Background: Accurate timing for diagnosis and treatment of latent tuberculosis (LTB) is important to reduce morbidity and mortality for both mother and child. Objectives: To investigate the prevalence rate of LTB and its associated factors during pregnancy using gamma interferon (IFN- γ) release assay (IGRA). Methods: A cross-sectional facility-based study carried out in Kassala hospital, Eastern Sudan between January and March 2015. Results: Two hundred and forty-nine women were enrolled in this study and 18.1% (45/249) had confirmed positive for M. tuberculosis infection using IGRA. The mean age, parity and gestational age of the LTB patients were 29.6 (4.4), 2.2 (1.2) and 21.9 (8.8), respectively. The vast majority of these patients was of rural residence (72.7%), housewives (91.1%) and illiterate (73.3%). More than half (25, 55.6%) gave a history of contact with tuberculosis patients, 26.7% (12/45) were vaccinated and 11.1% (5/45) had a medical history of diabetes mellitus. In logistic regression model, while age, parity, education, occupation, size of family members, smoking, BCG status and medical history of diabetes mellitus were not associated with latent tuberculosis during pregnancy, history of contact with TB patients (OR=13.5; CI=5.6 to 32.5; P<0.001) and rural residence (OR=0.3; CI=0.1 to 0.7; P=0.006) was significantly correlated to LTB in pregnancy. Conclusion: Thus, screening of all pregnant women living in high burden setting of tuberculosis is recommended even in the absence of overt clinical signs of the disease.</P>

ResultsIn this study, hundred patients with Pott's disease of the spine were recruited. 60 patients (60%) were females and 40 patients (40%) were males. The majority of the patients fall in the age group 45-54 years, which constituted 25 cases (25%) of the study group, followed by the age group 15-24 years, 22 cases (22%). The groups 65-74, 35-44 and 25-34 constitute 20 cases (20%), 18 cases (18%) and 15 cases (15%) respectively (Table 1). The mean age of presentation in our study was 41 years. In 36 patients (36%), Pott's disease was found in association with pulmonary tuberculosis. The main complaint in the whole study group was backache and lower limb weakness. The course of the disease was progressive. In 92 patients (92%), the onset was gradual. 87 patients (87%) said that they had experienced weight loss, where 74 patients (74%) had mild fever. 76% of patients presented with neurological deficits. Lower limb anaesthesia was seen in 72 patients (72%) and numbness in 70 patients (70%) of the whole group. 46 patients (46%) presented with weakness of the trunk, whereas 44 patients (44%) AbstractTuberculosis (TB) of the spine (Pott's disease) is the commonest and most dangerous form of skeletal TB. Delay in establishing diagnosis and management can cause spinal cord compression and spinal deformity resulting in serious neurological deficit and bad prognosis. This was a prospective hospital-based study investigating the data on hundred cases of Pott's disease presented to Khartoum Teaching Hospital during the period from 2008 to 2010. 60 patients were females and 40 were males. The mean age of our patients was ± 41. The course of the disease was progressive and of gradual onset in the majority of the cases. 76% of our study group was presented with neurological deficits ranging from lower limb anesthesia, numbness, trunk weakness, root pain, muscle pain and flexion spasm.

Introduction: Hypertensive crisis (HC) is recognized consequence of inadequate blood pressure (BP) control. A hypertensive crisis is further divided into hypertensive emergency (HT-E) and hypertensive urgency (HT-U). Method: Using a cross-sectional hospital-based study design, patients who had been diagnosed as having HC between January and October 2017 were consecutively recruited in the study. The criteria proposed by the Seventh Joint National Committee were used for the defi nition of HC. Result: A total of 81 (.81%) patients newly diagnosed as having HC were enrolled in the study. Of these patients, 50 (61.7 %) patients met criteria for HT-E, while 31 (38.3%) patients had HT-U. Renal impairment (16%), stroke (30.8%), acute coronary syndrome (13.6%) and heart failure (22.2%) were predominant complications associated with HT-E. Out of 81 study subjects, 13 (16%) patients died. Although there was no signifi cant difference in residence, history of smoking, Diabetes mellitus and history of alcohol consumption between groups, old age (P=.o22), male gender(.046), history of hypertension(.007), history of non-governmental employee(.003), poor compliance (p=.002) and high case fatality rate (p=.041) were signifi cantly associated with hypertensive emergency (HT-E). Conclusion: This study showed that HT-E has high case fatality rate among patients admitted with hypertensive crisis at kassala teaching Hospital. Therefore early detection of hypertension and appropriate management are the main stay for reducing morbidity and mortality among patients with hypertensive crisis.

This was a cross-sectional hospital-based study conducted at Neurology Department, Shaab Teaching Hospital, Khartoum in a period of two years. The aim of the study was to determine the most affected region of the spine in adult Sudanese patients with Pott's disease. Hundred patients with clinical suspicion of spinal TB were enrolled in the study. Clinical history and examination, investigations for TB and imaging studies were performed. Midthoracic spines (T5 -T8) and lower thoracic spines (T9 -T12) were found to be the most regions affected with tuberculosis. In 20 cases (20%) the disease affected the upper thoracic vertebrae (T1 -T4) and in 12 cases (12%) it was in the lumbar spines. Only four patients (4%) were having cervical spinal tuberculosis. The higher affection of the mid thoracic and lower thoracic levels of the spine was thought to be attributed to infection from combination of haematogeneous, lymphatic and direct invasion.

A 77-year-old woman was admitted to the hospital because of chronic gastrointestinal bleeding with increasing weakness and dyspnea.There was a 17-year history of gastrointestinal bleeding with an undetermined source, despite extensive evaluation on multiple admissions to this hospital that were characteristically complicated by severe anemia, with hematocrit levels as low as 13 percent, and congestive heart failure. Seven of the hospitalizations were during the two years before the current admission, and the most recent was four months before the current admission. During the 10 years before admission, the patient had received approximately 240 transfusions. Detailed panendoscopic examinations with angiographic studies 12 and 18 years before admission were unrevealing, and repeated upper and lower gastrointestinal endoscopic examinations in more recent years also failed to disclose the source of bleeding. During the three months before admission, the number of transfusions required increased to one or two every other week. Ten days before admission the patient had a hematocrit of 20 percent and was given two transfusions. After a day of improvement she had increasing weakness and dyspnea and was readmitted to the hospital.There was a history of chronic atrial fibrillation that was managed with digoxin; anticoagulant therapy was not considered a reasonable option. A cardiac ultrasonographic study, performed five months before admission, revealed left ventricular hypertrophy, with an ejection fraction of 61 percent and mild mitral regurgitation. The patient had had an appendectomy many years earlier. A right radical mastectomy had been performed 34 years before admission. She had had a stroke 25 years before admission, which resolved without residual problems. Twenty months before admission the patient had a bout of acute renal failure that was ascribed to treatment with trimethoprim-sulfamethoxazole, with an increase in the creatinine level to 3.7 mg per deciliter (330 m mol per liter); in recent months her base-line creatinine level had been 2.0 mg per deciliter (180 m mol per liter). An infiltrating ductal carcinoma of the left breast, demonstrated on biopsy nine months before admission, was managed by a lumpectomy; tamoxifen provoked nausea and vomiting and was discontinued. A left nephrectomy had been performed 30 years before admission, after multiple urologic procedures for urolithiasis. The patient had stopped smoking many years earlier and drank no alcohol. There was no history of hypertension, angina pectoris, or myocardial infarction.The temperature was 36.8 ° C, the pulse was 70, and the respirations were 28. The blood pressure was 150/80 mm Hg. The weight was 85.9 kg.On physical examination the patient was pale, massively obese, and in moderate respiratory distress. No lymphadenopathy was found. The head and neck were normal; the jugular venous pressure was obscured. Inspiratory crackles were heard over the lower third of both lung bases. The heart rhythm was irregular; S 2 was normally split, and a gr...