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Table of Contents
January-March 2014
Volume 9 | Issue 1
Page Nos. 1-51
Online since Thursday, November 13, 2014
Accessed 17,401 times.
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ORIGINAL ARTICLES
Knee joint diseases diagnosed by ultrasound and magnetic resonance imaging
p. 1
Elgeili Adam Yousif, Bushra Hussien Ahmed, Alsafi Ahmed Abdella, Qurashi Mohammed Ali
DOI
:10.4103/1858-5000.144640
Introduction:
A great number of people all over the world suffer from knee joint problems. The benefits of ultrasound (US) when compared to magnetic resonance imaging (MRI) are that the US is noninvasive, freely available, well-accepted by patients, cheap and that it has the advantage of dynamic evaluation and real-time imaging. In this study, there is a comparison between uUS and MRI in characterization of knee joint diseases using.
Materials and Methods:
This is an observational cross-sectional study of 200 patients, who attended the Radiological Center, College of Applied Medical Sciences, King Khalid University, Saudi Arabia, from October 2011 to August 2013. The US technique has been carried out according to the protocol of American Institute of Ultrasound in Medicine, using a linear probe transducer with high frequency 7.5-12 MHz.
Results:
The range of the patients' age was 12-80 years. The most common presenting symptoms were painful swelling of the knee joint and inability to move. In 125 of them US and MRI revealed variable diseases: Effusion (81), loose body (2), synovial cyst (4), quadriceps tendon rupture (1), meniscus tear (6), tumor (1) bursitis (8), arthritis (5), baker cyst (4) deep vein thrombosis (3) diagnosed with both US and MRI, and anterior cruciate ligament tear (6), posterior cruciate ligament tear (4) seen with MRI only.
Conclusion and Recommendations:
The study suggested that US can evaluate cystic lesions, as well as menisci, ligaments, tendons, and muscles tear. Most of the knee joint disorders were degenerative in origin. Since MRI is not easily available in developing countries and rural areas. US can be used routinely for the diagnoses of most knee joint diseases, shortening the list of MRI indications.
Introduction:
A great number of people all over the world suffer from knee joint problems. The benefits of ultrasound (US) when compared to magnetic resonance imaging (MRI) are that the US is noninvasive, freely available, well-accepted by patients, cheap and that it has the advantage of dynamic evaluation and real-time imaging. In this study, there is a comparison between uUS and MRI in characterization of knee joint diseases using.
Materials and Methods:
This is an observational cross-sectional study of 200 patients, who attended the Radiological Center, College of Applied Medical Sciences, King Khalid University, Saudi Arabia, from October 2011 to August 2013. The US technique has been carried out according to the protocol of American Institute of Ultrasound in Medicine, using a linear probe transducer with high frequency 7.5-12 MHz.
Results:
The range of the patients' age was 12-80 years. The most common presenting symptoms were painful swelling of the knee joint and inability to move. In 125 of them US and MRI revealed variable diseases: Effusion (81), loose body (2), synovial cyst (4), quadriceps tendon rupture (1), meniscus tear (6), tumor (1) bursitis (8), arthritis (5), baker cyst (4) deep vein thrombosis (3) diagnosed with both US and MRI, and anterior cruciate ligament tear (6), posterior cruciate ligament tear (4) seen with MRI only.
Conclusion and Recommendations:
The study suggested that US can evaluate cystic lesions, as well as menisci, ligaments, tendons, and muscles tear. Most of the knee joint disorders were degenerative in origin. Since MRI is not easily available in developing countries and rural areas. US can be used routinely for the diagnoses of most knee joint diseases, shortening the list of MRI indications.
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Assessment of field size on radiotherapy machines using texture analysis
p. 5
Yousif M.Y. Abdallah, Menas A Boshara
DOI
:10.4103/1858-5000.144642
The main objective of this study was to verify the superimposition of light and radiation field automatically using image processing technique. For radiotherapy machines (Co-60 and linear accelerator), each film scanned using digitizer scanner then treat using image processing program MatLab, where the congruence of the light and radiation field should be determined. The scanned image saved in a TIFF file format to preserve the quality of the image. The data analyzed include upper, lower, right, and left borders of the light and radiation field in megavoltage films. The result showed that the mean light field size was 10.0 × 10.1 cm, medical physicist score was 10.2 ± 0.11608 cm × 10.2 ± 0.099861 cm, and the field size that calculated by computerized score using MatLab program was 9.9 ± 0.36049 cm × 9.9 ± 0.1123 cm, the result also showed that the computerized score is more accurate in determining of borders and penumbra than medical physicist score.
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Surgical management of male breast cancer patients referred to the national cancer institute: University of Gezira; the forgotten lesson
p. 11
Ahmed M Elhaj, Ahmed A Alshaikh, Dafalla O Abuidris, Algaylani A Eltayeb
DOI
:10.4103/1858-5000.144646
Background:
Male breast cancer (MBC) is a rare disease accounting for about 1% of breast cancer patients worldwide. There is a lack of data about MBC patients and their management in Sudan.
Patients
and
Methods:
Medical records of all cancer patients treated at the Department of Oncology, National Cancer Institute-University of Gezira (NCI-UG), Wad Medani, Gezira State, Sudan, in the period from April 1999 to December 2010, were reviewed with regard to MBC. Variables assessed were individual, clinical characteristics, and initial surgical treatment.
Results:
There were 1,505 (19.2%, 1505/7836) Sudanese breast cancer patients treated at the NCI-UG from April 1999 to December 2010. The MBC frequency was 2.3% (34/1505); all were included in the current study. Eighteen patients underwent upfront surgery and these patients formed the subjects for the current study. Mastectomy and axillary clearance (AC) was performed for 11 (32.4%) patients. The rest- 7 patients- underwent total mastectomy only. The incidence of positive surgical margins is remarkable (27%). Only one of those with positive surgical margin was subjected to re-excision. Among those who underwent AC only two had adequate axillary lymph nodes clearance.
Discussion:
The results have been compared with similar studies and showed similar approach in management with minor differences
Conclusion:
These results indicated inadequate surgical management and urgent needs for improvement in the treatment of this rare type of cancer.
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Radiation dose measurements during hysterosalpingography
p. 15
Mohamed Yousef, Jumaa Yousif Tambul, Abdelmoneim Sulieman
DOI
:10.4103/1858-5000.144652
Objectives:
Hysterosalpingography (HSG) is an effective method to evaluate abnormalities of the uterus and fallopian tube using conventional X-ray or fluoroscopy. The aim of this study was to determine and evaluate the radiation dose for females undergoing HSG during the reproductive period.
Materials and Methods:
This study conducted in three radiology departments: Omdurman Teaching Hospital, Alneelain Diagnostic Center and Asia Specialized Hospital. A total of 50 patients was studied from three hospitals, 20 patients from Neelain Diagnostic Center in range of (25-40) years, 20 patients from Omdurman teaching Hospital in age range from (24 to 43) years. The study duration was carried out for a period of 3 months, from March 2011 to June 2011. Patient dose measurements were performed using unfors dosimeter. Organ dose and effective doses were estimated using National Radiological Protection Board software.
Results:
The mean patient dose was 20.1 and 28.9 and 13. 6 Omdurman Teaching Hospital, Neelain Diagnostic Center and Asia Specialized Hospital, respectively. Ovaries and uterus have the highest dose compared to other organs.
Conclusion:
The results of this study are higher compared with previous studies.
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Evaluating medicines prices, availability, affordability and price components in Sudan
p. 19
Salah Ibrahim Kheder, Hassan Mohamed Ali
DOI
:10.4103/1858-5000.144655
Background:
The aim of this study to measure medicines prices, their availability, affordability and price structure carried out in different sectors in Sudan.
Methods:
A field study was undertaken in the public and private sector in Sudan from March 2012 to April 2013 using a standardized methodology developed by the (World Health Organization) and (health action international).
Results:
Based on median price ratio (MPR), the central medical store was procuring lowest priced generics (LPGs) at 1.2 times their international reference price (IRP), while they were selling generics at 2.34 times the IRP. The revolving drug fund was procuring LPGs at 1.55 times IRP, and selling generics at 5.13 times the IRP. In public pharmacies, the median MPR for LPG medicines was 2.99 and 8.03 for originator brands (OBs). In private retail pharmacies, the median MPR is 3.84 for LPGs and 19.37 for OBs. Generic medicines were the predominant products in public and private pharmacy sectors (39.5% and 56.6% respectively), while for OBs were 1.8% in public sector pharmacies and 9.3% for private pharmacy sector. The affordability of LPGs in the public sector was good for half of conditions, with standard treatment costing a days' wage or less for 53.3% of treatments. In the private sector, the affordability of LPGs was similar to the public sector. The government worker would have to work 2.5 days to pay for 1-month of treatment with OB Glibenclamide for diabetes when purchased from private pharmacies, for LPG Glibenclamide he has to pay about half-a day's salary to buy the medicines from public and private sectors.
Conclusion:
In Sudan, the availability of the surveyed medicines was low in all sectors as both OBs (<10%), and 40-50% as generics depending on the sector. LPGs have been accepted in the country as they are more available than OBs. In both the private and public sectors, considerable price differences were seen between OBs and LPGs. Medicines are often unaffordable for ordinary citizens.
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Ventilatory functions as an evaluation tool in the assessment of pulmonary system adaptability in marathon runners
p. 31
Amrith Pakkala, CP Ganashree, T Raghavendra
DOI
:10.4103/1858-5000.144659
Background:
There are diverse opinions about the degree of adaptability of the respiratory system in delivering the physiological needs in case of severe exercise. Role of the normal respiratory system in delivering oxygen to meet the demands of various degrees of exercise has been a topic of considerable debate. One view holds that the respiratory system is not normally the most limiting factor in the delivery of oxygen, others hold the absence of structural adaptability to physical training cause of limitation of the pulmonary system. The role of ventilator functions in evaluating the respiratory functions in marathon runners has not been studied adequately in previous studies. Hence the need for this study.
Materials
and
Methods:
Pulmonary Function Tests were done before and after maximal exercise testing to assess dynamic lung functions in two groups' viz., athletes and nonathletes. The athletes were marathon runners.
Results:
On studying the differences in dynamic lung functions in two groups of nonathletes and athletes, there was no difference in forced vital capacity and forced expiratory volume in 1 s, before or after exercise (AE) testing in either. The other flow rates maximum mid-expiratory flow, peak expiratory flow rate, mid expiratory flow 25-75% were on the higher side in trained subjects that were consistently maintained AE testing. A higher adaptability of the respiratory system to the training stimulus in the form of a higher elastic recoil pressure of the lungs and a lower resistance of medium to small airways is suggested as the mechanism of adaptability in this study.
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Evaluation of attitudes of the community pharmacists toward warfarin interactions
p. 35
Ali Awad Allah Ali, Abutalib Alamin Abdallah
DOI
:10.4103/1858-5000.144661
Objective:
The major objectives of this study was to evaluate the attitudes of community pharmacists drug nutrient (warfarin-food containing vitamin K) and drug -drug interactions (warfarin-vitamin K).
Methods:
The data were collected through three scenarios by the researcher as a co-patient from a total of 90 practicing pharmacists in community pharmacies in Khartoum State during February to April 2011.
Results:
Only 7% in Omdurman city, 10% in Bahry and Khartoum cities had knowledge about food containing vitamin K. The ratios ranged from 7%-13%. The discussion showed that since the majority of pharmacists surveyed demonstrated lack of knowledge about drug-nutrient interaction, inadequate knowledge may lead to inappropriate patient counseling and adverse medical consequences.
Conclusion:
Additional training and integration of knowledge and expertise about drug-nutrient interactions among healthcare professionals is essential to provide appropriate patient counseling and optimal therapeutic outcomes.
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Clinical profile and management of aerodigestive foreign bodies in North - western Nigeria
p. 39
Abdullahi Musa Kirfi, Garba Mainasara Mohammed, Tijjani Sa'idu Abubakar, Abimiku Solomon Labaran, Musa Thomas Samdi, Mohammed Bello Fufore
DOI
:10.4103/1858-5000.144663
Background:
Aeordigestive tract emergences in Nigeria occur in all age groups. They sometimes have dreaded outcome if lodged in air passages.
Objective:
The aim is to present the results of this problem in a 5-year retrospective survey of cases in the Emergency Unit of the National Ear Care Centre, Kaduna, Nigeria, from January 2009 to December 2013.
Methods:
Retrieved cases were studied noting the clinical history, examination and intervention. The study included all patients diagnosed with aerodigestive foreign bodies within the period stated.
Results:
Fifty-seven thousand nine hundred and four patients were studied. Fifteen thousand eight hundred and fifty were emergencies. The hospital prevalence was 0.61% and the average annual incidence was 0.13%, male preponderance with male to female ratio of 2.24-1.00. All patients were symptomatic. Mortality was recorded in one patient who had a co-morbidity of esophageal perforation.
Conclusion:
Aerodigestive foreign bodies pose a serious challenge in a setting of poor resources and scarcity in diagnostic and interventional facilities
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CASE REPORTS
Successful pregnancy after breast cancer treatment in a Sudanese patient
p. 45
Dafalla Abuidris, Mohamed Elsnousi, Rehab SidAhmed, Ahmed Elhaj, Elgaylani Eltayeb, Sulma I Mohammed
DOI
:10.4103/1858-5000.144665
Breast cancer survivors, usually, suffer many side-effects from cancer treatments such as premature menopausal symptoms, osteoporosis, and infertility. We report a case of a pregnancy in a Sudanese patient after amenorrhea as a result of breast cancer chemotherapy treatment. A 34-year-old female with a history of right breast lumpectomy presented to the National Cancer Institute, Gezira University, Sudan with reoccurred malignant breast tumor. The patient underwent treatment that included the mastectomy, axillary clearance, followed by anthracycline-based chemotherapy for 4 months and then tamoxifen. However, whereas, on treatment, the patient developed amenorrhea as a side-effect of chemotherapy treatment. Despite this, the patient became pregnant and delivered full-term twin babies with no congenital abnormalities. Temporary chemotherapy treatment-related menopause may occur in younger women and factors such as chemotherapy drug type, dosage, and the patient's age may play a role.
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Charcot-Marie-Tooth disease type 5: A clinical and electrophysiological study
p. 49
Moawia Elbalal Mohammed, Salih Mohamed Alawi Albasseri, Izzadin Elawad
DOI
:10.4103/1858-5000.144667
A young male presented to our hospital with a long standing history of spastic paraparesis with no cerebellar or sensory ataxia. He had no sensory level or sphencteric disturbances. There is no similar family history. He had normal magnetic resonance imaging of the cervical and dorsal regions. Electrophysiologic studies including electromyography and nerve conduction were consistent with Charcot-Marie-Tooth disease type 5. This case is being reported for its rarity.
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Online since 5 Mar, 2014