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Incidence and Risk Factors of Acute Kidney Injury in ICU Patients of omdurman Teaching hospital

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Open Journal of Nephrology 2021年第1期11卷 43-57页

作者： Abdel Mumin Sid Ahmed Nusaiba Hassan Mohamed Eltahir omdurman teaching hospital Omdurman Khartoum State Sudan

Background: Acute kidney injury (AKI) is a common complication in critically ill patients and it is commonly associated with high mortality and morbidity with adverse short and long term outcome. Objectives: The main objective of this study was to determine the incidence of acute kidney injury in ICU patients in omdurman teaching hospital, and to assess the risk factors associated with the development of acute kidney injury in a critically ill patient. We also intended to find out the impact of acute kidney injury on ICU outcomes. Methods: In this descriptive prospective, cohort hospital-based study, 211 patients were studied and followed up during admission in ICU from November 2019 until July 2020 in omdurman teaching hospital. Results: 61 patients of the total 211 patients developed renal impairment during their stay in ICU. 64% (39 patients) were males and 36% (22 patients) were female, mean age was 41 ± 5, renal impairment developed after a mean of 5 days of admission and the most common cause was decreased level of consciousness and severe hypotension, sepsis accounting for 40% of the admission. The outcome in ICU showed that the mortality rate was high up to 41% in patients who developed acute kidney injury, Sepsis accounted for over 96% (24 patients) who have passed away. Conclusions: Development of AKI in ICU is an important risk factor for poor outcomes in critically setting. Prevention is the best method for avoiding AKI, with the early identification and recognition of high-risk patients.

关键词： Acute Kidney Injury ICU Risk Factors Outcome Frequency

Maternal Sepsis in Intensive Care Unit at omdurman New hospital-Tertiary Obstetric Facility, Khartoum-Sudan

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Open Journal of Obstetrics and Gynecology 2016年第11期6卷 637-645页

作者： A. Bashir Fazari E. Gailii W. Mohammed M. Abdallha M. Ali S. A. Rahman K. El Musharaf University of Medical Sciences & Technology Reproductive and Child Health Research Unit Khartoum Sudan omdurman maternity hospital Ministry of Health Khartoum Sudan Latifa hospital Dubai Health Authority Dubai UAE Royal Preston hospital Preston UK Atlantis Clinic Dubai UAE Graduate Entry Medical School University of Limerick Limerick Ireland

Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric related conditions. Objectives: It aimed to determine rate, characters, morbidity and mortality of septic obstetric cases at omdurman New hospital. Methods: It was a descriptive, prospective, analytic, cross-sectional hospital based total coverage study;conducted at omdurman New hospital (ONH), Khartoum-Sudan. Results: Sever sepsis and septic shock rate 1.16 (13/1124 = 1.16%) of hospital pregnancy complication admission. Hyperthermia, Tachycardia and hypotension are the main presenting clinical findings and uterine infection is the main focus of sepsis. The mean average Intensive Care Unit (ICU) stay is 6.3-day. Organs dysfunctions are the main morbidity and mortality is reported in five cases. Conclusion: Sever sepsis and septic shock contributes in maternal morbidity and mortality. Safe obstetric care prevents maternal sepsis and improves the outcome. Management of sever sepsis and septic shock remains a challenge in obstetric medicine.

关键词： Sever Sepsis Septic Shock Maternal Morbidity and Maternal Mortality

Frequency of Hypocalcaemia after Thyroid Surgery in the omdurman Military hospital in 2018

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Surgical Science 2023年第2期14卷 111-121页

作者： Ali Hassan Ali Ahmed Adeel Reham Abd Alhalem Hijo Khaleel Sirag Abdelazim Sirag Elnor Elwasila Mohammed Gibriel Badawi Ismail College of Medicine Karary University Omdurman Sudan University of Bahri Bahri Sudan

Background: Hypocalcaemia is a serious complication that may follows thyroid surgeries. So, the purpose of this study was to determine the frequency of postoperative hypocalcaemia after thyroid surgery in omdurman military hospital (Jan.-July 2018). Materials & Methods: In this retrospective facility based cross sectional study, 124 files were reviewed, the recorded data were age, sex, residence, diagnosis, type of surgery & postoperative calcium level, data were collected by a designed pretested checklist, data were analyzed by SPSS version 20 by using frequencies & cross tabulations, for postoperative hypocalcaemia. Results: Majority of the patients were between 21 - 41 years 49.2%, majority of them were females 83.9%. 97.6% of them underwent total thyroidectomy, 25% of the patients developed postoperative hypocalcaemia, also we found that there was no relation between sex, type of thyroid surgery & development of postoperative hypocalcaemia (P > 0.001). Conclusion: Our research showed that 25% of the patients who underwent thyroid surgery developed postoperative hypocalcaemia.

关键词： Thyroid Diseases Hypocalcaemia Thyroidectomy

Frequency and Associated Factors of Autonomic Dysfunction in Patients with Parkinson’s Disease in Khartoum State

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Advances in Parkinson's Disease 2019年第4期8卷 63-74页

作者： Abdel Mumin Sidahmed Husam A. M. Ali omdurman Teaching hospital Omdurman Sudan

Background: Autonomic dysfunction in idiopathic Parkinson disease is a frequent and disabling complication, with an estimated prevalence of 47% and has a significant impact on the patient’s quality of life. Objectives: The main objective of this study was to determine the frequency of autonomic dysfunction among Sudanese Parkinson patients and identify possible risk factors attribute to develop autonomic dysfunction and to assess the extent to which the progression of dysautonomia affects activities of daily living, health-related quality of life. Methods: In this descriptive perspective, cross-sectional hospital-based study, 51 patients were studied using standardized questionnaire including history and clinical examination. Results: A total of 51 patients have been examined: male to female ratio 1.5:1;mean age 55 ± 5 years;Parkinson disease duration, 7 ± 2 years. 47% of the patients had one or more symptoms of autonomic dysfunction with mean age 59 ± 10. Constipation and bloating were the most common symptoms where sweating abnormality was the least symptoms to observe. The symptom of autonomic dysfunction has been worse with disease progression in 50% of the patients and 47% of the patients reported that both motors and autonomic dysfunction symptoms were causing disability than autonomic dysfunction symptoms alone. Conclusions: The study demonstrates that autonomic dysfunction is not only common in Parkinson Disease, but it increases in severity with increasing disease stages. Older age with long disease duration was also considered along with advanced disease stages strong factors determining the presence of autonomic dysfunction. The study recommends that symptoms of autonomic dysfunction survey be a routine aspect of the evaluation of Parkinson disease patients, especially with advanced age.

关键词： Idiopathic Parkinson Disease Autonomic Dysfunctions Associated Factors Frequency

Relation Ship of Maternal Haemoglobin Concentration Measured in Labour with Neonatal Outcome among Sudanese Women

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Open Journal of Obstetrics and Gynecology 2021年第2期11卷 131-139页

作者： Nada Elamin Abdallah Badi Hassabelrasol Ata Almoula Nahla Idris Abdalla Idris Yassir Hamadalnil Siddig Omer M. Handady omdurman maternity hospital Khartoum Sudan Suliman Alhabib hospital Riyadh Saudi Arabia Faculty of Medicine Nile University Khartoum Sudan Faculty of Medicine Omdurman Ahlia University Khartoum Sudan

Objective: Data showed that maternal anaemia during pregnancy negatively affects maternal/fetal outcomes. We here attempted to re-confirm this in this specific region of Sudan, with special reference to fetal/neonatal outcome. Methodology: This cross-sectional observational study was carried out at Omdurman Maternity and Khartoum North Teaching Hospitals-Sudan from March 2018 to March 2019, with 246 pregnant women presented in labour enrolled. Maternal characteristics, haemoglobin (Hb) measured after labour initiation and fetal/neonatal outcomes were analyzed. Results: When maternal anemia was defined as Hb less than 10.0 g/dL, 80 (32.5%) had anemia and 166 had not. Anemic women (Hb;8.3 ± 0.31), compared with non-anemic women (Hb;11.4 ± 0.61), were significantly more likely to have low birth weight (LBW) infants (40% vs. 15.7%) and still birth (12.5% vs. 4.8%). There was a correlation between hemoglobin concentration and the followings: LBW, respiratory distress syndrome, neonatal nursery admission, still birth, early neonatal death, and low Apgar score. Conclusions: Maternal aneamia negatively affected fetal/neonatal outcomes. This data may be useful to make health policy in this area.

关键词： Maternal Hemoglobin Pregnancy Neonatal Outcome Birth Weight Apgar Score Sudanese Women

Clinical Characteristics and Current Medical Practice in a Group of Sudanese Patients with Epilepsy: A Cross Sectional hospital Based-Study

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Case Reports in Clinical Medicine 2021年第10期10卷 264-276页

作者： Muaz Elsayed Mohamed Issa Ibrahim Mahmoud Sarah Imam College of Medicine Omdurman Islamic University Omdurman Khartoum Sudan omdurman Teaching hospital Omdurman Khartoum Sudan College of Medicine University of Sharjah Sharjah UAE University hospital of Sharjah Sharjah UAE

Introduction: The epilepsy classification in under developed countries faces many difficulties in reporting, work-up and management strategies. Exploring local practice in general hospitals will positively add to the welfare of patients with epilepsy. The objectives of this study were to assess the current medical practice in epilepsy work up and to study the selection of AEDs as per ILAE guidelines. Methods: This was a cross sectional-retrospective hospital based study, conducted between April and September 2016 in omdurman Teaching hospital, Khartoum, Sudan. Patients aged 18 years old and above were enrolled. Epilepsy was defined as having at least two non-provoked seizures in the least 6 months in a patient who was assessed by clinical review and electroencephalogram (EEG). Epilepsy was classified as generalized, focal or unclassified. Medications refer to all internationally licensed antiepileptic medications (AEDs) in 2016. Results: One hundred adult Sudanese patients were enrolled for this study. The most common event described during the ictal phase was tongue biting in 50% of participants followed by body stiffness in 46%. Epilepsy was classified as generalized in 84%, focal in 11% and unclassified in 5% patients. In generalized epilepsy, the MRI detected 23.3% abnormal findings higher than the CT which detected 14.8% (4/27), p value = 0.032. In focal epilepsy, the CT detected 75% abnormal findings higher than the MRI which detected 33.3%, p value = 0.02. The AEDs used were as follows: Carbamazepine (CBZ) 48%, Na valproate (VP) 33%, Lamotrigine (LMT) 2%, Levetricetan (LVT) 1%, CBZ + VP 14% and CBZ + Oxcarbazepine (OXC) 2%. Conclusion: The current medical practice in omdurman teaching hospital should be modified to match the international league against epilepsy (ILAE) guidelines in workup, management, AEDs selection and classification of epilepsy.

关键词： Anti-Epileptic Drugs EEG Epilepsy Sudan

Florid Autonomic Features Associated with Medullary Lacunar Stroke

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International Journal of Clinical Medicine 2022年第12期13卷 679-690页

作者： Muaz Elsayed Akram Harazeen Asma Shams Pournamy Sarathchandran Feras Alrawi Tayseer Zain Samia Noor Department of Neurology Al Qassemi Hospital (EHS) Emirates Health Services Sharjah UAE Faculty of Medicine and Health Sciences Omdurman Islamic University Omdurman Sudan

Introduction: Autonomic nuclei affection results in variations in hemodynamics, temperature, sweating and ECG. Medullary strokes are challenging in their presentation, bizarre clinical signs, work and neurological outcome. The commonest cause is infarction of the posterior inferior cerebellar artery (PICA). Anatomical areas affected include the inferior cerebellar peduncle, dorsolateral medulla, nuclei of the Trigeminal, vestibular nuclei, Ninth and Vagus nerves. The descending sympathetic tracts and spin thalamic tracts. Serious cardiopulmonary events can complicate 11% of cases. Case Presentation: A middle-aged female developed sub-acute dizziness associated with vomiting and right head pains. She was unable to walk but remained cognitively clear. Her gastrointestinal symptoms were disabling and this was the main factor for presenting to the emergency room. The risk factors included hypertension and diabetes mellitus. Imaging studies were essential for posterior circulation stroke diagnosis and follow-up. She manifested remarkable autonomic features regarding the skin and hemodynamics. Nevertheless, the hospital course was controllable. Discussion: This case report was consistent with relevant literature in the contra lateral vaso motor changes and drop in body temperature during the acute phase. Moreover, our patient developed clinical and radiological extension through double antiplatelets. Superiority of the magnetic resonance imaging (MRI) scans in this patient enabled better diagnostic accuracy in a brainstem stroke. Conclusion: The autonomic features, in this case, represent major symptomatology and clinical signs. The variation in the hemodynamics and persistence of symptoms is thought provoking. This increases the awareness of emergency doctors for acute stroke presenting with autonomic features will enable early detection and helps outcome.

关键词： Autonomic Medullary Infarction Wallenberg’s Syndrome Brainstem Stroke

Hematological picture of pediatric Sudanese patients with visceral leishmaniasis and prediction of leishmania donovani parasite load

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World Journal of Clinical Cases 2024年第30期12卷 6374-6382页

作者： Zeinab Ibrahim Ahmed Elnoor Omaima Abdelmajeed Alamin Mustafa Thuraya Gasim Shima Algam Mohamed Musa Abdelrahman Hamza Abdelmoneim Islamia Ibrahim Ahmed Omer Hiba Awadelkareem Osman Fadl Department of Pathology Faculty of MedicineOmdurman Ahilia UniversityOmdurmanKhartoumSudan Mohammed Alamin Hamid Pediatric hospital Omdurman KhartoumSudan Department of Hematology and Blood Transfusion Medicine Federal Ministry of HealthKhartoumSudan Department of Pediatrics Faculty of MedicineOmdurman Islamic UniversityOmdurmanKhartoumSudan Tropical Diseases Teaching hospital OmdurmanKhartoumSudan Faculty of Medicine Al-Neelain UniversityKhartoumSudan Faculty of Medicine Omdurman Islamic UniversityOmdurmanKhartoumSudan Department of Pediatrics Faculty of MedicineUniversity of Science and TechnologyKhartoumSudan Department of Hematology Faculty of Medical Laboratory SciencesAl-Neelain UniversityKhartoumSudan

BACKGROUND Visceral leishmaniasis(VL)is a systemic protozoan infection caused by Leishmania donovani(***)and transmitted by sand flies,causing macrophage invasion in the liver,spleen,and bone *** of VL is currently based on clinical signs,symptoms,and specific in-vitro markers and bone marrow ***,VL's specific hematological and bone marrow manifestation in Sudanese pediatric patients is not well *** To examine the blood and bone marrow characteristics in pediatric patients from Sudan who have *** This is a retrospective hospital-based study with a sample of 107 consecutive Sudanese pediatric *** data focused on hematological and bone marrow *** included only the completed records of the pediatric patients with VL in the Tropical Disease Teaching hospital in Khartoum,Sudan from the period of 2016 to *** The majority of pediatric patients included in this study are below 5-years-old(n=59,55.2%).Moreover,anemia,thrombocytopenia,and leukopenia were among the prevalent characteristics in the population under *** further analyze the data,we developed a machine learning model using boosted forest algorithms to predict *** parasites load,with a mean accuracy of 0.88 for the training dataset and an accuracy of 0.46,0.50,and 0.74 for mild,moderate,and severe *** parasite load in the validation *** This study shows that the most common bone marrow change among Sudanese VL children was increased chronic inflammatory cells(n=88,82.2%)with present macrophage hemophagocytes(n=103,96.3%).While anemia and thrombocytopenia were the most common hematological *** results will hopefully lead to an early diagnosis and hence better management for Sudanese pediatric patients with suspected VL.

关键词： Machine learning Bone marrow Hematological changes Tropical diseases Leishmania donovani Visceral leishmaniasis

Trichomoniasis in Pregnant Sudanese Pregnant Women at Tertiary Obstetric Facility, Khartoum, Sudan

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Open Journal of Obstetrics and Gynecology 2016年第9期6卷 539-543页

作者： Hanan A. O. Abd Allha A. Fazari Khalid Y. M. Ahmed Reproductive and Child Health Research Unit University of Medical Sciences & Technology Khartoum Sudan omdurman maternity hospital Ministry of Health Khartoum Sudan Latifa hospital Dubai Health Authority Dubai UAE Faculty of Medicine Alnileen University Khartoum Sudan

Background: Trichomoniasis is a common Sexually Transmitted Disease (STD) and the most common curable one. Methodology: This was cross sectional, prospective, total coverage hospital based study. It aimed to determine the incidence, risk factors of the Trichomoniasis among the laboring Sudanese women at omdurman New hospital Khartoum-Sudan, from September 2012 to April 2013. Data were obtained, entered and analyzed using soft word package program for social science (SPSS) version 17. Results: The prevalence of Trichomoniasis is 6.8%. It was found that the awareness about the infection is very low only 35%. Diabetes and history of sexual transmitted infections are the risks seen among the study cases. Preterm labor was seen significantly. Conclusion: Syndromic management of all women with abnormal vaginal discharge is important since it causes reproductive morbidity.

关键词： Trichomoniasis Low Birth Weight Preterm Labor