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Volume No. 21 2018-01-01 5
Volume No. 22 2018-06-01 6

Situation analysis of Participation of Married Men in Family planning - AlkalaklaAlgoba North-Jebel Aulia Locality-Khartoum State (2014)

Omima Edris Mohammed Edri; Dr. Mustafa Elnimeiri

Background: Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births.

.Objectives: The overall objective was to study the situation of the married men in Alklakla Algoba North regarding their attitude and participation of family planning.

Methods: A community-based descriptive cross sectional study conducted from April 2012 to April 2015 at Alklakla Algoba North in Jabal Awlia Locality- Khartoum State. The estimated sample size mounted to three hundred and seventy two participants .By simple random sample clusters are selected and all house hold in the cluster were included(single-stage cluster sampling).A standardized administered questionnaire was developed, pre –tested and used to generate information on personal –demographic characteristics, general knowledge, attitude and participation about family planning methods .A modified scale (Very poor –Very good) and six point Likert type scale was used. The collected data were analyzed by the computer programme SPSS version 16 and presented as tables, pies and pillars coupled with narrative description. Regarding test of significance, p-value was accepted as 0.05. 

Results: Third of participant (35%) were fall in age group (30-39). The results showed that the vast (98% of participants had heard about family planning from mass media source, In addition 94% of participants knew that family planning methods could be obtained from health related facilities.52% of the participant did not use to help their wives in the choice of the family planning methods. Most participant (56%) did not use FP methods because they did not have enough information, (28%) of them did not participate for religious reasons and (18%) for cultural reasons. Moreover the knowledge of the respondents was statistically significant with the level of education (p-value =0.04) and opinion of men (p-value=0.021).

Conclusion: Most of the interviewed men had heard about family planning from mass media source and their knowledge about types of the methods , In addition they had negative attitude towards helping their wives in choice of the family planning methods. The dispute on the religious beliefs and cultural taboos that cast a grey shadow for many people on the use of family planning has to be clearly resolved. 

Association between H. Pylori and Urticaria or Gastritis

Sheema Mohsin Mustafa, Ahmed Bolad, Maha Ibrahim, Tarig Abbas, Alsagad Altayeb

Background: Studies have established that Helicobacter pylori can cause chronic gastritis. Recent evidence suggests that Helicobacter pylori infections play a great role in the pathogenesis of a variety of skin diseases, the best evidence for such a link is found for two diseases; chronic urticaria and immune thrombocytopenic purpura.

Objectives: the current study is aiming at evaluating the relationship between H. pylori among patients with different cutaneous problems mainly chronic urticaria by using immunological methods. On the other hand the study is aiming at verifying the effect of treatment on the prevalence of disease.

Materials and Methods: 119 Specimens (blood and stool samples) were obtained. Serum was stored at -20°C until used. Stool was collected in clean container and tested immediately. Specimens were processed by Serum ICT (ACCURATE, diagnostic use, china) and Stool Antigen ICT KITS (CERTEST BIOTEC S.L.) for detection of H. pylori. Significance tests, measures of accuracy and confidence intervals were calculated using the biomedical Stats Direct Statistical Software v2.7.9 (7/9/2012). IBM SPSS Statistics v22 was used in the descriptive data analysis.

Results and discussion: H. Pylori infection was detected in about half of the patients who suffered from either urticaria or gastritis. The prevalence of H. Pylori was estimated in the three groups as 48.3% (CI: 35.2% to 61.6%); in the urticaria group, 51.7% (CI: 32.5% to 70.6%); in the gastritis group and 13.3% (CI: 3.8% to 30.7%) in the apparently healthy group (labelled ‘Normal’). Proportions of H. Pylori infection in the urticaria and the gastritis groups were not statistically significantly different. Both groups, however, had a significantly different proportion of HP infected patients when compared with the apparently healthy (Normal) group. This statistically significant difference was suggestive of an association between H. Pylori and both of urticaria and gastritis.

Knowledge of Married Men about Family Planning - Khartoum State: Alkalakla Algoba North -2014

Omima Edris Mohammed Edris; Dr. Mustafa Elnimeiri

Background: Family planning allows individuals and couples to anticipate and attain their desired number of children as well as the spacing and timing of their births.

Objectives: The overall objective was to study the situation of the married men in Alklakla  Algoba North regarding their knowledge, attitude and participation of family planning.

Methodology: Community -based descriptive cross sectional study conducted from April 2012 to April 2014 at Alklakla Algoba North in Jabal Awlia  Locality -Khartoum State. The estimated sample size is three hundred seventy two participants. The single-stage cluster sampling was selected and all household in the cluster were included using simple random sampling. A standardized administered questionnaire was developed, pre–tested and used to generate information on personal demographic characteristics, general knowledge, attitude and participation about family planning methods. A modified scale (V. poor- V. good) and six points Likert type scale were used. The collected data were analyzed using SPSS version 16 and presented as tables, pies and pillars coupled with narrative description.

Results: One third of participants (35%) were in age group (30-39). The results showed that the vast majority ( 98% )of participants had ever heard about family planning from mass media source. 78% of the participants recognized the contraceptive pill as a method of family planning; followed by the natural methods (53%) and 44% of participants identified Injection methods; followed by the IUD (5%), then the barrier methods (28%). The implant was identified by 19% of them. 56% of the participants thought that the advantages of FP were health reasons followed by children spacing (%44). 12% of them stated that it was practiced when they had enough children while10% of them pointed that it was good for financial reasons.

 In addition the vast majority (94%) of participant knew that family planning methods can obtained from health related facilities . the knowledge of the respondents was statistically significant with the level of education (p-value =0.04) and opinion of men (p-value=0.021).

Conclusion: Most of the interviewed men had ever heard about family planning from mass media source. Good knowledge about types of the methods and from where they obtained the methods.  Dissemination of the correct knowledge about the benefits of family planning is highly recommended.

THE PREVELANCE OF HELICOBACTER PYLORI AMONG PATIENTS WITH CHRONIC IDOPATHEIC URTICARIA

Sheema Mohsin Mustafa and Ahmed Bolad

INTRODUCTION: Helicobacter pylori (H. pylori) is Gram negative, spiral flagellated bacteria that infect approximately 50 percent or more of the world population (Goodman et al., 2001). It is one of the most common chronic bacterial infections that affect humans at any age, women are affected just as often as men (Brown, 2000). Approximately two third of world population is infected with H. pylori, initial infection typically occurs during childhood after oral ingestion and the bacterium persists for life in the host unless treated (Everhart, 2000).

The prevalence of H. pylori is 30% in the developed countries, as opposed to >80% in most developing countries (Atherton et al., 2005).   In Sudan, evidence about the prevalence of H. pylori infection is very patchy and there is only one study which showed high prevalence (80%) of H. pylori infection among patients with symptoms of gastritis, 56% with duodenal ulcer, while 60% with duodenitis and 16% in symptomless individuals (Elbagir et al., 2001). The prevalence of infection rises with age and correlates positively with low socioeconomic status during childhood (Malaty et al., 1994). Several risk factors including gender, age and lifestyle e.g. smoking, play a role in the variation of disease prevalence (Baik et al., 2012).

H. pylori is the main causative agent of gastrointestinal diseases including chronic gastritis, peptic ulcer associated disorders, gastric and duodenal carcinomas leading to morbidity and mortality in humans (Black et al., 2004). Apart from its well-demonstrated role in gastroduodenal diseases, some have suggested a potential role of H. pylori infection in several extra-intestinal pathologies including haematological, cardiovascular, neurological, metabolic, autoimmune, and dermatological diseases. However, more systematic studies are required to clarify the proposed association between Helicobacter pylori and skin diseases.

Some studies have found an etiopathogenetic link between H. pylori infection and chronic idiopathic urticaria (CIU) and possible skin improvement after its eradication (.Chi. et al., 2013).

Pancreatic Tuberculosis: between the surgeon’s knife and the physician’s drugs; Case Reports and Review of the Literature 

Leena E Elomashfee, A/Maged M Massad, Elsagad E Mohamed, A/Monem E Abdo, Mutaz S A/Aziz, Tarik M. Husein, Mohammed Y Alalim 

Background: Despite of the increasing incidence of tuberculosis worldwide, pancreatic affection remains a rare clinical entity, that could be easily misdiagnosed as pancreatic neoplasm .We herein present a case of y pancreatic tuberculosis together with other 2 cases from our hospital records and a review of the literature.

Case outlines: A 60 year old Sudanese male patient, who is known diabetic for 18 years on Mixtard insulin, presented with six-month history of vague epigastric pain, anorexia and weight loss. He didn’t have chronic cough. The physical examination and chest X-ray film showed no abnormalities. Abdominal CT scan revealed a juxta ampullary hypodense pancreatic head mass with intrahepatic and extraheptic biliary dilatation. Whipple’s pancreaticoduodenectomy was carried out after the diagnosis of pancreatic head malignancy was strongly suggested. Pathological result concluded the presence of tuberculous granulomas in the pancreatic sections and mesenteric lymphoid glands with no evidence of malignancy. The patient did well post-operatively and started the antituberclous drugs.

Other 2 cases were found in our hospital records, presenting with pancreatic solid or cystic lesions with a clinical evidence of pulmonary TB. Radiologically guided fine needle aspiration and smear examination were cornerstone diagnostic modalities. Both of the patients showed good response to antituberculous.

Conclusion: Pancreatic Tuberculosis mimics pancreatic neoplasm clinically and radiologically. This similarity could lead to unnecessary major surgery, despite being successfully treated with antituberculous. 

Pre-eclampsia, HELLP syndrome, abruptio placentae, postpartum haemorrhage, and postpartum rupture of subcapsular liver haematoma; Case report and review of literature

Moawia E Hummeida, Magdi Lewis, Ismail Hussein, Duria A. Rayes

Background: Hepatic rupture during pregnancy is a rare but lethal condition requiring rapid recognition and multidisciplinary management. The condition is most often associated with preeclampsia/eclampsia and/or HELLP syndrome (Haemolysis, elevated liver enzymes, and low platelet count) (1). Because of the difficulty of diagnosis, the condition is often associated with increased morbidity and mortality (2).

Different modalities of treatments have been suggested. Treatment should be individualized depending on extend of rupture and available expertise. 

We describe a case of spontaneous postpartum hepatic rupture in a 40 -year’s grandmultiparous with the diagnosis of Pre-eclampsia, abruptio placentae and postpartum haemorrhage. Clinical presentation, diagnosis and treatment of this condition are discussed and related literature reviewed. 

THE ROLE OF CERVICAL LENGTH ASSESSMENT IN MANAGEMENT OF LOW AND HIGH RISK OF PRETERM LABOUR, REVIEW ARTICLE

Khalid Yassin MD, MRCOG, Elhadi Miskeen MD & A/Salam Gerais MD, FICS, FRCOG

Background: Transvaginal ultrasonography has been widely accepted as a non-invasive and objective method for the evaluation of cervical status in women with preterm labor, low risk and high risk.

Method: In this review, we focus on clinical studies involving transvaginal sonographic assessment of the cervix in asymptomatic women at high risk of preterm delivery and in the general pregnant population. Publication Types included systematic reviews, meta-analysis, randomized-controlled trials (RCTs), and case-controlled studies.

Result: We included thirty studies in this review. A significant role of the role of cervical length assessment in management of preterm labour was shown in details.

Conclusions: High-quality ultrasound machines in labour wards is more strongly indicated for predicting spontaneous preterm, although staffing issues and the feasibility and acceptability to mothers and health providers of such investigation to be explored. Further research should include comparing with other investigations of low-cost and effective tests to assess the cervical length by transvaginal sonography in predict of preterm labour is highly require.

Pattern of Heart disease in pregnancy among patient in Khartoum Teaching Hospital, Sudan

Khalid Yassin MRCOG, MD Amira Mutasim Elfil MD, Huda Hamid MD And Amel Alkamil MD, MRCP