among P. aeruginosa was 25% (1/4), among K. pneumonia was 17% (1/6), and among E. coli was 8% (3/37). Only blaOXA-51 was detected in P. mirabilis 10% (1/10) and only blaOXA-23 was detected in S. aureus 5% (1/18). Conclusion: In this study, the presence of blaOXA-51 and blaOXA-23 genes was increased in the isolated bacteria.

关键词： Urosepsis Carbapenem-Resistant Enterobacteriaceae (CRE) blaOXA-51 and blaOXA-23

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Urosepsis among Sudanese Patients: A Paradigm from Limited Resources Country

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Advances in Microbiology 2022年第3期12卷 109-120页

作者： Salma omer Ibrahim Mohammed Elimam Sami Mahjoub Taha Sanaa Mohammed Yousif Hajir Mohammed Hussein omer Mirghani Yousif Seitelbanat yassin Ali Elnaiem Yousif Abdelhameed Mohammed omer Abu Elhasan Adama Dawoud Abakar Elhadi Abdalla Ahmed Department of Medical Microbiology Faculty of Medical Lab Sciences University of Gezira Wad Medani Sudan Faculty of Medicine University of Gezira Wad Medani Sudan National Blood Bank Ministry of Health Khartoum Sudan Clinical Pharmacy and Pharmacy Practice Faculty of Pharmacy University of Gezira Wad Medani Sudan Department of Pharmaceutics Faculty of Pharmacy University of Gezira Wad Medani Sudan Resident at Gezira Hospital for Renal Disease and Surgery Urology (GHRDS) Wad Medani Sudan Cancer National Institute University of Gezira Wad Medani Sudan Wad Madani College for Medical Science and Technology Wad Medani Sudan Department of Medical Parasitology Faculty of Medical Laboratory Sciences University of Gezira Wad Medani Sudan

Background: Urosepsis is life-threatening sepsis that leads to organ dysfunction and results from a defective response to a urinary tract infection;the major precipitating is obstructive uropathy in the upper or lower urinary tract (UT). The magnitude and burden of bacteria that caused uropathy were reported to increase annually. In 30% of all septic patients who were diagnosed with urosepsis, 1.5% of them were found in urology and a quarter due to hospital-acquired urinary tract infections (HAUTIs). This study aims to determine the clinical pattern and the frequency of commonly used antibiotics against bacteria associated with urosepsis among Sudanese patients. Methods: This was a cross sectional laboratory-based study, study subjects were recruited from patients attended to Gezira Hospital for Renal diseases and surgery (GHRDS) and was diagnosed, on clinical and laboratory basis, to have urosepsis. Hundred (n = 100) urine samples were collected and inoculated on cysteine lactose electrolyte deficient agar (CLED) media and identify using the suitable biochemical test and performed antimicrobial susceptibility testing (AST) by Kirby Bauer disc diffusion technique for selected antimicrobial agents, according to clinical laboratory standard institute (CLSI) guidelines. Results: Amongst urosepsis infection the frequency of E. coli, S. aureus, Proteus mirabilis, Klebseilla pneumonia and Pseudomonas aeruginosa were (37%, 21%, 10%, 6%, 4% respectively). Resistance to commonly prescribed antibiotics was high, ranging from 17% for meropenem to 100% for cefepime. P. aeruginosa was multidrug resistant compared with other isolates. Conclusions: There was high rate of antibiotic resistance against the common causes of urosepsis in GHRDS, and this reflects the importance of culture and sensitivity test and necessitates adoption of guidelines for selection of suitable antibiotic.

关键词： Urosepsis Antimicrobial Susceptibility Gezira Hospital for Renal Diseases and Surgery Sudan

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Antibacterial, Antioxidant Activities and GC-MS Analysis of Dichrostachys cinera (L.) Ethanolic Leaves Extract

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Pharmacology & Pharmacy 2022年第12期13卷 545-557页

作者： Sitelbanat yassin Mohamed Abubker Anwar Mohamed Selma omer Salah Humeada Elhadi M. M. Ahmed Mirghani Abd Alrahman Department of Pharmaceutics (Pharmaceutical Microbiology) University of Gezira Wad Madani Sudan Department of Pharmaceutical Chemistry University of Gezira Wad Madani Sudan Central Laboratory University of Gezira Wad Madani Sudan Department of Microbiology Faculty of Medical Laboratory Sciences University of Gezira Wad Madani Sudan Department of Chemistry Faculty of Education West Kordofan University Kordofan Sudan Department of Pharmacognosy University of Gezira Wad Madani Sudan Medicinal and Aromatic Plants Research Center University of Gezira Wad Madani Sudan Department of Clinical Pharmacy and Pharmacy Practice University of Gezira Wad Madani Sudan

Traditional medicinal plants are one of the potential sources of antimicrobial drugs and there is a great concern in the use and development of herbal medicine for the treatment of various infections. This study aimed to evaluate the antibacterial, and antioxidant activities of Dichrostachys cinera ethanolic leaves extract and to determine the components of the crude extract. D. cinera extract was evaluated against Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa ATCC 27853. The antibacterial, antioxidant activities and active constituents were determined using standard methods. Antibacterial activity of the crude extract findings showed that all bacterial candidates were susceptible where S. aureus represent MIC at 12.5 mg/ml and MBC at 25 mg/ml, E. coli and P. aeruginosa both showed MIC 25 mg/ml and MBC 50 mg/ml. In the free radical scavenging assay of the extract and the standard quercetin at concentrations of 250 μg/ml, 125 μg/ml, 50 μg/ml, 10 μg/ml, and 5 μg/ml. The radical scavenging activity for the extract was about 92%, 89.6%, 86.8%, 82.8% and 37.8% respectively, compared to quercetin which gave 89.7%, 85.8%, 62.1%, 55.5%, and 45% radical scavenging activity. The GC-Ms analysis of the total constituents demonstrated that 1,6-Anhydro-2,4-dideoxy-.beta.-D-ribo-hexo (21.26%) with different peaks, followed by Glycerin (11.56%), 1,2,3-Cyclopentanetriol (10.18%), 8,11,14-Eicosatrienoic acid, (Z,Z,Z)-(6.18%), 1H-Pyrrole, 1-methyl-(6.08%), Phytol (5.91%) and 7-Bromo-6-(2-diethylaminoethoxy)-2,3-dihyd (5.44%) as major components in the extract. Finally, this study provided useful information on the therapeutic potential of D. cinera as an antibacterial agent and recommended to be evaluated against a wide range of Bacterial and fungal strains using different solvents and different parts from the plant.

关键词： Dichrostachys cinera Antibacterial Activity Antioxidant GC MS Analysis

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Assessment of Endometrial Carcinoma Markers and Hormone Receptors Profile before and after Bariatric Surgery: A Clinico-Pathological-Immunohistochemical Study

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Open Journal of Obstetrics and Gynecology 2019年第7期9卷 1019-1031页

作者： Walid Mohamed Elnagar Samah Said Elbasateeny Mai Mohamed Abdelwahab Mahmoud Abdou yassin Taha Abdelwahab Baiomy maha Abdelhamid Fathy Amin Dalia Abdallah El-Shafei Department of Obstetrics and Gynecology Faculty of Medicine Zagazig University Zagazig Egypt Department of Pathology Faculty of Medicine (Rabigh Branch) King Abdul Aziz University Jeddah KSA Department of Pathology Faculty of Medicine Zagazig University Zagazig Egypt Department of General Surgery Faculty of Medicine Zagazig University Zagazig Egypt Department of Physiology Faculty of Medicine Zagazig University Zagazig Egypt Department of Community Environmental & Occupational Medicine Faculty of Medicine Zagazig University Zagazig Egypt

Background: Obesity is a major risk factor for endometrial carcinoma, and we aim to assess markers of carcinogenesis including PTEN and Ki-67 and hormone receptors profile including ER, PR and AR before and after bariatric surgery to find out its effects in reducing endometrial carcinoma risk in morbid obese females. Patients and methods: The study included 80 females with morbid obesity (BMI > 40 Kg/m2) who underwent bariatric surgery. All were sampled by Pipelle biopsy at baseline and 12 months after operation and examined histopathologically and immunohistochemically for Ki-67, PTEN, ER, PR and AR. Results: Sixty two out of 80 (62/80) females showed no pathological abnormalities;4 had polyps;7 had simple endometrial hyperplasia;4 had atypical endometrial hyperplasia and 3 had endometrial carcinoma. In total, 34 females underwent gastric bypass operation (42.5%) and 46 underwent a sleeve gastrectomy operation (57.5%). There was a statistically significant difference between baseline weight and BMI before and after surgery (p < 0.001). Of the 7 women with simple hyperplasia, resolution occurred in 5 within 7 months of surgery. Three of 4 females with atypical hyperplasia (AH) showed resolution after 9 months. Mean Ki-67 score was lower at 12 months (p < 0.001) after surgery. 43/77 (55.8%) baseline biopsies were glandular PTEN null, including 9/15 of the women with baseline endometrial abnormalities, of whom 5/15 regained glandular PTEN expression as their endometrial abnormalities resolved. There was a significant reduction in ER score after surgery (p < 0.001). PR H-scores were not significantly different post-operatively (p = 0.193). AR H-scores were higher significantly in pre-operative biopsies than post-operative ones (p < 0.001). Conclusion: Females with morbid obesity have a higher risk of harboring endometrial abnormalities even if asymptomatic. However, the endometrial pathology and the high ER and PR expression can be normalized within one year without medical treatment, signifying the role of bariatri

关键词： Bariatric Surgery Obesity Endometrial Cancer Hormone Receptors

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Frequency and Antimicrobials Susceptibility Pattern of <i>Staphylococcus aureus</i>Associated with Wound Infections in Surgery Department, Wad Madani Teaching Hospital, Sudan

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Pharmacology & Pharmacy 2021年第12期12卷 334-343页

作者： Sanaa M. Yousif Adam D. Abakar Bakri Y. M. Nour Salma O. Ibrahim omer M. Abu Elhasan Mirgani A. Yousif Sitelbanat yassin Hajer M. Hussien Mohamed Taj-Eldin Elhadi A. Ahmed National Blood Bank Ministry of Health Khartoum Sudan Department of Medical Parasitology Faculty of Medical Laboratory Sciences University of Gezira Wad Medani Sudan Department of Medical Microbiology Faculty of Medical Laboratory Sciences University of Gezira Wad Medani Sudan Wad-Madani College of Medical Sciences and Technology Wad Medani Sudan Faculty of Pharmacy University of Gezira Wad Medani Sudan

Background: Most community and hospital acquired infections are due to Staphylococcus aureus, these infections involve both local suppurative and systemic conditions. There is an increase in the incidence rates of acquiring resistant strains of Staphylococcus aureus in hospitals and community in Sudan. This study aims to detect frequency of Staphylococcus aureus isolated from surgical-sites infections (SSIs) and traumatic wounds, and to determine susceptibility to commonly used drugs. Methods: Prospective cross-sectional laboratory based study was followed, 250 patients admitted to Surgery Departments at Wad Madani Teaching Hospitals during 2019 and 2020 were recruited;with clinical manifestation of SSIs and or/traumatic wounds. Swab sample was taken from each participant and incubated aerobically on mannitol salt agar. Biochemical tests and 16rRNA gene used for Staphylococcus aureus identification. Antimicrobial susceptibility was accomplished using Kirby Bauer disc diffusion technique. Results: Infection rate of wounds in males and females equal 71% (17/250) and 29% (73/250), while infection rate in the age group of 41 to 60 years was the highest with percentage of 49% (122

关键词： Staphylococcus aureus Surgical-Sites Wounds Meropeneme Sudan

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Evaluation of Bilateral Mental Nerve Block as an Alternative to General Anesthesia for Resection of Lower Lip Tumors

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Surgical Science 2017年第8期8卷 319-325页

作者： Ashraf Khater Islam A. Elzahaby Mohamed Hamdy Mohammad Zuhdy Omar Hamdy Mohamed Ezzat Mahmoud Abdelaziz Ahmad M. Farid Mansour Elmoatasem Amr Hassan Khalid Atallah Mahmoud Mostafa Saleh maha A. Abo-Zeid Amr yassin Ola Taha Abd Eldayem Mona Gad Department of Surgical Oncology Mansoura Oncology Center (OCMU) Faculty of Medicine Mansoura University Mansoura Egypt Anesthesia and Surgical Intensive Care Department Mansoura University Hospital Faculty of Medicine Mansoura University Mansoura Egypt

Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.

关键词： Mental Nerve Block Lip Tumors Lidocaine

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