Hospitals In Khartoum Research Articles

Significance of platelet count and platelet indices in patients with some thrombocytopenic conditions

Background: Thrombocytopenia is one of the most frequent causes for hematologic consultation in the practice of medicine and can result from a wide variety of conditions. Objective: The study was conducted on behave of platelets count in tie with platelet volume indices to measure their consistency. Methods: The study was “prospective cross-sectional hospital based design” and conducted at Khartoum hospitals (A.Gasim, Jafar I A, and R.ICK). Studied populations texture has stipulated concurred diagnosis of heart disorders (HD), lymphoid neoplasms (LN), hypoplastic bone marrow (HPB), renal transplantation (RT), patients under chemotherapy (CT), and fully checked healthy Sudanese population (HSP). Platelet (PLT) count and platelet volume index (PVI) were measured using automated method of Sysmex KX-21N and the data was analyzed using SPSS. Results: does established (24) mean and standard for the study population among which (HSP) was platelet distribution width (PDW) (11.4±1.5 fl), mean platelet volume (MPV) (9.3±0.8 fl), platelet large cell ratio (PLCR) (20.6±6.7%) and PLT count (245±45 X109/L), and established correlations between PLT count and PVI in thrombocytopenic conditions. Conclusion: we conclude that, PVI has the ability to change from normal to higher or lower than (HSP) in thrombocytopenic conditions and Sudanese has PVI mean lower than the mean of reference range, and there are inverse and reverse correlations between PLT count and PVI but not in (HSP) and reverse correlation in between PVI except between PDW and P-LCR in (HPB)

Epidemiology of Pregnancy- Associated Cerebral Venous Thrombosis (CVT) in Three Referral Hospitals in Khartoum, Sudan

Epidemiology of Pregnancy- Associated Cerebral Venous Thrombosis (CVT) in Three Referral Hospitals in Khartoum, Sudan

Maternal and Umbilical Cord Blood Levels of Zinc and Copper in Active Labor Versus Elective Caesarean Delivery at Khartoum Hospital, Sudan.

A case-control study was conducted in Khartoum Hospital Sudan to determine maternal and umbilical cord blood levels of zinc and copper in active labor versus elective cesarean delivery. Cases were women delivered vaginally and controls were women delivered by elective cesarean (before initiation of labor). Paired maternal and cord zinc and copper were measured using atomic absorption spectrophotometry. The two groups (52 paired maternal and cord in each arm) were well matched in their basic characteristics. In comparison with cesarean delivery, the median (interquartile range) of both maternal [87.0 (76.1-111.4) vs. 76.1 (65.2-88.3) μg/dL, P=0.004] and cord zinc [97.8 (87.0-114.1) vs. 81.5(65.2-110.2) μg/dL P=0.034] levels were significantly higher in the vaginal delivery. While there was no significant difference in the maternal copper [78.8 (48.1-106.1) vs. 92.4 (51.9-114.9) μg/dL, P=0.759], the cord copper [43.5(29.9-76.1) vs. 32.2(21.7-49.6) μg/dL, P=0.019] level was significantly higher in vaginal delivery. There was no significant correlation between zinc (both maternal and cord) and copper. While the cord zinc was significantly correlated with maternal zinc, there was no significant correlation between maternal and cord copper. The current study showed significantly higher levels of maternal and cord zinc and cord copper in women who delivered vaginally compared with caesarean delivery.

Urinary tract infections and antimicrobial sensitivity among diabetic patients at Khartoum, Sudan.

BackgroundPatients with diabetes mellitus (DM) are more susceptible to urinary tract infection (UTI) than non-diabetics. Due to the emergence of multidrug resistant (MDR) uropathogenic strains, the choice of antimicrobial agent is restricted. This study investigated the epidemiology of UTI, antimicrobial susceptibility, and resistance patterns of bacterial isolates from adult diabetic patients.MethodsA cross-sectional study was conducted at Khartoum Hospital, Sudan during the period of March − September 2013. Consecutive patients (men and women) were approached to participate in the study, irrespective of UTI symptoms. Socio-demographic and clinical data were obtained from each participant using pre-tested questionnaires. Clean-catch, midstream urine samples were collected and cultured for UTI diagnosis and antimicrobial susceptibility. Symptomatic bacteriuria was defined as a positive urine culture (≥105 colony-forming units [CFU]/mL of a single bacterial species) from patients with symptoms associated with UTI; asymptomatic bacteriuria was defined as a positive urine culture from patients without symptoms associated with UTI.ResultsA total of 200 diabetic patients were enrolled, 121 (60.5%) men and 79 (39.5%) women; 193 (96.5%) had type II DM. The overall prevalence of UTI was 39 (19.5%). Among the total population, 17.1% and 20.9% had symptomatic and asymptomatic bacteriuria, respectively. According to multivariate logistic regression, none of the investigated factors (age, sex, type of DM and duration) were associated with UTI. The predominant isolates were Escherichia coli (22, [56.4%]), and Klebsiella pneumoniae, [9, (23%)]. Eight of 22 E. coli, four of nine K. pneumoniae and one of five Enterococcus faecalis isolates originated from symptomatic patients. Six, four, three, and two of 22 E. coli isolates showed resistance to ampicillin, co-trimoxazole, nitrofurantoin, and amoxicillin-clavulanic acid, respectively. Two, two, one and one of nine K. pneumoniae isolates were resistant to ampicillin, co-trimoxazole, cephalexin, and amoxicillin-clavulanic acid. All 22 E. coli isolates were sensitive (100%) to gentamicin and cephalexin. All nine K. pneumoniae were sensitive to gentamicin (100%) and 88.8% were sensitive to cephalexin.ConclusionIn Sudan, about one-fifth of diabetic patients have UTI. E. coli is the most frequent isolate followed by K. pneumoniae.

Prevalence and Resistance Profile of Acinetobacter baumannii Clinical Isolates from a Private Hospital in Khartoum, Sudan

Introduction: Acinetobacter baumannii is an important cause of nosocomial infections worldwide. It is difficult to control, and the infections caused by it are difficult to treat, because it is multidrug resistant. Objectives: This retrospective study was conducted to determine the prevalence and antibiotic resistance pattern of A. baumannii at Royal Care International Hospital, Khartoum, Sudan over a 37 month period. Methodology: Antimicrobial susceptibility testing of the isolates was performed by the disk diffusion method as recommended by Clinical Laboratory and Standards Institute CLSI [1]. Result: Non duplicate 275 A. baumannii were isolated out of a total 2899 pathogenic Gram negative isolates (9.5% prevalence). The most frequently isolated A. baumannii was from ICU patients (72%) followed by inpatients (24%) and outpatients (4%). The greatest number of isolates were recovered from sputum (61%) followed by wound (19%). The Resistance rates were higher than most of the internationally reported levels. Cephalosporins, aminoglycoside, aztreonam, fluoroquinolones and carbapenems are becoming practically ineffective, where the colistin elicited the highest susceptibility levels. Conclusion: This report shows for the first time (to our knowledge) the prevalence and resistance profile of A. baumannii in Sudan. The prevalence will help to conduct better infection control policy, and an update the local antibiogram will improve the knowledge of antimicrobial resistance patterns in our region.

Detection and Molecular Characterization of Respiratory Syncytial Virus (RSV) in Children with Respiratory Signs in Khartoum State, Sudan 2011-2012

Background: The present study was to investigate the incidence of the respiratory syncytial virus infection in children and to characterize the RSV circulating in Khartoum state during 2011-12 winter seasons. Methodology: Throat swab specimens collected from 224 children less than 5 years old, with respiratory tract infections admitted at Khartoum Hospitals in winter season (2011- 2012), were screened for RSV using direct immunofluorescence assay (DFA) and reverse transcription- polymerase chain reaction (RT-PCR). Isolation in cell culture followed by nucleotide sequencing and bioinformatics analysis based on the G gene, were done for the RT- PCR positive RSV samples. Results: Out of 224 patients, RSV infections were detected in 136 (60.7%) patients, by using DFA technique, and 44 (19.6%) patients using RT-PCR. 22 strains of RSV were isolated in Hep-2 cell line. The clinical symptoms including Bronchiolitis, Pneumonia, Asthma and Allergy showed significantly different rates (p<0.05) in having RSV infection, (P-value = 0.017, 0.002, 0.0001, 0.0001) respectively. Bioinformatics analysis of nucleotide sequences of 7 cell culture isolated RSV strains revealed that all analyzed RSV belonged to the RSV-A genotype. Phylogenetic tree of RSV-A sequences showed that, all Sudanese strains were grouped with strains from Belgium and Saudi Arabia. Conclusions: This is the first report on molecular characterization that describes the circulation of RSV genotype in Sudan. DFA and RT-PCR offers rapid methods for detection of RSV in hospitalized children with Respiratory tract infection (RTI).

Knowledge, Attitude and Practice of Doctors and Nurses towards Health Education Activities and Life Style Changes in Khartoum Teaching Hospital Khartoum Sudan

Knowledge, Attitude and Practice of Doctors and Nurses towards Health Education Activities and Life Style Changes in Khartoum Teaching Hospital Khartoum Sudan

Evaluation of Different Thromboplastins and Coagulometers on International Normalize Ratio (INR) Readings for Patients under Stable Oral Anticoagulant Therapy

Background: Variations between various thromboplastin preparations have in the past led to decreased accuracy of INR readings. Because thromboplastin reagents vary widely in composition and manner of preparation, their sensitivity in monitoring oral anticoagulant therapy also vary widely. This study aimed to evaluate different thromboplastins and coagulometers on INR reading for patients under stable oral anticoagulant therapy. Materials and Methods: This was descriptive cross-sectional study; it was conducted in three hospitals (Alshaab teaching hospital, Khartoum teaching hospital, and Turkish hospital). A total of 50 citrated platelets poor plasma samples were collected from 50 Sudanese patients under stable oral anticoagulant therapy then prothrombin time (PT) and INR measurements were performed on three separated laboratories, using different coagulometers and thromboplastins reagents. Results: INR results showed that there was significant difference between INR of the three laboratories (P value=0.00), inspite of there was significant difference observed between INR in Khartoum hospital and Alshaab hospital, also between Alshaab and Turkish hospital (p-value=0.00). There was insignificant difference between INR in Khartoum hospital and Trukish hospital (p-value=0.178). Discussion and Conclusion: our investigation showed that some further efforts are needed to achieve harmonization of INR results among different laboratories because variation would most probably induce the clinician to make a change in warfarin dose. Standardization of instruments, reagents, and controls is warranted to decrease this variation.

Clinical interactions of honey with antidiabetic drugs among some Sudanese diabetic patients in Khartoum, 2013

Background: The aim of the study was to assess the possible interactions of honey with anti-diabetic drugs used by the Sudanese diabetic patients attending two main hospitals in Khartoum, Sudan. Methods: The study was two month, cross-sectional, hospital-based study, during the period from April to May, 2013. Results: 260 of diabetic patients were chosen and only 68 were enrolled in the study, 32 (47.1%) were male and 36 (52.9%) females, the majority were elderly 32(47%), the patients were from different tribes and different areas. The majority of the patients were from Khartoum 24 (35.2%) and central Sudan 23 (33.8%), 51 (75%)of the patients were clinically diagnosed with type 2 diabetes mellitus, Hypertension as complication was found in 39.7% of the patients whilst 39.7% were without complications. Conclusions: The use of the honey concurrently with anti-diabetic drugs was with significant positive effect. Our findings revealed that, the illiterate and university patients' represent the majority regarding the honey utilization. The majority of respondents use honey according to their own knowledge and did not inform her/his doctors.

Importance of dental records in forensic dental identification.

Introduction:The patient’s record maintains all the diagnostic information with regards to patients and contains valuable information that can be beneficial to the dentist as well as legal authorities during forensic human identification.Aim:Objective of the study was to compare dental records with an ideal dental record form, as well as to compare between dental records of private clinics and academic hospitals and to assess the awareness and the knowledge of the dentists regarding the maintenance of their dental records accurate for medico-legal purposes.Material and Methods:A comparative cross-sectional study between records kept in private clinics and academic teaching hospitals in Khartoum locality.Results:Our results showed that Students are more likely to encounter accurate dental records more than dentists in private clinics. In conclusion Students are more aware regarding medicolegal purposes of maintenance of dental records. Accurate maintenance of dental records is more among dental students. Therefore, private clinics encounter dental records as financial documents.

Assessment of biometry and keratometry in low and high degrees of myopia

Purpose: To investigate the possible ocular biometric and keratometric changes in low and high degrees of simple myopia. Subjects of Methods: A sample of 60 myopic subjects their ages between 10 and 30 years recruited from the Makkah Eye Hospital in Khartoum. In this sample, 30 subjects with myopia 6.00 D. Auto keratometry and A-scan biometry were measured from two eyes of each subject. Results: Subjects with high myopia have longer axial length (AL) (P Conclusion: Like previous studies myopia mainly develops with increases in AL of the eye rather than optical changes in cornea or lens.

Epidemiology of Cardiac Disease during Pregnancy in Khartoum Hospital, Sudan

Data was collected prospectively during the period of May 2011-through December 2012 at Khartoum Teaching Hospital from 75 pregnant women with heart diseases to investigate the epidemiology of cardiac disease in pregnancy. Means and proportions were calculated using student and X2 test, respectively. Univariate and multivariate analyses were performed, confidence intervals of 95% were calculated and P<0.05 was considered significant. With regard to classification of the cardiac disease, 60%, 26.7% and 13.3% was rheumatic heart disease, congenital heart disease and other acquired heart disease respectively. Ten cases were ended with therapeutic and spontaneous miscarriage and 65 cases reached viability. The reported medical problems that complicated the pregnancy of our patients included: congestive heart failure (14/75, 18.6%), arrhythmias (6/75, 8%), pulmonary embolism (4/75, 5.3%) and pulmonary oedema (2/75, 2.6%). There were two cases of maternal mortality (2.7%). In this study maternal cardiac complication were more common among women with past medical history of cardiac complication (OR=1.0; CI=, 1.0-1.0; P =0.023), NYHA class III & IV at booking (OR=15.9; CI=, 2.8-38; P =0.000), mitral stenosis without other valvular lesion (OR=5.3; CI=, 1.0-25.1; P =0.021), cardiomyopathy (OR=10; CI=, 1.1-88.6; P =0.036) and those without preconception counselling (OR=2.4; CI=, 1.3-4.2; P =0.002). Cardiac surgery prior to pregnancy did not guarantee a complication-free course in subsequent pregnancies. Thus Rheumatic heart disease is the most dominant aetiology of heart disease during pregnancy in Sudan. Cardiac surgery prior to pregnancy is not a grantee for pregnancy free complication.

Sonographic Evaluation of Obstructive Jaundice

Purpose: This study was done to assess the role of ultrasound in diagnosis of obstructive jaundice and to identify the most common causes and symptoms. Materials and methods: The study took place in different Khartoum clinical centers and hospitals in the period between Jan 2014 and July 2014. A total of 150 patients with obstructive jaundice were examined using ultrasound machine, 3.5 - 7 MHz probe. Results: The study revealed that 65.33 of the study population with obstructive jaundice were female and 34.67% was male. The most common affected groups were 46 - 65 years old and 25 - 45 years old. The common causes of obstructive jaundice were biliary stones (61.33%) which were common in females and abdominal masses (32.67%) which were common in females, too. Nausea, yellowish discoloration and abdominal pain were the most common symptoms (98%, 97.33% and 96.67% respectively). The causes of obstructive jaundice showed significant difference between males and females (P-value = 0.002). Conclusion: Ultrasound was superior diagnostic tool in detecting and assessing biliary system obstruction, because it was easy, available, accurate and noninvasive. The ageing and gender were considered as risk factors of obstructive jaundice.

Obstetric and gynecologic admissions to the intensive care unit at Khartoum Hospital, Sudan

Obstetric and gynecologic admissions to the intensive care unit at Khartoum Hospital, Sudan

Improved Detection of Mycobacterium tuberculosis in Sudanese Children by use of Insertion Sequence IS6110

This study was carried out in Khartoum state during the period from January 2010 to December 2013 to detect Mycobacterium tuberculosis in children with symptoms of tuberculosis infection using different conventional and advanced diagnostic techniques. One hundred ninety seven specimens of gastric lavage and sputum were collected from different hospital in Khartoum state.specimens were decontaminated and inoculated on Lowenstein Jensen media according to modified Pettrof’s method, two smears were prepared and stained by Ziehl Neelsen stainbacterial DNA was extracted from each specimen by using phenol chloroform method, and then the Polymerase Chain Reaction technique was adopted to detect Insertion Sequence IS6110 gene of M. tuberculosisin in these specimens. This study showed that the positive results for ZN, Culture and PCR were 16 (8.1%), 32 (16.2%) and 35(17.8%) respectively. The study concluded that the PCR technique is a most sensitive and specific technique for a fast identification of M. tuberculosis in gastric lavage and sputum from children who are unable to expectorate good quality sputum sample or diagnosed as negative using conventional diagnostic methods.

Poor adherence to the World Health Organization guidelines of treatment of severe pneumonia in children at Khartoum, Sudan.

BackgroundCommunity-acquired pneumonia (CAP) is as a major cause for childhood morbidity and mortality worldwide. This study was conducted to investigate the adherence and response of the WHO guidelines for treatment of severe pneumonia.MethodA cross-sectional study was conducted in the period of June 2009 to July 2010 at Khartoum Hospital, Sudan. Children admitted and treated for severe pneumonia were enrolled.ResultsOnly 39 (18.8%) out of 208 enrolled children received prescriptions that were adherent to the WHO guidelines of treatment of severe pneumonia. In logistic regression none of the investigated variable (age, gender, and clinical presentations) was associated with the adherence to the WHO guidelines. There was no significant difference in the response between adherent and non-adherent prescriptions. There was no association between the demographic, clinical data, treatment-adherence to the guidelines and the patients’ response.ConclusionThere is a poor (18.8%) adherence to the WHO guidelines of the treatment of severe pneumonia in the region regardless to the age, gender and clinical presentation.

Antenatal iron and folic acid supplementation use by pregnant women in Khartoum, Sudan.

BackgroundAnaemia during pregnancy can lead to adverse maternal and perinatal outcomes. The WHO recommends that all pregnant women in areas where anaemia is prevalent receive supplements of iron and folic acid. However, due to many factors, the use of iron and folic acid supplementation is still low in many countries. This study was conducted to assess the rates of iron-folic supplementation and the associated factors during pregnancy and the effects of taking iron-folic acid supplementation on rates of maternal anaemia and low birth weight (LBW) infants.MethodsA cross-sectional study was conducted at Khartoum Hospital, Sudan. Enrolled women answered a questionnaire on socio-demographics characteristics, their pregnancy and delivery.ResultsOf 856 women, 788 (92.1%) used iron-folic acid supplementation during pregnancy and 65.4% used folic acid. While place of residence, occupation and level of education were not associated with iron-folic acid usage, older age (OR = 3, CI = 1.4–6.3) and use of antenatal care (OR = 14.3, CI = 7.4–27.5) were associated with iron-folic acid use. Primiparity (OR = 3.8, CI = 1.9–7.6), maternal employment (OR = 3.9, CI = 2.25–6.77) and use of antenatal care (OR = 7.9, CI = 4.1–15) were the factors associated with folic acid. Using iron-folic acid was protective against anaemia (OR = 0.39, CI = 0.2–0.7) and LBW infants (OR = 0.3, CI = 0.17–0.68).ConclusionThere was a high rate of iron-folic acid supplementation use among pregnant women in Khartoum, Sudan, which was beneficial in preventing anaemia in expectant mothers and infants of LBW.

Urinary cystine calculi and detection of polymorphism in the SLC3A1 gene in Sudanese children

Abstract Objectives To investigate polymorphism in exon 8 of the SLC 3 A 1 gene in children with urinary cystine calculi in Khartoum. Methods A semi-quantitative chemical method was used to analyse 175 urinary calculi removed surgically from paediatric patients at Soba Teaching Hospital in Khartoum between October 2005 and May 2009. DNA was extracted with phenol chloroform isoamyl alcohol, and exon 8 of the SLC 3 A 1 gene was amplified in a thermocycler and sequenced with an AB3130 genetic autoanalyser. Results Of the 175 stones, 10 were cystine calculi (5.7%). The sex ratio of the patients was 2.3:1 (boys to girls), and the mean age at cystine stone onset was 31.1 ± 28.2 months (range, 3–125 months). Of the 10 patients, 8 had a positive family history of calculi formation, 4 had bilateral calculi, 3 had both renal and urinary bladder calculi, and 2 had obstructive acute renal failure. All patients required more than one surgical operation. One patient had a missense mutation M467K in exon 8 of the SLC 3 A 1 gene. Conclusion The prevalence of cystine calculi among urinary calculi in Sudanese children was 5.7%. A family history was found in 80% of children. A mutation ( M467T ) was identified at exon 8 of the SLC 3 A 1 gene in one child.

Case management of childhood tuberculosis in children's hospitals in Khartoum

No published information is available on the case management of childhood tuberculosis (TB) in Sudan. The aim of this study was to describe the case management of childhood TB in 4 children's hospitals in Khartoum State, Sudan. Data on 467 children aged 0-14 years registered in 2009 were collected from patient records; 52.9% males and 53.0% aged 5-14 years. Most cases were registered as new cases (89.5%) and most had pulmonary TB (72.4%). Of all cases, 31.0% had sputum smear microscopy done, 35.8% had X-ray and none had a record of being culture confirmed. Category III regimen was given to 58.5%. Reported outcomes were: cured (1.5%), completed treatment (14.6%), transferred out (13.1%), default (17.3%), death (4.3%) and treatment failure (0.6%). Age was significantly associated with treatment outcome, while sex, type of patient, site of TB and treatment category were not significant. Case management of childhood TB is suboptimal in this region.

Sero-prevalence of Toxoplasma gondii infection among pregnant women attending antenatal clinics in Khartoum and Omdurman Maternity Hospitals, Sudan

Objective: To determine the sero-prevalence of Toxoplasma gondii (T. gondii) infection among pregnant Sudanese women. Methods: One hundred and sixty three pregnant women attending antenatal care in Omdurman Maternity Hospitals, Khartoum, Sudan during June to August in 2013 were enrolled and screened for immunoglobulin G (IgG) and IgM antitoxoplasma antibodies using enzyme linked immunosorbent assay technique. Results: Among 163 pregnant women, 33 (20.2%) were positive for (IgG) antitoxoplasma antibodies, while 130 (79.8%) were seronegative. None of the examined women had IgM antitoxoplasma antibodies. The highest rate of infection (26.7 %) was detected among women aged 21-29 years. No statistically significant relation was observed between T. gondii sero-prevalence and the other variable of risk factors studied. Conclusions: Over 79% Sudanese women screened for antitoxoplasma IgG antibodies were seronegative and they were at risk of seroconversion during pregnancy. Moreover, the study showed that screening of T. gondii infections during antenatal care should be considered in Khartoum state as the main strategy to minimize congenital toxoplasmosis.